Keeping Clean: A Qualitative Analysis of Water, Sanitation, and Hygiene Among Residents of Recreational Vehicles in Seattle, WA US.

The growing number of people living in vehicles in the urban United States in recent years makes their water, sanitation, and hygiene (WASH) an increasingly relevant public health issue. The WASH context of people living in recreational vehicles (RVs) presents unique challenges, especially as it relates to wastewater disposal. This study answers the question: How do RV residents typically manage their wastewater and meet their other WASH needs? We examined the experiences of RV residents in Seattle, Washington participating in Seattle Public Utilities' mobile pump-out program, which has offered a free, typically monthly, door-to-door RV wastewater disposal service since 2020. We conducted semi-structured interviews with 31 clients and analyzed the data using qualitative content analysis. We found that RV resident water and hygiene experiences were similar to other urban unhoused populations, whereas their sanitation experiences were quite distinct, most notably with regard to open defecation prevalence and the relative risks of shared versus private sanitation. We proposed four WASH service delivery models that consider the possible implications of our findings for cities looking to engage with RV residents. The models included: mobile RV wastewater collection and water delivery, fixed RV dump stations and water resources, public WASH facilities available for all, and safe parking programs.