PUBLIC RECORD OFFICE
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Reference :-
mi............CO 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
COPYRIGHT PHOTOGRAPH-NOT TO
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It is believed that if the present infection were thus relieved and the people were taught in this way to give aid in preventive measures, that the Government forces in the Island would then be able to hold the ground gained and to carry the work in time to complete control of the infection.
7. It has been agreed as a tentative working plan that work as outlined above might well begin in Trinidad with three trained medical men and six microscopists. This force to devote its entire time to the work, to be under the general supervision of your own Surgeon-General, and to be enlarged as the needs of the work may require.
8. I omit details, these may well be left to your local authorities. The most important of these will be the selection of the medical officers who are to do the work. Its success will depend on them, on their training, their energy, their ability to teach and to lead the people with whom they are to work.
9. If the proposition thus stated in broad outline should meet with Your Excellency's approval, it may at Your Excellency's pleasure be submitted to the proper authorities for completion of details. If, when completed, it be returned to ine in budget form, the Secretary of State for the Colonies approving, I shall be glad to lay it before our Commission with recommendation that the necessary funds for the work be appropriated.
10. Funds appropriated for the work will be sent to the Treasurer of Trinidad to be expended in accordance with the budget and to be disbursed and audited as the Colonial funds are disbursed and audited.
His Excellency the Governor,
Trinidad.
I have, &c.,
WICKLIFFE ROSE,
Director, International Health Commission.
Enclosure 2 in No. 12.
The Rockefeller Foundation, International Health Commission,
725 Southern Building, Washington, D.C.,
28th November, 1913.
SIR,
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 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, I should confer with the proper authorities concerning our Commission's lending aid in active measures for its control.
2. I have just completed my visits to St. Lucia, St. Vincent, and Grenada. In each of these islands I conferred with the Officer Administering the Government, I inspected with the medical officers, with planters, and other influential citizens. the records bearing on the subject of ankylostomiasis, which in each case had been With medical officers I made clinical collected and arranged for my convenience. examinations of cases of ankylostomiasis in the general hospitals, the charity hos- pitals, and in some cases in the Yaws Hospitals, and the insane asylums; with medical officers I made journeys afield and examined clinically large numbers of people along the road, in the scattered homes of small peasant proprietors, in the villages, and in labourers' barracks on large estates.
3.
The official records you have. The impression which I get from these reports, confirmed and supplemented by my personal observations and reinforced by the testimony of medical officers and employers of labour, is that ankylostome infection is prevalent in each of these islands, and that it is the cause, direct and indirect, of much illness, loss of life, and noticeable [decrease] in economic efficiency.
4. I have conferred with the medical officers and with the Administrative Officer in charge of the Government in each island with reference to practical measures of relief and control.
It is agreed--and from this there has been no dissenting opinion—that present conditions justify systematic effort for the relief of the present sufferers and the
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ultimate control of the infection; and that if the work be undertaken on an adequate scale, this end can be accomplished.
5.
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 avoiding the pollution of the soil and water.
(b) By guarding the individuals from infection.
"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 these small islands it is quite possible to examine microscopically practically the whole population and to treat those found to be infected. 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 inexpensive preventive
measures.
The present infection thus relieved, and the people thus instructed, the Govern- ment forces in these islands may then be able to hold the ground thus gained and to carry the work in time to complete control of the infection.
6. In conference with the administrative authority in each case, it has been agreed as a tentative working plan that work as here outlined might well begin in St. Lucia with one trained medical man aided by two microscopists; in St. Vincent, with one medical man and two microscopists, or under certain conditions which the Administrator has in mind, with two medical men and three micros- copists; and in Grenada with two medical men and four microscopists.
This force to devote its entire time to the work and to be enlarged if at any time the work should require it.
7. I omit details, which may well be left to the local authorities in each case.
It is recognised that the success of the work depends upon the chief Medical Officer
in charge of it, on his training, his energy, his executive ability, his ability to teach and to lead the people of the island in which he is to work.
8. If the proposition thus stated in broad outline should meet with Your Excellency's approval, it may, at Your Excellency's pleasure, be submitted to the proper authorities for completion of details. If, when completed, it be returned to me in budget form, the Secretary of State for the Colonies approving, I shall be glad to lay it before our Commission with recommendation that the necessary funds for the work be appropriated.
9. Funds appropriated for the work will be sent to the Treasurer of the Island for which the appropriation is made, to be expended in accordance with the budget, and to be disbursed and audited as the Colonial funds are disbursed and audited.
His Excellency the Governor,
SIR,
I have, &c.,
WICKLIFFE ROSE,
Director, International Health Commission.
Windward Islands.
Enclosure 3 in No. 12.
The Rockefeller Foundation, International Health Commission,
725 Southern Building, Washington, D.C.,
28th November, 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 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, I should confer with the proper authorities concerning our Commis- sion's lending aid in active measures for its control.