Australian Doctor Australian Doctor 17th November 2017 | Seite 12

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Loowatt and ran a money-
raising campaign based
around turning “shit” into a
commodity. When in 2011
the Bill & Melinda Gates
Foundation issued the Rein-
vent the Toilet Challenge to
devise sustainable sanita-
tion technologies to handle
the number one (and, well,
the number two) of human-
kind’s basic necessities, the
requirements matched Gar-
diner’s waterless design. She
applied for the grant and
got it.
Men transport barrels full of waste to the
treatment site along mostly dirt roads.
The power of gas
The project she has run in
Antananarivo has killed two
birds with one stone — giv-
ing people a toilet, and con-
verting their waste to biogas,
generating enough electric-
ity to charge cellphones.
When that proof of concept
worked, Loowatt scaled up
to its current size — 100 toi-
lets serving about 800 cus-
tomers.
The Loowatt setup isn’t
free. Residents pay about
$20 as a deposit for a toilet
(which remains Loowatt’s
property) and about $5 a
month for service. For Mad-
agascar, where some families
exist on $1.70 a day, this
isn’t cheap. But Ms Rartja-
rasoaniony tells me she finds
it acceptable because main-
taining a latrine costs more.
“We have to empty it every
six months, and it is really
expensive,” she explains,
not to mention the unsightly
mess it creates. The manual
process is done by ‘informal
emptiers’ — usually men
who show up with buckets
to chug the goo into contain-
ers, dropping splotches of
repugnant gunk around the
yard for her egg-laying hens
to peck at.
In other countries this
task is also done by men. In
Ethiopia, they pour kero-
sene onto the waste to mask
the smell and drink heavily
before descending into the
pit to dull their senses. But
in India, it’s often women
of the lowest caste, the Dal-
its, who empty the pits —
by scooping the waste into
woven baskets, which they
carry away on their heads,
teaching their young daugh-
ters to do it too.
A history of toilets
A pile of shit begins to
endanger humans almost
immediately. Attracted to
the nutrients inside that pile
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Australian Doctor
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— phosphorous, nitrogen
and undigested proteins —
pathogens swarm in. Some
feed on it, others lay eggs.
When humans ceased
their nomadic lifestyles, set-
tling and beginning farm-
ing, they could no longer
walk away from their poo,
so they began to distance
themselves from it, by accu-
mulating it in pits, dumping
it into rivers or shovelling it
onto fields.
When people began to
move into cities, space
became scarce and waste
disposal got ugly. In medi-
eval Europe, people emptied
their chamber pots out the
window.
The first flush toilet that
used mechanical levers to
run the water was invented
in the 16th century by Eng-
lish writer and poet Sir John
Harington, who built one
in his home and another
one in the palace of Queen
Elizabeth. Later, in the mid-
dle of the 19th century, an
English plumber named
Thomas Crapper developed
that invention into a more
modern loo.
The industrial revolution
and urban development
locked the process of excre-
ment removal into pipes
and treatment plants, which
treated sewage to levels
that made it safe enough to
release back into the world.
That worked well for the
19th and 20th centuries,
but rather than truly solv-
ing the problem, it scaled
it to an industrial size. For
countries without this type
of large-scale infrastructure,
the sanitation problems
creates a huge health haz-
ard, whose toll on human
health is enormous. When
faecal matter makes it into
drinking water, it spreads
cholera, dysentery and even
polio, continuing the cycle
17 November 2017
of disease and poverty.
According to 2016 num-
bers from the WHO, about
842,000 people in low- and
middle-income countries die
every year from poor water,
sanitation and hygiene.
The US Centers for Dis-
ease Control and Preven-
tion have an even higher
estimate of children’s deaths
from diarrhoea — 2195
a day — more than HIV/
AIDS, malaria and measles
combined.
Rendered harmless
Back in Antananarivo, san-
itation worker Tojoniaina
Andriambololona tells me
as I enter an enclosure on
Loowatt’s waste-processing
site: “This area is consid-
ered contaminated, you
should wear a mask.”
The mask is a must. I
will be exposed to the fresh
poo collected this morning,
along with everything that’s
already germinating in it.
Nestling on a cliff over-
looking mud houses and
mango trees, the site occu-
pies around 400m 2 and
consists o