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།།། ། ། ། ummutimi C.O.885
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to accuracy and have been recorded more for their relative value than to demon- strate anything in this report, and to show in what villages the infection may still be latent. The time at my disposal did not enable me to find every case of This is the work of sleeping sickness, and I make no pretence to have done so. the medical officers appointed to the sleeping sickness stations. Six months would be none too much time to occupy one on a border 500 miles in extent, whereas spent just two, visiting some 240 villages and examining 17,000 people. It was sufficient for the purposes of my investigations to locate each focus of infection and. irrespective of the number infected, to adopt measures at once to prevent The spread of the disease from that focus. Taken in large groups of villages there is not much variation in the glandular index of different localities, not so much as one would expect, but the foci of infection are as yet small and the disease has not spread much from them. By a "focus of infection" is meant the presence of the disease among a population living in association with Glossina palpalis. There are three such foci in North-Eastern Rhodesia:-
(1) On the Luapula and Mansa Rivers just south of Madona.-This infection has been brought from the endemic area on the Lualaba River in the Congo Free State (Luba country).
(2) The north end of Lake Mweru. This infection has spread by direct
extension along the Luvua River from Kiambi and P'weto.
(3) The south end of Lake Tanganyika.-This in the same way has been introduced from the West Coast of Tanganyika by the constant com- munication between the natives of these parts.
It should be remembered in dealing with borders that in Africa a Loundary between two European Administrations does not necessarily mean also a division between native tribes; indeed, it is often otherwise, and to the native the boundary means very little, or perhaps one ought to say a good deal, for by crossing from one side to the other at convenient times he manages to evade the laws of both. But, apart from this, a boundary as a political division is practically disregarded by the native, and he resides on that side of it which suits him best, crossing from one side to the other to visit his relations (and their name is legion) as often as he pleases. A boundary is also a tribal intersection, splitting up the members of tribes or communities among whom communication for years past has been free and unmolested. Thus the three headmen, Sikapali, Kalimba, and Sima- lambwe, in North-Eastern Rhodesia still recognize Moliro (in the Congo) as their chief or father. Sleeping sickness was introduced into Moliro in 1905 and is now found in all three villages in North-Eastern Rhodesia. The disease has probably been brought into North-Eastern Rhodesia at the north end of Mweru near Pweto in the same way. In the case of an undefined boundary, such as exists between Mweru and Tanganyika, the difficulty of restricting the movements of natives is greater still, as no one knows where the actual border is, except the native, who proceeds to enlighten one in the following manner:-"The Belgian soldier comes so far and no further; and the Buana (English), he come so far and no further; here, no one comes." There are thus virtually two borders, one for the English and one for the Belgians, with a neutral zone between them. Who is responsible for cases of sleeping sickness occurring in this neutral (sic) zone? A case in point is at Pweto itself at the north end of Mweru. This Administration extends its influence as far as the Lunchinda Stream, 2 to 3 miles (or more) from Pweto, while the Belgian official does not come to the north shore of the lake at all, and Who is there are villages there which must be infected with sleeping sickness. responsible for these? In regard to sleeping sickness it is a matter that could be settled by arrangement with the Belgian authorities, but at the time of my visit there was no official at Pweto with whom such an arrangement could have been made, and I, therefore, deferred the matter until I arrived in Fort Jameson.
The case found on the northern border between Mweru and Tanganyika is an imported case from Tanganyika. He is a resident of Kaputa's village and contracted the disease by visiting Tanganyika to see his relations and to buy fish. If there is not An imported case is a case found outside an endemic area. Glossina palpalis or Morsitans* in the neighbourhood of such case it remains an
• Dr. Kinghorn, of the Liverpool School expedition, has since found another case at Kasompi, near the Mansa and Luapula Rivers. He was away from his village when I visited it.-J. C. S.
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imported case indefinitely. If Glossina palpalis is found near such a case it may establish an endemic focus and then spread along the line of distribution of Glossina palpalis. There is no "fly" at Kaputa.
IV. The Distribution of Glossina in North-Eastern Rhodesia.
So far as my observations have extended Glossina palpalis has been found in the following localities in North-Eastern Rhodesia :-
(1) On the Luapula River, extending 120 miles from 2 miles above the
Kapepwe Ferry to Kasiwa's village.
(2) On the Mansa River for about 5 miles from its junction with the
Luapula.
(3) On the Kalungwisi River from its mouth in Lake Mweru to the Lun-
tonfwe Stream, a distance of about 10 miles.
