PUBLIC RECORD OFFICE
Reference :-
TTICO, 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
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2. I enclose a report on ankylostomiasis in British Honduras, by the Principal Medical Officer, together with reports furnished to him by the Assistant Medical Officers in the districts. Instructions for the preparation of this report were sent to the Principal Medical Officer on the 19th September. The report only reached the Colonial Secretary's Office on the 13th November. In view of this delay I am not sending the report back for explanations.
3. I am afraid that the report of the Principal Medical Officer himself is valueless. It is simply guesswork based on his experience in out-districts when he was an Assistant Medical Officer.
4. As regards the Belize district, I am not aware that the Principal Medical Officer has, within the last few years, visited any of the villages. His statement that ankylostomiasis is evident. in all the villages along the banks of the river and the Indian settlements is discounted by the fact that he is unable to give me the names of these settlements. He says: "I do not remember the names, but these settlements during my time (were!) just a few houses, probably families along the There are no Indian settle- banks, and also along Black Creek, Spanish Creek."
ments in the Belize District on the mainland. Ambergris Caye, some forty miles from Belize, has an Indian and Spanish population. Dr. Woodman detected anky- lostoma there; since then the water supply has been greatly improved by the pro- vision of rain water tanks, and the Principal Medical Officer and the Local Board of Health are working together to get the people to adopt a better system of latrines, and it is hoped that the pail system may be enforced. These measures are not being taken with a special view to the eradication of ankylostoma, but, apart from treat- ment of affected persons, they are the proper steps to be taken for that purpose.
5. The Principal Medical Officer does not give his grounds for believing that the disease is severe in Progreso, Caledonia, and Samtenaja. It is a long while since he visited those places. If the disease had been severe there, I believe Dr. Woodman would have been aware of the fact. As to Corozal, its sanitary con- dition is much better than when Dr. Harrison resided in the north, both as regards water supply and latrines.
6. In Orange Walk there is no doubt that ankylostomiasis exists to a serious When the extent, and there appears to be a focus of infection in Guinea Grass. Medical Staff is brought up to its full complement I will endeavour to have special measures taken there.
7. At the Cayo, I have no doubt that there are cases, although Dr. Kellett has only seen one. But if ankylostomiasis were rife there, I think Dr. Kellett would have seen more cases. There were cases when Dr. Mackey was there; but a remarkable improvement has taken place in the town of El Cayo since my visit in 1906, and probably a still greater improvement since Dr. Harrison was there. The pail system of latrines is in general use, and most of the grass huts have been replaced with frame buildings with iron roofs from which the rain water is collected.
8. Even in Benque Viejo there has been similar improvement, although not to the same extent as in El Cayo. Attention to sanitary matters there practically commenced when Dr. Mackey was stationed at the Cayo.
9. There are a number of small Indian settlements in the Cayo district, too remote to be often visited, where I should expect ankylostomiasis to be prevalent. But they are not more remote than the Indian settlements in the Toledo District where we know ankylostomiasis is very prevalent, and if the conditions were as bad in the Cayo District I think we should know it.
10. I do not think Dr. Winter's report justifies Dr. Harrison's statement that from it the disease seems general in Stann Creek. In 1912 Dr. Winter was on leave and Dr. Woodman was in charge. In his annual report he said: "Two cases All the cases I saw had were treated in hospital, and I treated five more outside. lived in the Orange Walk District at Guinea Grass." Dr. Winter says that since the beginning of 1912 three cases of ankylostomiasis have been treated in the hospital, one being a Sikh, who is believed to have brought the disease with him. From Dr. Woodman's report we know that the other two had lived at Guinea Grass, The four deaths which, as I have remarked, seems to be a focus of infection. mentioned by Dr. Winter all occurred in 1910.
11. The district in which ankylostomiasis is most prevalent is Toledo. In fact, the opening of the hospital in Punta Gorda is mainly due to the necessity of doing
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something for ankylostoma. Although most of the cases treated have come from Punta Gorda town. The disease is most rife in Indian villages such as San Antonio. The inhabitants of these villages are the most backward of any of the inhabitants of this Colony, in which many of them were not born. It is almost impossible to treat people like these except in a hospital. But when cases success- fully treated return to their homes and repeat what they have learnt in hospital, the people will in time get some idea of how this disease is spread and will endeavour to avoid it.
I have, &c.,
Enclosure in No. 10.
WILFRED COLLET,
Governor.
REPORT ON ANKYLOSTOMIASIS IN BRITISH HONDURAS.
It is somewhat difficult to give a proper survey of the prevalence of ankylos- tomiasis throughout the Colony. There is no doubt that it is general, but whether it exists in a severe and fatal form I cannot tell.
I enclose reports from Assistant Medical Officers of all districts. These reports don't seem very explicit, or of much value from a scientific point, due, no doubt, from the scattered situation of the villages in each district. Medical Officers, in visiting these places, are unable, from want of time, to make a proper survey of the inhabitants.
Of Corozal, I am of opinion that the disease does exist to a large extent, and is general and much severe in places as Progreso, Caledonia, Satenaja, &c., and, speaking from memory, I am certain that it existed in the town of Corozal as well.
Orange Walk-Places like Trinidad, Albion Island, Tasistal, Isla, Guinea Grass were inspected in my time, and I doubt if circumstances have changed much since then.
Punta Gorda. Dr. Clements's report speaks for itself; it is fairly general. Cayo. I am certain that the disease is common in Benque Viejo, Succotz, and all Indian settlements.
Stann Creek.-There are no Indian Settlements in this district. From Dr. Winter's report the disease seems general.
In the town of Belize itself the disease is seldom seen, unless the infection is brought from without. This is due to the pail system and the ample latrine accom- modation over the sea. In the Belize District it is evident in all the villages along the banks of the river and in the Indian settlements.
It is very essential that something should be done, yet I am convinced that the ravages from hook worm infection is not severe as far as mortality is concerned, but exists only in a mild form. The difficulty arises from the very scattered situation of the villages and settlements and the apathy of the people to new methods.
It would be advisable and interesting to have the Medical Officers make a proper medical survey of the settlements in their districts, making, if possible, microscopical examination of the excreta in doubtful cases. Notes could then be taken of the latrine system employed in each place and remedies suggested. In the acute cases they could be put under immediate treatment.
The difficulties to surmount of habits, race, and intellectual incapacity is great; nevertheless. I am certain a deal could be achieved by personal visits. Of printed cards, &c., I have very little faith; they pay more credence and read more eagerly the printed matter accompanying any patent fake of medicine, but of other matters they pay no attention. This, I find, to be the case with pamphlets, &c., that are sent out for the Anti-Tuberculosis League.
J. H. HARRISON,
Principal Medical Officer.