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In the early twenty-first century, when surgery can be done microscopically and human achievement seems limitless, 2.6 billion people lack the most basic thing that human dignity requires. Four in ten people in the world have no toilet. They must do their business instead on roadsides, in the bushes, wherever they can. Yet human feces in water supplies contribute to one in ten of the world’s communicable diseases. A child dies from diarrhoea – usually brought on by fecal-contaminated food or water – every 15 seconds.

Meanwhile, the western world luxuriates in flush toilets; in toilets that play music or can check blood pressure, where the flush is a thoughtless thing, and anything that can go down a sewer – nappies, motorbikes, goldfish – does. In these times, Japanese women routinely use a device called a Flush Princess to mask the sound of their bodily functions; while in China millions of people happily use public toilets with no doors. The Big Necessity – as one Mumbai toilet builder called the toilet – is the account of my travels through the profoundly intriguing but stupidly neglected world of the disposal of human waste, which houses characters like Jack Sim, founder of the World Toilet Organization; Wang Ming Ying, who is attempting to alleviate environmental devastation and deforestation in China by persuading rural Chinese to install biogas digesters, which produce cooking gas from human feces; Dr. Bindeshwar Pathak, whose NGO Sulabh has built half a million toilets in India, as well as the world’s only museum of toilets; and the flushers of London and New York’s sewers, who scoff at roaches but hate rats nearly as much as they hate congealed cooking fat and tri-ply toilet paper.

Human “waste” – it needn’t be – is full of nutrients. It is a rich, valuable, inexhaustible material, as rich as the world of people who work with it. The Big Necessity is an overdue exploration of a hidden world and of the world’s biggest unsolved public health crisis. It is a cultural, colourful travelogue around a fact of life that is common to everyone, as necessary as breathing, and a source of endless fascination, if only we dare to look.

The Big Necessity: Adventures in the World of Human Waste is published in the UK by Portobello Books. To order a copy, click here.

The Big Necessity: The Unmentionable World of Human Waste and Why it Matters is published in the US by Metropolitan Books. To order a copy, click here.

The Big Necessity is published in Dutch by Uitgeverij Artemis. For more information, click here. It is published in Italian by Bompiani; in Spanish by Turner Publicaciones S.L.; in Swedish (Schibsted Forlagene); Korean (Samtoh Publishing Company); Chinese Complex (Goodness Publishing House); Chinese Simple (Citic Publishing House); and Arabic (Kalima). More information about publication dates will be forthcoming.

Read reviews of the book here.