Time for Plumbers Without Borders

cleanwater1Médicins Sans Frontieres – known as MSF internationally and Doctors Without Borders in the US – was founded in 1971 in the aftermath of the Biafra War, in which parts of south eastern Nigeria sought to secede from the federation. It is certainly a remarkable organization. It facilitates the work of over 34,000 volunteers, providing access to medical help for millions of people.

Your columnist does not wish to criticize the work of MSF in any way, but considers that the greatest boon to health in western countries and biggest reason why life expectancy is greater in rich countries than in poor is not dependent on doctors but on plumbers. Moreover, access to indoor plumbing, clean water and safe sewage disposal not only does much more than prevent disease. It also enormously enhances the quality and comfort of our lives. Plumbers matter. They really, really, matter. 

There are many organizations working on addressing these critical issues. There is even one with the name – which this columnist thought he had made up – Plumbers Without Borders. It is neither as large nor as well known as the medical charity whose name it has mimicked. 

Medical care should be addressed only after plumbing has been taken care of not only because clean water saves more lives than medicine but because a great deal of what doctors can do is dependent on having access to clean water. Without hygienic conditions medical intervention will often do more harm than good. 

Famously in the 1840s it became clear that the mortality rate at the Vienna General hospital was higher both for children delivered by doctors than for those delivered by nurses but also for their mothers. This was because doctors were also involved in conducting autopsies and didn’t know that it was important to wash their hands afterwards. 

In the same decade in England John Snow became an advocate for the theory that infected water could be an agent of the deadly cholera outbreak. He mapped the cholera infections in central London and showed that they were centered around a single public pump in Broad Street. He broke the handle off the pump and the epidemic cleared up. In doing this he not only proved the method of transmission of cholera but, more generally, germ theory as the explanation of epidemiology. 

People used to believe that bad smells caused disease. Not all bad smells. Henry VIII had his son’s bedroom walls washed in chlorine bleach. He believed that chlorine’s bad smell would ward of the damaging bad smells of feces and rotting food. 

We evolved to be repelled by certain smells. People who were disgusted by these smells had more descendants than those who were not. It gave our ancestors a good rule of thumb for avoiding disease. But we no longer need this approximation, as our knowledge had advanced enormously in the two centuries since the birth of John Snow. 

We also evolved on a planet that is two thirds covered in water. It constitutes some 70% of your bodyweight. Clean water is the greatest boon to our health, and even in western countries it is just a two or three generations old. Your columnist attended an elementary school with no indoor toilets and his father grew up in a house with no flush toilet. 

Doctors are great. But plumbers matter even more.

qlQuentin Langley is a Senior Lecturer in Marketing at the University of Bedfordshire Business School as well as a freelance columnist published in the UK and all parts of the US. He blogs on social media and crisis communications at brandjacknews.com

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