Parched City (18 page)

‘O For the Water They Waste in Britain’
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The above statement was emblazoned across a poster featuring a lone soldier marching through deserted terrain. A giant domestic tap floated surreally in the foreground of the poster, juxtaposing domestic comfort with the harsh reality of life on the front line. Conserving water for both unknown emergencies and the unknown duration of the war was a recurrent theme of the Metropolitan Water Board’s public relations campaign during the war. Remnants of the Board’s campaign point to a sustained volley of reminders to Londoners about their duty to value water. The sight of untold quantities of water being used to fight fires during the Blitz created a dangerous perception that supplies were bottomless. The Board’s Chairman Henry Berry issued a New Year greeting in 1942, suggesting Londoners resolve ‘not
to fill
the hand basin when washing but to make it a point of honour to reduce my consumption of water to the absolute minimum in this period of national emergency’.
⁶⁴
Like Dr Houston in the previous war, Berry’s wanted to conserve the coal that kept the water pumping into filtration systems and supply pipes.

A sustained possibility of invasion precipitated a national plan to ration the personal use of water to two gallons a day ‘for
all
purposes’.
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Toilet flushing with freshwater was to be supplanted by the use of wastewater. Successfully instilling such behaviour change presented another challenge.

Emergency Supplies, Edward Street, Canning Town, E16
, 4th December
1944. City of London, London Metropolitan Archives. Reproduced with kind permission from Thames Water.

Ironically, it was a natural rather than a manmade emergency that caused water rations to be imposed in 1944. A severe lack of rainfall the year before in the London region had affected reserves and sparked fears of shortages. Food could be neatly rationed into packets, tins and weighed in pounds by the Ministry for Food but measuring free-flowing water was more challenging. Commercial water users, such as breweries, had meters but domestic consumers were still charged on the rateable basis calculated by property value (no doubt a value grossly altered by the war and poverty for many Londoners). Between January and May 1944, reports in the national press increasingly highlighted the seriousness of the drought as the summer drew closer.
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All defects in fittings and leaky taps were to be reported to the Metropolitan Water Board’s distribution engineer and the use of hosepipes to water gardens or cars was banned. The need for a Minister for Water was even mooted. The period of water scarcity, amidst the existing wartime austerity was prolonged. In August 1944 London’s water scarcity only made a minor news
item, despite the fact that the flow of the Thames was ‘still one of the lowest on record’.
⁶⁷

Some emergency need was still evident from the effects of war and the natural drought in December 1944. A photograph of a mobile emergency drinking water tanker serving Canning Town in East London documented an apparently uncommon sight (mains repair was on the whole reportedly swift and successful).
⁶⁸
The photograph poignantly conveys the disruption of convenience and comfort through the strange sight of domestic taps relocation outdoors, juxtaposed with gutted buildings and a rubble-strewn landscape.

It is incredible that no waterborne health epidemic erupted in London between 1939–45, despite damage to over 6000 pipes in London’s water distribution network.
⁶⁹
Colonel MacKenzie published an essay in 1945 about his department’s measures to safeguard water purity. He proudly quoted a statement from the British Medical Journal, penned in January of that year: ‘One of the outstanding public health achievements of the war had been the protection of London’s water supply.’
⁷⁰
MacKenzie’s pride about the prevention of waterborne disease was understandable in the context of a city scarred by the loss of 29,890 people during the war.
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Over 50,000 people were also left with disabling injuries caused by the bombing campaign.
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Patriotic pride in London’s municipal water protection during the Blitz may have been one factor stoking the controversy that broke out in the 1950s, when a novel new water treatment philosophy from America made its way across the Atlantic.

Chapter Seven

Visions for the post-war landscape were drafted even before the conflict had ended. The London County Council published the first version of its
County of London Plan
in 1943. Housing was naturally central to restoring the stock depleted during the Blitz, however there was also a striking emphasis on the value of outdoor space and how principles of health could be embedded in those designs. As the plan’s authors believed: ‘Adequate open space for both recreation and rest is a vital factor in maintaining and improving the health of the people.’
²
Other post-war optimists were The Metropolitan Drinking Fountain and Cattle Trough Association, still in business, which announced to supporters in its 1945 report: ‘We are looking forward to a future of great activity in replacing structures destroyed in the raids and supplying new ones to the many Playing Fields and Open Spaces that are now being planned by Local Authorities.’
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The charity was not disappointed. 63 fountains were ordered in 1948 which was the highest number in a single year that the charity had ever installed.
⁴

Creating healthy public spaces in that year was an apt expression of a new, socialist medical era. Britain’s National Health Service was born in 1948. Concern for public health was paramount to the ideals of the new Labour Government’s nascent welfare state, in which free access to healthcare represented an economic commitment to the principle of social justice and equality. Enshrined in the National Health Service Act was the
ideal of preventing, as well as curing, illness.
⁵
This chapter investigates how drinking water became a focal point in the debate over how to deliver this health philosophy of prevention and social equality in a mode that some people were not willing to swallow, under any circumstances.

