SANITATION AT DAYTON
[The widespread flood disaster in Ohio during the last week of March led members of the Pittsburgh Flood Commission to study the situation. Morris Knowles, a member of the Engineering Committee of this commission, has had two assistants in the field for this purpose. One of these, M. R. Scharff, who had previously been employed by Mr. Knowles in making a sanitary survey of the coal-mining camps in Alabama, paid particular attention to the sanitary conditions resulting from the flood. The present article embodies observations made on this trip.—Ed.]
Following in the wake of great disasters which descend from time to time upon our cities, paralyzing the public services that make crowded city conditions possible, is the outcropping of disease that may, if unchecked, prove more disastrous even than the catastrophe itself. This tendency was discernible in the first reports of the floods that have recently devastated Ohio, Indiana and adjoining states, due to the heavy rains of March 24–28. Nearly every flooded city reported that its water works plant had been put out of commission, or the water supply polluted, which with the increased chance of infection, and the general lowering of vitality presented a situation of unusual menace and one demanding complete and immediate handling.
The most serious situation is Dayton, for here every sanitary problem presented at any other point was involved. The complete, immediate and effective organization to handle the situation which was formed there was typical of the effective work now done at such emergency periods.
At Dayton the water works plant was incapacitated by water that reached ten feet above the boiler grates; there was unknown damage to water distribution and sanitary sewerage and drainage systems; storm sewers and catch basins were clogged with filth and debris; dead animals were strewn on every side; the population was at high nervous tension, their vitality lowered by shock, exposure, cold, and lack of food and drink; hundreds of people were crowded for days in single buildings or dwellings; thousands, probably, had been exposed to intestinal infection by drinking the dirty flood water as it swirled through the streets; hundreds had only wet cellars and rooms to return to, if their homes were not altogether destroyed; and everywhere on everything—walls, ceilings, floors, furniture, streets and sidewalks—was a thick coating of the black, sticky, slimy mud left by the retreating waters. This in a measure pictures the situation at Dayton as the flood waters receded. And Dayton knew at once that the toll of the flood would be as nothing compared to the pestilence, unless attention and energy were directed to these problems.
This appreciation of the paramount importance of sanitation was a striking revelation of the success of the campaign of sanitary education that has characterized the last century. In every phase of the work of recovery, in the warning signs and directions on almost every post, in the placards on the automobiles of the sanitary department stating that “This car must not be stopped or delayed day or night,” in the daily exhortations in the free newspapers distributed throughout the city, in a thousand ways, Dayton declared again and again:
“Sanitation first and foremost. Then everything else.”
Such was the spirit of the members of the Dayton Bicycle Club, when they met as the waters receded from their club-house to consider what service they could best render to their stricken city, and volunteered to remove the dead animals strewn it the streets. Such also was the message reiterated by the Ohio State Board of Health, the city health officials, the representatives of the national government, the Red Cross, the Relief Committee, the Ohio National Guard, and every one of the splendid organizations that are working shoulder to shoulder to clean up Dayton and to prevent conditions more costly in toll of life than the deluge itself.
One of the remarkable features of the handling of the relief work at Dayton was the entire absence of red tape, the lack of conflict, and the universal evidence of harmonious co-operation between the various organizations at work, notwithstanding that there was no complete centralization of direction and that some of the organizations were proceeding practically independent of the others. “Results, not credit,” was the watchword, and the results were such as to reflect the most lasting credit upon all engaged in the work.
The Dayton Bicycle Club showed wisdom in volunteering to remove the dead animals from the street. Nearly every horse in the more than seven square miles of the city that was under water—and this area contained all the important livery stables—was drowned, and quick action was needed to remove the bodies to prevent serious results. A sanitary department was organized, and as rapidly as automobile trucks and wagons were volunteered, they were pressed into service. Over 100 vehicles and about 600 men were engaged on this work. A rendering company, which handles all the garbage collected in the city, agreed to take care of the horses and did so as fast as they came for a time. When the carcasses came so rapidly that it was necessary to heap them up on the grounds of the plant, and then on a vacant field nearby, the plant was a grewsome place indeed. Up to the night of March 31, 1,002 had been received. A number were picked up the next two days, so that the final total was probably in the neighborhood of 1,100.
