In the Footsteps of Nehemiah

Tutankhamun, Dr John Snow and Covid19

After making the trek from Zamalek Island to the Egyptian Museum in Cairo we made a bee-line to his funeral mask. We stood before it in all its glorious majesty and beauty – probably one of the most iconic and best recognised pieces of art in the world – Tutankhamun’s funeral mask dating from around 1323 BC. We all stood there, two parents proud of themselves for having made it across Cairo, and into the museum with two young children in tow. Our chance to experience that strange connection with another world, another time and another place. Jill happened to mentioned that her older sister, Anne, had once stood in front of this same iconic piece of art when it had travelled to the London Museum on loan in the 1972. That got me thinking immediately, in classic science fiction terminology, of portals in the time-space continuum! The majority of people are usually more interested in the mundane – taking a closer look at his beard and trying to identify any remnants of the super-glue used by museum workers to fix it back into place when it fell off during a routine move.

It is not only people who are funnelled around the world, unsuspectingly through portals of varying size, shape and form. Have you ever noticed how many buildings manage the same effect? In 2005, I was happy to attend the final opening of the Royal Netherlands Embassy in Addis Ababa; a building that earned its architects an Aga Khan Award in architecture for its brutalist moves and Ethiopic symbolism. Built mainly out of textured, pigmented concrete, I realised that practically the whole building had proceeded, across a shorter space of time, through one hole a mere twelve inches in diameter. Yes, the contractor was a local Ethio-Italian company who still mixed all of their concrete on site, using a single, industrial sized concrete mixer (colloquially known as a cement mixer). These thoughts bring to mind the cosmos, black holes, worm-holes, string theory, Einstein’s general theory of relativity and the like. Well perhaps not for everyone!


Bringing it back to my current field of expertise – Water, Sanitation and Hygiene Promotion - I am honoured to live in York, not a mile from where the famous Dr John Snow was born and raised in North Street. It was he, who managed to curtail an outbreak of cholera in Soho, London in 1854 by simply removing the handle off the offending water pump. With the help of Reverend Henry Whitehead and some meticulous research, he was able to trace the source of infection down to this one pump. He went on from there to be considered as a leading light and founder in the science of modern epidemiology.

Ironically, our ascendant epidemiologist put aside the contemporary and dominant ‘foul air theory’ otherwise known as the ‘Miasma Theory’ and began to develop the ‘germ theory of disease’. It was later confirmed the broad street water pump had been dug only 90 centimetres from an old cesspit, which had begun to leak faecal bacteria. The cloth nappy of a baby, who had contracted cholera from another source, had recently been washed into this cesspit.

And ever more sadly, after the cholera epidemic had subsided political controversy took precedence over public health concerns and government officials replaced the Broad Street pump handle. They had responded only to the urgent threat posed to the population, and afterward they rejected Snow's theory. To accept his proposal would have meant indirectly accepting the faecal-oral route of disease transmission, which was too unpleasant for most of the public to contemplate.

[Reference; Chapelle, Frank (2005) Wellsprings. New Brunswick, New Jersey: Rutgers University Press. p. 82. ISBN 0-8135-3614-6]

So where are we now with Covid19. Ironic indeed that the general use of face masks has been delayed in a kind of reversal of the germ theory over miasma theory. Is Covid19 being transmitted through the air in aerosol form? Yet to be proven perhaps, but everyone from the Mayor of London to the president of China is now insisting on the general use of masks – obviously not as smart as Tutankhamun’s but nevertheless creating a simple barrier between human carriers of the disease and especially those who are asymptomatic and displaying no physical conditions.

So what am I proposing to do now in Iraq? Look for those all-important portals just like our hero Dr John Snow. Where do people congregate over time and in space where the virus can live and dominate our species and transmit itself easily? So here are some examples we have come up with so far;

  • Shops and food stores and any point of sale of essential goods. Let’s work to distance customers from each other and from store keepers.
  • Military checkpoints and road blocks. Very common and ubiquitous in Iraq. Handing documents back and forth, leaning in through windows and chatting away at close proximity all highly efficacious ways at transmitting this deadly enemy.
  • As they begin to reopen we will need to develop SOPs – standard operating procedures for health facilities, schools, community centers, sports venues and any other place where humans gather and mix – this is clear.


So, I leave you with this - lateral thinking and looking for portals just as Dr John Snow did in the 1850s will clearly be our task for the next year or two until we beat this thing and prepare for the next pandemic.