August 26, 1897.]
CHINA OVERLAND TRADE REPORT.
the ship, but he does not put the questions which are put at home with reference to the existence infectious diseases on board. Part 2 of the regulations says that the officer of the Customs shall, ou the arrival of any ship from a foreign port, visit the ship and ascertain as far as possible whether such ship is infected. The question he puts is: "Has any case or suspected case of cholera, yellow fever, or plague occurred during the voyage?" An answer is given and if such a case has occurred it is the duty of the Customs officer to order the ship to be moored in a certain spot, which here would be the quarantine anchorage, and he has to acquaint the Medical Officer of Health, who visits the ship and proceeds in the usual manner by isolating the sick, disinfecting the ship, and following out the proceduro re- commended in these regulations. That is what is practically carried out here, the difference being this. The boarding officer visits every ship that arrives in this colony. He enquir for particulars wished for at the Harbour Mas- ter's office and also ascertains if there are any cases of infectious diseases on board and if there are he orders the ship into the quaran. tine anchorage, But he does not report
to the
Medical Officer of Health. The Chamber of Commerce admitted in a letter which they have written in connection with this subject the desirability of the medical inspection of vessels from infected ports. That is already done here. Why there should be any hesitation by the Government in declaring a port infected when there is definite knowledge of the prevalence of a disease at snch and such a place I cannot understand. A port must of necessity be proclaimed by the Government; medical inspection of all shipping from that port necessarily follows Theoretically, the medical inspection of all ships is perhaps a desideratum in that it may prevent the impor
tation of a few cases of infectious disease. T say "few
because during the ten years experience I have had here I do not think there have been more than twelve cases in any one year that have come to the hospital direct from ships entering the harbonr. I have ben through the records and I do not think there have been more than twelve. Theoretically, I say, the medical inspection of all ships is to be desired, but is the necessary interference to trade which would follow so small as to make the inspection justifiable? There is also the matter of
Har- expense. The
undoubtedly because of the old clothes that are kept in these shops that some of the I consider infections germs are in our midst. that the present system of inspecting ships is well adapted for local requirements; an improvement undoubtedly would be for the Government to appoint Dr. Jordan's assistant his deputy so that there need be no delay in the signing of bills of health, inspection of ships, and the examination of emigrants proceeding to Singapore and America. With regard to the Venice Commission I think we may recom mend the Government to adhere generally to the convention, but we cannot do so in its en- tirety ns surveillanco is practically impossible in this colony. To subject passengers and crews of infected ships to a period of teu days' observation means that some quarantine station similar to that at Singapore for the honsing of housands of persons would be necessary, as there may be three or four ships arriving from infected ports in our immediate vicinity. I am informed there is no place near the colony where such a station could be erected. With regard to surveillance, I do not see how it can be carried out where two or three thousand passengers are arriving daily, presuming that we had plague at Canton.
When
I do not see how so many passengers as come from there could be inspected and for each one to find a surety, as the Medical Officer suggested, that they would remain at a certain address for a given time. do not see how such numbers could be supervised. So that I think surveillance is practically impossible in this colony. With regard to infected ships-by that I mean ships arriving with disease on board, say with plague on board-we should have to deal with each one individually, not having any quarantine station where passengers could be kept during the in- cubation period of the disease, whatever it might be. I thought it better to place these views before yon, but of course I shall be very pleased to hear any member if he has anything
bour Master states that it would be neces- sary to have two receiving stations, one at either end of the harbour. Each receiving station would require a staff to maintain it, and I certainly think, taking into consideration the number of passengers that daily arrive here, the number of crews that daily arrive, and the number of emigrants that daily leave, that at least three medical officers would be required to carry on this if it is intended that all ships shall be examined on arrival. If three medical officers are required three steam launches would be re- quired. I say three because there would have to be one at either station and there would also have to be another to examine emigrants on board the ships. But still, I do not know that we need consider the expense, which is a matter for the Government to decide upon. medical inspection of all shipping was enforced here, namely, during the plague epidemie of 1894, all junks and eren river boats were examined by four or fire doctors, and I am informed that not one case of plague was detected on board the ships or juuks. Chinamen are not likely to travel when they are ill and I supposo that is why no cases were found. Smallpox and plague are practic- ally the only cases we have to consider. Small- pox occurs every winter and I take it we shall be more or less liable to plague in years to come. as the disease is evidently in the place and cannot be relegated by improved sanitation for some years. Cleanliness must bepromoted, overcrowding prevented, and other sanitary measures adopted so that there will be no opportunity for the germs to grow. Talk- ing of smallpox, I would mention here the desirability of urging upon Gorern- ment to order the periodical disinfection of the clothing in pawnbrokers' shops. The attention of the Government has been drawn to this question more than once, and it is
the
to say.
