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WATER-SUPPLY AND THE DROUGHT:

HEALTH AND ECONOMIC CONSIDERATIONS.

(BY A SPECIAL CORRESPONDENT.)

IN the course of last summer the position created bythe drought led us to a consideration of the water-supply of the country and the need for safeguardingit. At the close of 1921 the continuance of the droughtand the uncertainty of the future outlook make itdesirable to supplement these observations, apprecia-tion of which is apparent in the official circular(Dec., 1921) of the British Waterworks Association.

Husbanding the Supply.Recently heavy rain has fallen in various parts of Ithe country, and in some cases a certain amount of

leeway has been made up. Elsewhere, however, the ’position remains grave, and may remain so in certaininstances for a long time after the parched earth hasreceived the most copious supplies of water. Ingravitation supplies, with enormous storage reservoirs,full advantage can be taken of floods, although, evenhere, questions of the quality of the water impounded-must be taken into careful consideration. In pumping:schemes the same does not hold true, as the pumping

The table and graph show the monthly returns for1921 as regards temperature, rainfall, sunshine, andflow of River Thames.

Rainfall and Health in 1921.The year 1921 started auspiciously. The rainfall in

January was in excess (133 per cent.) of the averageand the rivers, springs, and wells gave every promiseof fulfilling their usual functions. From this pointonwards throughout the whole year (except September)the rain failed lamentably to come up to averageexpectations, every month (except, November) had atemperature above the average, and the sunshinerecords were most remarkable. Tjie consequence wasthat the shortage of water became apparent early inthe summer and has been acute ever since. Even atthe present moment there are many places wherewater is being sold at so much a gallon and is beingconveyed by road or rail considerable’ distances tosupply the needs of man and to save the lives of thelower animals. Apart from agricultural difficulties,most of us who acted like good citizens found our lawnsand shrubs and flowers almost ruined by the drought,and it is small consolation to remember that thereprobably has never been a year when yuccas floweredso abundantly all over the country.

It is satisfactory, however, to record that the year1921 has been, on the whole, remarkably healthy,

TABLE SHOWING TEMPERATURE, RAINFALL, SUNSHINE, AND FLOW OF RIVER THA3IES DURING EACH D’TONTH

---

OF THE YEAR 1921 (CAMDEN SQUARE AND THAMES CONSERVANCY RECORDS).

capacity must bear a fairly close relation to currentrequirements to be economically sound.

For example, if water is being lifted out of a riverinto storage reservoirs, and the consumption is, say,10 million gallons per day, it would be economically Iimpossible to have a reserve of pumping power vastly ’[in excess of that amount. It follows that when floods Icome the pumps can only deal with a limited quantityof the surplus water, which, in consequence, escapesseawards before it can be impounded in the storagereservoirs. Then again the flow of our rivers and theyield of our wells are largely governed by the immensebody of underground water which has accumulatedas the result of rain, which may have fallen manymonths previously. These underground reserves arelike the fly-wheel to the engine, they tide over difficultperiods, but there is a limit to their capacity and itmay take a long time to reach a period of equilibrium.Many waterworks authorities have of necessity foundthemselves in the position of the gambler who recklesslyspends his capital with little knowledge when hisexchequer may be replenished.Who really knows the present position of our under-

ground sources of supply, how much rain will be neededto restore the balance, and how long it will take toreach a position of safety ? The situation to-day is Iacute in many places, but even if we have copious rainto-morrow and in the days to come, it may be a longtime before things revert to normal. Whatever happens,the whole of 1922 at least will be a period of anxiousconcern for many waterworks authorities.

1 Water-Supply: Considerations Arising Out of the Drought.THE LANCET, August 13th, 1921, pp. 353-55.

both as judged by the relative absence of sickness andthe low death-rate. It used to be held that an abnor-mally hot year meant that the infantile death-ratewould go up by leaps and bounds, but the reverse istrue of 1921. This apparent lightening of the load ofsickness and death is the more remarkable, as the yearwas one of acute depression in trade, with much unem-ployment and the psychology of the nation was triedto the utmost by the cumulative effect of past andpresent happenings. For the first two years after thewar most people had, or behaved as if they had, enoughmoney to drown their sorrows in conviviality and thepursuit of pleasure. Last year proved very depressingto most individuals, the cumulative effect of heavytaxation, the high cost of living, vanishing of savings,heavy depreciation of securities, restricted credits,bad trade and uncertainty as regards the futurecombined to throw a gloom over 1921, which mademany of us wonder if the aftermath of war wasnot almost as hard to bear as the fateful years of1914-18.

