As a side note, I am asking for guest posts! I would love any post on any sanitation-relevant topic. Go ahead and send your submission or pitch to me at jen [dot] anne [dot] barr [at] gmail [dot] com.
Back to the post!
The sitting toilet that those of us in the West have come to know has been around for centuries. The ancient Romans would sit on the toilet. And the design makes an intuitive sense, right? If you want to be comfortable, you sit in a chair. (Ostensibly, anyway. I hate chairs). You want to be comfortable while defecating, right? So sit in a chair.
But millions of people--in the Middle East, parts of Europe, and Asia--squat. Some people squat because they don't have a facility and thus are forced to go in a field or a water source, but millions of others choose to squat, with toilets that are especially designed for it. A growing movement in the US is advocating for replacing our standard chair toilets with squat toilets in the interests of health.
So which is better?
Daniel Lametti of Slate wrote an excellent article in 2010 on the squat vs. sit debate. He explains the how defecation works:
"People can control their defecation, to some extent, by contracting or releasing the anal sphincter. But that muscle can't maintain continence on its own. The body also relies on a bend between the rectum—where feces builds up—and the anus—where feces comes out. When we're standing up, the extent of this bend, called the anorectal angle, is about 90 degrees, which puts upward pressure on the rectum and keeps feces inside. In a squatting posture, the bend straightens out, like a kink ringed out of a garden hose, and defecation becomes easier."
In his excellent 1966 book, The Bathroom, Alexander Kira, an architect, recommends the squatting position. A variety of people--from the healthy living types to actual medical doctors--have recommended squatting as a matter of health, claiming you get more complete defecations that flush more toxins from the body or that it prevents colon cancers. As with most cancer claims, it hasn't been fully substantiated (cancer is far too complex in many cases, to associate with just one thing), but squatting has been shown to prevent hemorrhoids. It also simply takes less time. Lametti got his 10 minute routine down to a minute by squatting on the edge of the toilet. (The perching sounds terrifyingly precarious, to me.)
However, just because our "ancestors" did it, doesn't necessarily make it better. The human body is a pretty buggy thing. Selective pressures only act on a population if it affects reproduction somehow. Most of the health problems that people argue that squatting will prevent don't occur until post-reproduction--in other words, after the individual has probably already passed on their genes.
Knees are another good thing to consider. What would be the ease for the elderly? Our knees are not particularly well-designed--bipedalism did a number on us--so how would our knees hold up as get older for such a deep squat to a high rise? Actually, not as badly as you might think, if people did it for their whole lives. We would develop the muscles.
In India, the trains would often give you the option of a "Western toilet" or a squat toilet. "Western" toilets are becoming more popular amongst the middle class in India, perhaps as a status marker and a sign of "modernization." Squatting--since it is what our ancestors do--often can carry the stigma of primitiveness with it. It reminds us far too much of the very animal nature of defecation or it is seen as a "cultural practice." ("Culture" in far too many discussions, is used as sort of a trump card of backwardness.) Chairs, on the other hand, are supposedly very "civilized," and by sitting we coat our most 'primitive' activity with a veneer of civility. Also by sitting, we really can't see what is going on while we defecate, increasing our distance from the act. It may be our body doing it, but we don't want anything to do with it.
Personally, whenever I could, I much preferred the squat toilets. Why? While the chances of catching a disease from a toilet seat are relatively rare, there is the mental discomfort from the idea of knowing that a very private part of my body is touching the same thing that other people's bodies have touched. Toilet seats feel unclean, even if microbially it may not always hold true. Plus, in Indian trains, because of the movement of the train, it is very possible to miss, and so the fixtures often don't look very appealing. Squat toilets do not have any direct body-fixture contact. You just are suspended above the bowl--no need for wiping the seat or seat covers.
Various entrepreneurs have sought to bring the squat toilet to here the in the US, either through an addition to the regular toilet that allows you to use it like a squat one or a completely different fixture. My favorite is a toilet that converts, allowing one to choose what style of defecation one chooses to use. (Watch the video if you're confused.)
However, people are generally very resistant to any change in this most intimate part of our lives, especially in Western cultures. Changes are seen as a bizarre deviation or a joke. (Just think of all the jokes about Japanese 'supertoilets.') Squatting is what our ancestors did, but because of that, we have a great resistance to it.
What are your thoughts? Sit or squat?