Why Technology Alone Will Never Provide Sanitation for the Poor

The word “still” carries a subtle indictment. We see it in the WHO/UNICEF Joint Monitoring Programme’s State of the World’s Sanitation report, which reminds us that “2 billion people still lack even a basic level of sanitation services.” Still. We’ve gone to the moon, developed nuclear warheads, and can communicate wirelessly anywhere on the planet—shouldn’t everyone have a toilet by now?

It is tempting to believe that the level of our technology defines the level of our human progress, that our advancements will inevitably lead to something profound and hopeful. How can we not hope that broadband and smartphones will put out the fires of global poverty? Or that solar biochar toilets and infrared sludge pasteurization machines will reduce the burden of disease in urban slums?

How can we not hope that broadband and smartphones will put out the fires of global poverty?

But when we measure human progress by the increasing sophistication of technology, we live in the shadow of a convenient myth—that our direction is the right one; that, in E.F. Schumacher’s words, “there is nothing wrong with modern technology except that it is as yet incomplete; let us complete it.”

The word “still” tells us that despite our technical prowess, there is something wrong with modern technology in our relationship to it. It has failed to deliver on its promises for a world free from poverty and disease not because the hardware is incomplete, but because our systems of access remain inequitable and unjust. To reduce that number in the JMP’s next report, we need to abandon the idea of boundless technological solutions and reorient our understanding of progress in terms of justice.

The promises that science could solve our thorniest quandaries were planted in the wake of the scientific achievements of the 19^th century. Men like Thomas Huxley and Herbert Spencer doubled down on Darwinian ideas in the social and philosophical realms. They developed a justification to solve the problems of the lower classes through the superior science of white men, even when those problems were not related to scientific or technological obstacles. When Spencer coined the phrase “survival of the fittest” in 1864, a concept fraught with undeniably racist implications, he confidently prophesied the eventual, ultimate perfection of the human race.

Despite our technical prowess, there is something wrong with modern technology in our relationship to it.

The modern development agenda is a contemporary embodiment of this illusory human exceptionalism. But this time around it has a humanitarian twist. “Survival of the fittest” has gradually morphed into “survival by the fittest.” Technology is offered to the poor and the slums as a golden ticket. The field of urban sanitation, specifically, has been especially fertile ground for the promise of new technologies to save the masses, having roots in the same thinking as Darwin and Spencer.

Said to be the architect of public health in England, Sir Edwin Chadwick transformed the field of sanitation in 1842 with the release of his Report on the Sanitary Condition of the Labouring Population of Great Britain in which he developed a scientific link between disease and environmental conditions. In a time when disease ravaged the urban poor and was best understood in fatalistic terms, Chadwick’s premise became known as the “sanitary idea.” It opened a door to radically new scientific approaches to public health.

The problem with Chadwick’s idea was that it was laced with the same racist, imperialistic views that his contemporaries held. Chadwick associated the poor with prehistoric cave-dwellers and implicated them in their own suffering. On October 8, 1889, Chadwick addressed the national Sanitary Institute saying, “The first knowledge we have of man is in a condition that is solitary and unsanitary… earliest remains found in cave dwellings…strangely beastlike and squalidly poor… yet found continuing in tribes in South America and Central Africa.” The backward state of humanity “has been augmented with the progress of civilization,” he continued, and the “superior classes with intelligence and power…guided by…science, cannot fail to be in the highest degree beneficial to the masses…[where] populations are allowed to be crowded, whole families in single rooms.”

We fail to see that regardless of the technological height of past civilizations, the same fault lines of health and sanitation have always existed between the haves and have-nots.

Chadwick painted the history of sanitation in homogeneous strokes, claiming that before his moment in time, all civilizations were foul, putrid, and unhygienic. They were, in his view, characterized by a universal lack of sanitation and health paralleled by a lack of technology. Such a conception of history blinds us to the reality of social inequalities and emboldens our preening sense of technological superiority. We, along with Chadwick, fail to see that regardless of the technological height of past civilizations, the same fault lines of health and sanitation have always existed between the haves and have-nots.

In Ancient Rome, for example, the simple technologies available—cesspits, flushing latrines, gravity-flow aqueducts and sewers—were enough to create basic sanitary conditions for those in power. The empire’s aqueduct system supplied the elite with an abundant water supply for bathing and hygiene. They relieved themselves in marble-floored latrines, which were either cleaned by slaves or emptied into the famous Cloaca Maxima sewer.

