Flushed with Ambition: Sanitation Initiatives for Health and Well-Being

Society Lifestyle

Japan has become known as the land of high-tech toilets, but the country has also been making efforts to improve its “toilet environment” as a way of boosting health and well-being. Here a long-time advocate of improvements takes a look at the array of sanitation-related activities now underway.

Wiping Out Toilet Taboos Is the First Step

Around three decades ago, the image of public toilets in Japan was that they were dark, dirty, dangerous, damaged, and disgusting. A study group was created at the time to try to make restrooms more agreeable.

The group, named Toiletpia Association, grew out of the Regional Exchange Center, a city-planning think tank that I once belonged to. Toiletpia fostered discussions between people from a variety of professions and industries, including architects, designers, landscapers, doctors, researchers, government workers, sanitation equipment makers, cleaning firms, and others.

What was the motivation behind creating a study group centered on the issue of toilets? The group arose, apparently, after the Regional Exchange Center discovered in a survey on the litter problem at sightseeing spots around Japan that tourists were turned off by the neglected condition of public restrooms. This then became a major problem to confront.

One of Toiletpia’s founders, Ue Kōo, who has been a driving force behind efforts to improve public restrooms, pointed out that one major source of the problem was the taboo surrounding toilets and the associated bodily functions. Because of this taboo, the problem was ignored, making it impossible to improve the situation.

The effort to improve restrooms in Japan got started in 1984, and over the years since has changed as the needs of society have changed. The activities over the past three decades can be divided into the following three stages: Stage 1 (1984–94)—Efforts to spotlight the issue of public restrooms and remove the surrounding taboos; Stage 2 (1995–2005)—Expanding the scope beyond just public restrooms to include the improvement of toilets used at schools, in times of disaster, and in nature spots; and Stage 3 (2006–to the present): Promoting ongoing initiatives that bring together the private and public sectors and civic groups. Incidentally, it was back in 1997 that I became involved in these activities. And in 2009, I established a nonprofit organization named Japan Toilet Labo as an umbrella group intended to stimulate the Stage-3 initiatives.

Taking the Stress out of Toilet Use

Along with improving plumbing and sewage technologies and sanitation, Japan steadily made the transition from primitive cesspool-type toilets, to the squat toilet, before moving on to the Western-style toilet and then taking another leap forward by developing the world’s first “Washlet,” equipped with such features as bidet washing and seat warming. Although Japan can boast of these world-leading technologies, toilets are about more than just technical advances.

What is particularly important with regard to toilets is to create an environment that is pleasant and safe so that people can use them in a stress-free way. This sort of environment must be suited to the needs of society and people’s daily lives.

Japan Toilet Labo has been striving to put in place an environment suited to diverse social needs, with a focus on toilets for children and sanitation measures for toilets used in the wake of natural disasters.

Students’ Aversion to School Toilets

Most kids these days are raised in households with Western-style toilets. So quite a few children only first encounter a traditional Japanese squat toilet when they enter elementary school. Many of the public elementary schools in Japan were built more than 30 years ago, so the buildings and facilities have become quite old. It can be stressful for elementary school children to have to use the restrooms in those old buildings.

A scene from a Poo-Poo Learning class at Tsurumaki Elementary School in Shinjuku, Tokyo.

According to a survey we conducted, around 40% of elementary school students avoided having a bowel movement at an elementary school toilet, and nearly 20% had a tendency to be constipated. As a way to address this problem, the Toilet Carpenters initiative was launched, which involves improving school and public toilets through group activities that involve cleaning and decorating toilet spaces. Kobayashi Pharmaceutical has also been providing support by donating Western toilets to schools and teaming up with Ōji Nepia, which produces toilet paper, to conduct an on-demand class called Unchi Kyōshitsu (Poo-Poo Learning).

It is vital to children’s health and well-being that they can have access to a stress-free toilet area. If children are hesitant to use the restrooms at school, this can negatively impact their diet, exercise, and studies. Children should also be given an opportunity to learn more about toilets and the body’s excretory process, in connection with their food education at school.

A group of Toilet Carpenters (left) at Kuragano Elementary School in Takasaki, Gunma Prefecture, and members of the same group (right) painting a wall at the school on July 20, 2013.

