If you haven't ordered yet, I generally find the rigatoni with the spicy tomato sauce goes best with diseases of the small intestine.
Če še niste jedli, priporočam rigatone s pekočo paradižnikovo omako, saj gredo najbolje z boleznimi tankega črevesa.
(Laughter)
(smeh)
So, sorry -- it just feels like I should be doing stand-up up here because of the setting. No, what I want to do is take you back to 1854 in London for the next few minutes, and tell the story -- in brief -- of this outbreak, which in many ways, I think, helped create the world that we live in today, and particularly the kind of city that we live in today. This period in 1854, in the middle part of the 19th century, in London's history, is incredibly interesting for a number of reasons. But I think the most important one is that London was this city of 2.5 million people, and it was the largest city on the face of the planet at that point. But it was also the largest city that had ever been built.
Oprostite, a zaradi postavitve odra se mi zdi, da sem tu za stand up nastop. Sedaj pa vas bom za nekaj minut popeljal nazaj v leto 1854, in sicer v London, da vam na kratko povem zgodbo tega izbruha, ki je po moje na mnoge načine doprinesel k sodobnemu načinu življenja, predvsem pa sodobnim velemestom. To obdobje v letu 1854, sredi 19. stoletja v zgodovini Londona, je izredno zanimivo iz številnih razlogov. Menim pa, da je najpomembnejši dejstvo, da je bil London velemesto z 2,5 milijona prebivalcev in je bil tisti trenutek največje mesto na planetu. Bil pa je tudi največje mesto vseh časov.
And so the Victorians were trying to live through and simultaneously invent a whole new scale of living: this scale of living that we, you know, now call "metropolitan living." And it was in many ways, at this point in the mid-1850s, a complete disaster. They were basically a city living with a modern kind of industrial metropolis with an Elizabethan public infrastructure. So people, for instance, just to gross you out for a second, had cesspools of human waste in their basement. Like, a foot to two feet deep. And they would just kind of throw the buckets down there and hope that it would somehow go away, and of course it never really would go away. And all of this stuff, basically, had accumulated to the point where the city was incredibly offensive to just walk around in.
Tako so viktorijanci istočasno skušali preživeti in nekako izumiti novo stopnjo v razvoju življenjskega stila, stopnjo, ki ji danes rečemo, gotovo veste, "urbani življenjski stil". Ta je bil takrat, sredi 50-ih let 19. st., v številnih pogledih še popolna polomija. Dejansko so živeli v prototipu modernega industrijskega velemesta s srednjeveško infrastrukturo. Tako so ljudje imeli na primer - da vas malce zgrozim - v kleteh greznice s človeškimi iztrebki. Mislim, globine 30 do 60 cm. Dejansko so vsebino čebrov nekako zlivali tja dol in upali, da bo čudežno izginila in seveda nikoli ni povsem izginila. Vse te tegobe so se nabirale do točke, da je bilo skrajno neprijetno že samo hoditi po mestu.
It was an amazingly smelly city. Not just because of the cesspools, but also the sheer number of livestock in the city would shock people. Not just the horses, but people had cows in their attics that they would use for milk, that they would hoist up there and keep them in the attic until literally their milk ran out and they died, and then they would drag them off to the bone boilers down the street. So, you would just walk around London at this point and just be overwhelmed with this stench. And what ended up happening is that an entire emerging public health system became convinced that it was the smell that was killing everybody, that was creating these diseases that would wipe through the city every three or four years. And cholera was really the great killer of this period.
Mesto je imelo neverjetno neprijeten vonj. Pa ne samo zaradi greznic, ampak že število glav živine v mestu bi vas presenetilo. Ne samo konji, na podstrešju so imeli tudi krave za mleko, s škripci so jih dvignili tja in jih vzdrževali tam, dokler ni zmanjkalo mleka in so poginile. Po tem so jih odvlekli do najbližje predelovalnice kosti. Če bi v tistem času hodili po Londonu, bi vas šokiral neznosen smrad. Sledilo je to, da je nastajajoči sistem za varovanje javnega zdravstva kot vzrok za smrtnost meščanov prepoznal smrad in določil, da smrad ustvarja bolezni, ki so vsake tri ali štiri leta povzročile morijo v mestu. Kolera je bila v tem času huda morilka.
