Wednesday, October 31, 2012

Sit or squat?

Hello everyone! It's been a while since I've posted, but I've been slammed with school. I'm so amazed, though, at how popular this blog has gotten! Thank you all who've read or shared!
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?

Sunday, October 14, 2012

Happy global handwashing day!

October 15th is Global Handwashing Day. (Check out the link.)

Handwashing is one of the most important hygiene steps that can be done to prevent fecal-oral transmission of diseases. Global Handwashing Day is to help promote this practice around the world.

Check out the CDC webpage on handwashing and handwashing promotional materials.

Mayo Clinic has some do's and don'ts of handwashing.

And enjoy this animation, winner of the 2009 Golden Poo Award--it's pretty adorable.


Saturday, October 13, 2012

Code Red! An app for that time of the month and adjusting to patriarchy in the public toilet

"Desperately seeking a tampon? There's an app for that," reads the headline on CommonHealth, the Boston NPR affiliate's health blog.

As the article says of the Harvard students who came up with this idea, "They came up with a simple prototype: a mobile app that would allow women in need to send out a “red alert” that would ping other nearby users who could rush over and delivery a tampon or sanitary pad or share information on where the nearest working tampon vending machine might be."


Menstrual waste management is one of the most taboo subjects in public health--even more than shit and sanitation. While there is an increased acknowledgement of the need for toilets, there has been no increase in discussions on menstrual waste management. Since it's all interconnected, I have no compunctions about addressing it on this blog.

Poor menstrual management can lead to infections, toxic shock syndrome, discomfort, and a series of social embarrassment. Discussions about menstruation in American society are silenced: men don't want to hear it. Even talking about menstrual issues with other women can be embarrass.

Why are women's bodies seen as abnormal? Women are the ones who are asked to adjust to 'the way things are.' Another example of this is the number of female urinary directors (more or less funnels that let women pee like men) and uneven toilet ratios that cause long lines for women. There are those who say women just need to go faster or need to deal with it or need to remember to carry supplies, but why are women's bodies seen as the abnormal, as the exception? Imagine, if you will, what it would be like if restroom facilities were based on women's bodies and needs. There would be more toilets, more safe design, more mirrors. And there would always be menstrual supplies available, and even perhaps wipes to help clean up menstrual waste in the restroom.

Before you say that that's too much, what if these were the normal supplies in a restroom, the standard set, just as toilet paper and soap are? Toilet paper and soap are the primary needs of men in restrooms; women require more. Public restrooms initially came up as only for men; that assumption has never been changed in the architecture and design of restrooms.

Every woman has, at one point or another, not had the right supply when they need it. It is difficult to deal without it: not using anything can cause an embarassing marking on one's clothes and fashioning a substitute from toilet paper can be problematic because not only does it leak quickly but it can shift. While some places have vending machines, they frequently don't work. So I think this app might be a fun idea, but the fact that there is a need for it--that somehow women are expected to use community ties to adjust to an architecture and system that is designed around men's bodies--is evidence of the quiet influence of patriarchy in modern lives.

Wednesday, October 3, 2012

2012 bill in India seeks to address manual scavenging

Manual scavenging, or the human disposal of human feces, is a common problem in many developing countries. Manual scavengers face an onslaught of health problems from close contact with human waste and the social oppression and stigma. No where is this more codified though than in India, where manual scavengers are the lowest of the "Untouchable" castes (or, as activists will refer to themselves, "Dalit," or "the oppressed").


The Hindu, India's largest newspaper, features an article by Agrima Bhasin, an alumnus from University of Oxford and an independent researcher in Delhi. In his article, Bhasin discusses a new 2012 bill to more aggressively fight manual scavenging, comparing it to a 2011 bill.

Something to address manual scavenging is necessary. In spite of the fact that a 1993 law banned manual scavenging, an estimated 1.3 million Dalits in India still make their living through manual scavenging in some form: emptying dry or pit latrines by hand, emptying septic tanks, working in the sewer system, or cleaning human waste from railroad tracks. The new law would heighten the severity of the punishment for the employment of manual scavengers.

The new bill, though, as Bhasin points out, is inadequate when it comes to allowing manual scavengers to improve their lives: taking away their occupation is less positive thing when social stigma does not allow them to gain more meaningful and less degrading work elsewhere.

If you're interested, definitely read the whole article.