An important book that demonstrates both the importance of sanitation as well as the fact that it is far from being a solved problem, even in modern cities. Well worth a read.

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Dates 03 February 2013 – 16 February 2013
Time spent reading 6 hours, 35 minutes
Highlights 52
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I need the toilet.

2.6 billion people don’t have sanitation.

The number of children dead from diarrhoea over the last decade exceeds all people killed by armed conflict since the Second World War.

Andrew Doran Andrew Doran


Milwaukee discharges treated sewage effluent – treated to remove some things, but not pharmaceuticals or all pathogens – into Lake Michigan, which also supplies its drinking water. Sometimes it discharges raw sewage too.

The average human being spends three years of life going to the toilet

Mohandas K. Gandhi, though he spent his life trying to rid India of its colonial rulers, nonetheless declared that sanitation was more important than independence.

it was considered an honour to attend monarchs seated on their commodes

They also borrowed Gardez l’eau, commonly shouted out before throwing the contents of chamber pots into the streets, and turned it into ‘loo’.

Andrew Doran Andrew Doran

Origins of the English word that always amuses Americans.

A sewer is a great leveller.

Without water, the average human produces 35 kilograms of excrement and 500 litres of urine a year. Add toilet flushes, and the total jumps to 15,000 litres.

‘If Bazalgette hadn’t built his sewers when he did,’ Rob Smith tells me, ‘we would – literally – be in the shit today.’ If Bazalgette’s sewers aren’t maintained, we will be again.

People would go to the beach and there would be something like black mayonnaise all over it and it was like a horror show.

London’s sewer rats generally run away from humans. New York’s don’t. ‘They come at you,’ says Steve.

Thomas Crapper (another Yorkshireman who did not invent the toilet but improved its parts).

Using paper to cleanse the anus makes as much sense, hygienically, as rubbing your body with dry tissue and imagining it removes dirt.

There is a United Nations Office for Outer Space Affairs, but none for resolving the biggest public health crisis on this planet, and one which the Human Development Report authors put in its proper place. ‘The 1.8 million child deaths each year related to clean water and sanitation dwarf the casualties associated with violent conflict. No act of terrorism generates economic devastation on the scale of the crisis in water and sanitation. Yet the issue barely registers on the international agenda.’

Every dollar invested in sanitation brings an average $7 return in health costs averted and productivity gained.

Pakistan, for example, spends 47 times more on its military budget than on water and sanitation, though it loses 120,000 people to diarrhoea a year

Reducing the number of people who don’t have something means knowing how many people don’t have something in the first place, but only 57 out of 163 developing countries have counted the poor more than once since 1990. Ninety-two have never counted them.

‘Cholera and typhoid,’ he tells me, ‘kill so many million kids a year, which amounts to two jumbo jets full of children crashing every four hours.’

UNICEF estimates that one in three girls in sub-Saharan Africa drop out of school, either when they’re menstruating, or permanently, because of poor sanitation facilities.

Even today, only 232 of India’s 5233 towns have even partial sewer coverage.

UK regulations concluded that spending more than three per cent of the household budget on water was an indicator of hardship. But poor people in Uganda, for example, spend twenty-two per cent of their budget on water.

There are reasons not to eat salads in China, and why the sizzling woks are so sizzling.

‘India is a democracy,’ the expert says. ‘We have to ask, to plead, to persuade. It takes longer. It is harder. China can do things faster.’

By the late nineteenth century, the leaders of the nightsoil trade had been given the ironic title of fenfa, or shit lords. The nickname was derived from junfa (warlords) and neither were to be messed with.

How many people have lingered in a cubicle so that the sound of their excretion – of whatever variety – can’t be associated with them when they come out? How many have cringed in a hotel bathroom too close for comfort to a bedroom containing a new lover?

Andrew Doran Andrew Doran

What isn't seen is sometimes heard.

Individual cleansing facilities were out of reach of the masses, unless you counted the enterprising gentlemen who tramped the streets of Vienna, Paris, London and Edinburgh, wearing large cloaks and carrying buckets. Passing citizens in need could use the bucket as a toilet and the cloak as a cover, or an early, cloak-like door.

