Up to 68,000 toilets have been built or refurbished since 2015 in China. Photo: Handout

A “Toilet Revolution” was launched in China five years ago. The aim was to eliminate epidemics such as the deadly Covid-19 outbreak, which has so far claimed more than 1,800 lives and infected at least 72,000 people.

Geared to upgrade hygiene and sanitation in urban and rural parts of the world’s second-largest economy, up to 68,000 toilets were built or refurbished between 2015 and 2019.

By the end of this year, an additional 64,000 will come online as part of the ultimate goal to have a 100% “civilized” toilet culture by 2030.

“The toilet issue is not a small issue. It is an important part of civilized construction in both urban and rural areas,” President Xi Jinping said at the launch of his ambitious building program.

Five years later, and what has become crystal clear is that the government needs to roll out a new Belt and Bathroom policy. Probably, with the same fanfare that preceded Xi’s vision of new Silk Roads crisscrossing the globe, which later became known as the trillion-dollar Belt and Road Initiative.

In 2018, a major report entitled the Toilet Revolution in China, which was published in the Journal of Environmental Management, illustrated what was at stake if the country failed to get it right.

Apart from rural regions, there are more than 100 city clusters with populations of one million-plus, according to Demographia’s World Urban Areas report.

“The toilet revolution requires a concerted effort from many governmental departments. It needs to address not only technology implementation, but also social acceptance, economic affordability, maintenance issues and, increasingly, gender considerations,” a team of academics and scientists mainly from the University of Science and Technology Beijing stressed.

“Aligned with the ecological sanitation principles, it calls for understanding issues across the entire sanitation service chain. Public-private partnership is also recommended to absorb private capital to make up the lack of funds, as well as arouse the enthusiasm of the public,” they added.

Yet that last statement has failed to materialize, despite a succession of high-profile campaigns and programs from the central government in Beijing.

Massive urbanization over the past three decades has further exposed weak links in the sanitation system and a deteriorating state of overall healthcare.

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“Since the early 1990s, China has undergone an unprecedented scale of urbanization, driving millions of rural villagers into cities. These cities create ever greater health risks: air pollution and pandemics such as SARS [Severe Acute Respiratory Syndrome] in 2003, avian influenza in 2013 and now the new coronavirus outbreak have become the largest threats to people’s health in urban areas,” Xun Zhou, of the University of Essex in the United Kingdom, wrote for The Conversation, an academic website.

“Making the current outbreak worse is the state of the Chinese health system: overloaded, ineffective, expensive and chaotic. While there have been some attempts to reform the Chinese health system, most were carried out in a haphazard fashion. For example, in the aftermath of the SARS crisis, many public health units were reconfigured into local centers for disease control, but a systematic prevention program for infectious diseases remains absent,” she added.

While hard numbers for Xi’s “Toilet Revolution” policy are sketchy, up to last year US$4 billion had been pumped into the project.

Unlike rural areas, the standard of urban facilities in China has improved dramatically in the past 30 years with upgraded sewage networks. But more needs to be done.

“Arguably, the biggest investment the government has made to address the broader public health problems associated with disease outbreaks is the toilet revolution. Started a few years ago to bring flush toilets to rural households and improve public toilets in crowded urban centers, it lifts sanitation standards,” Christopher Balding, of the Fulbright University Vietnam in Ho Chi Minh City, told the Nikkei Asian Review. “A fundamental problem in Chinese public health is low hygiene standards in toilets, restaurants, hospitals and meat markets.”

Tackling these problems has now become a priority for Xi’s administration, which has been rocked by public anger on how the crisis has been handled.

Xun Zhou, of the University of Essex, is convinced there needs to be a fundamental shift in Beijing’s approach to sanitation and health issues even at the cost of economic growth.

“In the PRC [the People’s Republic of China], protecting people’s lives and their physical health has remained largely political rhetoric,” she said.

“Seventy years after the founding of the PRC, China is a long way from being the disease-free ‘socialist garden’ imagined in the CCP’s [China’s Communist Party] utopian plans. If the SARS outbreak in 2003 was a wake-up call, the current coronavirus crisis should be an urgent warning: protecting lives should be given priority over the growth of GDP before it’s too late,” Xun Zhou added.

It appears the “Toilet Revolution” needs to be just that … a social revolution to stamp out further epidemics in the world’s most populous nation.

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  1. Why don’t we start with soap and hand washing. No soap in bathrooms, wet markets, homes, for washing hands. Spitting everywhere. You haven’t lived until you’ve seen people do snot bombs walking down the street. I don’t think the toilets will help until basic hygiene is taught.

    1. Hey, that is one of the funniest comments made about Chinese peoples’ hygiene habits. Spitting and spraying spit on all and sundry is a Chinaman’s right…unless the Commie Govt brings in a mass education program for its people on hygiene.

  2. The problem of public hygiene exists everywhere. There are poor areas in the US where children play around open sewers because the people are too poor to install sceptic tank systems. In many US cities, especially in the southern states, homeless people use the street as toilet because the cities refuse to build public toilets.

