OUOTE . . . The package i s delivered as a unit to the village, where it i s installed b y local personnel. following illustrations and step-by-step directions in t h e installation manual. An operation and maintenance nianual i s also provided, ap‘iin highly simplified, to permit perwnnel of limited technical training t o operate. maintain. and repair the system. Sewage disposal The remainder of the Alliance for Progress decade w i l l stress the r u r a l ;ireas and sewage disposal. Whereas water supply has been approached o n ;I national basis, sewage disposal has been case by case. P A H O plans to keep the mnnagenient and financing of water supplies and sewage disposal in one org:inizntion. According to Hollis, “We Mant to avoid the two organization .;ysteni that developed in the U S . In thc 1930‘s, water bonds had no trouble getting popular support, but as many :I\ hall‘ the sewage treatment bonds were turned down. Water in and h e n e r s out should be considered a p ;IC k age.” These figures give the scope of the job still to be done: 53% of the urban population lives in houses connected to ii sewage system. Only Uruguay has reached the charter goal of 7 0 % . Only five countries exceed the 53% average l o r a11 I.atin America. Very little headway has been made on the rural population. Here again, s a ! s Hollis. “We may have to come up \\ith some new approaches to reach the m a l l rural communities. But with the momentum :he water program has given to these communities. plus the organizational strueturcs established, u e may rtill see substantial progress on the rural sewage problem.“ “And when these traditional sanitation problems are under Setter control, WL\ will be faced-and. of course, we ;ire to a degree even now-with the urbanization and industrialization prohlenis already plaguing the U.S. and other iiiorc developed countries.”
ENGINEERING FOR HUMAN FULFILLMENT Clearly our first target in dealing with man’s environment is to free as possible of specific hazards. I am not make it safe-as suggesting that we try to create a world totally free of risk. That would be not only impossible of achievement but very possibly detrimental to man’s long-range growth. Rather, I am suggesting that no man or population group should be compelled to expose themselves to preventable risk of disease or disability, as a condition of employment or as a condition of urban living. This is a fair goal. It is also a minimal goal. Yet we don’t have t o look very far to discover that we are a long way from achieving this minimum. The air over our cities is filled with substances known to be dangerous. Thousands of workers in dozens of industries place their health in jeopardy when they punch the clock i n the morning. Through the water we drink, the food we eat, and the air we breathe, we are ingesting minute quantities of substances from arsenic to zirconium, day by day, throughout a lifetime. No one can yet say with any certainty what the cumulative effect may be. Meanwhile we already know how to remove a great many of these substances from our surroundings. What is lacking is the firm social decision to do it. This decision will not be made by professionals; it belongs to society at large. One way by which professionals can affect the decision is to enlarge the concept of health. It is out-of-date to think of health solely in negative terms-as the absence of disease and disability. The healthy individual is not merely unsick. He is strong, aware of his powers, and eager to use them. Therefore, in our approach to the environment we need to be conscious of sanity as well as sanitation. We should be as concerned with ugliness and loneliness as we are with carcinogens. The truly healthful environment is not merely safe but stimulating. This is a much higher goal than mere freedom from definable hazard. But by shooting for it we shall, I think, rally t o our banner many people for whom the negative objective is not worth the effort. It seems to me that we urgently need a major effort in what might be termed “engineering for consumption.” Consider, for example, the problem of solid wastes which is plaguing every city and blighting much of our countryside. Every day our urban communities produce 800 million pounds of solid wastes. Every yesr we spend upwards of $3 billion to collect and dispose of this accumulation. There is no limit in sight, either to the production of wastes or to the cost of getting rid of them. Yet the basic technologies for waste collection and disposal have remained relatively unchanged during a quarter-century in which the size of the problem and its visibility have magnified enormously. The same old methods are still in use-incineration, landfill, composting, salvage, and reclamation. They have been studied here and there, refined in certain ways. Occasionally they are put to imaginative use. But if there has been a real advance, it is much better hidden than the refuse.
Dr. William H. Stewart Surgeon General, Public Health Service.
U.S. Department of Health, Education, and Welfare, at the Third Annual Meeting of the National Academy of Engineering. Ann Arbor, Mich., Sept. 21. 1967.
Volume 2, Number 1 , January 1968
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