The Big Necessity Summary

“Sanitation is more important than independence.” – Mahatma Gandhi. How can something so essential to human dignity and health still be neglected by nearly half the world?

1. The Global Sanitation Crisis

Sanitation affects nearly every aspect of human life, yet 2.6 billion people live without access to a toilet. In some areas, defecation takes place outdoors or even in plastic bags that end up discarded in public spaces. This lack of basic hygiene exposes communities to a myriad of health problems.

Contaminated water and soil become breeding grounds for diseases when feces is improperly disposed of. Fighting these issues isn't just about improving infrastructure; it’s about saving lives. Disease and food contamination are rampant in regions with poor sanitation, impacting health and economic stability.

The shocking reality is that fecal matter can infiltrate drinking water and even food, leading to deadly diseases. Every 15 seconds, a child somewhere succumbs to diarrhea—a preventable tragedy tied to waterborne illnesses, primarily caused by unsanitary environments.

Examples

• Overcrowded slums where families live surrounded by refuse and contaminated soil.
• Diarrhea-related deaths surpassing combined casualties of several 20th-century wars.
• UNICEF’s focus on diarrhea as the primary existential threat to young children in developing regions.

2. Sanitation Saves Lives and Money

Investing in sanitation is both humane and economically smart. Improving toilet access reduces disease and extends average life expectancy. Historical evidence, such as reductions in child mortality in London after sanitation reforms, proves its value.

Sanitation isn’t solely a public health matter—it’s an economic one. Research indicates that a single dollar invested in sanitation yields seven dollars in savings related to healthcare costs and economic productivity. This ROI underlines why sanitation improvements should rank high on international agendas.

Devastating examples like the 1991 cholera outbreak in Peru show what happens when sanitation is ignored. Instead of spending millions proactively, Peru’s government reacted during the outbreak, which cost billions while economically devastating vital sectors like agriculture and tourism.

Examples

• Reductions in child mortality rates in post-reform London.
• Peru losing over three times what it spent on sanitation in economic fallout during cholera epidemics.
• Improved productivity and workforce health due to better urban sanitation in developing Asian cities.

3. Talking Toilets: Why Sanitation is a Taboo Subject

Discussing excrement is uncomfortable for many, perhaps due to cultural stigmas and societal evolution. Historically, open discussions about elimination were once normal, but modern practices have created barriers to important conversations about waste management.

Even global health language skirts the topic, prioritizing terms like “water-related diseases” over feces-linked ailments. Euphemisms employed in political and public health spheres contribute to a lack of funding and advocacy for sanitation reforms, keeping sanitation low on agendas worldwide.

This aversion to discussing sanitation leads to uneven resource allocation. For instance, governments like Pakistan prioritize militarization over providing clean water and sanitation—even though diarrhea claims more lives annually than armed conflicts.

Examples

• Anthropologist Norbert Elias documenting societal changes regarding toileting practices in “The Civilizing Process.”
• USAID dedicating only 10% of clean water funding toward solving sanitation problems.
• Pakistan spending significantly on defense while neglecting hygiene infrastructure.

4. Changing Behavior: Activism Meets Psychology

Building toilets is one thing; getting people to use them is another. In India, where open defecation is common, government efforts have often failed because they lacked cultural and logistical considerations. Providing latrines didn’t automatically translate into sustained usage.

Activists like Kamal Kar have adopted a more effective, grassroots approach, raising awareness through communal engagement. Shock tactics, like calculating how much feces surrounds living areas, compel entire communities to act together in improving sanitation. This method is known as Community-Led Total Sanitation (CLTS).

CLTS has gained international attention for its success. By emphasizing personal and collective benefits, this outreach strategy inspires ownership and care for hygiene improvements, countering the top-down shortcomings of government efforts.

Examples

• India’s Central Rural Sanitation Program increasing latrine availability only for many to remain unused.
• Kamal Kar’s community walks in Bangladesh that shocked villagers into understanding sanitation’s importance.
• Adoption of CLTS improving sanitation attitudes and behavior across rural areas in Africa and Asia.

5. Rich Countries Face Sanitation Problems, Too

Even in developed nations like the US, sanitation is far from perfect. More than a million Americans lack access to basic sanitation, and infrastructure nationwide rates poorly. Aging sewer systems risk collapse, and ecological damage continues from spillage into water bodies.

