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PUBLIC RECORD OFFICE
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C.O.885
19 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
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Swettenham are omitted in the reports published by the Advisory Committee. The only statement is an unworthy extract from the Perak Medical Report, in which it is said that the prophylactic measures have not been of an extensive nature, and that with our heavy rainfall the banishment of puddles and other suitable places for the breeding of mosquitoes is practically impossible." Yet it is just this practical impossibility which has been effected by Dr. Malcolm Watson in the neighbouring state of Selangor with an equally heavy rainfall. The extract from the Perak report suggests merely incapacity on the part of the Perak authorities.
(10) Similarly with regard to Hong Kong (page 13), I am surprised to find that all the excellent work done there and recently fully reported upon officially by Dr. Thomson is dismissed in a short extract of eight lines taken from the Medical Report of 1906.
(11) The only medical report quoted which gives anything approaching useful information is that of British Guiana (page 29). We learn that on the sugar estates alone 23,332 cases of malaria were treated in 1906, that steps have been taken to improve the drainage of the yards and surroundings of the labourers' cottages, and that there has been a marked decrease in the number of cases during the past few years. The inhabitants are urged to wake up" and do everything in their power against mosquitoes; but it does not seem to be understood that individual efforts are almost powerless in this direction, and that it is the authorities who should wake up. The abstracts given contain no accounts of attempts to measure the amount of malaria present, or of quinine distribution, or of a proper anti-malarial organisation. 3. The remaining ten Colonies have submitted special reports in response to the Secretary of State.
(12) In Jamaica (page 28), it is admitted that "no measures have been adopted by any public authority in this Colony for the prevention of mosquito-borne disease in the past year." Some "individual efforts" appear, however, to have been made, but the Acting Superintending Medical Officer evidently thinks that these were not worth describing, or that the whole matter was of no consequence. He adds that there "
are no reliable statistics available to supply the information asked for in the latter part of paragraph 4 of the Secretary of State's despatch." I venture to say that this is not correct, since the number of patients attending the hospitals and dispensaries for mosquito-borne diseases could easily have been given. It does not appear to have occurred to the Superintending Medical Officer that, even if there were no reliable statistics available, it was easy for him and his department to obtain them, without expense, by examining children for enlargement of the spleen, and by other methods. No mention is made of quinine distribution, or other details. The whole report appears to me to be a very careless reply to the Secretary of State. (13) The report for Barbados (page 30) is little better. There is no malaria, but filariasis is "extensively prevalent," and yellow fever occurs. Nevertheless, the so-called Health Commissioners and the so-called General Board of Health have declined to take any measures—a decision which is reported as having been "heartily approved by the local press." There is no annual medical report for the Colony. I can only infer that the people of this island are not fit to be considered a civilised community.
(14) A brief but fairly good report is submitted for Southern Rhodesia (page 33). The police have been placed in mosquito-proof barracks, with good results. Malaria has practically ceased to exist in urban areas, and is not very prevalent anywhere.
(15) In Papua (page 32), it is believed that anophelines have been "wholly exterminated" in the island of Samarai by drainage of a swamp; and that "malarial fever among those Europeans who permanently reside on the island has practically disappeared." The Administrator records great improvement in the health of Europeans during the past few years, and attributes this to the knowledge that mosquitoes disseminate malarial fever. I should think, however, that figures might have been given in support of the statement.
(16) The report from Mauritius (page 11) is one of the best, and shows work done along many lines. That of the Malaria Committee was excellent, and required only to be generalised. My own report, just submitted, deals at such length with the subject, that further remarks are unnecessary here.
(17) The British Central Africa Protectorate (page 25) sends also a good report by Dr. Hearsey, which shows evidence of thought and interest in the subject. He
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states that "with the exception of Chiromo there has been a decided decrease of malaria among Europeans," and that the number of pernicious cases and of deaths from blackwater fever has fallen. No spleen rates are given, and there is no evidence of a special organisation.
(18) In the Gambia (page 14), which sends a good report by Dr. Forde, there is such an organisation in Bathurst (for which £250 per annum was voted), and special legislation has also been enforced. Death-rate statistics are given, but do not, I think, show any marked improvement. Mosquitoes are said to enter Bat- hurst from outlying marshes, so as to counteract the effect of the minor anti-malarial measures within the town. No spleen rates are given, so that it is impossible to judge of the real amount of malaria present, or of the exact effect of the measures.
taken.
(19) Much work has been done in Ceylon (page 8), especially in the way of quinine distribution. The amount distributed cost Rs. 73,299 in 1906 alone, apart from the wages of the distributors. The Governor thinks that more good would result from 'a systematic crusade against anophelines," and the Principal Civil Medical Officer concurs in this. The report is a good one.
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(20) A very copious report comes from Southern Nigeria (page 17). Since 1900, when the work was started by Sir William MacGregor, £43,163 have been spent on swamp reclamation. Many other measures have been adopted by the Medical and the Public Works Department. The Governor reports that the condition of Lagos has been "immensely improved," and the Principal Medical Officer says that there has been a great reduction of malaria among European officials, and gives tables in support of this statement. The results would have been more decisively known if spleen rates had been taken. There seems to be no special organisation.
(21) Sierra Leone (page 16.) I visited this Colony in 1899, and showed exactly what measures should be taken there against the malaria which had so long given it the name of the "white man's grave." There is no doubt that, if my recommenda- tions had been followed with intelligence and energy, the disease would have been practically banished as at Ismailia and Klang. In 1901, hearing that little had been done, I collected £2,000 in order to give a further demonstration. On arrival in Freetown I found everything in the same state, except that the town had given (I believe) £500 a year to the Principal Medical Officer to act as Health Officer. Dr. Logan Taylor and myself did what we could with the money at our disposal, and our work was favourably reported on at the time by Dr. Daniels, of the London School of Tropical Medicine. Next year, however, Dr. Taylor reported that the authorities showed little desire to continue the work effectively; and we therefore abandoned our enterprise with regret. A year later the authorities asked for an enquiry on the whole matter; but we objected that, as so long a time had elapsed since we left, no conclusion could be come to by such an enquiry. The Principal Medical Officer was, however, decorated for his labours on the sanitation of Sierra Leone. Since then, so far as I can ascertain, little has been done. The report published by the Advisory Committee records that in Freetown in 1906 the City Council spent £1,978 out of a total revenue of £6,913 through the Sanitary Depart- ment, and that the Government spent £2,235 on the maintenance and repair of streets, bridges, and drains, &c., but these figures may have little or no application to malaria prevention. Streams were apparently partly canalised some years ago. A few statistics for 1904, 1905, and 1906 are given; but they show no decided improvement. Nothing is said about spleen-rates, quinine distribution, or malaria organisation.
On the other hand there is a strong article on the want of sanitation in Freetown by Captain Harvey, Royal Army Medical Corps, published in the journal of the Royal Army Medical Corps for July, 1908. The City Council has apparently refused to grant even the few pounds required for oil for antimosquito work. It would be interesting to enquire how much out of their slender revenue they continue to pay for their health officer. The sum which I understood they gave some years ago would probably have sufficed, if properly used, to rid the whole town of malaria. The entire story of malaria in Sierra Leone is a melancholy one, and nothing will be done there until strong measures are taken with the defaulters.
4. This analysis may be summarised as follows:-
(1) The whole collection of reports published by the Advisory Committee loses immensely in point by the omission of the excellent campaigns in the