It arrived in London in 1832, and every four or five years another epidemic would take 10,000, 20,000 people in London and throughout the U.K. And so the authorities became convinced that this smell was this problem. We had to get rid of the smell. And so, in fact, they concocted a couple of early, you know, founding public-health interventions in the system of the city, one of which was called the "Nuisances Act," which they got everybody as far as they could to empty out their cesspools and just pour all that waste into the river. Because if we get it out of the streets, it'll smell much better, and -- oh right, we drink from the river. So what ended up happening, actually, is they ended up increasing the outbreaks of cholera because, as we now know, cholera is actually in the water. It's a waterborne disease, not something that's in the air. It's not something you smell or inhale; it's something you ingest.
V Londonu se je pojavila leta 1832 in na vsake štiri ali pet let je epidemija usmrtila 10.000, 20.000 ljudi v Londonu, pa tudi v celotnem Združenem kraljestvu. Oblasti so bile torej prepričane, da je vzrok problema smrad. Iskali so način, da se znebijo smrada. Tako so zasnovali nekaj zgodnjih ukrepov za varstvo javnega zdravja v mestnem sistemu, eden od teh se je imenoval "Zakon o javnem redu", ki je - kolikor je lahko - ljudi prisilil, da so vsebino svojih greznic izpraznili v reko. Ker: če jih odmaknemo z ulic, bo vonj znosnejši in ... Saj res! Mi vendar pijemo iz reke. Posledično se je pravzaprav zgodilo, da se je število obolelih zvišalo, ker, kot sedaj vemo, je kolera v vodi. To je bolezen, ki se prenaša z vodo, ne preko zraka. Je ne vohamo in ne vdahnemo, v resnici jo zaužijemo.
And so one of the founding moments of public health in the 19th century effectively poisoned the water supply of London much more effectively than any modern day bioterrorist could have ever dreamed of doing. So this was the state of London in 1854, and in the middle of all this carnage and offensive conditions, and in the midst of all this scientific confusion about what was actually killing people, it was a very talented classic 19th century multi-disciplinarian named John Snow, who was a local doctor in Soho in London, who had been arguing for about four or five years that cholera was, in fact, a waterborne disease, and had basically convinced nobody of this. The public health authorities had largely ignored what he had to say. And he'd made the case in a number of papers and done a number of studies, but nothing had really stuck. And part of -- what's so interesting about this story to me is that in some ways, it's a great case study in how cultural change happens, how a good idea eventually comes to win out over much worse ideas. And Snow labored for a long time with this great insight that everybody ignored.
Tako so začetki javnega zdravja v 19. st. dejansko zastrupili pitno vodo v Londonu s takšnim uspehom, da lahko o tem kateri koli sodobni bioterorist samo sanja. Takšna je bila torej situacija v Londonu leta 1854 in sredi tega masakra in obupnih razmer in sredi te znanstvene zmede o vzroku smrtnosti ljudi je bil nadarjen multidisciplinaren znanstvenik 19. st. po imenu John Snow, sicer lokalni zdravnik v predelu Soho v Londonu, ki je že štiri ali pet let zagovarjal, da se kolera prenaša z vodo, o čemer ni uspel prepričati še nikogar. Snovalci politike javnega zdravja so preslišali njegove argumente. O tem je napisal veliko tehtnih člankov in izvedel precej raziskav, vendar ni šlo nič skozi. Del tega, zakaj mi je ta zgodba všeč, je, da na nek način predstavlja učni primer poteka kulturnih sprememb, kako dobra zamisel premaga precej slabše. Snow je dolgo garal s tem uvidom pred očmi, ki so ga drugi ignorirali.
And then on one day, August 28th of 1854, a young child, a five-month-old girl whose first name we don't know, we know her only as Baby Lewis, somehow contracted cholera, came down with cholera at 40 Broad Street. You can't really see it in this map, but this is the map that becomes the central focus in the second half of my book. It's in the middle of Soho, in this working class neighborhood, this little girl becomes sick and it turns out that the cesspool, that they still continue to have, despite the Nuisances Act, bordered on an extremely popular water pump, local watering hole that was well known for the best water in all of Soho, that all the residents from Soho and the surrounding neighborhoods would go to.
