International Affairs

The Toilet Papers

Can a high-tech sanitation appliance save lives in poor countries?

From the May 2014 magazine
Photography by Todd McLellan

We hear within us the perpetual call: There is the problem. Seek its solution.

—David Hilbert, presenting his twenty-three grand challenges to the International Congress of Mathematicians, Paris, 1900

One evening last November, I went to an upscale hotel in Manhattan’s SoHo neighbourhood to attend a German Scheisse party. The guests, most of them young, multinational, and professionally attired, milled around, awaiting a display of spectacular bad taste. They were not disappointed. Before long, an ebullient Singaporean man named Jack Sim ascended the stage and began delivering a barrage of puns. “Shit has arrived!” he declared. “You are the shit!” A guest wearing a baseball cap lettered with THE SHIT stood near me, feeling validated.

Sim, founder of the World Toilet Organization, no doubt felt the same way. A major milestone in his life’s work, the first official World Toilet Day at the United Nations, was winding down with this party, hosted by the German mission to the UN. A few hours earlier, he had spoken at the iconic UN headquarters uptown, as part of a panel on the progress of Millennium Development Goal 7.C, which concerns sanitation. Though he joked at the event about feeling like a father on his daughter’s wedding day, the overall tone was sombre. I heard one disheartening statistic after another, many repeated often.

Foremost was that approximately 2.5 billion people lack basic sanitation, meaning they have no access to secure and private facilities for the safe disposal of waste. Of those, an estimated 1.1 billion practise open defecation, shitting in fields, forests, and bodies of water, which in turn contaminates drinking water and food. The result, not surprisingly, is that some 800,000 children under the age of five die each year from diarrheal diseases. The panellists also discussed how lack of access to sanitation compounds other issues, such as poverty, violence against women, and poor school attendance, especially among girls.

Conversely, access to facilities that hygienically prevent human contact with excreta is known—among other health, economic, and social benefits—to reduce diarrhea morbidity by 37.5 percent, giving the international community a compelling incentive to focus on toilets. Yet, when 191 countries agreed at a 2000 UN summit to establish the Millennium Development Goals, a set of targets for the year 2015 in such areas as poverty, education, and disease, sanitation was initially left out. It took advocates two years to define the target, and even then the objective of halving the baseline figure of 2.7 billion people without improved sanitation has proven wildly optimistic. To date, the number has decreased by only 220 million, leaving the sanitation MDG among the furthest from being achieved. Panellist Csaba Kőrösi, Hungary’s permanent representative to the UN, noted that at the current pace it would take until 2075 to meet that objective. The magnitude of the challenge made Jack Sim’s puns (not to mention World Toilet Day’s commode costumes, toilet-shaped notebooks, and talking-point toilet paper) seem like rallying cries.

While there is agreement about the need to improve, there has also been debate about the best way of doing so. As comments from the floor began near the end of Sim’s panel, my ears perked up to hear a speaker introduce himself as Jason Kass, founder of the non-governmental organization Toilets for People. That morning, the New York Times had published an op-ed by him, in which he criticized one of the leading voices on sanitation in recent years, Bill Gates. In 2003, the Microsoft co-founder declared that the Bill & Melinda Gates Foundation would spend $200 million (US), later increased to $450 million, on a set of grand challenges for world health, in such domains as vaccines, diagnostics, nutrition, drugs, insect-borne diseases, and statistics. The idea was to fund innovative projects that might enable the international community to get past critical barriers that prevent health problems from being solved in the developing world. The program was expanded to include sanitation in 2011, with the launch of the Reinvent the Toilet Challenge.

