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Sanitation and disease: Health aspects of excreta and wastewater management
760
ULTRASOUND
SURVEY
OF BILIARY
prospective study of 22,707 men in Taiwan. Lancet, ii, 288-393. Beasley, R. P. (1982). Hepatitis B virus as the etlologic agent in hepatocellular carcinoma-epidemiologic considerations. Hepatology, 2, 21S26S. Chen, C. I., Chai, Z. C., Chang, D. Y., Lu, C. W., Chang, C. M., Lu, Y. H. & Lee, M. R. (1981). Study of hepatitis B -surface antigen&ia and 3-antigenemia in families of a community. Transactions of the Gastroenterological Society of th Republic of China, 10, 57. Gallstone Unit (1976). Intrahepatic calculi, clinical analysis of 90 cases. Zhonghua Yixue Zazhi {Chinese Medical Journal),
3, 70.
IN
TAIWAN
study in M&ii. Scandinavian 30um51 of Gastroenterology, 12, 341-346. Nakayama, F. (1982). Intrahepatic calculi: a special problem in East Asia. World Journal of Surgey, 6, 802-804. National Health Administration. Reoublic of China (1981). Health Statistic II, Vital S&is&, 1980, pp. 8 and 66. Ong, G. B., Patrick, K. W. (1976). Primary carcinoma of the liver. Surgery, Gynecology and Obstetrics, 143, 31-38. Waterhouse, J., Muir, C., Correa, P. & Powell, V. (1976). Cancer Incidence in Five Continents. Vol. III. Internationalai;?’ for Research on Cancer, WHO., Lyon,
-
Ker, C. G., Huang, T. J. & Sheen, P. C. (1981). Intrahepatic stones I; Etiological study. Journal of the Fonnosan Medical Association, 80, 698-711. Lindstrijm, C. G. (1977). Frequency of gallstone diseasein a well-defined Swedishpopulation. A prospective necropsy
Book Sanitation and Disease: Health Aspects of Excreta and Wastewater Management. Feachem, R. G., Bradley,
D. J., Garelick, H. & Mara, D. D. Chichester, UK: John Wiley & Sons, 1983. 501 pp., illus. Price: &33-50. ISBN: 0 47190094X. This impressive tome is the third and last in a series soonsored bv the World Bank and arises from a research protect in appropriate technology for waste disposal started in 1976. The earlier titles have covered two aspectsof sanitation alternatives; technical and economic appraisal, and design and planning. Thus the World Bank has aimed to produce a comprehensive guide to the enhancement of the public health by more effective and widespread provision of that most fundamental human need, the sanitary disposal of human waste. The volume under review is concerned with the public health, microbiological and parasitological aspects of human sanitation and tackles the subject from two different but logical angles: first, in Part 1
(Chapters l-8) is considered the theory and control of excrementally
LESIONS
spread diseases, and second, in the
larger Part 2 (Chapters 9-37) the environmental biology and epidemiology of all known pathogens are treated in detail.
excreted
The book has been written bv a distinauished group of authors, there being ‘some 13 lfurther contributors in addition to the four named, principallv from the London School of Hvaiene and Tropical Medicine. Throughout its many chapters the writing and presentation are uniformly good and clear; the book is designed for a wide audience and succeedsby virtue of the simple explanations, clear diagrams and avoidance of over-manv technical terms-in achieving the stated objective- of providing information for a very broadly-based readership. Whereas the tropical physician may consider the technology of
waste disposal irrelevant to his practice, no doctor with resnonsibihties for the over-all health of a tropical community should be unaware of the great mass of valuable information
in this excellent book.
Accepted for publication 25th January,
1984.
leview For those concerned with the principles of sanitary
disposal for both urban and rural peoples in developing countries
the lessons in Chapter
8 on “The
Human Element in Sanitation Systems” make an important
contribution.
All the advanced sanitary
technoloav in the world will be an exercisein futilitv if the peoples concerned do not understand and accept it. A further point that is well made is the tendency, often seen in situations
where urbanization
has
outpaced the provision of sanitary disposal systems, for installation engineers to follow European practices unaware that these often owe more to 19th century
evolutional expediency than to modern sanitary science. The many references quoted at the end of each chapter indicate the wide scope and comprehensive nature of the authors’
assessment of the recent
literature. It is sad, but perhaps not unexpected in a book of this nature, that the history of sanitary science as an arm of preventive medicine does not receive much attention. The fascinating historv of cholera. for example, is dismissed in one-short paragraph and the erroneous suggestionis implicit that not much was known or done about the sanitary disposal of waste before the second half of this century. It is the reviewer’s personal opinion-that the brief mention in Chanter 37 of llies and cockroaches as
vectors of excremental diseaseunder-emphasizes the true situation. Recent work has further indicted the
cockroach and it has for long been a military medical dictum that the “filthy
feet of faecal feeding flies”
were responsible for diseasetransmission on a large scalein areasof poor or defective sanitation. However these few criticisms should not detract from the excellence of this major review of scientific sanitation: the book itself is too large for every tropical doctor’s pocket, but it should certainly be near at hand, readily
available to all who have concern with the efficient and sanitary disposal of human waste. J. P.