Meanwhile, archaeological evidence suggests that in poor, urban neighborhoods the Cloaca-Maxima was choked with mud, human waste, and corpses. The average lifespan in ancient Rome is thought to be around 25 years due to egregious infant mortality rates, likely disproportionately affecting the poor due to a lack of sanitation.

When we can finally realize that the solutions are not new, we can stop reinventing the hardware and begin looking for ways to reinvent the systems.

Two-thousand years later, sanitation technologies have advanced, but the divide in access still lingers. Superior sanitation investments and services are funneled into the neighborhoods of the privileged, while 2 billion still lack basic access.

Each wave of new technology breaks, but access never changes. Now, others are coming to the same conclusion. Remi Kaupp, a sanitation adviser at WaterAid writes, “There isn’t much that needs improvement about having a tap connected to mains water and using a toilet that flushes into a sewer…The main ingredients needed to achieve universal water and sanitation coverage are well known, and…they are not glamourous.”

When we can finally realize that the solutions are not new, we can stop reinventing the hardware and begin looking for ways to reinvent the systems. This requires seeing the social dimensions at work.

We find an advocate for this approach in another 19^th-century public health reformer, Sir Henry Littlejohn. While Chadwick was preaching the intelligence of the superior classes, Littlejohn was changing the way neighboring Scotland understood the nature of poverty. As the Police Surgeon of Edinburgh, Littlejohn published a study that was similar to Chadwick’s in 1865. The Report on the Sanitary Condition of Edinburgh explored the relationship between disease and poverty during years of mapping mortality rates across city divisions. Littlejohn, however, came to strikingly different conclusions than Chadwick.

Can we yet admit that no technology can solve inequality? That, in fact, our faith in it as savior distracts us from the real underlying problem?

“The rich do not greatly feel the evil,” Littlejohn explained. “Their wants are supplied after a fashion, and they allow a large poor population to grow up in a state of neglect and helplessness as regards one of the first necessities of a healthy life… In Edinburgh we are deeply to blame in respect to the water-supply of the poor, and are largely responsible for the filthy and neglected state in which they live.”

Littlejohn had little confidence that Chadwick’s myth of progress would change the conditions of the poor. Rather, Littlejohn saw the “sanitary idea” through the true compounding inequalities long at work. But well-intentioned researchers, policy-makers, and philanthropists in today’s institutions continue to go the way of Chadwick, led on by the shimmering hope that we can fix this by our intelligence, by funding new inventions and tinkering in the laboratory.

Can we yet admit that no technology can solve inequality? That, in fact, our faith in it as savior distracts us from the real underlying problem? Until we do, we may be perpetuating history’s pattern and pulling modern development dangerously close to the imperialism from which we claim to be free.

Littlejohn exposes the fundamental problem of sanitation as one of environmental justice, more than a century before the term became mainstream. That is, that urban poverty, disease, and lack of sanitation are the products of a societal irresponsibility to equitably bear the environmental risks of cities. That is, not all members receive the same level of services, since it is service provision, not advanced technology, that protects public health in privileged neighborhoods and its lack that spreads disease in slums. Thus, what we may call “sanitation justice” implies cities that provide equitable sanitation services to all its members, regardless of race or class so that the burden of disease does not disproportionately fall on the poor.

It is service provision, not advanced technology, that protects public health in privileged neighborhoods and its lack that spreads disease in slums.

Several start-ups—such as Sanergy in Kenya, SOIL in Haiti, and Sanima in Peru—have started down this path. They have created successful businesses that hygienically collect human waste in urban slums while also creating jobs, using no more sophisticated technology than sealable buckets and composting. Emptying of pit-latrines is also a viable and growing business in slums across Africa (although it is still fraught with problems of worker safety and waste disposal). This is harder work than inventing technological stopgaps, because it requires creating sustainable systems of service provision where none existed before and committing to serving these communities over the long haul.

When we establish these downward-oriented systems of service delivery, systems that actively and intentionally serve the poor first, then we can truly reap the promised benefits of technology because we will have returned it to its proper place as a tool within systems of justice, not as an all-encompassing promise. Then technology may serve justice, not replace it, and we can say we’ve made real progress.