Some cities, like New York, face unique challenges when sewage systems become overwhelmed by weather events. Rainfall disrupts the city’s aging infrastructure, flooding streets and homes while dumping untreated wastewater into rivers and oceans—a practice that occurs weekly.

Ignoring these issues affects not only public health but also the environment. The global consistency of sewage-related concerns underscores that sanitation deserves more attention—even from wealthier economies.

Examples

• New York City’s sewage systems routinely overflowing during storms, spilling waste into waterways.
• Half of US sewer pipes potentially nearing collapse by 2020, according to the Environmental Protection Agency.
• Over one trillion gallons of untreated waste discharged into waterways annually by US utilities.

6. Waste as a Resource

What if human waste weren’t wasted? Feces contain nutrients like nitrogen and phosphates, ideal for farming. Biogas energy from digestion processes transforms fecal matter into fuel for heating and cooking, turning a hazard into an asset.

China leads in leveraging waste for energy. Millions of rural households use biogas digesters to convert human and animal waste into fuel. The leftover byproduct serves as fertilizer, enhancing crop yields. This closed-loop system reduces reliance on wood fuel, preserving forests.

Despite some skepticism about pathogen risks in the byproducts, reusing human “waste” demonstrates we can replenish resources while addressing sanitation challenges creatively.

Examples

• Biogas powering 15.4 million rural Chinese homes, drastically cutting energy costs.
• Fecal transplants showing 90% effectiveness against certain bacterial infections.
• Increased vegetable yields in fertilized fields using biogas slurry.

7. Challenges of Reusing Waste

Recycling waste presents technical, cultural, and logistical hurdles. Even where systems like biogas digesters exist, they often fail due to maintenance issues or lack of user knowledge. In many cases, old habits resurface.

In China, farmers reverted to wood after difficulties arose with state-sponsored biogas toilets. Meanwhile, debates linger over whether biogas fertilizer is pathogen-free or hazardous, showcasing yet unresolved risks and barriers surrounding waste reuse.

Global implementation requires adaptability and education to address local skepticism while optimizing safety procedures for repurposing human waste.

Examples

• Poor maintenance leading Chinese farmers back to unsanitary latrines and wood-fueled cooking.
• Disagreements among experts over pathogen neutrality in biogas residues.
• Deforestation challenges resurging with unsustainable biogas adoption rates.

8. Sanitation Systems Reflect Broader Societal Values

Sanitation isn’t just an issue of health—it reflects national priorities, cultural practices, and economic alignment. Neglected toilets point to ignored populations and systemic inequality on a global scale.

Architects and policymakers historically viewed sanitation systems like public sewers as cornerstones of functionality and civilization. When broken systems persist, they reveal political choices and institutional neglect that disproportionately affect marginalized groups.

Eradicating outdated attitudes surrounding sanitation aligns with efforts toward equity, public dignity, and better long-term outcomes worldwide.

Examples

• Le Corbusier’s praise for toilets as industrial marvels improving modern life.
• Pathak calling sanitation debates central to economics, politics, and culture.
• Developed cities like London and Tokyo initially modernizing through sewer system designs.

9. Changing the Conversation Around Feces

Sanitation reform requires frank conversations, challenging taboos head-on. Ignoring feces perpetuates avoidable health risks globally. Changing language and attitudes opens opportunities for effective education and resource allocation.

Rather than avoid the topic, advocates focus on education that connects toilets to broader themes like environmental conservation and economic development. This shift allows sanitation to be recognized as integral, not secondary, to human betterment.

Researchers and global leaders acknowledge that discussions around human feces extend to sustainability goals involving energy reuse and waste reduction worldwide.

Examples

• UN sanitation campaigns shifting terminology and investing in hygiene education.
• Community-led sanitation activists reframing defecation topics as empowering, solvable local challenges.
• Global architects like Rem Koolhaas incorporating wastewater recycling into city plans.

Takeaways

1. Push governments and institutions to prioritize funds for sanitation projects. Advocate for better allocation of international aid to improve toilet access worldwide.
2. Educate your community about the hidden value of waste and explore creative reuse solutions like biogas or composting methods.
3. Normalize conversations about sanitation to break the stigma and highlight its importance for public health and dignity.