PUBLIC RECORD
OFFICE
Reference :-
C.O.885
18 PUBLIC RECORD OFFICE, LONDON
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necessity for proper latrine accommodation; on 18 estates (out of some 40 or 50) accommodation had been provided, with encouraging results; and it was hoped that provision would soon be made on all estates.
In Trinidad the advance has not been so great. The evidence taken before the Labour Committee of 1905 showed that, while the medical authorities were aware of the nature of the disease, the estates authorities were not convinced of the The recommendation of the Committee may, practicability of remedial measures. however, be productive of effect.
In Jamaica the Colonial Government in 1905 issued a circular to employers of coolie labour, calling attention to the dangers of ankylostomiasis, and pointing out the simple precautionary measures to be employed.
No other West Indian Colonies now import East Indian labourers, and although ankylostomiasis is widely prevalent, it does not appear that any general measures for coping with the disease have been taken outside of the three Colonies just cited. Many individual cases are, however, annually treated on the lines now generally accepted.
MEASURES TAKEN IN THE CALCUTTA Depot.
per
Since there is no doubt that ankylostomiasis is very prevalent amongst the coolie labourers brought from India, many attempts have been made to weed out those infected with the disease before their arrival in the West Indies. In con- nection with the attempts to combat the disease in the Colony, the British Guiana Government in 1903 recommended that all the Indian coolies recruited for labour in British Guiana should be examined, and, if necessary, treated for ankylosto- miasis in the Calcutta Depôt. The views of Major Pilgrim, the Depôt Surgeon, and Senior Surgeon to the Calcutta General Hospital, were obtained on this proposal.
gave 75 Ile reported that the great majority of Indian coolies-some authorities cent. were infected with ankylostomiasis; and that since many who were infected were apparently in excellent health, the treatment, to be of value, must be applied to all the coolies without diagnosis. For such wholesale treatment the number of coolies in depôt was too great, and the time of stay too short. Moreover, the treatment with thymol frequently gave rise to unpleasant, and sometimes to dan- gerous symptoms; and the fear of treatment would certainly involve a large number of desertions and a consequent loss to the Colonies. Coolies suffering from the effects of the treatment would not be so well able to resist the rigours of the sea voyage to the Colonies.
Sir P. Manson, whose opinion was sought, agreed that the wholesale drugging of coolies in depôt was impracticable; and that treatment should be carried out either during the voyage or on arrival.
The British Guiana Government again brought up the question in 1905, sug- gesting that one of the Government Medical Officers should be attached temporarily to the depôt for the purpose of examining the coolies and either treating them in the depôt or giving directions for their treatment on board ship. The Agent was still of opinion that measures could not he taken in the depot without seriously hampering the work of recruiting; and the proposal was dropped.
MEASURES TAKEN ON COOLIE SHIPS.
In 1902 the British Guiana Government asked that the surgeons of coolie ships should be supplied with microscopes for the diagnosis of ankylostomiasis. The regulations under the Indian Emigration Act were accordingly amended so as to include microscopes amongst the instruments to be carried on emigrant vessels. The amended regulation was subsequently extended to other Colonies importing coolies.
The British Guiana Government afterwards advocated the supply of the drug thymol on coolic vessels. The Surgeons Superintendent of the coolie vessels were consulted in the matter, but as there was no unanimity in their views the supply of the drug has been left to their individual discretion. In 1906 Dr. Fonceca, one of the Surgeons Superintendent, put forward proposals for treating all the immi- grants on board each vessel, in suitable batches, with the drug beta-naphthol, which he considered safer than thymol. Sir P. Manson supported his proposals, and he was accordingly instructed to carry them out on a British Guiana vessel, making the treatment as general as possible, but not insisting on it if individual coolies
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objected to undergo treatment. The results of the experiment have not yet been reported.
Other Surgeons Superintendent were consulted in the matter, but the majority of them were hostile to Dr. Fonccca's proposals.
The reasons given were: (a) the difficulties of treatment in the limited space at their disposal and with the many claims on their time and attention during the voyage; (b) a reluctance to administer wholesale drugs in the properties of which they were not fully experienced; (c) a fear that such general treatment would involve discontent and even mutiny amongst the coolies; and (d) a belief that, in any case, their labours would be wasted, since the coolies are exposed to re-infection imme- diately on arrival in the Colony.
At a meeting held in November, 1906, the Surgeons Superintendent unani- mously resolved that the use of the drugs cited as specifics for ankylostomiasis should be left entirely to the discretion of individual surgeons.
One surgeon, however (Dr. Harrison) agreed to carry out Dr. Fonceca's pro- posals, and was given similar instructions; while another (Dr. Kenny), who had not expressed himself in favour of the proposals, subsequently secured the appoint- ment of an additional compounder to the Trinidad vessel, of which he was surgeon, to assist him in a systematic course of treatment during the voyage.
[ November, 1907.]
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No. 128.
H. R. C.
MEETING TO DISCUSS QUESTION OF ANKYLOSTOMIASIS IN WEST INDIES.
Sir P. Manson, in opening the proceedings, referred to the great loss of labour in the West Indies through the ravages of the disease, and the desirability of measures to deal with it. Ankylostomiasis readily yielded to treatment, and he had no doubt that great improvements could be effected by practicable measures. The Americans in Puerto Rico had taken up the question, and had systematically treated all the inhabitants, he understood, with thymol or beta-naphthol for the eradication of the disease. He recommended that information should be sought from the American Government as to the measures adopted, and that similar measures should be enforced, so far as practicable, in the West Indies. He expressed the opinion that the coolies introduced from India only contributed in a minor degree to the spread of the disease, and the chief point was to stamp it out in the Colonies. For this purpose the methods of treatment most suitable to the circumstances of the several Colonies should be investigated. It was desirable that an inspecting officer should be sent to report periodically on the enforcement of these measures. Good results might also be expected from the education of the children in the simple sanitary precautions to be observed for the avoidance of infection.
Professor Haldane explained that he had had experience of ankylostomiasis in the Cornish mines. He had discussed the question of the prevalence of the disease in the West Indies with Dr. Godfrey, of British Guiana, and, as a result of his con- versation, he had drawn the Secretary of State's attention to the matter. In his opinion sanitary measures were of the utmost importance; the fact that consider- able numbers of persons in the West Indies were infected was of minor importance provided that adequate measures were taken for preventing the spread of infection. Mr. R. W. S. Mitchell, C.M.G., late Emigration Agent at Calcutta, explained that though the majority of coolies in India were infected with the disease, in few cases was there any serious effect on the general health. Coolies recruited for labour in the Colonies were not rejected on account of ankylostomiasis infection, though, of course, advanced cases of the resultant anæmia were rejected.
Sir P. Manson explained that the drugs most commonly used for the treat- ment of ankylostomiasis were thymol, beta-naphthol, and oil of eucalyptus. Professor Haldane said that beta-naphthol did not give as good results as thymol. but it was safer in use. Sir P. Manson himself used eucalyptus, chloroform, and castor oil in certain proportions. He was of opinion, however, that while thera- peutic remedies should not le neglected, sanitary measures were of the utmost importance.
Mr. J. Cadman, who had experience of this disease both in the Cornish mines and in Trinidad. gave some statisties, carefully compiled, on an estate of the
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