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Most readers of this article will be able to “flush and forget” their bodily waste, conveniently and hygienically, at any time, almost wherever they are. However, this is far from the case for a huge proportion of the global population. About one in every three of us do not have access to an effective toilet— one that satisfactorily separates us and everybody else from our potentially disease-carrying feces—within or near our home, our workplace, or our school. This lack of access has dire impacts on lives and livelihoods. Data from the United Nations Children’s Fund and the World Health Organization (2015), which have been monitoring worldwide water supplies and sanitation, show that, in 2015, 32 percent of the global population—2.34 billion people—did not have access to an “improved” toilet. The data also indicate that 950 million women, men, and children do not even have use of a dirty, unsafe latrine; they are obliged to resort to open defecation, on beaches, on riverbanks, on railway lines, in the fields or forests, or using plastic bags, which are then disposed of at random. Of the world’s open defecators, 560 million live in India. The proportion of people with access to an adequate toilet is reported to be much greater in towns and cities of the world than in rural villages. However, the forty-eight countries classified as “least developed” by the United Nations had only an average of 47 percent toilet coverage in their towns and cities in 2015. Urban population growth is currently very rapid and likely to remain so, particularly compared with slowing growth in rural

Shit in Developing Cities: A World of Ill Health, Indignity, Violence, and Death