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Small islands are closed systems, microcosms of the planet.
This documentary details the challenges of small island sanitation:
I find it especially interesting how this combination of poor sanitation and the traditional root vegetable diet of the Pacific Islands has resulted in the world's highest rates of obesity. Root vegetables are very high in resistant starch possibly feeding an overgrowth of Firmicutes intestinal bacteria associated with obesity, diabetes and heart disease. This would occur over generations such that children are born predisposed to obesity, a matter of microbial predisposition. Sanitation is not yet commonly associated with global obesity epidemics, but I wonder if poor sanitation is a major factor in obesity epidemics, i.e., Persian Gulf nations. en.wikipedia.org/wiki/Obesity_in_the_Pacific
We have the exact challenges here in Florida, USA as we pollute important coastal waters with septic waste and nutrient-laden water discharges from Lake Okeechobee. The Indian River, for example, is in peril for these reasons. I'm presently on a team having notified Florida Department of Health of a lawsuit claiming they have violated the Endangered Species Act in allowing septic waste to threaten the Indian River Lagoon (IRL). Here's our website; my input including links is under Re-Plumbing the Future: www.manateeindianriverlagoon.com/