A MAD Approach to

Clean Water & Sanitation

The MAD Journey

exploring societal ecosystems

The MAD Models

catalyzing alternative societies


We have just returned from our first boldly MAD journey to Make A Difference; working alongside UN Youth Representative for SDG 6, Samuel Malinga, to address Clean Water and Sanitation in Uganda.


And what an insightful and exhilarating journey it has been so far. Over the last three months a ridiculously ambitious group of doctors, philanthropists, engineers, researchers, business consultants, impact investors, entrepreneurs, health practitioners, students, data scientists, environmental activists, design professors, social innovators  and strategists from 17 countries have delved deeply into the topic of sanitation.

This unlikely combination of individuals doesn’t even have a love for sanitation in common. In fact, while some people in the group have dedicated their careers to the topic, others have barely considered the fact the 2.4 billion people around the world do not have access to adequate sanitation facilities. What brought these inquisitive problem-solvers together was what we affectionately call their MADness. Their shared, deep desire to Make a Difference.

And that’s where we come in. We invite MAD people with diverse perspectives and interdisciplinary backgrounds to work together to address those big daunting challenges that demand a bolder, more explorative and collaborative approach. And through this case we aim to illustrate how the varied insights and experiences of the group have pushed us to explore solutions that seem so MAD they may actually work.

In this article we will whisk you through our 3-month journey of thought-provoking questions and unexpected insights that have led us to a MAD idea that we feel deserves to be tested.


THE role of mad

And this is where we bring in our disclaimer; our role at MAD is to catalyse exponential leaps in development. This article is written to provide a little insight into how we bring people together today, to Make A Difference for tomorrow. We write these articles with courageous vulnerability, acknowledging that we don’t have answers, but we are asking the thought-provoking questions that enable us to learn with every leap, sharing our half-thought-thoughts with the community so that together we can crack the big challenges.


So in this article you will find the series of questions we have asked so far, and where they have led us. And a spoiler alert: at the end is a question we are inviting/challenging you to explore further with us.

AN 8 min journey into an Alternative Reality

So take the next 8 minutes to read this series of articles, step out of your current reality and join us in an alternative reality, where there is a fundamental belief that the big problems are solvable.


Welcome to a journey of explorative questions and MAD ideas :) We start with an overview of the problem(s): According to the World Health Organisation 842 000 people in low- and middle-income countries die as a result of inadequate water, sanitation, and hygiene each year.


Traditional flush systems are simply not viable as municipalities in these markets do not have the budget for sewerage infrastructure and even if the money was available, piping clean water to flush down a toilet is a waste of a precious resource.


Pit latrines are a common alternative, but not only are they often unsanitary, they can be fatal as rotting floors have led to many children falling through to the pit and drowning. On top of this, if the pits are not properly maintained they can even exacerbate the problem as they overflow or infiltrate the water table.


Well-intentioned aid programs in the past have donated public toilet blocks, but as local communities were not involved in the design, decision-making, construction or long term planning for the facility, the block may be built in the wrong area, contextually inappropriate, misused, incorrectly maintained or even padlocked by a member who takes private occupation of the facility.

Introducing the MAD Explorative Approach

The first, (unsurprising) insight, is that the situation is always way more complex than it seems; the problem you think you are solving, is not really the problem that needs to be solved. And although you know this going in, you need to start somewhere.

So, where to start?

With the expert; Samuel Malinga, a Ugandan engineer, social innovator, MAD entrepreneur and founder of Sanitation Africa, who has developed affordable toilets and emptying services for Ugandans living in slums and rural areas. Sam’s work is so highly regarded that he has been invited to participate in accelerator programs across the world, is an experienced sanitation advisor and has been selected by the UN as their global youth ambassador for SDG 6: Clean Water & Sanitation.

And although Sanitation Africa’s 16 technically innovative and affordable sanitation solutions are addressing the technical needs of the local context, they are not being adopted by the community at the rapid rate initially anticipated. The reason for this provides great insight into how we should think about solving sanitation challenges globally.