A 1903 toilet, the first in a station of the Paris Métro’s new Line 1, provided thirteen stalls for men and fourteen for women, three of which included bidets with warm water. There were six attendants, and the toilets were open from 7 a.m. until midnight.

Andrew Doran Andrew Doran

A golden age of public toilets. Six attendants!

Shit is less acceptable than piss, which is less acceptable than fart. And so on through to snot and spit, ‘which is not taboo at all. That’s the same order as the acceptability of eliminating these substances from the body in public.’

Andrew Doran Andrew Doran

A hierarchy of excretion slang.

To be uninterested in the public toilet is to be uninterested in life.

His latest weapon is an ‘anti-pipi’ wall, whose angles spray the urine stream back onto the offender.

One organization which lobbies for older people’s rights refers to the ‘bladder leash’, which confines hundreds of thousands of elderly people to their homes because they are scared of not being able to find a toilet when they leave the house.

Andrew Doran Andrew Doran

Things you just don't think about.

nearly all American public toilet partitions have gaps in the doors large enough to see into.

Andrew Doran Andrew Doran

This is a weird one. I remember when I worked in the US that people used to drape long pieces of toilet roll on the gaps to increase their privacy. If Americans were doing this in my office and presumably everywhere else, why would they still be designed this way?

‘Water, faecal matter, toilet paper, hair, lint, rancid grease, stomach acid and trace amounts of Pepto Bismol, chocolate, urine, body oils, dead skin, industrial chemicals, ammonia, soil, laundry soap, bath soap, shaving cream, sweat, saliva, salt, sugar. No artificial colours or preservatives. Some variations in taste and/or colour may occur due to holidays, predominant cuisine preference, infiltration/ inflow, or sewer cross-connections.’

Sick people excrete sickness, and it all ends up in the sewers.

Europeans know that lead used by Romans two thousand years ago is still in their hills. They can’t afford to calculate that soil can handle risk; they prefer not to risk that it can’t.

The UK, however, applies over seventy per cent of its sludge to farmland and has no plans to do otherwise

Andrew Doran Andrew Doran


The lesson of the Government of India’s latrine-building programme is a strange and perplexing truth: giving someone a latrine – even someone whose only other option is open defecation – doesn’t mean they’ll use it or maintain it.

In fact, poor people have money, but their money is busy. They prioritize. A toilet is rarely considered a priority when there is food to buy and school fees to pay, even when the lack of a latrine contaminates that food and makes children too ill to go to school.

Technology for the poor, he says, should not be poor technology.

Dr Fayyaz Dr Fayyaz


Eventually, the villagers of Mosmoil calculated that they were eating ten grams of each other’s faecal matter a day.

Already, there are nearly a billion slum-dwellers on the planet, and Africa’s slum-dwelling population is expected to double on average every fifteen years.

Countless coastal cities – Vancouver, Brighton – have no better solution for disposing of their excreta that putting it in the sea. What’s the hope for slums?

In poor places, nothing is wasted, because waste only comes with wealth, and waste can, in the flourishing informal economy of the slums, create it.

The recyclers and 15,000 one-room businesses in Dharavi, a Mumbai slum that is the largest in Asia, create an economic output estimated at $1.4 billion a year.

Pay toilets, meanwhile, charged one rupee per entry. Even assuming you don’t have diarrhoea, and you only need to go once a day, this adds up to 150 rupees a month

Andrew Doran Andrew Doran

Surely it adds up to at most 31 rupees per month? Am I missing something?

On future Space Station missions, and on the planned 2012 mission to Mars, astronauts will be drinking their own urine, sweat, breath and tears because they have to.

In 2000, twice as much water was used throughout the world as in 1960. Water consumption is currently at about 1700 litres per person per day, but that’s an average, and most of it is not going down sinks and toilets, but onto fields, into irrigation channels, sprayed around greenhouses.

Londoners supposedly drink tap water that has gone through seven pairs of kidneys – probably an exaggeration but based in truth, as London takes drinking water from the Thames down-stream of towns which discharge their cleaned effluent into the same river.

We spend a fortune on cleaning effluent to a high standard, then we discharge it into the river, which makes it dirty again.

UK sewage works consume 65,000 gigajoules of energy daily, a quarter that produced by the country’s largest coal-fired power station.