PUBLIC RECORD OFFICE
C.O.
Reference :-
885
20 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH—NOT TO
110
districts are not nearly so infected as the sugar estates, nor is the danger of re- infection nearly so great.
J. E. GODFREY,
Surgeon-General.
22nd February, 1909.
VIDE SURGEON-GENERAL'S ANNUAL REPORT FOR 1901-1902, PAGE 10, PARAGRAPHS 60 TO 64.
The presence of this disease, due to an intestinal worm (the duodenale anky- lostomum), is now generally recognised. There are strong grounds for believing that this disease has been, and is still being, introduced into the Colony by East Indian immigrants; that it is on the increase is, I think, beyond doubt; but at the same time the increased number of reported cases to a large extent is due to its being more generally recognised and recorded.
It is hardly too much to say that this parasite causes more harm than all the other intestinal parasites put together, and it is a well-established fact that persons suffering from this disease are liable to be carried off by comparatively slight ailments, the whole system being so debilitated and undermined.
It is especially prevalent among the East Indian immigrants, and I am con- vinced the estates are yearly losing a considerable amount of labour by it. In December last I addressed a Circular Letter to the estates' authorities on this subject, asking their co-operation and assistance by providing for each hospital a microscope in order that the disease might be diagnosed in the earliest stages. While on this point it may be of interest to give the following quotation from Manson's book on tropical diseases :-
"C
Ankylostomiasis is an important disease from the standpoint of the employer of native labour. The invaliding and inefficiency which it causes among coolies, not to mention the deaths, are often financially a serious matter to the planter and the mine owner. expense or trouble undertaken for the treating and controlling of this To them, any wisely directed helminthiasis will be abundantly repaid by the increased efficiency of the labourer."
Mode of Infection. It is spread through the agency of the dejecta of people suffering from this disease, the embryos finding their way into the human alimen- tary canal either by muddy water or in the mud or dirt adhering to the hands or food receptacles of the workmen. It is, therefore, essential to prevent fæcal con- tamination of the soil and water by the depositing of fæces about huts and fields. This can best be done by the establishment of latrines of a simple kind and suited to native habits.
I hope next year to be able to give full statistics showing the number of cases treated and its prevalence in different parts of the Colony.
-
VIDE PAGE 13, PARAGRAPHS 106 to 110, Surgeon-GeneraL'S ANNUAL REPORT, 1903-1904.
The presence of this disease, due to an intestinal worm (the duodenale anky- lostomum), is now generally recognised. This disease has been, and is still being, introduced into the Colony by East Indian immigrants. That it is on the increase admits of no doubt.
It is hardly too much to say that this parasite causes more harm than all the other intestinal parasites put together, and it is a well-established fact that persons suffering from this disease are liable to be carried off by comparatively slight ailments, the whole system being so debilitated and undermined.
It is especially prevalent among the East Indian immigrants, and I am con- vinced the estates are yearly losing a considerable amount of labour by it. While on this point it may be of interest to give the following quotation from Manson's book on tropical diseases :-
'Ankylostomiasis is an important disease from the standpoint of the employer of native labour. The invaliding and inefficiency which it causes among coolies, not to mention the deaths, are often financially a serious matter to the planter and the mine owner. To them any wisely directed
111
expense or trouble undertaken for the treating and controlling of this helminthiasis will be abundantly repaid by the increased efficiency of the labourer."
Mode of Infection. It is spread through the agency of dejecta of people suffering from this disease, the embryos finding their way into the human alimen- tary canal either by muddy water or in the mud or dirt adhering to the hands or food receptacles of the workmen. They may also be introduced through the skin, and, in my opinion and that of several of the Medical Officers who have closely -studied the subject, the disease known in this Colony as "ground itch" is due to the irritation caused by the embryos working their way through the skin. Persons who work in contaminated fields and trenches are the principal sufferers from "ground itch."
It is therefore essential to prevent fæcal contamination of the soil and water by the depositing of feces about huts and fields. This can best be done by the establishment of latrines of a simple kind and suited to native habits. I am con- vinced that we shall never make any marked progress in stamping out this disease until this is done.
VIDE PAGE 12, Paragraphs 86 to 88, SURGEON-GENERAL'S ANNUAL REPORT FOR 1904-1905.
I drew special attention to the extensive prevalence of this disease in my last Annual Report.
In January of this year I submitted, for the information of His Excellency the Governor, a special report with figures showing the number of cases that had been reported on the different sugar estates in the Colony from June to November, 1904. This report was printed and circulated amongst the proprietors and managers on the different sugar estates in the Colony. In Appendix C I attach a copy of this report; and in order to complete the report I have added two tables showing the total number of cases treated from November, 1904, to 31st March, 1905, and the number of immigrants by the ship "Moy" (the third and last ship with immigrants for the season 1904-1905) who were found to be infected on arrival. The fact that the immigrants by the three ships for the season 1904-1905 were found to be infected to the extent of 24.5 per cent., 58'2 per cent., and 57′2 per cent., respectively, proves what I have always asserted, that is, the disease is being yearly introduced into this Colony by the new immigrants.
I am pleased to be able to report that at last I think I have been able to con- vince the planters that they are yearly losing an appreciable amount of labour by what is undoubtedly a preventable disease. Several of the managers of the sugar estates have erected latrines, with marked results. On one estate where, through
the activity of the Medical Officer and the hearty co-operation of the manager, latrines were established, the disease has almost entirely disappeared, but a careful watch is being kept for cases of re-infection.
I hope next year to be able to give much fuller details as to the working of these latrines and the results.
VIDE PAGE 10, PARAGRAPH 72, SURGEON-GENERAL'S ANNUAL REPORT, 1904-1905. Ankylostomiasis, to which I have drawn special attention in another paragraph
of this report, is thus referred to by the Medical Inspector :-
=
"It will also be noticed that the number of cases returned as suffering from ankylostomiasis is nearly double that of any previous year, pointing, I think, to greater accuracy in diagnosing rather than to any very great increase in the disease. Now that microscopes have been provided in all hospitals, the diagnosis of this disease is rendered both accurate and easy, and the medical officers are not slow to avail themselves of the facilities offered, with the result that diagnosis of anæmia is steadily giving way before that of ankylostomiasis."
}