(4) The whole of the lake shore of Mweru with the exception of the swampy
region on the south shore and south-east corner.
(5) The island of Kilwa.
(6) The west and South shores of Lake Tanganyika from Moliro to Kituta. Glossina palpalis is found always near water. The water must be of good volume, such as a fair-sized perennial stream or lake. Trees must overhang the On lakes water or form good shade on its banks. The denser the foliage, consequently the shade, the more abundant the fly. It is never found away from water.
it is more abundant round the mouths of rivers where ambatch trees are likely to grow. It is never found in swamps and marshes where there is no shade. It is a greedy blood-sucker, but not so voracious as Glossina morsitans. It attacks tentatively from below by settling on the boot or leg and does not bite at once. Glossina morsitans goes straight for the neck and shoulders and bites at once. The surest way to find it is to go on a river or lake in a canoe and creep along the banks under the trees. By walking along the banks of a river among the If trees have trees it is frequently missed. It is unusual to find it at landing places or ferries much used by natives, or even at places where women draw water. been destroyed or cut down at any place on the river bank it is seldom or never found there. The greatest distance it was found from water was at Mweru, where it was found in the trees fringing the lake separated from the water's edge by 50 It is never found in mid-stream unless carried out or 60 yards of sandy beach. there from the banks. Rivers carrying Glossina palpalis may be safely crossed if a sufficient clearing is made at either landing place. Fishing in Africa on rivers supporting Glossina palpalis may become a most dangerous occupation.
It
In
Glossina morsitans is found always in dry, thickly wooded, well shaded Its distribution is widespread and continuous It is a voracious feeder country, not necessarily near water. belts of it extend for a distance of 150 miles or more. and attacks from behind, generally the shoulders or neck, and bites at once.
On open plains where game is In thick bush, is not necessarily found in association with game. frequently found in abundance it is scanty or not found at all. where perhaps no trace of game spoor is to be found, it is most abundant. buffalo country it is generally to be found, but it is also found abundantly in coun- tries where buffalo are not found and said not to exist. Its great enemies are sun and wind. It is only found in well-shaded, wooded country which affords protection from sun and wind. In open country or in patches of country where trees have been lopped in the making of gardens, it disappears, while, in the sur- The surest way to get rid of it is to cut down the rounding bush it will swarm. trees. It is not found in villages where the surrounding trees have been cut down, though the village be situated in the midst of a belt, except when carried in from the surrounding bush. It is also found in dry, stony, river beds in the shade. It avoids human food and human surroundings.
V. Measures Adopted.
The measures carried out are directed against:-
(1) The introduction of fresh infection from without.
(2) The prevention of the spread of the infection from within:
1. The Congo border has been divided for the purpose of control into three
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PUBLIC RECORD OFFICE
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Reference :-
C.O.885
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
COPYRIGHT PHOTOGRAPH-NOT TO
19 PUBLIC RECORD OFFICE, LONDON
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sections and each section is in charge of a Native Commissioner. The sections
are:-
2.
1) The Luapila section from Chongolo to the Mununshi Stream (250 miles). (2) The Mweru section from the Mununshi Stream along the Luapula and Lake Mweru to Seremani's village on the northern border (180 miles).
The Tanganyika section from Seremani's village to Moliro, thence along
the lake shore to the Kalamko River and the Saisi (130 miles).
Attached to each section of the border is an area so defined as to include all infected villages, all villages in direct communication with infected villages, and the entire distribution of Glossina palpalis as far as this has been ascertained. These areas are represented roughly by a line running about 10 miles from, and parallel to, the border. They are defined as follows:-
(1) The Luapula sleeping sickness area on the Luapula River from the Luera
River to the Muñunshi Stream.
(2) The Mweru sleeping sickness area from the Mununshi Stream to the mouth of the Luapula River at the south end of Lake Mweru, the island of Kilwa, the east and north shores of the lake to the Lun- chinda Stream, and the northern border as far as Seremani's village. (3) The Tanganyika sleeping sickness area from Seremani's village for the remainder of the northern border to Lake Tanganyika, the south end of the lake shore to the Kalambo River and thence along the Anglo- German border to the Saisi River.
In each area a sleeping sickness station has been established as near as possible to the respective entrances of the infection, viz.:—
(1) At Madona on the Luapula.
(2) At Chiengi on Lake Mweru.
(3) At Sumbu on Lake Tanganyika.