At about the time this work was started, a reconstruction department was organized, under the Citizens Relief Committee, with divisions, each under an engineer, assigned to street cleaning, sewers and drains, streets, and levees. By March 31, the removal of dead animals had been practically completed, and the organization and equipment of the sanitary department were merged with those of the street cleaning division of the reconstruction department. Sanitary notices directed that all mud and rubbish be deposited at the curb, the city was divided into districts and collection progressed rapidly, considering the wagons and trucks available. More wagons could have been put into service, but horses were lacking. All mud and rubbish was hauled to one of the half-dozen city rubbish dumps located in low outlying sections, or was dumped off bridges into the river. The employes of the city water works department were able to get into the pumping station on March 28 and the following day pumping was resumed. Dayton’s water supply comes from a number of deep drilled wells along the Mad River. It is pumped direct into the mains without storage, by means of a Holly vertical, triple-expansion, crank and fly-wheel engine. This pump has given rise to the local name of “Hollywater” applied to the city supply. It was feared at first that the distribution system had been badly damaged, but investigation showed that only three small mains had been broken. Water, at reduced pressure, was therefore possible, except in one or two small sections.
AN IMPROVISED COMFORT STATION
Dayton water is exceptionally pure, but it was feared that there might have been leakage of flood water into the pipes while the pressure was cut off and so notices to “boil all water, even the Hollywater” were posted. Samples were promptly taken for analysis from various portions of the distribution system by the chemist of the National Cash Register Company, the bacteriologist of the city Board of Health, and by the State Board of Health, but the injunction to boil water was continued, even though the first analysis was favorable.
The catch basins and storm sewers throughout the city were badly clogged with wreckage and filth, and early cleaning was imperative. The city was divided into seven drainage districts, and gangs of men and wagons assigned to shoveling out catch basins and hauling the rubbish to the dumps. At the same time systematic inspection of the sanitary sewerage system was begun. It had been expected that the sewers would be clogged, like the storm drains, and the early sanitary notices issued contained these warnings:
IMPORTANT
Sanitary Notice
FOR YOUR OWN HEALTH
(1.) Do not use Sanitary sewers and Closets until notified by the Board of Health. Even if the hollywater system is on, the sewers are full of mud and will clog. Burn or bury all excreta garbage and filth. Add lime and bury deep. Use disinfectant in out-door trenches also.
(2.) Thoroughly scrub, clean and dry your cellar. Keep your cellar windows open. Remove and burn or bury all rubbish. Sprinkle lime around cellar, especially in damp places. Sprinkle floor with disinfectant sent herewith (two tablespoons-full to one quart of water.)
(3.) Thoroughly clean your in and out door premises.
(4.) Place concentrated lye or a tablespoon of disinfectant in each sink or trap in toilet, basement and kitchen. Allow to stand over night. Do this every evening.
(5.) Boil all water, even holly water, and thoroughly cook all food. Boil all cooking utensils. Do this for months to come.
(6.) Do not enter houses which have been flooded until thoroughly cleaned and dried.
(7.) Keep your own self clean.
Do these things to avoid pestilence and sickness.
Do it for yourself.
Do it for Dayton.
Take care of yourself and you will take care of Dayton.
Maj. L. T. Rhoades,
U. S. Army.
ONE OF THE EARLY NOTICES
“Do not use water closets. Contents will reach cellars. Use vessels, disinfect, and bury in back-yards. Disinfectants: carbolic acid, chloride of lime, bichloride of mercury, and creolin.”
“Do not use sanitary sewers and closets until notified by the Board of Health. Even if the “Hollywater” system is on, the sewers are full of mud and will clog. Burn or bury all excreta, garbage and filth. Add lime and bury deep. Use disinfectant in out-door trenches also.”
Inspection showed a much better condition than was anticipated. In all but three districts, the sanitary sewers were running freely and the warnings were replaced by new notices:
“Sewers are open and ready for use. If the water supply is not sufficient for flushing, fill the tank of the closet with a bucketful of water, and flush as usual.”
