Tag Archives: cholera

July 18, 1911: Death by Cholera in the U.S.; 1908: Irrigating the Nile Valley

Quarantine in NYC Harbor in 1879

July 18, 1911: Cholera Kills Boy; Eighth Death Here. New York Times Headline. “The sixth death from cholera since the arrival in this port from Naples of the steamship Moltke, thirteen days ago, occurred yesterday at Swineburne Island. The victim was Francesco Frando 14 years old.

Dr. A.H. Doty, the Health Officer for the Port of New York stated, “The great thing in fighting cholera is to isolate each case as soon as it is suspected, and, secondly, to take care that there is no local infection, like the contamination of the water supply, in the place where the suspected cases are isolated. That is why I detained all the passengers of the Moltke, although at the time there were no absolute cases of cholera among them. I let the crew take the vessel back to Europe, but refused to allow any of them to come ashore.”

Alvah H. Doty

Commentary: Quarantine was the best weapon against cholera in the late 19th and early 20th century. Obviously, chlorination of drinking water had not taken hold across the U.S. by 1911. A few short years later and it would be used as treatment in the majority of U.S. municipal water supplies. Doty was an interesting historical character. His obituary can be found at http://freepages.genealogy.rootsweb.ancestry.com/~quarantine/dotyobit.htm.

Update July 18, 2017: Note the care and attention given to eight deaths from cholera at the New York port of entry near the turn of the 20th century. Today, the world shrugs off the news that there have been 300,000 cases of cholera in Yemen and 10,000 deaths from cholera in Haiti. What has happened to our humanity?

Nile River Irrigation

July 18, 1908: Engineering Record article. The Nile Irrigation Question. “The Nile Valley, from the great lakes of Central Africa on the south to the Mediterranean Sea on the north, is throughout, if watered, an essentially cotton country, and having in view the threatened shortage in the world’s future supply of one of its great necessities, and the large share of America in its provision in the past, it will be interesting to note what has been done and is being proposed in Egypt and the Sudan by means of irrigation to supplement the present supply of cotton and to meet the growing demand. In Egypt, at present, nearly all other cultivation is gradually yielding to that of cotton, notwithstanding the greater amount of hard work which the latter requires among a race to which it is by no means congenial.

The Nile system consists of the White Nile, which originates in the larger group of Central African lakes, the Victoria Nyanza, the Choga, the Albert Edward and the Albert Nyanza; and the Blue Nile, which is the largest source of supply, draining the mountains of Abyssinia. These two meet at Khartoum, the river thence flowing to the north being the Nile proper. It is on the latter that the principal conservation works have been and are now being erected, while on the White and Blue Niles, especially on the former, the work of the future will no doubt be chiefly concentrated.

As upper and lower Egypt, most of which is practically rainless, are dependent on the branches for their water, the Nile proper being merely a channel for its conveyance, and as much of the water is lost by spills and evaporation on the White Nile, it is a fortunate circumstance that Great Britain, with its large Indian irrigation experience, has even a greater control over the Sudan and the upper country through which the river flows than over Egypt itself. Hence not only will the former be benefited by direct irrigation on now unprofitable lands, but the latter will also receive more water by works undertaken under British initiation and financial help, on the White Nile.”

Commentary: Note the reference to “lazy” Egyptian farmers and how wonderful it was that British innovation was helping to save their less fortunate and inferior brethren. Racism and colonialism were dominant themes in some engineering writings from this period.

July 4, 1961: Revolutionary Pipe Joint Patent; 1832: Letter from Chester Averill about Cholera; 2013: Natural Immunity from Cholera

Fastite Joint

July 4, 1961: On this date, Patent Number 2,991,092 was issued to Mr. J. W. MacKay of the American Cast Iron Pipe Company in Birmingham, Alabama, for the Fastite push-on-rubber gasket joint for iron pipe. The Fastite gasket uses a dual-durometer gasket having a stiff rubber ring to hold the gasket in place against insertion loads and a softer, fatter section to provide the leak-free seal. The push-on gasket soon supplanted the bolted mechanical joint for virtually all underground pipe-to-pipe connections and is part of ANSI/AWWA C111/A21.11, Rubber-Gasket Joints for Ductile-Iron Pressure Pipe and Fittings. In 2014, Mr. MacKay is alive and well at age 104. He was inducted into the state of Alabama Engineering Hall of Fame in 2011.

