PUBLIC RECORD OFFICE
Reference :-
ECO 885
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ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
22 PUBLIC RECORD OFFICE, LONDON
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houses. Use of mosquito-nets. Taking of quinine, &c., by officials. No measures in native shambas." The revenue and expenditure of the Protectorate, the rainfall, the number of men employed for minor works and their cost, and the distribution of quinine in schools, are all referred to as " not known in the Medical Department' --though they are obviously elementary matters which must be known in every The Medical Department which exercises any influence over sanitary affairs. Annual Medical Report for 1910 is referred to for further information; but I have received some details separately. From these it appears that the medical and sani- tary expenditure rate to total is rather high, namely 8 per cent., with an average pay rate for medical officers of £593 a year (to judge from the figures given). No men were employed for minor measures, but £500 is put in the estimate for epidemics and anti-malaria measures. Quinine is given in certain schools "when children have fever."
(14) East Africa Protectorate.-Return under date 21st February, 1911,* signed. Births and deaths not given. No statistics from hospitals and dispensaries. Thirty-two medical men, including two special health officers. Medical and sanitary expenditure rate, 39 per cent., and 27 per cent. for Nairobi. Frequency of filariæ studied and found to be high. No major works mentioned, but six men are said to be employed at Mombasa at a total cost of £80 per annum. Legislation is “under consideration."
Some details were given in the Annual Report of the Advisory Committee for 1909, pages 13-16. Bush and rank vegetation were being cleared. Drainage was being improved in Nairobi at a cost of £4,000. Swamps, water-holes and borrow- pits were sometimes being dealt with, especially in connection with the railway, and there were reclamation works. Minor works were done at Kisumu at a cost of £200, and houses were described as proofed at the Coast and Kisumu. These matters are not mentioned in the Return for 1910.
(15) Somaliland.-Return under date 17th February, 1911,* signed by the Senior Medical Officer. Births and deaths unknown. No yellow fever, dengue or filariasis. Malaria rates high. Two medical officers. No major or minor measures. Quinine free at the Government hospital. The prevalence of malaria requires ex- planation.
(16) Seychelles.-Return under date 9th March, 1911,* unsigned. High birth- rate and very low death-rate (I know that the figures are well kept). No yellow Medical fever, dengue, or filariasis, and only a few imported cases of malaria. and sanitary expenditure rate fairly high, namely 76 per cent. Five medical men. No works or quinine distribution mentioned, or apparently needed.
(17) Mauritius-Return dated the 25th July, 1911, and signed by the Acting Director, Medical and Health Department. Thick population. High birth-rate
Filariasis occurs. and death-rate. No dengue or yellow fever.
High malaria rates. Out of 12,724 children examined, 24-0 per cent. had enlarged spleen, and the average spleen was twice the normal. There are 104 sugar estates, employing 39,000 Jabourers, with a high death-rate of 64 per cent. There are 59 medical men (in a population of 374,000), and the medical and sanitary expenditure rate is 78 per cent. The sanitary expenditure (without salaries and wages) is 16 per cent. of the total expenditure. Four major works costing £606; and 45 men employed on minor works at a cost of £897 (this was before the development of the scheme recommended by myself). Quinine distributed at 35 depôts besides the dispensaries, and in camps and schools. Eighteen of the sugar estates have now undertaken mosquito reduction, and six employed special" moustiquiers" with working gangs under them. The anti-malaria work is in charge of a special officer, an entomologist, under the Medical Director. The disease has been stamped out at Phoenix near the military barracks at a small cost, and an epidemic in the district of Moka was stopped. Much good work is being done, both by the Government and the Estates. No special legislation exists. Good Return.
(18) Ceylon-Return under date 24th July, 1910,* signed by the Principal Civil Medical Officer. High birth-rate and rather low death-rate. No yellow fever or dengue. Filariasis not high. High malaria rates. Out of 376,921 children ex- amined 19.8 per cent. had enlarged spleen (there is a little kala-azar). There were 349 medical men, and the medical and sanitary expenditure rate was fairly high, namely 62 per cent. No special legislation. A committee was appointed to advise regarding malaria at Kurunegala. No major works. A small minor-work gang in
In Appendix I, to [C'd, 6024].
une town.