Yet, despite all these things and the discomfortsand hardships produced by the prolonged drought,the pulse of the nation remained good. We are led,however, to wonder a little if the same is true as regardsour mental equipment. Registered illnesses and deaths,and even the recorded experiences of individual medicalmen, do not necessarily convey the whole story of thewell-being of a community. Our nerves have jangledto sad tunes of recent years and it is impossible to shutone’s eyes to the frequent cases of nervous breakdown.If the processes which lead to mental instability couldbe recorded on the baragraph, we fear that the graph

149

GRAPH SHOWING THE MONTHLY RETURNS FOR 1921 OF TEMPERATURE, RAINFALL,SUNSHINE, AND FLOW OF RIVER THAMES.

would show a sorrypicture of the direc-tion in which manylives are now drift-ing.

It mav seem a

curious thing to em-body these reflectionsin an article dealingchiefly with the

drought in relationto water - supply.Nevertheless, we feelthat prosperity is thekey to both thehealth and happinessof the nation, andthere are considera-tions which have earisen, or are arising,out of the droughtwhich throw con-

siderable light on theproblems of our

economic welfare.

Some PracticalDeduictions.

In the first placeit is abundantly clearthat without detri-ment to health, or

infringing the lawsof decency, we canreduce the consump-tion of water verymaterially. Thisfact -will doubtless beborne in mind whennew Water Billsappear before Parlia-ment.

°

Secondly, the timeis ripe for challengingthe necessity forproviding one-thirdof the supply as

compensation water,irrespective of thereal needs of thesituation and becausethat proportion isgoverned by pre-cedent.

Thirdly, freshcapital expenditureshould not be in-c u r r e d withouttaking stock of whathas been going on

within recent years.It is within our

knowledge that mil-lions of pounds have ebeen saved by theapplication of scienceto the water prob-lems of the daywithout any loss ofsecurity, and we seeinfinite scope foradvance in thisdirection.

Fourthly, the pub-lic are being rousedto take an interestin meteorology andwater questions in away never experi-enced before, andthis may lead to.

150

useful economies being effected without in any wayimperilling the safety of our water-supplies.

Fifthly, the detection and prevention of waste hasreceived so useful a fillip and has proved so effectivein practice that a reversion to the old careless order ofthings should not be countenanced. In this connexionwe would warn the public that the days of frost are athand and that the reckless running of taps with the ideaof preventing pipes being frozen is not permissiblelegally, or justifiable morally.

Lastly, we think that the serious inequalities in thedomestic rate of consumption of water throughout thecountry merits the attention of the Ministry of Healthand Parliament. Surely some standard, or standards,could be fixed sufficiently elastic to meet the require-ments of different places without interfering with thelaws of decency and good health. This would be thesurest way of maintaining waste detection at thehighest point of efficiency, of encouraging personaleconomy in the use of water, and of saving theratepayers unnecessary expenditure.

The Citizcn’s Duty.Passing now to the problems which confront us all

in 1922 and perhaps later, it would be well if everycitizen, quite independently of what the skies may sendus in the shape of rain, snow, or hail, considered thata state of drought continued to prevail until authori-tative statements to the contrary are forthcoming. Inthe case of many supplies, chief anxiety may be feltas late as next autumn, and it would be a grave mistaketo imagine that torrents of rain in the near future arenecessarily going to tide us comfortably over futurecontingencies.

The main thing is for each individual to continue toeconomise in the use of water by the methods whichexperience has already taught us, and, if possible,to devise new plans for conserving a commodity, thevalue of which has only been brought home to us bythe bitter lesson of adversity. It needs to be remem-bered that in most cases no amount of expenditurecould possibly be in time to retrieve the situationcreated in 1921 if it persisted in 1922 even to a moderateextent. Waterworks authorities may be trusted to dotheir utmost to conserve water and to ensure its purity,but it is the bounden duty of each consumer to exercisethe strictest economy lest worst things befall.

