Increased Infections: Poor Toilet Design and Disinfection - infections from sitting on toilet seats?

  • Ashok
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Re: Increased Infections: Poor Toilet Design and Disinfection

Let me add to the confusion going on the subject of Sitting vs squatting

I am going to talk about our habits in the wash room and hand washing. Lot of emphasis is placed on hand washing with soap, that too for sufficient time and all over. There are a lot of videos on the subject by National and International Bodies.


After we get up from the seat after ablution with water, cleaning with paper or any other material and our hands dirty,
1. We straiten our clothes,
2. Tie the ribbon of Pyjama, Salwar etc., or fix the zip and buttons of pants and jeans,
3. If one is having an under wear, that too is to be placed and tied properly,
4. We open the door by its handle,
5. We close the door,
6. We walk to the wash basin and open the tap.
We do all this with our dirty hands, before we wash them.

Am I wrong in thinking that there should be a wash basin right along with the toilet seat so that we can wash our hands before leaving the seat.
We may wash them again after coming out of the toilet cubicle, if we so want.
The wash basin may be flush with the wall and may be rotated on a pivot, to come in front. Or some other arrangement.
The problem is more aggravated in rural scene where the person has to walk back home from the field and at times even children playing with them and so their clothes.

The possibility of Using the hand wash water with soap etc. can also be used for flushing the urinals.
The same can be done in Toilets also if septic tanks are not being used.

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  • muench
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Re: Increased Infections: Poor Toilet Design and Disinfection

Hi Ashok,

Thanks for raising those points. The "disinfection issue" is not an easy one - where and what needs disinfection... perhaps the door handle is filthier than the toilet seat... Next time you handle money you potentially touch something filthy again etc. Hence the point of handwashing with soap "at critical times", e.g. before eating, after using the toilet. Just disinfecting the toilet seat might have little practical benefits in the scheme of things.

Hi Hester,

I wanted to come back to two points that you made:

And for my understanding: if Linda says she has evidence from infections caused by unclean sitting toilets, why would we not believe her?

--> This is nothing personal against Linda. There are all sorts of health claims floating around in the internet. You'd be gullable if you believed every single one of them. I just said that I'd like to see some scientific evidence please, or otherwise her statement should be clearly marked as "hear say" or perhaps as "anecdotal evidence". Remember the statement that I questioned was:
"Three in 10 women using these toilets without proper disinfection is bound to have recurrent infections. As opposed to those who use squat hole toilets. These infections according to the State Minister of Health Uganda, Hon. Sarah Opendi are a cause of infertility causing women 's Fallopian tubes to clog." (there are many health myths floating around regarding infertility in Africa; that's why I get extra suspicious when I see fertility mentioned in this context)

Do you not question such health claims when they get thrown at you? I have become very careful with believing anything regarding health, based on my work with Wikipedia Medicine. Any health-related claim in Wikipedia requires one or more reliable sources. I think that's very good practice. See here what is a reliable source in that context:

Sure, a discussion forum is not Wikipedia. Here we can voice opinions, guesses, hypotheses, stories, possible linkages and anecdotal evidence. That's fine. But it should be clearly identifiable as such.

You also said:

For some reason, the good old French have squatted for ages and still do, to a large extend - and they won the World Soccer games. Could we ask a French woman about the experiences in her country, and the reason why many French prefer squatting over sitting on toilets?

I don't think this is correct unless there are pockets of France that I haven't travelled to yet and where that is the case. On all my trips to France, I have never come across a squat toilet except for once at a camping park in the South of France about 30 years ago. There is an increasing Muslim population in France though (I think) so perhaps squat toilets with water hoses for washing with water are being installed in public spaces to cater for their needs? Is that what you have observed?

Could we hear from our French forum members? Is Heather right to say that many French prefer squatting over sitting on toilets?

For those wanting to know more about squat toilets and where they are common there is a fairly good Wikipedia article about it: (see also its talk page if you want to see what the editors of this article discussed during its development: )

See you,

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  • lindasemana
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Re: Increased Infections: Poor Toilet Design and Disinfection

Dear Elizabeth,

There is a basis for what i shared but for the sake of scientific validation i am to research and present more of this. The basis was from a personal experience i have suffered recurrently that led me discuss with women in a workplace of 283 people who were sharing the toilets. The outcome of this discussion was.....there was a high rate of infections especially where there was no provision of disinfectants for the women to use before using the same toilet seat with affected persons. I want us to consider seriously the fact that women's anatomy is open and that makes it more susceptible to infections in a busy place where the stance ratio is high. Besides this there those moments when there is a splash from the toilet bowl. Emphasis should be on disinfection, but if squat toilets reduce on the risks entailed in a woman's parts touching the bacterial infested toilet seat - i vote for that.
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  • hester
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Re: Increased Infections: Poor Toilet Design and Disinfection

Dear all,

Elisabeth, I totally agree that if we talk about the link between sanitation and health, scientific evidence is needed to verify statements on cause-effect relations. I reacted to the discussion because I wanted to give value to a post coming from Uganda, from a practical experience of a group of women who feel unsafe using a sitting toilet. Their choice is to go to a squatting toilet instead, it is their preference, as women who grew up in Uganda and have a life time experience using toilets and having to take care of their own personal health. At the same time, their negative experiences with dirty sitting toilets seems to be shared with more people in Uganda, to an extend that government is willing to take measures, taking into account the preference of (at least a group of) public toilet users. I never before heard of infertility in women caused by contact with a toilet seat, but I will ask a friend who is gynecologist, she will answer me and then I will come back to this forum with my findings. As for the French, it is true that they won the World Cup, but for the squatting: I think that in general, if households have money and continuous water supply, they will go for comfort, and the same for countries with sufficient resources to build and maintain public toilets and provide continuous water supply. But: how many fast growing cities in the world have continuous water supply? Also, will sitting toilets be considered the best option by all people on the globe? Personal or cultural preferences may differ from one country to the other.
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  • kimgerly
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Re: Increased Infections: Poor Toilet Design and Disinfection - The Türkish implementation

Here's my experience using squat toilets in Türkiye which were common when I lived there decades ago as a child, and are still prevalent when I traveled there last decade.

Türks usually have a water spigot with a small water catchment bucket (to be mindful of managing this resource) in the stall and in the vicinity where one squats, so one can reach and turn the spigot without much difficulty. Simple and manageable, provided one has access to a water supply.

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