November 19 is World Toilet Day, the annual reminder about the importance of sanitation to health, communities, the environment, and the economy. While the day organized by the United Nations (UN) is an opportunity to celebrate how much the toilet has done for civilization, it also serves as a stark reminder that over 4 billion people live without access to safety managed sanitation. Instead they often use unreliable, inadequate toilets or practice open defecation. Untreated human waste gets out into the environment and spreads deadly and chronic diseases.