• Friday, July 19, 2024
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Lessons from the British cholera outbreak

British cholera outbreak

I was recently exposed to a person who tested positive for covid-19 and I had to do the mandatory two week quarantine at a guest room in my house. I did a little thinking during that period. One of the major reasons responsible for the community spread of the pandemic is the absence of such ‘privileges’. Travelers who return to the country are told to self isolate for 14 days, but flout that guideline not necessarily by will, but because a major way to do so effectively (which is reduced contact with people who may likely contact and spread it) is almost impossible given our architectural culture.

Largely due to urban population growth, the demand for shelters in cities across the country has trumped the care in which residential homes are designed. Asides the disregard for the importance of ventilation, the decline of “boys quarters”, a colonial heritage, is a common feature in our architectural designs. In such a scenario, it is almost impossible to get people to effectively follow health guidelines. Nations grow by learning from their mistakes and making sure not to repeat the same. A notable example is how Britain handled its cholera outbreak in the 19th century.

Cholera was first identified and reported in Britain in October 1831, when Keelman William Sproat of Sunderland contracted the disease and died just three days later. When it spread like wildfire and engulfed London just a year later, a couple of theories were put forward. One of them was the miasma theory–cholera was air-borne, transmitted via poisonous vapours, ‘miasma’, from rotting of organic matter. It seemed to be backed up by the many falling victim to the disease living in overcrowded slums where the air was most polluted. An official report released by the London Board of Health, attributing the outbreak to ‘the poor, ill-fed, and unhealthy part of the population, and especially those who have been addicted to the drinking of spirituous liquors, and indulgence in irregular habits’.

It took Edwin Chadwick to go against the dominant view of urban poverty being a result of laziness or immorality, but rather due to the conditions in which people lived. The actual fact was that cholera was in fact, a bacteria transmitted via contaminated water sources. In the mid-1800s, London’s poorest were surrounded by their own and others’ filth, as basement cesspits overflowed due to the lack of an efficient sewage system. The Thames, the main source of drinking water for residents, became more and more polluted.

To handle the epidemic, the British government introduced new measures, one of which was the Nuisances Removal and Diseases Prevention Act of 1848. That law encouraged property owners to clean their dwellings, to prevent ‘atmospheric impurity’, and ‘Householders of all classes should be warned, that their first means of safety lies in the removal of dung heaps and solid and liquid filth of every description from beneath or about their houses and premises’. The establishment in 1848 of the Metropolitan Commission of Sewers was to bring its sewer and drainage infrastructure under the control of a single public body. Properties were to be cleaned and connected to sewers.

History exists to teach its willing audience lessons. Nigeria and others who behave like her, belong to the unwilling audience.

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The coronavirus pandemic was supposed to be a teachable moment for Nigeria. At the onset of the pandemic in Nigeria, there were multiple health epidemics such as Yellow Fever, Lassa Fever among others. There was a window of opportunity to pass legislation to mitigate the disasters.

The fixation on the Infectious Diseases Bill–a cover for political machinations and a fight for the control of the Nigerian Centre For Disease Control–robbed us of ample opportunity to pass health centred legislations. In 2021, the country has no business with having open sewers, let alone its major cities. Lassa Fever which is spread by rodents should have been eradicated long ago if we had a proper waste disposal system, and heaping of wastes in public places which is injurious to public health.

A key lesson to learn from the British handling of the cholera outbreak two centuries ago, is the seriousness in which it approached public health matters, even walking back on wrong ideas from important places such as the London Board of Health. The same boldness has been missing in handling the Port Harcourt Soot Disaster caused by illegal bunkering and gas flaring. It’s been nearly seven years since the issue first came to light and like the Ogoni Clean Up, pronouncements have fallen short of actions, mostly to appease oil companies doing business in the region.

An effective way the Brits handled cholera was through legislation, and then enforcement. Laws were made to provide a sewage system and for the spacing of buildings. On 15 June 1858, the government of Benjamin Disraeli tabled the Metropolis Local Management Amendment Bill. Within a record 18 days, a bill was created, passed, and signed into law that would repurpose the entirety of the River Thames, “for the improvement of the main drainage of the metropolis, and for preventing, as far as may be practicable, the sewage of the metropolis from passing into the river Thames within the metropolis”.

If we’re going to increase our national life expectancy, we have to take public health matters as seriously as we take oil sales. It does not help that in the middle of a pandemic, items that should have been distributed as palliatives to help mitigate a lockdown were hoarded and left to rot. It gives one a sense of direction as to exactly what plans the government has for its people and honestly, such a plan is no plan at all.

Nwanze is a partner at SBM Intelligence