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Student Surname: carter Given Name:Lachlan Student Number:z3218261

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Course Code:GENM0518 Course Name: Health and Course Convenor: David

power in the internet age

Assignment Number:1 Question Number: Due Date: 2/2/11

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Created on 01/02/2011
 Health and power in the internet age

This essay is being written as an evaluation of the health of the London “courts” during the period
containing 1844, including speculation on the life expectancy rates of classes and a look at how they
compare to modern society. I will also evaluate which powerful members of society have a larger
impact on the overall health of a population. In conclusion I will evaluate the impact technology, in
particular the internet, has had on the “health” status of society as a whole.

WHO definition of health: “Health is a state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity. ”

Health of the courts during 1844:

After reading the article with the scientific understanding I poses I am able to surmise based on the
information provided that the health of the population during 1844 in the Liverpool “courts” would
have been abysmal. Two key aspects of the article have led me to believe this.

“At best the court might share one communal water tap in the middle and one or two communal
toilets at the end often toilets would be in disrepair or choked for lack of water supply, making
conditions and atmosphere both noxious and very unhealthy. At worst the premises would be
surrounded by filthy middens and cesspools.”

“Ash pits and privies were unfrequently emptied and their contents consequently spread over the
court…”

Both extracts from: 1999, the Liverpool Family Historian, Volume 12, issue 12

These 2 statements lead me to believe that the population of the courts at the time would have
been extremely physically unhealthy, never mind their social and mental wellbeing which would also
have been seriously affected by a life in such squalor.

Given the notable proximity and inadequacy of the sewerage and waste management in the courts,
combined with the centralised location of the water supply meaning that it was never very far away
from a cesspit. We can assume that the population suffered greatly from the effects of cholera and
dysentery. Both of which are common when large populations live in a densely populated areas
without ready access to fresh drinking water.
Cholera “Intestinal infection with Vibrio Cholerae results in the loss of large volumes of watery stool,
leading to severe and rapidly progressing dehydration and shock”

Drasar, B. S.; Forrest, Bruce D., eds (1996). Cholera and the ecology of Vibrio cholera, Chapman & Hall, London

This would have been the most devastating disease the population would have suffered in the
courts as the only way to effectively stop its spread is to introduce wide spread sanitisation
standards and practices that would have seen a large part of the court demolished. In fact we can
infer based upon the article that the health of the courts population became so abysmal that by the
year 1893 large sections of the courts had indeed been demolished due to public outcry concerning
sanitation, cholera is the likely cause of this outcry. (Liverpool Family Historian, 1999)

Life expectancy in 1840’s London and the population’s health:

In my research I have learnt that before 1920 and the many biomedical model advancements that
have occurred this century accurate information concerning the life expectancy of particular target
populations is hard to come by, however based upon an number of factors we can establish a that
the life expectancy of Londoners contains a number of hinges. For example a lot of the data available
claims that the average life expectancy of a Londoner was 40 years however recent historians have
stated that these figures may have been eschewed by their inclusion of infant mortalities. Another
interesting point of note is that in 1800’s the infant mortality in England and France dropped to only
20% due to advances in sanitation high by modern standards but amazing at the time. (Stephen
Blaha, 2002)

“Dr W. Duncan estimated that in 1847 nearly 60,000 persons in the borough suffered from fever and
40,000 suffered from diarrhoea and dysentery. It was the most fatal year in the history of London…
Vauxhall Ward nearly one seventh of the population was swept away in the course of the year….in
lace street one third of the ordinary population was swept away in the course of the year”

1999, the Liverpool Family Historian, Volume 12, issue 12

This extract indicates that people of the time did not understand the spread of sickness and disease
and so were helpless to stop it. Health was appalling and the social consensus seemed to be that
disease and “miasma” was something that they had to persevere if they wanted to remain in the
cities. To fully understand this attitude we need to understand that the modern biomedical model
was not established, indeed germ theory had not yet been proposed either and most people would
look upon a scientist strangely if he proposed that they were getting sick due to millions of tiny
creatures they could not see swimming around in their water or crawling over their food.

When we compare the mortality rates of disease in London, remembering it was considered normal
for the time; to the current mortality rates in Australia the results are shocking. For example the
average life expectancy in Australia is 81.4, more than twice that of London during the mid-1800.
The vast advances in medical technology become even more apparent when we consider that the
Infant mortality rate in Australia is .43%, while in London at the time it has been approximated by
historians to be 20%. (theworldbank.org)
From Historical records we know that common medical belief at the time held that all sickness was
spread by smell and the source of cholera and other disease in London was the “miasma”. People
did not understand the concept of sanitation and thus contaminated drinking water and food,
particularly seafood led to many deaths that could have otherwise been prevented. However
considering that society at the time was undergoing an industrial revolution and the “price of life”
was cheap when compared to the might of the empire then it is not all that strange to find that
parliaments and even society at large ignored radical doctors such as John Snow who proposed that
cholera was spread by contaminated water not “miasma”. Over all we can tell that health in “the
courts” was intolerable by modern standards.

Greatest contributors to social health;

When I started this course I was aware that Engineers were necessary to ensure the public wellbeing
and collective health of a society, but I was unaware that they could actually influence the entire
direction undertaken by governments to ensure the health of a populous society. Now that I have
completed this course and I have a better understanding of health and the way in which power
within a society allows it to be controlled I can see that engineers are extremely influential due to
their political, social and economic powers. Perhaps the best example of the power and influence of
engineers on the health of a population is the reinventions of the London sewer system in 1858 by
Joseph Bazalgette.

In the Mid 1800’s London was suffering in the grip of Cholera, the commonly held belief was that
Cholera and other sickness was spread as a result of the foul smelling London smog known as the
“Miasma”. A doctor who went by the name of John snow, however had a different theory, he came
to the conclusion that cholera could not have been air born after he observed that in a particular
street where cholera was endemic one side had suffered no outbreak while the other side was
decimated. His continued tracking of cholera outbreaks led him to the conclusion that cholera was
caused by contaminated drinking water, in particular the infamous broad street pump. (Steven
Johson, 2006)
NB: included is a copy of the original John Snow Cholera map:

Published by C.F. Cheffins, Lith, Southhampton Buildings, London, England, 1854 in Snow, John. On the Mode of Communication of
Cholera, 2nd Ed, John Churchill, New Burlington Street, London, England, 1855
When Dr Snow tried to convince the government and other members of the scientific community of
the significance of his discovery however he was met with criticism and ridicule. This highlights how
important it is to have both political and social power in order to further the health of a society.

In vast contrast to this we have the engineer Bazalgette who believed that the Miasma was indeed
the cause of the cholera epidemics that plagued London and the other major cities of the industrial
world. He correctly determined that the source of the sickness was the revolting condition of the
London sewers and spent a large part of his career developing the political power to overhaul and
redevelop the sewers. He was able to achieve the necessary influence after he was appointed as the
chief engineer of the Metropolitan Board of Works. The reinvented London sewers ultimately solved
the problem of “the great stink” and also resulted in the cessation of outbreaks of Cholera,
dysentery and other sicknesses that are cause by waterborne bacilli.

History and our greater understanding of the biomedical model have shown us that Dr. Snow was
correct; Cholera is indeed cause by drinking contaminated water. However history also shows us
that without the political and social power wielded by Bazalgette, London may never have escaped
the clutches of death disease and the “great stink”.