PUBLIC RECORD OFFICE
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Reference :-
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885
18 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH—NOT TO
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8. It is most important to consider, with regard to prevention, the width of the fly-ranges (infective areas) and the constant traffic with these from inland.
Also the
9. The most important and most practical preventive measures at the present time appear to be a combination of the clearing of and segregation from the infective areas, with or without deportation. segregation in fly-free country will favour the administration of any special treatment.
10. Our action in the Nile Province, the Nile itself not being a true inter- tribal boundary and there being constant migration from bank to bank, must depend on the result of our enquiries into the capacity of Glossina morsitans and G. pallidipes of carrying the infection and also on the action (if any) which may be taken by the Sudan and, especially, the Congo Free State Governments in the matter.
11. The natives of the Uganda Protectorate, by keeping their sick from the water-side, their dwellings outside the fly-range and their water sup- plies, fords, ferries, landing, markets, &c., cleared of undergrowth; placing them, wherever possible, in fly-free situations could, in all probability, themselves control the disease; and though it is not likely that the bulk of them will yet attempt it, it is possible that they may in the course of years gradually acquire a habit of using the defensive measures now proposed.
12. It is probable that sleeping sickness may remain endemic in certain parts of the Protectorate which will become localised as time goes on. Whether the lake-shore or Nile-bank regions will remain permanently dangerous to a population living in them will depend chiefly on the natives themselves.
13. It is most important that the duration of infection in the fly should be
determined.
14. In the Uganda Protectorate, although it may be impossible to eradicate sleeping sickness in a few endemic centres, I believe there is good ground for hope that the present epidemic may be so far controlled, over the greater part of its extent, that the disease, even though we fail to find effectual and practicable cure, may cease to be a menace to the population and a serious obstacle to the development of the country, and, further, that fresh outbreaks of anything like the dimensions of the present one should become almost impossible of recurrence in the future.
I have, &c.,
AUBREY D. P. HODGES, M.D. Lond., &c., &c.,
Medical Officer-in-Charge, Sleeping Sickness Extended Investigations,
Acting Senior Medical Officer, Uganda.
APPENDIX A.
HALF-YEARLY REPORT OF THE SLEEPING SICKNESS EXtended InvesTIGATION REPORT FOR JULY, 1906, BY DR. BAGSHAWE; WITH EXTRACT FROM REPORT BY DR. LOWSLEY.
Leaving Kiyagara camp on July 1st, I crossed the Mpanga to Kibira, followed the river to another camp and recrossed it on the 3rd. I passed through forest to Kinyema, where I joined the main road (Mbarara to Fort Portal).
up
I proceeded through the Kibile forest to Isunga, crossing and again examining the Durro River. This river is quite wrongly indicated on the map. It has evidently been confused with the Mpanga, the course of which at this part is marked some miles further west than it should be.
At Isunga a large crater lake was examined.
From Isunga I went to Butiti (Church Missionary Society station), to confer with Mr. Johnson on the epidemic of "Muhinyo" in the Saza of Chaka. He gave me valuable information as to the routes and affected villages. I went from there to Kikumu, on the Fort Portal-Entebbe Road, near the boundary of the Kingdom
of Uganda. Here the first cases of "muhinyo" were met with. I then turned south to Kyegayuki (near the deserted village of Kantuni) and thence to Karwenyu (? Kasingi of map), where six days were spent. The next camp was on the Katonga, at Izina, and the one following at Kasinga, from which place a small lake in the course of the Katonga was examined.
On the 29th. I crossed the Katonga, which rises north of Kitakwenda and not south-west as the map seems to indicate.
Search has been made everywhere for tsetse-fly, but none has been met with nor have any cases of sleeping-sickness been seen.
Between the bridge over the Mpanga carrying the Fort Portal to Mbarara road and that of the Entebbe-Fort Portal road, the river has been carefully examined in five places with a negative result.
The Katonga is a swamp river bordered by reeds and papyrus, it has been examined in this region in three places negatively.
As neither tsetse-fly nor sleeping sickness has been met with during this month the rest of my report will deal with "muhinyo." Apart from its intrinsic import- ance as a disease, leading to chronic disability and sometimes death, it is confused with sleeping sickness by the native and is liable to be so confused by the Europeans.
My movements for August are uncertain.
I have proposed to the Collector, Fort Portal, that I be supplied with hut-tax porters to clear the neighbourhood of the ford at the mouth of the Mpanga. Until I know how much clearing is required a given case I cannot give any estimate of the amount required in others.
I am waiting for a reply from him.
That finished, I propose to go to Lake Kafuru, examine the small lakes and rivers in the neighbourhood of Kazinga, ascertain by careful clinical observations and gland punctures whether both sleeping sickness and "muhinyo" exist there, or if I was in error in coming to the conclusion I reached after a short visit.
Should I find no sleeping sickness I shall return to Fort Portal and leave for the Semliki River.
I write from the eastern border of Kitakwenda, two days from the lake.
OBSERVATIONS ON MUHINYO.
The disease is known to the natives as muhinyo, less commonly as ruhinyo. A is the same disease as few call it mongota (sleeping sickness), in the belief that that existing on the Victoria Nyanza.
They recognize it readily: of those who said they had muhinyo there were few who had not characteristic symptoms.
The name may be connected with ruhinyo, a stretcher or bier, or Okwehinya, to wince (vide Lunyoro Grammar, Maddox).
Most of the victims use a stick to aid in locomotion, hence probably the notion that the name of the disease denotes " walking-with-a-stick."
Definition. It is a peripheral neuritis leading to weakness of the lower extremities and to a less extent of the upper. Most of the patients suffer from breathlessness with accelerated or irritable heart, and many have dropsy.
History.I am communicating with the Collector, Fort Portal, whom I have asked to obtain from the King and the Saza chief (now at Fort Portal) information as to the origin of the disease. The natives affected could tell me little. There for two years. was an idea that it came from Entebbe. They said they had known
Distribution in Toro.-The villages chiefly affected in Toro are in the saza of As the disease Chaka, and lie on either side of a road from Mbarara to Kakumiro. was first reported from Ankoli it seems not unlikely that it has extended along this road, which is much used.
In the group of villages called Karwenyu and Izina, there were a large number of persons affected. At Kikumu, Kyegayuki, and Kasinga a few (vide sketch map).