The Big Necessity

Why I Wrote a Book About Human Waste

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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.