It turned out to be a truly high-profile initiative, attracting teams from institutions in Canada, the Netherlands, Singapore, South Africa, Switzerland, the United States, and the United Kingdom. Each group was asked to design a toilet that could remove pathogens from waste while recovering such resources as energy, clean water, and fertilizer. The device would also have to operate without relying on infrastructure like electricity, sewage, and water; be viable for sale at an amortized cost of less than five cents per user per day; and promote sustainable, profitable sanitation services in poor communities. Perhaps most ambitiously, it would have to be of sufficient quality that even consumers in wealthy nations might want to use it. To meet these goals, participating engineers would have to combine the technical proficiency of their peers at NASA with the environmental sensitivity of a Greenpeace campaigner, the design sensibilities of a Milanese fashion house director, and the bottom-line ruthlessness of a Goldman Sachs VP.

“The trouble,” Kass wrote, “is that the Gates Foundation has treated the quest to find the proper solution as it would a cutting-edge project at Microsoft: lots of bells and whistles, sky-high budgets and engineers in elite institutions experimenting with the newest technologies, thousands of miles away from their clients.” The op-ed went on to argue that these ambitious parameters had only led to incredibly expensive toilets, which were more or less a waste of money, especially when compared with more modest solutions, such as the low-cost composting toilet developed in Haiti by an organization called SOIL.

Kass seemed to be criticizing the Gates grand challenge approach as arrogant, almost magical thinking that was doomed to fail and, worse yet, would in the process distract from solutions that could save lives. Yet it was inarguably drawing some of the best minds in North America and abroad—Rhodes Scholars, Ivy League Ph.D.s—and it seemed to have many people excited about even the most decidedly unsexy global health issues. Would it prove genuinely useful to solving them?

Given Kass’s feistiness in the Times, I was almost disappointed when he asked a polite technical question from the floor about building latrines in flooded areas. A Pakistani woman responded with equal decorum, the panel soon ended, and, in grand UN style, another began. The ensuing talk of statistics and the “post-MDG” world sounded pessimistic compared with the prospect of a miracle toilet, but the discussions ended on a high note, with the singing of a few lines from the musical An Inconvenient Poop. Then we all packed up our toilet paper and headed for the Singaporean mission, stop one on the shit party circuit.

It is by the solution of problems that the strength of the investigator is hardened.

Five days before Christmas, as the rest of the University of Toronto’s downtown campus shut down for the winter break, a team of engineers on the third floor of the Wallberg Building hurtled toward a deadline. Under the guidance of Yu-Ling Cheng, director of the Centre for Global Engineering, the group had just received the final parts for a toilet prototype Cheng had been working on since the Gates Foundation approached her to participate in the first round of Reinvent the Toilet.

“Toilet,” Cheng stressed, was a misnomer at this stage. “It doesn’t look like a toilet,” she said. She showed me to a small room near her office, where two young engineers fussed around a long auger connected to a series of plastic tanks, metal chambers, and pipes—one of two components for a waste processing system designed to underlie a typical squat toilet in South Asia (Cheng had conducted her field research in Bangladesh). The taller of the two engineers, a recent graduate named Ryan Wills, explained that this mechanism would filter liquids from solids, prepare the liquids for pasteurization, and mix the solids with sand for incineration.

As Wills stepped me through the process, Cheng described how the plant was meant to operate. She referred to it as a “sanitation appliance,” in part because its daily use cycle was more akin to how North Americans use dishwashers than how they use toilets. “The first-level user,” she said, “shouldn’t have to do anything more complicated than the analogue of us flushing the toilet.” Then, once the day’s waste had collected, a “second-level” user would be responsible, per the Gates parameters, for disposing of the liquids (potentially for fertilizer) and incinerating the solids. The incineration would take place inside a smouldering chamber, which the researchers were working on in a room down the hall.

This was their second crack at a model, following a proof-of-concept demonstration at a Reinvent the Toilet Fair in August 2012, in Seattle, where they earned third place for their efforts. First place was awarded to a solar toilet, conceived by a group from the California Institute of Technology, that generated hydrogen and electricity; second went to a device from Loughborough University, in the United Kingdom, that produced biological charcoal, minerals, and clean water. The most promising teams, including Cheng’s, then received additional funding for integrated prototypes, which would be displayed at the second Reinvent the Toilet Fair, in Delhi this past March. Beyond that, it remained uncertain whether they would receive further investment from Gates to continue on the path toward production and sale.

