CTTTTTI
PUBLIC RECORD OFFICE
Reference :-
C.O.885
·19 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
152
so we should deduct about four days, leaving 10 to 12. Now, to give one course to 800 in batches of 35 would require 23 days.
Dr. Fonceca also states in his report er "Forth," 1906, page 3, that he had not 12 fine days during the first two months. In two months even säiling ships are near, at, or past, St. Helena; the average passage from St. Helena to Demerara is about 21 to 25 days; deducting five days for preparation for arrival, leaves 16 to 20 days. Dr. Fonceca states in his report er "Mersey," 1907, that it took him 18 days to treat 602 adults only once; yet he states that the double course is necessary. Such weather is very common during emigrant voyages, so that on sailing ships, even in absence of serious amount of sickness, there would often not be time for a double
course.
Most of these coolies in india have ankylostomes, yet lead happy, healthy lives. If cleared of them on board ship they would be quickly reinfected after landing. for the plantations reek with these parasites, so all the gain would be freedom för a few days or weeks, even if the treatment were quite successful.
cent.
The meeting, with the exception of Dr. Fonceca, was of opinion that the Dr. Fonceca treatment carried out and described by Dr. Fonecca had failed. states that of 45 cases treated in hospital he had five positive failures, equal to 11 per We know, and 'Dr. Fonceca urges the point in his report ex "Forth," 1906, pages 2 and 5, that failure to find the parasite is no proof that the person is free. Also the conditions on hoard ship do not favour accurate observation, so the per- centage of failures must have been far higher than 11 per cent. If this was so in the hospital it must have been still higher amongst those treated in the 'tween decks. Such a result of so much trouble is very far from being successful.
Almost any procedure may seem easy by itself yet may be impracticable when added to a long code of compulsory inspections, meals, &c. Surgeons would feel bound to comply with the Government rules and so would be led to give to this routine the time which is now given to sanitation, discipline, care of the sick, &c., work which is obligatory under the Indian Emigration Act and Rules, which long experi- ence has proved to be of great benefit to the emigrants.
The compelling of medical men to administer to the people in their charge a course of treatment of which as medical men they may strongly disapprove, is unknown in medical practice, is opposed to the teaching and spirit of medical science, and would leave them responsible legally and morally for any mishap which might occur while depriving them of the guidance of their own judgment. The medical officer on the spot is the only one in a position to judge of the existing conditions in each case.
We feel confident that the General Medical Council would endorse this view.
With regard to Sir Patrick Manson's letter, in which he approves of Dr. Fon- ceca's proposals, we assume that Sir Patrick Manson has, when ordering medical treatment, been accustomed to do so, whether in a hospital or elsewhere, under conditions in which he could ascertain (1) that the person was in a condition fit for the treatment, and (2) that he would be under proper care while treatment was being carried out. Sir Patrick Manson could, therefore, naturally conclude that a course such as that now under consideration, would have been recommended only under conditions similar to those to which he himself had been accustomed. We feel sure that no one of Sir Patrick Manson's experience and eminence would, if he were fully acquainted with the conditions on emigrant ships, endorse a sugges- tion that drugs should be there given to a lot of healthy people in a wholesale, routine fashion. We feel he would not do so, even if the drugs had been tested by years of careful experience, much less where, as in the present case, such experience is wanting.
No one accustomed to work in a well-organised shore hospital with its trained staff, can know the difficulties which confront a surgeon on an Indian emigrant ship, even in his purely medical work. But in addition to such work he is responsible for the discipline, sanitation, diet, amusements, &c. Out of a crowd of ignorant coolies he has to organise nurses, cooks, policemen, cleaners, &c., and to daily supervise them. His only assistance is from two (sometimes three) more or less helpful native compounders, who, in their turn, need direction and supervision. In addition he has to contend with unfavourable weather and has medical charge of a crew numbering between 50 to 100 people.
28471
153
No. 76.
JAMAICA.
THE GOVERNOR to THE SECRETARY OF STATE. (Received 5 August, 1908.)
(No. 327.)
King's House, Jamaica, 17 July, 1908. MY LORD,
WITH reference to Lord Elgin's despatch, No. 410, dated the 26th of November, 1907,* on the subject of the disease called ankylostomiasis. I have the honour to transmit herewith, for your information, copies of letters from the Superintending Medical Officer and the Protector of Immigrants, with their cnclosures, on this matter.
2. The various suggestions made in this correspondence are receiving my consideration, and I propose to instruct the Superintending Medical Officer and the Protector of Immigrants to submit such draft changes in the Regulations and Law as they may be able to recommend.
SIR,
I have, &c.,
SYDNEY OLIVIER,
Governor
Enclosure 1 in No. 76,
SUPERINTENDING MEDICAL OFFICER to ACTING COLONIAL SECRETARY.
(No. 752/2186/07.)
Island Medical Office, 18 May, 1908.
Is reply to your minute on despatch, No. 410, dated 26th November, 1907, I have the honour to forward answers from those medical officers who have had an opportunity of seeing and recognising the disease called ankylostomiasis. Some of the reports are very interesting, and I think I might single out Dr. Calder's as being one of the most interesting.
Statistics are difficult to arrive at, inasmuch as the District Medical Officers have changed stations a good deal recently, and also owing to the fact that very few of them have had any special training in tropical diseases, and not one in ten really knows anything about bacteriology.
As His Excellency the Governor has, I am glad to say, recognised the necessity of having a Bacteriologist attached to the Public Hospital, Kingston, I hope that on the completion of the Bacteriological Laboratory, all specimens that the average District Medical Officer has neither the time nor the necessary training to investi- gate will be sent to that hospital for examination. In that way cases that are now believed to be ankylostomiasis will or will not be certified as such.
During the year 1904-5, shortly after my advent here, a circular was issued 1. estate owners by the Acting Protector of Immigrants with a view to precautions being taken against the spread of ankylostomiasis, a copy herewith enclosed---“C." As showing the spirit in which this attempt at sanitation was met by estate owners, I attach a copy of a letter-"A"-written by a Mr. Melville. This letter shows it is hopeless to expect help from the estate owners unless they should be, by law, forced to take adequate precautions and obey whatever instructions are given them about sanitation through the medium of the Protector of Inimigrants.
The correspondence herewith attached tends to show-
(a) That although the trenches may have been provided at one time, the
coolies have not taken the trouble to use them. See letter
"B."
(b) That there is apparently no supervision on the estates to force them to
use the trenches that may have been provided,
(e) That the trench system is now no longer supplied, and nothing artificial
replaces it.
No. 130 in Miscellaneous No. 204.
3415
DUBLIC RECORD OFFICE Reference: