How to Shit Around the World: The Art of Staying Clean and Healthy While Traveling

by Jane Wilson-Howarth

International travel is rewarding and fun, but sometimes it exacts a price. Activities we take for granted - eating, bathing, and going to the bathroom - can range from challenging to risky in unfamiliar territory. In "How to Shit Around the World", Dr Jane Wilson-Howarth takes a sympathetic and funny approach to one of the most human activities, interweaving hilarious anecdotes from fellow travelers with sensible tips and techniques.

More than jus a 'how-to', "How to Shit Around the World" inspires the traveler to be adventurous in dealing with foreign toilets, and to heed the fascinating cultural lessons to be learned from the simple act of using the bathroom.

Genres: Travel, Nonfiction, Self Help, Reference, Health

165 pages, Paperback

First published May 4, 2006

About the author

As a child Jane dreamed of intrepid adventures and encounters with exotic wildlife but it wasn’t until she was 22 and with a zoology degree to her credit that she started travelling: she organised a six-month expedition to catalogue the creatures living in Himalayan caves. To cut a very long story short, this trip lead to a parasitology then medical qualification, a husband and many more exotic trips. She experienced leeches, malaria mosquitoes, ticks and scorpions first hand and, realising how good information contributes to enjoyable travel, wrote her first travel health guide, "Bugs Bites & Bowels", which will launch in a sixth edition in March 2022 as "Staying Healthy When You Travel". Her first book was a travel narrative, "Lemurs of the Lost World". So far, nine of her books have been books published.

Dr Jane has lived in various very remote corners of the globe and has spent about 13 years in South Asia. Jane’s third son made his first big trip – to Nepal – at the age of three weeks. Her experiences of living in rural Nepal proved a rich resource for her writing as her travel biography, first novel and adventure stories for children bear witness.

She practised as a general practitioner / family physician for 15 years in Cambridgeshire and boasts more letters after her name than in it; she teaches extensively on travel health including an annual commitment to a workshop on diarrhoea at the University of Cambridge medical school. She has written a health feature for Wanderlust magazine since it was first launched in 1993 and her words have been published in national newspapers and the academic press. She is proud to have a tale in two of Bradt's anthologies "To Oldly Go" and "Kidding Around", and also several in "Fifty Camels and She's Yours.".

In September 2017 she moved back to Nepal and is dividing her time between Kathmandu and Cambridge. Her Nepal photos are on Instagram @longdropdoc and she tweets (occasionally) also as @longdropdoc. Her blogs are on her author website www.wilson-howarth.com where there are photogalleries relating to her books.

Reviews

[Maisie · Rating 4 out of 5]

So, I’m currently preparing for a two-year backpack trip to Asia with my boyfriend. Somewhere online I got this book as a recommendation and decided to give it a try. I’ve been reading a few chapters every morning on my way to work (regardless the very appealing cover, that gave me a lot of weird looks).

I thought it would just be a boring informative read about tips and tricks for survival.
Ended up really enjoying this book.
It tells you all about the outside world, things you might not even consider happening to you on a trip to a foreign country. Things such as sickness, diseases, hygiene tips, foods to eat (or most definitely shouldn’t) and basicly all the do’s and don’ts regarding ‘emptying your bowels’ while being out in nature.
It shows that traveling won’t always be as fun and amazing as it seems. It might not be the prettiest subject but it shows how to prevent a lot of ‘shitty situations’ from happening to you or your loved ones while being away.

The book contains of short anecdotes about people and their experiences about being out in the wild. Found the anecdotes quite funny at times and sometimes even relatable in some kind of way. Though I haven’t experienced it yet myself, it wasn’t hard to understand their feelings or frustrations.

If you’re looking for some good tips before traveling to a foreign country or just looking for a quick read, you should definitely give this book a try. Plus the title actually matches the story, it tells you all the ways you could possibly think of to shit around the world!

