Fluid Lives

Malaria, dengue and health in contemporary South Asia


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Liquid archive: memory, materiality, emphemerality

Last summer I went to an exhibition called the Museum of Water by the artist Amy Sharrocks, held briefly in Toynbee Hall, in Spitalfields. The premise was simple, visitors to the museum were invited to bring a sample of water that was meaningful to them, inscribing the story behind it on a small card. The short, some funny, some poignant, accounts inscribed on the small cards displayed with them were; a powerful kind of auto-cataloguing. Amy Sharrocks had asked contributors:

How do you enjoy water?
Do you swim in pools?
Do you splash in puddles?
Do you drink from a tap?

Choose what water is most precious to you. Find a bottle to put it in. Tell us why you chose this water. We will keep it for you.
Help us build a collection of water for future generations to enjoy.
What water will you keep?

It is a brilliantly simple, elegant but powerful idea to ask people to create and contribute their own donations got people to think about the meaning and biography of water in all is meaningful, social, kinship-mediating, life-changing, political, joyous, tragic, multiple, slippery, fluid and leaky form. That warm sunny evening stayed with me as I cycled home (alongside a canal), but the rest of the year since then. So when I read that it was going to be held again (with a great set of accompanying events), this time in the grander and more watery setting of Somerset House on the banks of the River Thames, I felt compelled to visit it again.

Corporation Pop

At Toynbee Hall, the ‘Corporation Pop’ had made me smile with its thrifty humour, but also because it was a smart demonstration of the curious properties of water. A simple glass of tap water, so described by someone’s grandparents, it the only exhibit not in a bottle, being ever replaceable, interchangeable and yet meaningfully the same, ‘next time’ out of the tap. Now I found a bottle of ‘Clapton Damp’, and the attendant frustrations and health concerns that come with living in a damp flat. (Since my last flat caused mold to grow on both my wooden kitchen utensils and leather shoes, I could only commiserate). Several other people had contributed snowballs (now melted), the holy water of a range of religions (Zam Zam collected on Hajj or Ummrah, water from several sites along the Ganges, from Catholic shrines), some pre-packaged, others collected by pilgrims themselves. Some was pond water, some was gym water (in a Fire and Rescue Services bottle). Several bottles were from swimming baths, one apparently donated by a woman who had campaigned successfully to save Brockwell Lido (somewhere I’m sorry not to live closer to anymore). Several were very moving, more than one bottle of tears, but particularly the water collected by a woman the day her partner died some years ago, which had gradually evaporated with time, along, she hoped, with her grief.

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In fact, the gradual evaporation of the donations was another interesting dimension of the Museum. The ephemerality of water (another donation had consisted of ‘mist’ collected, several of ice), visibly present, but all the time slowly disappearing by entropy out of its containers. A little like the fine detail of memory there, but fragile, liking all kinds of powerfully meaningful and emotional aspects of life together, just as water at once escapes containers imperceptibly, as much as it carves valleys in the form of streams. A powerful kind of magic trick.

I was happy to meet Amy again, who was kind enough to point out my donation of Delhi water on its shelf, and add that my short account of where I guessed it had come from on its journey into my water bottle had got her thinking about water distribution. I had no idea until she told me that London has a circular water main delivering water around the city, somewhere between the ring main of a house distributing electricity and the M25. She was also collecting interviews with donors (both the collection and soon the sound archive will be on the Museum of Water’s website), and I was excited to hear that she will soon be taking it not only to several UK festival, but overseas to Copenhagen and if I remember rightly to New York. I have to confess that I still think the Museum of Water would be an amazing thing to take to Delhi, perhaps in collaboration with a collective like Khoj  at the back of Malvyia Nagar, in the streets of Khirki Ex, and one of the malls at Saket. So many similar, powerful questions and emotions linked to water and everyday life, place, social relations, notions of dirt, difference, mixing, of religion, neighbours, scarcity, and status abound in South Asia, arguably more so than in the UK, and no less powerful in the face of climate change.

For myself, I find the Museum of Water project compelling for two reasons. Firstly that it seems to reach people with a remarkable strength of emotion and meaning, in a way that social and historical research often struggles to – in a way that is complex, nuanced and powerfully intelligible in an almost primordial way. There is much to learn from this project in that sense. Secondly, because the everyday life of water remains an animating theme in project, even as I’m principally interested in dengue, as it is the linking medium between mosquitoes and humans. Water is hard to study for its ubiquity, it gets away from one in its material properties that allow it to both flow out of ones control and lift into the air as vapour, but it is indispensible and consequently links us all together, to each other and the wider world in a way that is also inescapable.

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Mapping Life and Death in Victorian Soho

Friday 15th March was the 200th anniversary of physician John Snow‘s birth (1831-1858). Although better known in his day for his work on ether and chloroform as anaesthesia (including administering them to Queen Victoria during the birth of her last two children), he is best known today as one of the fathers of modern epidemiology, tracing and mapping a cholera outbreak in 1854 to a pump on Broad(wick) Street in Soho. So there has been a flurry of internet excitement in urban and epidemiological circles around the 200th anniversary of John Snow’s birth – The Guardian even describing him as a ‘data journalist‘ (although given his fight to get his work recognised as science I’m not sure he’d have found that title useful!). Two weeks later, I have finally got around to seeing the London School of Hygiene and Tropical Medicine‘s exhibition ‘Cartographies of Life and Death: John Snow & Disease Mapping‘.

For the most part, the exhibition places the power of mapping and cartography as an innovation central to thinking about the recording of death and disease. 1854 was also the year that the Crimean War broke out, where Florence Nightingale was to assiduously collect and record of data on cleanliness and sanitation in hospitals using ‘coxcomb’ diagrams. The combination of detective work and powerful visual narratives in the shape of maps and mapping means the topic fits well with contemporary interests in data visualisation, the potential of health and medical records as datasets and in particular for ‘big data’ in drawing out correlations between types of ill health and other factors, recording disease incidence and modelling its progression.

