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Cholera and the Broad Street Pump

You are Henry Bidgood

Faction: Indeterminate
Ideological Reference: James Ansley Hingeston

You believe that Cholera epidemics are associated with certain particular states of weather and specific meteorological conditions, and you are aware of the works of James Ansley Hingeston on these subjects. As an avid weather tracker and an amateur balloonist like your fellow Boardmember John Stevens, you too witnessed Henry Tracey Coxwell make a successful balloon ascent today from the Surrey Zoological Gardens. Can improvements in weather tracking aid in the battle against Cholera?


GENERAL DIRECTIVE:

You are a member of the special Sanitary Committee of the Board of Governors and Directors of the Poor of St. James Parish. On 14 August 1854, you and your colleagues on the General Board of Governors and Directors of the Poor voted to forgo standard meeting protocols and form this special emergency response committee to address any threat of Malignant Cholera throughout the parish. Collectively, you wield the power and financial backing to make whatever arrangements you deem necessary regarding administrative courses of action, medical responses, future meetings, etc.


REQUIRED READINGS

•    Chapter 1 of The Ghost Map by Steven Johnson (2006).
•    Chapters 2 and 10 of Disease Maps: Epidemics on the Ground by Tom Koch (2011).
•    Anticontagionism between 1821 and 1867 by Erwin Ackerknecht (1948).


CHARACTER-SPECIFIC ONLINE RESOURCES

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2485840/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2438686/

http://books.google.com/books/about/Topics_of_the_day_medical_social_and_sci.html?id=0hADAAAAQAAJ

YOU ARE IN THE “Indeterminate” FACTION.

You and the other Indeterminate members of the Board do not have fixed opinions as to the origins of Cholera. As such, your opinions may be influenced by compelling scientific arguments made by members of the other factions.

Anti-contagionist members of the Board believe that the Cholera outbreak may be explained by a number of factors, including: classic Hippocratic epidemic constitution, atmospheric influences, elevation above sea level, miasma arising from exposure to decaying animal or vegetable matter, diet, lifestyle and socioeconomic status. No human-to-human transmission is involved.

The Contagionist members of the Board believe that Cholera is transmitted by the direct passage of some chemical,  physical  or biological  agent originating  from a sick person and transmitted to a susceptible victim by contact or fomites or, for a relatively short distance, through the atmosphere.

PLEASE NOTE: Although you and your faction colleagues do not have fixed ideas on specific notions of disease, your specific agendas may be quite different. Over  the course  of our debate, and even outside of class, you may (and should)  consult with one another to identify those  issues upon which you can agree as well as those upon which you disagree. For the purposes of final voting on any measures of remediation  and prevention, some  degree of  consensus will be required. It will be important to listen  closely to arguments so that you may determine your own position. At every opportunity, press your Anti-contagionist and Contagionist colleagues for evidence and scientific data to support their arguments. For final voting, however, you may remain Indeterminate and abstain if you so choose.

SPECIFIC INSTRUCTIONS: The format of the meeting is divided into two class sessions. For Session I, you will prepare a short (< 1 page) written statement that introduces your character and your ideologies on Cholera. You will deliver this statement as a speech of roughly 1-2 minutes, detailing your position and making specific suggestions that can be debated and brought to a vote in Session II. You should address three questions: What is the source of the outbreak? How is Cholera communicated from person to person? And, what steps should be taken to contain the outbreak?

MEETING AGENDA

CLASS SESSION I: OPENING STATEMENTS AND PROPOSED RESPONSES
The Special Committee convenes on the evening of Thursday, 7 September 1854. Prior to the meeting you have taken the time to look into the atmospheric conditions over the past two weeks. When invited by Chairman Frederick Crane, you will stand and deliver your personal statement on weather and Cholera. Also, listen intently and take notes as colleagues make their presentations. Be sure to propose any specific remedial actions by the end of Session I so that these issues may be debated and brought to a final vote at the end of Session II.

INTERLUDE: JOHN SNOW GIVES HIS TESTIMONY AND RECOMMENDATION
Between the two class sessions, Dr. John Snow requested to be heard by the Board and has testified that the Cholera outbreak is being driven by contaminated water originating from the pump located on Broad Street. He has recommended that the Board remove the handle from the Broad Street pump immediately, so as to interrupt public access to what he considers as a tainted water supply. In preparation for Session II, use the online Cholera Data Manager to examine closely the data upon which Dr. Snow bases his arguments. Also consult Dr. Snow’s map and the accompanying Excel spreadsheets to conduct your own analyses of these data and raise further questions and/or support for your arguments. You should also examine William Farr’s data and figures and utilize them similarly.

CLASS SESSION II: DEBATE AND FINAL VOTING ON PROPOSED COURSES OF ACTION
Whenever necessary, you must argue for anything that you see connecting weather and the current Cholera outbreak. You will question the utility of removing the pump handle from the Broad Street pump, unless you see some pattern in the mortality data that is also apparent in local weather data. How important do Dr. Snow and his Contagionist colleagues consider atmospheric conditions in their theories? In your opinion, it is necessary that any explanation to be grounded in the sound use of scientific data. Be prepared to offer data of your own based upon your own research.

“Indeterminate” FACTION STRATEGY

Your faction, the Indeterminates, will consider Dr. Snow’s recommendation thoughtfully, and you will scrutinize any data that is presented during the debate. Most importantly, however, you and your faction colleagues recognize that action must be taken and ideologies should not interfere with your decision making. Specific steps must be implemented promptly, and you are seeking to embrace compelling arguments that strike you as common sensical, practical and effective. Challenge your colleagues on the Board if they seem unreasonable, unclear or unconvincing in their arguments. Ask insightful questions so that you may form your own opinions. You may reserve the right to abstain from any final votes; in this respect, also realize that your faction holds the power to sway the outcomes of votes in one direction or another.

SECRET OBJECTIVE
To earn bonus credit for this role-playing activity, you must also achieve your secret objective:

Propose and have the Board vote on a local ordinance requiring the shuttering of all windows and closing of doors upon first notice of harmful weather conditions, such as heavy mists forming at low elevations, that might favor Cholera.