PUBLIC RECORD OFFICE

Reference :-

TILIC.O.

885

20 PUBLIC RECORD OFFICE, LONDON

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8

Colony or Protectorate.

Year.

No. of New Cases of Leprosy recognised during the year,

Total No. of

Cases known to be present during the year.

No. of Deaths from Leprosy during the year.

Estimated Population.

Straits Settlements

...

1897

231

550

166

("Number of

580,563

new cases

1898

233

533

149

592,587

recognised" is a list of

1899

211

505

174

admissions and re-admis-

560,403

1900

191

448

126

sions to the Asylums).

567,178

1901

183

446

112

574,029

1902

181

451

96

581,219

1903

215

491

106

588,544

1904

212

598

178

595,782

1905

274

607

112

603,824

1906

223

624

153

611,790

1907

203

594

133

619,796

1908

206

595

118

628,016

1908

Under 300

1908

Nil

6

Nil

20,000

1905

3,781

1906

1907

1908

3,746 3,558

Fiji

Tonga

St. Helena

EG ER EN EN

3

• NOTE-A death from leprosy is recorded in 1901.

B.-Distribution of Cases-Most of the observations bearing on this question are recorded in the extracts printed at the end of this Report. To them, however, may be added that littoral distribution is reported from Gibraltar, Malta, Bahamas, and St. Lucia, and general distribution from Cyprus, Gambia, Sierra Leone, Southern Nigeria, East Africa Protectorate, Barbados, Bermuda, British Guiana, and Leeward Islands. It must, however, be remembered that many of the smaller Colonies are insular and that the whole population may be considered littoral. Cases are reported to be confined to natives in Southern Nigeria and to be found among all races without distinction in Cyprus, Barbados, and the Leeward Islands. Other notes on racial distribution will be found in the extracts.

C.-Notification of Cases.-The returns show that notification is not usually compulsory. It is enforced in Cyprus, Bechuanaland Protectorate, Swaziland, British Guiana, Grenada, British North Borneo, Ceylon, and Seychelles, and, for males only, in Malta.

D and E-Administrative action and segregation.-Disinfection is generally not required. It is carried out in Malta, Southern Nigeria, Bermuda, Trinidad, British North Borneo, and the Straits Settlements. In Swaziland and St. Kitts- Nevis huts are destroyed by burning.

Where there is a leper asylum, compulsory segregation is naturally effected by confining the patients to it; for example, in Cyprus, British Guiana, British North Borneo, and Ceylon.

A partial, but apparently a fairly high, degree of segregation is attained by legislation providing for the detention of lepers found in an indigent state, engaged in certain prohibited trades, or using public baths or other specified institutions. Ordinances of this character are found in Barbados, Jamaica, Trinidad, the Straits Settlements, and Fiji. The following extract from the Straits Settlements' return will indicate the general character of such legislation:

The Governor in Council may by notification in the "Gazette" prohibit the carrying on by a leper of any of the following trades or callings: baker, butcher, cook, any trade in which the person employed handles or comes in contact with articles of food or drink, drugs, medicines, or tobacco in any form, washerman, tailor, any trade or calling in which the person employed manufactures, handles, or comes in contact with wearing apparel, barber or any other similar trade or calling in which the person employed comes in contact with other persons, domestic servant, nurse, jinrikisha puller, licensed hackney carriage driver, boatman on any boat licensed for the conveyance of passengers or cargo. Any leper so offending may be

9

committed to a leper asylum by a court of two magistrates until discharged by order of the Governor. Any leper who shall enter any hackney carriage, jinrikisha, or other public vehicle, or lodge in any hotel, boarding house, or lodging house, or bathe in any public bath, may on conviction before a magistrate be detained in a leper asylum until he is discharged by order of the Governor.

If it be proved to the satisfaction of a magistrate that any leper is not maintained in a state of isolation from the general public it shall be lawful for such magistrate by warrant under his hand and seal to order the deten- tion of such leper in a leper asylum until he is discharged by order of the Governor.

Illustration.-A leper who frequents the public streets, whether in a vehicle, on foot, or otherwise, will not be in a state of isolation.

When a leper is so arrested and committed to an asylum the municipal or governmental authorities, as the case may be, disinfect the house or room in which he had dwelt.

Lepers are allowed to live in their own houses as long as they obey the clauses of the Lepers Ordinance already quoted.

