This week’s readings address some of the many pathogenic contaminants present in drinking water supplies. The Fawell and Nieuwenhuijsen (2003) reading introduce us to a series of environmental contaminants — microbial, chemical and radiological — that enter the waterways through groundwater or, more often, surface water contamination. We’ll go over these on Thursday. Though many are ‘naturally-occurring’, there is an implicit argument in this reading and others that we are witnessing an escalation of the number and kind of contaminants due to human activity (anthropogenic contamination). The production of harmful by-products from chlorine-based disinfection of water serves as an example of the complex trade-offs involved in ‘hydrosocial’ drinking water management. TTHMs are a class of disinfectant by-products that remains in elevated concentrations in the water in Flint, in violation of the Safe Drinking Water Act (City of Flint Annual Water Report 2014; in Hanna-Attisha 2016). The citation reveals this was known to the City and presumably the State, though no action was taken. The banality with which drinking water safety violations can occur — even where ‘improved’ sources and routine systems of monitoring exist — should remind us that Flint’s water crisis is only a dramatic case of a disastrously commonplace reality.
The study of WASH-related illnesses worldwide is wracked by the problem of data: the variance in water supply, distribution, uses and practices are often lost in the approximations needed to produce numerical metrics, making water-related illnesses particularly resistant to classification by these means (Schmidt 2014). This may hamper the ability to advocate for certain interventions in an era of global health (from colonial medicine and then international health and development) that has been largely driven by replicable metrics to which monetary projections can be assigned (see Adams 2015). At the same time, water-related illnesses represent the greatest attribution of the global burden of disease, and so are inherently bound up in these global health projects.
Another fundamental assumption in all this — one drawn from the biomedical tradition — is that human beings respond identically to the presence of pathogenic contaminants — or predictably unequally, based on age, gender or nutritional status. But in addition to the projects of describing the pathophysiology of various contaminants and accounting for them quantitatively, there is a small but growing effort to understand the qualitative and even affective dimensions of our relationships with these kinds of toxic exposures.
There is a move among medical anthropologists to think more about these contaminants as part of the “chemical infrastructures” of our everyday lives (Murphy 2013; Nading 2015). As Alex Nading explains, drawing on Marget Locke’s nuanced understanding of ‘local biologies’: “Despite global health’s universalizing vision, neither bodies nor chemicals behave the same way everywhere” (2015). This body of work is especially focused on the ways in which global health projects to eradicate disease have unanticipated consequences of producing new harms, in scale or in kind — like the disinfectant byproducts in our readings. These effects are carried through by chemicals and other substances which ‘leak’ from the ‘social’ to the ‘natural’ world and reveal the inadequacy of these conceptual borders. Such inorganic chemicals may translate social effects between, for example, humans, bacteria, watersheds, and bureaucracies. It is a framework I introduce as a means of destabilizing the universality of human health in relation to particular contaminants, and in turn, troubling the hegemonic production of data and interventions into water and sanitation systems from a global scale. I’d be interested in hearing any thoughts on the utility — or futility — of this kind of research!
Adams, Vincanne. Metrics: what counts in Global Health. Duke University Press, 2016.
Fawell, J. & Nieuwenhuijsen, M. J. Contaminants in drinking water. Br. Med. Bull. 68, 199–208 (2003).
Hanna-Attisha, M., LaChance, J., Sadler, R. C., & Champney Schnepp, A. (2016). Elevated blood lead levels in children associated with the Flint drinking water crisis: a spatial analysis of risk and public health response. American journal of public health, 106(2).
Murphy, Michelle. “Distributed reproduction.” Corpus. Palgrave Macmillan US, 2011. 21-38.
Nading, Alex M. “Local biologies, leaky things, and the chemical infrastructure of global health.” Medical anthropology 36.2 (2017): 141-156.
Schmidt, Wolf‐Peter. “The elusive effect of water and sanitation on the global burden of disease.” Tropical medicine & international health 19.5 (2014): 522-527.