Squat toilet (flush toilet) with water cistern for flushing (Cape Town, South Africa)

A squat toilet (or squatting toilet) is a toilet used by squatting, rather than sitting. This means that the posture for defecation and for female urination is to place one foot on each side of the toilet drain or hole and to squat over it. There are several types of squat toilets, but they all consist essentially of a toilet pan or bowl at floor level. Such a toilet pan is also called a "squatting pan". A squat toilet may use a water seal and therefore be a flush toilet, or it can be without a water seal and therefore be a dry toilet. The term "squat" refers only to the expected defecation posture and not any other aspects of toilet technology, such as whether it is water flushed or not.

Squat toilets are used all over the world, but are particularly common in some Asian and African nations, as well as in some Muslim countries. In many of those countries, anal cleansing with water is also the cultural norm and easier to perform than with toilets used in a sitting position. They are also occasionally found in some European and South American countries.

Squat toilets are regarded as traditional by many. In 1976, squatting toilets were said to be used by the majority of the world's population.[1] However, there is a general trend in many countries to move from squatting toilets to sitting toilets (particularly in urban areas) as the latter are often regarded as more modern.[2][3]

Design

Side view of a ceramic squat toilet in Japan before installation

Squat toilets are arranged at floor level, which requires the individual to squat with bent knees.[4] In contrast to a pedestal or a sitting toilet, the opening of the drain pipe is located at the ground level.

Squatting slabs can be made of porcelain (ceramic), stainless steel, fibreglass, or in the case of low-cost versions in developing countries, with concrete, ferrocement, plastic, or wood covered with linoleum.[5][6] Slabs can also be made of wood (timber), but need to be treated with preservatives, such as paint or linoleum, to prevent rotting and to enable thorough cleaning of the squatting slab.[6]

There are two design variations: one where the toilet is level with the ground, and the other where it is raised on a platform approximately 30 cm (1 ft).[7] The latter is easier to use for people who urinate while standing, but both types can be used for this purpose. There is also no difference for defecation or squatting urination.

Use

How to use a squat toilet correctly (sign in a toilet cubicle in Japan)

The user stands over the squat toilet facing the hood and pulls down (up in the case of skirts or dress) their trousers and underwear to the knees. The user then squats over the hole, as close to the front as possible, as excrement tends to fall onto the rear edge of the in-floor receptacle if the user squats too far back.[7]

Health, hygiene and maintenance

The standing surface of the squatting pan should be kept clean and dry in order to prevent disease transmission and to limit odors.[5]

Squat toilets are usually easier to clean than sitting toilets (pedestals), except that one has to bend down further if the squatting pan needs manual scrubbing. They can be cleaned by using a mop and hose, together with the rest of the floor space in the toilet room or cubicle.

Health effects

The squatting defecation posture is more physiological, ideal and relaxed.[8] This is because it allows for better relaxation of the puborectalis muscle and hence straightening of the anorectal angle, and for faster, easier and more complete evacuation of stool.[9][10][8] The squatting position therefore prevents excessive straining, and hence protects against stretching of the nerves, such as the pudendal nerve.[10][8] Damage of these nerves can lead to permanent problems with urinary, defecation and sexual function. The squatting position also increases intra-abdominal pressure.[9] The squatting position is often recommended as part of a range of measures to manage constipation and its sub-types, including obstructed defecation syndrome and dyssynergic defecation. Chronic, excessive straining during defecation, which is more likely to be needed in the sitting position, may be associated with the development of inflamed hemorrhoids or any of the spectrum of pelvic organ prolapse disorders, such as rectocele, rectal prolapse, etc.

However, according to some sources, excessive straining in the squatting position while defecating may increase the risk of severe hemorrhoids, or increase the tendency of prolapse of hemorrhoids, because of increased perineal descent and intra-abdominal pressure.[11][12] Prolonged and repeated straining on a sitting toilet has the same effect.[12]

Society and culture

There are two different attitudes towards squat toilets, largely dependent on what users are used to, or whether the toilet is at a public or private place: Some people regard squat toilets as more hygienic compared to sitting toilets. They might be easier to clean and there is no skin contact with the surface of the toilet seat.[2] For that reason, some people perceive them as more hygienic, particularly for public toilets.

