Right now we are flushing our drinking water literally down the drain.  Did you know that:  

• Over a quarter of all the clean, drinkable water you use in your home is used to flush the toilets.
• Older toilets can use 3 gallons of clean water with every flush, while new toilets use as little as 1 gallon.
• Many people in the world live on 3 gallons of water day or less. We can use that amount in just one flush of our toilet.
• Source: Water: Use Less-Save More by Jon Clift and Amanda Cuthbert:

But we have options and alternatives to this wasteful use of our water.  My colleague Allen Hershkowitz wrote about the need for waterless urinals in his blog with Laurie David last week.  NRDC's Guide to Greener Living can give you some more ideas on how to conserve water.  And now I want to expand on these options by sharing with you how the use of composting sanitation can be a water conservation technique, a public health benefit in countries without access to sanitation, and a real business opportunity.

Making Sanitation Your Business

Although our body naturally separates our solid waste from liquid waste, our current flush toilet system mixes them together.  We then send this waste to a treatment center just to be separated again.  Why not cut out the middle man and just keep it separated from the beginning.  That's where the waterless toilet comes into play. 

If you think about it, you might come to the same conclusion as me that it seems logical to keep our waste separate.  It also makes sense that with a limited supply of fresh water, we should promote its conservation.  But sometimes we need a little incentive and a better understanding to get us to the point where we can embrace something different, like a toilet that does not flush. 

So what I learned this week at the World Water Forum is that there is a real business case for composting toilets, which can also be called waterless toilets, urine-diverting toilets, and ecological sanitation.  They all share the common fact that they do not require water.  In fact, by switching from a flush toilet to a no-flush composting toilet, a person can save more than 8,000 liters (2,000 gallons) of water per year, assuming an average flush rate of four times daily.

So where's the business in doing your "business"?   

Well, did you realize that our waste can be turned into a fantastic fertilizer?  Of course not immediately, but with proper treatment and time, the bacteria will die off leaving behind an environmentally friendly fertilizer. 

And forgive me if I sound like an infomercial, "but wait, there's more."  Not only can you compost the solid waste, but the urea found in our urine is also a good fertilizer, helping to avoid harmful chemical alternatives that can contaminate our water and food.  In some composting toilet systems, there is even the possibility to capture and use the biogas released from the decomposing solid waste. This energy can be used for things such as cooking or lighting a home.  More beans please. 

But setting the jokes aside, I learned this week at the World Water Forum that many developing countries face stresses on their agricultural production's ability to feed their communities due to a variety of factors including drought and population growth.  As the need for improved agricultural output increases, the need for fertilizers does as well. 

However, I learned that some organizations operating in developing countries have seen a lack of interest and/or use of waterless sanitation.  This was due to a variety of different reasons including unfamiliarity with the benefits of good hygiene and sanitation practices or behavioral patterns.  This is where innovative thinking and business opportunity collide. 

Several organizations and communities are already working to promote waterless toilets by making a business case for its deployment and use.  By showing communities how their composting toilet can be used as fertilizer at a low-cost, the economic value in its use is beginning to lead to more use. 

Although this is a snapshot of several case studies that I heard this week from colleagues working in the developing countries, after doing some quick research on the internet on composting toilets and fertilizer, I learned that this idea is perhaps not novel.  I found places in the U.S. and elsewhere that have been using composting waste as part of their fertilizer.  For example, I found an article about how cities such as Austin, Dallas and Houston produce something called Dillo Dirt which is made from yard waste and landscape trimmings collected by the municipality combined with treated with dried sludge (made from sewage and human waste) to make a nutrient filled topsoil. 

This is not to say that composting toilets are a silver bullet to promoting sanitation and hygiene in developing countries.  They do require proper planning and management and the capacity to do so.  Nor will this technology be the right intervention to solve the sanitation crisis affecting the 2.5 billion without access to a toilet.  Instead, what I am saying is that in areas where promoting and delivering waterless sanitation technology is practical, appropriate and feasible, it should be considered.  And in these areas, especially where there hasn't been sustained access to sanitation and the public health value may not resonate, the possibility of making a business case for the use of composting toilets seems like an innovative approach.  Moreover, in areas where toilet use is common and water conservation is important, such as in the U.S., making a business out of keeping fresh water out of our toilets and producing fertilizer may be just what we need.  

• Health-care savings of US$ 7 billion a year for health agencies and US$ 340 million for individuals;
• 320 million productive days gained each year in the 15- to 59-year age group, an extra 272 million school attendance days a year, and an added 1.5 billion healthy days for children under the age of 5, together representing productivity gains of US$ 9.9 billion a year; and
• Time savings resulting from more convenient drinking-water and sanitation services, totaling 20 billion working days a year, giving a productivity payback of some US$ 63 billion a year.

Based on this WHO study, we see a significant payback of US$ 83 billion a year from the US$ 11.3 billion a year investment needed to meet the Millennium Development Goal for water and sanitation.  As many have pointed out in this week's debates, this payback makes a very strong argument in favor of promoting safe water and sanitation in these difficult financial times. 

