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Authors: James Salzman

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Is It Safe to Drink the Water?

I
F YOU BOARD A FERRY IN BUSTLING
H
ONG
K
ONG, CROSS TO
Lantau Island, and get on a local bus, the forests of cranes atop new buildings soon give way to forested hills too steep for the construction boom to reach. An hour’s ride up the spine of the mountain range brings you to Po Lin Monastery. Towering above the temple buildings sits Tian Tan Buddha, a bronze statue of Buddha sitting cross-legged. The statue is massive, one of the largest seated bronze statue of Buddha in the world. Lantau Island is hot and humid, even in the hills, and you get thirsty climbing the many ceremonial steps up to the statue. A decade ago, amid the monastery buildings, stood a public fountain. Chained to the fountain was a bamboo ladle, thoughtfully provided for the thirsty visitor. And there was a small line of tourists patiently waiting to drink from it.

Such communal drinking cups have been common in many parts of Asia. They used to be widespread in the United States. A century ago, though, this practice started to change due to safety concerns. In 1908, for example,
Technical World Magazine
featured an article by a Lafayette College biology professor with the ominous title “Death in School Drinking Cups.” Newspapers and public health boards took up the cause as well, with dire warnings and grim illustrations of this dangerous practice.

A 1910 pamphlet titled “The Cup-Campaigner” made its views on the dangers of common drinking cups gruesomely clear
.

In 1909, Kansas became the first state to ban communal cups in public places, and others soon followed. Indeed, the success of the paper Dixie Cup was largely due to the new demand for cheap, disposable drinking cups for use at public fountains.

At the turn of the twentieth century, shared water cups in American public places came to be regarded not only as unsafe but illegal. Even today, some American and British churches now advise against taking Communion from a common chalice during flu season. Yet shared cups remain commonplace in many parts of the world. While you didn’t find many Western tourists drinking from the Tian Tan Buddha fountain, there was a line. For most of the visitors, it obviously seemed safe to drink the water. From the perspective of this American visitor, though, one could not help but find the practice gross.
Yuck
, I thought to myself as I watched them take turns drinking from the cup.
Don’t they know that’s unsafe?

All successful societies throughout history have depended on
reliable access to drinking water, whether through natural sources such as rivers and oases or built structures such as wells and reservoirs. We explored in the last chapter who gets access to water, but access is not enough. The water has to be safe to drink. And this presupposes a deceptively simple question:
How do we know what “safe” water is?

In twenty-first-century America, the answer seems simple—government experts and scientists tell us. We take for granted that our tap water is treated to exacting chemical and biological analyses. The name of the relevant federal law says it all: the Safe Drinking Water Act. This law requires the Environmental Protection Agency to set maximum contaminant levels for copper, lead, and more than eighty other compounds. Our water is regularly tested by local officials, and if the standards are violated, we expect to find out and have something done about it. It is not as if the water we drink from the tap is pure, distilled H
2
O, of course. There are plenty of minerals and bacteria in our tap water and, indeed, in the bottled water we buy at stores and restaurants, but it is considered safe enough to drink.

This seems a commonsense, perhaps obvious approach. Yet, in historical terms, the very idea of the need to conduct detailed chemical and biological analyses, much less care about drinking water’s invisible contents, is still stunningly novel. The germ theory of disease has only existed for about 150 years, a recent development compared to the history of human settlement. And even this approach has shortcomings. Legitimate questions are still being asked about our drinking water. Are the standards stringent enough? Can the infrastructure treating our water meet these standards? How can we be sure that we are even regulating the right substances?

Our technical understanding of water safety is more sophisticated than ever before, but a society’s regulation of drinking water has never been a purely technical matter. While the Safe Drinking Water Act may look dramatically different than the laws and practices relied on by other societies and in other times, they share far more similarities than differences. The fundamental problem, as we
shall see, is that no source of water can ever be totally safe, completely risk-free, either today or two hundred years from now.

The conception of safety evolves over time and across cultures, informed by a society’s understanding of disease, technological capability, and aversion to risk. Popular perceptions shape our management of safe drinking water just as surely as do chemical assays. Because of the universality of this challenge, because safety is a timeless moving target, one can take valuable lessons for today from the historical record.

The next three chapters explore this broad topic. In
chapter four
, we will explore nonliving, chemical dangers such as arsenic and modern challenges such as pharmaceutical residues and persistent organic pollutants in our water sources. Then, we turn to terrorism and the dangers we face from enemies intent on poisoning the water we drink. But first, in the pages that follow, let’s consider how societies have dealt with waterborne diseases and the immediate dangers they present.

D
ESPITE THE ENTICING IMAGES ON BOTTLED WATER LABELS OF GUSH
-ing mounting streams and burbling springs, the simple fact is that freshwater is just not very clean. Water is a great solvent, but many things in nature that are water-soluble are not good for us. Teeming numbers of microorganisms live in water. In fact, natural selection has ensured that many of these microorganisms can
only
live in water. As hydrologist Francis Chapelle has memorably described:

These bacteria, algae, fungi, and viruses—often as many as 100 million
per milliliter
—can live in water that is hot or cold, clear or muddy, rapidly flowing or stagnant. They can live in desert pools where water temperature exceeds 140° F, or on frozen tundras where temperatures dip below -50° F. We like to think that water drawn from unpolluted rivers, streams, and lakes is naturally pure and fit for human consumption. Sometimes it is, but this is not common. Water, by its very nature, is often very dirty.