Nato pa se je nekega dne, in sicer 28. avgusta 1854, majhen otrok, petmesečna deklica, katere niti imena ne vemo, poznamo jo kot Lewisovega dojenčka, se je nekako okužila s kolero in zbolela za to boleznijo na naslovu Broad Street 40. Na tem zemljevidu se ne vidi, toda ta zemljevid postane osrednji fokus v drugi polovici moje knjige. Torej v Sohu, soseski delavskega razreda, to dekletce zboli in izkaže se, da greznica, ki jo še vedno imajo, navkljub "Zakonu o javnem redu", meji na izredno priljubljeno vodno črpalko. Lokalni vodnjak, ki je slovel po najboljši vodi v celotnem Sohu in h kateremu so hodili vsi prebivalci Soha in okoliških sosesk.
And so this little girl inadvertently ended up contaminating the water in this popular pump, and one of the most terrifying outbreaks in the history of England erupted about two or three days later. Literally, 10 percent of the neighborhood died in seven days, and much more would have died if people hadn't fled after the initial outbreak kicked in. So it was this incredibly terrifying event. You had these scenes of entire families dying over the course of 48 hours of cholera, alone in their one-room apartments, in their little flats. Just an extraordinary, terrifying scene. Snow lived near there, heard about the outbreak, and in this amazing act of courage went directly into the belly of the beast because he thought an outbreak that concentrated could actually potentially end up convincing people that, in fact, the real menace of cholera was in the water supply and not in the air. He suspected an outbreak that concentrated would probably involve a single point source. One single thing that everybody was going to because it didn't have the traditional slower path of infections that you might expect.
Tako je to dekletce nehote pomagalo kontaminirati vodo v tej črpalki in eden najbolj grozljivih izbruhov kolere v angleški zgodovini je sledil dva ali tri dni pozneje. Resnično, 10 odstotkov soseščine je umrlo v sedmih dneh in verjetno bi je še več, če ljudje ne bi zbežali po začetku izbruha. Dogodek je bil izredno grotesken. Predstavljajte si, kako v roku 48 ur od izbruha kolere umirajo celotne družine, sami v svojih garsonjerah, v svojih malih stanovanjih. Neverjetna, grozljiva slika. Snow, ki je stanoval v bližini, je slišal za izbruh, in pogumno odbrzel v epicenter izbruha, ker je ocenil, da bi lahko tako koncentriran izbruh morda ljudi vendarle prepričal, da je resnična nevarnost kolere v pitni vodi in ne v zraku. Domneval je, da bi tako koncentriran izbruh lahko imel eno samo točko izvora. En sam kraj, h kateremu so vsi hodili, ker ni prišlo do tipičnega počasnega načina okužbe. Odšel je torej naravnost tja in začel ljudi spraševati.
And so he went right in there and started interviewing people. He eventually enlisted the help of this amazing other figure, who's kind of the other protagonist of the book -- this guy, Henry Whitehead, who was a local minister, who was not at all a man of science, but was incredibly socially connected; he knew everybody in the neighborhood. And he managed to track down, Whitehead did, many of the cases of people who had drunk water from the pump, or who hadn't drunk water from the pump. And eventually Snow made a map of the outbreak. He found increasingly that people who drank from the pump were getting sick. People who hadn't drunk from the pump were not getting sick. And he thought about representing that as a kind of a table of statistics of people living in different neighborhoods, people who hadn't, you know, percentages of people who hadn't, but eventually he hit upon the idea that what he needed was something that you could see. Something that would take in a sense a higher-level view of all this activity that had been happening in the neighborhood.
Priskrbel si je tudi pomoč še ene izjemne osebnosti, nekako drugega protagonista knjige - Henryja Whiteheada, okoliškega duhovnika, sicer ne znanstvenika, vendar zelo socialno povezanega in je poznal vse v soseski. In ravno Whiteheadu je uspelo izslediti večino, ki so pili vodo iz črpalke, in tiste, ki tam niso pili. Tako je Snow naredil "zemljevid izbruha". Kazalo je, da so tisti, ki so tam pili, večinoma zboleli, tisti, ki pa niso pili, niso zboleli. Premišljeval je, da bi to predstavil kot nekakšno statistično preglednico prebivalcev različnih sosesk, ljudi, ki niso, oz. delež ljudi, ki niso, naposled pa se je domislil, da bi potreboval nekaj bolj očitnega. Nekaj, kar bi nazorno prikazalo dogajanje v soseski. Tako je ustvaril ta zemljevid,
And so he created this map, which basically ended up representing all the deaths in the neighborhoods as black bars at each address. And you can see in this map, the pump right at the center of it and you can see that one of the residences down the way had about 15 people dead. And the map is actually a little bit bigger. As you get further and further away from the pump, the deaths begin to grow less and less frequent. And so you can see this something poisonous emanating out of this pump that you could see in a glance. And so, with the help of this map, and with the help of more evangelizing that he did over the next few years and that Whitehead did, eventually, actually, the authorities slowly started to come around. It took much longer than sometimes we like to think in this story, but by 1866, when the next big cholera outbreak came to London, the authorities had been convinced -- in part because of this story, in part because of this map -- that in fact the water was the problem.
