Sanitation

Pooping Around the World

In the past 2 years, my husband and I have traveled to 40+ countries. As a traveler suffering from Irritable Bowel Syndrome (IBS), I take careful note of the bathroom facilities around me. Dealing with IBS forced me to pay attention to toilets around the world. 

From using water over toilet paper, to pipes that cannot handle anything but bodily waste, to open defecation, cultures and countries can vary drastically in how they do their business. 

In this article, I cover my firsthand experience of pooping around the world—and discuss some sustainable toilet practices that protect our ecosystem. 


How much do you think about how you poop?  

First Flush Toilet in North America. Newfoundland, Canada

First Flush Toilet in North America.
Newfoundland, Canada

According to the World Health Organization, 2 billion people worldwide do not have access to basic sanitation facilities such as toilets or latrines. Of these, 673 million defecate in the open. Open defecation includes gutters, bushes, and open bodies of water. 

Defecating in open water has been going on forever. In 2015, my husband and I visited Newfoundland, Canada. There’s an archaeological site where the Colony of Avalon was started in 1624. Here, close to the harbor, is a toilet build out of stones.   

The chamber of the toilet had an outlet directly to the sea. At high tide, the water rose and filled the chamber halfway. At low tide, the matter in the chamber washed out to sea. 



Shit Rivers 

Large contaminated bodies of water can make huge numbers of people sick. In our travels, we have seen numerous rivers that I call “shit rivers.” 

Shit river on a Cambodian island.

Shit river on a Cambodian island.

Shit rivers are run-off from homes, businesses and hotels that typically line the busy street in booming tourist areas in some poorer countries—areas that don’t have sound solutions for proper disposal of waste. 

If the odd color of the water doesn’t give away the presence of a shit river, the smell soon will.

Often, the river of shit starts in the town and empties in the ocean. We’ve seen them in India, Indonesia, Peru, Colombia, and Ecuador. 

The shit river isn’t new either. 

The river Thames in London, England was so contaminated during the 19th century that four major outbreaks of cholera between 1832 and 1866 led to the death of tens of thousands of people. 

Today, the threat of cholera in developed countries is low. In the world’s poorest locations, Cholera kills an estimated 143,000 people each year.   


Controlling the spread of bacteria

While traveling, I have gotten dysentery in Columbia, food poisoning twice in Peru, and once more in India. My husband also got food poisoning in Peru, Egypt, and Indonesia. 

Pre-cut fruit may be washed with unclean hands or unclean water

Pre-cut fruit may be washed with unclean hands or unclean water

What causes diseases like dysentery? Ingesting fecal matter (poop). Generally, this occurs from eating food prepared with unwashed hands or drinking contaminated water.

Gross. 

How does fecal matter make its way into water or food? 

Traveling through northern India, we side-stepped piles of poop in the streets. We saw children pooping on busy streets in Indonesia.

These piles get covered in flies. 

The flies make their way to the restaurants where people prepare food. Flies land on the food. We eat the food. 

Or, food is handled by a person who hasn’t washed (or hasn’t properly washed) his or her hands. 


Water gets contaminated when fecal matter is too close to a water source, and then someone ingests the water. This can come from drinking contaminated water or eating fruit or vegetables washed with contaminated water. 

Bacterium causing diseases like dysentery and cholera are containable. But the World Health Organization reports that diarrheal disease is the second leading cause of death in children under five years old, and is responsible for killing approximately 500,000 children every year. 


Heavy tourism and toilets 

Cute backcountry photo. But did you poop sustainably?

Cute backcountry photo. But did you poop sustainably?

In Peru, we visited a remote area of the Amazon. We went several miles downriver to visit a macaw clay-lick, where the animals gather to ingest needed salt. The Tambopata Reserve holds the highest concentration of avian clay licks in the world. As such, this area is popular with tourists. Tours to visit the clay lick start at 5 am. While waiting for the macaws, a light breakfast is served. 

We ate. We had coffee. We had to poop. 

We ALL had to poop.

The guide instructed us that if we needed the bathroom, there was a trail. Walk down. Find yourself a spot.


Ours was a group of 9. There were at least 5 other groups of similar size there with us, and more to arrive throughout the day. Yikes. 