After peeking in on the smouldering chamber, which was not quite ready to be tested, Cheng asked me what I thought of what I had seen so far. I was struck, I replied, by the project’s scale. She wasn’t just attempting to reinvent the toilet, but to reinvent the entire infrastructure that surrounded it. I avoided bringing up the many issues she knew must be addressed before the prototype could be sold to a consumer in Bangladesh at a cost of five cents a day, let alone to a wealthy Westerner: Could it be made compact enough to fit in a small space? How could it be powered simply and cheaply? Could it be mass produced? Would poor people decide that its components were worth more to them as scrap? Who would repair it? Would someone remember to run it at the end of every day? What would it smell like? Each question seemed like a grand enough challenge on its own. Answering all of them with one device would constitute a massive coup, if she and her team could pull it off.

May the new century bring it gifted prophets and many zealous and enthusiastic disciples!

In its sizable ambitions for Reinvent the Toilet, the Gates Foundation—whose $40-billion endowment makes it the world’s second-largest private foundation, and by far the largest private donor focused on international development—follows a course Bill Gates laid out at the 2003 World Economic Forum in Davos, Switzerland. Inspired by the German mathematician David Hilbert’s creation in 1900 of twenty-three grand challenges in mathematics, Gates declared that his foundation would fund grand challenges for global health. Though open competitions with similar ambitions had been held, notably the Ansari X Prize for suborbital space flight, Gates’s adoption of Hilbert’s frame was new—an innovation to drive innovation.

The grand challenges were also of a piece with the independence afforded the Gates Foundation by its wealth, and its stated desire to take on risks that governments could not. The notion that it might invest in some approaches to world health with the full knowledge that they would fail represented a new kind of thinking, influenced by venture capitalism, that the cautious bureaucrats who plan and direct most traditional aid projects could only dream of. Gates’s program promised an apotheosis to slow, incremental improvement: money for blue-sky initiatives that bore a slim chance of success, but that might—just might—cure a disease or solve a problem in one fell swoop, and perhaps create whole economies in the process.

The grand challenges only became a movement of sorts, however, when countries began to get on board. In late February of 2008, Peter Singer, a former director at the University of Toronto Joint Centre for Bioethics and one of the scientists who participated in the selection of the original Gates challenges, received a call from someone in Canada’s finance department on budget day. “You’ll be interested in the minister’s speech,” the official said. For years, in op-eds and behind the scenes, Singer had argued for Canada to adopt the Gates Foundation’s model on a national scale. Now, he was told, Jim Flaherty would be introducing a $50-million Development Innovation Fund (later $225 million), designed to provide grants to researchers working to improve the lives of people in poor countries. This fund paved the way for a more radical change: the formation, by Singer, businessman Joseph Rotman, and Tanzanian-born doctor Abdallah Daar, of the non-profit Grand Challenges Canada, to distribute it. (Brazil and Israel have since followed with similar organizations, while the United States has created one under the aegis of its Agency for International Development.)

I had heard Singer described as a salesman extraordinaire, and when I left Cheng’s office to meet him at GCC headquarters, inside the MaRS Discovery District, he did not disappoint. After jumping up to greet me warmly at the door, dressed casually in a blazer and jeans, he guided me back to a conference table where he had surrounded himself with brochures, notes, and an open laptop. As I fussed with my recorder, he asked if he could tape our interview as well. “I get coaching,” he said, possibly not joking.

