Dear Brown,

Thank you very much for your interest in the topic. Thank you also for sending the very useful references on homeless. We can see this issue everywhere in the world. As you mentioned most of the studies are focused on various health issues of homeless people and majority of them particularly dealt with high income countries' cases.

We have conducted this scoping study in a small scale since 2011, so that we could explore widely in future. Our study mainly focused on right-based approach based on the field investigations to draw an attention to the global scientific and non-scientific(e.g. political) communities. The study highlighted a homeless person's vulnerability and a lack of insecurity of that person give rise to other human right violation for example a lack of access to adequate WASH.

In the world, most of the development projects are household oriented and focused. Therefore, homeless people are always excluded from these programs including WASH services. Another issue we found from the literature that lack of global definition. Every country define homeless people in different way which create lots of confusions for planning. Frequent migration or nomadism and lack of database/statistics of homeless people are also great barriers for both planning and implementing any programs. These are the issues in low income countries like Bangladesh. How about in USA or other high income countries?

I have been collecting some case stories from various countries around the world. Your cases from USA would be also valuable to explore widely. I would be happy to discuss more with you on this. I am listing some of my articles which could be interesting even for designing and planning any sanitation technology and programs for homeless or nomadic people. These studies explored the WASH-borne hazards and vulnerability of the nomadic-cultured communities and discussed some sustainable sanitation technologies or closed-loop sanitation systems which might be effective for them. You can also find some related studies online.

Thanks a lot. Have nice time!
Best regards
Nazim

1. Uddin, S.M.N., Li, Z., Ibrahim, M. B., Lapegue, J., Adamowski, JF., Donati, P. F., Huba, EM, Mang, HP. Avirmed, B. and Cheng, S. (2015) Evaluation of ‘Closed-loop sanitation system’ in a country with cold climate: a case from peri-urban Ger areas of Mongolia. Environment and Urbanization. 27(2), 1-18.
2. Mahmood, Ibrahim. B., Li. Z., Uddin, S. M. N., Mang, HP., and Germer, J.(2015) Co-composting of fecal matter in Mongolia using two different technologies. Journal of Water, Sanitation and Hygiene for Development, 5(1), 165-171.
3. Uddin, S.M.N., Li, Z., Mang, HP., Ulbrich, T., Schubler, A., Rheinstein, E., Huba, E.M., and Lapegue, J. (2014) Opportunities and challenges for greywater treatment and reuse in Mongolia: Lessons learnt from piloted systems, Journal of Water Reuse and Desalination, 4(3)182-193.
4. Uddin, S.M.N., Li, Z., Mang, H. Huba, E.M., and Lapegue, J. (2014) A strengths, weaknesses, opportunities and threats analysis on integrating safe water supply and sustainable sanitation systems. Journal of Water, Sanitation and Hygiene for Development, 4(3), 437-448.
5.Uddin, S.M.N., Muhandiki, and Sakai, A., Mamun, A. A., and Hridi, S. M. (2014) Socio-cultural acceptance of appropriate technology: identifying and prioritizing barriers for widespread use of the Urine Diversion Toilets in Rural Muslim Communities of Bangladesh. Technology in Society, 38, 32-39.
6. Uddin, S.M.N., Li, Z., Gaillard, J. C., Tedoff, PF., Lapegue, J, Mang, HP., Huba, E.M. Kummel, O., and Rheinstein, E. (2014) Exposure to WASH-borne hazards: A scoping study on peri-urban Ger areas in Ulaanbaatar, Mongolia. Habitat International, 44, 403-411.
7. Uddin, S.M.N., Muhandiki, V.S. Fukuda, J. Nakamura, M. and Sakai, A. (2012) Assessment of Social Acceptance and Scope of Scaling Up Urine Diversion Dehydration Toilets in Kenya. Journal of Water, Sanitation and Hygiene for Development, 2(3), 182-189.

Dear Mr. Nazim.

Thanks for sending along this article. I am interested [and research] homelessness and exclusion around centralized water and sanitation systems in both “developed” and “developing” countries. After drafting a pilot proposal on women's health, homelessness, and WASH for a project in the United States last year, I found the same thing.

There are few articles that focus solely on provision of WASH or health/social impacts of WASH among these nomadic communities. Most articles were public-health focused and only tangentially took into account water supply and sanitation. Or they were ethnographic studies that sometimes spoke to water and sanitation challenges. I'm including a few of those references below for you. I'm going to download your article as soon as my library makes it available.

Homeless [or houseless, as I prefer to say] individuals live all over the globe: North America, South America, Europe, Africa, etc. It seems that urban planning codes and other policies limit provision of services for these traveling populations [more so in high-income countries, surprisingly]. It's a unique question – how do you provide WASH services to a nomadic population?!

I would love to talk more about this issue any time. In the meantime, thanks for sharing this article. Have a great day!