What we experienced in the Amazon is common at popular tourist attractions worldwide. When tourism expands at a rapid pace, it can be difficult to keep up with providing enough sanitary facilities to accommodate the growth.

A sign we encountered at a New Zealand campsite.

A sign we encountered at a New Zealand campsite.

Even in modern countries like New Zealand, booming tourism is bumping up against the capacity of public bathrooms at popular sites. Following Lord of The Rings popularity, word got out about the country’s stunning scenery. After the movie’s release in 2001, tourism in New Zealand increased by 50%. The country has seen even more increases in tourism since then. A lack of sanitation facilities has left many of the country’s campsites covered in poop and toilet tissue. 

When we visited, we were surprised by the number of aggressive signs posted in heavily used areas intended to remind campers to keep the surrounding environment clean. Water quality in New Zealand was once one of the world’s cleanest. New Zealand’s system of rivers and lakes are now some of the most polluted among OECD countries. Over tourism happens in obvious places—and in somewhat non-obvious places thanks to social media. In Australia, a boat house popularized by Instagram received so many tourists that the city of Perth spent $278k to construct a public toilet along a remote stretch of highway.

Developing sanitary systems in remote areas that allow for sustainable and responsible tourism, but do not disturb the surrounding wildlife, disrupt the life of inhabitants, or pollute the waterways is complicated.


Water over toilet paper as a cleaning method

In many countries, people use water to clean themselves after using the toilet instead of toilet paper. Exactly how water is used depends on the country.

In Japan, the bidet has been popular for many years and the technology when it comes to the toilet experience is impressive.

You can warm your toilet seat, dry after you use the bidet, adjust water pressure, or play music if you are feeling shy about the sounds of the bathroom experience. 

In the Indonesian countryside, it’s a little more primitive. You squat. The right-hand scoops water from a bucket into the left-hand. The left-hand is the hand you use to clean yourself. 

A bucket of water is often used to flush the toilet. We observed this method in many countries, including Peru, Cambodia, and Madagascar. In some countries, especially in places with lots of foreigners, you can find multiple types of toilets in the public bathrooms. 

Protecting piping systems

In places where water is used for cleaning instead of paper, the plumbing isn’t built to handle toilet paper. 

Signs all over the world instruct users to throw paper in the bins provided.

In the Western world, our pipes have been built to manage toilet paper—just don’t dispose of wet wipes in there.

Gender separation  

Ever wondered whether there are separate bathrooms for men and women all over the world?

Yup, turns out there are. Separate bathrooms for men and women seem to be a universal feature of bathrooms in the developed and developing world. Very rarely do we see unisex bathrooms. 



Solutions and the Manavta Project 

There are no perfect answers when it comes to creating the best the sanitation facilities worldwide. It’s complicated.

But it’s important we try. That’s what my friend Nabeel Jaffer is doing with his non-profit, The Manavta Project

We met Nabeel while traveling in Egypt and immediately bonded over sanitation policy (weird, I know). Manavta empowers leaders to bring safe sanitation to their communities through education.

Manavta is focused on building toilets for poor communities in Nepal. Manavta’s first project was at a school in Nuwakot Nepal (a little outside of Kathmandu). They built a toilet for around 100 people. It was built specifically at the school to model sanitation for the community. 

The second was a post-earthquake project in Sindhupalchowk, Nepal (the epicenter of the 2015 earthquake). Three EcoSans toilets were built and are currently being used by around 7 families (50 people). 

EcoSan toilets are closed systems that do not require the use of water, and recycle nutrients to create resources for agriculture. EcoSan toilets may be an answer to minimal environmental impact in many areas of the world. 

Manavta plans to scale up in installations of these EcoSan toilets as the communities have found urine quite useful for farming. You can learn about these projects at https://www.manavtaproject.org/projectjholunge

Ending thoughts

Having more toilets available in countries like Nepal with proper disposal of waste will go a long way in protecting our fragile ecosystem and preventing the spread of disease.  Diarrhea is a nuisance for me with IBS—it shouldn’t be a death sentence for those without access to proper sanitation.

People are “going to go” whether they have proper sanitation or not. If a toilet isn’t available, a person will find one. Maybe it’s a street. Maybe it’s a spot on a trail. Maybe it’s the ocean. 

Between feces, chicken feet, wet wipes, trash, and shit rivers, I think the environment could really use a break. Projects like Manavta are paving the way for greater access to sanitary facilities for some of the world’s poorest people. 