In the course of our conversation, he detailed GCC’s formation, its aims and ambitions, and how it furthers global development. Controlled and avuncular, he spoke at times in fully formed bullet points:

  • “Firstly, the grand challenges approach is not about innovation for its own sake. It’s about innovation with impact.
  • “Secondly, the grand challenges approach captures the public imagination in a way that a less focused approach to innovation would not.
  • “Thirdly, the grand challenges approach fundamentally is a governance platform for how different organizations in different countries can work together to solve common challenges.”

The phrase “innovation with impact,” which comes up often at GCC, makes for a great sound bite. In practice, it seems to mean finding researchers with good ideas, giving them money to develop or spread life-saving (or life-enhancing) services and products, and then, crucially, measuring the results in terms of lives saved or improved. Along the way, according to Singer’s next two bullets, GCC sought to draw public attention to development issues, and find international partners who were focused on similar problems.

Lacking Gates-scale funding, GCC’s aims have been more humble than wholesale reinventions of consumer products, and it has chosen fewer areas of focus than Gates has, singling out mental health, point-of-care diagnostics, hypertension, and early childhood development. To date, the organization has committed $135 million to more than 500 projects, emphasizing those that could have an immediate impact—bio-fortification, for example, which involves adding nutrients to staple foods. Among the other initiatives Singer mentioned was a simple swab test for diarrhea specimens that had helped identify a rotavirus epidemic in Botswana, and a program to introduce progressive Egyptian imams to Nigerian imams whose preaching threatened the health of women and children. (GCC departs from the Gates grand challenges by folding social innovation into the framework.)

GCC’s sanitation programs included a $100,000 grant to help SOIL—the organization Jason Kass cited in his op-ed criticizing the Gates Foundation’s challenge—bring its EcoSan toilets to scale in Haiti, with a first step of reducing their price point from $200 to $50. “It’s really about how they provide them to households,” Singer said. “They rent them to households, then they collect the effluent, turn it into fertilizer, and use the fertilizer to grow vegetables, which increases jobs and productivity.”

Job creation for GCC appeared to mean local job creation, a marvellous notion when set against the history of foreign aid. For decades, financial assistance was frequently, even primarily, deployed by Western governments as a domestic economic tool, with funds conditional on the recipient country’s purchase of the donor country’s goods or expertise. Between 1999 and 2001, the Organisation for Economic Co-operation and Development classified nearly 54 percent of foreign aid as “tied.” Since then, a number of Western countries (Canada included) have gradually halted the practice, while the vanguard of aid administrators tries to forge a new path. “The majority of our support goes to innovators in low- to middle-income countries,” Singer said. “People close to a problem understand the cultural issues—that this colour of bed net will work, or that colour of bed net reminds somebody of a death shroud.”

However, “in” those countries does not always mean the same thing as “from” those countries. For example, SOIL’s project lead, Sasha Kramer, is American, though she has lived in Haiti for the better part of a decade; and the rotavirus swab test implemented in Botswana, arguably GCC’s most significant early success, was the product of Western researchers. That team’s work was not quite what Kass referred to as “experimenting with the newest technologies, thousands of miles away from their clients,” but it nevertheless had ideological implications. Despite advances in tied aid and other areas, recent years have seen a growing reaction against Western-directed development efforts, from the likes of Dambisa Moyo, whose 2009 book, Dead Aid, argued that foreign aid had mainly harmed Africa. This criticism spawned responses such as the “give directly” movement, which argues that the most effective way to combat poverty is simply to hand over cash to poor people in poor countries. Set against these currents, the grand challenge pioneers would have to think hard about how to bridge cultural and geographical gaps, and to learn from the failures of the idealistic engineers and scientists who have gone before them.

The problem before us appears only as a single link in a chain of related problems.

