{"id":652557,"date":"2013-04-15T11:57:55","date_gmt":"2013-04-15T15:57:55","guid":{"rendered":"http:\/\/blog.ted.com\/?p=74773"},"modified":"2013-04-15T15:15:51","modified_gmt":"2013-04-15T19:15:51","slug":"talking-st-with-rose-george-a-qa-about-the-global-health-issue-no-one-wants-to-bring-up","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/652557","title":{"rendered":"Talking s**t with Rose George: A Q&A about the global health issue no one wants to bring up"},"content":{"rendered":"
\"At<\/p>\n

At TED2013, Rose George talks about a major global health problem\u2014the 2.5 billion people who live without toilets. Photo: James Duncan Davidson<\/p>\n<\/div>\n

A single gram of poop contains 50 diseases, one million bacteria, 1,000 parasites, 100 worm eggs and 10 million viruses, by journalist Rose George\u2019s tally. For people who have flushing toilets, this is something that they rarely have to think about. But for the 2.5 billion people in the world who have no toilet at all, feces is to blame for a devastating toll of disease.<\/p>\n

Consider these other numbers. Four thousand children die every day from diarrhea, a common symptom from exposure to many of those fecal microbes. That\u2019s more than die from HIV\/AIDS, tuberculosis and measles combined. Each year, $260 billion is lost because of lack of sanitation. Despite this, just 10 to 25 percent of related budgets focus on sanitation, compared to 75 to 90 percent for clean water. \"RoseRose George: Let's talk crap. Seriously.<\/span><\/a>Clean water is no help when it is continuously contaminated by poor sanitation.<\/p>\n

In today’s talk<\/a>, given at TED2013, George describes how she \u201cplunged into the world of sanitation, toilets, and poop,\u201d an odoriferous adventure that she chronicled in her 2009 book The Big Necessity: The Unmentionable World of Human Waste and Why It Matters<\/i><\/a>. If you\u2019re hankering for even more dirty talk, we spoke with George about people\u2019s reactions to her project, the surprisingly wide-ranging impact of sanitation and the future of poop.<\/p>\n

In your talk, you start off with a story about your own bathroom experience — the first time you thought, \u201cWait, where is this stuff going<\/i>?\u201d What happened after that? How does a reporter start researching poop?<\/b><\/p>\n

Well, there\u2019s a long story and a short story. I\u2019ll give you the short one. The first thing I did when I decided that I was going to dive into the world of poop was look at who was doing stuff in that world. The first I came across was the World Toilet Organization<\/a>. So one of the first things I did was to go to their annual show in Moscow. I ended up in a Russian winter near the Kremlin, and the WTO had its exhibit on one floor and, on the floor below, was a fur coat exhibition. There were more people in the fur coat exhibition.<\/p>\n

It\u2019s quite a select gathering of people. It\u2019s certainly changed over the past six years, but at that point, it was really quite a small field. That\u2019s where I started making my acquaintances and getting to know who was who and who was doing what. A few people I met in that couple of days ended up being written up in the book — like Joe Madiath<\/a> in Orissa, and Jack Sim<\/a>. This guy Scott Chapman, who I met in the caf\u00e9, looked really bored. We started having this conversation, and he said, \u201cWhy should I be interested in toilets?\u201d I started telling him what I had learned by that point — that 2.6 billion people don\u2019t have a toilet — and he looked really surprised. He became a really enormous toilet evangelist. So that was really quite fun to watch.<\/p>\n

That is where I started, and then I went to a couple of other WTO events. I just ended up sort of wandering around the world with people who I found were doing interesting things.<\/p>\n

What was it like pitching the topic of poop to editors and your agent? What was their reaction? Did they get it initially, or did it take some convincing?<\/b><\/p>\n