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A large quinine distribution chiefly through the headmen." This is the principal measure employed; but the reporter says that no organised campaign against malaria in any particular town or district has been attempted, though a commencement is being made in this direction-see especially his previous reports (Advisory Committee's Annual Reports for 1909, page 11; and for 1910, page 4).
(19) Straits Settlements.-Return under date 28th September, 1911,* prepared Death-rate higher than recorded birtli rate. by the Principal Civil Medical Officer. No yellow fever, but a little dengue and filariasis. High malaria rates. No census for malaria or filariasis. Fifty Government medical officers, including 24 assistant surgeons. Two special health officers, excluding municipality; and 84 other regis- tered practitioners. Medical and sanitary expenditure rather high, namely 71 per cent. No special legislation. No major works. Number of men employed for minor works reported as "unknown." No distribution of quinine.
(20) Hong Kong.-Return dated March, 1911,* and signed by the Medical Officer of Health. Refers mostly to the city. Apparently births much below common rate. Death-rate moderate. No yellow fever. Two cases of filariasis and one of dengue. Malaria rate considerable, but is largely maintained by influx of Chinese from without the city. No census taken. Forty-two medical men, including four health.officers. Considerable medical and sanitary expenditure, namely 86 per cent. Sanitary expenditure alone, 5'2 per cent. Special legislation in force. Training of All the European sanitary inspectors, and the mountain streams cost £3,063. scavenging inspectors and police are said to pay special attention to mosquito- breeding, and small conservancy gangs attend also to minor works-ahout 50 men including foremen. No quinine distribution. From a table given, malaria appears to have diminished considerably since 1901, but there was a marked increase in 1910. Hygiene taught in schools, pamphlets distributed, and sanitary lectures employed.
(21) Fiji-Return under date 29th September, 1911, signed by the Chief No yellow fever and endemic Medical Officer. High birth-rate and death-rate. malaria, but admission rates for filariasis and dengue were 26 per cent. and 15 per cent. respectively. The reporter evidently thinks that questions (b) and (c) under Heading 17 of the Return, relating to the number of persons examined for filariasis and enlarged spleen, refer to examinations made in hospital, and, regarding malaria, he remarks: There is no malaria except that imported and the anopheles.” Twenty-one Government medical officers, including one special health officer. High No anti-mosquito medical and sanitary expenditure rate, namely 117 per cent.
Apparently no minor legislation, though filariasis and dengue are so common. works, except one of canalisation in the town of Suva by a prison gang “under a General sanitation under Municipal European warder at £150 per annum.' Ordinance Regulations.
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5. Other communications on the Subject. In addition to the Returns just dealt with, the Reports of the Advisory Committee for 1909, 1910 and 19117 publish a number of other communications on the subject-mostly general remarks, or replies to a Circular of the Colonial Office to the Governors, dated the 31st March, 1909, regarding a letter of Professor William Osler on the prevention of malaria in Italy' by means of quinine (Report for 1909, page 4). I will now make a few notes on such of these as I have not yet touched upon, and on a few other documents which have been sent to me.
The Returns for St. Lucia, St. Vincent, Grenada, and Trinidad have not been received by me, but letters from them are contained in the Reports referred to.
The Report of 1909 contains a letter (dated 20th May, 1909), from Grenada (page 39), in which the Governor says that malaria is not widespread in the Colony, and that the cost of free quinine distribution would not, therefore, be justified. No other information regarding this island is given in the Reports. The late Sir Rubert Boyce visited it a few weeks before this letter was dated, namely, on the 1st April, 1909, and gives a very different picture in his book, "Health, Progress and Adminis tration in the West Indies" (Murray, 1910). Comparing Grenada with Barbados, he remarks (page 156) under the heading of malaria, “ What a contrast is Grenada ! A stiff clay soil, numerous hills and valleys, and whole islands threaded with streams innumerable, and here and there a marsh. It is not, therefore, to be wondered at that malaria is the chief disease of the island." He gives figures to support this view. Thus in one of the 10 districts there were 1,119 cases of malaria in 1907 (total population of island, 71,505). Sir Rubert Boyce's statement is, therefore, at
† [Ca. 1999], [Cd. 5514), [Cd. C021].
• In Appendix 1. to [Cd. 6024].
B 3
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