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Earnest Goh is wearing a dark blue suit and a broad smile. He slips off his laceless black leathers and, by way of demonstration, squats over a toilet one of his Singapore Polytechnic students has invented. It’s a special design that facilitates four different shitting positions: the wall-facing squat, as favoured in Japan; the forward-facing squat of Southeast Asia; the legs-apart sit; and the legs-together sit. (Check it out at sg.geocities.com/sitsquattoilet.)

Goh makes no secret of his preference: he’s a squat man, through and through. "Ergonomically, it is much better," he says, with a confident smile. On the table beside him, there’s a pro-squatting book written by Jonathan Isbit on sale for $35. It’s called Nature Knows Best and on the cover is an illustration of a man squatting in an idyllic mountain setting. Oddly, he’s still wearing his shorts.

We’re in an expo hall at the Venetian Macau during the World Toilet Summit – a gathering of some of the world’s leading minds on sanitation and waste disposal, organised by the World Toilet Organisation, which makes effective use of its famous acronym. The three-day summit is actually a very serious affair geared towards addressing a global crisis in sanitation. Thankfully, it also has the odd scented porta-loo and four-way craptacular.

Goh pulls out diagrams that show how the sit-down method can eventually lead to the anus compacting the vaginal cavity, causing painful health problems. Besides, he believes squatting just facilitates a more effective evacuation. "I feel that it comes out cleaner," he says. "There’s less leftover."
I raise my concern about the unidentified slurry that effectively turns the floors of most squat jobs into effluential skating rinks. His response is to play a YouTube video of an ad that shows a lithe young woman bracing herself against the walls of a toilet stall in order to avoid sitting on a heavily-soiled seat. Ernest follows this with a slide that states unequivocally that squat toilets are more hygienic. I believe him. Anyway, I’m terrified my anus will cave into my vagina.

I return to the conference room, where a delegate from the British Toilet Association is holding forth about forward-thinking public toilets. I lean over to Rose George, author of the excellent The Big Necessity: Adventures in the World of Human Waste, and whisper, "I’ve just found out I should be squatting." She replies knowingly, "Yeah – sitting’s ridiculous," and gets back to writing notes.

George, a diminutive journalist from Yorkshire, has traversed the sewers of New York and London and inspected in fine detail toilets in countries far and wide. She points out that shit is a major health problem related to at least 50 different diseases and responsible for illnesses and deaths worldwide – even in developed countries. Lack of organised sanitation results in about 1.8 million child deaths from diarrhoea every year, and half of the population in developing countries suffers from health problems related to water and sanitation defects, according to the WTO.

But shit gets no love. Though sanitation, with long-term vision, can offer a high return on investment ($7 earned for every $1 invested, George reckons), few people want to go near it. "All the money goes to water, and all the political attention," says George. "Nobody wants to talk about latrines. No politician wants to stand in front of a latrine."

She hopes a celebrity will take up the issue as a pet cause. Just the other day, Matt Damon mentioned latrines at the Clinton Global Initiative, and apparently British actress Emma Thompson’s husband is into biogas. That’s not enough for George – she wants an Angelina Jolie or a Bono to take shit under their wings. Her hero is a sanitation whistle-blower who calls himself ‘Dr Shit’ and goes round schools in South Africa taking photos of inadequate toilets and shaming the headmasters into action.

Apparently, we spend about three years of our life on the toilet (for most of us, not all at once), and the world already has deep knowledge of matters scatological. We know that it kills us; we know that not enough energy is dedicated to addressing that fact. The imbalance between the problems and the scant political attention is baffling to George. "I don’t understand why people aren’t up in arms about it.”

Perhaps the WTO summit will change that. The Prince of Orange (that’s Holland, by the way, not the cell phone company) is here, after all. Or perhaps the media will just cover it for the cheap laughs and ignore the important issues: as has been proven since Chaucer first made fart jokes in print, there’s no better way to engage a reader. Just as well, then, you have Time Out to bring you the real dirt. Now excuse me while I enjoy the Venetians gambling tables – I’m off to play craps.

Buy Rose George’s The Big Necessity, published by Macmillan and on sale now.

Hamish McKenzie