[Leah · Rating 4 out of 5]

This book was one of a couple of enjoyable things I took away from my Cultural Anthropology class in college. Our professor swore by it and reread it every summer before she began her annual travel. I found the book to be quite funny at times, and the inset accounts never failed to make me chuckle. I definitely recommend this book as a good basic overview of communicable diseases in the traveler's realm and how to avoid them, as well as for anyone who might actually need to learn how to shit around the world. I imagine it can be a very traumatizing experience to do it wrong. The chapter on parasites is woefully incomplete in my opinion but that's just because I'm a big Parasitology nerd and would read about it all day if I could. Definitely a worthwhile read for travelers or even just the curious intrigued by the title, especially since the short length keeps it from getting too dull.

[Charles Kerns · Rating 5 out of 5]

OK, the title stinks, but the writer knows her "stuff." My insides were always a mystery to me. I never paid much attention. They did their thing and I did mine. But inner mindfulness is needed when you travel to places that don't have the sewage control that we gringos are used to.

I now meditate on my bowels when I travel. They have learned to behave after reading the book and I respect them for it. The book shines a light on a dark subject. It is not pretty (the title suggests differently, but is wrong), but it is a subject that needs to be put on the table. Remember that and read carefully.

[Chris Lemig · Rating 4 out of 5]

I recently realized that my biggest fear surrounding my upcoming trip to India was not about culture shock, the language barrier or getting lost in a country of a billion people, but where and how am I going to take a crap. This book went a long way to put me at ease.

Here's some of what I learned:

Improperly cooked and/or handled food is the number one cause of traveler's diarrhea, not contaminated water! Water treatment systems for most travel scenarios are a scam. Boiling your drinking water is completely effective.

Peel it, cook it, boil it, or forget it.

Every traveler has about a 50/50 chance of getting some form of traveler's diarrhea. The best remedy for getting better is to drink lots and lots of fluids. This book has a great rehydration recipe that I can easily bring along.

Toilet paper did not become popular in the West until the 1930's. Most of the world thinks we are the ones who are unsanitary. Using the left hand and copious amounts of water after you go is much healthier. (This remains to be seen and I will report back to you all in the fall...)

All in all, a great book. I highly recommend it to anyone traveling to developing countries.

[Emma · Rating 5 out of 5]

This book was a wonderfully refreshing and light-hearted look at sanitation and hygiene while travelling. Every chapter focuses on a specific theme, such as how to clean oneself when toilet paper is unavailable, different types of toilets one might encounter, how to make water safe to drink and how to avoid becoming ill in the first place. Each chapter ends with an incredibly helpful "Tips" section and the personal stories from both the author and other travelers were quite entertaining. I wholeheartedly recommend this book for anyone traveling abroad, especially to the less developed world, and anyone who is curious about bathroom and sanitation practices throughout the globe.

[Sharon Darrow · Rating 4 out of 5]

This title will raise eyebrows if you read in public, especially when you break into laughter while engrossed in the anecdotes it contains. All kidding aside, if you are a world traveler, or if you aspire to travel, you need to read this book before and during your trip. Written by a doctor, it contains an immense amount of valuable information to keep you safe and healthy.

I recommend this to everybody who is planning a trip!

[Sheryl · Rating 4 out of 5]

Informative. Not really a pleasure read though it is written with self-effacing humorous stories. I read this before my first trip to a third world country and it gave some insight into what I might expect. I had no problems on my trip but I did have a good list of some necessary optional items should my bodily functions rebel. I'm glad I read it.

[Ashley · Rating 3 out of 5]

Jodi Ettenburg of Legal Nomads recommends this book to all of her readers, and it's an interesting and informative look at travel health in developing countries. Sadly I'm all too familiar with some of it - but still learned something!

[Stefanie · Rating 4 out of 5]

Let's just say it's interesting, but I'm learning some things I'm not sure I wanted to know....

[Totochelamouche · Rating 4 out of 5]

Expect to learn in the chapters that follow how to eat armadillo without contracting leprosy.

