They perform an essential health service—in secret

This is Exilien Cenat. He is a bayakou, the Haitian term for laborers who empty latrines. I took his photo while he was cleaning out a pit toilet that served several families in Port-au-Prince. Despite the unpleasantness of his job, Exilien represents a solution—a crude one—to the deadly problem of poor sanitation.

I’d been assigned to photograph a National Geographic story on open defecation, a subject that didn’t disturb me too much. I’ve covered wars and conflicts in places where sanitation is not a priority. The difficulty, I thought, would lie in making visually interesting images out of such a banal subject—something so universal that everybody does it.

But following people to the bathroom, or wherever they go, is surprisingly tough. People can’t even talk about this most basic of human actions, let alone discuss it in a way that brings positive change to their communities. Yet without proper sanitation, you can’t have clean water.

Haiti’s bayakou perfectly distill many of our issues about defecation. People throw stones at them, almost as if embarrassed that they need someone like the bayakou to clean up their waste. Therefore, many bayakou operate at night and hide what they do—even from their families. Even so, the bayakou are well paid and in high demand. Port-au-Prince’s precarious sewage system rests on their shoulders.

Finding a bayakou who would agree to be photographed proved to be the most difficult part of this project. But after five months of trying, I connected with Exilien. He was eager for me to document his work because he rejects the idea that his profession is shameful. He is proud of what he does and wants to be respected.

I arranged to meet Exilien and his two colleagues late at night in a courtyard between several houses. My photo editor had been concerned about the conditions so I’d packed protective gear: face masks and scarves (to block the smell) as well as rain gear (to protect my clothes). But when it came time to put it all on, I found I couldn’t do it. I didn’t want to make him feel like his job was disgusting. It’s his profession, something only a few people know how to do, and he does it well.

Most of the lights in the courtyard were out, and the families were asleep. The toilet in the outhouse hadn’t been emptied in more than a year. Exilien began his work by reaching into the hole to scoop out the freshest layer. The stench permeated the air. His two colleagues deftly dumped the sewage into what looked like old seed sacks, tying them up perfectly without any leaks. They had more experience than Exilien and had graduated from cleaning the hole.

In order to endure the smell and discomfort, the three men drank and smoked throughout the night. One guy would hold a cigarette so Exilien could take a few puffs without touching the cigarette with his soiled hands.

Once the contents of the hole were beyond his reach, Exilien climbed down into it. He told me that he’d come across snakes and human remains in toilets. Snakes were his enemies, he said. Other bayakou told me about encountering live wires and suffering electric shocks.

Those are the dangers they can see. Hidden from sight are the diseases. Cholera still kills in Haiti, although treatment centers make it less deadly in the city. Exilien said he gets sick often. By the end of the night, his eyes were nearly swollen shut.

Bayakou wash themselves very carefully after a night’s work (as did I—and I threw away what I was wearing). Most work naked to avoid ruining clothes. Exilien kept his on for most of that night, I think because I was there. But in the end, after he’d cleaned himself and changed, he had to strip down completely.

The owner of the toilet expressed dissatisfaction with how it had been cleaned. So Exilien, after removing his fresh clothes, went back to do more.

Afterward, the three men loaded the sacks of sewage into a cart and rolled them down to the river, where they dumped the bags in the water. There’s a government facility that treats sewage, but you need a truck to get there, and they don’t have one.

Exilien wanted people to see what he does. No one wants to be invisible. That’s what I find so powerful about photography. When you take someone’s picture, you are telling them: Your life is important.