Just as contemporary developments in computing power are allowing new manipulations of very large data sets, mid-19th century developments in printing and map making had allowed Snow to plot, record and then publish his work in map, rather than simply tabular form as ‘On the Mode of Communication of Cholera‘ the following year in 1855. In 2013 both printed and mobile (phone) maps now allow one to walk around the streets of Soho itself, and get a sense of the visual clarity that maps provide, but also as one crosses roads and dodges boisterous late Saturday afternoon pedestrians, to get a sense of the everyday melee that the data was distilled out of. The exhibition brought these kinds of data visualisations up to date with a screen showing Google Earth updated with postings to the Pro-MED  (Program for Monitoring Emerging Diseases) email list.

It’s hard to disagree with Beth Skwarecki list on the PLOS Public Health Perspectives blog of the top three things she things she thinks we’re still learning from John Snow’s work:

  1. That data visualisations can make powerful arguments for change,
  2. that microbes have been under our noses all the time
  3. and that sanitation and clean water are still (no brackets needed!) really important.

But other striking things emerged from the exhibition and maps too. On the handbill version of the exhibition map, sites in contemporary Soho are marked with quotes from Snow’s ‘On the Mode of Communication of Cholera‘. We learn that residents of Soho themselves had their suspicions about different water sources:

“37 Broad Street. Mr Eley, the percussion-cap manufacturer of 37 Broad Street informed me that he had long noticed that the water became offensive, both to smell and taste, after it had been kept about two days. This as I noticed before, is a character of water contaminated with sewage. Another person had noticed for months that a film formed on the surface of the water when it had been kept a few hours.”

Elsewhere

“Brewery on Broad Street. There is a brewery on Broad Street, near to the pump, an on perceiving that no brewer’s men were registered as having died of cholera, I called on Mr Hugguns, the proprietor […] the men were allowed a certain quantity of malt liquor, and Mr Hugguns believed they do not drink water at all; and he is quite certain that the workmen never obtained the water from the pump in the street. There is a deep well in the brewery, in addition to the New River Water.”

Similarly, there was a Workhouse on Poland Street, which with its large number of (by definition) poor residents living in close conditions might be expected to have had a large number of deaths, saw only 5 deaths out of 535 inmates. But the workhouse had its own pump on the premises, and received piped water from the Grand Junction Water work, not the Broad Street pump. The dept of the pump in both of these cases is significant, placing it below the level of a shallow bore pump that drew in water contaminated by cesspits and drains. Faecal contamination, even of piped water remains a significant problem in rapidly urbanising cities where functioning sewerage systems may be hard to come by or entangled with water distribution pipes owing to the order in which they are laid.

Nonetheless, the Broad Street pump water had its own attractions, particularly its taste and coolness at the end of a long hot summer.

“The pump-water was also sold in various little shops, with a teaspoonful of effervescing powder in it, under the name of sherbert; and it may have been distributed in other ways which I am unacquainted with.”

Although the shorthand that a map provides as a visualisation of data is powerful enough a technical and rhetorical form to eventually challenge and displace the miasma explanation for cholera (no surprise that Edward Tufte is a fan of Snow’s work) to that of germ theory, it is also clear that many of these insights would not have been available to Snow without spending consdierable time walking the streets and talking to people. It was not only proximity to the Broad Street pump that lead people to drink from it. The sensual dimensions of water, it’s taste, coolness and slight carbonation also shaped people’s preferences for one pump or another. In Steven Johnson’s book The Ghost Map, an entertaining account of Snow’s work and battle to get it recognised (and excellent TED talk), further details of the Eley family, whose percussion-cap business was based at 37 Broad Street (above) also appear.

“Even emigres from Golden Square retained their taste for the Broad Street well. Susannah Eley, whose husband had founded the percussion-cap factory on Broad Street, moved to Hampstead after being widowed. But her sons would regularly fill a jug with Broad Street water and deliver it to her by cart. The Eley brothers also maintained two large tubs of well water for their employees during the work day. With temperatures reaching the mid-eighties in the shade on those late-August days and no wind to freshen the air, the collective thirst for cool well water must have been intense.” (No page number)

While the addresses of those who appear on the parish burial records provide would have provided Snow with points that could have been plotted on a map, without his work walking the streets and talking to people, recognising the significance of the social and economic relations of those who lived in the streets around the Broad Street pump, cases would have been missed. Furthermore, vital counter examples such as the lack of deaths of those associated with the Brewery and relatively few at the Workhouse on Poland Street with their independent source of water would not have emerged. Yet Snow’s struggle to get his interpretation of the data recognised, against a miasmatic framing of disease and the handle of the contaminated Broad Street pump permanently removed, is also indicative of contemporary struggles with government bodies to provide adequate infrastructures.

In his recent book ‘Urbanising Cholera: The Social Determinants of Its Re-emergenceRajib Dasgupta argues for a return to a more holistic approach to epidemiology, understanding how biological, environmental and behavioural factors are located within wider structures, in contemporary rapidly growing cities, like Delhi. He argues that diseases like cholera need to be approached as a complex phenomenon at the interface between biomedical, environmental, social and political domains. Water infrastructures too are at this interface, winding their way through present day cities, linking neighbours in unexpected ways, and fractures and disjunctions, as well as distrust between others. All of these factors need carefully tracing and understanding how they come together as a complex assemblage of relations, or in the case of disease as medical anthropologist Merill Singer might better put it, a syndemic.

More on the John Snow Bicentennary: http://vimeo.com/channels/johnsnow