Well-cooked, piping hot meals are safe, but food that is lukewarm or has been cooked, allowed to go cold, and then is handled by someone is risky.

There are innumerable myths about what causes bad stomachs in travelers, but it is nearly always contaminated food, or occasionally - just occasionally - dirty water.

Salads are often grown in highly contaminated ground (people without toilets often relieve themselves in vegetable gardens), and low-growing fruits, especially strawberries, can easily become contaminated by human feces. The most hazardous raw foods are those that can trap filth in crevices and are difficult to clean - lettuce is among the worst. Conversely smooth skinned items can be cleaned quite well, so carefully washed tomatoes and items that can be peeled like carrots or radishes are fairly safe.

The myth of locals being immune is ill-informed travelers' folklore, and the distressingly common idea that eating bad food will immunize you is responsible for a lot of unnecessary illness in travelers, as well as exposing them to dangerous filth-to-mouth infections like thyphoid.

In the Middle East and South Asia, some melon sellers puncture the fruits and soak them in roadside drains to make them weigh heavy before sale. This is a probable explanation of why, in the days of the British Raj, melons were blamed for Indian cholera outbreaks.

Choose freshly cooked, piping hot food rather than reheated food or food kept lukewarm on a hotel buffet. Sizzling hot street food is likely to be safer than just warm food, even if produced by an international hotel. In international hotels order à la carte foods if you can.

Pork and dog are the riskiest kinds of meat. Pigs and dogs are often the local rubbish disposal consultants where environmental hygiene is poor.

In most developing countries, fresh milk - even milk that says it is pasteurised - should be boiled before drinking.

Yogurt is usually safe because the milk is boiled before fermentation and the final product is slightly acidic and thus less favorable for the survival of noxious bacteria.

Sorbet tends to be acidic and, since acids are unfavorable ot bacteria, this is a fairly safe food. Ice cream is often risky in developing countries since power cuts make it difficult to store safely, and it is microbe paradise. Ice, too, is often made with dirty water or handled with dirty hands. Sometimes it is delivered in huge blocks that are dumped onto the ground outside the drinks stall or hotel.

I'm often surprised at the women travelers who don't know about panty liners. Many of us have used them for years, and find we only need two extra pairs of briefs for even a long trek as they keep clean for days. Bring enough for one per day, plus extras for accidents, or for added protection during a bout of diarrhea. They come in various lengths, and the most convenient are individually wrapped, so a spare can be slipped into a pocket. Pack them in a small zip-lock bag. Extras will always be gratefully received by a woman who hasn't yet experienced the comfort and convenience.

Studies in several Asian countries suggest that bottled mineral water produced locally may not be entirely safe. Most of it is not even "mineral water" but treated (or untreated) tap water. Yet there has been a boom in "mineral water" production so that it is available in a surprising number of quite remote destination now. The quality is patchy, but if I need water in a city in the developing world, I drink bottled water. It is usually safe enough. Other kinds of bottled drinks, the colas and other carbonated drinks, should be safe because the contents are somewhat acidic which is unfavorable for microbes, and boxed drinks will also be safe. Beware of "homemade" drinks that have involved a lot of handling during concoction.

If you need really safe water - you may be traveling with a young baby or your own health dictates that you must take special care - the safest means of treating water is to boil it. Water that has been brought to a good rolling boil is safe, and even water heated above 60C is unlikely to harbor any nasty microbes.

Chemical "sterilization" takes time (thirty minutes), gives water a taste, and does not kill all microbes. But for most purposes the water will be rendered safe enough. Safest of the chemical options is iodine, and chlorine is the next most efficient means. Adding vitamin C reduces the unpleasant taste from iodine, but this must not be added until the purifying thirty minutes has been completed.

When staying in a more down-market place ask for a glass of boiling water.

If you are offered a drink - or food - which you think may be contaminated, take as little as possible; the less you consume, the less you risk stomach trouble.

