I began this series of posts with a piece exploring the topic of race.  In the 2nd I tackled disease, HIV and hypochondria.  In this, the third in the series, I will continue to share the concerns, uncertainties and revelations that led up to and culminated in my visit to Zambia.  I do this in the hope of helping many of you better understand  your own fears, paranoia  and to perhaps answer questions you might otherwise be uncomfortable asking or discussing.  The topics in this series are delicate ones, many of which are considered off-limits or too embarrassing to discuss openly.  As I seek to express, analyze and discuss them, please keep this in mind.   A more in-depth introduction can be found in the first post in this series: Travel Fears: Africa – Revelations as A White Traveler. You can see part II of the series here: Travel Fears: Africa – Disease, HIV and Light Hypochondria.

Bathroom Revelations

I was 24 when I learned a shocking fact.  People take two approaches to using toilet paper – some of us fold, while others scrunch. Both work well and have their uses but what really shocked me was that it wasn’t until I was 24 years old that I learned there was another way to wipe my bum. That comes to about 8,760 days spent going about my business without the foggiest clue I had a whole different set of options.  I find this to be a perfect illustration of just how taboo the subject is.   It also strikes me as an interesting example of just how unoriginal we can be when servicing parts of our daily routine. Which, in part, is probably why westerners find the thought of using squat toilets terrifying.

For those unfamiliar, a squat toilet is…well…a hole in the ground. If you’re lucky that hole can be quite fancy with slightly raised foot rests and at times even a sanitary hose for bidet-like cleaning. At the end of the day though, it’s just a hole in the ground. A hole that you have to squat over to use while praying that your aim is good, that you don’t fall over, have your phone slip out of your pocket and into the hole, and that you don’t spray paint your shoes.

Despite traveling in quasi-squat countries for years they terrified me and I managed to avoid them.  I would walk into a restroom, throw open the stall door and then issue a stream of muttered profanity when greeted by a squat toilet’s open maw.  Then, after a nervous and awkward staring contest I’d eventually give up, reverse my route and then commence the tourist’s squat toilet dance.  You know – that dance which resembles that of a small child who needs to use the restroom but refuses, instead walking stiffly around the house, sweating, and shooting daggers at anyone who tries to talk to them in the process.  If you’re observant you’ll find a lot of western tourists doing this same dance in squat toilet countries.  It’s a comically uncomfortable experience and one that can be more than a little embarrassing.

Worse than just the dance though is the behavioral change that goes with it.  While a lot of us are hesitant to admit it, I know more than a few travelers have actually structured their schedules around safe toilet breaks.  That’s a pretty fundamental behavioral factor in a trip not to talk about….right?  As an individual that is lactose intolerant and whose stomach has a fairly resilient but temperamental disposition, I’ll admit that strategic toilet thinking has definitely shaped more than a few day’s itineraries. Which left me nervous…which in turn…well…left me in need of a porcelain perch that much more often.

Squat Toilets

No longer! Zambia finally forced me to confront my fears, take a squat and I’m happy to tell you all I survived…barely.  Fellow travel bloggers LOVE to sing the praises of squat toilets. How they prefer them, how much healthier they are, how comfortable they are, how they’re natural and even how much more sanitary they are.  The wikipedia page for squat toilets is basic, but still manages to read as a public service announcement noting they:

• Make elimination faster, easier and more complete. This helps prevent “fecal stagnation,” a prime factor in colon cancer, appendicitis and inflammatory bowel disease.
• Protect the nerves that control the prostate, bladder and uterus from becoming stretched and damaged.
• Securely seal the ileocecal valve, between the colon and the small intestine. In the conventional sitting position, this valve is unsupported and often leaks during evacuation, contaminating the small intestine.
• Relax the puborectalis muscle which normally chokes the rectum in order to maintain continence.
• Use the thighs to support the colon and prevent straining. Chronic straining on the toilet can cause hernias, diverticulosis, and pelvic organ prolapse.
• A highly effective, non-invasive treatment for hemorrhoids, as shown by published clinical research.
• For pregnant women, squatting avoids pressure on the uterus when using the toilet. Daily squatting helps prepare one for a more natural delivery.

Squat Toilet Strategy

Every time I use a squat toilet I feel like I’m participating in a timed military drill.  Get in. Get down.  Rescue the prisoners. Get up. Get out.  Why?  Well, let’s just say it really sucks when your knees start to burn, the muscles in the arches of your feet start to cramp, you’re dehydrated, and you’re still trying to take care of business.  All while trapped in a tiny thatched mud hut in the middle of nowhere aiming for a small square cut into the cement floor. No rope to support yourself, oddly stained brick walls you don’t dare touch just out of reach, and nothing to prop yourself up on.  Oh, did I mention the giant spiders staring down at you from the roof?  Yes. Giant spiders. Meanwhile praying you’re not accidentally and embarrassingly re-decorating your paints or shoes in the process. All of which makes resting lazily on a porcelain standing toilet look REALLY good.

