Indeed, if all governments applied Chadwick’s recommendation of universal sanitation, cholera
would
be history. That cholera remains a health problem at all is testament to our continuing unwillingness to seriously grapple with its root cause: global poverty.
Today a billion people around the world still lack access to improved water supplies such as piped systems, capped wells, and springs. Hundreds of millions more rely on water sources that, though improved, are still contaminated and unsafe. Two billion have no way of properly disposing of human waste. Two million to three million children die annually of waterborne diseases, including cholera. This problem could be fixed for $10 billion to $20 billion a year for fifteen years. That’s less than a third of the $61 billion Americans spend annually on soft drinks. We’re not talking fancy indoor plumbing, just basic water treatment and latrines for everyone on earth.
One temporary solution to this hygiene nightmare is the U.S. Centers for Disease Control’s Safe Water System (SWS). This cheap, hardy, easy-to-use water-purification system has been deployed in twenty-two countries on three continents. It has been used in refugee camps, disaster areas, war zones, rural villages, and urban slums. It relies on a simple idea: bottle in-expensive chlorine for people to use to treat water stored in the home and keep the water in a closed, narrow-neck plastic bottle that, unlike traditional wide-mouthed containers, cannot easily be recontaminated by unclean hands. This is no permanent cure for contaminated water. It’s a stopgap. Until the next Edwin Chadwick comes along, however, a stopgap will have to do.
Prove it
As we have seen in previous chapters, disease is a screen on which we project our deepest fears, hopes, and prejudices. So it was with tuberculosis, an ancient illness that became epidemic during the nineteenth century at the same time a new cultural movement—Romanticism—was catching fire. In the growing cities of the industrial world, Romantic beliefs and tubercular symptoms intersected and reinforced one another. For a time, tuberculosis was welcomed in some households, envied in others, as a sure sign of creative genius. Eventually Romantic tuberculosis would completely upend ruling-class beliefs about beauty and status. But once TB’s real cause was understood, the disease’s reputation soured. TB became associated with poverty, overcrowding, and bad hygiene. Thus stigmatized, it became a powerful catalyst for the creation of modern public health systems, a control on both the disease and the poor people seen to be its carriers.
That graveyard cough
Tuberculosis is caused by a bacterium. It appeared in human populations about fifteen thousand years ago, probably jumping to us from cattle when people began to domesticate livestock. TB did its work not in days or weeks but over years, striking when age, poor nutrition, overwork, or illness compromised a person’s immune system. TB robbed the body of energy, progressed to spasmodic coughing, advanced to hacking up blood and bits of lung, and ended in a gasping, lingering death. There was no cure. One could survive to old age, but most TB victims died young. TB thrived in crowded conditions, where the microbe could easily pass from person to person. It flourished in slums and sweatshops where people were ill fed and overworked and ventilation was poor. By the early 1800s, TB was killing about a quarter of all Europeans. Later, when Asia industrialized, TB death rates there were just as bad.
The ancient Greeks called TB
phthisis,
a term that compares the inexorable destruction of the body’s vitality to the waning of the moon. The seventeenth-century English religious writer John Bunyan called tuberculosis “the Captain of all these Men of Death.” In the nineteenth century, the most common term for TB was consumption. It was also called pleural abscess, hectic fever, the white plague, the
would
be history. That cholera remains a health problem at all is testament to our continuing unwillingness to seriously grapple with its root cause: global poverty.
Today a billion people around the world still lack access to improved water supplies such as piped systems, capped wells, and springs. Hundreds of millions more rely on water sources that, though improved, are still contaminated and unsafe. Two billion have no way of properly disposing of human waste. Two million to three million children die annually of waterborne diseases, including cholera. This problem could be fixed for $10 billion to $20 billion a year for fifteen years. That’s less than a third of the $61 billion Americans spend annually on soft drinks. We’re not talking fancy indoor plumbing, just basic water treatment and latrines for everyone on earth.
One temporary solution to this hygiene nightmare is the U.S. Centers for Disease Control’s Safe Water System (SWS). This cheap, hardy, easy-to-use water-purification system has been deployed in twenty-two countries on three continents. It has been used in refugee camps, disaster areas, war zones, rural villages, and urban slums. It relies on a simple idea: bottle in-expensive chlorine for people to use to treat water stored in the home and keep the water in a closed, narrow-neck plastic bottle that, unlike traditional wide-mouthed containers, cannot easily be recontaminated by unclean hands. This is no permanent cure for contaminated water. It’s a stopgap. Until the next Edwin Chadwick comes along, however, a stopgap will have to do.
Prove it
As we have seen in previous chapters, disease is a screen on which we project our deepest fears, hopes, and prejudices. So it was with tuberculosis, an ancient illness that became epidemic during the nineteenth century at the same time a new cultural movement—Romanticism—was catching fire. In the growing cities of the industrial world, Romantic beliefs and tubercular symptoms intersected and reinforced one another. For a time, tuberculosis was welcomed in some households, envied in others, as a sure sign of creative genius. Eventually Romantic tuberculosis would completely upend ruling-class beliefs about beauty and status. But once TB’s real cause was understood, the disease’s reputation soured. TB became associated with poverty, overcrowding, and bad hygiene. Thus stigmatized, it became a powerful catalyst for the creation of modern public health systems, a control on both the disease and the poor people seen to be its carriers.
That graveyard cough
Tuberculosis is caused by a bacterium. It appeared in human populations about fifteen thousand years ago, probably jumping to us from cattle when people began to domesticate livestock. TB did its work not in days or weeks but over years, striking when age, poor nutrition, overwork, or illness compromised a person’s immune system. TB robbed the body of energy, progressed to spasmodic coughing, advanced to hacking up blood and bits of lung, and ended in a gasping, lingering death. There was no cure. One could survive to old age, but most TB victims died young. TB thrived in crowded conditions, where the microbe could easily pass from person to person. It flourished in slums and sweatshops where people were ill fed and overworked and ventilation was poor. By the early 1800s, TB was killing about a quarter of all Europeans. Later, when Asia industrialized, TB death rates there were just as bad.
The ancient Greeks called TB
phthisis,
a term that compares the inexorable destruction of the body’s vitality to the waning of the moon. The seventeenth-century English religious writer John Bunyan called tuberculosis “the Captain of all these Men of Death.” In the nineteenth century, the most common term for TB was consumption. It was also called pleural abscess, hectic fever, the white plague, the
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