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| Dr. John Snow (1813-1858) |
From time immemorial, being sick of cholera was considered as a result of miasma (foul/ haunted air) or because of being immoral or poor. It was even believed, to prevent cholera you just had to spray a sweet fragrance in the air around you. This preventive measure was supported by the most learned medical practitioners of the society at the time and it continued being the case until the 1850’s when this ideology was challenged by John Snow.
John
Snow was born in 1813 in a poor family and his father was a coal miner. Given
his family background, Snow was destined to be a coal miner like his father but
his mother noted his curious, inquisitive and active mind and decided his son
will not be a coal miner. Snow’s mother used her small inheritance and sent snow
to school.
Snow
studied and graduated. He was attached to a doctor to apprentice under. During
his apprentice, there was cholera outbreak in 1831. The cases were so many that the doctor was so
overwhelmed that he sent Snow to the slums and mines to check the cholera cases
that had been reported there. In his effort to treat the sick people in the
slums he tried the various methods that were common for treating cholera such as the use of strong herbs, opium and
bleeding but none worked, his years of apprentice amounted to nothing.
Cholera
was mysterious at the time, a person would wake up healthy and suddenly and
swiftly he would vomit, complain of stomach ache and intestinal pain, and then they
would die within hours. Medical advancement, has shown that, the cholera
bacteria multiplies twice it’s self every 30 minutes leading to persistent
vomiting and diarrhea, causing to great loose of water in the body leading to dehydration.
The cholera victim loses so much water that a patient does not die out of the
germs, but because of lack of water in the body that causes the blood to be sludgy
and unable to circulate through the body, therefore critical organs such as
kidney, liver, heart and brain would shut down one by one causing death. Years
later, it was discovered that drinking glucose could act as remedy to increase absorption
of water in the body slowing down the progress of cholera.
Days
later, the cholera outbreak ended mysteriously just as it had started but the
experience left a print on Snow’s mind. He had noted that most patience
complained of stomach and intestinal pain and diarrhea and he theorized that
the sickness must have been as a result of something egested other than
inhaled. Since, if it was something inhaled then the patience would have
complained of throat or lungs pain.
To
actualize his theory, he took to the study of the water supply in the town.
There were two water pump station on a street where people on opposite side
would fetch water. On one side of the street, waste water running from toilets
and households containing fecal matter flowed towards the water pump. The
statistic indicated that people who consumed water from this pump had died of
the cholera and further they were 998% likely to die compared with the people
who consumed water from the other pump.
The other Pump had waste water containing fecal matter flowing away from
it. In conclusion, Snow noted that fecal waste water had to do with the cholera
outbreak; He proceeded to publish the research and distributed it all over
London saying the cause was a “self-multiplying poison”. He in away
intentionally avoided to use the term germs since at the time the medical
community were repulsed by such a term. He was sure he had made a discovery,
that cholera was a waterborne disease.
In
as much as his findings were backed with data and a clear scientific method
approach, the medical community gave him a cold back and informed him that the
miasma theory was the only true reason why people got sick of cholera. The
medical community refused his idea. The Medical establishment believed in the
one and only ancient theory - the Miasma Theory that had a powerful grip over
the establishment and no one would part from this theory.
After
the chaos of the cholera outbreak settled, people moved on with life as usual. John
Snow progressed with his career as a doctor. He gained prominence in the field
of euthanasia. He was able to come with proper procedure and dosage to be used
during euthanasia. He even euthanized the queen. He became one of the founders
of the Epistemology Society in order to find means to control contain and
prevent outbreaks of epidemics.
In
1854, as snow was reading a newspaper he read a case; where in Broadway street
many people had died of a cholera outbreak, that the hearse was do full of
caskets carrying dead bodies that others had to be tied on top and on the sides.
This time Cholera did not seem to have a specific pattern it cut through the
classes indiscriminately, the rich and the poor, male and female, the
professionals and the casuals, the educated and the uneducated, the moral and
the immoral, all were victims of this terrifying disease. This experience was
enough to remind him of the cholera of his youth and to push him to action. He
rushed to the center of the epidemic. He knew he needed to act fast, as every
second there was likely a case of a new contamination or death.
He
walked the streets of broadways and beyond. He visited as much sick people as
he could or their physician or care giver collecting information from every
person. He was assisted with a curator, named Whitehead, who being a religious
person was trusted by the people and was familiar with almost all death in the
area.
