Ploughing through a stack of documentaries on iPlayer I started watching Extra Life - A Short History Of Living Longer, a four-part series called casting a spotlight on "the forgotten heroes of global health". For part 3 on Data I thought we'd get Florence Nightingale and her graphs, and we did, then when cholera came up I assumed it'd be John Snow and his famous map of cases clustered round a water pump in Soho. Not so. Instead David Olusoga popped up at Three Mills, just behind my local Tesco, and proceeded to tell the story of William Farr and London's last cholera epidemic.
Which started here...
This is Priory Street in Bromley by Bow, a brief residential backwater two streets south of the Bow roundabout and very much not the sort of place you'd expect to be epidemiologically significant. Today it's lined by roomy 1970s housing built when the eastern end of the street was devoured by the Blackwall Tunnel Approach Road. Before that it was mostly prefabs, courtesy of direct hits by the Luftwaffe, and before that a closely packed Victorian terrace. London's last cholera epidemic kicked off here in June 1866.
Cholera first arrived in London in 1831 and surged with particularly nasty consequences in 1849 and 1854, killing thousands. Scientists wrongly believed it was caused by miasma, a noxious form of "bad air" emanating from rotting organic matter, and continued to believe this even after John Snow's removal of the Broad Street pump handle supposedly proved otherwise. Joseph Bazalgette's groundbreaking sewer system was actually driven by the intention to remove the smell of sewage from the capital, rather than the contaminated seeping liquid itself.
William Farr was the government's chief health registrar at the time, and was overly swung by his own pet theory that deaths were concentrated in low-lying areas because miasma was heavier than air. He even produced a graph to demonstrate this, because that's what pioneering statisticians do, entirely failing to spot that correlation does not imply causation. But during the 1866 outbreak his nose for data-collecting paid dividends, as compiling a list of deaths by area confirmed that 93% were within the area served by the East London Waterworks Company. Here's Farr's map with the first two cases circled... at 12 Priory Street.
Number 12 was the home of a labourer called Mr Hedges and his wife, both aged 46. Their water closet wasn't yet connected to Bazalgette's new sewer system because that wasn't quite finished, so all the local sewage still drained directly into the River Lea. Tidal flow meant contaminated water drifted upriver as well as down, reaching the reservoirs of the East London Water Company just beyond Bow Bridge. When Farr visited the site on 3rd August the company claimed all their water was filtered, whereas in fact the reservoirs were inadequately protected allowing river water to seep in with deadly consequences.
Farr immediately wrote to Joseph Bazalgette who set about installing two temporary pumps at Abbey Mills, and within weeks local sewage was diverted to the new Northern Outfall sewer rather than the Lea. The outbreak ceased, but not before 4000 people within the catchment area of the East London Waterworks Company had died. Of wider consequence is that Farr was now finally 100% convinced that cholera was a waterborne disease, and this swung wider medical opinion in favour of what turned out to be the truth.
The Lea is much cleaner round here these days, although swimming remains unadvised because sewage is still intermittently discharged upstream. The reservoirs that supply the capital are larger and much more carefully regulated, not to mention a lot further away. Modern day residents of Bromley-by-Bow can turn on their taps in full confidence that drinking the water will no longer kill them. And Bazalgette's Low Level Sewer still takes Priory Street's effluent away, indeed in the most astonishing coincidence it runs directly underneath... as the telltale stink pipe at the end of the road confirms.
Cholera still kills tens of thousands a year across parts of the world where sanitation and infrastructure are inadequate, but we have Victorian scientists and engineers to thank for wiping it out here. I confess I never previously realised the role my immediate neighbourhood played in that success, but sometimes local history is the most amazing history of all.
