Inside Out

Don’t hold your nose: the 400-year-old flush toilet is overdue for an upgrade as hundreds of millions of people go without it

  • More than 2.3 billion people have no access to basic sanitation, leaving 890 million people defecating in open space, according to the WHO
  • That leaves over 500,000 deaths a year among children under five, and US$200 billion in annual health costs from diseases
PUBLISHED : Sunday, 11 November, 2018, 2:06pm
UPDATED : Sunday, 11 November, 2018, 10:18pm

One of the quirkier moments of my 20-year journalistic career was an interview with the world-renowned chairman of one of Hong Kong’s most illustrious hotel groups.

As I was escorted into his huge, luxurious office to a sofa with epic views across Hong Kong’s Victoria Harbour, it was impossible to ignore eight toilets, seat covers up, lined along the wall towards his vast desk. It was obviously impossible to ignore them, so I could not resist asking as he walked up to shake my hand what eight toilet seats were doing decorating his office.

“You have to take toilet seats very seriously,” he responded, unabashed and matter-of-fact: “Our hotel guests spend an average one hour a day in the bathroom, and much of that sitting on the toilet. It’s a very important part of our attention to customer service that they should be as comfortable as possible. I think it is important that I test the choices personally.”

He would have shared common cause with Bill Gates, who has spent US$200 million of his foundation’s money over the past seven years on his “reinvented toilet” project, tackling one of those epic secrets that sit hiding in plain sight: why is it that despite the tremendous environmental inefficiency of the modern flush toilet, the technology at the heart of them has not changed in more than four centuries?

It was this question that drove Gates to walk onto a podium in Beijing last week with a carefully sealed jar of human poop in his hand to open the world’s first Reinvented Toilet Expo, showcasing 20 radically new technologies intended to transform the world’s toilet market – introducing “the most significant advances in sanitation design in nearly 200 years.”

Why now, and why in Beijing? Perhaps because November 19 is the United Nation’s World Toilet Day, and because, according to the organisers of the worldwide Reinventing the Toilet Challenge, “China owns the biggest toilet market in the world”, with a leadership - from Xi Jinping down - that wants to “consider sanitation systems from cradle to grave”. Hold that thought!

While the flushing toilet – called the Ajax - was invented by John Harington in 1596 and installed in his home in Kelston in Somerset, it was Yorkshireman Joseph Bramah who patented the first practical water closet in England in 1778. Most famous of all was plumber Thomas Crapper (also a Yorkshireman), who heavily promoted sanitary plumbing from his bathroom fittings showroom in London, and persuaded Prince Edward (later King Edward VII) to install 30 lavatories with cedarwood seats in his Norfolk country seat, Sandringham House.

Until Harington’s radical invention, most of the world’s (mainly rural) population used the open countryside as their toilet.

Infographics: The colourful history of toilets around the world

In more crowded urban areas, people either used “night soil” chamber pots in their homes, or pit-and-plank arrangements beyond the smelling distance of their homes.

Even today, according to the World Health Organisation, more than 2.3 billion people worldwide have no access to basic sanitation, leaving 890 million people worldwide defecating in places “such as street gutters, behind bushes or in open bodies of water.”

This leads to over 500,000 deaths a year among children under five, and annual health costs amounting to more than US$200 billion due to diarrhoea, cholera or other diseases borne in polluted water.

As Gates noted, keeping his poop-jar firmly at arm’s length: “This small amount of faeces could contain as many as 200 trillion rotavirus cells, 20 billion shigella bacteria and 100,000 parasitic worm eggs.” And then some.

What appalled Gates and his wife Melinda, as they were being guided through a Durban slum a decade ago, was not just the awful, undignified horror of life without basic sanitation, but the fact that the flushing water toilets that most of the rich world relies upon have not seen radical improvement in centuries.

Six best toilets in the world: from the top design to the one you should use in the wilderness

As much of the world’s population becomes urban – the UN says 70 per cent of us by 2050 – so the environmental shortcomings of flushing toilet technology and the massive sewerage systems that underpin them are a matter of rising concern.

Ros Stanwell-Smith at the London School of Tropical Medicine may famously have commended our urban sewerage systems as “the barometer of civilisation”, but as the growth of urban slums puts increasing pressure on existing city infrastructures, so the awesome – often impossible – challenge of retrofitting creaking infrastructure daunts many city planners.

The United Nations Development Project (UNDP) estimates that leakage from seeping urban systems means that 1.8 billion city dwellers nowadays use water that is “faecally contaminated”.

Hence Bill and Melinda Gates’ clarion call for radically new toilet technologies that bring hygiene and dignity to the world’s unserved rural communities, and improved environmental efficiency to urban toilet infrastructures.

That means waterless toilets - flush systems can use over six gallons (27 litres) of water per flush, and account for around one third of every household’s water consumption - and “off-grid” systems that end the need to build, or retrofit, huge, complex and expensive sewerage systems.

It is in China, the world’s biggest toilet market, that has most aggressively attacked this challenge, with the leadership driving coordinated action from the State Council through eight major ministries.

“The toilet revolution in China… integrates along the sanitation service chain environmental protection, disaster prevention, resource recovery and sustainable development,” says China’s Reinventing the Toilet Challenge website. No less than Premier Li Keqiang called for “innovation in the country’s patriotic health campaign.”

Most visible is the campaign being driven by the China National Tourism Administration (CNTA), arising out of the appalling experiences of tourists as they visit the country’s most iconic – and increasingly crowded – tourist destinations.

The plan is to build 71,000 hygienic public toilets by the end of 2017 – impressive until you are reminded that China has over 600,000 registered villages, and 57 million homes still without their own toilets.

Gates joked from the podium in Beijing that he never imagined that he would “know so much about poop”, and that his wife Melinda had to rein him in from getting too animated on the subject with friends over the dinner table.

Maybe Melinda is wrong. Methinks all of us should know more about poop, and how to handle it. The sooner we bring on new technologists to replace John Harington’s 400-year-old designs, the better.

David Dodwell researches and writes about global, regional and Hong Kong challenges from a Hong Kong point of view