World Toilet Day 2024 is themed ‘Sanitation for Peace’ and the associated global campaign is ‘Toilets: a Place for Peace’, emphasising that toilets should be safe spaces accessible to everyone. This message aligns with the cultural significance of toilets across languages. For example, ‘restroom’ in English suggests a peaceful space, akin to the Persian “مستراح.” In East Asia, terms like 화장실 in Korean and 化粧室 in Japanese denote a space for makeup and beauty enhancement. 

Despite this significant cultural importance for toilets, the World Health Organization (WHO) reports that inadequate drinking water, sanitation, and hygiene access leads to approximately 1.4 million deaths annually. As of 2023, over 1.5 billion people still lack access to basic sanitation services [1]. Therefore, transforming the perception of toilets from dirty or unsafe spaces to peaceful and inviting areas is essential for ensuring that everyone has access to properly managed sanitation. This shift is crucial for achieving Sustainable Development Goal 6 (SDG6) and creating environments where people feel comfortable and secure. While it can be challenging to establish such facilities in certain locations, it is a necessary step toward universal sanitation access globally. 

Many individuals in low- and middle-income countries (LMICs) face significant difficulties with their sanitation systems and still do not have access to safe toilets. For instance, a photo taken in a densely populated urban area in the Gambia shows a dark and unsafe alley leading to a toilet. Additionally, during the rainy season, this alley often becomes flooded, making it difficult for individuals to reach the toilet. Approximately 419 million people, mostly living in remote or rural areas, were practising open defecation or other similarly precarious sanitation practices, as shown in a photo taken in a rural part of the Gambia [1]. These inadequate sanitation practices lead to public health and environmental issues and can pose risks of sexual exploitation, threatening women’s privacy and safety [2].  

Unsafe sanitation practices in the Gambian urban areas (left) and rural regions (right) [Both Photos by Shotaro Goto]. 

A typical sanitation system in Korea and Japan requires 4 to 6 litres of clean water for flushing sourced from water treatment plants. Once flushed, wastewater needs to be conveyed and treated adequately. Hashemi and Boudaghpour (2020) estimated that a septic tank sanitation system in Korea could cost around US$60,000 for a lifespan of 20 years [3]. Such requirements for adequate water, energy, and related infrastructure can make more conventional approaches to sanitation provision less accessible in LMIC settings. 

Given such realities, is it possible to make toilets peaceful and dignified places again for urban and rural populations worldwide, by combining ancient wisdom, modern aesthetics, and unconventional approaches? 

In Korea, from the Silla dynasty to the Joseon dynasty (57 BC–1897 AD), people recognised the potential for using excreta as fertiliser. Ancient Korean societies understood that urine and faeces could improve soil fertility if collected and stored separately. Farming tools called ojum-janggun (urine jar) and ddong-janggun (faeces jar) were used to facilitate this. Additionally, Korean temple toilets were designed to direct faeces into well-ventilated compost chambers, allowing for easy collection and use as fertiliser [4]. These toilets were referred to as “haewuso (해우소, 解憂所)”, which translates to “a place to resolve worries.” In Kenya, Haiti, and many other countries today, providers of container-based sanitation are adopting a similar philosophy that combines the dignity of basic service provision with principles of the circular economy [5]. 

Korean traditional farming tools for storing and recycling urine (left) and faeces (right) [4]. 

Aesthetic and hygienic aspects are essential for transforming toilets into peaceful spaces from cultural perspectives. In South Korea, the Manghyang Service Area, located in South Chungcheong Province, is recognised as the most beautiful public restroom in the country [6]. Likewise, Japan is known for maintaining high standards of cleanliness in both household and public toilets. Since 2020, some public toilets in Tokyo, like the one at Yoyogi Fukamachi Minipark, have been designed by renowned designers. These toilets are so visually appealing that they attract many visitors [7]. There are also successful alternatives to sanitation service provision for everyone, such as Brazilian ‘condominial sewerage’ systems [8, 9]. 

Public toilets located in the Manghyang Service Area of Korea (left) [6] and in Yoyogi Fukamachi Minipark of Japan (right) [Photo by Shotaro Goto]. 

We have approximately five years to achieve SDG6, which aims to transform toilets into safe and peaceful spaces that provide dignity and this essential basic service to everyone. To accomplish this, we need a sanitation revolution in LMICs. This can draw on successful practices from Japan, Korea, and other regions, and experiences from high-, middle-, and low-income settings, as appropriate. 

This transformation requires viewing sanitation as a service and understanding of the policy, institutional, and regulatory aspects associated with it. Furthermore, we must change our perception of human excreta, seeing it as a resource rather than waste. In other words, we need to shift the mindsets of those responsible for urban and rural sanitation [10]. We should learn from past sanitation practices while considering the fundamental elements of an ‘enabling environment’ and the importance of behaviour change. Embracing innovative approaches is essential to achieving peaceful and dignified toilets for all. 

References: 

[1] World Health Organization (WHO). (2024). Sanitation. https://www.who.int/news-room/fact-sheets/detail/sanitation [Accessed November 1, 2024] 

[2] Saleem, M., Burdett, T., & Heaslip, V. (2019). Health and social impacts of open defecation on women: a systematic review. BMC Public Health, 19, 158. 

[3] Hashemi, S., & Boudaghpour, S. (2020). Economic analysis and probability of benefit of implementing onsite septic tank and resource-oriented sanitation systems in Seoul, South Korea. Environmental Technology & Innovation, 18, 100762. 

[4] Han, M., & Hashemi, S. (2017). Sanitation revolution: From waste to resource. Desalination and Water Treatment, 91, 305-310. 

[5] Container Based Sanitation Alliance. (2024). Collective action for safe sanitation in low-income urban communities. https://cbsa.global/  [Accessed November 3, 2024] 

[6] Maeil Business Newspaper. (2024). Manghyang Rest Area toilets have been selected as the most beautiful public toilets in the country. https://www.mk.co.kr/en/society/11142802 [Accessed November 3, 2024] 

[7] Reuters. (2024). Tokyo’s public toilets are a unique tourist attraction for visitors. https://www.reuters.com/world/asia-pacific/flushed-with-pride-public-toilets-tourist-draw-tokyo-2024-04-05/ [Accessed November 3, 2024] 

[8] Mota, J., & Paiva, I. (2024). The Use of Appropriate Sanitation Technology in Low-Income and Informally Occupied Areas: A Case Study of EMBASA’s Experience With the Condominial Sewerage System in Salvador da Bahia, Brazil. In Oxford Research Encyclopedia of Global Public Health. 

[9] Rissoli, C. A., & Martins, M. M. F. (2024). A Case Study of Brasília and the Federal District: Community Participation and Sanitary and Environmental Education in Condominial Sewerage Systems at CAESB. In Oxford Research Encyclopedia of Global Public Health. 

[10] Gambrill, M., Gilsdorf, R. J., & Kotwal, N. (2020). Citywide inclusive sanitation—business as unusual: shifting the paradigm by shifting minds. Frontiers in Environmental Science, 7, 201.