PUBLIC RECORD OFFICE
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Reference :-
C.O. 885
20 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
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VIDE PAGE 11, PARAGRAPH 76, SURGEON-GENERAL'S ANNUAL REPORT FOR
1905-1906.
I reproduce the following paragraph from my last annual report:-
[See preceding sub-enclosure.]
VIDE PAGE 13, Paragraph 92, SURGEON-GENERAL'S ANNUAL REPORT FOR
1905-1906.
(1) I have in previous reports drawn special attention to the extreme prevalence of this disease; and in my last annual report I wrote as follows :-
"I am pleased to be able to report that at last I think I have been able to convince 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. one estate where, through the activity of the medical officer and the hearty On 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 fufler details as to the working of these latrines and the results."
(2) The Medical Inspector reports that 4,918 cases were treated in the estates' hospitals during the year; and that on eighteen of the sugar estates latrines have been established with most encouraging results. These latrines are now an absolute necessity, and I trust that next year I shall be able to report that every estate in the Colony has been provided with ample latrine accommodation.
VIDE PAGE 10, PARAGRAPHS 63 AND 64, SURGEON-GENERAL'S ANNUAL REPORT FOR 1906-1907.
With regard to anchylostome infection, it is disappointing to find that more has not been done in the matter of latrine accommodation, for, as I have stated in my report, I believe the decrease in the amount of the two diseases mentioned above is due to the fact that on some estates this question has been taken up seriously, and full and proper accommodation provided. If others could be induced to follow their example the results would, I feel sure, be still more satisfactory.
It must not, however, be forgotten that the efforts in this direction should not be confined to sugar estates. Anchylostome infection and allied diseases are rife in the villages, and unless the remedy is employed here also these villages will remain a constant source of danger to the Colony.
Enclosure 5 in No. 48.
LETTER from the Immigration Agent-General to the Government Secretary. SIR,
I HAVE the honour to acknowledge the receipt of your letter, No. 247, dated
6th April, 1909. 9th ultimo, and in reply beg to state that I have already, in my memorial No. 2455/ 1036, dated 31st October, 1908, addressed to the Secretary of State for the Colonies, expressed my views on the subject of the measures to be adopted for dealing with ankylostome infection, and from the enclosed pamphlet* (submitted in triplicate) which contains a record of the proceedings at the fourth quarterly meeting of the British Guiana branch of the British Medical Association, held on the 5th November last, it will be seen that those medical officers who have had special opportunities of becoming practically acquainted with the subject, and who may, therefore, be considered experts, have arrived at conclusions almost identical with those expressed a my memorial.
• Not received in Colonial Office.
2.
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may, however, express my belief that the figures on which the Surgeon- General bases his opinion of the prevalence of the disease do not convey an accurate impression of the extent to which it exists in the Colony. Apart from the fact that they relate to a special portion of the community, it seems that the 39,000 cases reported do not refer to 39,000 individuals treated. couple of years ago by Mr. King, Immigration Agent, an indentured immigrant In one instance, reported a was treated on no less than eleven occasions.
3. From the attached table,* compiled from figures supplied by the Medical Department, it may be noticed that the percentage of the immigrants by the ships Mutlah," "Sutlej" and "Ganges," found on arrival on the estates to be infected, differed but little from that of the immigrants by the "Ems," although all the immigrants by the latter ship had been twice treated during the voyage, while the immigrants by the first three vessels had not been so dealt with, and this fact would seem to show that the treatment does not eliminate the worms from the system, but merely expels a portion.
In his
cases
4. But a further question arises in my mind, and that is, whether the sick nurses are in a position to determine the presence or otherwise of the ova circular letter, No. 249/427, dated 9th May, 1908, Dr. Godfrey, then acting Surgeon- General, stated in paragraph 6:-"It is well to remember that in the Ankylostomum duodenale the stools should be examined shortly after they have been passed, otherwise the ova develops rapidly, and the embryo having quitted the shell, the egg is no longer visible," from which it is evident that on these nurses must fall the duty of examining the stools. We find, however, that the time of the nurses is, or should be, fully occupied by their ordinary duties, such as attending to the patients in hospital, compounding and issuing the medicines, purchasing and examin- ing the food, and supervising its cooking, attending the Government medical officer on his visit, writing up the case book, hospital register, ration book, property book, register of births and deaths, medical reports, &c., visiting the ranges, necessitating, in some instances, a walk of more than a mile, for the purpose of personally ascer- taining whether there are any sick in their rooms, and, if so, having them sent to the hospital, and also attending when necessary, at their own houses, the members of the staff and their families.
5.
With respect to the suggestions of the Secretary of State for the Colonies, I may point out that the Local Government Board have ample powers under Sections 188 to 194 of the Local Government Ordinance, 1907 (which are practically a reprint of Sections 44 to 51 of the Public Health Ordinance, 1875) for dealing with the disposal of focal matter in the villages; and I would urge, therefore, that if the estates are to be compelled to provide latrines, the Local Government Board be also required to put in force the powers vested in them for dealing with the question in the villages.
6. If, however, the advice offered by the Secretary of State in Sections (@) and (e) of paragraph 9 were carried into effect, and the people tutored into the know- ledge of the benefits to be derived from the proper disposal of the fœces, and made to understand that compliance with the law was imperative, I doubt very much whether it would be necessary, except in very few instances, to bring into operation the penal clause of the Ordinance, and the example set by the more respectable portion of the community would be quickly followed.
7. For many reasons, I deprecate the imposition of penalties. Where matters of custom are concerned, it is always sound policy to lead, and not to drive, the people, more especially in such a Colony as this, where a large proportion of the inhabitants have been unable, in consequence of their knowledge of their right to a return passage, to merge into the general population. There is, therefore, the danger of these East Indians being driven to claim their right to be returned to their country, or even, failing this, of being induced to leave the Colony for Suriname, Trinidad, or Cayenne, where the conditions are more favourable to the conservation of their racial habits and customs, and where the employers would be only too ready to welcome any labourers from this Colony.
I have, &c.,
ROBERT DUFf, Immigration Agent-General.
16996
• Not received in Colonial Office.