Visions of Sparkling Teeth

It was in America that the notion of engineering public water to actively improve a population’s health first gained ground. News was coming from health professionals across the Atlantic of research and then, in 1945, a trial of chemically enhancing tap water’s nutrients with a naturally-occurring ingredient: fluoride.
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By 1950 American dentists were optimistic about the test results: ‘The fluoridation of public water supplies as a partial protection against tooth decay is a tremendous step forward in the profession’s fight against dental decay.’
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The subject of fluoridation entered international public health discourse. Though it was a national issue in Britain, London’s experience was contoured by its symbolism as the capital, and also by the complexity of the city’s local government structures. Records of the Metropolitan Water Board’s (MWB) involvement in the national and local fluoridation debate reveal a period of high emotion, characterised by clashing ideologies about drinking water as an instrument of public health.

MacKenzie remained the MWB’s Director of Water Examination after the war. His title was de-militarised by the 1950s from Colonel to plain E.F.W. MacKenzie. The decade had already seen London’s post-war austerity relieved during 1951’s Festival of Britain celebrations, when the South Bank was transformed into a twenty-seven acre site celebrating ‘British achievement in science, technology and industrial design’.
⁸
If MacKenzie had taken a night-time stroll along the river during the festival, as one of the eight million people who visited, he would have shared the popular sight of a light spectacle illuminating
iconic Thames-side buildings, light-based artworks projected into the sky, and even onto fountains and pavements.
⁹
Whether or not MacKenzie enjoyed this sight, the scientist certainly appeared to share the Festival’s curatorial vision that the cross pollination of science and technology could enlighten the future of humanity through new innovations.

In spring 1952 MacKenzie gave a lecture at the Westminster Hospital Medical School. Its subject was fluoridation. His lecture took place midway through the trip of a team that had been dispatched by the British Government to research that very issue. The team had a grand title: The United Kingdom Mission on the Fluoridation of Domestic Water Supplies in North America. Before MacKenzie knew the outcome of that Mission’s findings, he was already convinced about the benefits fluoridation could bestow on the teeth of young Londoners, not to mention its effectiveness in cutting the National Health Service’s 43 million pound dental bill. This water examiner seemed at ease with his potential role in dispensing an improvement in London’s public health. For him it was merely a ‘daily supplementation of the fluorine intake in areas where it was known to be insufficient’ (fluorine is the name of the chemical in its pure, gaseous form).
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Importantly to the debate that would ensue, MacKenzie explained that fluoride was already present in all water, but at inconsistent levels. In some parts of America, fluoride levels were naturally higher than others. The effect this had on locals’ teeth was a visible mottling of the enamel. Research, initially prompted by this discolouration issue exposed fluoride’s agency both as a preventer of dental caries and as the culprit for mottling. When consumed via water, different concentrations of the naturally occurring chemical produced vastly different results.

MacKenzie relayed to the Medical School audience that extensive American-based research into fluorine during the 1930s and 40s had moved to water treatment in some States. America’s fluoride research had revealed how precise levels of the added
chemical needed to be, in order to achieve the desired effect. As the Director explained from the conclusions of American scien-tists: ‘…reduction of caries’ incidence in school children might be expected from concentrations of fluorine of between 1.0 and 1.5 p.p.m.’ and critically that ‘no further appreciable benefit was obtained by a higher fluoride content.’
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Research underway in the United Kingdom, in the few places where fluorine was at high enough levels to compare with the American studies, was corroborating this view.

Equalising the natural substance involved using an artificial compound: sodium fluoride. Injecting the water supply with fluoride, according to MacKenzie, should not cause any controversy in Britain because of precedents demonstrated by other dietary supplements: ‘The ethics of so-called mass medication had been satisfactorily settled in such matters as improvement of flour by calcium, addition of vitamins to margarine or of iodine to salt.’
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One note of uncertainty that MacKenzie did sound was about the ‘possible harmful effects’ of fluorine.
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But there was no doubt from his speech that he was vociferously pro-fluoridation. In his closing words, he posed the American Public Health Association’s question about the un-fluoridated States: ‘“What are the rest of us waiting for?”’
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‘The same question might well be asked, and indeed is being asked, in this country today’, Mackenzie concluded.
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During his sales-pitch, the Director of Water Examination neglected to mention one critical piece of information. Some segments of the American public were firmly opposed to mandatory fluoridation.

