Shitty Livelihoods, or What?
In the days when public health arguments and supply-led approachesdominated efforts to sanitize poor communities, the economic benefits ofinvestments were presented purely in terms of savings to the health budget, and gains to economic production in terms of person working hours and days. WHO has recently conducted an extensive exercise to calculate these benefits: for example, it has calculated that a US$1 investment in water and sanitation services yields between US$3 and US$34, depending on where it is spent, and that reaching the Millennium Development Goals (MDGs) for water and sanitation would save the world US$7.3 billion in health-related expenditure every year and US$750 million annually in the value of adult working days (Figure 6.1).1
But equally, if not more, important gains of an economic kind have recently begun to attract attention. These relate to the sanitary consumer economy: the growth of entrepreneurship, manufacture and employment to respond to the demands of people who are set to become proper toilet users. Economically active sanitary personnel extend way beyond public health engineers and sanitation promoters to include those who build facilities, service them, and market toilets and waste disposal to potential customers.