Sanitation doesn't get a lot of headlines but, all told, its absence kills 6,000 children a day, according to British charity Water Aid. And the solution chosen by the developed world—the flush toilet—is running up against limits in the amount of water available to flush away human waste.

The United Nations has attempted to fill this gap by securing a pledge from developed countries to halve the number of people without any form of sanitation—whether basic outdoor latrines or indoor toilets—by 2015 as part of  its Millennium Development Goals (a series of goals for world development, ranging from alleviating poverty to fighting diseases like AIDS). To accomplish this task, however, a toilet would have to be installed every second between now and then, according to the U.N.

As a result, this objective may be the furthest of these goals from being realized. At present rates of progress, sub-Saharan Africa, for example, would only reach the target by 2076, according to Water Aid. And the developed world is in no better shape: U.S. Environmental Protection Agency estimates predict a $122 billion spending shortfall on wastewater treatment necessities between 2000 and 2019.

In an effort to better understand this sanitation crisis, Scientific American's David Biello spoke with Rose George, author of The Big Necessity: The Unmentionable World of Human Waste and Why It Matters. (Read an excerpt here.)

What inspired this book? Why toilets?
It was kind of a gradual process. … I was introduced to Dr. Bindeshwar Pathak of Sulabh [a non-governmental organization devoted to sanitation] in India. He was a Brahmin [member of the highest Hindu caste] who devoted his life to saving untouchables [the lowest caste] from the horrible job of cleaning dry latrines with their bare hands. His life's work was installing half a million public toilets, which American tourists have probably enjoyed.

Right now, 2.6 billion people have no toilet, not even a bucket. That's four in 10. And diarrhea kills more children under five than TB, HIV and malaria combined. I found that absolutely shocking. And I found these people who I came to admire, kind of sanitation foot soldiers like Dr. Pathak, trying to do their bit. It's a colorful cast of characters. Dr. Pathak also set up the International Museum of Toilets—the biggest toilet museum in the world—which is one room in New Delhi.

6 Comments

1. 1. Walt129 07:08 PM 10/15/08

   Finally! A scientific journal has the forthrightness to say it "out loud." As a former resident of a home with the luxury of a septic tank and a wish to have a flammable gas producing system attached, I welcome this article and book. Add this proposed enhancement to our world quest for more fresh, drinkable water and we are well on the way to a brave new world indeed!

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2. 2. Aviatar 07:18 PM 10/15/08

   "The thing about shit, the reason it smells, at least according to the London School of Hygiene, is because it can be so toxic and carry so many diseases." Evolution is a probable factor in our malodorous perception. Humans who have learned to avoid shit, warned by its odor, will increase their chances of good health and longevity.

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3. 3. Marshal-Green 07:56 AM 10/16/08

   I am uncertain why exactly composting toilets is not considered a viable solution. They really require much less maintenance compared to a water based system on the whole. Although expense could possibly become an issue with the 3rd world, economies of scale will help with that matter as composting toilets become more popular. Electricity isn't even necessary for some models
   
   Take a look at www.biolet.com for some examples of self contained composting toilets.

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4. 4. Marshal-Green 07:56 AM 10/16/08

   I am uncertain why exactly composting toilets is not considered a viable solution. They really require much less maintenance compared to a water based system on the whole. Although expense could possibly become an issue with the 3rd world, economies of scale will help with that matter as composting toilets become more popular. Electricity isn't even necessary for some models
   
   Take a look at www.biolet.com for some examples of self contained composting toilets.

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5. 5. creuynni 09:58 AM 7/15/10

   exactly - compost toilets! easy answer! they don't cost much to make- though have to have the space to make them, the flushing variety would have had to go somewhere
   and could help provide fertlisation for soil even...
   
   in a day and age where the 'west' is looking towards eco-ways of living, other countries can do so, often easier than the so called 'developed' countries....

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6. 6. mcphilosopher 02:13 PM 2/13/13

   Thank you for focusing policy makers's attention to simple public health issues that save more lives than the search for the silver bullet in the high-cost practice of for-profit medicine.

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