Environmental Science & Engineering - www.esemag.com - November 2004
Comments? send them to the editor.

Bacteria, not bullets, are the biggest killers

By Tom Davey,
Editor

The name Florence Nightingale is inextricably linked to advances in medicine, perhaps eclipsing the fame of Harvey, who discovered the circulation of blood, or even Hippocrates, the legendary father of medicine in Ancient Greece. In an age when women were kept out of virtually all of the professions (except the oldest one) she courageously used her upper class connections to become a nurse. Her vision scandalized her family who thought male nakedness was simply not proper for a lady to witness.

But Florence was both determined and well connected. She spoke and wrote Latin, Greek, French, German and Italian, and was deeply interested in history. This was a formidable woman. Sidney Herbert, then British Secretary of State at War, capitulated to her repeated requests and sent her to the Scutari hospital in Turkey during the Crimean War. She found some 2,000 British soldiers who were laid: “Like paving stones in four miles of corridors.” As she and her nurses cleaned, fed and comforted wounded and sick soldiers, she grew increasingly angry, complaining to Sidney Herbert: “No mops, plates, forks, spoons, nor even scissors for cutting the men’s hair which is literally alive” (from lice). Although the Crimean War was brutal, ten times more men died from infection than from military wounds. Certainly she must have saved hundreds of wounded soldiers with her cleansing and care of the troops, who memorialized her as: ‘The lady with the lamp.’

But, according to Reputations, a BBC documentary, reviewed some time ago in The Guardian Newspaper, the real killer was the hospital itself as Scutari was built over a cesspit. Nancy Banks-Smith of The Guardian, in reviewing the documentary, wrote that the medical efforts were really whitewashing a sepulcher. “When Lord Palmerston, a neighbour of the Nightingales, sent a sanitary commission, they flushed, aired and ventilated Scutari, and the death toll dropped from 42% to 2%. Strictly speaking we should erect a statue to a plumber in Trafalgar Square”, concluded Ms. Banks-Smith.


... Ms. Banks-Smith should have included engineers and chemists in her witty rejoinder... history repeatedly shows that these two professions have constantly been in the vanguard of public health initiatives.

Florence Nightingale’s fame coincided with the inventions of photography, and sound recording. Indeed, Thomas Edison recorded her voice, giving us two rare flashbacks of her era.

Like Darwin, she took to her bed for years but kept up a barrage of complaints and suggestions for public health initiatives. While born into the ranks of wealth and privilege she rejected the offer of a State Funeral and burial at Westminster Abbey. Appropriately, it was common soldiers who carried her coffin to burial.

Actually I think Ms. Banks-Smith should have included engineers and chemists in her witty rejoinder on plumbing, for history repeatedly shows that these two professions have constantly been in the vanguard of public health initiatives. Equally, their anticipation of designs of water and wastewater treatment systems and processes have usually been ignored by historians.

To design a war weapon is to immortalize your name for eons; witness the Bren, Browning, Colt, Kaliznakov, Smith & Wesson, Webley, etc. But who knows the names of Ardern, Lockett and Fowler, discoverers of the activated sludge process in Lancashire, still a benchmark process in wastewater treatment, or the French nobleman/scientist Antoine-Laurent Lavoisier, who, in 1780, made milestone discoveries in chemistry, particularly phosphorous, but was arrested by The Revolution and pleaded for two more weeks to conclude his experiments. The tribunal declared that: “The state has no need of chemists.” His request denied, he was guillotined, taking much of his knowledge with him.

In 1847, years before Joseph Lister and Louis Pasteur made their giant strides in medicine, a young Hungarian doctor, Ignaz Semmelweis linked the high mortality rates in maternity wards to a lack of simple hand washing by doctors in between treating patients. His superiors scoffed, as the British medical establishment was to do some five years later when Dr. John Snow postulated that a cholera outbreak in London was waterborne. The findings of both these medical pioneers were the subject of scorn for many years and both died in relative obscurity.

And who knows of John Walker of England, who, in 1827, invented the ‘Lucifer’ match, making phosphorous a commercial commodity and perhaps an important contributor to the Industrial Revolution as it provided a cheap, portable means of combustion. Can you imagine running a household or factory, with no way to ignite cooking or process appliances? Try camping without matches or lighters if you’re not convinced.

‘Lucifers’ were very popular among troops in the awful trenches in World War I as they permitted troops to smoke between barrages. A favourite song among British troops at the front went: “While you’ve a Lucifer to light your fag (cigarette), smile boys all the while.”

We should learn the lessons of the Scutari military hospital. While the Prime Minister and Provincial Premiers are fighting for more health spending, they might be reminded that ‘The Invisible Professions’ of chemistry and engineering are fundamental health services which are in the front line of our public health systems but at the back door for funding. After Cain slew Abel, water-borne diseases went on to kill more humans than all the recorded wars in history.

See our home page on how to order your subscription. We regret we can only accept orders from Canada.