Isabel Medem: Disrupting Global Sanitation with a Game-changing Toilet – Ep. 55


Isabel Medem is the co-founder of Sanima, a social startup that took on the challenge of providing sanitation to Lima, Peru, a city where 850,000 plus people are denied access to basic sanitation—something most of us take for granted every day.

World Toilet Day (November 19th) raises awareness of the fact that roughly 4.2 billion people are living without access to safely managed sanitation. Isabel was extremely bothered by this statistic, so she and her co-founder decided to build a company to tackle this problem at its root. It’s taboo, it’s unsexy, but it’s one of the most profound issues facing humanity as a whole today.

The solution is about taking action to tackle the global sanitation crisis and achieve Sustainable Development Goal 6: water and sanitation for all by 2030.

Even though sanitation is a human right recognized by the United Nations, we urgently need massive investment and innovation to quadruple progress all along the ‘sanitation chain’, from toilets to the transport, collection and treatment of human waste.

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10:33 – “If you do a water toilet, you need the infrastructure, you need piping, you construction, you need investments and you need a whole system and you need a treatment facility for that. So that’s just not—also, from a sustainable environmental aspect—that doesn’t make sense.”

11:18 – “And we first designed our own toilet, which was also one of the first steps in Peru. We spent one two weeks designing with Peruvians and a Peruvian team. We built a Peruvian team very quickly. Very interesting prototypes came out, a few of which actually lasted.”

17:28 – “[Having a toilet is] only one part of the problem, because the toilet fills up and we need to take that burden off of people’s minds as well. And so that’s why we focused on designing a service—on designing a way in which we can every week reliably and respectfully pick up and take away the accumulated feces so that the users no longer have to worry about that.”

20:52 – “When you say [these people] ‘don’t have access to’ sanitation, it’s actually like the government isn’t providing it to them.”

23:55 – “The toilet was probably going to work. But we needed the service to work, and we needed to know whether people were willing to hand us a bucket and whether they were willing to pay a little bit for it.”

33:29 – “I think the most important thing was to hire people, to build a team very, very quickly. I think that to me, that was the most important thing. Build a team now. Don’t just keep it in your head, and don’t make yourself the only person that will be thinking about this. Get other people in it.”

39:35 – “We need [access to sanitation]. And it’s not being provided to them. And then also this way of saying ‘people lack access to’ often makes it sound as though it were the responsibility of them to sort of find access to it, as though it’s also something that you can sort of plug into, right?”

43:41 – “I remember that the first month when we were accepting payments through the bank. I checked—I knew today was the day that we were going to start receiving payments, and I looked at the bank account and I saw the payments coming in. And that was a very emotional moment to me.”

48:55 – “Let go of people sooner rather than later. It’s not helpful for you or for them.”

51:59 – “It doesn’t mean that we have to eradicate social entrepreneurship. It means [we need] to make it better. But for us to make it better, we have to allow ourselves to become critical about it.”

RESEARCH NOTES ON World toilet day: 


“In some countries, the sanitation crisis is more pronounced, and incredibly high levels of the population are living without toilets: 75% in Uganda, 67% in Ghana, 66% in Ethiopia, 58% in Kenya, and 53% in Bangladesh.

“This lack of access to safe sanitation results in more than three-quarters of a million unnecessary deaths each year, with children, the vulnerable, and the elderly being at particular risk. Statistics show that every two minutes, a child younger than five dies from diseases due to poor water and sanitation.”


Written by Sarah Moore

Lack of improved sanitation facilities

“According to the World Health Organization and UNICEF, in 2015, only 68% of the world’s population used improved sanitation facilities, with Sub-Saharan Africa and Southern Asia having only 30% and 47%, respectively. An estimated 2.4 billion people are still without improved sanitation. About 13% of the world’s population lives without ANY FORM of sanitation and practice open defecation.”


Diseases and water, sanitation and hygiene

“If countries fail to step up efforts on sanitation, safe water and hygiene, we will continue to live with diseases that should have been long ago consigned to the history books: diseases like diarrhoea, cholera, typhoid, hepatitis A and neglected tropical diseases including trachoma, intestinal worms and schistosomiasis. Investing in water, sanitation and hygiene is cost-effective and good for society in so many ways. It is an essential foundation for good health.” – said Dr Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health


Benefits of access to clean water for women 

“But the benefits of having a source of clean water in a community are much wider. When women and girls no longer have to walk miles to fetch water each day, they have more time to learn. Literacy rates rise. And when schools build proper toilet facilities, girls spend more time in school and less time at home.” 


Written by Katie Dahlstrom and Helen Medina

Open defecation and increased risk of sexual violence among women

“Recent evidence shows that the implications of poor sanitation can extend beyond diseases. It can put women at a high risk for non-partner sexual violence (NPSV). Studies in Odisha have found that women feared unwanted sexual encounters such as being watched, indecent exposure, and NPSV when they go out in the open to meet their sanitation needs in the absence of toilets.”


Written by Apoorva Jadhav, Abigail Weitzman and Emily Smith-Greenaway

Time spent sitting on the toilet 

“It found men spend an hour and 45 minutes every week going to the toilet – whereas women get everything over with in a mere 85 minutes a week.”

“The poll of 2,500 people revealed that going to the toilet accounts for the biggest chunk of time spent in the bathroom – an average of one hour and 42 minutes a week, or almost 92 days over a lifetime.”


Danger of not having access to toilet facilities 

“Without proper sanitation facilities, people often have no choice but to live in and drink water from an environment contaminated with waste from infected individuals, thereby putting themselves at risk for future infection. Inadequate waste disposal drives the infection cycle of many agents that can be spread through contaminated soil, food, water, and insects such as flies.”


Toilets and economy

According to Secretary-General Ban Ki-moon:

“Toilets play a crucial role in creating a strong economy. A lack of toilets at work and at home has severe consequences, including poor health leading to absenteeism, reduced concentration, exhaustion, and decreased productivity. ” 

“Every dollar invested in water and sanitation leads to $4 in economic returns.”


Water poverty in the US

“One study found that between 2013 and 2017, around 1.1 million people in the U.S. had insecure water access. Almost a half of these people lived in the 50 largest metropolitan areas of the U.S. This included 65,000 people in New York who did not have access to piped water.”


Written by James Kingsland

Effort to reinvent toilet 

“A global research team, led by Georgia Tech Associate Professor Shannon Yee, Ph.D., has been developing a portfolio of reinvented toilets that bring together the best concepts from the last decade of the Bill & Melinda Gates Foundation-led Reinvent the Toilet Challenge.”

“While using the G2RT won’t differ from current toilet designs, how the toilet processes waste will be drastically different. Instead of relying on a network of pipes and millions of gallons of water, G2RT will treat human waste within the toilet appliance itself. Urine will go through a filtration process that produces clean water, and fecal matter will be reduced to pathogen-free solids and clean water.”


Written by Ayana Isles

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