11/21/2012 10:58 am ET Updated Jan 21, 2013

The Economy Is in the Toilet -- Literally

Q: What did one toilet say to the other?
A: You look a bit flushed!

We all chuckle at good potty humor and what better day to crack a joke than on World Toilet Day! But, all jokes aside, the global sanitation crisis is no laughing matter and on World Toilet Day it's important to remember a crisis that is so often forgotten and to look toward solutions that can create transformative change.

While many of us may take toilets for granted, in developing countries billions of people are not able to flush away their feces so easily. Nearly 2.5 billion people in the world do not have access to a toilet or other hygienic sanitation facility and 1.1 billion people are still defecating in the open. This is a crisis because using a hygienic toilet or latrine is essential for sanitation, and without one people face a plethora of tragically preventable diseases. Consider the following statistics:

• Diarrhea is the second leading cause of death among children under five in the world.
• Around 1.5 million deaths each year -- nearly one in five -- are caused by diarrhea. It kills more children than malaria, AIDS, and measles combined.

It is disgraceful that so many people, most of them young children, die from diseases that could easily be eradicated by simply improving sanitation. On World Toilet Day I invite you to join me in giving a shit about all the people who still lack access to toilets. Let's think about innovative solutions that focus on sustainability - so we can solve the sanitation crises -Forever.

For years, NGOs and governments have constructed toilets in developing countries and after time, they no longer function. They fill up or break down and the family is again left without a hygienic sanitation facility. Or new families move to towns where toilet projects have been completed and they don't have a way to get access for themselves. We need to think about solutions that can provide sanitation in the long-term for both the family with the full latrine and the family who is new to town. How do we do this?

Water For People focuses our sustainable sanitation program on the idea of Sanitation as a Business. Sanitation as a Business is simple -- we find ways for the private sector to make money by establishing businesses that provide sanitation services. Entrepreneurs in developing countries are looking for business opportunities and realizing that there is a market for toilets and sanitation services. When entrepreneurs can create a viable business by providing sanitation services to paying customers (households, community members at public latrines) it is a more sustainable model. These entrepreneurs can empty or service full toilets so that families are able to continue using them, and can construct new toilets or latrines for new families who move to the area.

To support this market based approach, we look toward creative business models like the use of ecological sanitation and the sale of compost, as well as innovative pit emptying services in cities. In urban areas, entrepreneurs can make money by constructing, servicing, maintaining, and emptying toilets. NGOs can provide training for entrepreneurs to develop the skills needed to grow and maintain successful sanitation businesses. It's a fine line, however, and NGOs must be careful not to create dependency on this training support. That's why Water For People works with a local business development service (BDS), which in turn provides direct support to local sanitation entrepreneurs to grow their businesses.

Since Water For People initiated its Sanitation as a Business program, we have witnessed great examples of the program's impact. In Uganda, one entrepreneur raised equity of UGX 35million ($14,000) and purchased a 10-ton truck to expand his septic tank emptying business. He now has two 10-ton trucks for toilet emptying thereby increasing the number of toilets that can be emptied, while also increasing his profitability. This year in Malawi, through Water For People's work with a BDS, seven sanitation entrepreneurs were trained, established businesses and invested their own equity to empty toilets and/or construct latrines. Business is picking up and in the first couple of months, 49 toilets have been emptied and families now have access to a toilet again.

While many are raising awareness of this critical issue, on World Toilet Day I am hoping to shift the discussion so that rather than simply constructing more toilets in developing countries, NGOs and governments alike will begin looking at innovative solutions that create sustainable change. Together, we must define success as lasting sanitation and water services so that in time Everyone will have access to hygienic toilets Forever.

I welcome your comments, please join the conversation @Waterforpeople, and learn more about Water For People's Sanitation as a Business program.