Source: Maury D. Gaston, American Cast Iron Pipe Company.

Chester Averill

July 4, 1832: Date of letter from Chester Averill (Professor of Chemistry, Union College) to the Mayor of Schenectady, New York during the middle of a cholera epidemic which praised the disinfecting properties of chloride of lime (chlorine). The treatise quoted many learned men of the time who demonstrated that chloride of lime eliminated the spread of contagious diseases by attacking the miasmas associated with them. The letter also made reference to the destruction of certain “viruses” that may have been responsible for transmission of the diseases. The germ theory of disease would not be espoused by Louis Pasteur for another 30-40 years. However, Averill, like many others in the early 19th century suspected that something other than “bad air” caused disease. What follows is a small extract from his treatise.

“‘Chlorine is by far the most powerful agent hitherto discovered to counteract contagion and all kinds of noxious effluvia and its sanative powers appear equally extraordinary.’ Dr. Sillimaii’s Chem. vol. 2, p. 68.

I have here quoted the opinions of eminently scientific men, at least three of whom are M.D.’s. and all of whom, it may be thought, do not deserve to be styled empyrics. But what weight ought these opinions to have in this discussion? Surely no more than those of any other person even much less eminent, unless they are better substantiated by facts. It was thought advisable, however, to quote them, since they may serve to correct any bias which entirely opposite opinions, proceeding from no higher source, may have occasioned.”

Reference: Averill, Chester. Facts Regarding the Disinfecting Powers of Chlorine: With an Explanation of the Mode in Which it Operates and with Directions How it Should be Applied for Disinfecting Purposes. Letter to John I. DeGraff, Mayor of Schenectady. Private printing. 1832.

July 4, 2013: In today’s New York Times (July 4, 2013), there was an extraordinary article that summarized recent research findings on human genetic adaptation to killer cholera. A few quotes give a summary of the findings: “People living in the Ganges Delta, where cholera is an ancient, endemic and often lethal disease, have adapted genetically to the scourge through variations in about 300 genes, say researchers who have scanned their genomes for the fingerprints of evolution.

The researchers also found unexpected changes in genes that protect against arsenic, suggesting that arsenic exposure in Bangladesh is not just a modern problem associated with deep tube wells but may have ancient roots.

These instances of natural selection probably took place within the last 5,000 to 30,000 years, the researchers say, and show how evolution has continued to mold human populations through the relatively recent past…. People with blood group O are particularly susceptible to cholera, and indeed few Bengalis have blood group O. John Mekalanos, a cholera expert at the Harvard Medical School, said the new finding was one of several that ‘are starting to give a strong impression that the human genome has been dramatically shaped by responses to microorganisms.’”

Reference: Wade, Nicholas. 2013. “Gene Sleuths Find How Some Naturally Resist Cholera.” New York Times. July 4, 2013.

June 16, 1858: Death of Dr. John Snow

Dr. John Snow

Dr. John Snow (March 15, 1813–June 16, 1858) is famous for the Broad Street Pump episode but he accomplished so much more than that. He was first and foremost a physician who trained in England in the early part of the 19th century. He made significant contributions to the development of anesthesia and he is considered by many to be the Father of Modern Epidemiology.