And this is water from natural surroundings. Once water in wells, rivers, or lakes comes into contact with the garbage and animal and human waste we inevitably produce in towns and cities, things only get worse.

Travel books to distant places have long held warnings not to drink the water. Martin Lister warned seventeenth-century visitors to Paris that drinking the water caused “looseness, and sometimes dysenteries.” Euphemistic phrases for travelers’ upset stomachs range from “Montezuma’s Revenge” in Mexico and “Delhi Belly” in India to “Mummy Tummy” in Egypt and the “Karachi Crouch” in Pakistan. While the names may be lighthearted, the condition is not. The Centers for Disease Control estimate that 20 to 50 percent of international travelers suffer from diarrhea and abdominal cramping every year. These generally strike within a week of arriving. The main causes of these scourges are bacteria such as
E. coli
and shigella, with protozoa such as giardia afflicting in some regions, as well.

The frustrating question posed by such omnipresent travelers’ woes is why travelers get sick drinking the same water that locals drink with apparently no problems at all. The answer is immunity. The local citizens have spent their lives with these microorganisms in their water, and their bodies’ immune systems have developed antibodies to counter many of the specific pathogens that afflict visitors. This is not true for all microorganisms, of course, which is why some waterborne diseases, such as cholera, remain such widespread problems in developing countries.

Asking whether it is safe to drink the water remains an important question, both in the United States and abroad. But how to consider such a broad-ranging question? The basic task of providing safe water has remained the same for as long as we have had human settlements, and it can be broken into four separate challenges.

• S
OURCE IDENTIFICATION
—how to find drinking water
• S
OURCE PROTECTION
—what to do around the source to keep the water uncontaminated
• T
REATMENT
—how to make the water safe for drinking
• D
ISTRIBUTION
—how to get water from the source to the final point of consumption, and keep it clean during the journey

To protect against waterborne diseases, every one of these tasks must be effectively managed, and each presents its own set of quite difficult technical, policy, and legal challenges.

Source Identification

Everyone needs to know how to find a reliable source of drinking water. For some of us, this involves no more than going to the sink or pulling a bottle of water from the refrigerator. For early explorers of unknown lands and mariners in uncharted seas, however, death from thirst was a very real threat. They all faced the same terrible fear of running out of water before chancing upon a new source. A person can go three weeks or more without food. The body starts consuming its own fat and muscle. But we can only go a few days without water, and it is a terrible way to suffer.

In 1906, Pablo Valencia wandered for eight days in the Sonoran Desert outside Tucson, Arizona. When found by the rescue party, he was described by his rescuer in gripping detail.

Pablo was stark naked; his formerly full-muscled legs and arms were shrunken and scrawny; his ribs ridged out like those of a [starving] horse; his habitually plethoric abdomen was drawn in almost against his vertebral column; his lips had disappeared as if amputated, leaving low edges of blackened tissue; his teeth and gums projected like those of a skinned animal, but the flesh was black and dry as a hank of jerky; his nose was withered and shrunken to half its length, the nostrillining showing black; his eyes were set in a winkless stare, with surrounding skin so contracted as to expose the conjunctiva, itself black as the gums; his joints and bones stood out like those of a wasted sickling, though the skin clung to them in a way suggesting shrunken rawhide used in repairing a broken wheel.

This was no less terrifying for ancient nomadic peoples in arid lands. Discussions of springs and wells are found throughout the Old Testament, their importance clear because each had its own name. Indeed, it may be the earliest example of critical intellectual property. Knowledge of water sources has always been vital to a group’s survival.

As the journalist Elizabeth Royte has described, “From the beginning of human time, access to sufficient clean water was the
sine qua non
for establishment of a settlement. Lack of good water cramped expansion, and the search for new sources drew civilization’s map.” Archaeological excavations from the Neolithic Period onward have found a striking correspondence between settlements and reliable sources of nearby drinking water, whether wells, springs, streams, or lakes. Storage of drinking water was often necessary to urban planning, as well. Thus one can find examples of sophisticated water management in virtually every archaeological excavation of ancient civilizations—from complex drains in Machu Picchu high atop the Andes, to intricate systems of canals in Egypt, to the Romans’ towering aqueducts that remain standing today. Indeed, the historian Karl Wittfogel invented the term “hydraulic civilization” to describe those societies that maintained power by control over water resources.

The need to identify safe sources of water is as crucial for mobile settlements as permanent ones, and nowhere has this been more true than during times of war. As the Roman general Vegetius observed, “An army must not use bad or marshy water: for the drinking of bad water is like poison and causes plagues among those who drink it.” Napoleon was only half right when he said that an army marches on its stomach. It also needs to slake its thirst. Consider that in the Napoleonic Wars, disease killed eight times more soldiers than battle injuries. In the American Civil War, diarrhea and dysentery claimed more lives than the battlefield. And during the pivotal battle of El Alamein during World War II, as many as 50 percent of the German and Italian troops suffered from waterborne diseases. The German general commanding the North African theater, Erwin Rommel, is said to have claimed that his defeat was due to dysentery, not Field Marshal Montgomery’s Eighth Army.

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