PUBLIC RECORD OFFICE
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༢「། ། ། ། mmmmmiC.O. 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
To whom it may concern:
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ANKYLOSTOMIASIS.
(Proposed Leaflet.)
Much of the weakness, bad health, and poverty of blood in some districts are caused by certain worms in the intestines. These worms lay eggs, which are passed in the operations or excrement of persons who have these worms.
These eggs can only be seen with a microscope, and when they are found in the excrement it is certain that the worms are in the intestines from which the excrement comes. The ordinary worm medicines have no effect on these worms. They require a special remedy.
If you are pale and bloodless, or have shortness of breath and beating of the heart on walking upstairs or up a hill, you are probably suffering from these worms. wish to find this out, put into a box, which will be given you, a small piece of your excrement, write your name and address on the box and return it to the person from whom you get the box.
If
you
If the eggs of these worms are found, your name will be noted; and it is hoped that before long free treatment for the complaint will be offered to you. This will cost you nothing.
DEAR SIR,
No. 12.
MR. W. ROSE to MR. H. R. COWELL (COLonial Office).
•
(Received 29 December, 1913.)
The Rockefeller Foundation, International Health Commission,
725 Southern Building, Washington, D.C.,
December 18, 1913.
I BEG to acknowledge receipt of copy of reports on ankylostomiasis in Jamaica. I did not include Jamaica in my recent itinerary because, geographically, I expect to go to Jamaica and British it was out of the zone which I visited. Honduras at some later time.
2. I am enclosing, for the information of the Secretary of State for the Colonies, copies of letters which I have addressed to the Governors of Antigua, the Windward Islands, and Trinidad. This summarises in brief form the results of my recent visit to the islands.
3. When the Advisory Committee has been appointed, I should be very glad to have a list of the names for our files. I take it that this Committee will be called upon at an early day for service. A most important work will be the selection of men for the work in the various Colonies. In all our conferences in the British West Indies it was realised that the success of the work depends upon the selection of the men who are to do it. The work calls for young men of good training who are intelligent, alert, energetic and who will have ability to teach and to lead the The development of work in a number of the Colonies people with whom they work. about the same time is going to create a rather unusual demand. I should think the Committee could be extremely helpful in getting men on the list available for this service in the Colonies.
4. It has occurred to me also that if this Committee has been appointed, perhaps it might be very helpful in opening up the way for me in Egypt-the matter to which I referred in my last letter.
Mr. H. R. Cowell,
SIR,
Colonial Office.
Very truly yours,
WICKLIFFE ROSE.
Enclosure 1 in No. 12.
The Rockefeller Foundation, International Health Commission, 725 Southern Building, Washington, D.C.,
December 19, 1913.
As a result of a series of conferences held in August of this year at the Colonial Office in London, it was agreed that on my first journey afield I should
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visit Antigua, St. Lucia, St. Vincent, Grenada, Trinidad, and British Guiana, that I should confer with the medical officers and governing authorities of these Colonies concerning the prevalence of ankylostomiasis, and that, where conditions should seem to invite, should confer with the proper authorities concerning our Com- mission's lending aid in active measures for its control.
2. In accordance with this agreement I visited Trinidad in October and November. I inspected the records given me by the Surgeon-General and the records at a number of estate hospitals bearing on the subject of ankylostomiasis in Trinidad. I conferred with the Surgeon-General and with five other medical officers who have had experience with the disease. With Dr. Eakin I inspected the cases of infection in the Royal Gaol, and, with Dr. Scheult, those in the Government Hospital. With Dr. Dixon I visited the Port-of-Spain market place, some of the coolie hotels, and a free dispensary; made clinical inspection of the children in some of the schools, inspected a number of homes and premises in the suburbs of Port-of-Spain and in a neighbouring village.
Later, I visited the Caroni Sugar Estate, the Tenants' Estates near San Fernando, and some of the estates under the management of the New Colonial Company, Limited. On these estates I conferred with employers of labour, managers, medical officers, and the Protector of Coolies; I visited the coolie yards. inspected the cases and records in the estate hospitals, made clinical examination of the children in a number of schools, and made a survey of sanitary conditions of the coolie yards and of the villages with reference to contamination of the soil.
3. The records of the Government medical institutions and estate hospitals show that ankylostome infection is prevalent over the Island; that it is especially prevalent among the coolies from India; and that it is the cause, direct and indirect, of much illness, loss of life, and noticeable decrease in economic efficiency.
These records were confirmed and supplemented by my own observations and by the testimony of medical officers. the employers of labour, and the labourers themselves. At one estate hospital I was shown a record for three estates of the results of microscopic examination of all coolies at the time of their arrival on the estates. This record shows that of a group of 36 coolies just received from India, 32 were infected; of another group of 13, all were infected; of another group of 12, all were infected; of another group of 12, 10 were infected; and of a group of 52, forty-one were infected.
4. In our conference at Government House with reference to practical measures of relief and control, it was agreed, as I understand, that present condi- tions in Trinidad invite systematic effort for the relief of the present sufferers and ultimate control of the infection; and that, if the work be undertaken on an adequate scale, this end can be accomplished.
5. It would seem to be extremely important that any plan of work for the control of the infection in this Island should include the population of both villages and estates, and that these two phases of the work be carried on together.
•
6. To quote the late Dr. C. W. Branch, of St. Vincent, "The measures for the prevention of hookworm disease fall into two groups :—
*
(1) The attempt to suppress or diminish the existing human infection.
(2) The attempt to prevent new infections--
(a) By adopting the pollution of the soil and water. "(8) By the of this sound
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"Of these, the first is the more important and easier. The measures of the second group are necessary, but will be unavailing in the absence of the first.
In order to secure the active co-operation of all the people-the villager and small peasant proprietor as well as the indentured coolie--it would seem to be extremely important that the work begin with measures of relief and education. In a small island like Trinidad, it is quite possible to examine microscopically prac- tically the whole population and to treat those found carrying infection. This can be done in such way as to teach the people by demonstration what this parasite is, what it is doing for them, how they get it, and how they can avoid it. And to this may be added at the same time systematic instruction of all the people by means of lectures, lantern slides, and concrete object lessons in simple and inex- pensive preventive measures.
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