Wooden public convenience stations were also established over sewer manholes in the business sections and in residential sections without sewer connections.
The three sewer districts that were out of commission were the St. Francis, the North Dayton, and the Riverdale low line. The St. Francis sewer is a gravity line, and a manhole at the lower end was completely choked up. It was necessary finally to dynamite this manhole in order to open the line. The two latter lines are both low, and sewage has to be pumped into the river by pneumatic ejectors. The air lines from the compressor plant in the water works pumping station were laid in the levees which were washed out and at one point about 200 feet of pipe was lost. This was difficult to repair, and these districts had to be left without sewerage until April 2, when a by-pass on each line into the storm drains was opened, and the backed-up sewage lowered sufficiently to clear most of the cellars and to permit the use of water closets.
While this work was proceeding the organizations devoting their energies to control of infectious disease, inspection, and administration had been far from idle. The State Board of Health had three sanitary engineers and two physicians, trained in public health work, in the city before the waters receded. The city Board of Health was one of the first in the field, and the medical corps of the Ohio National Guard promptly took up the work. Co-operating with one another, under the direction of Major L. T. Rhoades of the United States medical corps, who was appointed chief sanitary officer, and with the assistance of local doctors and nurses and those furnished by the Red Cross, these organizations soon established control of the entire city in a comprehensive and effective manner.
The Ohio State Board of Health engineers were assigned to assist in the water works, sewerage, and general cleaning up. Then, in co-operation with the city board and Major Rhoades, the city was divided into sixteen sanitary districts, with a physician in charge of each. These physicians inspected their districts, reported to headquarters, conditions requiring particular attention, instructed people in sanitation and followed up all reported cases of illness to guard against contagion.
The city bacteriologist reestablished his laboratory, which had been inundated, and took up diagnostic and analytical work. The state plumbing inspector and the state inspector of workshops and factories established offices, and joined with the city inspectors in pushing inspection work rapidly. Men were sent out to trace all contagious cases that were on the books at the time of the floods, and the reporting of infectious diseases and deaths were resumed as rapidly as possible.
Four contagious disease wards were established in addition to the tuberculosis and small-pox hospitals, two in the St. Elizabeth and Miami Valley Hospitals in the city and one each in North Dayton and Riverdale. As fast as infectious cases were reported or discovered, they were removed to one of these wards, and the houses placarded and disinfected.
A food inspection office was also opened, and all food arriving on relief cars was inspected before distribution to relief stations, that which had already been distributed being inspected at the stations.
The medical corps of the Ohio National Guard established a base field hospital in the new courthouse, and a supply depot in the probate court room of the old courthouse. In addition, seven relief hospitals were established in Dayton View, Miami City, Edgemont, South Park, the Davis Sewing Machine Company’s plant, North Dayton, and Riverdale, with a surgeon of the medical corps of the National Guard and a corps of civilian physicians and Red Cross nurses in charge of each. These stations had maternity, general, and infectious wards. Hospital and proved infectious cases were promptly forwarded to St. Elizabeth’s or the Miami Valley Hospital. The base hospital received all cases among the companies of the National Guard on duty; those which would obviously not recover in time for useful service were returned to their homes. The supply depot of the field hospital not only furnished the base hospital and the seven field stations, but supplies were also furnished to the sixteen stations of the sanitary committee, at the request of Major Rhoades.
An efficiently manned hospital doing all classes of work was established by the National Cash Register Company and the American Red Cross in the administration building at the National Cash Register Company’s plant, and other medical relief stations were maintained in the city by the Red Cross.
Up to the close of the first week following the flood no unusual prevalence of infectious disease had developed. Some cases of diphtheria, pneumonia, and measles were reported, but the number was not substantially larger than that previous to the flood. When the conditions that prevailed during the first three days after the disaster are considered, with the strain on the entire population during the first days of reconstruction, it seems impossible that Dayton will escape without a considerable number of cases of intestinal and exposure diseases, such as typhoid and pneumonia. But the complete, efficient, and harmonious system of public health organization that has been established gives promise that no epidemic will follow and that the first cases, due to infection before control was established, will be the last.