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Francis Koster: Balancing life, liberty, pursuit of happiness

By Francis Koster

As I listen to intense discussions between various political tribes as they debate about the spread of COVID-19 verses excessive government regulation, I am reminded of a story I heard sitting around a campfire at Boy Scout camp many decades ago. 

My camp had a hand-pumped well, and the story made quite an impression on me.  

In 1854, London had no running water. Local municipalities would tax citizens and businesses to fund the digging of public wells located in town squares to provide water for bathing and drinking. Since there were no indoor toilets or sewers, human waste was put in pits, called “cesspools.” Both men and women wore perfume to mask the odor that was everywhere.

A plague of cholera had started. Millions were dying all around the world. The spread seemed to occur in areas with high odors. The commonly held belief by both doctors and citizens was that cholera was spread by stinky air, then called ‘Miasma’.  

Dr. John Snow, a well-respected London medical doctor, noticed that many of the sick he was treating seemed to live or work in a specific neighborhood. Acting as a volunteer, he began to search out the addresses of the sick and the dead and created a hand drawn map showing were they lived and worked — just like contact tracing is being done today with COVID-19.  

His map showed that the disease concentrated in an area that got its water from one single well. He visited the site and saw there was an old cesspool and a public washing tub very close to the well. Several people at a time would pump water, fill the tub and wash their families dirty clothes. They had to keep refilling the tub because it leaked badly, and the leaking dirty water flowed downhill around the well so that people stood in a puddle when pumping water.

Among the clothes he observed being washed were dirty diapers.

Dr. Snow believed that the disease was not spread through the air. Instead, he thought it was spread by contaminated water from the tub that was leaking back into the well.

He took his map to the local political leadership and argued that the well was a hazard to public health and should be shut down. After much debate, it was agreed that an experiment would be conducted, and the well pump handle was ordered removed so the well could not be used.  

During the shutdown after the ground dried up because the unused tub stopped leaking, the top portion of the well was  discovered to be cracked so that dirty water from diapers and the nearby cesspool full of human waste could have been leaking into it. That was fixed, as were many other wells that were discovered to be in similar disrepair. The number of sick and dying in the neighborhood dropped quickly.  

In spite of the many lives saved, the story does not end there. Shortly after the handle was removed, local business near the shut-down well started to suffer because their customers went elsewhere to get their water and were shopping near their new well. The businesses began to protest to local politicians their loss of income and argued that government had no right to impact their business. They claimed that Dr. Snow’s carefully assembled data was wrong. Dr. Snow was threatened with physical harm.

The politicians caved, and the well was put back in service. The disease did not return. 

Some groups said that the well was never the problem, claiming Miasma was the cause of the cholera, while others pointed to the well repairs that had been made and said the short term economic harm was well justified.

This same debate is going on today. At the federal level, in spite of lots of scary new data, there has been no upgrade in water quality regulations for almost 20 years. New chemicals that impact human health continue to be released into our rivers and lakes.  

At the same time, over the past 12 years, due in part to pressure from companies potentially facing inspection, the budget of our North Carolina Department of Environmental Regulation has been cut by one-third.  

As a consequence, many volunteer groups are drawing pollution maps and publishing their findings on the web.

In America, life expectancy is falling, birth defects are rising, and pollution is far more common in areas with high numbers of poor people. In the current debate around the issues of “life, liberty and the pursuit of happiness,”  life is losing.   

Koster, who lives in Kannapolis, spent most of his career as chief innovation officer in one of the nation’s largest pediatric health care systems.

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