Abstract
A potable, safe and adequate supply of water is at the very heart of public health, and we ignore this basic fact at our peril. For most medical and public health students, their first exposure to the discipline will be the story of John Snow and the Broad Street pump during the 1854 cholera outbreak.
The role of water from the pump, contaminated with faeces from the nearby cesspit in which mothers steeped their babies nappies; the protection afforded to the local brewery workers from a deep well on the premises which supplied the water for the beer; and the vulnerability of the percussion cap factory workers who depended on the street pump with its shallow access to the contaminated aquifer, underlined by the cholera death of the factory owner’s wife, is drilled into every students consciousness. Although a resident of Hampstead, Mrs Ely was so keen on the sweet-tasting water from the pump of her childhood that she had a regular supply brought to her by cart, a taste that led to her early demise.
Perhaps what is less well-known is that during a previous epidemic affecting Vauxhall, the Oval and Kennington in 1848–1849, Snow had demonstrated that the survival of residents depended on whether their water came from the Lambeth or the Southwark and Vauxhall water company, which drew its water from the heavily sewage-polluted river Thames. A few years earlier, in 1845, the Liverpool Guardian Society for the Protection of Trade had conducted an inquiry into the Liverpool water supply and concluded that not only was it miserably inadequate, but that it was also the most expensive in the country. Suspicions were expressed that the supply was deliberately restricted to keep up monopoly profits and the suggestion was made that the supply would be better if unified under a public authority. 1
So began a to and fro between municipalisation and privatisation which continues to the present day and in which issues of access, quality and affordability tussle with the Benthamite principle of ‘the greatest good of the greatest number’ in conflict with the ideologues of the free market and the appropriateness of making profit out of a commodity that is essential to public health. The insights from the early public health pioneers, such as Snow in London and William Henry Duncan, the country’s first Medical Officer of Health, in Liverpool, and the scandals that they exposed, initiated a process of public investment in reservoirs and supply lines that was to continue until the Thatcher government of the 1980s ushered in an era of privatisation that swept everything in its path. Buried within this saga is a remarkable sub-plot which focussed on access to safe drinking water for the working man, something that was to find its later expression in the school drinking fountain.
That story began with a paper given in the Health Department of the National Association for the Promotion of Social Science, Liverpool meeting, in October 1858 by one Charles Pierre Melly, an ancestor of Liverpool jazz musician and Bon viveur, George Melly. In his paper, Melly, a cotton merchant and philanthropist, drew attention to the existence in Geneva of abundant beautiful stone drinking fountains providing free drinking water to the citizens of towns in Switzerland and across the continent. He linked his observation to the condition of labourers in the city’s docks, other working men and visitors to the city who were obliged to spend their sparse resources on refreshment in local public houses.
In advocating the provision of drinking fountains on the Geneva model, Melly had already led by example in paying out of his own pocket for the construction of a network of 30 magnificent ‘Melly’ drinking fountains around the city crafted from polished Aberdeen marble. Melly’s first fountain was erected in 1854, to be followed by London in 1859 and copied around the country and in North America where the initiative was often associated with Temperance Society initiatives to wean the working man off his fondness for beer or worse. As a child growing up in Liverpool, some of these drinking fountains were still functioning and it was normal for more contemporary utilitarian porcelain versions to be found in every school (Figure 1).
A drinking fountain in the Old Bailey Courts of Justice, 2019.
Sadly, Melly’s fountains found no favour in the world of privatised water and school fountains now seem to be a largely thing of the past in contrast to the United States where they continue to flourish. In the light of current concern about the excessive consumption of fizzy and sugary drinks and their impact on obesity, physical and dental health, now seems to be an opportune time for a reappraisal.
The rise of carbonated and sweetened drinks in the form of ‘pop’ and lemonade seems to have taken off not least in the early 1930s with the alignment of the Coca Cola Company’s marketing campaign focussed on the character of Father Christmas, but the pervasive influence of these products on public health is largely a post-war phenomenon. In our 1950s household, where money was in short supply and aspiring parents had other priorities, pop was unknown, my father’s view being succinct and persuasive that ‘the lion drinks water and he is the strongest animal in the jungle’. We were fortunate too that Liverpool water was sweet tasting from the Welsh mountain lakes; sweets were on Sunday if we were lucky. The momentum is now building against carbonated drinks of all kinds and the post-millennial generation seems comfortable to rediscover the taste of unadulterated water. Some enlightened places are even erecting modern drinking fountains (Figure 2).
A modern drinking fountain, complete with facility for recharging personal drinking bottles, in Borough Market, Southwark, London.
Sadly, in this festive period, the Coca Cola pantechnicon, decked out in Christmas colours, is once again about to tour the nation’s urban centres distributing free fizzy and sweetened drinks. Would it be asking too much to require the privatised water companies to reinstate the Melly fountains and their equivalents around the country or would that be asking too much from the shareholders?