When I returned to Cheng’s lab in the Wallberg Building, a faint smell of baking told me that the smouldering test had begun. Near the chamber in the corner room, Ryan Wills stood pouring peanut oil into a KitchenAid Artisan Series blender. I watched the beater whip through a small batch of synthetic feces, appreciating its textural approximation of the real thing. That morning, Zach Fishman, a mechanical engineer with a shaved head, had shown me a small plastic bag labelled “Gates Formulation,” which contained the same mixture of sand and faux poop each group would use for its demonstrations in Delhi. Now he showed me a different bag containing two large ersatz turds made of miso paste and sausage casings, the standard toilet industry surrogate, and explained to me in earnest how the U of T researchers had deviated from both the Gates and industry formulations, mixing the miso with cotton fibre, among other alterations, to concoct a particularly diarrheal blend.

The array of technical detail involved was staggering, and it would all have to come together in a fully integrated prototype for the impending Delhi fair. Though Cheng was devoting thought to the “user interface,” and had spent time in Bangladesh listening to people talk about their sanitation habits and what they might want from a new breed of toilet, the experience of people squatting down to do their business simply was not yet her focus; for now, there was not much more for the casual observer to see. The smouldering test ended, to the team’s approval, and I excused myself as they turned to discussing the battle plan for the coming weeks.

It was hard to square their zeal with the warnings about technology-centred development approaches that have emerged in the international community over the past few decades. Weeks before visiting Toronto, I met for coffee in Brooklyn with Parker Mitchell, who co-founded Engineers without Borders Canada in 2000, a year after graduating from the University of Waterloo. “When we started,” he told me, “everyone said, ‘Really, you’re going to get engineers to do international development? Engineers do math and drink beer. They’re not interested in this stuff.’ ” However, within a year the organization had attracted 2,000 members and a growing network of chapters, donors, and partners, so he quit his job to work there full time.

Engineers without Borders only took off after an early false start, he said. “We bought an $800 compilation of something called the Appropriate Technology Library. It was twenty-six discs. Rainwater harvesting, biogas digesters, all these things.” He initially planned to design similar products out of a lab at Waterloo. “Then I read Ian Smillie’s Mastering the Machine and went, ‘Oh, damn, this is not going to work.’ ”

In his seminal book, Smillie, a prominent Canadian development veteran and foreign aid critic, tells the story of the West’s failure to reduce the gap between rich and poor by technological means. During the colonial and early post-colonial eras, he writes, attempts by wealthy nations to bring technology to impoverished countries were often self-serving and ill suited to target populations, such that by the 1960s poor countries were increasingly littered with the husks of large-scale projects imposed on them by the West: expensive irrigation schemes that delivered water to small fractions of the areas promised, for example, or factories that depended on imported raw materials and foreign technicians.

He cites 1973 as a turning point, when the British economist E. F. Schumacher published Small Is Beautiful, a critique of global capitalism arguing that governments should concentrate instead on “intermediate” (or “appropriate”) technologies: small, locally controlled, context-sensitive applications, such as windmills or energy-efficient stoves. But by the turn of the century, even this movement had produced few sustainable solutions to worldwide poverty, in part because it had continued to focus on new inventions at the expense of dissemination. “Widespread diffusion of technologies that seemed genuinely relevant,” he writes, “proved far more difficult than had been imagined.”

With this in mind, Engineers without Borders refocused on local empowerment in host countries. The stalling of the appropriate technology movement coincided with a tech boom in the West, however, that was fuelled by the most powerful dissemination engine in the history of the planet, accompanied by enough breathless technological solutionism to fill a Taj Mahal–sized outhouse. Small surprise, given Gates’s position at the hub of the era, that his foundation was so excited by technology despite decades of failed promise. His outsize endowment led some to fear that this focus would take over the development agenda, while structural problems were left unaddressed. “A technical approach can cover up underlying power issues,” said Mitchell. Indeed, this January, Oxfam released a report pointing out that the world’s eighty-five richest people control more wealth than the world’s poorest 3.5 billion. Gates, whose estimated net worth of $76 billion (US) makes him the planet’s richest man, has acknowledged the injustice of systemic inequality, but he remains a target for those who believe the world’s poor would be better served by a solution that gives them more control over their toilets rather than one that depends on his discretion.

