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Writer's pictureTLPMC - Taylor's Lakeside Pre-Medical Club

Unsung Hero of Medicine: Toilets, Sewers and Sanitation

Author: Sean Ho Ka Wai

 

We use toilets every day, from our homes to our schools. And yet, most take for granted the miracles given by our porcelain thrones. Here, we will take a trip back in time to see the evolution of toilets, sewers, sanitation, and its importance.


In 1596, Sir John Harington designed the first flush toilet for Queen Elizabeth I.



Sir John Harington, picture by : HP Mech

Alexander Cumming and Thomas Crapper's newly improved toilet

Unfortunately, it did not mask the stench. Alexander Cumming and Thomas Crapper both successfully improved the design in 1775 and 1880 respectively by adding a bend in the pipes. The bend contained water and prevented the stench from wafting back up the toilet. The design is still in use in toilets today. Despite this, sewers weren't a thing, and the excrement piled up in latrines, where workers had to clean them out.






And why were sewers so important? Before toilets and sewer systems, most people couldn't dispose of their excrement properly. They threw their waste onto the streets and left it under the hot sun. The accumulation of fecal matter created the perfect environment for bacteria to grow, which spread diseases such as cholera, dysentery, and typhoid. The lack of hand-washing facilities and sewer systems also meant that human excrement regularly contaminated clean water.


A Court for King Cholera. Illustration from Punch (1852).

As a result, outbreaks due to unsanitary conditions were commonplace, such as the 1854 Broad Street Cholera outbreak. It took the Great Stink of London (1858) for the English Parliament to finally recognise the importance of water treatment facilities and the construction of sewer systems. 






In modern times, sanitation has played a pivotal role in preventing outbreaks and reducing the severity of health crises such as the COVID-19 pandemic. Hence, the United Nations (UN) declared clean water and sanitation a universal human right. Despite the declaration, 2 billion people lack access to basic sanitation, with 4.5 billion lacking regulated sanitation services. In light of the disparity, the UN has made clean water and sanitation the 6th Sustainable Development Goal, which aims to provide universal clean, affordable drinking water and equitable sanitation and hygiene, especially for women and girls, among others by 2030.



 

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