Girls Matter

Universal History Archive/UIG via Reuters

Universal History Archive/UIG via Reuters

It all started in the year 1909. 

The brave women of New York city sparked a campaign for change, a fight against oppression and inequality, a fight that’s lasted over a century. They’ve paved the way and are now joined by millions of women and allies around the world, fighting for the same thing – change. 

A lot has been done to elevate women’s rights since this first march. In 2018 alone, women in Saudi Arabia were finally granted the legal right to drive, voters in Ireland struck down a draconian ban on abortion, Iranian women watched the World Cup in a stadium alongside men for the first time in decades, and the #MeToo movement sparked a much-needed international conversation about harassment and sexual assault. Most recently, a Netflix documentary about Indian women fighting stigmas around menstruation, Period. End of Sentence, won the 2019 Oscar for Best Short Documentary. 

There is no doubt that progress has been made. It’s been slow but steady and significant.

Watch Charimaya Majhi, an inspiring woman and community leader from our project in Jholunge, speak on the importance of cleanliness for woman.

At Manavta, our mission is to create sustainable sanitation solutions for populations in need. In particular, today we highlight the girls in need. In Nepal, as many as 3 out of 10 girls report missing school because of their period, as access to safe and private latrine facilities are unfortunately few and far between. Skipping school once a month takes a huge toll on these children’s ability to intake and retain information, causing many girls in developing nations to eventually drop out. At Manavta, we’re changing that by continuing to raise awareness about the sanitation crisis, building toilets in high-need rural areas of Nepal, and educating along the way.

Malala Yousafzai said, “we cannot all succeed when half of us are held back”. This means that our collective success depends on equalizing the playing field.

 Ladies and allies, Happy International Women’s Day.
Keep fighting the good fight.
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It's World Toilet Day

Let me start by offering you all a Happy World Toilet Day! Happier, if you have access to a toilet… happiest if you’re reading this while sitting on your fully accessible toilet.

I’ll begin by paying my respects:

World Toilet Day is about inspiring action to tackle the global sanitation crisis. 

The toilet, dubbed by The Economist Magazine as the world’s most useful invention, has saved billions of people from death and disease. Despite this, 892 million people are still subject to open defecation and the diseases that come with it. I say subject to because open defecation is not a choice that populations in countries such as India, Nepal and Kenya can make. Millions of people are forcefully subjected to live a life of poor sanitation and hygiene, simply due to lack of resources. Thankfully, organizations such as UNICEF, the UN and WHO are tackling this crisis with initiatives such as WASH to ensure that everyone has access to a toilet by the year 2030. Achieving this goal is essential to eradicating poverty, thereby making this world a safer, cleaner and happier place to live. 

Enter Manavta…

For those we haven’t had the pleasure to meet, we’re Manavta, a non-profit organization that builds sanitation facilities at rural schools in Nepal. Our name, Manavta, means Humanity. Our journey began when we fell in love with Nepal and its people. We did our research and realized that more than half of the population doesn’t have access to a toilet. Even more disconcerting is that the lack of sanitation facilities in rural communities forces girls who start menstruating, to abandon educational opportunities, often leaving them trapped in a cycle of poverty. We’ve joined forces with fellow #ShitDisturbers and are looking to change the world, one toilet at a time. Through sustainable and innovative sanitation systems, we are not only looking to save the planet but humanity along with it. Our philosophy is to educate and empower the communities affected by this crisis so that together, we can help millions enjoy the same freedoms that we do.

For those of you enjoying this read on the toilet, remain seated a little while longer to spread this shit.

Road to Jholunge

Update from the Field

Namaste from Nepal! To say the least our first few months back, have been eye opening. We have spent some time connecting with local NGOs, district public officials and learning about the current WASH situation. While scoping out various districts, we connected with local NGO Educating Nepal and have had the opportunity to spend time in a small village located in the district of Sindhupalchowk, named Jholunge (jho-loon-ge).

Nestled in the valley of Maghi Gaon, the village is home to some of the best fishermen in Nepal. Through a somewhat treacherous road, the village can be reached within 5 hours by local bus. However, as the current border blockage with India continues to make headlines, traveling has been quite the task especially with a lack of fuel and transportation.

