Everyone Poops: The Risks of Being Polite

Written by

Lisa Schechtman
Lisa Schechtman Lisa Schechtman is the head of policy and advocacy at WaterAid in America, the U.S. member of WaterAid International, the world’s largest NGO focused on providing safe drinking water, sanitation and hygiene education (WASH) services for poor communities in 27 countries around the world. Prior to joining WaterAid, Lisa served as policy director at the Global AIDS Alliance, and was a member of the Developed Country NGO Delegation to the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Lisa has a Masters of Arts in International Human Rights and Global Health Affairs from the University of Denver, and a B.A. in English Literature and French Language from Northwestern University. She is based in Washington, DC.

When you work on global health policy, it’s hard to avoid topics that push the boundaries of “polite” conversation. Lots of things about our bodies are considered private, even embarrassing. Poop is a good example.

Sex is another taboo. Yet both sex and poop are basic to being human. They are subjects that turn heads when we global health advocates talk shop over dinner or drinks. They are linked in more ways than being impolite.

In fact, both poop and sex can cause life-threatening illness. Poop, in the form of diarrheal diseases that arise from unsafe drinking water and poor sanitation or hygiene, can lead to death. Sex too can contribute to serious illness, including HIV. These are highly preventable situations, especially when good services and accurate information are readily available.

Safe drinking water, sanitation and hygiene (WASH) are also basic elements of a comprehensive response to HIV and AIDS.



People living with HIV (PLHIV) have compromised immune systems. This means they are more susceptible to illness. We know that hand-washing with soap can stem the spread of germs that make us sick, as with flu or pneumonia. WASH programs teach people why hygiene matters and how to do it. They enable access to water that helps keep things clean without adding to the burden of women and girls responsible for collecting the water their households need. This lets people living with HIV stay healthier longer.


People being treated for HIV with antiretroviral therapy (ART) require clean water to take their medicine, and good nutrition for their medicine to work. With 50% of all malnutrition linked to poor quality water and sanitation, WASH programs can be a matter of life and death for those on ART. It’s pretty basic: keep the nutrients in by preventing diarrhea, let the drugs do their work.

Stigma and discrimination

People living with HIV and AIDS face enormous stigma and discrimination. Remember, these are taboo topics we’re talking about, and ignorance often leads to fear. Many human rights violations can result: lack of access to health care and education, violence, unemployment, eviction from housing and others. But stigma and discrimination can also lead to a violation of the right to water and sanitation if PLHIV and their families are discouraged or prevented from using taps and toilets. WASH programs can help by including everyone in the community, rather than treating various needs separately and therefore highlighting difference.

I am pleased to attend the 19th International AIDS Conference this month here in Washington, DC, on behalf of WaterAid. It is a space where the concept of universal human rights is accepted and people are allowed to be themselves, where that taboo topic of sex leads the agenda, and people challenge each other to get real.

I hope it will also be a space that allows us to talk about poop, especially with policymakers. Not only because diarrhea is a critical issue in the fight against HIV and AIDS, but because the HIV epidemic has taught us valuable lessons about how silence can lead to death.

The more polite we are, the more people die of diarrheal diseases and other outcomes of poor sanitation. If we can’t even talk about it, how can we do something to change it?

So let’s stop being polite. Let’s change those social norms that keep our poop behind closed doors. After all, everyone poops. If everyone had a safe and clean place to do so, and water and soap to wash their hands after, we’d have a much healthier world. On behalf of 2.5 billion people currently living without sanitation, and more than 33 million people living with HIV, join us in breaking the poop taboo.

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