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After World War II, Australians and new migrants rushed to build their dream home and garden. As housing estates proliferated in the suburbs, local authorities struggled to keep pace with increasing demand for water supply and sewerage connection. In all five cities, suburbs were constructed with no roads, kerbing and channelling, or sewerage. New subdivisions had reticulated water, but manual night cart collection continued in some suburbs and septic tanks were common until sewer lines were built. As the housing stock increased and septic systems were replaced with reticulated sewerage, water supplies were stretched beyond capacity. Authorities turned to the well-worn path of dam construction to increase supply, but when consumption exceeded capacity, especially in hot, dry seasons, unpopular water restrictions were implemented, with hoses and sprinklers banned. The sight of green suburban lawns turning brown undermined the myth of unlimited supply at the turn of a tap, but expectations were reinstated as soon as it rained.
In the first half of the twentieth century, Australian metropolitan water authorities faced the challenge of keeping up with rising demand for water and sewerage. State governments could draw on income tax revenue to fund infrastructure projects and subsidise water authorities, but the demands and expectations of new suburban households resulted in periodic water shortages and a reliance on septic tanks and pan collection in unsewered areas. Because water demand is habitual and culturally determined, governments responded to these shortages by imposing water restrictions and investing in large storage works. Each of the five cities was supplied with safe water at the end of World War II, but the provision of sewerage was uneven. Brisbane and Perth lagged; Sydney and Melbourne’s sewerage systems would struggle to cope with new demands in the post-War boom period.
The conclusion summarizes the major themes and findings of the book. The first major advance in the control of infectious intestinal disease in the modern era was in the treatment of water supplies. In the first half of the twentieth century, the combined package of underground sewerage and purified water won broad cultural acceptance. Modern sanitation conveyed enormous population-level benefits, even as it produced some unanticipated vulnerabilities and contrary health outcomes. Oral rehydration therapy and childhood immunizations have dramatically improved childhood survival rates, contributing to soaring population growth and deepening environmental challenges.
The fourth chapter, “Innovations,” discusses the environmental challenges in a rapidly urbanizing London, the capital of the largest empire of the modern period. It explores the early innovations in dealing with excreta disposal, including the creation of an underground sewer system and efforts to use the highly dilute sewer effluvia as fertilizer. The direct health benefits of modern sewerage alone were modest. Many smaller and less wealthy cities and towns opted for other methods of human waste disposal, including the tub-and-pail system. Much infectious intestinal disease was the result of pathogen-laden flies alighting on food and the contamination of the urban milk supply. The major reductions in mortality and morbidity from intestinal pathogens came about as a result of the filtration and chemical treatment of drinking water with chlorine or ozonation.
Chapter five, “Adoptions and Adaptations,” explores the evidence for the adoption of modern sewerage and water purification systems beyond the early centers in northern Europe and North America. The principal constraints to adoption of modern sanitation were fiscal, although ecological, political, and cultural forces also played large roles. The overall result was that the sanitation revolution beyond the North Atlantic was adopted piecemeal and that the benefits were generally concentrated in the core urban areas inhabited by those with political and economic power. Into the mid-twentieth century, the flush toilet and the disposal of human waste via water carriage made little impact on the overall problem of excreta disposal, and even the provision of piped water was generally limited to the cities and large towns in which Europeans, local elites of European ancestry, and/or non-European elites had an authoritative presence.
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