ki število smrti v soseski dejansko prikazuje kot črni stolpec na vsakem naslovu. Na zemljevidu lahko vidimo, da se črpalka nahaja v središču in da je hiša v neposredni bližini izgubila približno 15 stanovalcev. Ta zemljevid je v resnici nekoliko večji. Bolj ko se oddaljujete od črpalke, bolj se število smrti znižuje. Tako lahko vidimo, da se nekaj strupenega širi iz vodnjaka, že na prvi pogled. Tako so se s pomočjo tega zemljevida in nekaj prepričevanja, ki ga je izvajal v naslednjih letih skupaj z Whiteheadom, mestne oblasti na koncu dejansko spreobrnile. Sicer je trajalo dlje, kot bi si mi danes želeli predstavljati, toda do leta 1866, ko je v Londonu vnovič prišlo do velikega izbruha kolere, so bile mestne oblasti spreobrnjene - delno zaradi tega primera, delno zaradi tega zemljevida - da je bil izvor pravzaprav v vodi.
And they had already started building the sewers in London, and they immediately went to this outbreak and they told everybody to start boiling their water. And that was the last time that London has seen a cholera outbreak since. So, part of this story, I think -- well, it's a terrifying story, it's a very dark story and it's a story that continues on in many of the developing cities of the world. It's also a story really that is fundamentally optimistic, which is to say that it's possible to solve these problems if we listen to reason, if we listen to the kind of wisdom of these kinds of maps, if we listen to people like Snow and Whitehead, if we listen to the locals who understand what's going on in these kinds of situations. And what it ended up doing is making the idea of large-scale metropolitan living a sustainable one.
Gradnja kanalizacije v Londonu je že potekala in takoj so se lotili izbruha in ljudem rekli, naj vodo prekuhavajo. In to je bilo zadnjikrat, da je v Londonu prišlo do izbruha kolere. Tako mislim, da del te zgodbe - v bistvu je strašljiva, je zelo temačna zgodba in je zgodba, ki se še vedno dogaja v številnih mestih tretjega sveta. V resnici gre tudi za zgodbo, ki je v osnovi optimistična, ki kaže, da je mogoče rešiti te probleme, če sledimo razumu, če sledimo modrosti takšnih zemljevidov, če sledimo ljudem kot Snow in Whitehead in sledimo krajanom, ki razumejo, kaj se dogaja v takšnih primerih. Kar se je na koncu zgodilo, je ohranitev ideje velemestnega "urbanega načina življenja" kot vzdržnega.
When people were looking at 10 percent of their neighborhoods dying in the space of seven days, there was a widespread consensus that this couldn't go on, that people weren't meant to live in cities of 2.5 million people. But because of what Snow did, because of this map, because of the whole series of reforms that happened in the wake of this map, we now take for granted that cities have 10 million people, cities like this one are in fact sustainable things. We don't worry that New York City is going to collapse in on itself quite the way that, you know, Rome did, and be 10 percent of its size in 100 years or 200 years. And so that in a way is the ultimate legacy of this map. It's a map of deaths that ended up creating a whole new way of life, the life that we're enjoying here today. Thank you very much.
Ko so ljudje opazovali, kako desetina njihovih sosedov umira v roku sedmih dni, je obstajalo soglasje, da tako ne gre naprej, da ljudje niso bili ustvarjeni za življenje v mestih z 2,5 milijona ljudi. A zaradi Snowovih dejanj, zemljevida, zaradi vrste reform, ki so sledile zemljevidu, so nam danes samoumevna mesta tudi z 10 milijoni ljudi, mesta, kot je tudi to, so obstojna. Niti za sekundo nas ne skrbi, da bi New York propadel, kot je, vemo, razpadel stari Rim, in se zmanjšal na desetino velikosti v stoletju ali dveh. Na nek način je to glavna zapuščina tega zemljevida. Zemljevid smrti, ki je na koncu ustvaril nov način življenja, življenje, ki ga uživamo tudi mi danes tu. Najlepša hvala.