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Reinventing the toilet, Bill Gates way

Published Apr 25, 2012 05:50pm


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-Photo by Uzair A. Khan

The abysmal state of sanitation stinks to high heaven in Pakistan. The economic losses resulting from poor water supply and sanitation in Pakistan equal $6 billion. Alarmed by the under spending on basic disease prevention in Pakistan, Rachid Benmessaoud of the World Bank noted that the “total amount of the losses caused by poor sanitation in Pakistan is 7 times higher than the national health budget.”

Realising that millions of lives are lost each year due to poor sanitation, water supply, and hygiene, The Bill & Melinda Gates Foundation has decided to challenge engineers and innovators to redesign the toilet to offer safe sanitation to billions who are forced to relieve themselves in open.

According to recent estimates more than 2.5 million lives could be saved globally if sanitation facilities were improved for the underserved populations. Because of inadequate sanitation facilities and lack of access to potable water, millions perish, whereas millions more fall ill and are crushed under the burden of disease. Despite recent progress, Pakistan continues to fall short of meeting the minimum global standards in water, sanitation, and hygiene (WASH). The economic losses resulting from inadequate sanitation in Pakistan are almost 4 per cent of the GDP. In Nigeria, economic losses due to sanitation, counted as healthcare costs and premature deaths, equal 1.3 per cent of its GDP. Put together, Asian and African countries are estimated to lose 6 per cent of their GDP to health concerns resulting from inadequate sanitation and water supply.

The Millennium Development Goals (MDG) has set out to reduce by half the proportion of people without access to safe drinking water by 2015. The sanitation-focused MDG has not been met. Water Aid, a UK based not-for-profit agency, reports that approximately 400,000 additional children’s lives could be saved if the 57 countries that have fallen behind in meeting the sanitation MDG by 2015 would strive to meet the MDG targets by 2015.

The return on investment (RoI) in water supply and sanitation projects is huge for the community and the economy. A study by the World Health Organisation revealed that every dollar invested in WASH returns on average $8 in economic benefits. Try estimating the RoI for holding on to Pakistan’s nuclear arsenal and conventional weapons that have consumed billions of dollars while millions of Pakistanis have no choice but to defecate in open.

I often wonder what kind of misguided priorities would result in a scenario where a nation can engineer sophisticated weapons but cannot provide potable water and decent sanitation facilities to one-half of its population. Pakistan is in fact not alone in this conundrum: India, with a much larger economy, faces similar stark contrasts.

An Indian colleague, Professor Dinesh Mohan, explains how scarce funds were misspent in the subcontinent, which has left the people without toilets and the armies flush with cash. According to Professor Mohan there are two types of sciences: the Brahmin science and the Shudra science. The Brahmin science is occupied with the cosmos and the celestial. Whereas, the Shudra science is concerned with sanitation, water supply, and food. Professor Mohan laments the fact that the scientists in the subcontinent overwhelmingly pursued the Brahmin science, which delivered missiles, satellites, and nuclear bombs. Whereas had they pursued the Shudra science, the people of subcontinent could at least have focused on achieving the absolute minimum standards of sanitation decency.

And while the educated elite in Pakistan pursued nuclear science and missile technology, the task of providing affordable and safe water supply and sanitation was left to the disenfranchised masses who have been motivated, over the years, by the teachings of Dr. Akhtar Hameed Khan, the ultimate development professional, and his intellectual protégées, such as Hafeez Arain and Nazir Ahmed Wattoo. From Orangi Pilot Project in Karachi to Hassanpura in Faisalabad, the successful, community-built water supply and sanitation projects are evident of the fact that the road to economic and social salvation in Pakistan will be paved by the masses and the state will only have a tangential role in the impending reforms in Pakistan.

Hasanpura, Faisalabad, is a shining example of a community-led water supply and sanitation scheme. Motivated by Anjuman Samaji Behbood, a Faisalabad-based NGO led by Nazir Ahmad Wattoo, the community self-financed and constructed sanitation facilities at a fraction of the cost the municipal authorities had estimated for the project. Irteza Haider, a development professional working for the National Rural Support Program, reviewed Hasanpura scheme for Water Aid and wrote the following in his report:

“Since 1996, the community led sanitation project has led to the dramatic transformation of Hasanpura. That the streets, once filled with sewage and refuse, have been transformed into clean, safe environments where healthy children play and seniors relax is testimony to the success of improved sanitation in Hasanpura. The burden of disease has been reduced considerably; children are clean, healthy and happy. Parents are delighted that they do not have to pay huge medical bills or see their children suffer in pain.”

Source: Haider, Irteza (2008). Development of community- based sanitation infrastructure in Hasanpura, Faisalabad. Water Aid, UK.

The Bill & Melinda Gates Foundation is soliciting interests in developing new toilet designs that could be introduced in remote parts of the world inhabited by the very poor who lack access to running water or sewerage pipes. Successful applicants will receive funding to design, prototype, and test “entirely stand alone, self-contained, practical sanitation modules which intake bodily wastes and swiftly dispose of them without any incoming water piping, outgoing sewer piping or electric or gas utilities.” If interested, submit your letter of intent by May 10, 2012.

