PUBLIC HEALTH

PUBLIC HEALTH is not a new idea.
The Romans understood the need for clean water supplies and built huge aqueducts to bring in water to the centre of their cities, along with water pipes and public baths.

They also constructed elaborate sewage systems to remove waste from their cities. The Romans were not even the first to build aqueducts. The Etruscans had started to build them in 312BC.

Ancient Chinese and Indian religious writings had recommended good diet and hygiene to protect health, but in medieval Europe, all of this was forgotten. The church frowned on washing, as it seemed too much like a bodily pleasure. There was no concept of hygiene, and sewage and rubbish were just thrown out into the street. It is no coincidence that during this period Europe was ravaged by plague, leprosy, tuberculosis (TB, also known as consumption), typhoid and cholera. People thought that these diseases were spread by miasma (unpleasant smells). This idea probably did encourage some disposal of waste. The miasmic theory of infection persisted into the 1800S, until the effects of bacteria were finally demonstrated.

The cholera epidemics had already brought matters to a head. For centuries the River Thames had been London`s sewer and source of drinking water. It was black and stinking, and finally everyone had had enough. The government commissioned a report from a civil servant called John Chadwick, which turned out to be the most influential document ever prepared on the subject of public health. It was published in 1842. The report described the probable causes of disease in the poorer parts of London, and also suggested practical ways to solve the problem. These public health measures included supplying houses with clean running water and proper sewage drainage.

Not long after this came the first proof of the risks from contaminated water, during a terrible cholera outbreak in 1854. John Snow, a London doctor, realized that many cholera cases were clustered in a small area near Broad Street. Investigation showed that they all drew their water from a public pump. Snow removed the pump handle, and within a few days the epidemic stopped. Even so, it took several years for the medical profession to accept that cholera was not spread by foul air, but by drinking water contaminated by sewage.