In Malta male lepers are segregated and the rule will shortly be extended to females. In Bermuda, where there is no asylum, segregation is effected in a small hut or outhouse. Grenada receives two pauper cases in the Poor Asylum. In Swaziland cases are isloated at their own kraals or a hospital. In Tonga lepers must be isolated by their relations.

In

Native systems of segregation appear to be widely spread in Africa. One method is described in the extract from the Gold Coast Report on page 12. Southern Nigeria lepers are segregated "in the hinterland at leper farms' outside several of the large towns voluntarily by the natives and under the control of the native chiefs." It is noted that "medical officers very rarely see leprosy." The East Africa Protectorate return states that "the Arabs would appear to practise a system of segregation of their own accord. They are shy of reporting cases and usually isolate their cases in the bush." There would also seem to be some voluntary segregation in Basutoland and the Bechuanaland Protectorate.

Deportation of persons domiciled outside the Colony may be resorted to in Bermuda and Gibraltar. Cases found in Hong Kong are deported to Canton.

Institutions.

No institution for leprosy exists or is under construction in Gibraltar, Gold Coast, Northern Nigeria, Basutoland, Bechuanaland Protectorate, Nyasaland, Swaziland, Uganda, Bermuda, or the Montserrat and Virgin Islands Presidencies of the Leeward Islands. A Government Refuge for Lepers is under construction in the East African Protectorate. At present the Government pays the Church Missionary Society hospital a capitation fee for retaining in segregation at Mzi- zima lepers found in the town of Mombasa. In Grenada two pauper cases have for some years been treated in the Poor Asylum. In St. Lucia lepers have usually been treated in the Yaws Asylum when they would consent to go there. At the beginning and end of 1908 there were three such patients. Fiji maintains a segre- gation station on part of the Island of Beqa, 18 miles from Suva, which of the nature of a hospital or asylum, but is more of a village settlement where is not the patients live in separate houses, three or four in each." erecting a stone cottage, with outbuildings, in an isolated district in which to St. Helena " is now segregate the leper child. to be guardian and caretaker. Should more cases of leprosy occur, additional The grandmother of the child has volunteered rooms could be built on to the original cottage as necessity demanded.”

LIST OF LEPER InstitutionS IN CROWN COLONIES AND PROTECTORATES.

No, of Patients at beginning of year 1908.

44

No. of Patients

at end of

Joar 1908.

Colony or Protectorate.

Name of Institution.

No. of Beds.

Cyprus

Malta

Leper Asylum, Nicosia Leper Asylum

115

95

98

72

71

65

Sierra Leone...

Kissy Incurable Hos- pital (Leper part).

Average num-

Average num-

ber 6.

13869

ber 6.

B

10

Colony or Protectorate.

Name of Institution.

No. of Beds,

No. of Patiente

year 1908,

at beginning of

No. of Patients

at end of

year 1908.

Southern Nigeria

Southern Rhodesia ...

Bahamas

Barbados British Guiana

British Honduras Jamaica

Leeward Islands

St. Vincent

Trinidad

British North Borneo

Ceylon

Hong Kong

Mauritius

Seychelles

Leper Asylum

Leper Asylum

Capuan Island

Hendela

Yuba Leper Asylum... Onitsha Asylum Morgenster Asylum... General Hospital (One male and one female ward set apart). The Lazaretto

24 (12 m., 12 f.)

21

16

(10 m, 11 f.)

29

(7 m., 9 f.)

27

Huts built as

required.

10

6 (April, 1909)

4

G

136 475

119 403

121

431

(334 m., 141 f.) | (285 m., 118 f.)

(306 m.,

125 f.)

Corozal Leper Hut

2

Nil.

Nil.

Leper Asylum

170

113

105

Rat Island, Antigua

Fort Charles Asylum

St. Kitts.

50 61

37

32

60

61

Pauper Asylum (Leper

part).

Kalmunai

St. Lazare

Round Island Leper

Asylam.

Accommodation

for 20.

(256 m., 109 f.)

39

382

30

See page 34. 200

Huts built

as required.

6 in 1908-9.

365

262

2 282 22 2

320

128

267

5 *** * *

325

129

Straits Settlements

Singapore Male and Female Leper Asy- Jums.

63

Male Leper Hospital

382

356

370

Jerejak Island, Pe- nang.

Female Leper Ward

17

13

15

Jelutong, Penang. Malacca Leper Asy-

6

Nil.

Nil.

lum.

Fiji

Beqa Leper Station ...

A verage 36.

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