Excessive use can cause enlargement of the thyroid gland in the neck, so long-term users should not add iodine to all their drinks. It is usually possible to take a range of drinks from various safe sources and a great deal should be in the form of boiled water.

Travelers in developing countries can be lulled into a false sense of security by assuming that bottled water is safe water. Tests and visits to bottling plants in Nepal showed that while the majority of samples were free of fecal contamination, some rogue companies were merely bottling inadequately treated tap water. Quality control is a major issue - even leading companies lack on-site lab facilities to test for many impurities. A number rely on one-off tests in Europe at the start of production to accredit their brands. Nepal, like many countries with limited resources, has very few regulations in place to protect the quality of bottled water. This problem is not restricted to the developing world. In the USA, the Natural Resources Defense Council (1999) tested 1,000 samples of 103 U.S. brands and found that at least one-third had levels of bacteria and chemicals that exceeded the standards regulating the bottled water industry.

The liver of dogs, bears, and other carnivores is so loaded with vitamin A as to be toxic. Don't eat it.

The easiest way of taking such a sugar and salt solution is to open a packet of Oral Rehydration Salts (ORS), dissolve it in clean water, and then drink a couple of large glasses after each time you open your bowels. [...] It is important to get the volume right; improperly made up solution can do more harm than good. If in doubt, overdilute.

Normally you obtain a lot of fluid from your food, about three liters a day.

Allowing yourself to get dehydrated in hot climates will put you at risk of kidney stones and bladder infections.

He misunderstood that together salt and sugar (whether in the form of ORS or salt added to cola) are a vehicle for fluid absorption, not a one-off treatment.

These kinds of cramps are common in diarrheal disease, but eating small quantities of bland foods can reduce them. Pure carbohydrates are best (boiled potatoes, rice, couscous, or plain crackers), and these also assist absorption of fluids if you drink plenty of water with them.

The physiological phenomenon called the gastro-colic reflex is something that travelers should understand. When any hot or very cold food or drink is swallowed, there is a reflex tendency for the bowels to open. Under normal circumstances this happens perhaps when breakfast stimulates your daily evacuation.

If your intestines are ailing, then, avoid very hot drinks or foods or very cold or iced drinks. Aim to take any drinks at room temperature and allow food or hot drinks to cool before consumption.

I had no other choice but to shit into a carrier bag and throw it out the window. It was no fun for me or my husband lying beside me. Have a carrier bag and toilet paper with you at all times!

Explosive diarrhea that comes on suddenly, you feel awful, often there is fever and, sometimes, visible blood in the stool, suggests bacterial or bacillary dysentery, usually due to Shigella. It definitely will ruin your day and is best treated with oral rehydration therapy and antibiotics. If you can, go to a doctor and get a stool checked in a laboratory. If none is available, consider taking a threeday course of one of the following antibiotics: ciprofloxacin, norfloxacin, or nalidixic acid.

It is dangerous to treat dysentery (bloody diarrhea or severe diarrhea with fever) with "blocking" paralytic medicines such as Immodium or Lomotil. They can cause intestinal perforation.

The typhoid risk is highest in those visiting tropical Latin America or the Indian subcontinent. Travelers to other regions too might choose typhoid immunization, but this decision is dependent upon how "rough" you are traveling. It is worth noting that the injectable vaccines do not give any cover against paratyphoid fevers, however the new oral vaccine probably offers around 50 percent protection. In addition immunity, although only partial, appears to last longer.

If you need to get your underwear to dry quickly, roll it in a hotel towel.

A large, tough plastic bag is useful for soaking dirthy clothes overnight so that they are then easy to wash. Cheap hotel sinks often have no plug, and improvised stoppers will not maintain a full sink all night.

Malaria mosquitoes love sweaty feet, so a shower before dusk will reduce the bite rate.

