The Cholera Story – Chhada Nathan Kabariti

This seminar is meant to teach us about the shaping of public health in NYC and other places in the world. The more assigned readings I read, the more I realize how significant the public is in the shaping of its health.

This week’s readings discussed the cholera epidemic that started in India and left a trail of buried people as it crossed borders around the globe. The readings explained how the epidemic killed so many.

In 1832, NYC was a booming city with immigrants from all over the world. The immigrants often lived in crowded neighborhoods with very poor sanitation and animals walking in the streets. One person would drink water that another had used to wash clothes which another had used to relieve himself. Human and animal waste was left to pile up in privies/outhouses which were right near the tiny rookeries people inhabited. Suffice it to say, I wouldn’t wish the living conditions upon my worst enemy. The poor immigrants and blacks could not do anything to escape the overcrowding of the inhabitable cities. On the other hand, the upper class found it easier to move out to the open rural areas where they was a cleaner atmosphere and they were less susceptible to disease. The point is, however, that the living conditions in NYC were not any better than the conditions, the location the film “Cholera Can be Conquered” identified as the source of the cholera bacterium.

To make matters worse, some Americans during the Era of the Common Man believed they wouldn’t contract cholera because it was a punishment for the dirty poor people who led immoral lives. The Many Meanings of Cholera shows that people believed cholera was attracted to the evil in these people’s bodies and it could never harm the pious moral individuals. This explanation was favored because it established moral superiority and even led some to promise relief from cholera if one was converted. Others viewed cholera as a display of God’s power over man and regarded the epidemic as a humbling experience. Still, others blamed the politicians and city leaders for allowing an unequal society to emerge.

Surprisingly, many physicians at the time did not believe that the acute symptoms of cholera which included: sunken eyes and cheeks, body tremors, dehydration, wrinkling of the hands and feet, excessive vomiting, violent diarrhea, and death were caused by a single biological entity. They did not attempt to think of a scientific explanation for the epidemic. Rather, they believed the city’s poor atmosphere along with preexistent individual factors was what caused many people to feel healthy at breakfast but be buried before dinner. Many physicians really believed cholera was meant to cleanse evil that they even rejected the notion that they could get infected and dove straight into cholera nests with many different treatment plans designed to rid the cholera patient of his/her impurities that the cholera found so attractive. Obviously, many physicians then became infected and lost their lives.

The City’s Response explains that NYC’s legislative branch, the Common Council, created the Board of Health in 1805 after the yellow fever epidemic to report on public health. The problem was that the Board of Health was nearly inactive until the cholera epidemic. Most of its quarantines were removed or breached due to pressure by the city’s merchants. The board did not even consist of doctors who could help in the public health decisions. A different council called the Special Medical Council was created to fulfill that purpose but it only consisted of seven physicians. To aid the city cleaning, the board attempted to house the poor but these homes were not any better, and sometimes worse, than the city’s rookeries. As the epidemic worsened, the Board of Health specified a method for the disposal of corpses, and tried to raise money to open more than just five hospitals.

Before the epidemic, the Board did not accomplish much after the yellow fever epidemic subsided. During the epidemic, the Board was still not used to its full potential by the city leaders and physicians. After the 1832 epidemic, the Board’s activities returned to the minimum level they were before and it wasn’t active again until cholera reappeared in the epidemic of 1849.

The lesson from the cholera story is that if city leaders and physicians accept a public health problem, it ends up affecting people much worse than if they were to work together to form a solution. In the reading, Cholera and Medicine, it says “Due to a lack of understanding, medical knowledge could do little to limit the impact of cholera in 1832”, but I believe it should say “Due to physicians’ bias, medical knowledge…” because physicians did not approach the cholera epidemic with the correct mentality. Instead, they attached social meanings to the cholera epidemic that supported their own pre-existing beliefs while ignoring alternate explanations until it was too little, too late. That’s just sad.

Chhada Nathan Kabariti