What I’ve realized is that a primary source for many of the issues we have with squat toilets stems from basic cultural body dynamics.  In places like Zambia, Dubai or India you’ll regularly see people casually relaxing in a squatting position.  For many it’s a comfortable alternative to sitting cross legged or in a chair. Even more important though, they’ve been squatting in this position since they were kids AND when they do it, they do it flat footed.

As you’ll note in the photo above I definitely can’t squat flat footed and if you’re having a lot of issues with squat toilets, you probably can’t either.  My tendons are too tight and i’m not flexible enough.  This is partially due to my height, but it is largely just because I’ve never needed to. When I squat I’m squatting on the balls of my feet. The rest of my foot is completely off the ground.  As a result I’m far less stable and far more prone to cramping than a more flexible or flat footed squatter. In turn this means that my body weight isn’t as well settled which puts added strain on my already weak knees causing increased discomfort.  I’ve tried to squat flat footed, but have a lot of work to do if I’m ever going to manage it.  I think in my particular case it is especially bad because of the muscles I’ve developed during 9 years as a salsa dancer….a dance which is danced predominantly on the balls of one’s feet.

If you’re nervous about squat toilets my advice to you is to experiment and to see if you can squat flat footed.  If you can’t and you have a few weeks left before your trip starts, begin stretches and exercises designed to improve your ability to squat flat footed.  You’ll be doing yourself a huge favor. Even if you can squat flat footed, consider pausing to squat for 3 minutes straight 3x a day in the lead up to your trip.  It’ll be good for your thighs, and help refresh the muscles you’ll need!

To reduce risk of splatter damage it’s advisable you take a wide squat base. This should improve balance and more importantly keep you cleaner. If wearing pants or shorts keep them above the knee when squatting, just mind what’s in your pockets. The temptation is to lean forward and rest your body on your legs, but you’ll be far better off if you can keep your spine straight as this should help reduce…shall we call them, “explosive projectiles” … or you can take a slightly different approach like my buddy Mark over at Migrationology who just takes his pants off completely.

Cleanup

This is still the part of the process I’m less than comfortable with. The toilets in Dubai had fancy hoses and nozzles. The more traditional or basic versions around the world often just provide a small bucket with water or a water tap.  Unfortunately, it’s as straight forward as you’re afraid it is.  Take the water, in whatever form it comes, and rinse yourself.  If water alone is insufficient use your left (not right) hand to help clean yourself, and then use the water to wash your fingers further.

But, that means you’ll be squatting there with a wet bum, right?  Yep. Unfortunately it seems that’s not a concern. No pat dry necessary (allowed?). Just shake off as much water as you can, and then pull your pants up and go about your business.

If, like me, you find the concept of touching a hose/handle/cup/nozzle that everyone else has touched…shall we say…suspect? Then you can plan ahead and take a pre-filled plastic coke bottle in with you for use as your own private water source. The locals will likely see this as “less clean” but we’ll agree to disagree.  If your trip is shorter, you can also pack in your own wet-wipes or toilet paper. Just be mindful when disposing of the paper, as many toilets can’t handle it. If you’re not able to shower on a daily basis or expect to have food-related complications I highly recommend you have wet-wipes on hand.  They’ll make a huge comfort difference and do wonders for your mood.

It’s also interesting to note that use of water/toilet paper seems to vary from country to country.  Not all squat toilets lack toilet paper. In Zambia, there was rarely water available and always toilet paper to be found.  In Dubai, however, a mixture was often present.

Final Thoughts and Tips

You’re not always going to be able to avoid squat toilets.  However, you will be able to avoid them far more often than you think. When trying to seek out a traditional western seated toilet make sure to keep a close eye out for handicapped bathroom stalls.  Even in bathrooms that were almost exclusively squat toilets, the handicapped stall was typically a traditional western toilet.  Other bathrooms (such as the old wing of the Dubai Airport) alternated between squat and sitting toilets every other stall.

Unfortunately, you’ll find that many of the toilet seats in squat-centric countries are cracked, missing or damaged.  This is because toilet anxieties go both ways – an oddly re-assuring fact.  Traditional squatters don’t like and are at times unsure how to use our seated toilets. So, many will actually squat while perched on top of the toilet seat.  This ends up damaging the seat or breaking it free altogether.

If using rural squat toilets it can be immensely useful to take a brick, or stick in with you.  The brick to help brace yourself if you’re having stability issues, and the stick to help balance yourself.

I hope this post helps alleviate some of your fears, answer some of your questions, and better prepares you for your next face-to-face encounter with squat toilets.

If you’ve got an added piece of advice feel free to chime in!