    In countries like Switzerland there is a clean public toilet now in every public place, park, at every major bus and train station. In the US public toilets disappeared in the 1970’s. The cost of maintenance and the problem with gays who used them for sex and at times crime, became unmanageable. While in Switzerland a restaurant had to have clean toilets for its customers since at least 1945, a law to require that in the US is not very old yet. For decades restaurants in the US didn’t have to have toilets for their guests. The only such requirements existed for bars that sell beer. Toilet requirements for restaurants and stores were introduced around the 90’s and later.

    In rural areas outhouses persisted until the 80’s even in Switzerland. And they were difficult to use, no light at night, no heat, scant ventilation and no disinfectants to cut smell – the odors were so pungent they made eyes tear. The only country to produce clean outhouses is Japan. It understood for the longest time that hygiene is of primary importance.

    In India outhouses are a hole in the ground with an enclosure around it and a toilet bench made from wood. When the hole fills up, a new hole is dug and the enclosure moved. These toilets contaminate the groundwater and the drinking water wells, leading to nationwide chronic intestinal problems.

    In Nepal there were scant outhouses. The cities used a meadow near the river as collective toilet field. Further out, people used a corn field.

    These are examples to show that China is by no means the only country suffering from a lacking understanding of the importance of hygiene. What goes forgotten when looking at the modern, fully automated factories, glittering skyscrapers and the new mega airport outside Beijing, is that China is a vast country with over 100 different ethnicities. Income levels vary greatly and with them comfort of houses and bathrooms.

    As to the farmers wanting to use human waste as fertilizer: there exist composting toilets. In Haiti a program to collect human waste for composting was introduced. If human waste is used as fertilizer without full composting, it spreads disease. In Europe that was the source of typhus, plague, pest and other infectious diseases that wiped out a very large portion of Europe’s inhabitants in the Middle Ages until use of human waste as fertilizer was prohibited.

    More recently, with central pickup to composting facilities, use of human waste was rediscovered. And similar technology could be introduced in China’s rural areas.

    But, the world should not forget that there are 1.4b people in China and that problems, which are not even fully resolved in the US, will take way more time, effort and money to solve in such a large country. China is after all a developing country. Even if Trump stripped China of that status, it is his ignorance of the vast differences between Chinese cities and rural areas that lead to such false conclusion.

    Covid-19 should open China’s eyes that there will be epidemics time and again until the problem with hygiene is solved. And as a commenter stayed; it has to start with education to hygiene from kindergarten on.

    Nevertheless, Xi’s actions to contain the virus and take care of the people is impressive: the west is too fast to criticize: no western health system would be able to cope with 70’000 sick people in one city in a matter of 4 weeks. China’s massive response to build more temporary hospitals – in just about every public building in Wuhan and even entire hotels converted into hospitals, China’s response stands unique in the world. As more people can be treated right at the beginning of being infected, mortality will decrease and recovery increase.

    To claim that it is all because Li Wenliang wasn’t listened to is wrong. He was only one of 8 doctors who recognized a new Corona virus from the first patients on. Nor is Li the only “martyr” or courageous person. Countless doctors and nurses work to near collapse from too much work. They are the unknown, real heroes. For the west to use Li as a way to endlessly criticize the Chinese system is wrong. A similar condition in the west would likely result in way more chaos because there isn’t any preparedness for such a giant epidemic.

    1. The Chinese Communist Party murdered 80 million of its own people and called it progress.

      In 70 years, the only thing that has changed in China is money – money between the hands of its dictators and billionaires – if only to create a glittering illusion of prosperity and near-supernatural business acumen with which to lure foreign money to its shores.

      The lie is now exposed. Exposed to every man, woman and child *on Earth*.

      No one can talk it away.

      No one can legislate it away.

      Nothing can smooth it over.

      No amount of money will pay for it.

      All the money in the world couldnt buy it into silence, stuff it away, or legitimize it.

      Where Chinese socialism brought suffering and death to its own, it now threatens the Entire. Fucking. Planet.

      You must understand this.

      The party enriches itself over the basic sanitation of its working class.

      That isnt communism’s Golden Future. That is slavery.

      Just like the sweatshops in Milan and Prato. Its over.

      Hand things over to Taipei. That would be honorable enough to allow “The People’s Leader” to continue her studies at Harvard while her people suffer and die, screaming in the dark in Wuhan…

  3. In my experience of 18 years in China, it has been rare to see soap in a public toilet. If there is a soap container it is often empty as at two universities I have worked in.
    And, when there is soap I hardly ever see anyone using it.
    “In many countries, there is a low prevalence of hand washing with soap. A study of hand washing in 54 countries in 2015 found that on average, 38.7% of households practiced hand washing with soap.[13]
    A 2014 study showed that Saudi Arabia had the highest rate of 97 percent; the United States near the middle with 77 percent; and China with the lowest rate of 23 percent.[14]

  4. When I was a child at Boarding School in south India, we are off Thalis with our fingers, however, before the dining room there were a bank of taps and soap and hand washing was de-rigeur. Peer monitoring. Our cooks bathed and changed thier clothes before they touched any food. Of course it was pure vegetarian with most of the food grown on a 350 acre estate, with our own dairy cattle..had the most luscious yoghurt every day with our lunch and dinner and pure ghee with our rotis. With more than 250 children from 6 to 16, in my four years there, never had a case of the trots. Oh, yes, we had pour flush latrines, which users were responsible to keep clean. Social monitoring. We bathed twice a day and changed our clothes at the same time.

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