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- "No innovation in the past 200 years has done more to save lives and improve health than the sanitation revolution triggered by the invention of the toilet."
– Sylvia Burwell
- "Apart from the sanitation, the medicine, education, wine, public order, roads, the fresh water system, and public health ... what have the Romans ever done for us?"
– Graham Chapman
Sanitation is an Industrial Era technology in Civilization VI. It can be hurried by building 2 Neighborhoods.
Strategy[]
Sanitation may or may not be a high priority to research based on the victory condition you're pursuing. The Sewer is useful for situations where you need to add 
Housing without dedicating the additional space to another district (i.e., an Aqueduct or a Neighborhood) but adds only 2 Housing, and Sanitation is often obtained after Urbanization. Furthermore, Aqueducts and Neighborhoods provide adjacency bonuses to other districts, and Neighborhoods additionally allow the construction of Shopping Malls or Food Markets in the expansions, while Sewers do neither.
The Medic is a somewhat useful unit for military campaigns, particularly for prolonged sieges where it can allow your units to heal more quickly and attack more often than they otherwise could. In the expansions, Medics become much more useful after researching Combustion, which allows them to upgrade to Supply Convoys.
In Gathering Storm, civilizations seeking a Diplomatic Victory benefit the most from Sanitation, since the Országház paired with a large number of 
Envoys will greatly boost their accumulation of 
Diplomatic Favor.
Civilopedia entry[]
A clean water supply and sanitation has been rather important for the rise of civilization, since without such folk tend to fall prey to disease and death. Especially when crowded together in urban centers. The earliest signs of city sanitation have been found in the ruins of the Harappan settlements Mohenjo-daro and Rakhigarhi in the Indus Valley c. 2500 BC. There groups of homes obtained water from a common well, and waste water (with all that was in it) was emptied into covered drains which lined the streets.
Roman cities and villas had even better water and sanitation systems, with stone and wooden sewers – the famed Cloaca Maxima in Rome, which emptied into the River Tiber – to carry the waste away from civilized folk. But there is little evidence of sensible sanitation across the rest of Europe until the late Middle Ages; hence, the Plague of Cyprian (likely smallpox), Plague of Justinian (bubonic plague), the Black Death. Slowly – because of the expense – during the Renaissance sewers replaced the pail closets, outhouses and cesspits of Europe. (Meanwhile, the Mayan city of Palenque is believed to have had underground aqueducts and flush toilets.)
In 1596 Sir John Harington published his work A New Discourse on a Stale Subject in which he described the forerunner to the modern toilet, which he had installed in his home, incorporating a flush valve, a water tank, and a means to wash down the bowl when used. He also installed one for his godmother Queen Elizabeth I at Richmond Palace, but she refused to use it because of the unseemly noise.
With the onset of the Industrial Revolution, urban growth and more disposable income for many workers – and the invention of the S-trap by Alexander Cumming in 1775 – indoor toilets became a practical reality. Inventor Joseph Bramah added a float-valve system to the water tank, and in 1778 began installing toilets in homes and businesses across London, a very lucrative operation by all accounts. For soon, everyone wanted one.
See also[]
- Sanitation in other games