The story of Dr. John Snow and how he discovered the cause of a cholera epidemic in the Golden Square neighborhood of London in 1854 has reached almost mythical proportions in public health literature.  Three excellent books describe Snow’s life and the details of the Broad Street Pump incident. (Hempel 2007; Johnson 2006; Vinten-Johansen et al. 2003)

Snow was born on March 15, 1813 in the City of York.  He served his medical-apothecary apprenticeship in Newcastle-on-Tyne with later assistantships in the villages of Burnop Field and Pateley Bridge.  In 1836 at the age of 23, Snow moved to London to complete his medical education.  He qualified as a licensed apothecary in 1838 and a surgeon with a London practice in October 1838.  With an office in the parish of Saint Anne-Soho, Snow would have a medical career of only two-dozen years before he was struck down at the age of 45.

At the age of 17, Snow became a vegetarian and soon thereafter committed to only drinking boiled water or, preferably, distilled water as a result of the writings of John Frank Newton.  He embraced abstinence from alcohol around 1836.  Snow was known to be quiet, frugal and energetic, a man of integrity and a surgeon with an indifferent bedside manner.  He refused to dispense pills and other medicines just because his patients wanted them.  He was able to make a living and acquire some success as a physician when he perfected the administration of chloroform as an anesthetic used during surgeries and infant deliveries.  He even delivered two babies while attending Queen Victoria.

He never married.  His solitary existence and his abstinent personal habits allowed him more time than his colleagues to develop his medical practice and enabled him to pursue his intense interest in determining the cause of cholera epidemics.

Snow gave away all of the knowledge he developed.  He made it available for free to any doctor who wanted it.  No attempt was made by him to patent his many devices for dispensing chloroform and ether. As a result, physicians hired him to use his skill with their patients and he became famous for this.

One overriding personal characteristic of this ascetic doctor of the Victorian era was courage.  He worked hard to develop his ideas and used the scientific method and laboratory investigations to establish his case in whatever area he was working.  Once he became convinced of the rightness of his position, nothing could dislodge him.  It was only his tremendous courage that made it possible for him to go up against the establishment and argue that something other than foul air was causing the deadly cholera. (McGuire 2013)

Snow’s determination of the cause of the cholera epidemic near the Broad Street pump and his ability, albeit temporary, to have the pump handle removed is worthy of recounting here.  The 1854 cholera epidemic struck the Golden Square neighborhood of London with particular viciousness. It began on August 31 and started to wind down about September 7, however, many died over the next few days. Well over 500 people died during this epidemic in a small neighborhood. Snow tracked the numbers of deaths in the neighborhood, and it was clear to him from the pattern of death that the Broad Street pump was the center of the affliction and most likely the source of infection. On September 7, Snow convinced the Board of Governors and Directors of the Poor of St. James Parish that the epidemic was being caused by water from the pump. The next day the commissioners ordered that the pump handle be removed. Structural defects in the Broad Street well sump and the cross-connection to the nearby house sewer were not corrected until 1855.

Incredibly, the residents of Broad Street petitioned the Commissioners to reopen the well that had caused hundreds of deaths in their neighborhood.  This was partly due to the official linkage of the severe, isolated epidemic in the Broad Street area to miasma (foul air). In an amazing footnote to history, the commissioners voted 10 to 2 to reopen the well on September 26, 1855, one year and one week after the last deaths during the epidemic.  According to contemporary reports, there was much rejoicing in the street that the Broad Street well was reopened.  The polluted well was not permanently closed until the cholera epidemic of 1866.

With the emphasis on the Broad Street pump episode in most historical accounts, his pioneering work in epidemiology based on cholera occurrence in a district of London served by two water supplies usually gets lost.  Snow was able to demonstrate that homes in areas of London that were being served contaminated water from the tidal portion of the Thames Estuary were far more likely to have cholera deaths than the homes served water from an unpolluted upland source. He believed that dumping sewage into a water supply perpetuated the death spiral caused by cholera and other waterborne diseases. Snow had strong opinions on sewers and drinking water systems.