Despite his overwhelming success at disseminating Microsoft’s products and brand, the challenges of conjuring similar triumphs in impoverished countries with toilets and condoms, another Gates initiative, are different. Though cheap Chinese manufacturing has made it easier than ever before to bring an industrial product to scale, the engines of human behaviour remain notoriously difficult to control. “The more a technology needs to be consciously adopted and used by multiple individuals in a society,” said Mitchell, “the less likely a grand challenge approach is to work.”

Even given a brilliant technological success, the spread of a Reinvent the Toilet commode in a country such as Bangladesh would depend heavily on addressing deeply entrenched sanitation habits, and on appealing to basic human nature—in other words, on marketing. “Who sells toilets? ” he mused. “Not a lot of people do.”

[A] problem should be difficult in order to entice us, yet not completely inaccessible, lest it mock our efforts.

At an industrial park in Piscataway, New Jersey, Jim McHale, vice-president of research, development, and engineering for the plumbing fixture giant American Standard, flipped open his laptop and launched a video. Over a bubbly soundtrack of sitar and tabla, a rural Bangladeshi courtyard appeared onscreen. A boy ran up to an older woman in a peach-coloured sari and playfully plucked something from her hands. As he fled, a knock sounded at the courtyard gates. A young woman, the boy’s mother, opened the door to an attractive female doctor, and the two huddled conspiratorially to discuss the son, who had apparently been sick.

It looked like a friendly exchange, until the mother said something that caused the doctor to rise and place her hands on her hips. A drum sounded, the music paused, and the mother said something in Bengali that included the English word “toilet,” prompting the doctor to deliver a lecture to the extended family gathered in the courtyard. After she spoke the words “SaTo pan,” a 3-D graphic of a latrine pan came onscreen, with moving arrows to emphasize its non-stick plastic surface, its waste-removing water flow, and its hinged lid to prevent odours from escaping. Another graphic showed the pan in position next to a plastic washing pot and two squatting bricks inside a latrine hut, then the video cut back to the doctor surrounded by ten smiling Bangladeshis. “SaTo pan!” they chanted, and the advertisement ended.

I assumed that the moment of tension was precipitated by the mother confessing that the family had no household toilet. In fact, McHale corrected me, she was thanking the doctor for telling them about the pan, and the doctor was admonishing her for whispering. “Everybody must know about the SaTo,” she exclaimed. The spot aimed not just to sell the pan, in other words, but to de-stigmatize talk of the shit it would contain.

The ad’s production values were of Super Bowl quality. It had been designed by the SaTo pan’s manufacturer, RFL Plastics, a division of the Bangladeshi conglomerate PRAN-RFL Group. McHale recounted for me how, upon hearing about the Reinvent the Toilet initiative in 2012, he had contacted the Gates Foundation and secured a grant to develop a product that might help out in the short term. After conducting field studies in Bangladesh, he and his team returned to Piscataway and began implementing American Standard’s resources and expertise, modelling a latrine pan, and building prototypes using the same methods as they would to develop a toilet for the American market. Crucially, and in stark contrast to the Reinvent the Toilet prototypes, they wanted the pan to require as little change as possible in Bangladeshis’ toilet habits, and to take advantage of the country’s existing supply chain. “We’re making a product,” he said. “We have to design it right from the beginning, or it will be a flop.”

In the spring of 2013, RFL started selling SaTo pans for $1.65 each, and American Standard collects a royalty from each one. They sold 50,000 last year, and projected sales of up to 20,000 a month in 2014. (American Standard was also in the process of donating over half a million units via its Flush for Good campaign.) McHale ventured that they might soon be selling a million annually just in Bangladesh, to say nothing of the far larger Indian market next door. American Standard was also developing new products, such as a connector that could link a latrine to an exterior pit, a toilet stool for use in African markets, and a ceramic model of the SaTo. This last product promised modest health benefits, McHale told me, but that wasn’t necessarily the point. “Ceramic,” he said, “is very aspirational.”