The Toilet Threat: Unsanitary Conditions

The flush toilets that we use today provide us with a lifeline through a system that combines water supply and electrical power with all of the various processing functions. But in the event of a powerful earthquake or other natural disaster that would cut off the supply of water and electricity, flush toilets would become inoperable. This is what occurred in the case of the 1995 Great Hanshin-Awaji Earthquake, the 2004 Niigata-Chūetsu Earthquake, and the 2011 Great East Japan Earthquake—causing severe difficulties for toilet usage. When toilets become clogged with waste, this not only creates foul odor but also results in terribly unsanitary conditions.

As toilet conditions deteriorate, disaster victims often attempt to reduce the number of times they go to the bathroom by consuming less food and liquids. This in turn reduces their strength and immune powers, which can lead to deteriorating physical condition, chronic illnesses, or even death. The most common form of death among victims of the Great East Japan Earthquake was related to the physical and mental exhaustion of those living in evacuation shelters.

Past disasters have taught us the importance of implementing measures at the time of a disaster to ensure proper sanitation. If Japan can establish such sanitation measures for times of disaster, it will be possible to provide support not only within the country but overseas as well.

Since 2012, Japan Toilet Labo has been holding a Disaster-related Sanitation Management Workshop, with the aim of training people how to create a safe and reliable toilet area following a disaster.

Participants in the Disaster-related Sanitation Workshop held at Japanese Red Cross College of Nursing on October 11, 2014.

New Mindset Needed for Toilet Diversity

In November 2014, as part of the lead-up to the 2020 Tokyo Olympics and Paralympics, Japan Toilet Labo launched a project to put in place an environment where toilet usage is available to everyone, free of concern and regardless of gender, cultural background, or disability. As the first stage of this Global Toilet Hospitality Project 2020, an effort began last year to solicit opinions from people regarding how to improve public restrooms. Around 2,000 pieces of feedback have been gathered as of November 2015.

For example, those who use wheelchairs or guide dogs, pointed out the importance of keeping floors clean and dry. Wheelchair users noted how water and dirt can cling to a wheelchair, while those accompanied by guide dogs did not want to make their trusted partners have to lie down on such a floor. Another sort of comment received from foreigners and the visually impaired was that toilets had too many buttons, making it hard to know which button was used for a particular function. In addition, there was feedback about how dividing restrooms into those intended for men or women can create difficulties in the case of transgendered individuals or care-givers and receivers of different genders.

Scene from the panel discussion at a forum held at Taishō University on November 14, 2014, as part of the Global Toilet Hospitality Project 2020; discussion centered on how to make restrooms more accessible to users with special needs.

Plans call for the project members to present results compiled from the gathering of feedback in December 2015, and then begin efforts the following year to address the difficulties identified. In addition to improving facilities, it will likely be necessary to engage in the development of materials and to rethink the framework for providing information to the public.

Learning about the toilet-related difficulties that various people face also teaches us more about the nature of their disability or situation. Quite a few problems can be solved once we are aware of the nature of the difficulty. I would like to continue striving to expand my awareness of other people through my work with toilets.

Improving Toilets to Improve People’s Lives

Finally, I would like to touch on the issue of the sanitary conditions of toilets in developing countries. Some 2.5 billion people around the globe do not have access to sanitary toilets, and roughly 1 billion people are forced to defecate in the open. According to UNICEF, of the estimated 6.6 million children who died in 2012 before reaching the age of five, diarrhea was the cause of death in 9% of the cases, accounting for around 580,000 lives lost. Up to now this issue of fatalities related to toilet sanitation was treated as a separate subject from toilet-related issues in Japan, but moving forward I think that they should be considered together.

We need to create a world in which everyone, day or night, has access to safe and reliable toilets. This is not such a difficult task. New technologies and know-how are already transforming our lives at a remarkably rapid rate. As long as we take fundamental steps to improve awareness of the need to improve toilet facilities, success is likely.

Even more foreign visitors will be flocking to Japan with its hosting of the 2019 Rugby World Cup as well as the 2020 Tokyo Olympics and Paralympics. This will be an opportunity for Japan to showcase an array of new technologies and features for toilets, including energy- and water-conservation systems, sanitation and toilet-cleaning technologies, new sewage treatment methods, resource uses of human waste, universal design innovations, improved information provision, volunteer-based support, and prototype toilet designs. Japan will thus have a chance to show the world what it is capable of doing. I hope to contribute to the effort, so Japan can build on this experience to move on to an even higher stage of sanitation evolution.

(Originally written in Japanese and published on November 17, 2015. Banner photo: Participants in an event organized by Japan Toilet Labo.)

Great East Japan Earthquake Paralympics disasters Hanshin-Awaji Washlet toilet