PUBLIC
RECORD
OFFICE
Reference :-
TREPIC.O. 885
20 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
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5. Recent experience has convinced me, however, that this is so. I would affirm that, with the rarest exceptions, nearly every one of the cases of great anæmia or of severe dropsy occurring among Tamils is attributable to infection with hook worm and to no other cause. The disease is, when left untreated, almost uniformly fatal, and this issue is reached usually in a few months.
6. While it cannot be affirmed that infection with hook worm will produce serious illness in every person, yet it is probable that, in the majority of persons, sooner or later the parasite entails severe illness, while I believe that in Tamils, owing perhaps to persistent re-infection, perhaps to other causes, such as ill-feeding, it, sooner or later, in all cases has a fatal termination.
7. The obvious and necessary treatment desirable to secure expulsion of the worms is in cases not too advanced followed by rapid recovery. But, owing to the constant re-infection, treatment must be also constantly repeated. It is clear, there- fore, that in this, as in other maladies, prevention is better than cure.
8. During the last six months I have had 2,000 sick Tamils brought under my immediate care in estate hospitals. There was no single one of these coolies who was not affected (generally severely affected) by ankylostomiasis. Directly or indirectly the disease was responsible for certainly 90 per cent. of the deaths
observed.
9. At several estates inspection showed that 60 per cent. of the coolies at work were in an advanced state of ankylostomiasis, and that in all cases examined anæmia from the same cause was in some degree present. These facts may serve to enable Government to realise the wide extent of the disorder in Negri Sembilan. There is no reason to suppose that it is any less prevalent in the other States of the Fede- ration.
10. I need not labour the point how detrimental a factor the prevalence of a disease such as this must be to industries in which Indians are engaged, or how impossible it must be to expect to maintain a healthy and vigorous Tamil population in the country under circumstances so adverse. The insidious spread of ankylosto- miasis as observed to-day forms a pestilence which, if less dramatic and less compel- ling attention, is not less destructive or calamitous, and demands attention no less seriously, than plague. The means of preventing the disease happily are very simple: but under existing conditions, and without the strong arm of compulsion, they will never be applied.
11. Yet all that is necessary to prevent the spread of the disease is suitable disposal of the excreta of those affected, since it is through the excreta only that the disease is propagated. Burial in earth prevents the eggs of the worms developing. All that is needed, then, is to make compulsory the use of proper latrines, wherever coolies are housed.
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vinced of the wisdom of the measures promulgated by the Surgeon-General. have seen these measures in operation upon one of the large sugar estates, known I as Pln. Diamond, and I am convinced that these measures are essentially labour- protecting, and that they should be enforced not only on the plantations where there is indentured labour, but throughout the whole Colony. If this were done, the gain to the Colony would far outbalance any necessary initial expenditure. I have satisfied myself, from examination of the cases in the hospitals in the Colony, that the disease ankylostomiasis producing great ravages amongst the labouring classes. For instance, it is well known that this disease is the grave complication in pregnancy, and jeopardizes not only the life of the mother, but also that of the child. I therefore trust that every effort will be made to combat a disease which paralyses labour at its sources."
In Trinidad I visited three plantations and reported to His Excellency the Governor :-
" I visited several estates in the Colony especially with reference to indentured labour and ankylostomiasis, and I wish to report that in my opinion the labourers are exceedingly well looked after, very comfortable and happy. much yet remains to be done to devise some means of preventing the spread of It is true that ankylostomiasis among the East Indian labourers, but I do not foresee that there will be any great difficulty in providing latrine accommodation, and I am of opinion that the planters themselves who have taken the lead in this matter will heartily co-operate with the Medical Authority. I am of opinion, therefore, that a very great deal is being done for the welfare of the indentured labourers, that they are happy and contented, and that in the hospitals they receive the most modern treat ment and every attention; and further, I am convinced that the planters would be most willing to co-operate with the Health Authority in bringing about further health security. Medical men and planters alike have informed me that the utility of adopting special precautions by erecting latrines for the indentured labourers 'is weakened if the free labourers in the villages are not also compelled to take similar care of themselves. As conditions now obtain the indentured labourer and his family run the chance of getting infected in the villages in which precautions are not taken."
RUBERT BOYCE.
To the Right Honourable
19774
The Secretary of State for the Colonies.
No. 47.
19104
SIR,
No. 46.
WEST INDIES.
have, &c.,
W. L. BRADDON, State Surgeon, Negri Sembilan.
SIR RUBERT BOYCE to COLONIAL OFFICE. (Received 8 June, 1909.)
REPORT ON ANKYLOSTOMIASIS AMONGST THE INDENTURED LABOURERS.
HAVING been given the opportunity of observing this disease and being aware of the attention which is now being directed to it as well as to indentured labour in the West Indies, I seized every opportunity of visiting plantations employing coolie labour.
I found that in British Guiana, Trinidad, St. Lucia, and Grenada, the health authorities were giving their attention to the eradication of the disease, and for this purpose had framed measures and issued circulars and literature bearing upon the subject.
In British Guiana I reported as follows to the Administrator :-
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During my stay in this Colony I personally examined the steps which your medical authority has taken in respect to ankylostomiasis, and I am firmly con-
FEDERATED MALAY STATES.
THE ACTING HIGH COMMISSIONER to THE SECRETARY OF STATE.
(No. 166.)
MY LORD,
(Received 14 June, 1909.)
Government House, Singapore, 20th May, 1909.
WITH reference to your Lordship's despatch, No. 28 of the 4th February,* I have the honour to transmit copy of a letter from Dr. Fraser, forwarding a report by Dr. Stanton on the subject of ankylostomes and ankylostomiasis in the Federated Malay States.
2. Dr. Fraser has been requested to collaborate with the Director of Public Works in the drafting of such a circular as he suggests in his letter.
3. On receipt of the circular a further despatch will be sent to your Lordship.
I have, &c.,
133/08. SIR,
Enclosure in No. 47.
ARTHUR YOUNG.
Dr. Stanton's Report on Ankylostomiasis.
13th May, 1909.
I HAVE the honour to forward Dr. Stanton's report on the subject of anky- lostomes and ankylostomiasis.
* No. 43.
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