Having a good wash can demand some subtlety, but cleaning wonders can be achieved, in the privacy of a very small tent, by squatting over a small dish of water and using a disposable cloth, soap, and preferably a close friend to scour your back. Start before sunset (with its attendant frost or mosquitoes) and begin at the savory end of your person, the lips. Then systematically work your way down. If you wish to use the cloth ever again, keep green ones for the upper part of your lovely body, and blue for bottoms. Finally hang the cloths out to dry, which they do even in a heavy frost at night, and once dry (usually about an hour after dawn), you can pack them into separate polyethylene bags. When they begin to get a bit fruity, just burn them and use new ones.

If you want to bathe outdoors and there are lots of people about, it is possible to bathe modestly by putting on a sarong or lungi. This is a tube of cotton cloth that is wide enough to cover all essentials so that you can bathe comprehensively but modestly under a village waterspout in full view. For women, a long wraparound skirt can be used in the same way. Such garments will dry quickly in the midday sun along with your freshly washed underwear.

If your bathing water comes from a source that may be contaminated with bilharzia, try to ensure that the water is taken from the lake in the early morning and stored snail-free, otherwise it should be filtered or have Dettol or Cresol added.

If you have been exposed to bilharzia parasites, arrange a screening blood test more than six weeks since your last contact with suspect water.

Bathing early in the morning carries a lesser risk for bilharzia than bathing in the last half of the day.

The species that occur in Africa and the Middle East (Schistosoma haematobium and S. mansoni) and America (Schistosoma mansoni) are slow penetrators. Since it takes at least ten minutes to get through the skin, a quick splash across a suspect stream should do you no harm; vigorous towelling dry after bathing also kills any parasites caught in the act of skin penetration.

It took years of traveling to develop an efficient laundry technique. Try this. Keep your clothes on in the shower. Get soaked. Turn off the shower. Then rub yourself (and your clothes) all over with soap. You can then either continue showering to rinse the clothes before taking them off, wringing them out, and hanging them to dry or you can remove them for an extra-thorough rub under the shower to get rid of those nasty stains and smells.

People suffering from bilharzia pass eggs in their urine or feces, and if these enter suitable, well oxygenated freshwater, they will hatch out and swim off in search of a snail to infest. [...] Travelers are infected when swimming, paddling, or even showering in waters contaminated with human waste, which usually means that the victim has paddled or swum within 200 yards of a village or point where people use water - for washing clothes perhaps, or where village children romp. [...] The highest-risk geographical regions are the great lakes of the east African Rift Valley, but the infection can be acquired from many freshwater lakes, streams, and slow-moving rivers where there is waterweed for the snails to feed on. There are foci in the Middle East, and in the tropical Americas (northeast Brazil, the Guianas, Surinam, Venezuela, and some Caribbean islands.

The reputations of many "dangerous" beasts seem exaggerated, although tropical South American rivers can harbor stingrays which can cause exceedingly nasty injuries.

It seems to have been the hyperbolic accounts published by Theodore Roosevelt that are the basis of the fearsome reputation of the piranha: there are no reliable accounts of human deaths due to these fish.

Some trekkers and mountaineers take acetazolamide (Diamox) capsules to speed acclimatization and reduce high altitude insomnia; this medicine is a mild diuretic [...] so take them in the morning otherwise you will be awakened by your bladder in the night.

In rural Bangladesh, there are millions of people, little cover, and locals find foreigners fascinating. It is impossible, therefore, for women to relieve themselves outdoors in privacy. We traveled with three large cheap black Chinese umbrellas to hide behind when I needed to go.

[Patrick · Rating 3 out of 5]

This book focused more on travel health than on the practicalities of using the various 'personal' equipment found in various regions. I was sort-of looking forward to reading about German 'shelf toilets' or those nasty hybrid sitter/squatters. There is a chapter or two delicately covering these oddities, but for practicalities, How to Shit in the Woods was much more useful and informative for the act itself.

That said, Wilson-Howarth covers various food-borne illnesses in great (and sometimes gross) detail, and discusses prevention and treatment with expertise. There's a chapter for women's health, one for children, and one for seniors. This is a good reference for heavy travelers and adventurous eaters.

