PUBLIC RECORD OFFICE
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Reference -
C.O.88
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
18 PUBLIC RECORD OFFICE, LONDON
62
LOCAL LABOUR used at Entebbe Station, imported from (1) Lake-shore counties; (2) Inland counties; and (3) Inland provinces.
(1)
Buvuma
1901.
1902.
1903.
1901.
1903.
Total.
Yearly Average Labour.
Deaths from Sleeping Sick- ness in 1903. Chiefs'
Ratio of Deaths to Yearly
Average
|
1
T
Returns."
Labour,
35
Per cent.
2,580
Sesse
761
847 1,500
723
356
4,187
837
918
109
Bu-iro
2,680
4,751
5,406 1,164 1,486
18,487
3,697
1,427
38
Mawakota...
791
Buddu
**
2,708 1,470 1,239 3,406 2,391 4,067 2,921 3,129
894
7,105
1,421
395
27
15,014
3,183
368
11
452
837
1,911 1,847 1,498
6,5 15
1,329
412
31
593
2,081
1,895 3,238
2,709
10,516
2,103
1,622
77
62,754
12,551
5,142
40
:
Kiadondo...
Chagwe
Bugerere
Batambala
Buyara
Bwekula
***
リ
ལྕཊྛ །
-
-
7221
63
I have said above that, in consequence of the free and constant traffic with the lake-shore, it is impossible to say, in the case of a labourer coming from any lake-shore county, that he has not already been exposed many times to risks of infection. It is also impossible to eliminate these chances in the case of persons from the most inland districts, though they are less at greater distances from the We will lake and where, at the corresponding coast, the epidemic is less severe. suppose then, for the sake of argument, though it is a most unwarranted supposi tion, that, in the case of the inland provinces and counties, the visit of the labourers supplied by them to Entebbe was their first visit to an infected area, and their first and only chance of exposure to infection. If this were so, and I think it approaches absurdity to suppose it in the majority of instances, then the deaths given in the above table would represent the extent to which sleeping sickness has been con- tracted at Entebbe by these labourers and carried inland.* But, even on this supposition, the proportion is on the whole and in most cases very small, and there is no evidence of any considerable number of cases of this invariably fatal disease having originated in this way.
I believe, however, that these deaths really represent the prevalence of the disease or the death-rate among a very much larger number of people, namely, the total population of each county or province, and that the true percentages are not those in the table but smaller in the ratio of the number of the population to the number of imported labourers.
One thing at any rate is quite obvious, viz., that there is no direct relation between the number of deaths and the number of labourers supplied.
Take, for instance, Butambala, a so-called inland county a great part of which is only about 15 miles from the lake-shore. Here we find that 48 deaths occurred in 1905, and that 7,664 labourers have been supplied, a yearly average of 1,533 labourers, to which 48 deaths stand in the relation of 3.1 per cent. In Bugerere, where we have on one side the Victoria Nile with fly, and also the highly-infected Usoga (though not much traffic), we get a percentage of 5.2. In Buyaga, which supplied no labour, nine deaths are returned, which is about the average number for counties at a like distance from the lake. In Kabula we have a similar distance and a similar number of deaths, but, since it has supplied only a few labourers, we can calculate a death-rate as high as 30 per cent. Mawagola is in the same case, but Buganadzi, having an even smaller death return, and having supplied a very large proportion of labour, gives a death-rate, on the supposition we made above, of only 1.4 in 1,000. In Unyoro there exists the Lake Albert epidemic, of which we have, as yet, no exact returns, but in Ankolé and Toro, in spite of the labour supplied, there is no evidence of sleeping sickness, those cases and centres which have been rumoured to exist having turned out to be in reality beri-beri.
Map No. IV. has been prepared specially to assist in demonstrating the spread of the epidemic; the relation of hinterland to coast in the distance of its penetra- tion inland; and the proportion of its prevalence in the hinterland to the intensity of infection at the corresponding or nearest coast line. The same map will also be found to illustrate Appendix F. Map No. V shows fly distribution, fly-free areas, &c., &c., on the Entebbe Peninsula.
A. D. P. HODGES.
Total
(2)
417
591
1,003
290
58
2,359
472
25
5-2
896
1,711
1,998
1,736 1,321
7,664
1,533
18
3-1
9
-
938
1,008
1,236
896
539
4,617
923
5'
0:5
Busuju
Singo
453 719
947
521
176
2,816
563
4
0-7
1,396
1,657
1,983
1,709
514
7,761
1,552
25
18
Bularwezi
807 1,350
2,439 3,071
1,536
9,203
1,810
62
3:3
Mawagola
2
8
61
83
156
31
10
30.0
Gomba
Buruli
418
358
1,592
236
152
120
2,528
505
25
5-0
908 202
833
2,380
478
8
1.6
Kabula
18
50
27
20
130
26
8
30-0
Bugangadzi
5-43
1,897
4,719 5,032 3,767
16,848
3,371
5
0.11
Koki
539
873
1.013 708
176
3.306
G61
42
6-3
Total
59,788
11,957
276
2-3
-
(3)
Unyoro
Ankole
Toro
1,812 2,974 4,978 | 3,911
ད་
7
78
20 594 607
1,643 2,127 4,748 3.908
2,998
472
16,673
3,334
None attributed to Lake Victoria epidemic.
1,700
340
None returned.
12 501
2,500
Total
30,877
6,175
153,109
1
30,682
18,132
།
276*
14
Grand total
Total inland counties and provinces
Thongh the natives are inclined to conceal their sick, it is found that they readily attribute to sleeping sickness any death from a chronic ailment or one which they do not understand, so that their returns are more likely to be over than under estinated, especially in these southern and western districts where beri-beri has been found to exist, and from many of which authentic cases of sleeping sickness have not yet been reported (Koki, Buddu, Turo, Aukols, e.g.).—A. D. P. Hodges.
APPENDIX F.
SEGREGATION AND TREATMENT BY MEANS OF ATOXYL.
In this appendix I include copies of my letter, No. 78/S.S.E., to His Excellency the Commissioner, and No. 81/S.S.E. to yourself, dated October 20th and October 25th, 1906, respectively, which allude to His Excellency the Commissioner's scheme for segregation and to my proposal to combine with it treatment by means of atoxyl.
His Excellency's scheme of segregation includes, in brief, besides segregation of the sick, deportation of reputed sound persons from a zone of two miles from the lake shore from all such places as are dangerous or such as it is impossible or unnecessary to deal with by clearing. These people will not be compelled to live at
• The death-rate from sleeping sickness among the labourers.
;