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Sanitation is More Profitable than Curative Healthcare: Jack Sim

Jack Sim, the sanitation evangelist and founder of the World Toilet Organization, believes that technology-driven toilet infrastructure will be the fulcrum of preventive and predictive healthcare. Globally known as Mr Toilet, he says that smart sanitation will lead to “very few people seeing doctors in the future”.

By Mrinmoy Bhattacharjee

Why has the need for smart sanitation economy emerged?
We all know that prevention is better than cure. Sanitation is the cheapest medicine in the world because if the people, especially the poor, have proper sanitation and hygiene, we will not have to bear the cost of hospitals, doctors and medications plus loss of productivity and income and trauma.

The World Health Organization has said that $1 invested in sanitation and hygiene results in $5 saved. That is smart sanitation. However, sanitation was traditionally viewed as an expenditure and not revenue. This led to poor health and poverty, which is a considerable constraint on the economy.

How can a smart sanitation economy propel economic growth and well-being of people?
When people have toilets, sanitation and hygiene, and when river water can be free of faecal contamination, people will become healthy. And healthy people can produce more income and become wealthy. They can also pay more taxes, which will be used for the public good and building life infrastructure. A sick nation cannot be a prosperous nation.

How can a smart sanitation economy be fostered?
Swachh Bharat Abhiyan, or Clean India campaign, has created much awareness. But it was a supply-driven project done in a hurry to finish in time for 2nd October 2019 on Mahatma Gandhi’s birthday. We forgot that behavioural change, from centuries of open defecation to using a toilet, will take a long time to change.

Therefore I think that for the next 10 years we need to focus on good toilet culture. We need to emulate the Japanese toilet culture where everyone demands a proper, safe toilet with safely managed sanitation treatment of the sewage.

Right now the pits may be getting dug into the water table, and the shit will be contaminating the underground water taken from the wells. This is very dangerous as it will cause Diarrhea and kill more people. We must check that pits are not reaching places with high water tables.

We need technologies to map the areas with high water tables and rectify these pit latrines so that their faecal sludge is safely treated. We need to test the well waters in all areas to ensure the water is safe for people. It can be done simply by using bio-indicators like species of fish or living organisms or insects.

Each of them can only survive at certain cleanliness levels. So you can tell the danger zones smartly. Goldfish will die immediately in dirty water. Guppy fish will survive better but will also die if it is too toxic. Of course, you can use high tech equipment too.

What policy formulations and regulatory reforms are required for building the economy?
Toilets cannot be useful unless there is some water. We need policy changes to bring water to the people. Hygiene cannot be achieved without soap.

Schools need toilets, tourism needs toilets, and transportation points need toilets. Workplace toilets need to improve. So, the first thing to start with is to renovate all the government office toilets to international standards. Only when civil servants, who have proper toilets at home, are using similarly good toilets at their office will they have a vision of the real Swachh Bharat spirit.

Today, the higher rankings officers have toilets that are different from those for the rest of the staff. These policies have been made without empathy. We need everyone to use the same toilet. IAS officers must use the same toilets as everyone in the office block. Then they will want to improve the conditions of toilets in India.

What new business models do you expect or are seeing being developed in this economy? How could traditional businesses get challenged?

If you do a cost-benefit analysis, you will undoubtedly find sanitation to be more profitable than the medical profession. Because sanitation has been a half public and half private good, it has been neglected and, in the absence of a demand-driven economy, business models have not developed.

Now that 110 million toilets have supposedly been built, there’s a huge business in their maintenance, supply of soap and detergents, cleaning services and repairs and upgrades. This is a new billion-dollar industry. If you do tap into this industry, the toilets will fall into disrepair, and people will go back to open defecation.

Which are the areas that offer funding and financing opportunities?

Banks can loan if you can project that healthy, productive people will pay taxes in the future. Social impact bonds are another instrument useful in such a case. You pay only upon successful implementation by private sector investments.

What role can entrepreneurship and startups play in making the sanitation economy sustainable?
Start offering cleaning services, supplies of daily-use products in toilets, maintenance and upgrade services.

What entrepreneurial trends are visible in this area, globally and India?

The future toilet will become a status symbol. The better your toilet, the higher will be your status. This will be relative to income levels, and the people will spend on toilets and sanitation improvement because they will not want to be looked down by neighbours and friends. Right now they spent too much money on festivals, temple offerings, snacks and drinks.

Where can traditional wisdom come in?

Health, cleanliness, safety and dignity are human needs. The swamis, gurus and priests in every place of worship should be promoting this. We can have a national competition for these gurus, to challenge who can promote clean behaviour in the most effective way. The winners in each religious group get a Modi Prize or President Award.

How can technology, including Artificial Intelligence (AI) and Big Data, boost the smart sanitation economy?

Toilet is full of data downloads of health statistics. The future toilet will encompass AI-driven health data collection and diagnosis. Preventive health and predictive health will overtake curative health if we interface toilet data with the genome mapping of the person.

It need not be intrusive tests. We can get the data from faecal and urine samples while the users use the toilets. Very few people will see doctors in the future. Most will be cured at early stages by AI doctors instead of human doctors (who are in any case making decisions with the aid of AI).


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