[Kristen · Rating 5 out of 5]

One of the best travel health books available on the market. As amazing as it seems, a book about travel health can be funny, interesting and you can learn from it as well. The key rules that this book helps remind the traveler are:

1. Eat hot food hot, if it has turned cold, don't eat it.
2. Eat cold food cold. If it is warm, don't eat it.
3. If the dining room is empty and all the locals avoid the place, you should too!
4. And a good general rule of thumb, when traveling in third world countries, avoid the green salad.

[AJ Payne · Rating 4 out of 5]

This was surprisingly good. I'm not sure if all of the facts in the book are true or not, but they seem plausible, and the advice doesn't seem harmful in anyway. Lots of really great tips on how to avoid getting sick while travelling, and what to do if (and when!) you do.

Plus, many of the stories are laugh out loud funny in that gross, commiserating, I can't believe that happened, type of way.

Really good and fast read to get a ton of trips for when you are travelling in less than sanitary conditions and how to stay healthy.

I recommend it for all globe trotters!

[Alex Drysdale · Rating 3 out of 5]

A lot of commonsense stuff in here, but if you're considering any remoter or 3rd world trips it would probably be worth skimming through.

Seemed a lot longer than it could have and there were tons of quotes and anecdotes from some of the authors friends or followers that really lengthened the book more than it needed to be.

Overall there are some good facts about shitting around the world even though the book was a little long-winded.

[Betty Anne · Rating 3 out of 5]

Let's be real: I purchased this for the title. That being said, it is an interesting little book though I think it is just a lot of repetitive information. Make sure the food is cooked and this is how you purify your water to the best of your ability, etc.
I did like the section on traveling and menstruation. Very helpful.

[Cherie · Rating 2 out of 5]

C Not that great. A lot of health info that any savvy traveller would already know. She could probably take the most important parts of this book out and write an article. Lots of anecdotes and humorous stories, but not enough to sustain throughout this entire book.

[Del · Rating 4 out of 5]

I bought this book in preparation of a trip around the world. The personal antidote were comical and I was happy to not have any of the same experiences.

Very solid practical advice if you are traveling in places that may be less then hygienic.

[Dana Kraft · Rating 3 out of 5]

Not as humorous as I expected based on the title. Good info but be aware that it might also scare you. Best thing I learned was that the food at the hotel isn't necessarily any safer than what you would find at a street stand.

[Marco · Rating 3 out of 5]

Wow. Very informative.

[Lara · Rating 4 out of 5]

😂😂 Essential for travellers?

[Teena in Toronto · Rating 3 out of 5]

Quick read about how to protect yourself when you are travelling. The actual experiences of people are funny.

[Laura JC · Rating 3 out of 5]

In spite of the off-putting title, some useful and practical advice for travellers.

[Redmar · Rating 4 out of 5]

A must read for anyone travelling abroad. My cover however reads: Shitting Pretty: how to stay clean and healthy while travelling. A very informative read that doesn't take itself too seriously.

[Elizabeth · Rating 2 out of 5]

It was repetitive and all over the place, unfortunately.

[Jacq · Rating 4 out of 5]

Useful tips for foodie travelers, who want to avoid the runs. Author makes this an engaging and funny read at the same time.

[Kookie · Rating 3 out of 5]

If you aren't comfortable in a place unless you know where the bathrooms are, this book is for you.

[Meg · Rating 4 out of 5]

Got this book for Christmas before my trip to Africa. I thought it was informative, funny, and gross all at the same time. Granted some things I already knew, it was still a helpful read in preparing for my trip, and as a result I didn’t get sick on my trip!

[Fergus Randall · Rating 3 out of 5]

Fascinating read, but I'm now scared of whole new categories of bacteria that can kill me in exotic ways

[Stephanie Crabtree · Rating 5 out of 5]

This was one of my favorite university travel books. Very practical but also very entertaining. I graduated in 2008, so some information could potentially be dated now.