Abstract

A year ago there was a major crisis about the water supply in Walkerton, a small Ontario town in a farming area near Georgian Bay. In May 2000, there was a sudden outbreak of bloody diarrhea that affected up to half the town population of 5,000, sent almost 900 people to get medical attention, hospitalized almost 100 of them and killed at least seven people. It was shown that Escherichia coli 0157:H7 (E. coli) contaminated the water supply and that a "boil water" directive was sent to the town's population only after people had become ill. There was a public outcry and a series of government responses, including a public inquiry into the circumstances surrounding these events.

In this brief account we suggest that many features of this case can be characterized in terms of complex adaptive systems. Such systems are increasingly being used as a way of understanding the nature of health, health systems and the development of health policy. (See our recent report Towards a New Perspective on Health Policy, which can be downloaded from our site: http://www.healthandeverything.org.) There is not enough space here to provide a full account of such systems. Instead, we will use the Walkerton case as an example to illustrate some of their features.

 

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    Healthcare Quarterly, 4(4) June 2001

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