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Take a lesson from brave, stoical Snow

A reception held at the London School of Hygiene & Tropical Medicine to celebrate the life and work of the legendary physician and epidemiologist, John Snow, whose 200th anniversary fell on 15 March, had the buzz of a celebrity book launch. And yet on this occasion, this much-deserved figure of idolatry had been dead for 155 years.

Snow was vilified by the medical and political elite in his lifetime for identifying that virulent cholera outbreaks in London originated not in ‘miasma’, or bad air, but in the water supply. Nonetheless, this modest teetotaller managed to persuade the guardians of a pump in Broad Street (now Broadwick Street) in Soho – who were desperate to end an outbreak in 1854 - to remove the pump handle. 
In a lecture by Snow biographer Sandra Hempel, I learned that while this act in itself did not prevent the contemporaneous outbreak, which killed 600 but was already on the wane, it probably prevented further spread of the disease. The likely source was a household whose baby originally contracted the disease and whose mother then unknowingly washed contaminated nappies into a leaky drain that deposited into the Broad Street well. Later, as she nursed her husband, she washed sheets into the same drain – but by now the well was unused and no further outbreak occurred.
While the pump, a replica of which stands on Broadwick Street today, is the symbol of Snow’s achievements, Hempel and the assembled academics seemed persuaded that his true achievement was in the case of modern epidemiology. When the virulent Broad Street outbreak occurred, he was already undertaking a huge experiment in South London trying to identify the pattern of cholera deaths in that area.
By knocking on doors, counting the dead, and asking people which water company they were supplied by, Snow worked out that those supplied by Vauxhall & Southwark were eight to nine times more likely to die than those using Lambeth Waterworks water, brought from out of town. The directors of the latter decided in 1847 to move the intake for their reservoirs to Seething Wells between Surbiton and Thames Ditton.
Slowly the establishment came to absorb and accept Snow’s theories and they now shape modern epidemiology and public health policies around the world. He also initiated the use of chlorine as a disinfection agent.
Thanks to Snow, waterborne disease is not a life-threatening challenge to today’s Soho residents. However, it is worth reflecting on the lessons he can teach today’s water engineers and scientists about modern challenges like affordability and climate change.
The stoicism, doggedness, bravery and patience of Snow is still required if our infrastructure is to be secured for future generations. His radical and rounded approach, which risked innovation and embraced social research, scientific knowledge, customer experiences, pragmatic action and political lobbying is surely one to be emulated.

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