PUBLIC RECORD OFFICE
Reference :-
LTC.O.885
سانا
19 PUBLIC RECORD OFFICE, LONDON
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(9) The sanitary condition of the barracks and compound to be supervised by a headman, who is held responsible for its maintenance, and any person found soiling such compound with fecal matter to be fined. (h) Newly arrived coolics not to be located in old barracks nor on the old sites of barracks unless such sites have been free from buildings for some time-say one year.
6) Education of the people. Coolies should be instructed that drinking water or eating food with muddy hands, drinking stagnant or muddy water and entering their houses with muddy feet tends to convey the disease.
(k) Where areas are found to be infected the labourers' barracks to be removed to another locality, the previous site stripped of cover and exposed to sunlight.
(2) When cases of badly-infected coolies occur, I would advise their removal to a dry district, as in my experience curing them under adverse local conditions is hopeless.
(m) Notification of the discase.
2nd. 3rd.
Ankylostomiasis should be placed on the list of notifiable diseases, as by this the existence in a locality would be known, the recognition of the disease by the public become more general with the knowledge of the need for the avoidance of the disease; the public would thereby become their own police, and estate managers in self-protection take more interest and care in the health of the labourers.
At present the public does not know the meaning of the term, or if the disease is known does not recognise the seriousness of the malady, but notification, and, in case of coolies, compulsory treatment, would bring it home.
Treatment en masse--this is impracticable.
General and special measures.
Much of this is covered in the foregoing-but I believe much could be done in "marking down" the infective centres by tracing out the origin of cases; in this notification would help, but a medical officer should, on its becoming known to him that ankylostomiasis prevails in a district, be empowered by the Superintending Medical Officer to visit such locality and ascertain by examination of the residents, if possible, the source of the disease, thereupon warning the public against any suspected stream, pond, or other water-supply or locality.
For such duties a special fee to be paid, as also for all microscopic work entailed thereby and the gratuitous treatment of all cases requiring it.
In my experience the treatment of negroes affected by this disease is not successful where such treatment is attempted outside of a hospital, as they will neither adhere to the diet nor carry out the drug treatment correctly; hence mild cases continue "at large," distributing the disease, and I can think of no means whereby this difficulty can be met; as a result of these conditions the disease increases and is increasing in suitable localities, and there appears no possibility of checking it. As stated in a previous paragraph I believe, by the education of the people to knowledge of this disease, and by notification a species of personal quarantine of the call for self-protection might enable some people in infected areas to escape; but I fear that the mass is not to be warned; looking upon any filthy fluid as "water," it is not probable that the negro labourer will be made to disbelieve in the salubrity of his usual water-supply.
The Superintending Medical Officer,
I have, &c.,
J. A. L. CALDER.
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inasmuch as the streams would be so thoroughly flushed that any ankylostoma ova would be washed away.
(a) There are no sanitary regulations in force for dealing with the disease, except those issued during the administration of Sir Alexander Swettenham, having reference to the digging of pits for the convenience of coolies, in such situations so as to prevent the contamination of the water-supply. These regulations are still in force.
(b) In the rural parts of my district and the same may be said to apply to the entire island so far as I know-there is no latrine accommodation, the must convenient place in the adjoining bush being used for the purpose. On estates where indentured coolies are located pits are dug as mentioned under “A." In centres of population, such for instance as Port Antonio, the most up-to-date sewerage is in use as regards the bulk of the better-class people, the dry-earth system is also used, many of the closets are over the sea, and the others are on the pit system. In another centre of population, Moore Town (the Maroon settlement), I doubt if there are half a dozen latrines in the entire place-of course the houses are not close.
(e) Thymol is the treatment; it is made into an emulsion with castor oil, 20 to 30 grains to the ounce, and of this one ounce is given every other day. I am aware the authorities advise against giving it in oil as absorption may occur and symptoms of poisoning result. I have had a fairly extensive experience of this method of administering the drug, and nothing has ever occurred to indicate the slightest danger in connection with it.
As to suggestions as to what local measures might be taken--
1st. I would advise as regards coolies, the regular administration of thymol to those who show the slightest indications of anæmia. It is hardly necessary to examine the stools in every case before the administration of the medicine, as anæmia, unless caused by some other condition, is sufficient to warrant the giving of the drug. Steps should be taken by the sanitary authorities-the sanitary laws as they now stand are sufficiently stringent to meet the circumstances-to prevent the contamination of the water-supply.
2nd. As regards treatment en masse. The disease is at present confined largely to the East Indians, although cases are occasionally seen among the creoles; with the former, so long as they are under Government protection, it is an easy matter to deal with the disease. The sporadic cases occurring among creoles are a distinct danger, and those of course are difficult to reach. Notification might be of some use, although I hold that notification without compulsory treatment is into go hardly of any benefit. An exact diagnosis would be a difficulty; one might a district and see a dozen cases of anæmia and be perfectly certain that ankylosto- miasis was the cause of the trouble, but without an examination of the stools it would be impossible to notify them. I have no doubt but that the law could be so framed as to compel persons to submit their stools for examination, but what about. the cost? A microscopic examination of a stool and a notification certificate would hardly be covered by the present fee of 2s. 6d.
3rd. As regards general and special sanitary regulations, these are embraced under the preservation of the water-supply from pollution, the proper disposal of fæcal matter, notification and compulsory treatment, and possibly segregation until cured.
I have, &c.,
C. A. MOSELEY,
District Medical Officer.
Kingston.
(No. 14.) FIR,
Port Antonio, 22 February, 1908. HAVING reference to the extract from the circular sent out by the Secretary f State for the Colonies on the subject of ankylostomiasis, I have found the disease uninfluenced by the rainy seasons. Ileavy rains would, I think, act beneficially.
SIR,
St. Ann's Bay, 14 April, 1908. In reply to your circular dated 31st January, 1908, I have to report that ankylostomiasis is not very prevalent in the St. Ann's Bay Medical District of St. Ann, only 13 cases having been treated in the hospital here during the past ten years.
5. My experience of the disease is not sufficient to enable me to say whether the disease is on the increase or not, or what effect the rainy season has on the prevalence.
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