by Tracey Olexa

Created on: March 31, 2010   Last Updated: April 01, 2010

Everyone’s experienced it, the discomfort, the regret for consuming something tainted, the urgency to find the nearest toilet.  Those of us among the fortunate 60%, deal with a bout of diarrhea privately perched upon a porcelain throne.  Once we have “taken care of business,” a simple flush puts the whole episode behind us.  Often unpleasant, but rarely fatal, our diarrhea is whisked away through a network of pipes and pumps, out of sight and out of mind.

But, imagine a place without porcelain, pipes or pumps.  Imagine if instead, you had to use an overflowing pit latrine or defecate openly for relief.  Imagine if your “business,” and everyone else's, was not whisked away but instead dotted school yards and flowed along market streets. 

This is a reality for the 40% of the world's population that lack access to sanitation (1).  This is a reality for the 4,500 who lose the daily battle to diarrhea.

Sanitation is paramount in improving public health. Waste containment and treatment have a direct, return-on-investment in terms of water safety.  Statistics abound to support that those with toilets fair far better than those without. Access to hygienic toilets reduces diarrheal deaths by approximately 30% (2). 

Annually, 5 million work days and 3.5 million school days are lost to inadequate sanitation in Madagascar (3).  And, financial estimates equate that $1 invested in sanitation will yield $9 in public health savings (4). 

When taking such statistics into account, the answer of what to do about the 4,500 that die daily is seemingly simple. We should build toilets and lay pipe.  Yet, this simple solution has, unfortunately, been tried and failed. 

Well intentioned aid groups from sewer-served nations have traveled far to provide the gift of sanitation.  Toilets have been installed and treatment facilities have been erected.  Yet, too often these facilities are in disrepair a short time later. 

Educated trades-people and capital are required to effectively operate and maintain sanitary facilities.  In the sewered world, when a toilet backs up, it is easily fixed with a call to the plumber and a signed check. 

If a manhole overflows, a local public works official can be relied upon to remedy the problem.  His service is guaranteed because his salary is covered by our monthly utility bills.  

Construction-centered solutions are doomed

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