“Snow who distilled his own drinking water, agreed that London water should be improved, but he considered the abolition of cesspools and the increasing preference for water closets a sanitary disaster…water closets connected to sewer lines that emptied into rivers also used for metropolitan drinking water were, in his mind, primarily an efficient means of recycling the cholera agent through the intestines of victims as rapidly as possible.  Sanitary reforms were needed, but flushing the waste of a town into the same river by which one quenched ones’ thirst seemed sheer stupidity.” (Vinten-Johansen et al 2003)

Dr. John Snow died of a stroke on June 16, 1858, 42 days after the birth of John L. Leal who grew to be a physician who carried on Snow’s concern about the ability of contaminated water to spread disease.  If the discoveries of Dr. John Snow had been accepted and followed by engineers, sewer planners and drinking water providers beginning in 1854, millions of deaths would have been avoided.  Snow was only one person trying to overcome the juggernaut of the miasma theory.  He was far ahead of his time.

References:

Hempel, Sandra. 2007. The Strange Case of the Broad Street Pump: John Snow and the Mystery of Cholera. Los Angeles, Ca.: University of California.

Johnson, Steven. 2006. The Ghost Map: The Story of London’s Most Terrifying Epidemic and How It Changed Science, Cities and the Modern World, New York City, N.Y.: Riverhead Books.

McGuire, Michael J. (2013). The Chlorine Revolution:  Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. 2003. Cholera, Chloroform, and the Science of Medicine. New York City, N.Y.: Oxford University Press.

May 7, 1848: Public Health Act, England

May 7, 1848:Public Health Act is passed by a reluctant Parliament fearful of spread of cholera. National Board of Health is formed and leads local boards to regulate water supply, sewerage, offensive trades.”

“The first local boards [of health] were created under the Public Health Act 1848 (11 & 12 Vict. c.63). The aim of the act was to improve the sanitary condition of towns and populous places in England and Wales by placing the supply of water, sewerage, drainage, cleansing and paving under a single local body. The act could be applied to any place in England and Wales except the City of London and some other areas in the Metropolis already under the control of sewer commissioners. The Act was passed by the incoming Liberal government, under Prime Minister Lord John Russell, in response to urgings by Edwin Chadwick.”

March 16, 1802: Corps of Engineers Established; 1804: Birth of Chester Averill

March 16, 1802: President Jefferson authorized to establish the Corps of Engineers. “The history of United States Army Corps of Engineers can be traced back to 16 June 1775, when the Continental Congress organized an army with a chief engineer and two assistants. Colonel Richard Gridley became General George Washington’s first chief engineer; however, it was not until 1779 that Congress created a separate Corps of Engineers. One of its first tasks was to build fortifications near Boston at Bunker Hill. The first Corps was mostly composed of French subjects, who had been hired by General Washington from the service of Louis XVI.

The Corps of Engineers as it is known today came into being on 16 March 1802, when President Thomas Jefferson was authorized to ‘organize and establish a Corps of Engineers … that the said Corps … shall be stationed at West Point in the State of New York and shall constitute a Military Academy.’ Until 1866, the superintendent of the United States Military Academy was always an engineer officer. During the first half of the 19th century, West Point was the major and, for a while, the only engineering school in the country. The Corps’s authority over river works in the United States began with its fortification of New Orleans after the War of 1812.”

Chester Averill

March 16, 1804: Birth of Chester Averill who became a Professor of Chemistry at Union College in Schenectady, New York. Averill is known for a letter that he wrote to the Mayor of Schenectady, New York during the 1832 cholera epidemic which praised the disinfecting properties of chloride of lime (chlorine). The treatise quoted many learned men of the time who demonstrated that chloride of lime eliminated the spread of contagious diseases by attacking the miasmas associated with them. The letter also made reference to the destruction of certain “viruses” that may have been responsible for transmission of the diseases.

Commentary: Averill’s letter is an extraordinary document that is worth reading. He was far ahead of his time. Indeed, he preceded Dr. John Snow’s conclusions about cholera transmission (1849) by 17 years.

March 15, 1813: Birth of Dr. John Snow

Dr. John Snow

March 15, 1813: Birth of John Snow. Dr. John Snow (March 15, 1813–June 16, 1858) is famous for the Broad Street Pump episode but he accomplished so much more than that. He was first and foremost a physician who trained in England in the early part of the 19th century. He made significant contributions to the development of anesthesia and he is considered by many to be the Father of Modern Epidemiology.

