changing in many places, but not as easily as he would hope. ‘It’s
frustratingly slow,’ he said.
O in public health is convincing
people. It’s not just a matter of showing a new approach works better
than existing methods. It’s also about advocating for that approach,
presenting a compelling argument that can help turn statistical
evidence into action.
In the world of public health advocacy, few have been as effective
- or as pioneering – as Florence Nightingale. While John Snow was
analysing cholera in Soho, Nightingale was surveying the illnesses
faced by British troops fighting in the Crimean war. Nightingale had
arrived in late 1854 to lead a team of nurses in the military hospitals.
She found that soldiers were dying at an astonishing rate. It wasn’t
just the fighting that was killing them; it was infections like cholera,
typhoid, typhus and dysentery. In fact, infections were the main
source of death. During 1854, eight times more soldiers died from
diseases than from battle wounds.[32]
Nightingale was convinced poor hygiene was to blame. Each night,
she walked over six kilometres along the corridors of the wards, lamp
in hand. Patients lay on filthy mattresses, rats hiding beneath,
surrounded by walls covered in dirt. ‘The clothes of those men were
swarming with lice,’ Nightingale noted, ‘as thick as the letters on a
page of print.’ With her nurses, she set about cleaning up the wards.
They made sure linens were laundered, bodies bathed, and walls
washed. In March 1855, the British government sent a group of
commissioners to the Crimea to tackle conditions in the hospitals.
Whereas Nightingale had focused on hygiene, the commission
worked on the buildings, improving ventilation and sewage systems.
Nightingale’s work earned her fame back at home. Shortly after
returning to England in summer 1856, Queen Victoria invited her to
come to Balmoral to discuss her experiences in the Crimea.
Nightingale used the meeting to push for a Royal Commission to
examine the high death rates. What had really happened out there?
As well as contributing to the commission, Nightingale continued
with her own research into the hospital data. This work accelerated