CROWDY
ULTRASOUND
SURVEY
OF BILIARY
prospective study of 22,707 men in Taiwan. Lancet, ii, 288-393. Beasley, R. P. (1982). Hepatitis B virus as the etlologic agent in hepatocellular carcinoma-epidemiologic considerations. Hepatology, 2, 21S26S. Chen, C. I., Chai, Z. C., Chang, D. Y., Lu, C. W., Chang, C. M., Lu, Y. H. & Lee, M. R. (1981). Study of hepatitis B -surface antigen&ia and 3-antigenemia in families of a community. Transactions of the Gastroenterological Society of th Republic of China, 10, 57. Gallstone Unit (1976). Intrahepatic calculi, clinical analysis of 90 cases. Zhonghua Yixue Zazhi {Chinese Medical Journal),
3, 70.
IN
TAIWAN
study in M&ii. Scandinavian 30um51 of Gastroenterology, 12, 341-346. Nakayama, F. (1982). Intrahepatic calculi: a special problem in East Asia. World Journal of Surgey, 6, 802-804. National Health Administration. Reoublic of China (1981). Health Statistic II, Vital S&is&, 1980, pp. 8 and 66. Ong, G. B., Patrick, K. W. (1976). Primary carcinoma of the liver. Surgery, Gynecology and Obstetrics, 143, 31-38. Waterhouse, J., Muir, C., Correa, P. & Powell, V. (1976). Cancer Incidence in Five Continents. Vol. III. Internationalai;?’ for Research on Cancer, WHO., Lyon,
-
Ker, C. G., Huang, T. J. & Sheen, P. C. (1981). Intrahepatic stones I; Etiological study. Journal of the Fonnosan Medical Association, 80, 698-711. Lindstrijm, C. G. (1977). Frequency of gallstone diseasein a well-defined Swedishpopulation. A prospective necropsy
Book Sanitation and Disease: Health Aspects of Excreta and Wastewater Management. Feachem, R. G., Bradley,
D. J., Garelick, H. & Mara, D. D. Chichester, UK: John Wiley & Sons, 1983. 501 pp., illus. Price: &33-50. ISBN: 0 47190094X. This impressive tome is the third and last in a series soonsored bv the World Bank and arises from a research protect in appropriate technology for waste disposal started in 1976. The earlier titles have covered two aspectsof sanitation alternatives; technical and economic appraisal, and design and planning. Thus the World Bank has aimed to produce a comprehensive guide to the enhancement of the public health by more effective and widespread provision of that most fundamental human need, the sanitary disposal of human waste. The volume under review is concerned with the public health, microbiological and parasitological aspects of human sanitation and tackles the subject from two different but logical angles: first, in Part 1
(Chapters l-8) is considered the theory and control of excrementally
LESIONS
spread diseases, and second, in the
larger Part 2 (Chapters 9-37) the environmental biology and epidemiology of all known pathogens are treated in detail.
excreted
The book has been written bv a distinauished group of authors, there being ‘some 13 lfurther contributors in addition to the four named, principallv from the London School of Hvaiene and Tropical Medicine. Throughout its many chapters the writing and presentation are uniformly good and clear; the book is designed for a wide audience and succeedsby virtue of the simple explanations, clear diagrams and avoidance of over-manv technical terms-in achieving the stated objective- of providing information for a very broadly-based readership. Whereas the tropical physician may consider the technology of
waste disposal irrelevant to his practice, no doctor with resnonsibihties for the over-all health of a tropical community should be unaware of the great mass of valuable information
in this excellent book.
Accepted for publication 25th January,
1984.
leview For those concerned with the principles of sanitary
disposal for both urban and rural peoples in developing countries
the lessons in Chapter
8 on “The
Human Element in Sanitation Systems” make an important
contribution.
All the advanced sanitary
technoloav in the world will be an exercisein futilitv if the peoples concerned do not understand and accept it. A further point that is well made is the tendency, often seen in situations
where urbanization
has
outpaced the provision of sanitary disposal systems, for installation engineers to follow European practices unaware that these often owe more to 19th century
evolutional expediency than to modern sanitary science. The many references quoted at the end of each chapter indicate the wide scope and comprehensive nature of the authors’
assessment of the recent
literature. It is sad, but perhaps not unexpected in a book of this nature, that the history of sanitary science as an arm of preventive medicine does not receive much attention. The fascinating historv of cholera. for example, is dismissed in one-short paragraph and the erroneous suggestionis implicit that not much was known or done about the sanitary disposal of waste before the second half of this century. It is the reviewer’s personal opinion-that the brief mention in Chanter 37 of llies and cockroaches as
vectors of excremental diseaseunder-emphasizes the true situation. Recent work has further indicted the
cockroach and it has for long been a military medical dictum that the “filthy
feet of faecal feeding flies”
were responsible for diseasetransmission on a large scalein areasof poor or defective sanitation. However these few criticisms should not detract from the excellence of this major review of scientific sanitation: the book itself is too large for every tropical doctor’s pocket, but it should certainly be near at hand, readily
available to all who have concern with the efficient and sanitary disposal of human waste. J. P.
CROWDY