In a recent TED Talk, “Let's talk crap. Seriously.”, UK-based journalist Rose George discussed the significance of sanitation and the lack of access to toilets as a root for larger public health problems around the world. As Rose shared stories about her time abroad, she reflected on the toilet being such an inventive and wonderful disposal device that it can easily be as “locked out of conversation” as it is “locked behind a door”.

While the toilet can be taken for granted to those who have access to it, they play a dynamic role in preventing illness and disease in many developing countries. The lack of appropriate spaces and systems for people to use the restroom in regions creates hazardous environments for entire communities. For instance, diseases such as schistosomiasis and intestinal worm infections are easily spread in communities that don’t have access to toilets or sanitation facilities. Pneumonia and diarrhea alone are responsible for nearly one-third deaths in children under the age of five. Typhoid and rotavirus are important vaccine-preventable diseases related to poor sanitation practices. Many of these diseases infect people by contaminating water sources or by touching skin. Children become especially vulnerable to becoming infected with these diseases since they often play outside barefoot and put their hands in their mouths without washing them.

Here’s a look into some of the diseases that are prevented by proper access to sanitation facilities:

Schistosomiasis: inhabited by snails carrying the parasite and transmitted by contact with contaminated fresh water. Intestinal schistosomiasis can cause abdominal bleeding, enlargement of the liver, lungs and spleen and blood diarrhea and urine. After malaria, schistosomiasis is causes the most deaths as a parasitic disease. According to the World Health Organization, sanitation alone can reduce schistosomiasis by as much as 77 percent.

Hookworm: a parasite found in human feces and is transmitted to humans from contaminated soil through skin (usually due to walking barefoot). Prolonged exposure to hookworm can cause serious health consequences including malnutrition, anemia, bloody diarrhea and physical growth retardation, particularly in children.

 Rotavirus: the leading cause of severe childhood diarrhea in both developed and developing countries, results in over half a million deaths each year. Another two million children are severely sickened and hospitalized by the disease. Rotavirus is the most common cause of diarrheal hospitalizations and deaths among children worldwide.

Typhoid: severe bacterial infection spread through water or food contaminated with human waste. The disease causes high fever, flu-like symptoms, abdominal pain, constipation or diarrhea, rose-colored spots on the chest, and systemic illness that can result in severe morbidity or death.

While programs working to improve water, sanitation and hygiene (WASH) are further being implemented, Rose emphasized the role of toilets by recognizing it as the “best medical advance[ment] in the last 200 years”, as illustrated by the readers of the British Medical Journal.

To view Rose George’s talk, visit: