Just a Little Imagination and Will


January 04, 1993|By JONATHAN POWER

London. -- No famine, no war, no flood, no earthquake has ever claimed the lives of 250,000 children in a single week. Yet malnutrition and disease claim that number of the world's children every seven days. That is the first consideration.

The second, as UNICEF's newly published ''State of the World's Children'' makes plain, is that for a mere $25 billion it would now be possible ''to control the major childhood diseases, eradicate polio, halve child malnutrition, bring clean water to all communities, provide a basic education for every child, and make family planning available to all couples.''

That figure, $25 billion, is not very much. It's what it will cost Hong Kong for its new airport, what it will cost Japan for its new road from Tokyo to Kobe, what western Europeans spend on alcohol every three months, or Americans on cigarettes every six, or half what the Third World spends on the wages of its soldiers every year.

If this, indeed, is the quite modest cost of such a gigantic step, it overshadows the front-page debate on what to do or not to do about Bosnia and Herzegovina. If it's the number of lives and degree of suffering we are concerned about, then here is an attainable goal that does not confront political antagonism, military complications or sheer futility.

The third consideration is to recall the rich world's own 19th-century history. During its turbulent days of industrial revolution, ''dark satanic mills,'' rural exodus and chaotic urban growth, the great breakthroughs in public health were made.

In 1834, Edwin Chadwick, a tough, bullying lawyer, was appointed secretary of Britain's Poor Law Commission. He was firmly convinced, in an era when fine ladies used powder and perfume to hide unwashed body smells, that filth led to disease and disease to loss of income and poverty.

In a landmark study of the conditions among Britain's working class, Chadwick discovered that the annual loss of life due to filth and bad sanitation exceeded that of any war yet fought. His report, tersely entitled ''The Sanitary Idea,'' was sold, read and debated across the country and became the driving force behind a series of important public-health acts.

A contemporary of Chadwick was the scientist John Snow. Four successive outbreaks of cholera claimed hundreds of thousands lives in overcrowded tenement slums. In London, the most densely peopled city of all, Snow mapped the sites of London's communal water hand pumps against the addresses of those who had recently died.

Quickly he showed that the majority of deaths were clustered within walking distance of the pump at Broad Street. Snow created a media event: With journalists witnessing, he removed the handle of the pump. Within a month the death rate from cholera fell to minuscule proportions. For the first time the public authorities learned the connection between clean water and this dread disease.

In the U.S. in the 1890s the Noble Order of the Knights of Labor saw its membership jump from 11 to over 700,000. It was made up of health reformers, doctors and middle- and upper-class women who campaigned for sanitary reform, an eight-hour working day and the abolition of child labor.

In Switzerland, in 1922, a doctor, Hans Eggenberger, organized a petition to persuade the authorities to iodize all salt as it came through the railway station from the salt works. Less than a teaspoon of iodine is required for a lifetime, he argued, but without it neck goiters and impaired mental and physical capacity may result.

One country in Europe through much of the 20th century ignored Eggenberger's insight -- Franco's despotic Spain. Widespread iodine-deficiency diseases persisted there right up to the mid-1980s.

Perhaps too carelessly, we take all this progress for granted and compound our historical laziness with a failure to see that such simple revolutions could be replicated all over the world at little cost, or rather at mainly the cost of imagination and will power. If we could lift our eyes for a moment from the great televised crises of our age, we could see that this ''silent emergency,'' which claims so many children's lives quite unnecessarily, could be dealt with and overcome even before the end of the century.

Jonathan Power writes a column on the Third World.

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