The story of Dr. John Snow and how he discovered the cause of a cholera epidemic in the Golden Square neighborhood of London in 1854 has reached almost mythical proportions in public health literature.  Three excellent books describe Snow’s life and the details of the Broad Street Pump incident. (Hempel 2007; Johnson 2006; Vinten-Johansen et al. 2003)

Snow was born on March 15, 1813 in the City of York.  He served his medical-apothecary apprenticeship in Newcastle-on-Tyne with later assistantships in the villages of Burnop Field and Pateley Bridge.  In 1836 at the age of 23, Snow moved to London to complete his medical education.  He qualified as a licensed apothecary in 1838 and a surgeon with a London practice in October 1838.  With an office in the parish of Saint Anne-Soho, Snow would have a medical career of only two-dozen years before he was struck down at the age of 45.

At the age of 17, Snow became a vegetarian and soon thereafter committed to only drinking boiled water or, preferably, distilled water as a result of the writings of John Frank Newton.  He embraced abstinence from alcohol around 1836.  Snow was known to be quiet, frugal and energetic, a man of integrity and a surgeon with an indifferent bedside manner.  He refused to dispense pills and other medicines just because his patients wanted them.  He was able to make a living and acquire some success as a physician when he perfected the administration of chloroform as an anesthetic used during surgeries and infant deliveries.  He even delivered two babies while attending Queen Victoria.

He never married.  His solitary existence and his abstinent personal habits allowed him more time than his colleagues to develop his medical practice and enabled him to pursue his intense interest in determining the cause of cholera epidemics.

Snow gave away all of the knowledge he developed.  He made it available for free to any doctor who wanted it.  No attempt was made by him to patent his many devices for dispensing chloroform and ether. As a result, physicians hired him to use his skill with their patients and he became famous for this.

One overriding personal characteristic of this ascetic doctor of the Victorian era was courage.  He worked hard to develop his ideas and used the scientific method and laboratory investigations to establish his case in whatever area he was working.  Once he became convinced of the rightness of his position, nothing could dislodge him.  It was only his tremendous courage that made it possible for him to go up against the establishment and argue that something other than foul air was causing the deadly cholera. (McGuire 2013)

Snow’s determination of the cause of the cholera epidemic near the Broad Street pump and his ability, albeit temporary, to have the pump handle removed is worthy of recounting here.  The 1854 cholera epidemic struck the Golden Square neighborhood of London with particular viciousness. It began on August 31 and started to wind down about September 7, however, many died over the next few days. Well over 500 people died during this epidemic in a small neighborhood. Snow tracked the numbers of deaths in the neighborhood, and it was clear to him from the pattern of death that the Broad Street pump was the center of the affliction and most likely the source of infection. On September 7, Snow convinced the Board of Governors and Directors of the Poor of St. James Parish that the epidemic was being caused by water from the pump. The next day the commissioners ordered that the pump handle be removed. Structural defects in the Broad Street well sump and the cross-connection to the nearby house sewer were not corrected until 1855.

Incredibly, the residents of Broad Street petitioned the Commissioners to reopen the well that had caused hundreds of deaths in their neighborhood.  This was partly due to the official linkage of the severe, isolated epidemic in the Broad Street area to miasma (foul air). In an amazing footnote to history, the commissioners voted 10 to 2 to reopen the well on September 26, 1855, one year and one week after the last deaths during the epidemic.  According to contemporary reports, there was much rejoicing in the street that the Broad Street well was reopened.  The polluted well was not permanently closed until the cholera epidemic of 1866.

