PUBLIC RECORD OFFICE
19
Reference :-
MCO 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
COPYRIGHT PHOTOGRAPH-NOT TO
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up or drained. 3. All insanitary privies should be got rid of and sanitary ones provided as directed by the Medical Officer in charge of an estate.
2. All puddles and all muddy places near houses should be filled
4. No one should defecate on the surface of the ground, especially if it be moist or wet and shaded, such as is often the case in banana plantations and in the bush, as the hookworm needs fresh air and damp, well-shaded soil, and no person should defæcate into any spring, pool, pond, or other water supply, so as not to cause infection.
Every one should use a latrine, pit, or trench for such purposes.
5. The hands should invariably be washed before eating or taking food, and no person should ever touch with a dirty hand any food or utensil used to hold food or drink.
6. All fruit that has fallen on the ground or that has been picked up from the ground should be washed before it is eaten, and all vegetables should be washed or boiled before being eaten.
7. No person should walk barefooted, but shoes should be worn (and stockings or putties if possible) so as to keep the feet and legs protected from the young of the hookworm which lie on the surface of the ground.
8. Any person who is suffering from "anæmia " or who is passing worms should consult the doctor at once.
9. Where estates are infected with hookworm disease, or where a large number of the labourers are infected, it is advisable that all coolies returning from labour should bathe their legs and feet in a solution of Jeyes fluid, carbolic, cyllin or such antiseptic solution as may be prescribed by the Medical Officer in charge of the estate and of such strength as he may direct.
10. Where possible it is advisable to saturate the soil in the vicinity of trenches and latrines and the pathways leading to them with sea (salt) water, which is now held to be most destructive to the hookworm and its ova.
sea,
Where estates are near the sea, the coolies should be encouraged to bathe in the
5.
I have, &c.,
J. E. KER, Superintending Medical Officer.
HOOKWORM DISEASE-ANCHYLOSTOMIASIS
Is a disease prevalent among the peasantry and labourers in Jamaica, chiefly among those who walk barefooted and barelegged. The disease is one which causes much ill-health, rendering those who suffer from it unable to work on account of weakness, which is often wrongly attributed to laziness. The chief symptom of the disease is" anæmia or weakness.
33
The cause of the Disease.
The disease is due to worms which are parasites. The worms, which are about half an inch long, are called "hookworms" because they have in their mouth end four claw-like hooks by which they attach themselves to the inside of the bowels of any person in whom they live. A person may harbour hundreds of these worms.
The symptoms of Hookworm Disease.
The worms suck up blood from the bowel of the person in whom they live, caus- ing him to suffer from weakness or anæmia due to the loss of blood.
A person suffering from anæmia becomes weak, pale, depressed, and unable to work, the face may also become puffy, and the ankles and feet swell, due to dropsy, and such person often becomes very emaciated and frequently dies.
If the lower eyelid of a person sick of the disease is turned down it will be seen to be pale and whitish instead of red, while the inner parts of the lips may be the
same.
There are also other symptoms noticeable in a person who suffers from hook- worm disease; they are nausea, vomiting, pain over the pit of the stomach, indigestion, shortness of breath, and palpitations of the heart. Some fever, which is often mistaken for malaria, may also exist.
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Dirt-Eating.
Some people who suffer from the disease contract the unnatural and dangerous habit of eating earth and mud, and are consequently termed "dirt-eaters."
A person may continue to infect himself by eating earth or mud that is infected with the parasite.
How infection is spread from Person to Person.
1. The female hookworms, when living in the bowels of an infected person, lay large numbers of eggs, which pass out of the body with the excrement.
The eggs, when they are deposited on the soil either of yards or compounds round houses or on banana cultivation, cane patches, in the bush or elsewhere, especi- ally where the soil is damp or muddy, or where there are puddles, hatch out and the young of the worms lie about on the surface of the ground ready to attach themselves to the bare feet, legs, or other exposed portion of any person who comes in contact with them.
The young of the worms, having attached themselves to the exposed portions of a person's skin, enter the skin, and in doing so give rise to irritation or inflammation or sore places, and then, working through the body, gradually get into the bowel.
