Public Health & Toilets
(University of Minnesota public health students are writing about their experiences abroad this summer.)
By Marie Quasius
Environmental Health Sciences
Writing from Valdivia, Chile
My classmate/apartment-mate Lauren wrote a blog entry earlier this summer about the difficulties of adjusting to daily life in a foreign country. We left our lovely apartment in Concepcion, with its occasionally-interesting bathroom situation, for the trail to Macchu Picchu. We’d imagined four days of rugged camping, and instead found that our 7 porters (!) were carrying pots, pans, gas and vegetables and meat for cooking, as well as a ‘dinner tent.’ However, the bathrooms on the trail fulfilled every expectation we ever had that we’d be roughing it.
Our first night, we set up camp in a barnyard behind a family’s house. There were some vicious donkeys in the adjoining field, a boisterous rooster trying to rape each and every one of the hens, a pair of black pigs, some mangy-looking stray dogs and cats, and a little boy with a small green parrot riding around on his shoulder. Despite his best efforts to engage us in play, we remained a little appalled by his personal filth and the ever-present parrot, with whom he was sharing a bowl of corn. At any rate, we managed to avoid the little boy (and his filthy bird), the horny rooster, and all of the animals that strolled the barnyard for most of the night. However, we couldn’t avoid the “toilet� which was cleverly disguised as a hole in the ground enclosed by a small outhouse-like structure, the inner walls and floors of which seemed to be smeared with POOP. (The advantage of an unlighted bathroom in such a situation is that the headlamp cannot simultaneously light every filthy corner of the outhouse.) Upon examination, we couldn’t ascertain where the dirty water discharged to, though the nearby creek (slightly downhill) was a target for our suspicions, leading to a mutual resolution to *never* touch that water. (I must confess that before the public health rotations we did in Valdivia, it never would have occurred to me to wonder where human waste went after the toilet.)
Most of the bathrooms along the trail were quite adequate, even if they too followed the design of the Asian squat toilet. (I am personally of the opinion that Asian-style toilets can be extremely clean—but just as your average Western toilet in an Exxon station can stretch the outer limits of the imagination, so can a poorly maintained Asian toilet.) Lauren and Heather were not enamored of the Asian-style squat toilets, however, and probably wouldn’t agree with my opinion that they have some advantages (since I had a full year of experience with filthy toilets in Malaysia and India, and found that when the toilets are *that* dirty, it’s a lot easier to squat than to try to hover).
However, I too met my match in a toilet at a rest stop on the 3rd day. It was mid-day, we were at some obscene altitude that made it difficult to breathe, and the toilet was located a good distance downhill from the campsite. In desperate need, I scampered down the hill and around the side of what I delightedly thought for a moment to be an evergreen Port-a-Potty. However, when I skidded to a stop in front of the door, which was swinging open, it was because I realized that this toilet was nothing more than some wooden boards with a circle carved out over a deep (and foul-smelling) hole in the ground. There was nowhere that human excrement could go except… down into the hole. Grimacing, I attempted to pull the door shut behind me, only to find that the door didn’t close, nor did it make even the slightest effort to close. So, at 4,300 meters above sea level, I proceeded to yodel at the top of my lungs to prevent other people from barging in on me while I used the HOLE. (The risk of asthma complications paled in comparison to the possibility of falling in that HOLE because someone’s surprise arrival threw me off balance.)
I can’t for the life of me, despite my future vocation as a lawyer, make any argument for the potential hygienic advantages of *that* toilet, which quickly became a rite of passage among the hikers (“So, have you used the toilet here yet?�). Being exposed to the roughest toilets in Peru (or so I really hope) reinforced my appreciation for the sparkling white ceramic bowls in the bathrooms at home, accented as they are by immaculate grey plastic toilet paper dispensers (even if they dispense only 1 square at a time), which so many of us take for granted.
I have been in Oaxaca, Mexico for 3 weeks now working with a home for older adults and taking Spanish classes. This past weekend some friends and I went to Puerto Escondido for a few days, which is a beach town on the Pacific coast. We left the day before the striking teachers and others were supposed to close the roads leading into town, but I don’t think it actually happened. From these three weeks being here, the city has changed very much. Businesses have been staying closed or closing early to avoid targets from those protesting. 
I made it to Oaxaca, Mexico a week ago. I have been pretty much busy since I arrived. I stayed in a hostel for a few days before my homestay, along with the other NGO interns. There are 8 of us, all involved in different projects around the city-state-and country. My project is dealing with a home for the elderly who don’t have family to live with or other resources to take care of themselves. My job, which I created, is to conduct a needs assessment of the kitchen/foodservice/nutrition of the residents. My days are typically like this: