Most of the houses built are back-to-back housing and they are built to pack in as many people as possible and as cheaply as possible. Most back-to-backs were built as courts, with housing surrounding a central courtyard on three sides, with single access to the main street. The entrance to the court is often very narrow and they are very dark with little sunlight, damp with poor ventilation and incredibly smelly. With demand for housing so high, houses were built on any plot of land which a builder or landlord could buy. There are no gardens and each street has a privy at the end of it. This is causing great sanitation problems as the men whose job it was to clean out the privies very often never did and thus, this is causing our people to have terrible and fatal illnesses such as cholera and tuberculosis. Someone should at least be appointed to watch over the sanitation men and make sure they do their job because during the year, the privies flood and the poor people who live in the cellars of the back-to-back terrace cul-de-sacs have sewage and disgusting water flow into their houses. In some cities builders build tenements of six or seven stories.
Bad housing poses many threats to the health of our people. The houses are very damp and infested with mould. Floors are boards over flagstones laid on bare earth. Roofs often have no slates so rain ran into the houses. The houses were also very close together which meant it was hard for air to circulate. Windows, if they are not boarded up to avoid the Window Tax, are kept shut to keep out the smell of refuse outside. Damp and poor ventilation caused many chest infections. Also, if food were stored more hygienically then maybe it would not be so easily infected. Very few houses have piped water; poor people get their water from rivers or streams or from rainwater or wells. This water is often polluted and should not be drunk because it carries many fatal diseases. Water companies supply most people. They pump water to stand-pipes set up in the streets or in the courts. This is also a sanitation danger because when the privies flood, does it flow into the cellars of the houses, it flows into the taps in the courts, which people drink from and this again can cause very many diseases. Even then, sometimes the water is only sometimes available for two hours a day, so when water does come there is a scramble to fill as many buckets, cans or jars possible. Disease spread quickly as families of more than four are crammed into one or two rooms. They share beds or have none at all and despite these conditions they take lodgers in to help pay their rent. And with water in short supply, washing (clothes or bodies) is rarely done and so diseases are carried by body lice or by bacteria’s on bodies or in dirty clothing. As well as that, there is no proper system for collecting rubbish and refuse could also spread many infections.
The air in towns and cities is becoming increasingly dense due to air pollution. They attract horse-drawn traffic and as a result the streets are filled with horse manure. Thousands of chimneys of forges, workshops, factories and domestic fires belch out smoke all day every day. When there is no breeze, the smog will settle and choke those with weak chests.
These problems combined to produce a health disaster. Disease is now associated with living in towns although many diseases have been present since the Middle Ages. Overcrowding and poor sanitation made the disease even more of a problem.