Starting this December, Manavta will be building urine diversion toilets for three families and working alongside the community, students of Suryoda Primary School and artists from Kathmandu, to spread the good word about stopping open defecation. As many of you may know, Sindhupalchowk is also the epicenter of the earthquake and has been the site of much of the destruction that was witnessed in the media. Jholunge in total lost 25 members of their community and are currently rebuilding their homes, schools and lives. Their story is something I will come to learn while I spend the next few months living with them. We are so grateful to be able to work with this community and are equally heartfelt by the support our fans have shown us during the past few years leading up to this project. 

We are set to depart next week and I encourage you to keep an eye on our Facebook, Twitter and Instagram (links at the very bottom of the page) to learn more about the progress and the community we are working with. If you would like to get involved with our current operations you can connect with us on social media or at toilets@manavtaproject.org, we would love to hear from you!

Are Toilets a Human Right?

In 2010, the United Nations General Assembly adopted resolution 64/292, which “Recognizes the right to safe and clean drinking water and sanitation as a human right that is essential for the full enjoyment of life and all human rights”.

Does that make toilets a human right?  

The concept of a right to sanitation is concerned with its necessity in order to realize the other human rights, like those included in this list (e.g. health, nutrition, dignity and an adequate standard of living). The UN High Commissioner for Refugees emphasizes that adequate sanitation is necessary for maintaining access to clean water, which is critical to the rights to quality of life and health.

Making sanitation a human right requires that it apply universally (i.e. to everyone without discrimination). This equality is especially important for women, as menstruating women are stigmatised in many cultural practices.

For instance, the rural Nepali practice of chaupadi requires that "impure" menstruating women remove themselves from contact with other people. They are often forced to stay in sheds outside the house, or in other unclean environments, which often expose women to the elements. If sanitation is formally acknowledged as a human right, it would supersede cultural norms that guarantee the equal humanity of all people – a right applies to everyone, always, even when they’re menstruating.

In fact, the UN General Assembly’s Human Rights Council also recently reaffirmed the human right to drinking water and sanitation with a specific focus on menstruation. It notes that women and girls’ inequality can be worsened by inadequate menstrual hygiene.

This Human Rights Council resolution and its 2010 resolution, which was adopted shortly after the General Assembly’s resolution mentioned above, indicate that States have the primary responsibility for ensuring realisation of these rights. Nepal’s interim constitution is fairly progressive in recognising the right to sanitation. Article 16 on the Right Regarding Environment and Health includes the statement that “Every person shall have the right to live in clean environment,” which includes sanitation and hygiene.  

Of course, moving from recognising to implementing a right isn’t the easiest step. It's worth noting that being a right does not obligate States to provide toilets. Infrastructure is critical to realising adequate sanitation (and large scale infrastructure requires State or major communal action), but the right doesn’t actually require toilets for all. Recognition of sanitation as a right focuses on the need for environmental hygiene to achieve health and an adequate standard of living.

Rather than mandating toilets, the right to sanitation obligates States in ensuring that there is an environment conducive to realising sanitation services that are available, acceptable, accessible, affordable and of sufficient quality, as noted by Catarina de Albuquerque, the previous Special Rapporteur on the Human Right to Safe Drinking Water and Sanitation. That doesn’t require a flush toilet in all circumstances but may require hardware or infrastructure of some type, although de Albuquerque also makes clear that individuals are expected to contribute to realising this right. States are obligated to enable this right only if limiting factors (like poverty) prevent people from achieving this standard on their own. Just as a side note – Manavta’s toilets aren’t your conventional flush toilets anyway!

So if toilets aren’t a right, what does a rights-based perspective bring to the issue?

It’s a call to action. It provides a legal framework that allows people to demand change, especially marginalized groups – rights are for everyone, not just the privileged. In Nepal, marginalized individuals include women and rural communities, populations that have been a focus of Manavta’s work.

Some groups in Nepal have started demanding, and achieving sanitation services and have used the language and obligation of human rights to do so. While States aren’t obligated to provide toilets, the language of rights allows prioritisation of sanitation services like water and wastewater connections. There is still significant progress to be made, and plenty of community-level work to be done. The right to sanitation is far from being realised in Nepal, which is why Manavta and other like-minded organisations continue to use toilets to lay the groundwork for health, dignity and an adequate standard of living.