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10. Then besides the planters and their labourers we in Grenada have to deal with a large number of peasant proprietors, more or less well to do, and with a great number of persons who manage to get a little patch of land to cultivate and an occasional odd job. An army of sanitary inspectors would not prevent such as these from fouling the ground." Nothing but teaching and levelling up can ever do it. It is probable that by persistent teaching in schools an impression may be made, but it is difficult.
11. For example for years and years doctors and others have preached the doctrine of fresh air, yet it has not advanced the people one jot. Every West Indian of the lower class hermetically seals his house at night. It is a tradition and almost a superstition. Doctors and clergy tell me that they often have to refuse to enter a house at night until the doors and windows have been opened, so unspeakably foul is the air in which these people habitually sleep. All reasoning is futile. Such is the seething mass of ignorance with which the Government has to deal.
12. It may be as well too to point out the geographical difficulties which differentiate the Windward Islands from others..
The islands are a mass of hills and valleys. When I tell your Lordship that in all Grenada there is not, so far as I have been able to ascertain, a single spot fit for even a small golf links hardly a spot fit for cricket, or even in most cases for lawn tennis, that bicycles are unknown, and motors still a matter of rumour, you will realise the difficulty of working on a general sanitary system, except in the towns, where sanitation is fairly attended to.
There are but few villages and the population lives here and there and any- where on the hills, on the slopes, in the valleys-anywhere.
13. As far as it reaches the water systém is good and the quality of the water good, but there are, of course, many places to which the system has not penetrated. As a whole, however, Grenada is letter off than most of its neighbours in this respect.
14. I have tried to convey some idea of the conditions here for your Lord- ship's consideration before any further steps are taken.
I have, &c..
RALPH WILLIAMS,
Governor.
Enclosure in No 71.
GRENADA,
REPORTS by members of the Medical Staff of the Colony upon the Secretary of State's Windward Islands Despatch (General) of 26th November, 1907, "relative to the measures proposed for stamping out Ankylostomiasis.
SIR,
Richmond Hill, January 14, 1908.
Is answer to your circular of the 7th instant. I have the honour to report as follows:-
The existence of ankylostomiasis in Grenada has been well recognised since 1896 when the parasite was found at post-mortems made at the Colony Hospital by the late Dr. Boyd.
I am of opinion that the disease has not spread materially during the last ten years and I do not think that it exists to an extent which need cause anxiety as to the health of the labouring population generally.
It is confined to the labouring class, and to that part of it which lives outside the towns. In my experience East Indians suffer more frequently or more severely than Negroes.
I have noticed that cases are more severe in the wet season than in the dry, but it seems pretty certain that infection would be more likely to take place in the wet, and that the anemia, the principal symptom, would come on later, and might cause those affected to seek treatment in the dry season.
Outside of the towns there is no sanitary supervision, and among the labourers and peasant proprietors, domestic sanitation is of a very low standard. All night soil is thrown on the surface of the land, in the garden or under the cocoa, and anyone suffering from ankylostomiasis is pretty sure to infect the soil in the imme- diate neighbourhood.
There are three common means of infection (1) drinking water from drains
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and very small rivulets, (2) walking about in the damp ground in 19 feet, and (3) by introducing the parasite into the month with dirty fingers.
As far as I know none of the estates provide latrines for their labourers, and the labourer does not provide one for himself.
Thymol is the usual vermifuge employed, followed by iron and arsenic; severe cases are sent to the hospitals.
A few cases have been found among the inmates of lunatic asylum, in patients who were dirt or filth caters.
All dirt eaters are now examined once a month, and treated with thymol. All estate owners who supply barracks or huts for their labourers, might be compelled to provide latrines approved of by the local sanitary authority.
The schools throughout the country are very insufficiently supplied with latrines, and those that do exist are generally in a condition far from satisfactory. Printed instructions as to the disposal of night soil should be sent to every house- holder once a year.
Each district should be supplied with a Nuisance Inspector acting under the supervision and direction of the Medical Officer. The offices of Nuisance Inspector and Poor Law Officer would be a good combination.
I have, &c..
The Honourable
SIR.
The Colonial Secretary.
EDWIN F. HATION,
Medical Officer.
St. Andrew's, January 16th, 1908. In reply to your circular of the 7th instant, I beg to report as follows;--- “Ankylostomiasis undoubtedly exists in my district (No. 8, St. Andrew's)
but the evils caused by it are not serious: the common round worm (Asenris Lum- bricoides) does far more harm.
I have been 25 years in medical practice in Grenada, and I am unable to remember a single death as directly due to the ankylostomum; but I confess that it is quite possible I failed to diagnose cases in the first years of my residence in the West Indies: for little or nothing was taught about the disease at that time.
I believe that Ankylostomiasis has increased in this Colony since the cultiva- tion of the cocoa tree was substituted for that of the sugar cane; with the latter cultivation the soil had frequent chances of becoming thoroughly dry--a condition very unfavourable for the development of the larvae.
Under present conditions, the earth is always damp; and, as the average peasant invariably allows the cocoa to grow right up to the four sides of his house, the ground around his dwelling is in perfect condition to receive the thousands of eggs laid by each small female worm, and to afford all the moisture necessary for the hatching and for the development of the parasite in its early stage.
These conditions in themselves would not be dangerous if the people living under them are cleanly and refined; but, unfortunately, no race of human beings (excepting the Chinaman) are so dirty and careless as to the disposal of their excreta as the negro: the children of the lower classes are not only permitted to micturate from the doorsteps, but are allowed to deposit their egg-laden fæces anywhere on the ground near their houses.
As ankylostomiasis tends to cure itself, it follows that all that is necessary to eradicate the disease is to destroy, or so dispose of, the fæces in such a way that the eggs in them shall have no chance of hatching and re-entering the human host.
In response to the questions asked by the Secretary of State, I beg to reply as follows:-
(1) Labourers working in damp cocoa estates should be encouraged to wear boots and to wash themselves frequently; for this worm in its larval state can enter the human body through the soles of the feet and the palms of the hand. Latrines with deep pits in the ground should be placed not only near the “boucans,” but also in the fields: all employees should be compelled to use these latrines: and at regular periods the fæces found in them should be covered with "white lime," and the holes filled up with earth. These arrangements would work per- fectly if carried out strictly, but the manager would be a very clever man if he succeeded in getting his labourers to do their share of the business.