To each station a Native Commissioner and a medical officer are to be appointed whose services will be given entirely to sleeping sickness and whose duties will extend over the area allotted to each station. They will be exempt from ordinary district duties, and have control over the movements of all natives within such area, as well as over all other matters relating to sleeping sickness.
The duties of the Native Commissioner will be as follows:-
This
(1) To patrol the border by means of messengers in sub-section.
measure is to prevent all communication with the Congo Free State. On the Luapula section this is comparatively easy of accomplishment with the assistance of canoes. On the Mweru section, including the island of Kilwa, it is a matter of extreme difficulty without the assistance of steamer communication or the establishment of another station on the island. From Chiengi to the south end of the lake in an open boat is a journey of five days and in the stormy seasons of the year not without danger. The steamer (Belgian) takes one day. The male population at the south end of Mweru live on the water and subsist entirely on fish and its trade. There is no Palpalis on this part of the lake shore, but they frequently cross to Kilwa Island, which is infested with it, and infected with sleeping sickness. To control a people of this description who for years have led a free roving life, and who are not inclined to regard with favour any restrictions placed upon their movements, means constant supervision and firm treatment. This class of native will never understand the meaning of such restrictions, and he will disobey them on every pos- sible occasion, not from any wilful disposition to disobey the laws, but from sheer ignorance of their meaning. This part of the lake too, to the east of the Luapula mouth, has ill-defined swampy shores, with small subsidiary lakes or lagoons communicating with the open water, and split up by long narrow strips of land and sand-spits, jutting far out into the lake, on which are situated the small fishing communities. They use a long narrow canoe which they propel with
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great dexterity, darting into the shallow waters to evade a steamer, or hiding themselves in the long reeds. This is the kind of people at present being controlled by means of water-police and no better method of dealing with them can be devised, but the control is too far away, and either a subsidiary station must be placed at Kilwa, or a steamer communication provided. I must point out here that an oflicer placed on Kilwa would incur great risk of becoming infected. The northern border offers some difficulty inasmuch as no border may be said to exist. It is being patrolled in sub-sections by messengers. On Tanganyika' the system of canoes is being largely used and here again occurs the necessity of some quick means of water communication for the Native Commissioner.
(2) To move all villages situated actually in contact with the fly at least 5 miles away from it on some other water supply. This is a measure of most difficult execution, and must, of accessity, take considerable time until new gardens and crops are planted. In some cases it will prove quite impossible or impracticable to do so, and in these cases the fly is to be exterminated by cutting down the trees and under- growth on the banks of the river or shore of the lake for a distance of 300 yards on either side of the village.
(3) To clear for 300 yards round all villages situated in or near belts of
Glossina morsitans.
(4) To make a census of the villages within the area, and to restrict the movements of natives leaving and entering the area. No natives are to leave the area without a pass from the Native Commissioner, and whenever possible, a certificate from the medical officer, and natives arriving in the areas from without, are to be reported by the chiefs and headmen to the Native Commissioner. This work is to be carried out by chiefs and headmen whose co-operation and assistance in matters of this kind will prove invaluable. These men should receive small annual subsidies from the Administration. in proportion to the amount of work expected of them.
(5) To explain to the chiefs and headmen the reasons for these measures, and to encourage them to take an active interest in seeing that they are carried out.
The duties of the medical officers will be:-
(1) To visit periodically every village in the sleeping sickness area; to palpate them, and puncture every case of glandular enlargement for trypanosomes, and to move all cases of sleeping sickness thus found to a hospital camp for treatment. Each station will have a camp for the treatment of cases, and they are to remain there with their relatives or friends until certified by the medical officer that it is safe for them to return to their villages.
(2) To report to the Native Commissioner any village found infected, and
to indicate the necessity or otherwise of the removal of the village.
́ (3) To investigate the distribution of Glossina palpalis and other species of Glossina, and to report to the Native Commissioner any village situ- ated in, or sufficiently near, the fly as to constitute a danger of infection, and to indicate what clearings should be made to render the village safe.
(4) To choose the site for the hospital camp free from all dangers of infection, and to be responsible for the proper treatment and attention to patients at all times.
(5) To keep records of all work done and reported on, and to keep all suspected cases not proved by puncture under observation if necessary at the hospital camp.
(6) To be responsible for the sanitation and health of the sleeping sickness
station.
VI. Expenditure.
The estimated expenditure to start and maintain three sleeping sickness stations on the borders of North Eastern Rhodesia will be about as follows:-