Quotes of the Day

Save the poop jokes, because Rose George has heard them all. When the London-based journalist decided to write a book on human waste, toilets and the world sanitation crisis, she knew that she'd be the butt of a few jokes around the pub. What she didn't realize — at least not fully — was just how important her subject was. George's new book The Big Necessity: The Unmentionable World of Human Waste and Why It Matters delves into the taboo subject of bowel evacuation, with tact, sensitivity — and the right amount of style. Reporting on the sewers of London and the slums of New Delhi and the high-tech toilets of Tokyo, George comes to understand that sanitation is no laughing matter — it's the difference between life and death. "I thought a toilet was my right," writes George in the book's introduction. "It was a privilege." (Listen to George talk about the global sanitation crisis in this week's Greencast.)

Toilets are a privilege that nearly half the world lacks. At least 2.6 billion people around the planet have no access to a toilet — and that doesn't just mean that they don't have a nice, heated indoor bathroom. It means they have nothing — not a public toilet, not an outhouse, not even a bucket. They defecate in public, contaminating food and drinking water, and the disease toll due to unsanitized human waste is staggering. George notes that 80% of the world's illnesses are caused by fecal matter: A single gram of feces can contain 10 million viruses, 1 million bacteria, 1,000 parasitic cysts and 100 worm eggs. According to the estimates of one sanitation specialist George cites, each of the 2.6 billion people who live without sanitation may ingest up to 10 grams of fecal matter a day. The consequence is often diarrhea, which is a mere irritation in the West, but in the developing world a lethal condition that kills 2.2 million people a year — more than AIDS, tuberculosis or malaria. And it's all for lack of a toilet, which may be why George isn't one for toilet jokes. "I don't think 2.6 billion people without a toilet is very funny," she writes.

But despite the horrific fate of the toiletless masses across much of South America, Africa and Asia, sanitation has never been high on the world's development agenda. NGOs and governments focus on making sure the poor have access to enough clean drinking water, but comparatively little funding goes into sanitation, even though the two are sometimes inextricable: Untreated sewage often ends up poisoning the available clean water in developing nations. In The Big Necessity, George makes a passionate argument for putting sanitation at the top of the global development agenda, profiling the efforts of redoubtable activists fighting a war for toilets.

One of them — the practical world leader of sanitation advocacy — is Jack Sim, the irrepressible founder of the World Toilet Organization, otherwise known as the other WTO. Sim, a retired Singaporean entrepreneur, built the WTO from a group of one — himself — to a sprawling network of 151 organizations in 53 countries. Among his innovations is World Toilet Day, this Nov. 19, which is meant to publicize the plight of billions of people who go without toilets and fight the taboo that nearly all cultures have about business in the bathroom. That quiet embarrassment — similar to the hush around sexual practices that once muffled AIDS activism — keeps sanitation out of the world's top health priorities, and ensures that even those who go without toilets suffer in silence. Sim, his fellow activists and George are determined to make their voices heard.

In The Big Necessity, George introduces the reader to a fascinating and enlightening universe. In India, Bindeshwar Pathak, an ordinary idealist, invents a basic and cheap latrine, and proves that even the most destitute Indians will pay for a clean toilet. In China, George meets Wang Ming Ying, a tiny woman from the rural province of Shaanxi who promotes the use of biogas — energy created from the fermentation of human waste — which can be used for electricity and cooking fires, and helps slow the deforestation ravaging her country. In Japan, George recounts the history of Toto, maker of the world's most advanced toilets, which can do everything including check your blood pressure — and wonders why they never caught on in the West.

But what lingers after you finish reading The Big Necessity is characters like Champaben, an outcast woman from the untouchable Dalit caste in India whose job is to clean the country's dry, filthy latrines. She regularly contracts dysentery, giardiasis and brain fever from her exposure to human waste. No one deserves that fate, and as George makes clear, the very least we can do for every person on this planet is to give them a place to go.

See TIME's special report on the environment.

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• Bryan Walsh
• At least 2.6 billion people around the planet have no access to a toilet — and it is a critical, underserved need.