Some people regard sitting toilets as "more modern" than squat toilets.[2] Sitting toilets have a lower risk of soiling clothing or shoes, as urine is less likely to splash on bottom parts of trousers or shoes. Furthermore, sitting toilets are more convenient for people with disabilities and the elderly.[13]

A trend towards more sitting toilets in countries that were traditionally using squat toilets can be observed in some urban and more affluent areas, in areas with new buildings (as well as hotels and airports) or in tourist regions.[2]

Public toilets

Squat toilet at a motorway service station near Toulouse, France. In areas of Europe where squat toilets are used, they are usually public toilets

Squat toilets are used in public toilets, rather than household toilets, because they are perceived by some as easier to clean and more hygienic, therefore potentially more appropriate for general public use.[2][14] For instance, this is the case in parts of France, Italy, Greece, or the Balkans, where such toilets are somewhat common in public toilets (restrooms).[14]

Preferences by country or region

The following general statements can be made:

  • Squat toilets are common in many Asian countries, including China and India.[15][16][17] They are also widespread in Nepal, Indonesia, Bangladesh, Pakistan, Sri Lanka, Malaysia, Myanmar, Iran and Iraq. They can be found in nations like Japan, South Korea, Taiwan, Thailand, and Singapore.[7][16]
  • People in sub-Saharan African countries, especially in rural areas, widely use squat toilets, for example in Kenya, Rwanda, Somalia, Tanzania, and Uganda.[2]
  • Much of the world's population use squat toilets, especially in rural areas of developing countries.
  • Countries in the Middle East and North Africa often have both types of toilets, i.e. sitting and squatting.
  • In Hindu or Muslim cultures, the prevalence of squat toilets is generally quite high, as is the practice of anal cleansing with water.[2]
  • In Latin and South America, flush toilets are always of the sitting type, whereas dry toilets may be either of the sitting or a squatting type. The occurrence of squat toilets in urban areas of Latin America appears to be rather low.
  • Squat toilets are rare in Australia, New Zealand, United States, Canada, and countries in Northern and Western Europe (except public toilets in France).[2] Where they do exist, they have usually been installed to accommodate visitors, tourists, students, or recent migrants from places that use squatting toilets traditionally.

Europe

In Southern and Eastern Europe including parts of France, in Greece, Albania, Balkans, and Russia they are common, especially in public toilets.[14] But the trend in Russia is to move away from squat toilets. Squat pit latrine toilets are present in some rural areas of Eastern Europe.

Squat toilets are generally non-existent in Northern and Western Europe.[2] France and Italy are an exception and have some squat toilets remaining in old buildings and public toilets because they used to be the norm there in the early 20th century.[18] In BMW Welt in Munich, the public restrooms have some stalls with squat toilets.

China

Many areas in China have traditional squat toilets instead of sitting toilets, especially in public toilets.[19] Nevertheless, sitting toilets have increasingly become the norm in major urban areas and cities.[19] Sitting toilets are on the one hand associated with development and modernization, and on the other hand with reduced hygiene and possible transmission of diseases.[19]

Japan

Although in Japan it is believed that the squat toilet is traditional, the trend in Japan is to move away from squat toilets: According to Toto, one of Japan's major toilet manufacturers, the production of Western-style toilets increased rapidly since 1976.[20] In 2015, only 1% of all toilets produced by this company were squat toilets.[20]

Since the 1960s, the trend has been to replace squat toilets at schools and public places with sitting toilets.[20] This trend was thought to accelerate in the run-up to the 2020 Summer Olympics in Tokyo.[20]

Since the 1980s, high-tech sitting toilets are emerging that replace traditional squat toilets, especially in urban areas. One of those toilets with the brand name "Washlet" includes a "posterior wash" before wiping, and features heated toilet seats. However, many rural people have no experience with such high-tech toilets and need detailed instructions.[21] High-tech sitting toilets have also become commonplace in South Korea.