His mention of consumer desire recalled for me the “sanitation ladder,” a concept used by some organizations to describe the process of moving people from open defecation to poor sanitation facilities, to shared ones, to improved ones, to full-blown systems with flush toilets like the ones in the West. Successive rungs on the ladder are typically depicted on charts in terms of their rising complexity and health benefits (or, for critics, their rising financial and environmental costs), but the ladder served equally well as a tool for asking how, exactly, to get people from one rung to the next. The question is not just economic: cultural behaviours around sanitation are extremely difficult to change, for such reasons as disgust, shame, and simple preference. To American Standard’s advantage, people at the lower end of the ladder in Bangladesh have been primed to begin climbing it in recent years, thanks to a radical approach known as community-led total sanitation. The brainchild of Indian agricultural scientist Kamal Kar, who developed it while consulting in a Bangladeshi village in 1999, CLTS involves drawing villagers’ attention, in explicit and often extreme ways, to the effects of open defecation, thereby capitalizing on their innate capacity for disgust.

I had heard about the program from Ashley Raeside, a medical student at U of T, who assisted with applications in Malawi for Engineers without Borders Canada and UNICEF. Local facilitators, she said, “would ask for some nshima [cornmeal], and they’d put it down in the grass beside a pile of shit, and flies would start going back and forth, and people would be like, ‘Oh no!’ ” Or there was the transect walk, in which people mapped the houses in their communities that had toilets, whose toilets were covered and whose weren’t, and who was shitting in the bush. “You saw more change in sixty days than in a five-year sanitation project that had been funded to the tune of blank,” she said. She shared Mitchell’s skepticism about the technological bent of Reinvent the Toilet, but noted that the Gates Foundation was in on the CLTS action as well, and had financed UNICEF’s sanitation marketing in Malawi. (GCC finances similar programs in Cambodia and Nigeria.)

I asked McHale whether he thought the Gates Foundation’s high-tech toilets would eventually pay off. “You have to have a portfolio of things you’re investing in,” he replied, “that are going to give short-term, mid-term, and long-term results.” Reinvent the Toilet might be blue-sky thinking, but in the SaTo pan it had already led to at least one success.

When we finished talking, I excused myself to use the facilities (which were as well appointed as you would expect) before joining Jim Reinhart, a senior product manager with American Standard, for a tour of its design and development facility. As we made our way through a wonderland of porcelain tanks and chrome fixtures, I asked how many varieties of toilets the company sells in North America. He replied that in the wholesale business he oversaw, “we have over 1,000 SKUs, when you include colours and everything else.”

When compared with the company’s single latrine pan for a single market in the developing world, this abundance seemed mildly galling. But a while later, opposite a $2,400 children’s bathtub shaped like a fire truck, we stopped at a timeline of American Standard’s history, and I suddenly came to see it as hopeful. The first heading read, “1870s: The Rise of Public Health,” roughly marking the establishment of New York’s first public health body and the widespread construction in the US of sewage and waste water treatment facilities, made possible by a booming postwar economy. In the 1870s, the average American life expectancy was just over forty, and its steep rise over the next fifty years is to some degree the story of improved access to sanitation. This also suggests what could develop in a poor country, out of a similar nexus of awareness, infrastructure, resources, and demand. Yu-Ling Cheng’s team hoped to find this nexus in Bangladesh. American Standard had just taken one step along the way.

Who of us would not be glad to lift the veil behind which the future lies hidden?

