I need the bathroom. I assume there is one, though I’m at a spartan restaurant in the Ivory Coast, in a small town filled with refugees from next-door Liberia, where water comes in buckets and you can buy towels second-hand. The waiter, a young Liberian man, only nods when I ask. He takes me off into the darkness to a one-room building, switches on the light, and leaves. There’s a white tiled floor, white tiled walls, and that’s it. No toilet, no hole, no clue. I go outside to find him again and ask whether he’s sent me to the right place. He smiles with sarcasm. Refugees don’t have much fun, but he’s having some now. “Do it on the floor. What do you expect? This isn’t America!” I feel foolish. I say I’m happy to use the bushes; it’s not that I’m fussy. But he’s already gone, laughing into the darkness.
I need the bathroom. I leave the reading room of the British Library in central London and find a “ladies” a few yards away. If I prefer, there’s another one on the far side of the same floor, and more on the other six floors. By 6 p.m., after thousands of people have entered and exited the library and the toilets, the stalls are still clean. The doors still lock. There is warm water in the clean sinks. I do what I have to do, then flush the toilet and forget it immediately, because I can, and because all my life I have done no differently.
This is why the Liberian waiter laughed at me. He thought that I thought a toilet was my right, when he knew it was a privilege.
It must be, when 2.6 billion people don’t have sanitation. I don’t mean that they have no toilet in their house and must use a public one with queues and fees. Or that they have an outhouse or a rickety shack that empties into a filthy drain or pigsty. All that counts as sanitation, though not a safe variety. The people who have those are the fortunate ones. But four in ten people have no access to any latrine, toilet, bucket, or box. Nothing. Instead, they defecate by train tracks and in forests. They do it in plastic bags and fling them through the air in narrow slum alleyways. If they are women, they get up at 4 a.m. to be able to do their business under cover of darkness for reasons of modesty, risking rape and snakebites. Four in ten people live in situations in which they are surrounded by human excrement, because it is in the bushes outside the village or in their city yards, left by children outside the back door. It is tramped back in on their feet, carried on fingers onto clothes and into food and drinking water.
The disease toll of this is stunning. Eighty percent of the world’s illness is caused by fecal matter. A gram of feces can contain 10 million viruses, 1 million bacteria, 1,000 parasite cysts, and 100 worm eggs. Bacteria can be beneficial: the human body needs bacteria to function, and only 10 percent of cells in our body are actually human. Plenty are not. Small fecal particles can then contaminate water, food, cutlery, and shoes—and be ingested, drunk, or unwittingly eaten. One sanitation specialist has estimated that people who live in areas with inadequate sanitation ingest 10 grams of fecal matter every day.
Diarrhea—usually caused by feces-contaminated food or water—kills a child every fifteen seconds. That means more people dead of diarrhea than all the people killed in conflict since the Second World War. Diarrhea, says the UN children’s agency UNICEF, is the largest hurdle a small child in a developing country has to overcome. Larger than AIDS, or TB, or malaria. 2.2 million people—mostly children—die from an affliction that to most westerners is the result of bad takeout. Public health professionals talk about water-related diseases, but that is a euphemism for the truth. These are shit-related diseases.
I’m often asked why I wrote The Big Necessity.
First I establish that I am no scatologist, fetishist, or coprophagist. I don’t much like toilet humor (and by now I’ve heard a lot of it). I don’t think 2.6 billion people without a toilet is funny. Then I tailor my answers and language to the social situation—still managing to spoil many lunches—by explaining the obvious. Everyone does it. It’s as natural as breathing. The average human being spends three years of life going to the toilet, though the average human being with no physical toilet to go to probably does his or her best to spend less. It is a human behavior that is as revealing as any other about human nature, but only if it can be released from the social straitjacket of nicety. Rules governing defecation, hygiene, and pollution exist in every culture at every period in history.
It may in fact be the foundation of civilization: What is toilet training if not the first attempt to turn a child into an acceptable member of society? Appropriateness and propriety begin with a potty. From this comes the common claim, usually from sanitation activists, that the toilet is the barometer of civilization. How a society disposes of its human excrement is an indication of how it treats its humans, too. Unlike other body-related functions like dance, drama, and songs, wrote the Indian sanitarian Dr. Bindeshwar Pathak, “defecation is very lowly.” Yet when discussing it, he continued, “one ends up discussing the whole spectrum of human behavior, national economy, politics, role of media, cultural preference and so forth.” And that’s a partial list. It is missing biology, psychology, chemistry, language. It is missing everything that touches upon understanding what the development academic William Cummings called “the lonely bewilderment of bodily functions.”
If my questioner is religious, I say that all the world’s great faiths instruct their followers how best to manage their excrement, because hygiene is holy. I explain that taking an interest in the culture of sanitation puts them in good company. Mohandas K. Gandhi, though he spent his life working towards ridding India of its colonial rulers, nonetheless declared that sanitation was more important than independence. The great architect Le Corbusier considered it to be “one of the most beautiful objects industry has ever invented”; and Rudyard Kipling found sewers more compelling than literature. Drains are “a great and glorious thing,” he wrote in 1886, “and I study ‘em and write about ‘em when I can.” A decent primer on sanitary engineering, he wrote, “is worth more than all the tomes of sacred smut ever produced.” Anton Chekhov was moved to write about the dreadful sanitation in the far-Eastern Russian isle of Sakhalin. And Sigmund Freud thought the study of excretion essential and its neglect a stupidity. In his foreword to The Scatologic Rites of All Nations, an impressive ethnography of excrement by the amateur anthropologist—and U.S. army captain—John Bourke, Freud wrote that “to make [the role of excretions in human life] more accessible … is not only a courageous but also a meritorious undertaking.”
If the cultural standing of excrement doesn’t convince them, I say that the material itself is as rich as oil and probably more useful. It contains nitrogen and phosphates, which can make plants grow but also suck the life from water because its nutrients absorb available oxygen. It can be both food and poison. It can contaminate and cultivate. Millions of people cook with gas made by fermenting it. I tell them I don’t like to call it “waste,” when it can be turned into bricks, when it can make roads or jewelry, and when, in a dried powdered form called poudrette, it was sniffed like snuff by the grandest ladies of the 18th-century French court. Medical men of not too long ago thought stool examination a vital diagnostic tool. (London’s Wellcome Library holds a 150-year-old engraving of a doctor examining a bedpan and a sarcastic maid asking him whether he’d like a fork.) They were also fond of prescribing it: Excrement could be eaten, drunk, or liberally applied to the skin. Martin Luther was convinced: he reportedly ate a spoonful of his own excrement daily, and wrote that he couldn’t understand the generosity of a God who freely gave such important and useful remedies.
Starting tomorrow in Slate, we’ll talk about toilets in outer space and a burgeoning movement to turn human waste into drinking water. We’ll bring you a report on the lowest of India’s untouchables, the latrine cleaner—and one man’s plan to improve their lot. And we’ll hear about an excrement-into-fuel technology that’s changing life in some Chinese villages. Stay tuned.