The figure at left is the personification of cholera
With this data, he plotted a map to illustrate where death of people was more clustered. He noted the death was more clustered near a water pump on Broadway Street and radiated outwards, thinning as a person moved away from the water pump. Having earlier developed a case study that proposed that cholera was a waterborne disease, he was sure this was an affirmation of his findings. He went to meet the Local Health Committee and proposed that the handle of the water had to be removed to prevent further spreading of the disease. He showed them the data and he firmly persuaded them to do so and finally, though reluctantly they removed the handle. Days later, maybe because of the removal of the handle or because of nature cholera ended. All this work of visiting broadways street, visiting the sick and the victims of the sick, plotting the map, visiting the register office, organizing meeting with local health officer, removing the handle on the water pump happened within 72 hours (3 days). For all this activities to have succeeded within such a short time it required his total commitment and dedication.
Since
many people and important members of the society had died a Commission was
formed to investigate the disease. Snow and whitehead were invited to be
members of the commission. On investigation they found that the water pump
obtained water from a well. The well had been dug next to a cesspit. The
cesspit was not properly built and the waste from the cesspit was leaking to
the well. A woman, whose child had died of cholera, had thrown the nappies of the
child in the cesspit. The waste leaked to the well. This all made a complete
chain. The commission made a report that cholera had been caused by leakage
from the cesspit. This was a small discovery by the commission but a great leap
to the discovery of causes of cholera.
Snow,
did not live to see triumph of his ideas. It would be years later when the
report by the commission would be believed and implemented.
John
Snow effort to stop cholera is remarkable. It may not all be attributed to him
directly, but looking at it in hindsight we come to appreciate his
determination and courage. That during
his lifetime microscopes were yet to be invented to identify germs in the water
and in fact things like germs and bacteria were still unknown; That using his own
logical mind to develop methods to meticulously collect data and join the dots
and give them meaning; that he took a
whole traditional medical practice head on by challenging the well engrained belief
that cholera was caused by foul air and being immoral; that he developed a new
scientific reason based on data; That he was able to collect data and plot it
on a map and to date the same method(coronoid diagraph) he develop on top of his head is still being
used, this demonstrates how effective and practical his innovation was;
that he courageously walked the streets
of London meeting and interviewing sick
patients to collect data in as much as it was suspected cholera was cause by
breathing foul air in that street; his pioneering to flow against the times. To
date millions of lives have been saved due to his study. His study and method
has improved health and healthcare around the world.
In
current times, we now know cholera is caused by egesting contaminated water or
food and that basic hygiene can greatly prevent cholera.
The
battle that Snow fought years ago is the same battle we fight today. Narrow and
ancient views have prevented the discovery of new truth. In this present age we
have perceptions and theories that exist side by side by scientific evidence
that have been tested, confirmed and proved but due to the powerful grip
tradition or custom has on us we hold on to them. Frank Fanon has to say this
about this condition, “Sometimes people hold a core belief that is very strong.
When they are presented with evidence that works against that belief, the new
evidence cannot be accepted. It would create a feeling that is extremely uncomfortable,
called cognitive dissonance. And because it is so important to protect the core
belief, they will rationalize, ignore and even deny anything that doesn't fit
in with the core belief.” Now or days to come, we shall find ourselves in a
position to lead a new order or be the cause of change. To be the people to
push humanity one step to change to a better world. Changing a core belief is a
herculean responsibility we must all embrace.
It
will take incredible courage for a person to challenge an entire infrastructure
of tradition or ignorance, to speak truth to power but by the example set by
many pioneers before us such as John Snow who want a better health care,
Wangari Mathai who wants a better environment, Martin Luther who burns with the
dream of all people to be treated equally, we know we are in good company. John
Snow gives us an example that any ordinary person from unknown background, no
wealth or no fame or title can use his own creativity and knowledge to
challenge the imperfection of a system or bring people together and challenge
the status quo. And to strongly know that
it is within their power to remake or to rethink an ideology and make it
closely align with the ultimate truth or utopia that all humanity are working
towards.
I end with the words of John Lewis who said “if you do not do everything you can to change things, then they will remain the same. You only pass this way once; you have to give it all you have.” John snow change the way the world thinks and in the process changed the world, the world awaits for you.