With the emphasis on the Broad Street pump episode in most historical accounts, his pioneering work in epidemiology based on cholera occurrence in a district of London served by two water supplies usually gets lost.  Snow was able to demonstrate that homes in areas of London that were being served contaminated water from the tidal portion of the Thames Estuary were far more likely to have cholera deaths than the homes served water from an unpolluted upland source. He believed that dumping sewage into a water supply perpetuated the death spiral caused by cholera and other waterborne diseases. Snow had strong opinions on sewers and drinking water systems.

“Snow who distilled his own drinking water, agreed that London water should be improved, but he considered the abolition of cesspools and the increasing preference for water closets a sanitary disaster…water closets connected to sewer lines that emptied into rivers also used for metropolitan drinking water were, in his mind, primarily an efficient means of recycling the cholera agent through the intestines of victims as rapidly as possible.  Sanitary reforms were needed, but flushing the waste of a town into the same river by which one quenched ones’ thirst seemed sheer stupidity.” (Vinten-Johansen et al 2003)

Dr. John Snow died of a stroke on June 16, 1858, 42 days after the birth of John L. Leal who grew to be a physician who carried on Snow’s concern about the ability of contaminated water to spread disease.  If the discoveries of Dr. John Snow had been accepted and followed by engineers, sewer planners and drinking water providers beginning in 1854, millions of deaths would have been avoided.  Snow was only one person trying to overcome the juggernaut of the miasma theory.  He was far ahead of his time.

References:

Hempel, Sandra. 2007. The Strange Case of the Broad Street Pump: John Snow and the Mystery of Cholera. Los Angeles, Ca.: University of California.

Johnson, Steven. 2006. The Ghost Map: The Story of London’s Most Terrifying Epidemic and How It Changed Science, Cities and the Modern World, New York City, N.Y.: Riverhead Books.

McGuire, Michael J. (2013). The Chlorine Revolution:  Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. 2003. Cholera, Chloroform, and the Science of Medicine. New York City, N.Y.: Oxford University Press.

Commentary: In 2013, we had a great time celebrating the 200th anniversary of his birth.

TDIWH—January 9, 2014: MCHM Chemical Spill in West Virginia; 1985: Plane Crashes into Kansas Water Treatment Plant; 2012: First Haitian Cholera Victim; 1997: Water is Still Deadly Drink in Parts of the World

Middle Tank (#396) was the source of most of MCHM spill

Middle Tank (#396) was the source of most of MCHM spill

January 9, 2014: MCHM Chemical Spill in West Virginia. “Charleston, WV; January 9, 2014. 7:46AM. You’re trying to get your children up, fix breakfast and get them ready for school. You stick your head out the door to see how cold it is, and a wave of something smelling like black licorice hits you. The Elk River below you seems fine, but that odor is rolling off the surface. None of the radio news stations are saying anything. Wait. You know where your water comes from-the Elk River. Is the drinking water safe? You call the water department to find out what’s going on.

Sounding the Alarm: Do Not Use!

So began the day for 300,000 people in Charleston, West Virginia and in the surrounding nine counties. A tweet from Gov. Earl Ray Tomblin at 2:36 PM on January 9 previewed the 5:45 pm press conference where a Do Not Use order was issued by West Virginia American Water (WVAW) for all of the water in their service area. (A Do Not Use order is the most serious warning that can be given for drinking water. It means that tap water can only be used for flushing toilets and fighting fires.) At the press conference, the governor declared a state of emergency for the affected area.

It later became clear that a spill of about 10,000 gallons of something called Crude MCHM took place at a Freedom Industries facility 1.5 miles above the intake of the Kanawha Valley Water Treatment Plant (KVWTP), which is run by WVAW. When the spill actually occurred and when the material entered the water treatment plant has not been determined at this writing. The maximum MCHM concentration measured in the influent to the plant was about 3.4 mg/1. No one has adequately explained why the plant intake was not shut down early on January 9.

By 7 PM on January 9 a full-blown water-buying panic had gripped the area. Cases of bottled water were stripped from shelves within a 20-mile radius of Charleston. The morning of January 10, President Obama declared the nine counties a federal disaster area.”