I have two main publishers. My first was the British publisher Portobello<\/a>. It was bit of a weird process because I went to them with another idea for a book, about Darfur. For various reasons nobody wanted it, and the publisher there, we were sitting in his little office and he said, \u201cRose, I don\u2019t want that book but I do want you.\u201d I can\u2019t remember the exact list [I pitched him] but toilets was about number three. His face was not that impressed. And he said, \u201cUm yeah, well, what do you mean?\u201d So I started on my 2.6 billion, and Sulabh International<\/a>, and untouchables in India who have to clean toilets with their bare hands in this day and age. And I do remember that he actually got up out of his chair with excitement, and from then on was fully behind it.<\/p>\n

Then on the back of that book deal was a four-part series<\/a> for Slate<\/i> on the world of sewage. I went down to the sewers in London and looked at a campaigning group in London called RATS, Rowers Against Thames Sewage<\/a>, and I went to Sewage School and hung out with kids learning to make sewage soup and how to clean sewage. And it was great — really good fun. Subsequently, I ended up getting a publishing contract with Metropolitan Books<\/a>, and they were absolutely behind it from the beginning. There was never any question — which is weird. There is certainly a perception that Americans are more prudish about this kind of stuff, but that absolutely has not been the case. Americans have been much more enthusiastic about this book all the way through, and I\u2019ve done far more American radio interviews, far more American publicity, and I still get emails from Americans and Canadians. So that\u2019s been quite a revelation for me.<\/p>\n

Why do you think this topic is so taboo in general? Obviously there are various reactions depending on where you are, but why in general do you think this is something we don\u2019t talk about enough?<\/b><\/p>\n

I actually don\u2019t think it\u2019s true that it is taboo — I just think there\u2019s no avenue for discussion about it. It\u2019s been my experience that people are very happy to talk about it. When I was doing the research, which was a two-year process, honestly only about two or three people changed the subject. And I was asked all the time what I was working on, and I\u2019d always say \u2018toilets\u2019 or \u2018public health\u2019 or \u2018sanitation.\u2019 Invariably, people would pause just to take that in. Then they would go, \u201cOh, well I\u2019ve got a great toilet story!\u201d The thing is, we do or think about this stuff every day. Every parent with a toddler has to think about it when they change a nappy or diaper. Everyone who has to find a decent toilet in a shopping mall has to think about it. Everybody has to think about it because they spend a lot of time in the toilet.<\/p>\n

I think there are two areas where poop still is taboo. I think it\u2019s been taboo in advertising on TV. The toilet industry and the toilet paper industry have felt unable to be frank about their product, but I think that is changing quite a lot. In the last few years, there have been lots of plain-speaking toilet paper ads that I\u2019ve seen in the US and in the UK as well. But the more important place where I do think it is very taboo still is in the corridors of power, and in the people who fund sanitation as a development issue. Certainly when I started, it was considered for some reason unspeakable. Politicians don\u2019t think it is a vote-getter because they don\u2019t hear people demanding toilets — whereas they do demand clean water. The other thing is that it sort of gets kicked around between various ministries. Because sanitation has so many effects across all aspects of development — it affects education, it affects health, it affects maternal mortality and infant mortality, it affects labor — it\u2019s all these things, so it becomes a political football. Nobody has full responsibility. There\u2019s no Minister of Sanitation. There doesn\u2019t necessarily need to be one, but the responsibility for it in a political environment gets shared around and doesn\u2019t really get the attention it deserves.<\/p>\n

I think that\u2019s changed now because sanitation has become a human right, so governments are going to be obliged to take it seriously. I think that\u2019s a wonderful change. I think the taboo is breaking all over the place, so it is quite exciting.<\/p>\n

You mentioned all the different areas that poop and sanitation actually touch. In your talk, you also mention education and economics. At what point in your research did you realize that your topic had such wide impact? Was it a gradual process, or was it something you had a hunch about early on?<\/b><\/p>\n

It was definitely a learning process. I mean, everybody is an expert on poop, really, but I started out not knowing how to make the connection. Because none of it is rocket science. If you have a girl who doesn\u2019t have a toilet at school, she is not going to want to go to school when she\u2019s got her period. It\u2019s pretty straightforward. But I just didn\u2019t make the connection. Only along the way, it was talking to people like Joe Madiath or the Water Supply and Sanitation Collaborative Council<\/a>, the UN advocacy agency that deals with sanitation — people who were in the field. The other thing was there wasn\u2019t much connection between people working in sanitation. There\u2019s all sorts of divisions in development — in water, and health, and education and sanitation — so you kind of have to learn from all sorts of people.<\/p>\n

