The importance of URINETOWN the musical and social determinants of health.

1.8 billion people around the world drink faecally contaminated water.

2.5 billion people in the world don’t have access to adequate sanitation.

Over 1400 children die EVERY DAY from diarrhoea associated with unsafe water and poor sanitation.

At least 1.1 billion people in the world drink water that is of at least moderate health risk – they don’t have access to safe water.

Where there is nowhere safe and clean to go to the toilet – a natural bodily function that we all have to do – people all over the world are exposed to potentially fatal diseases and have to endure a significant lack of dignity and lack of privacy.

The people this affects most in the world are those that are the poorest, have most difficulty getting their voices heard and are the most marginalised.

The eradication of poverty and ensuring that prosperity, health and wellbeing are sustainable are some of the most serious, and pressing, challenges that face the world’s society today. The only way to address these challenges is through a coordinated, collaborative approach stretching across borders.

If you don’t have a toilet you still need somewhere to go and people who find themselves in that situation end up having to urinate or defaecate behind a bush, in a field, beside a road, on a beach or on a street.

No dignity.

No protection from violence.

No protection from infection.

No respect of basic human rights.

So what has this got to do with URINETOWN the Musical?

I was intrigued to be taken to see URINETOWN the musical – third row seats in the stalls to see a musical I had, to be honest, never heard of before but one I came out of wanting to see again.

URINETOWN is set in the future. A future where a terrible drought has crippled a city’s water supply. Water is so scarce that the government enforces a ban on all private toilets in an effort to control water consumption. Not too dissimilar to people all around the world who don’t have access to a toilet at the current time.

People living in that city must pay to use the public toilets owned and operated by a private company full of corruption. At the same time as introducing a law banning private toilets a law enforces the illegality of urinating or defaecating in public. Violators of this law are taken away to a mysterious place called URINETOWN – a place from where no one ever returns.

What happens to you in URINETOWN is something you’ll just have to see the musical to find out – I won’t spoil it that much for you but when you do you’ll realise the serious undertones that this musical has as well as providing a superficially funny performance with great music.

I digress.

The poorest people in this future society are forced to huddle in a line at the filthiest public toilet in town run by Penelope Pennywise and her rebel assistant Bobby Strong. With fee increases about to occur, there is an uprising of the people under the leadership of Bobby to fight the tyrannical regime for the right to make the public toilets free for all to use.

The striking similarities between what this musical talks about for the future and the lack of access to safe water and sanitation for millions of people around the world right now, today, is obvious.

This musical really brings to light the terribly undignified circumstances that the people who are living in poverty without access to safe water and sanitation have to endure every hour of every day and it serves as a clear reminder to us all about where we do not want our global society to end up in the future and where we must not let it go.

If you want to know more then have a look at the work the British Medical Association have been doing with End Water Poverty and WaterAid UK.


Access to clean water is a basic human right.

Access to proper sanitation is a basic human right.

We all have a duty to make sure that URINETOWN doesn’t become the reality of the future and that we tackle, right now, the situation for the billions of people living around the world who are existing in inhumane situations that those with political and social influence can do something about.


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