18
disease is increasing or decreasing in the territory. From native reports, it would appear to be decreasing.
Separate huts are erected as required for the inmates. There are at present six lepers segregated there.
A. M. FLEMING,
Medical Director.
19
leprosy is most prevalent among the large consumers of fish-more especially of im- perfectly-cured fish. The natives, on the other hand, do not incriminate this dietary in any way.
Some stress is laid by one or two observers on the possible connection between the disease and the filthy habits and insanitary condition of the dwellings and sur- roundings generally of certain tribes who are especially subject to this complaint.
й, HEARSEY,
Principal Medical Officer.
EAST AFRICA PROTECTORATE.
Very little is known about leprosy in this country. observation are confined to the coast.
Such cases as come under In 1907 there were two cases in Nairobi-soldiers who had arrived from the Nyasa- Presumably inland cases are imported ones. land Protectorate some months previously. system of segregation of their own accord. They are shy of reporting cases, and The Arabs would appear to practise a generally isolate their cases in the bush.
It is hoped that when the Government leper establishment is opened that more reliable data may be obtained.
Jubaland.-Nil.
A-Number of known cases.
Tanaland. Twenty-two cases in Government Leper Village, situated 25 miles from Lamu in absolute isolation. Patients do not leave village, are fed by Govern-
ment, and do a certain amount of farming.
Malindi.-Fourteen cases in vicinity of this station. merly there no longer exists. Seven of the above cases live in one village.
The leper colony for- Rabai.-Six cases are definitely known to exist in this district, and the presence of others is suspected.
Mzizima.-Eight cases under control.
Chonyi-Two cases have been seen (uncontrolled).
Teita. Two or three cases have been observed here (uncontrolled).
Mombasa.—According to native account, some 50 cases exist here, but one does
not see them.
Shimoni-Six cases exist, all of which are isolated at least five miles from each other and are living in isolated huts in the bush about 20 miles to the S.S.W. of Vanga and about 10 miles to the east of the Anglo-German boundary.
B.-Distribution.
Both littoral and inland (Teita is about 100 miles from the coast).
Nairobi, May 11th, 1909.
CHIEF SECRETARY,
UGANDA.
LEPROSY has been very little met with in those parts of the Uganda Protec- torate which have hitherto been administered by means of stations. Personally I have not seen half-a-dozen cases in 11 years in Government stations. The disease existed to a slight extent among the Sudanese and their followers, who were brought into Uganda viâ the Congo, but it appears to have died out.
There appears, however, to be a centre of infection somewhere in that part of the Protectorate east of the Nile Valley, and between Busoga and the Abyssinian border, an area of which at present very little is known.
In the southern part of this area, which is essentially an inland one, cases of leprosy are frequently met with, and the disease is said by natives to be commoner further north. It is probable that the cases which have been occasionally met with in other parts of the Protectorate have originated in this area.
Seven cases of leprosy were returned as occurring in Uganda Protectorate during 1908, with one death.
No measures exist for the notification or segregation of leprosy, but the disease could, I presume, be dealt with under the Dangerous and Infectious Diseases Ordi-
nance.
No hospital or asylum for leprosy exists in the Protectorate, but I understand that the Church Missionary Society is projecting a medical station with hospital and leper asylum in the near future in the neighbourhood of Kumi, the newly- opened station on the southern confines of the infected area referred to above.
A. D. P. HODGES,
Principal Medical Officer.
Entebbe,
30th June, 1909.
BAHAMAS.
A. D. MILNE,
Principal Medical Officer
Mainly fish diet."
PUBLIC RECORD OFFICE
C.O.
Reference :-
885
20 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
NYASALAND.
By far the large majority of cases are met with on the shores of the lakes and
on the banks of the Shire river, and but comparatively few inland.
The disease is said to be most prevalent among people engaged in catching and curing fish (by drying), and who trade in this commodity. Thus a large propor- tion of the lepers have been observed round Lake Chilwa, and as to "grouping of cases the majority of these appear to live on Chisi Island, in that lake.
}}
The disease is more prevalent among certain tribes than others. The Chikunda, Anyanja, Anguru, Atonga, Chipeta, Achewa, and Wakonde furnish most of the cases, whereas among the Yao, Angoni, and Awemba leprosy is but seldom seen.
It would appear that natives attach some importance to humidity of the soil as an etiological factor, and believe that people who live in huts erected on damp soil are liable to develop the complaint. On the lake the vast majority attribute leprosy to the water they drink. They attach little or no importance to contagion, and it is said that among certain tribes, the Chipeta, for example, it is not uncommon to find a leprous man living with a healthy woman, and vice versa.
As regards diet, there is a general concensus of opinion among Europeans that
BRITISH GUIANA.
The disease is fairly uniformly spread over the inhabited part of the Colony bordering on the sea shore and river. It is not, as far as I am aware, found in the interior among the aboriginal Indians.
I am of opinion that the disease is contagious, and that neither soil nor food has any relation to its distribution. The East Indian and black races constitute about nine-tenths of the population, and in these cases the proportion of those affected is practically the same.
Cases are as a rule not notified until the disease has made a considerable advance. Undoubtedly there are a good many cases which are not reported
J. E. GODFREY,
15 May, 1909.
18969
Surgeon-General.
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