Ground Itch.
Many persons suffer from what has been called " ground itch," that is, inflamma- tion or ulceration of the skin which is caused by the young of the worm, and which usually affects the exposed parts, such as the feet, legs, and hands.
2. Any person who, after handling or digging the soil, neglects to wash his hands before taking food may also become infected with hookworm disease. The young of the worm enter the mouth if the hand which is soiled by infected earth touches it, or if a soiled hand touches food that is being eaten or that is about to be
eaten.
Carriers of the Disease.
Every person who harbours the hookworm does not of necessity suffer from hookworm disease, as the quantity of blood sucked up by the worms may not be sufficient to cause " anæmia," but to a person who carries the worm in his bowels, even which pass in small numbers, may cause other persons to become infected, for the eggs out of the bowels of one person with the excrement, if deposited on the ground and not covered over with soil, will develop, and may cause other persons to become infected.
1.
6.
HOW TO PREVENT INFECTION AND HOW TO DESTROY THE WORMS.
All yards round houses and compounds should be kept clean, and bush cut down, so that the sun may dry up all moist ground.
2.
All puddles and all muddy places near houses should be filled up or drained. 3. All improper privies should be got rid of and sanitary ones provided.
4. If proper privies cannot be provided, owing to the expense, a trench two or three feet deep or a pit should be dug, and all excrement should be passed or thrown into it daily, and every day such excrement should be covered over with fresh sun- dried earth, so that the worms cannot develop; for to do so they need fresh air and moisture, neither of which they can obtain when covered over with dry earth.
Before one trench is quite filled in another should be dug.
5. No one should defæcate on the surface of the ground, especially if it be moist or wet and shaded, such as is often the case in banana plantations and in the bush, as the hookworm needs fresh air and damp, well-shaded soil, and no person should defæcate into any spring, pool, pond, or other water supply, so as not to cause infection.
Every one should use a latrine, pit, or trench for such purposes.
6. The hands should invariably be washed before eating or taking food, and no person should ever touch with a dirty hand any food or utensil used to hold food or drink.
7. All fruit that has fallen on the ground or that has been picked up from the ground'should be washed before it is eaten, and all vegetables should be washed or boiled before being eaten.
8. No person should walk barefooted, but shoes should be worn (and also stockings or putties if possible) so as to keep the feet and legs protected from the young of the hookworm, which lie on the surface of the ground.
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PUBLIC RECORD OFFICE
Reference :-
IC.O._885
23 PUBLIC RECORD OFFICE, LONDON
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9. Any person who is suffering from should consult the doctor at once.
12th February, 1913.
C
anæmia," or who is passing worms,
Issued by the Central Board of Health, Jamaica.
7.
HOW TO TAKE THE MEDICINES FOR ANÆMIA ARISING FROM HOOKWORM INFECTION.
Take one of the two purgatives to-night in water.
Take at 6 o'clock to-morrow morning half of the capsules.
Take the other half at 8 o'clock the same morning.
Take the other purgative at 10 o'clock.
You should neither drink wine, rum, any alcoholic liquor, nor castor oil after
taking the capsules.
Come for more medicine until the doctor says you are cured.
Have a sanitary privy in your yard with a bucket in it.
Do not defæcate on the surface of the ground, otherwise you infect the ground,
but always use the privy.
Do not walk barefooted, so that you may avoid contracting "ground itch" in your feet.
Wear shoes or boots and you will not suffer from "anæmia,"
(Circular 38: No. 1390.)
8.
SIR,
I HAVE the honour to request that as soon as coolies who have arrived, or who are to arrive in the Island this year, are located on estates under your medical charge you will make a systematic examination of everyone, either in hospital or as an out- patient, with a view to finding out, for His Excellency the Governor's information, whether they harbour the hookworm.
Island Medical Office, Kingston, 16th May, 1912.
Those Medical Officers who have not got microscopes should send specimens of fæces to Dr. Scott, who will supply receptacles for holding such matter.