The tale of America’s
Fluoride Wars
interprets public response to the first artificial dose of fluoride in Michigan neatly: ‘For most, it was another blessing bestowed on us by modern science. But for some, it was one chemical too many.’
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Members of the United Kingdom’s fluoridation mission to the U.S. were well aware of the controversy the subject had ignited there. The visit coincided with the deliberations of a U.S. Government Select
Committee, appointed to
Investigate the Use of Chemicals in Foods and Cosmetics
.
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In media coverage of the Committee’s proceedings, opponents to fluoridation were prominent as the national fluoridation debate ramped up. The U.K. investigators also felt the formidable force of local pressure groups, whose members engaged in public deliberations about the merits of fluoridation. Anti-fluoridation lobbyists in Seattle held enough sway to swing the pendulum completely against the proposed additive.
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Tampering with the Tap

Within the MWB’s records, the first murmur of opposition to fluoridation in London came from the manager of the
Housewives Today
publication, the mouthpiece of the British Housewives League. In January 1953, a letter sent to the Board, penned by Mr H.F. Marfleet from Stepney Green in East London (clearly not a housewife himself), raised this concern: ‘I’ve heard a rumour that the water supply of the metropolitan area is to be treated with fluorine, which is supposed by some people to be a preventative of dental caries.’
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Marfleet wanted to reassure
Housewives Today’s
readers that the rumour had no basis. The Board’s response left the rumour open to further speculation: ‘There are no regulations regarding the amount or quality of any substance that may be added to the water. The possibility can, however, be envisaged of the Ministry making regulations in such matters.’
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It was quite a revelation that additions to the water supply were, in fact, totally unregulated. Chlorine was simply accepted as a necessity.

Four months later, Mr Marfleet issued a complaint: ‘As a consumer of Metropolitan Water, I write to register my strong disapproval, and respectfully to ask you to represent this opinion to the Board.’
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Marfleet feared ‘mass medication’ would soon be pouring out of his kitchen tap. The same year, the U.K. fluoridation mission to America published its report, which MacKenzie shared with his water examination committee.
Fluoridation’s positive impact on dental health was endorsed, as a health measure to top up levels of the substance in areas where it was deficient. MacKenzie acknowledged that public suspicion had to be addressed because of the ‘flood of propaganda leaflets and articles’ opposing the measure.
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So despite the endorsement of America’s fluoridation policy, the U.K. Mission and the Government remained cautious.

Examples of public opposition in America were cited as grounds for the suggestion that Britain needed its own trials, to supply British-based evidence. A flicker of scientific doubt was also expressed in the U.K. Mission’s report: ‘…evidence of harmlessness is so strong as to be almost conclusive.’
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Almost harmless was clearly not the same as absolutely harmless. The state’s line was to encourage more research about the long-term health effects of ‘low levels of fluoride’.
²⁴

The Times
reported from the House of Commons in December 1953 that the Minister for Health, Mr MacLeod, had announced that ‘selected communities’ would soon experience fluoridation trials. Later on, Norwich was revealed to be one of those trial communities. However, the motion to commence the experiment there was defeated by Norwich City Council in June 1954. ‘City refuses to be Guinea-Pig’ ran the Manchester Guardian’s banner headline.
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Fifty complaint letters had been received by the Council and none of them were positive about the fluoridation plans.

Four other trials were imminent: Anglesey (North Wales), Kilmarnock (Western Scotland), Andover (Hampshire) and Watford (Hertfordshire).
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London remained exempt, as Watford lay beyond the MWB’s boundaries. Before the trials began, in July 1955 the Ministry of Health issued a ‘reference note’ to equip health, local governments and water authority officials to defend the virtues of fluoridation.
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State rhetoric was pitched against increasingly public anti-fluoridation sentiment, encapsulated by one emotive
Picture Post
article entitled ‘Hands Off Our Drinking
Water’. Could fluoride enter foetuses or infect breast milk, asked its author?
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Language was carefully employed in the Ministry of Health’s Reference Note to neutralise the polarised debate. Controlled ‘demonstrations’ rather than ‘experiments’ were to take place.
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Emotional anti-fluoridation arguments were also addressed in the note, including the belief that fluoridation was poisonous. The Ministry’s experts argued that only ‘exceedingly high concentrations of fluoride’ i.e. of the kind used in industrial processes were known to cause any harm to the human skeleton.
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It also reassured readers that most fluoride would be excreted in bodily fluids or absorbed as a natural component of the bones. The point that fluoride
naturally
occurred in all water supplies, and therefore
already
entered the human body was driven home: ‘What
is proposed is to make good a deficiency in those water supplies which lack this beneficial element…’
[publication’s bold].
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Fear was also tackled by the assurance that the fluoride compound to be used in the demonstrations was ‘indistinguishable from the naturally-occurring fluoride ion’.
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Highlighting the chemical composition of water in its raw state ruptured the notion of purity to which anti-fluoridationists clung. What was pure drinking water? The Ministry of Health’s answer was crystal clear: ‘If it is argued that the addition of fluoride to water affects the “purity” of the water, it can be answered that water in nature is never chemically pure and that most waters have to be treated chemically before they are suitable for supply, about thirty chemicals being used in water works to produce clear and wholesome water suitable for domestic and industrial purposes.’
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(This was quite an admission.) Of those chemicals, chlorine was paraded as a precedent for why adding substances to raw water, as well as taking them away, could be so beneficial to public health. Like chlorine’s prevention of bacterial havoc, the experts argued, fluoride was an equally preventative measure for the health of future generations.