Thankfully, this news of why we benefit from investing in water has been central to many of the discussions this week.  The recent launch of the OECD Report "Managing Water for All: an OECD Perspective on Pricing and Financing" provides useful analysis for policy makers on how to strengthen financing for water and address the challenges this crisis faces.  Similarly, how some governments are recognizing these benefits in legislation is also being highlighted.  For example, the U.S. and China are two countries that have water resources in their domestic economic stimulus bills.  Specifically, the U.S. has committed $10 billion towards water resources in the recent stimulus: $6 billion allocated to wastewater and $4 billion to drinking water.  There is also a 20% set aside as a green reserve that can be used to fund green infrastructure, water efficiency, energy efficiency, and other environmental innovation.  For more information about the stimulus' provisions on water check out the American Rivers summary. 

While the U.S. stimulus is a good start for our domestic water resources, we still have a lot further to go in supporting international safe drinking water and sanitation efforts.  Legislation such as the Paul Simon Water for the World Act of 2009 introduced this week by Senator Durbin is a good step.  This new legislation "places water in the forefront of America's development priorities, seeking to reach 100 million people around the world with sustainable access to clean water and sanitation by 2015."  We will also need sufficient appropriations and greater political support for clean water, but the U.S. has an opportunity to take a significant step forward by demonstrating that we are serious about putting together the right tools to tackle the global water and sanitation crisis. 

Therefore, with the right mix of political support plus financial investment in access to safe water and sanitation for those most in need, we have the opportunity to see mulitiple benefits, not only to the economy but for our planet.

Responding to requests by the community of Fort Chipewyan, the Alberta Government conducted a health study to investigate the cancers being found in this small community located directly downstream from Alberta's tar sands oil development.  On my last few visits to this region and with this community, I kept hearing similar stories being told by the people I met.  Stories of their brother, mother, sister, or best friend who had acquired a rare form of cancer that ultimately took their life.  These tragic stories continue everyday and have left this community with many questions about their environment. 

Interestingly, the study concluded that indeed, there are more cases of cancer in this small aboriginal community that lies directly downstream from the toxic tar sands, than the health officials expected.  In fact, the study found 47 individuals in the community had 51 different cancers over the 1995 to 2006 study period, more than the 39 cases health officials had expected to find.  The study also concluded that further investigation is required to evaluate if there is a risk posed by living in Fort Chipewyan and that as part of an overall assessment of the health status of the community, further analysis should also be done of many potential risk factors, such as lifestyle risk factors, family history and occupational and environmental exposures.

Clearly there are follow-up measures that should begin immediately.  Another opportunity for follow-up was recently covered in the Edmonton Journal calling for bio-monitoring in the community.  As the story notes, "biomonitoring involves sampling human fluids and tissues to find out which chemicals people have been exposed to, and to see if the levels fluctuate over time."

I am most struck by the statements from Alberta heath officials who are saying that there is no cause for residents to be alarmed.  If cancer rates are increasing, and even the Government's own report concludes that more investigation is needed into the causal impacts for these cancer outbreaks, then what are the other facts in this Study that can provide assurance that tar sands oil development is not polluting their waters and their community.  In fact, the report did not look into the causal connections and this is a serious gap of information that is still needed. 

After meeting the members of this vibrant community over the past couple years, the stories that you hear and the images of the many new gravestones in the community's cemetery are overwhelming.  However, key members of the government are sending signals through their actions and words that they are not concerned with the impacts in this community.  For example, in a recent trip to visit the tar sands in January, Canada's Natural Resources Minister Lisa Raitt did not reach out to the First Nations in Fort Chipewyan for a meeting even though the public health and environmental concerns of the First Nations are well-known.  To add more insult to injury, the health minister Ron Liepert said government efforts should not focus on the environment but rather on other factors such as lifestyle.  While lifestyle could be a contributor to the report's results, it is very surprising that he would preclude review of the role tar sands oil development has on these cancers given that this is, according to Liberal Leader David Swann, "the largest development on the planet".

To date, all the major newspapers both in Canada and the United States have featured stories about tar sands oil development.  There is also an Academy Award nominated film on this very topic called "Downstream" which tells the heartbreaking, yet hopeful, story of the people in Fort Chipewyan an their resolve to stop the strip mining of oil and pollution of their water.  The story is one of a community's deep inner resources and the committed doctor who comes to their aid by simply doing his job and calling attention to a serious public health distortion in this small community.  Therefore, I ask myself, how much more evidence, more public awareness, and more education is needed for the Alberta government to wake up from this fog of denial and finally dedicate sufficient resources and human capital to address this critical situation?  I think the Alberta Liberal Leader David Swann, a former medical officer of health, made a very astutue comment in the Canadian Press last week when he said urgent action is required and suggested it isn't happening because of the location of the problem.  He said, "I guess if this development was upstream of Calgary, we'd know a lot more about what was going on in the environment, in the food, in the air, and what people are consuming on a daily basis, than we do today."

It is my hope that this new study does not end up on some shelf in the Alberta Government collecting dust, but is instead used as a the starting point for more targeted research and investigation into not only why this community is falling ill to so many cancers but also what can be done about it.