The big necessity by Rose George is an unusual book since it discusses the details of how human societies deal with human waste. 2.6 billion people have nowadays no form of sanitation which has immense implications for public health. When excrement is disposed in open fields flies, the weather and other factors disseminate the droppings. One of the startling statistics of the book is that people in areas without sanitation ‘consume’ on average 10 gram of human waste a day contributing to the spread of diseases and bad public health in general.

The book describe the diverse ways countries and communities deal with human waste. From the untouchables in India, the lowest caste who are responsible for removing the human waste, to the hygiene obsessed Japanese with high-tech restrooms. From the Chinese who use the ‘night soil’ to create energy to the experimentation with new latrine pit designs in Tanzania. The diverse ways of human waste managements show some of the difference in social structure and culture around the world.

The provision of sanitation is an important public good that not only requires monetary investments but also cooperation of the users. Especially lack of maintenance of sanitation systems may prevent the development of this public good. Various examples are discussed where communities in India are rewarded when their community is open defecation-free. The solution to sanitation is not necessarily the same for each context due to variation of population density, availability of water, etc. Hence institutional diversity can also be studied for the problem of human waste.