Communal and State Action.

In respect to communities, we could cite manyinstances where water authorities influenced by ques-tions of drought, temporary expediency, or economicalconsiderations have cut the Gordian knot by callingin all the resources of science to their aid with resultsalike favourable to water consumers and the progressof knowledge. It is perhaps unnecessary in thisconnexion to utter a word of caution, because publicwater authorities are now so keenly alive to questionsof safety that they would not dream of countenancingnew departures which did not bear the hall-mark oiscientific approval.As regards the State it is a moot question whethei

the Ministry of Health should not be prepared for evereventuality and consider the feasibility of providingmobile sterilisation plants, available at a moment’,notice and capable of being rushed to the rescue 0’

any water-supply in distress. Quite apart from th<present situation the provision of a live force ready tccombat and deal with sudden emergencies is noi

inconsistent with the policy of a Ministry, whiclalready has shown its desire to subordinate criticisnto active help.

Waterworks authorities have already been asked b;the Ministry for certain particulars as regards quantitof water, and no doubt in time a comprehensive reporwill be issued on the subject, which should prove t,be of great value. We hope that the Ministry has, owill consider, the question of quality as well. It habeen, and still is, a golden opportunity for the collatio:of all facts bearing on the quality of our suppliethroughout the country, and only the Ministry c

Health can call for official returns of this kind. MorE

over, the department is well qualified to deal with thesubject scientifically and from the epidemiologicalpoint of view.

So far as our necessarily limited information isconcerned we hear, on the whole, favourable news asregards the quality of water supplied during 1921 toconsumers, but the future needs careful watching, andthe transition from a period of unparalleled droughtto normal conditions may not be wholly free fromdangerous elements.

Public Health Services. WILLESDEN MUNICIPAL HEALTH SERVICE:

INTERCHANGE OF VIEW BETWEENDISTRICT COUNCIL AND LOCAL

PRACTITIONERS.

THE resolutions1 passed by the Willesden Division)f the British Medical Association on Nov. 15th, 1921,;ave rise to a detailed reply, dated Dec. 21st, fromhe clerk to the Willesden Urban District Council,nd this in turn to a reasoned rejoinder from theWillesden Division passed at a special meeting onran. 17th. As these two documents are of more thanlocal interest, dealing, as they do, with problems ofpublic health administration likely to arise elsewhere.we give them at substantial length, alluding, for thesake of brevity, to the disputants as Council andAssociation respectively where no ambiguity can

arise.THE COUNCIL’S VIEW.

The Council, as the local sanitary authority andlocal education authority, has certain duties andpowers placed upon it under Acts of Parliament,its health policy being determined in accordance withthe provisions of these Acts and the consents or

directions of the Government departments concerned.The Council cannot accept the view that its functionis to deal with the health of the necessitous poor only ;it has to safeguard the health and act in the interestsof the entire community.

Municipal Clinics.Municipal clinics developed as the result of the

medical inspection of school children, amongst whommany defective conditions requiring treatment werereported year by year. These children had, in themajority of cases, not received medical attention, andit was to secure it for conditions hitherto not medicallytreated that school clinics were established in Willes-den and elsewhere. The same might be said ofM. and C.W. clinics ; the majority of cases whichattend would not go to a private practitioner foradvice until their health was undermined. TheCouncil considers that advice in health and earlytreatment following upon the first manifestations ofdisease are factors of prime importance in preventivemedicine, and that municipal clinics, in providingthese facilities for mothers and pre-school children,are carrying out health work of national importancenot provided for by any other agency. The clinics,too, provide specialist treatment and, in addition,have a staff of visiting consultants, whose servicesotherwise would not be generally available for thepersons attending.

Efficiency and Results.In all the services carried out on behalf of the

ratepayers the Council limits expenditure to theutmost extent consistent with efficiency, and istherefore anxious to receive information from theAssociation by which expenditure might be curtailedand the health services provided through otheragencies. The Council would be glad to learn pre-cisely in what respects its policy is opposed to theinterests of the general community. The statementthat the Council’s present arrangements tend to

1 THE LANCET, 1921, ii., 1125.