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165
year direct from the shipping to the hospital is, I think, in favour of the idea that the cases get ashore before the Medical Officer gets on board. My statistics show that last year more than fifty per cent. of the cases of infections diseases occurring in this colony (ex- clusive of plague cases) wero imported, although it is perfectly true that not all of them had disease when they arrived developed the here. With regard to your remarks about the plague in 1894 the explanation is that the Medical Officer who boarded the juuks did not ferrat out the nooks and corners, whereas my suggestion is that each medical officer should have an interpreter so that while the medical officer is inspecting the people on the deck the interpreter shall be below looking around to see if there are any sick people hidden there.
The MEDICAL OFFICER OF HEALTH-Mr. President, I am in rather an unfortunate posi- tion in that I am the only member of the Board present now who happened to have been present on the 8th April last, when the resolution was passed in regard to quarantine regulations; but I can assure the Board that there was no misunder- standing with regard to the regulations of the Local Government Board. I think the mem- bers of this Board know that I have had much experience at a port at home during the cholera epidemic at Hamburg in 1892 and 1893, and I know exactly what was done then and what are the general regulations in regard to the They are arrival of ships from foreign. that no vessel can communicate wthi the shore unless it has first been boarded by a toms officer. You say that a boarding officer corresponds with the Customs officer at home. I say he does not. because the boarding officer does not board each vessel before she communi- cates with the shore, and therefore if we are to rely on the boarding officer in future he must pay his visit before the ship communicates with the shore. That would be an admirable system, but I do not think it would be so admirable as having three medical officers to do this work.
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As you have moved no resolution on the question of the medical inspection of vessels— for I take it there are two distinct questions before us-1 heg to move-"That the report of the Health Officer of the Port, together with the minutes of members, be forwarded to the Colonial Secretary for the information of His That resolution Excellency the Governor." does not pledge the Board to any decision what- On the 8th April last the Board passed a resolution in reference to quarantine regu lations. The resolution was proposed by the President. seconded by the only unofficial mem- ber of the Board, Mr. Ede, and supported by the Colon al Surgeon, so that presumably there
ever.
was son!
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reason for such a resolution, and sooner than interfere with it I move the resolution I have just read ont. Then in regard to the Venice Convention, you say you think this Government may adopt the convention, but that they cannot adopt it in regard to the surveillance or observation. In that case I do not see how the Government can adopt the convention when the convention clearly lays down that certain things for surveillance and observation shall be carried out. It seems to me deplorable that the sanitary authority of an enlightened British colony should confess their inability to subscribe to a sanitary convention recommended by our own Government and adopted by every one of the European powers eighteen in all-some of whoin are certainly not so enlightened in It should be sanitary matters as ourselves. remembered that that convention applies solely to plagne and it recommends that persons arriving from plague infected ports should be one of two systems --- either subjected to
lazaretto for ten detention in a boat or days, including the length of the roy. age, or surveillance, which means that the persons may proceed to their destination but will be followed there and a general supervision Cus-exercised over their movements. Great Britain has wisely decided to adopt the system of surveillance as it does not interfere with ship- ping and practically protects the country from Each of the countries an outbreak of plague. subscribing to the convention may impose certain additional restrictions and in such a colony as this, surrounded as we are by Asiaties, I have thought that an additional restriction in the way of guarantee would be of great advantage as the sanitary authorities will then be acquainted with their moyements for a period of ten days. I think, sir, that the result of such a regulation as that would be that, instead of having, as the Health Officer of the Port tells us, bundreds of destitute' coolies arriving in the
from plague-infected ports, colony should have a few respectable Chinese, and those resible Chinese could be supervised. If we only look a: the alternative we can see the advantage of this system. The alternative, which I am in favour of if anything better is not adop, is the total prohibition of immigra. tion fro. plague-infected ports. The Captain Superintendent of Police is a strong advocate of such a prohibition and he will doubtless support
The CAPTAIN SUPERINTENDENT of POLICE The police board the ships. The MEDICAL OFFICER OF HEALTH-What information do they get?
cases.
The CAPTAIN SUPERINTE..ENT OF POLICE -They could get information.
The MEDICAL OFFICER OF HEALTH-If
can be done it
fresh that
opens ont a way of preventing the ships bringing infec- tions cases into this port and landing those With regard to the question of the re- luctance of the Government to declare a port infected, there is no doubt that reluctance does exist. A short time ago the Board asked the Government to declare Amy an infected port and the Government regreted they were unable Whatever the explanation may be to do so. the fact remains that the Government are not inclined to declare ports iufeted aud so neces- sitate the medical examination of ships from such ports before they communicate with the shore. I could give you other instances, but Amoy is the most recent one. that not more than a dozen cases of infections disease were admitted during the course of one
Your statement
We
me in this if the other fails. It is a matter for the shipping firms to decide whether they prefer to prevent all communication with infected ports or to allow...e to come here who are prepared to furbis the necessary guarantee. I submit that if we demand this guarantee we shall have in the place of hundreds of destitute coolies, a over those few respectable Chinese, and
I can exercise sufficient surveillance.
We
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