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On a sunny day, Old Montreal through to the city's festival-laden downtown probably has the most dense pedestrian traffic in the country.

You can buy all manner of food and drink, hear magnificent music and delight in crowd-watching, but you will be hard-pressed to find one essential thing – a public washroom.

So the news that Montreal plans to install 12 public toilets in the downtown core is welcome.

It is also being greeted with a great deal of skepticism. These promises have been made before – most recently in 2014 – but never seem to come to fruition.

In fact, as the Montreal Gazette noted in an excellent piece, North American cities have an abysmal record when it comes to providing public facilities:

  • New York signed a deal to install 20 public toilets in 2005, but only five are operating;
  • Toronto also promised to install 20 public toilets, but only three are up and running;
  • Seattle, a pioneer in providing public facilities back in 2003, threw in the towel after five years, but is now vowing to try again.

There are, of course, some success stories, most notably Vancouver, which has nine self-cleaning public toilets, not to mention 94 more public facilities in city parks.

Also: Urban design in the time of climate change: making a friend of floods

But this still pales in comparison to places such as Paris, with more than 400 sanisettes, Amsterdam with its public urinals and London and Melbourne with their helpful toilet maps and apps.

These big cities have made it a public-policy priority to provide toilets, in part because they are dependent on tourism, but also because they have recognized that if you don't provide places for people to do their business, they will do it anyway – in parks, in canals and in alleys.

In Canada, we behave as if urination, defecation and menstruation are not routine bodily functions, but are somehow optional if we are away from our homes.

We design, construct and maintain public spaces such as roads, sidewalks and parks, but act as if people using those spaces will never need a bathroom unless they are attending an "event" such as Canada Day, and you need to content yourself with a long line-up to use a porta-potty that requires you to hold your breath.

Toilets need to be considered a No. 1 (and No. 2) priority of urban design; they are essential for an inclusive, healthy society.

This is particularly true as the population ages, and more and more people live with chronic health conditions. A number of health issues affect bodily functions, including diabetes, colorectal cancer, irritable bowel syndrome, prostatitis, shingles, stroke and dementia, not to mention the regular needs of children, pregnant women, menstruating women and anyone with a bladder or a colon.

There are three common excuses for not investing in public toilets: Their cost, weather challenges and available options. Let's tackle each of these in reverse order.

Why spend tax dollars on public loos, when anyone can pop into a Tim Hortons or a Starbucks? First of all, not everyone is welcome, particularly those who are homeless, and many stores limit access to customers. Basic bodily functions should not necessitate a commercial transaction – not any more so than walking on a sidewalk.

Canada's extreme temperatures are often cited as a key reason we cannot build public bathrooms. That's nonsense. The temperature outside the International Space Station varies from about -150 C (dark side) to 120 C (sunny side) and they manage to keep a toilet functioning year-round.

Public toilets often get shelved because they are deemed expensive. In Montreal, each new public toilet will cost about $300,000, which we are told is – shock! horror! – the average price of a condo.

It also costs money to clean and otherwise maintain the facilities. There are also frequent complaints about public washrooms sometimes being used for "illicit" activities such as sex, drug-taking and vandalism.

So what?

It costs more than $1-million to build a kilometre of road, and we also pay to clear them of snow and fill potholes. We also police roads to ensure that people aren't speeding or defacing road signs.

Why is building and maintaining roads for cars considered an unquestionable necessity and legitimate expense, but having public washrooms is deemed a superfluous luxury?

The answer is not to refuse to build public bathrooms, it is to value and maintain them as any other public infrastructure.

The city of Surfers Paradise is trying to solve its public urination problem with a series of pop-up toilets

Globe and Mail Update