When it comes to public health, Pakistan indeed has a choice. Its establishment can continue ignoring the dire needs of millions of poor and force them into misery and disease, or it can invest in sanitation to meet the MDG for 2015. Should it choose to invest in sanitation and not bombs, experts believe that 13,000 additional children’s lives could be saved by 2015 in Pakistan.

Murtaza Haider, Ph.D. is the Associate Dean of research and graduate programs at the Ted Rogers School of Management at Ryerson University in Toronto. He can be reached by email at

The views expressed by this blogger and in the following reader comments do not necessarily reflect the views and policies of the Dawn Media Group.


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Murtaza Haider is a Toronto-based academic and the director of

He tweets @regionomics

The views expressed by this writer and commenters below do not necessarily reflect the views and policies of the Dawn Media Group.

Comments (15) Closed

Hamza Apr 26, 2012 02:03am
Do we actually NOT need to rescue millions of lives in some way or the other be it in Pakistan or elsewhere?
Abbas Apr 25, 2012 02:41pm
Salute to Professor Murtaza Haider for providing research based indepth articles rather than just another emotional discourse. Pakistan needs most of these genuine scholars who do not buy degrees but earn it. Wish he was a Associate Dean of Research for Pakistan's University
Starr Apr 27, 2012 05:32am
There is no outdoor place left in Pakistan, it is disgusting and unsanitary to do outdoor both by females and males. Let Melinda & gates do whatever it takes to help poor Pakis in rural areas.
malik Apr 26, 2012 06:46am
Health is a necessity and educating regarding sanitation as well necessary. 1)Measures should be taken to do something with ponds and areas where everything is dumped. 2)Our routines to pick dead animals should get better. But i have never been able to see toilet as a necessity. If toilet was a necessity how did our forefather (all around the world) live a life without it. It is wrong to take in use foreign datas statistics and apply them in pakistan. They are not for us. We should look at our own needs and act accordingly. People dont have food to eat cant afford clothes to warm themselves and we are thinking '' lets get water toilets , that is our main problem.'' Even if we do get it who is going to upgrade them every now and then. Go to these people and see what they need first.
asim Apr 26, 2012 06:27pm
There is another policy which is geared and focused on people,their need and aspirations. Unfortunately, it is non existsnt in current affairs of state.
g.a. Apr 25, 2012 06:19pm
I asked one of my Indian friend about open air defication problem-----his answer was that it is not a problem. These guys will go to open space because that is more natural. These are outdoors men.
Agha Ata Apr 25, 2012 12:09pm
Please remember there are two kinds of policies to run this country, the army policy and the civilian’s policy. The leaders on both sides have their own angles to look at the things, their own aims and objects, their own priorities and their own ways to deal with everybody. On the track of history they are running parallel, it seems they will never meet each other. It is a long tale of one country and two policies.
Kanwal Apr 25, 2012 03:42pm
A brilliant article as usual.
Riaz Murtaza Apr 25, 2012 08:52pm
Sanitation and Water supply is a very critical issue for Pakistan. Each and every household is responsible for its upgrading too !
austrianecon Apr 25, 2012 08:10pm
This is actually a paradox. Do we actually need to rescue millions of lives in a country which is on the cusp of a demographic crisis? Our effort would be better spent in bending the population curve by making contraceptive use and family planning prevalent throughout Pakistan. The current demographic trajectory of Pakistan is not sustainable and is a significant drag on economic growth.
Nasr Apr 26, 2012 04:53pm
Long over due need, I pray that this challenge is met soon. I still remember the scene when on a cable car in 1998 in Murree or Nathiagali I saw below me that strewn around garbage and so many cute childrens playing around, mothers cooking in the open and quite a few children relieving themselves in the open that morning in the beautiful lush valley. I was shocked and that was 15 - 16 years ago I wonder what would be the situation now.
DPD Apr 27, 2012 08:02am
sure it is natural, just as TB, Cholera, typhoid, dysentry, diptheria etc are all natural. It is one thing to safely dispose away human waste by composting, it is another to leave it lying around and contaminating natural water sourcs and infecting another.
Agha Ata Apr 26, 2012 12:11pm
What about old men and women? What about sick people? What about bad weather, like snow, heat, rain, especially in winter or in hot summer? What about night time, when it is not safe for women and also for men? And what about people who live in cities, who have no outside, close by? How can all these people do their business more naturally and safely?
umesh bhatia Apr 26, 2012 01:03pm
Great article..specially the insight that both India and Pakistan can cutdown armed forces spending, live in peace with each other..Save and spend much needed resources on improving the living condition of the poor. Good supply of water, improved Sanitary conditions and personal Hygiene are the hallmark of good health and living condition of the NATION(S).
junaid kamal Jun 19, 2012 12:39pm
A very impressive and appreciative efforts of The Bill & Melinda Gates Foundation in Pakistan.