See also

References

  1. ↑ Kira A. The Bathroom. Harmondsworth: Penguin, 1976, revised edition, pp.115,116.
  2. 1 2 3 4 5 6 7 8 9 von Münch, E.; Milosevic, D. (2015): Qualitative survey on squatting toilets and anal cleansing with water with a special emphasis on Muslim and Buddhist countries by using the SuSanA discussion forum. Ostella Consulting, Schwalbach, Germany
  3. ↑ "Japan Phasing Out Squat Toilets". nippon.com. 2019-01-08. Retrieved 2021-11-19.
  4. ↑ Burns, Anthony S.; O'Connell, Colleen (2012). "The challenge of spinal cord injury care in the developing world". The Journal of Spinal Cord Medicine. 35 (1): 3–8. doi:10.1179/2045772311Y.0000000043. PMC 3240914. PMID 22330185.
  5. 1 2 Tilley, E.; Ulrich, L.; Lüthi, C.; Reymond, Ph.; Zurbrügg, C. (2014): Compendium of Sanitation Systems and Technologies - (2nd Revised Edition). Swiss Federal Institute of Aquatic Science and Technology (Eawag), Duebendorf, Switzerland: 44. ISBN 978-3-906484-57-0. Retrieved 31. August 2015
  6. 1 2 Reed, Brian; Shaw, Rod (2011). G005: Latrine slabs - an engineer's guide. Loughborough, UK: WEDC. p. 11. ISBN 9781843801436. Retrieved 8 April 2015.
  7. 1 2 3 "Japanese toilets". Japan-Guide.com. Retrieved 16 October 2018.
  8. 1 2 3 Ghoshal, UC; Sachdeva, S; Pratap, N; Verma, A; Karyampudi, A; Misra, A; Abraham, P; Bhatia, SJ; Bhat, N; Chandra, A; Chakravartty, K; Chaudhuri, S; Chandrasekar, TS; Gupta, A; Goenka, M; Goyal, O; Makharia, G; Mohan Prasad, VG; Anupama, NK; Paliwal, M; Ramakrishna, BS; Reddy, DN; Ray, G; Shukla, A; Sainani, R; Sadasivan, S; Singh, SP; Upadhyay, R; Venkataraman, J (November 2018). "Indian consensus on chronic constipation in adults: A joint position statement of the Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology". Indian Journal of Gastroenterology. 37 (6): 526–544. doi:10.1007/s12664-018-0894-1. PMC 6339668. PMID 30617919.
  9. 1 2 Steele SR, Hull TL, Hyman N, Maykel JA, Read TE, Whitlow CB (20 November 2021). The ASCRS Textbook of Colon and Rectal Surgery (4th ed.). Cham, Switzerland: Springer Nature. ISBN 978-3-030-66049-9.
  10. 1 2 Hari Krishnan, R (April 2019). "A review on squat-assist devices to aid elderly with lower limb difficulties in toileting to tackle constipation". Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. 233 (4): 464–475. doi:10.1177/0954411919838644. PMID 30898031.
  11. ↑ Clark S (22 June 2018). Colorectal Surgery: A Companion to Specialist Surgical Practice (6th ed.). Edinburgh: Elsevier. ISBN 978-0-7020-7243-7.
  12. 1 2 Seow-Choen F, Tan K (2009). Bland KI, Sarr MG, Buechler MW, Csendes A, Garden OJ, Wong J (eds.). Chapter 85:Hemorrhoids (2nd ed.). Springer. p. 857. ISBN 9781846288326. {{cite book}}: |work= ignored (help)
  13. ↑ "Fear of public squat toilets confines elderly to homes". South China Morning Post. 15 March 2006. Retrieved 1 May 2019.
  14. 1 2 3 Olmert, Carol (2008). Bathrooms Make Me Nervous: A Guidebook for Women with Urination Anxiety (shy Bladder). Bathrooms Make Me Nervous. ISBN 978-0-615-24024-4.
  15. ↑ Lechner, Norbert (2012): Plumbing, Electricity, Acoustics - Sustainable Design Methods for Architecture. John Wiley & Sons, Hoboken, New Jersey.
  16. 1 2 Chang, Jin-Soo (2014). "The Cultural and Environmental Unsoundness of the Chinese Public Squatting-Type Toilet: A Case Study toward a Sustainable Excreta Treatment System". Environmental Engineering Research. 19 (2): 131–138. doi:10.4491/eer.2014.19.2.131.
  17. ↑ Lonely Planet Southeast Asia on a Shoestring. Lonely Planet. 2014. ISBN 9781742207537.
  18. ↑ Gershenson, Olga; Penner, Barbara (2009): Ladies and gents - Public toilets and gender. Temple University Press, Philadelphia, Pennsylvania.
  19. 1 2 3 Tobin, Joseph; Hsueh, Yeh; Karasawa, Mayumi (2009): Preschool in Three Cultures Revisited: China, Japan, and the United States. University of Chicago Press, Chicago, Illinois.
  20. 1 2 3 4 "Japan Phasing Out Squat Toilets". Nippon.com. 8 January 2019. Retrieved 13 February 2018.
  21. ↑ Cavusgil, S. Tamer; Rammal, Hussain; Freeman, Susan (2012): International Business: The New Realities. Pearson, Australia
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