The Insight

Even toilets designed for low income markets cost money. They cost money to install, and they cost money to maintain and they cost money to empty. The lack of government provision for toilets and unsustainable aid models places the economic and logistical burden of sanitation on the poorest members of society, who simply don’t have the economic means to invest in quality sanitation.


Sanitation Africa’s biggest problem is not a technical problem, but rather a market demand problem; people who have not had a toilet before do not see the value in buying one. Individuals would rather spend money on a motorbike or a goat than on the toilet “money-pit”.

It is with this insight, we saw an opportunity to invite our broad community of innovative problem-solvers across different sectors, industries, cultures and interests to come together to contribute their skills, knowledge, experience and networks to tackle a challenge, that if solved, could dramatically decrease the devastating number of illnesses and deaths caused by waterborne diseases globally.


>> LEAP 1 - Explorative Question: 

“How do we encourage people living in slum are to prioritise buying a toilet when the alternative is free?”


In collaboration with Seeding Impact, we hosted a hackathon with students from KTH and Karolinska Institutet (with Sam and his business developer, Joseph on whatsapp to answer questions.) The students went back to the root cause - why is it important to buy a toilet? To stop the spread of diseases. And that was the first “aha!” moment; Sanitation Africa’s individual selling approach will not address community-wide health issues, because if one person buys a toilet but their neighbour doesn’t, their neighbour’s poor sanitation habits will still lead to them contracting waterborne diseases. And so, the challenge evolved into...

>> LEAP 2 - Explorative Question 2:

“How do we create a resilient and cholera free community?” 

In collaboration with Cordial Business Advisors, we hosted a Think Tank where we presented the community-focussed question to a carefully selected group of executives, researchers, philanthropists, investors and business model innovation experts, that hailed from Uganda, Nigeria, South Africa, India, Argentina and Sweden.

Together the leapfrog hypothesis emerged... Just as markets like Uganda, leapt from “no phone” directly to mobile phones (skipping landline telephones), they can leap from “no toilet” to an onsite biomass producer (skipping the need for heavy sewerage infrastructure or even digging a hole and extracting). Meaning if we could develop local market demand from farmers for fertiliser and biogas, we could turn a toilet into a value-creating asset -  the second “aha!” moment; people could be paid to pooh! Which pushed the challenge one step further...

>> LEAP 3 - Explorative Question 3:

“How can human waste power the creation of resilient communities?”


It was time to take this question to the market, and so we gathered a team of MAD adventurers (a data scientist from Italy, an environmental activist from Germany, a doctor from Egypt and the two MAD women from Sweden and South Africa), we packed our backpacks and headed to Uganda to join the Sanitation Africa team, meet with the local community, immerse ourselves in their current reality and explore how human waste could drive economic growth at a local level and propel communities out of poverty.


There is a whole article dedicated to the insights from the journey (see next chapter beneath), but amongst all the possibilities that emerged, one struck us as especially powerful; If we could flip the “money pit” toilet into a “renewable source of economic and social prosperity”, it could be the catalyst that radically transforms the health and wealth of this community.


But we feel there is an opportunity to take at least one more leap. Our ambition is for schools to financially benefit from the closing of the sanitation loop, by pioneering a self-funding schools model. The premise being that schools can invest in and maintain the biofertilizer-producing toilets, the revenue generated from fertilizer sales can cover the salaries for teachers - covering school fees and providing free education for the poorest communities around the world!


The ultimate goal is to propel communities out of poverty by providing pioneering sanitation solutions, stimulating economic development and providing free education to the world’s poorest communities. Which brings us to explorative question number 4.

>> LEAP 4 - Explorative Question:

“How can we develop a resilient self-funding school model that enables the scaling of waterless 

sanitation systems across low-income markets globally?”

And this is where you come in, we are forming a global team of MAD people who are ready to join the next big leap and get involved in the self-funding schools pilot. So before this article ends and you return to your current reality, we are asking you to adopt the MAD mindset, and connect us to the innovators, manufacturers, entrepreneurs, visionaries, doers and funders who are MAD enough to give it a shot.  

Definition of Madness:

"Our shared deep desire to Make A Difference"

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