-Abby Brown

• Abdu, Lawan. “Disease Pattern and Social Needs of Street People in the Race Course Area of Kano, Nigeria,” February 2013.
• Acosta, Olga, and Paul A. Toro. “Let’s Ask the Homeless People Themselves: A Needs Assessment Based on a Probability Sample of Adults.” American Journal of Community Psychology 28, no. 3 (2000): 343–66.
• Baggett, Travis P., James J. O’Connell, Daniel E. Singer, and Nancy A. Rigotti. “The Unmet Health Care Needs of Homeless Adults: A National Study.” American Journal of Public Health 100, no. 7 (2010): 1326–33.
• Chamard, Sharon, United States, Department of Justice, Office of Community Oriented Policing Services, and Center for Problem-Oriented Policing. Homeless Encampments. Washington, DC: U.S. Dept. of Justice, Office of Community Oriented Policing Services, 2010.
• Cousineau, Michael. “Health Status of and Access to Health Services by Residents of Urban Encampments in Los Angeles.” Journal of Health Care for the Poor and Underserved 8, no. 1 (n.d.).
• Daly, Gerald. Homeless: Policies, Strategies, and Lives on the Street. Psychology Press, 1996.
• Donovan, Ellen, Ken Unice, Jennifer D. Roberts, Mark Harris, and Brent Finley. “Risk of Gastrointestinal Disease Associated with Exposure to Pathogens in the Water of the Lower Passaic River.” Applied and Environmental Microbiology 74, no. 4 (February 15, 2008): 994–1003. doi:10.1128/AEM.00601-07.
• Douglass, Richard. “Health Care Needs and Services Utilization Among Sheltered and Unsheltered Michigan Homeless.” Journal of Health Care for the Poor and Underserved, February 1999.
• Edidin, Jennifer P., Zoe Ganim, Scott J. Hunter, and Niranjan S. Karnik. “The Mental and Physical Health of Homeless Youth: A Literature Review.” Child Psychiatry & Human Development 43, no. 3 (November 26, 2011): 354–75. doi:10.1007/s10578-011-0270-1.
• Ehrenreich, Ben. “Tales of Tent City.” The Nation, June 3, 2009. www.thenation.com/article/tales-tent-city.
• Ferren, Kimberly, Ruth D. Green, Lesa Green, and Linda Testani Dufour. “Health Needs of Homeless Clients Accessing Nursing Care at a Free Clinic.” Journal of Community Health Nursing 11, no. 3 (1994): 139–47.
• Finley, Susan. “The Faces of Dignity: Rethinking the Politics of Homelessness and Poverty in America.” International Journal of Qualitative Studies in Education 16, no. 4 (2003): 509–31. doi:10.1080/0951839032000099525.
• Herring, Chris. “The New Logics of Homeless Seclusion,” 2012. www.rc21.org/conferences/berlin2013/RC21...1-ChrisHerring-1.pdf.
• Hill, Ronald Paul, and Mark Stamey. “The Homeless in America: An Examination of Possessions and Consumption Behaviors.” Journal of Consumer Research 17, no. 3 (December 1, 1990): 303–21.
• Loftus-Farren, Zoe. “Tent Cities: An Interim Solution to Homelessness and Affordable Housing Shortages in the United States.” California Law Review 99, no. 4 (n.d.).
• Montauk, S. L. “The Homeless in America: Adapting Your Practice.” Am Fam Physician 74, no. 7 (2006): 1132–38.
• Nickasch, Bonnie L. “Healthcare Experiences of the Homeless,” 2006.
• Popescu, Gabriel-Adrian, and Ioana Chirca. “The Starry Heaven and the Crowded Shelters: Public Health Risks.” Southern Medical Journal 103, no. 1 (January 2010): 3–4. doi:10.1097/SMJ.0b013e3181c38c5e.
• Raoult, Didier, Cédric Foucault, and Philippe Brouqui. “Infections in the Homeless.” The Lancet Infectious Diseases 1, no. 2 (2001): 77–84.
• Wasserman, Jason Adam, and Jeffrey M Clair. At Home on the Street: People, Poverty, and a Hidden Culture of Homelessness. Boulder, CO: Lynne Rienner Publishers, 2010.
• Wescoat, J. L., L. Headington, and R. Theobald. “Water and Poverty in the United States.” Geoforum 38, no. 5 (2007): 801–14.

Dear All,

The study on "Water, Sanitation and Hygiene for Homeless People" has been just published online at the Journal of Water and Health. (www.iwaponline.com/jwh/up/wh2015248.htm)

There are very limited studies can be found which focused on ‘WASH for homeless’ in research, development and implementation. I hope the findings of this study will bring some novel ideas and thoughts to the global audience on the issues raised and argued. I strongly believe it will have a significant impact on the greater Water, Sanitation, Hygiene and Health sector. Although there is no concrete global number of homeless, it has been estimated that the global number of homeless people is from 100 million to 1 billion. Therefore, without addressing these homeless people in WASH and Health sectors, meeting the targets of Millennium Development Goals (MDGs) is a great challenge.

I am copying the abstract below:

Abstract:
This short communication provides insights into water, sanitation and hygiene (WASH) for homeless people through a scoping study conducted in Dhaka, Bangladesh. It investigates the homeless' access to WASH through the lens of a rights-based approach. It demonstrates that homeless people's denial of their right to WASH reflects their marginal position in society and an unequal distribution of power and opportunities. The study ultimately suggests a rights-based approach to work toward dealing with the root causes of discrimination and marginalisation rather than just the symptoms. For the homeless, who not only lack substantive rights, but also the means through which to claim their rights, an integrated rights-based approach to WASH offers the possibility for social inclusion and significant improvements in their life conditions. Given the unique deprivation of homelessness it is argued that in addressing the lack of access to adequate WASH for homeless people the immediate goal should be the fulfilment and protection of the right to adequate shelter.

Thank you

Best regards
Nazim