Sanitation voted greatest medical breakthrough

Kounteya Sinha / TNN / Jan 22, 2007, 01:01 IST

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Sanitation has been voted the most important medical advancement in the last 166 years.

Sanitation voted greatest medical breakthrough

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Sanitation has been voted the most important medical advancement in the last 166 years.

NEW DELHI: Sanitation (clean water and sewage disposal) has beaten vaccines, oral contraceptive pills, X-rays and the germ theory to be voted the most important medical advancement in the last 166 years.
In an online poll conducted by the British Medical Journal, 11,000 participants (29% being doctors), including leading doctors, scientists and the general public were asked to vote and decide what was the biggest medical advancement since 1840 �� the year in which the journal was established.
It received 15.8% of votes, relegating advances like discovery of antibiotics, DNA structure and Oral Rehydration Therapy to lower positions.
Discovery of antibiotics got the second position with 14.5% votes while anaesthesia bagged the third spot with 13.9% votes. Vaccines stood forth with 11.8% votes while discovery of the DNA structure bagged the fifth position with 8.8% votes. Experts, however, agreed with the standings.

They said sanitation came to be reckoned as one of the major factors in health services when John Snow and Edwin Chadwick in the 19th century explained that the lethal cholera was spread by water and not through air and promoted the use of sewers. Poor sanitation is still a major cause for millions of deaths.
Fiona Godlee, editor of BMJ, said, "We wanted to look back at the most important medical milestones since 1840. We asked readers to nominate milestones.

A panel narrowed the field down from more than 70 to 15. We invited champions to write on each one. And then we invited readers to vote."
Johan P Mackenbach, professor of public health at the University Medical Center Rotterdam, wrote the piece called "Sanitation: Pragmatism Works". He wrote, "Despite erroneous theories of disease causation and the lack of an evidence base, new sewage disposal and water supply systems in the 1800s revolutionised public health in Europe.
In the 1780s, the Industrial Revolution began. Expanding industry attracted labourers and their families to towns and cities, which grew rapidly. Unplanned urbanisation, appalling working conditions, and low wages led to a deterioration in the health of the population.
Infectious diseases exacted a huge toll in morbidity and mortality, among them tuberculosis, diphtheria, measles, smallpox, typhoid, and typhus, as well as the enteric fevers."
"We now know that dysentery is caused by ingesting food or water contaminated with faecal micro-organisms in environments where sanitation and access to clean water are inadequate. It was cholera, another consequence of economic progress that concentrated people's minds. Observations on the spread of cholera, as in John Snows studies improved understanding that water was the source of cholera," he added.

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