Reference: McGuire, M.J., 2014. “The West Virginia Chemical Spill: A Massive Loss in Public Confidence.” Source. CA NV Section AWWA, 28:3:31 Summer.

0109 plane crashJanuary 9, 1985: Plane crashes into Kansas water treatment plant. “Last January the Board of Public Works (BPU) of Kansas City, Kansas was the victim of an airplane crash at their Quindaro water treatment plant complex. Although all members of the airplane’s crew were killed, the members of the BPU operations staff on duty that morning were unharmed, although shook up. The airplane managed to miss two nearby power plant structures, the east side of the treatment plant, and the chemical treatment plant building where the four employees were working, but landed in a primary basin less than 50 feet away from the building. An intensive manpower effort was launched to get the debris cleaned up and the plant back in operation as soon as possible. Three weeks to the day after the crash, the basin without a walkway bridge was returned to service. Kermit

Mangum, the water plant superintendent, is scheduled to talk about this story at the KSAWWA conference in Wichita.”

Commentary: Thanks to Paul Crocker of the Kansas City BPU for providing this information.

The most effective treatment for cholera is intravenous hydration.

The most effective treatment for cholera is intravenous hydration.

January 9, 2012: New York Times headline—Haiti: Cholera Epidemic’s First Victim Identified as River Bather Who Forsook Clean Water. “The first Haitian to get cholera at the onset of the 2010 epidemic was almost undoubtedly a 28-year-old mentally disturbed man from the town of Mirebalais, researchers reported Monday.

The man, whose name was not revealed in the report, in The American Journal of Tropical Medicine and Hygiene, was known as the village “moun fou” — Creole for “crazy person” — said the authors, who work for Partners in Health, a Boston group associated with Dr. Paul E. Farmer that has provided free health care in Haiti since 1987.

Although his family had clean drinking water, the man often walked naked through town to bathe and drink from the Latem River just downstream from the Meye River, into which raw sewage drained from an encampment of United Nations peacekeepers from Nepal.

Map: Distribution of cholera cases in Haiti

Map: Distribution of cholera cases in Haiti

Haiti’s outbreak was of a Nepali strain, and that encampment is considered the source.

The man developed severe diarrhea on Oct. 12, 2010, and died in less than 24 hours. Two people who washed his body for a wake fell ill 48 hours later. Haiti’s first hospitalized cholera case was in Mirebalais on Oct. 17.

The epidemic has since sickened nearly 500,000 people across Haiti and killed nearly 7,000.”

Commentary:  The death toll is now about 10,000 with no end in sight. The UN finally took some responsibility for starting the epidemic. It was caused by poor sanitation habits of Nepalese soldiers who were stationed in Haiti to aid in recovery from the devastating earthquake.

0109 India slum childrenJanuary 9, 1997: New York Times headline— For Third World, Water Is Still a Deadly Drink. By Nicholas Kristof “THANE, India— Children like the Bhagwani boys scamper about barefoot on the narrow muddy paths that wind through the labyrinth of a slum here, squatting and relieving themselves as the need arises, as casual about the filth as the bedraggled rats that nose about in the raw sewage trickling beside the paths.

Parents, like Usha Bhagwani, a rail-thin 28-year-old housemaid, point out their children and fret about how to spend their rupees. Should they buy good food so that the children will get stronger? Or should they buy shoes so that the children will not get hookworms? Or should they send their sons and daughters to school? Or should they buy kerosene to boil the water?

There is not enough money for all of those needs, so parents must choose. It was to save money, as well as to save time, that Mrs. Bhagwani was serving unboiled water the other day to her 5- and 7-year-old boys in her one-room hovel. Her bony face and sharp eyes softened as she watched them take the white plastic cup and gulp the deadly drink.

The water has already killed two of her children, a 15-month-old, Santosh, a boy who died two years ago, and Sheetal, a frail 7-month-old girl who died just a few months ago. But everyone in the slum drinks the water, usually without boiling, and water seems so natural and nurturing that Mrs. Bhagwani does not understand the menace it contains.”