Getting serious about human waste

Image from cover of "The Big Necessity" by Rose George

TEXT OF INTERVIEW

Kai Ryssdal: The short list of critical problems the planet faces is pretty straight forward: war, famine and drought, global warming and . . . toilets? Not among the usual suspects, but maybe they ought to be.

Rose George writes about the dirty world of human waste and where it goes in her latest book, "The Big Necessity." Rose, welcome to the program.

Rose George: Thank you for having me.

Ryssdal: You use the word "sanitation" in this book, and really that's a euphemism for a euphemism for a euphemism. Why is something that is so necessary in our lives and in our economy and in our health system and in everything so hard to talk about?

George: It hasn't always been that way. It's been a gradual process over the last 250 years or so. And it's really come about with the rise of the flush toilet. When it came into really common use in London in the 19th century, one in two children died from diarrhea and disease before the age of 5, and afterwards mortality dropped by a fifth. So, it's been an incredible invention, but one of the side effects of it is that it's brushed the issue of sanitation out of our public discourse. We don't have a mutual word for it.

Ryssdal: When international organizations go out and give money and grants and development aid to developing countries, is it spent on the infrastructure needed for sanitation or does that somehow wind up at the end of the distribution chain?

George: There is an expression in the world of development, which is "WatSan,' and that stands for water and sanitation. And there's a reason it's not in alphabetical order: because the bulk of the funding and the attention that's given to water and sanitation goes to water. Water is easier to talk about. No one is going to be embarrassed to be photographed standing in front of a nice clean and shiny tap gushing out life-saving water. But nobody wants to stand in front of a latrine, even though its public health benefits are actually greater than a simple water pipe. And this translates into a financial bias toward water.

Ryssdal: Even though I'd imagine you can have substantial economic development without some treatment of sanitation, right?

George: Well, it's one of the most effective health preventions you can make.
And the World Bank and the World Health Organization has calculated that if you invest $1 in sanitation, then you reap $7 in health costs diverted and in labor days that are gained. Your workers are not off sick from diarrhea. So, it's extremely cost effective. It's actually a bargain.

Ryssdal: So, we here in America have excellent sanitation. Most of the developed world also has really good sanitation. What does that do, though? What are the costs? I mean, obviously, we reap the benefits, but what are the costs?

George: Well the costs are a system that is, arguably, not particularly sustainable. It's expensive in terms of both money that needs to be spent on upgrading and maintaining these very large sewer systems and waste water treatment plants and, on the other hand, it's also wasting water, which is an increasingly precious resource, even in the Western world and certainly in many parts of the U.S. And so, activists would say that people who want to look at the waste water system again, who think, "OK, it was a solution in the past, but it's in need of evolution."

Ryssdal: What happens when you're at a cocktail party and someone asks you, "What do you do?" And you tell them, "I'm writing a book on toilets around the world."

George: That's happened to me a lot over the last few years, as you can imagine.

Ryssdal: I bet.

George: There's generally a slight pause of bemusement, and then suddenly it's as if a tap has been switched on. All these stories come pouring out. Everybody's got a toilet anecdote, and that's perfectly understandable because we spend a lot of our life in the bathroom. Someone has calculated that we spend three years of our life in the bathroom. So that's a lot of thinking time.

Ryssdal: The book by Rose George about sanitation and all that word implies is called, "The Big Necessity." Rose, thanks a lot for your time.

George: You're welcome.

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