After such examination has been made you will be so good as to send in a report for His Excellency's information.
9.
I have, &c.,
J. E. KER, Superintending Medical Officer.
(Circular 41: No. 1358.) SIR,
Island Medical Office, Kingston, May 23rd, 1912. I have the honour to inform you that His Excellency the Governor has appointed Dr. W. D. Neish to proceed with the Protector of Immigrants to enquire into the health conditions prevailing among East Indian immigrants, especially with regard to the prevalence of ankylostomiasis; and to visit all estates in the Island on which coolies are employed, and giving directions to managers with regard to latrine and general accommodation. His Excellency desires that you would be so good as to accompany Dr. Neish and the Protector when in your district, and give every assistance and information possible.
I have, &c.,
J. E. KER, Superintending Medical Officer.
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If found to be suffering from hookworm disease a coolie should be sent to the nearest hospital available for a few days, for treatment by thymol
Treatment should be given at intervals, and weekly examinations of fæces of any immigrant who is found to be harbouring the worm should be made until they cease to show ova.
3. Dr. Scott will be glad to examine any specimens of blood or fæces sent up to him, and where any medical officer has not the means of, or time for, making such examinations, such specimens should be sent to Dr. Scott, who will furnish bottles for specimens of fæces and glass tubes or slides for taking specimens or smears of blood.
4. You should advise all estate owners to instruct all coolies to wash their hands and feeding utensils before food is taken, so as to remove all soil from them.
5. Overseers and estate owners should be advised to supply their coolies with shoes and putties (of some description) so as to protect their feet and legs.
6. Coolies should neither be allowed to pollute their own water supply nor that of any neighbouring estate, and all water supplies should be protected from pollution. Special attention should be paid to the water supply.
7. Trench closets should be provided on all estates as being the cheapest mode
of disposal of filth, unless owners are willing to provide more elaborate systems; but
this matter the Protector of Immigrants is seeing to.
8. Where coolies cannot take thymol, the eucalyptus, chloroform, and castor
oil mixture often acts excellently, and can be taken outside a hospital.
9. You will be so good as to have all coolies admitted to hospital examined for hookworm disease and treated if necessary.
SIR,
(Circuar 55: No. 1359.)
11.
I have, &c.,
J. E. KER,
Superintending Medical Officer.
Island Medical Office, Kingston, July 5th, 1912. WITH regard to Circular 44, No. 1359, dated 7th June, 1912, would you kindly arrange that all new coolies should be sent from the estates to hospital to be examined for hookworm, where they can be properly watched and dosed, in batches. 2. If not yourself in charge of a hospital, kindly arrange with the Medical Officer in charge of the neighbouring hospital to receive them, in batches so many at a time.
3. Kindly make early arrangements so that the examination may be done at the earliest moment.
I have, &c.,
(Circular 66: No. 2851.)
12.
J. E. KER,
Superintending Medical Officer.
SIR,
Island Medical Office, Kingston, 16th October, 1912. WITH reference to Circular 55, No. 1359, of 5th July, 1912, asking you to arrange for examination for hookworm of all new coolies arriving in your District, and to keep a record of the percentage of those infected with the disease, I have to ask that you would be so good as to immediately report to this Office after examina- tion the number found to be infected.
I have, &c.,
H
SIR,
10.
(Circular 48: No. 1763.)
Island Medical Office, Kingston, 19th June, 1912. 1. I HAVE the honour to direct that when a quarterly inspection of coolies on estates is made by you, on any estate, under Law 23 of 1879, you will have the coolies lined up and each one examined separately as to his or her health and condition.
2. Any cooly who is suffering from anæmia, dyspepsia, weakness, or emacia- tion should at once have his or her blood tested for Eosinophilia, and a specimen of the fæces examined for the ova of ankylostomes.
(Circular 69: No. 2978.)
13.
J. E. KER, Superintending Medical Officer.
SIR,
Island Medical Office, Kingston, 7th November, 1912. I AM requested by His Excellency the Governor to ask that you would be so good as to furnish, month by month, a return of the number of cases that you have