Thursday, September 27, 2007

The Sanitary Revolution

Following on from my previous post... I read with interest this BMJ News item on the most important medical milestone since 1840. 150 milestones were short-listed, including the discovery of antibiotics and the development of anaesthesia. And 11000 BMJ readers voted. And which milestone was voted #1, with 15.8% of the votes? The sanitary revolution. Here is a brief excerpt:

The work of the 19th century lawyer Edwin Chadwick, who pioneered the introduction of piped water to people's homes and sewers rinsed by water, attracted 15.8% of the votes, while antibiotics took 15%, and anaesthesia took 14%. The next two most popular were the introduction of vaccines, with 12%, and the discovery of the structure of DNA (9%).

Johan Mackenbach, professor of public health at Erasmus MC Medical Center, Rotterdam, who championed the cause of sanitation, said, "I'm delighted that sanitation is recognised by so many people as such an important milestone. The general lesson which still holds is that passive protection against health hazards is often the best way to improve population health.

...."The original champions of the sanitary revolution were John Snow, who showed that cholera was spread by water, and Edwin Chadwick, who came up with the idea of sewage disposal and piping water into homes.

Inadequate sanitation is still a major problem in the developing world. In 2001, unsafe water, sanitation, and hygiene accounted for over 1.5 million deaths from diarrhoeal disease in low and middle-income countries. Clearly, sanitation still plays a vital role in improving public health now and in the future."

There is something perverse about the current fad for bottled drinking water when clean, safe piped water is available. It is so easy to lose our perspective of our priorities.