By Barbara J Penner, on 17 September 2013
This blog entry makes the case for why toilets are relevant to discussions of health, gender and urbanism, and argues that toilets are just as relevant to a so-called developed world city like London as they are to a developing world city like Nairobi.
I should start off by acknowledging that toilets are not nearly as invisible in public discourse as they were a decade ago. One reason for their new visibility is the United Nations’ Millennium Development Goals, which in the year 2002 set the target of halving the number of people without basic sanitation – currently estimated at 2.6 billion people – by 2015. This goal still looks very far away (indeed, this is supposedly the most off-track of all MDG targets) largely because sanitation has always been an unloved and underfunded cause in comparison to its sexier and cleaner companion: water. Nonetheless, the sanitation field has lately been energized by the arrival of important new champions from WaterAid to the Bill & Melinda Gates Foundation, who have seriously invested in their drive to Reinvent the Toilet.
The reason for the new interest in sanitation is obvious: every day, thousands of children under five continue to die due to faecally transmitted diseases, deaths that improved sanitation could do much to prevent (studies suggest that improved sanitation could create a 30% reduction in child mortality). Sanitation is also much more cost-effective than most other interventions, which is why toilets are often referred to by NGOs as ‘the cheapest medicine’ – every dollar invested is said to return $3 to $34 in terms of improved productivity. But apart from these arguments, other justifications are also emerging that emphasize the environmental and social benefits of sanitation. And study after study proves one thing: few social groups benefit more from improved sanitation than women.
There are many explanations for why clean, secure toilet facilities with running water help create safer and more equitable societies for women. Below are some of the main ones:
- clean safe toilets ensure better female health – not going to the bathroom can create medical problems like urinary tract infections, resulting in missed days at work and school
- clean safe toilets reduce female labour – it is usually women who carry water for household needs, including personal cleansing
- clean safe toilets limit exposure to sexual violence – when women, particularly in slum areas, travel long distances to find a toilet or defecate in the open (usually at night), they are vulnerable to assault and harassment
- safe clean school toilets greatly increase the chance of young women staying on in education after puberty and the onset of menstruation.
In other words, the provision of toilets positively contributes to female health, safety, and dignity in many ways. This recent realization has helped secure stronger support for toilets in international development circles – this year the UN finally officially recognized 19 November as World Toilet Day.
It fascinates me, however, that this discussion about the global sanitation crisis focuses almost exclusively on what is happening ‘out there’: in Southeast Asia, India, and Africa in particular. What about our own situation here in the Global North? Of course, we are blessed with (almost) universal sewerage coverage – most of us will never know the indignities of outdoor defecation. But this doesn’t mean that we can afford to be complacent about toilets, particularly if we’re women. Toilets are important for women here, for the same reasons they’re important for women in the developing world: the lack of clean, safe ‘away-from-home’ options negatively affects female health and mobility, especially at times when women are pregnant or menstruating. This does not seem to be a surprising or controversial fact to point out. Indeed, women’s organizations in London have been very vocal about this issue since at least the 1870s.
Yet, overall, our cultural views towards toilets in the UK might still be characterized as ambivalent — even schizophrenic. On the one hand, we clearly do value toilets on some level: Victorian London’s pioneering sewer system continues to be recognized as a source of great national pride and in our own homes, bathrooms are larger and more lavish than ever. Yet the trend toward private comfort contrasts sharply with the general condition of public facilities; 50 percent of UK public toilets have been closed since 1995. Many of those that remain have been privatized and charge fees – most loos in Westminster now cost 50p. It constantly surprises me that there is not more public awareness — or outrage — about developments, which so obviously degrade the quality of our street life.
This is ultimately why it is important that, sewers or no, we should not exempt cities in the Global North from current debates about sanitation. It is only by looking at sanitation cross-culturally that we may come to consider our own situation far more critically than we have done thus far. At the very least, surveying the sanitation field globally will remind us that it is incredibly short-sighted to take toilets for granted, as few public amenities do more to create healthy, livable, age-friendly, and equitable cities.
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- Maggie Black and Ben Fawcett, The Last Taboo: Opening the Door on the Global Sanitation Crisis (London, 2008)
- Rose George, The Big Necessity: Adventures in the World of Human Waste (London, 2008)
 United Nations University, Sanitation as a Key to Global Health: Voices from the Field (2010), p. 11. Available at: http://inweh.unu.edu/wp-content/uploads/2013/05/2010_Sanitation_PolicyBrief.pdf
 See, for instance, Amnesty International, “Risking rape to reach a toilet: Women’s experiences in the slums of Nairobi, Kenya” (7 July 2010). Available at: http://www.amnesty.org/en/library/info/AFR32/006/2010. This has also been emphasized in the Water Supply and Sanitation Collaborative Council’s dramatic postcard publicizing the problem. (See image above.)
 See Barbara Penner, ‘A World of Unmentionable Suffering: Women’s Public Conveniences in Victorian London,’ Journal of Design History xiv/1, (2001), pp. 35-52.