But the economics, that was actually specifically a guy called Guy Hutton<\/a> who\u2019s been really, really excellent at putting together the economic argument. And again it makes sense. If people can\u2019t work, obviously there\u2019s going to be an economic impact. But I would have never linked that to the toilet.<\/p>\n

When you started your research, did you have a hunch that toilets would have such a serious impact on human health?<\/b><\/p>\n

I had no idea that people — that children — were dying of diarrhea at the rate that they do. That was a real shock \u2013 in fact, I still find that shocking. It\u2019s completely shameful because it is so preventable.<\/p>\n

Another thing I found really striking were the unexpected health aspects. For example, malnutrition: Children who are malnourished, you can find them in a well-fed family. Relatively recently, people have figured out, it sometimes is because they have diarrhea. So no matter how many high-protein foods the child is given, it goes straight through them. There\u2019s now been research that links sanitation to stunted growth. That\u2019s pretty new to me. And vaccinations. When my book came out, someone wrote to me who is a vaccinator. And he wrote, \u201cYou know, people just don\u2019t realize that sometimes because these kids are malnourished and because they have diarrhea, we have to give them six or ten times the amount of vaccine to take it in. People don\u2019t know the connection.\u201d They don\u2019t link sanitation to all these things. I find that really fascinating.<\/p>\n

On a lighter note, what was the silliest thing you learned about toilets or poop? Were there any crazy gold-plated toilets, or crazy advanced Japanese toilets?<\/b><\/p>\n

Oh yeah. I used to work at Colors<\/i><\/a> <\/i>magazine as a writer and researcher, before I started writing the book, and someone had a bit of an obsession with toilets. We used to regularly feature the latest gold-plated toilet, usually from somewhere in Asia. And then there is of course a senator in South Korea who built a toilet-shaped museum, or a toilet-roll-shaped museum, I think. There\u2019s all kinds of stuff. And I think it is important to have the funny humor stuff, because that is what disarms people and makes it easier to talk about.<\/p>\n

People like Sulabh International<\/a>, a fantastic Indian NGO that has built toilets all over India, they know that, so they set up the International Museum of Toilets<\/a>, which is in a compound near the international airport in Delhi. And it\u2019s great. It\u2019s just one room, but it\u2019s got replicas of toilets and it\u2019s pretty humorous. They have a copy of a French commode in the shape of books.<\/p>\n

Wacky is fine — I knew I had to have some humor in it. Sulabh really helped, and Japan helped as well. But I always was careful and determined not to write a book of toilet humor. Other people have done that, and that\u2019s fine, but it is a serious subject. It was quite tricky doing that balancing act.<\/p>\n

Yeah. I\u2019ve been to Japan and I was amazed about the toilets and the technology they have.<\/b><\/p>\n

Once you use a Japanese toilet, you\u2019re spoiled.<\/p>\n

Are there any sanitation initiatives that you think are doing a particularly good job acknowledging this poop problem and trying to address it? I\u2019m thinking in particular of the <\/b>Gates Foundation\u2019s Toilet Challenge<\/b><\/a>.<\/b><\/p>\n

Over the last two or three years it\u2019s been really exciting because a lot has changed. I think the Gates Foundation should absolutely be applauded, because I think they\u2019ve been really instrumental in that. As soon as Bill and Melinda Gates started talking about toilets — and they openly use the word \u2018toilet\u2019 — that gave the subject huge legitimacy that it didn\u2019t have before. I think that\u2019s broken the ice for NGOs that were maybe a little shy about talking about toilets. They disguised it as water-related illnesses, or as \u2018people need water.\u2019 And they do. But what\u2019s the dirtiness in the water? It\u2019s usually poop. I think that\u2019s been an opening of the floodgates a little bit.<\/p>\n