23rd February 2007
Last week I did what every self-respecting public health person should do at some time in their life – I made the pilgrimage to the site of the Broad Street pump.
I know it’s a bit cheesy but I couldn’t resist doing the whole reverential thing. I stood on the pink granite kerbstone that marks the spot where the notorious faucet once gushed its lethal liquid. I walked round the block past the Victorian houses where so many innocent souls perished. And I toasted Dr John Snow with a glass of pure clean tapwater (followed by a whisky chaser) in the pub that now bears his name.
Being a London lad with a deep respect for history, I’d been there many times before. But what made it so special this time was that I’d just read a fascinating new book, The Ghost Map by Steven Johnson. In his 300 evocative pages, Johnson grippingly recounts the story of how Snow, in 1854 a fashionable and successful society doctor and anaesthetist living not a stone’s throw from Mayfair, bravely pounded the streets of Soho at the height of the cholera epidemic, painstakingly gathering the facts he needed to build his case. The result was his iconic map plotting every death in the area, with the Broad Street pump standing starkly and undeniably at its epicentre. QED, and one in the eye for Chadwick and his fellow miasmatists.
Why am I telling you all this? Well, what makes Johnson’s book different is his interspersing the familiar story about the battle against cholera in London with a powerful thesis on the perils of uncontrolled global urbanisation and inadequate city infrastructures. He argues that, by crowding together in cities, the world is rushing headlong towards an inevitable series of massive disasters, natural and man-made – from Sars and pandemic flu to bioterrorism and dirty bombs. Proximity may be cost-effective, but the risks are high and ultimately urbanisation, or the city-planet as Johnson calls it, is unsustainable.
This is the same point that has been brought home over the past week in the troubled world of poultry farming.
The outbreak of H5N1 in Suffolk has shown just how vulnerable intensive rearing of flocks can be. A glimpse into one of the sheds and you can see how these overcrowded bird-cities – in their way not unlike the packed tenements of mid-Victorian Soho – have been a disaster waiting to happen. Yes, they’re cost-effective. Yes they provide cheap meat of a uniform standard. But proximity is risky and all the antibiotics that can reasonably be pumped into a turkey are no defence against bird flu.
The irony is that everyone was expecting the threat to come from the skies. While most us were simply hoping it might never happen, armies of twitchers were posted on the cliff-tops and round the estuaries, maintaining a constant watch for the odd goose, duck or swan coming in very low, with perhaps a trailing wing or a hacking honk, looking more than a little peaky. And if any such feathered foe should make it to our shores, it would immediately be pounced on by the swat team from Defra, have a 30-mile cordon placed around its neck and find itself being interrogated about where it had come from and which other goose, duck or swan it had been mixing with. But surprise surprise, what actually happens is that the dreaded virus turns up, as if by magic, behind the closed doors of an ultra-controlled and regulated intensive turkey farm. Now here’s a mystery. Why? How? Conspiracy or cock-up? Who’s to blame? Where’s the Broad Street pump?
These questions are keeping a lot of people awake at night. Vets and virologists have been burning the midnight oil, drawing their bird-ghost maps of Europe and beyond. Red-eyed agri-boffins and biosecurity experts have been working 24/7, trying to track down the source. Public health people have been re-drafting their pandemic flu plans and worrying about how they can distribute zillions of antivirals in three days flat. Perhaps Bernard Matthews has missed some sleep wondering whether he should have rubbed more Vicks on his booties’ chests.
But I reckon the real breakthrough will be made by MI6. You can bet your decontaminated boots that M has got a Daniel Craig lookalike already on the case. My guess is that, even as we speak, our man is embedded undercover somewhere in a secret poultry shed deep in the forests of Transylvania, cunningly disguised as a turkey, closing in on the evil genius threatening our sovereign nation.
I can see the final confrontation now. Evil Genius: ‘So we meet at last Mr Bond.Would you prefer to be roasted, basted or turned into twizzlers?’ Our Man: ‘Just make sure you use the wishbone, Gobbel. You’re going to need it. And by the way, the name’s Snow – John Snow.’
The Ghost Map by Steven Johnson. Published by Allen Lane, Penguin. RPP £16.99.
Dr Alan Maryon Davis has been elected the next president of the Faculty of Public Health.