How to make poop pay
Sitting in the McGill home is always an adventure. The people who come and go here are ever on the cusp of one public health crisis or another. It is not uncommon to find a visitor walking in describing a water system, malaria coordination, and, today, sanitation.

Steven, known as the “Bog Man”, dropped by this morning and within a few moments I was lured into the latest hope: turning human waste from latrines into fertilizer. Jim McGill, who works primarily on water and a recent convert to what a pit latrine can do to combat amebic dysentery, was quick to hand me a book to peruse. It’s title, “What does your poo tell you?

All of this was over lunch- very tasty- with Kate from Water for People and an engineer, Anthony. I first heard about the pit latrines three years ago, but only last year did I encounter the idea that you could use human waste as a fertilizer. (If this makes you squeamish don’t worry your plumbing is in doors). This year though the conversation about sanitation and latrines has reached an important stage: income generating.

These are the wires of mission work in Malawi: public health and entrepreneurialism. When you cross these two, things really start to happen. Three years ago the conversation was a modest hope of selling subsidized toilets to folks here in the north. The benefits of these “outhouses” is monumental, yet the value is unforeseen by most. They can free families from a persistent, curable disease that often goes untreated is the claim, but freedom is not always an easy concept to grasp by those who live without its power.

The path to freedom in this instance is very steep. To see freedom from dysentery, a village needs 70% of its households to have gone from poor hygiene practice to healthy practice. 70% would then be the “tipping point” toward eliminating one of the big four in any village.

The big four are malaria, HIV/AIDS, dysentery, and malnutrition. Ever before all discussions seems to be a kind of cart and horse, chicken and egg debate. Which one first? Which one is the priority? Yet, no matter what the priority it is the presence or absence of power- which actually determines the pecking order. So it seems you start everywhere hoping one will take.

The recent conversation around latrines is trying to cross the wires of mission in Malawi: how can you take a public health issue and turn a modest profit? How can someone be motivated to make a significant change in their life without a very concrete benefit? In other words, how do you make poop pay? Because without this the chances of generating the social power of 70% is near hopeless. In a country where everyone is ready to sell something as the only means of generating cash, finding something to sell is a great motivator.

Yet, how in the world can you convince someone to collect their feces to sell, let alone find a buyer?

Easier than it would seem. Malawians are primarily farmers who want to see results. Hence they are not sold so much on concepts or ideas as they are on yields- think cash. If you add fertilizer made from feces, your tomatoes grow bigger. If you spray diluted urine on your corn, they start grow faster and produce more maize. More crops mean something to sell. Something that will create more things to sell is valuable. So the proof is there, but now comes the risk.

To do this right, everyone must have a fair share of the enterprise. In other words, the people who make the toilets (masons), the people who promote the toilets (Bog Man et al), and the people who use the toilets, should each have a share of the risk involved. This is much slower way of bringing public health to a village, but it is the right way. Each one of these three need to have a share in the success or failure of the enterprise. Success in this instance would be the sale of manure made in a “sky loo” by a farmer. The risk of the promoters comes in subsidies and guarantees. No one would be motivated to risk any of these if there were not cooperation by all three.

Undercutting this effort is the other form of public health effort, headed up primarily by UNICEF. This effort is best categorized as the big “give away.” The benefit of this method is that it builds confidence in the west that something is happening now. This is a huge benefit when the word crisis gets bandied about. Yet, in the end, this method undercuts any market formation. Why would you buy something you can get for free? And no NGO is willing to give everyone everything. While more people may get a sanitary toilet quicker than in the entrepreneurial model, there is great evidence to show there is no sustainable impact nor the relationship that is necessary for such an innovation to impact long held habits and beliefs.

The greatest difference though is one of power. In the UN based model the power stays with the West. We determine the number, we determine the distribution, and we determine the price. In essence we hold all the cards. Who has the power is the question I have learned to ask when working with Malawi. If I hold the power over others, then I have taken away something more precious than what I hoped to offer. This question must be asked more and more as we get involved with Malawi or any country racked with extreme poverty. For to give help but keep the power, ultimately dissolves as fast as it appears. If you give people power, though, the change goes deep. And so the question remains, how do you make poop pay?