Sasha Kramer fights Haiti’s most pressing health, economic, and environmental problems, one toilet at a time. “When I came to Haiti with a delegation of observers after the 2004 coup, I immediately saw that the most pervasive human rights abuse was poverty and lack of access to basic services,” Kramer recalls. In rural areas only 16 percent of people had access to toilets, in cities only 35 percent (the lowest sanitation coverage in the Western Hemisphere). “People dispose of their wastes in the ocean, rivers, plastic bags, and abandoned lots. In the countryside where I lived, there was nowhere to go to the bathroom privately. It showed me how much we take sanitation for granted, and what it means to your health, and your dignity, when it’s denied.”

Driven by her conviction that sanitation is a basic human right, and the need for a simple, low-cost solution, Kramer turned to ecological sanitation. “Collecting, composting, and recycling human waste into fertilizer for agriculture simultaneously helps solve so many problems that result from extreme poverty: poor public health, low agricultural productivity, malnutrition, environmental degradation, and waterborne disease—the country’s leading cause of death in children under five.

It also eliminates the need for chemical fertilizers that are fossil-fuel-intensive to produce and unaffordable for Haitian farmers.”

In 2006, Kramer and engineer friend Sarah Brownell founded Sustainable Organic Integrated Livelihoods (SOIL). The nonprofit organization focuses on transforming Haiti’s wastes into valuable resources, protecting fragile soil, and empowering communities.

The team developed Ecosan, dry composting toilets that turn human waste into nutrient-rich fertilizer. “The technology itself is very simple,” explains Kramer. “Feces fall into a drum beneath the toilet. Instead of flushing with water, you use a dry substance. SOIL employees collect filled drums and drop off empty ones every week. Full drums arrive at a compost site, where a long composting process kills pathogens and renders fertilizer.”

Can that fertilizer change a nation? To appreciate the potential impact, consider this: Haitian farmers can afford only one kilogram of nitrogen per hectare; most use none at all. By comparison, Mexican farmers use 200 kilograms per hectare. Kramer calculates that if Haiti recycled 50 percent of the nutrients in human waste onto farmland, input would leap to 17 kilograms per hectare. “When land is fertilized for the first time you get a huge jump in production, so a 17-fold increase would have significant results.”

Boosting productivity could make the nation more competitive. Currently, nutrient-deprived soil, trade regulations, and foreign farm subsidies force Haiti to import more than 60 percent of its food. Only 10 percent of rice is grown locally, compared with more than 80 percent just 30 years ago. So despite a shockingly low GDP, the cost of living is very high—on par with the U.S.

According to Kramer, Haiti’s problem isn’t lack of soil fertility, but lack of soil itself. “Deforestation erodes whole layers of soil into the ocean every year. High-altitude photos show a brown ring of soil and human waste runoff hugging the coastline. Ecological sanitation gets that out of the water and back onto farmland to enrich, not pollute. Haiti’s soil is so thin, even massive amounts of chemical fertilizers can’t restore soil structure. On the other hand, fertilizer from human waste provides nutrients essential to rebuilding soil. Producing a resource themselves that will make them less dependent on other countries really excites and motivates Haitians. Although their dignity is challenged in so many ways, they have tremendous national pride and desire for self sufficiency.”

The 2010 earthquake shook her efforts, yet opened new opportunities. Asked to deploy toilets in Internally Displaced Persons (IDP) camps, Kramer worried that SOIL lacked experience in emergency work, yet agreed to try. Her team built 75 toilets in six months and “to my amazement they worked fantastically well.” An influx of money to Haiti at that moment reinforced what she had learned in other parts of the country—paying people nominal sums to maintain toilets is crucial.

She tests her theories in the toughest places. One notorious and impoverished slum in northern Haiti languished with no public or private assistance. No public sanitation existed, so the neighborhood was hit especially hard by the recent cholera epidemic. SOIL revitalized three large public toilets, paid locals to manage them, and performed hygiene education. The number of drums collected there soon soared from one per week to 25, and cholera cases decreased.

Today, Kramer tracks rural and urban pilot programs to determine the most effective way to manage, finance, and ultimately turn projects over to Haiti’s own government or entrepreneurs. “We have to demonstrate results to create demand,” she stresses. In fact, word has spread and communities across the nation clamor for Ecosan toilets.

“I fell in love with the people of Haiti on my first trip,” Kramer shares. “They had endured 200 years of political strife, their environment was in terrible shape, and poverty was pervasive. But even in the face of terrible repression and danger, they showed such warmth, energy, resilience, and courage. In nature, soil transforms wastes into resources. The same kind of transformation can happen with marginalized people. This is liberation ecology.”