The Malta Independent on Sunday
Reforms and improvements to sanitation
The nature of disease is often unpredictable in that it can affect different countries and continents. An epidemic is a disease that affects a large number of people within a community, population or region. What the world is currently experiencing is a pandemic. In other words, a pandemic is an epidemic that’s spread over multiple countries or continents, while an endemic is something that belongs to a particular people or country and is present permanently. For example, Malaria is limited to certain regions or countries.
Contagious diseases, especially infectious diseases, have an emotional impact on human lives as they disrupt the normal way of life, instilling fear and mental confustion.
Currently, the world is in a “bipolar state” with regard to vaccinations as some countries are achieving herd immunity and are coming out of the pandemic (especially European countries like Malta and the UK) while others, mainly third World countries are lagging behind (such as Latin American countries, India and Africa). The USA is also in a “bi-polar state” as northern States are well ahead in herd immunity in comparison to the southern States.
The successes of the 19th century, especially with regard to health legislation in the fields of sanitation, nutrition and the widespread development of immunisation and antibiotic treatments plus improvements in the standard of education have helped to a great extent in overcoming fears and bringing forth periods of relative peace of mind.
Still, new viruses can raise their ugly head at any time. Adding further to the distress, new strains, variants and mutations of the same virus, the causes of which are diverse, often crop up, as in the case of the Corona virus.
As to the cause of viruses, some speculate and come up with explanation of conspiracy theories that they are man-made in laboratories as part of germ warfare, while others conclude they are a natural phenomenon. Others postulate global warming as the reason stating that as the ice sheets thaw, they release new bacteria and viruses held under them.
Whatever the causes of new diseases and mutations of same, the global Covid-19 pandemic has reminded us that the entire world is truly a “valley of the shadow of death”; a new invisible virus travelling around the globe, visiting nations and threatening lives in every nation on earth. All around the world, people live in fear of being invaded by this unseen enemy.
Epidemics were also a means whereby attention and reform was made to the unsatisfactory state of sanitation. It was not until 1885, under the Governorship of Sir J. A. Simmons (1884-1888), after a further cholera epidemic had
visited Malta in 1865 that completion of the extension of drainage was made in the cities and on to the country villages and districts. The provision of pure potable water throughout the island was also essential. The drainage works were commenced in 1875 and completed under the Superintendence of Captain Tressider in 1885, in the teeth of opposition. They cost £101,377. ()
Among the health reforms, a reorganisation of the medical services took place under Ordinance No. VIII of 1885 under which the post of Chief Government and Inspector of Hospitals were created.
Following a Royal Commission in 1838, the Water Police and the Quarantine departments were amalgamated under the Superintendent of Quarantine, who became an important dignitary in Malta. A review of measures to prevent disease gave rise to a comprehensive set of regulations which were later consolidated in a special ordinance embodied in Maltese law. ().
The nomenclature of Police physicians was changed to District medical officers under the Department of Charitable Institutions ().
The Health Authorities went a long way to disseminate health education material as part of the Curriculum of Elementary Schools. For instance, the book, titled Short easy lessons in hygiene or sanition for the pupils of the Government Elementary Schools, printed at the
Government Printing Office in 1910 is a fine example of such a drive to create a special awareness in health matters. Topics covered in this book, containing 61 pages (in the Maltese and English languages), are as follows: Air, Water, Food, Clothing, Light, Cleanliness, Exercise and Diet, Cleanliness of Dwellings, Parasites, Disease, The Human Body, The Soil, Ventilation, Mosquitos and Flies, Precautions to be taken in case of Infectious Disease and Disinfectants.
For instance, the book carried interesting information on family and neighbours dealing with patients with Small-pox, Plague, Cholera, Diphtheria or other cases of infectious diseases. Should a patient be treated in his own house, the following rules were to be followed:
The patient was to be placed in a large well-ventilated room in the uppermost floor
All furniture not absolutely required was to be removed from the room
All bed and window curtains, carpets and damask chairs were to be taken away at once
The windows were to be, if possible, kept open, preventing the draught from reaching the sick bed by means of screens
No one was to be allowed in the room except those necessarily engaged in nursing the patient
No food except such as is given to the patient was to be allowed in the sick room
No article was to be removed from the sick room unless previously disinfected with
corrosive sublimate, Condy’s fluid or lime-water according to the direction of the medical attendant
Accumulations of dirty linen used by the patient were to be particularly avoided
Dirty linen was to be at once steeped in boiling water with a view to it being disinfected and afterwards properly washed.
This feature is part of a research that will appear in an upcoming publication about the Cholera in Malta during 1837. Any comments or contributions may be sent directly to the author at anthonyzd7@gmail.com