top of page
TBN orange paperback.jpg


In the early twenty-first century, when surgery can be done microscopically and human ambition seems limitless, 2.6 billion people lack the most basic thing that human dignity requires. Four in ten people in the world have no toilet. They must do their business instead on roadsides, in the bushes, wherever they can. All this excrement contaminates food and water supplies. A gram of human shit can carry 1 million bacteria, 10 million viruses and 100 worm eggs. Diarrhoea — usually brought on by fecally contamined food or water — kills more children under 5 than anything else except respiratory infections (also linked to poor hygiene). Shit is a very powerful weapon of mass destruction.

Meanwhile, the western world luxuriates in flush toilets; in toilets that play music or can check blood pressure, where the flush is a thoughtless thing, and anything that can go down a sewer - nappies, motorbikes, goldfish - does. The Big Necessity - as one Mumbai toilet builder called the toilet - is the account of my travels through the engaging but enraging world of human waste disposal. I met activists such as Jack Sim, founder of the World Toilet Organization; Wang Ming Ying, who is attempting to alleviate environmental devastation and deforestation in China by persuading rural Chinese to install biogas digesters, which produce cooking gas from human feces; Dr. Bindeshwar Pathak, whose NGO Sulabh has built half a million toilets in India, as well as the world's only museum of toilets; and the flushers of London and New York's sewers, who scoff at roaches but hate rats nearly as much as they hate congealed cooking fat and tri-ply toilet paper.

Human "waste" — it needn't be — is full of nutrients. It is a rich, valuable, inexhaustible material, as rich as the world of people who work with it. For a 2014 afterword, I travelled to Rwanda's prisons, where genocidal murderers cook prison food with gas derived from their latrines; and I wondered why so many Americans complain that biosolids (the dirt left when wastewater is cleaned, and used as fertilizer) are making them ill.


The Big Necessity is an overdue exploration of a hidden world and of the world's biggest unsolved public health crisis. It is a cultural, colourful travelogue around a fact of life that is common to everyone, as necessary as breathing, and a source of endless fascination, if only the toilet wasn't a dirty word.


Ms. George is the kind of writer — tenacious and clever — who will put you in mind of both Jessica Mitford (in her exposé “The American Way of Death”) and Erin Brockovich. She is angry about what she discovers, and she offers the kind of memorable details that make her points stick.

The New York Times

Throughout her exploration of the dark and pungent world of human waste and its disposal, George remains curious, sceptical, open-minded and remarkably good-humoured. [...] Rose George has written a tactful, outspoken, amusing, shocking, highly informative and useful book. It may even - if you read it carefully - change your life.

Sunday Telegraph

The Big Necessity belongs in a rare handful of studies that take a subject that seems fixed and familiar and taboo and makes us understand it is historically contingent and dazzlingly intriguing. Jessica Mitford did it with her classic study The American Way of Death; Michel Foucault did it with Madness and Civilization. Rose George has produced their equal: a gleaming toilet manifesto for humankind.


The topic invites euphemism or tittering toilet humour, but she has an answer to those who think it beneath their dignity: how a society disposes of its sewage tells you a lot about its economy, politics and religion. Rose George's book, which looks at the toxic effects of poor sanitation and the heroic efforts of the visionaries who seek to improve it. [...] An invaluable contribution. [...] As she prods, pesters and provokes, she proves an excellent shit-stirrer.

The Guardian

[Ms George] glides with rueful and articulate poise through the biology, ecology, physiology, psychology and basic hydraulics of her subject, always articulate and persuasive. [...] You will be hard pressed to put this extraordinary book down.

New York Times

The last taboo, surely, is shit. The byproducts of digestion are so hard to mention—adolescent jokes aside—that symptoms of bowel cancer are often ignored until it is too late. But as Rose George explains in this fascinating and eloquent book, there is a great deal that needs to be said about excretion that is not remotely funny.

The Economist
bottom of page