When I emailed Cheng in February for an update on her toilet prototype, she told me that they had shipped the model off to Delhi as scheduled. “It is a huge milestone to get to a fully integrated prototype,” she wrote, “but we already have many ideas for redesigns and improvements.” Her hope of continual refinement brought to mind a baseline number that Janice Gross Stein, director of U of T’s Munk School of Global Affairs, had suggested to me for grand challenge projects. “If the failure rate is not in the neighbourhood of 90 percent,” she said, “Reinvent the Toilet is not meeting its objectives, because it’s not taking adequate risk.” Put another way, if over 10 percent of the prototypes proved to be worth the investment to scale them up for the consumer market, it would mean the Gates Foundation had settled for modest, anodyne ideas rather than potentially transformative ones.

Of course, this butts up somewhat uncomfortably against GCC’s notion of innovation with impact. With the expectation of results, grand challenges start to look a lot like aid with a slight shift in emphasis. But by accepting risk, properly contextualized as a counterpart to the hard work of UN diplomacy, NGO programs, and corporate dissemination strategies, GCC could eventually help to solve some of the world’s most daunting challenges. And under the current government, at least, it might have the freedom to move in this direction; its free-market realism fits neatly within the ethos of a Conservative government that last year folded the Canadian International Development Agency into the newly minted Department of Foreign Affairs, Trade, and Development.

The Gates Foundation, for its part, is constantly making decisions about which toilets to continue investing in. Brian Arbogast, director of the organization’s water, sanitation, and hygiene program, told me that after the Delhi fair some prototypes would remain in India for field testing. When I asked him which ones, he was coy; his views on the U of T toilet could be read either way. “It’s not the closest to market,” he said, “but there’s a simplicity to the solution that is exciting. It could be broadly relevant.”

Cheng was able to appreciate a much bigger picture. “Even if nothing directly comes out of these first approaches,” she pointed out, “the profile that has been raised for the sanitation challenge has catalyzed other initiatives.” Then she told me about another, smaller project inspired by her fieldwork in Bangladesh. During her first visit, she spent time with a group of women, one of whom told her that she increasingly struggled to care for her elderly in-laws. Others agreed. (Although Bangladesh remains poor, its average life expectancy has risen from forty-seven years in 1972 to seventy today.) “As their in-laws get older and become unable to use squat toilets,” Cheng said, “it is their job to help them use the toilet or, worse, to clean up after them if they don’t make it to the toilet.”

She brought this feedback home to the Centre for Global Engineering and shared it with one of her classes, which turned around and designed a prop that elderly Bangladeshis could use to assist them in squatting and standing up afterward. Chances were slim that this device would make it to market, but it was an instance of concern directed toward others, conceived by a bunch of students who might otherwise have been drinking beer.

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  • Julian Dierkes

    I enjoyed this article for attempting to cover the complexities involved in such a seemingly simply issue as improved sanitation.
    As an academic with a particular interest in contemporary Mongolia, I was struck by these complexities when I was trying to comb through the Social Progress Index that has come to include Mongolia this year (http://www.socialprogressimperative.org/en/data/spi/countries/MNG).
    In the data that is included for the SPI, rates of access to piped water and to improved sanitation were explicitly identified as a weakness for Mongolia. While these rates seem obvious measures, the Mongolian context shows that they may not indicate “progress” as intended by the authors (see my blog notes on the SPI as it relates to Mongolia at http://blogs.ubc.ca/mongolia/2014/mongolia-2014-social-progress-index/). For the 30% or so of Mongolians who live as pastoral herders in a vast landscape, piped water and improved sanitation is, well, a pipe dream. The only way to bring such facilities to them would be to settle them more permanently which is unlikely to be perceived as progress in the Mongolian context.
    The broader implication – beyond the general point that a complex understanding is necessary for even simple-seeming challenges – is that the urgency of a need for improved sanitation and the social and engineering technologies needed to bring it to more people, may depend to some extent on population density.
    In the sparsely populated countryside of Mongolia, open defecation is less likely to be a health hazard. In the capital Ulaanbaatar’s “ger districts” (outward-spreading settlements of yurts with few facilities and very limited infrastructure) with their relatively high population density the urgency for improved sanitation may be much greater.