PUBLIC RECORD OFFICE
Reference :-
UILT CO. 885
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ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
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No. 8.
SIERRA LEONE.
THE GOVERNOR to THE SECRETARY OF STATE.
(Received 13th April, 1914.)
(No. 180.) SIR,
Government House, Sierra Leone, 31st March, 1914. I HAVE the honour to acknowledge the receipt of your despatch No. 97 of the 24th ultimo,* enclosing a copy of a letter from the Director of the Tropical Diseases Bureau on the subject of sleeping sickness in Sierra Leone.
•
In a
2. Dr. Bagshawe's letter has been referred to the Principal Medical Officer, a copy of whose observations I enclose for your information, together with a copy of his minute of the 7th September, 1913, which is referred to in paragraph 2. The report by Dr. Young referred to in paragraph 4 of Dr. Rice's minute has also been received, and I enclose a copy for your information, together with the specimens of the tsetse fly obtained by him.
follows. 3. The position of affairs in Sierra Leone appears to be as minute dated the 7th September last, the Principal Medical Officer expressed the opinion that sleeping sickness is endemic and wide-spread, both in the Colony and Protectorate." He has recently modified this opinion by stating that he is "still in doubt whether there is any more sleeping sickness in the Colony than there has been for the past hundred years, as it is possible that the increased attention directed to the subject is merely the result of improved and more careful methods of diagnosis." 4. The fact remains, however, that sleeping sickness exists both in the Colony and in the Protectorate, and the question is whether its existence is a menace to the health of the population, and, if so, to what extent. This is obviously a question which can be settled only by your expert advisers. If the public health is threatened, I see no reason why a person who is suffering from sleeping sickness should be any less liable to be compulsorily segregated than a person suffering from plague, yellow fever, or smallpox. If, on the contrary, there is no danger to the public health, no action is required.
5. As Dr. Rice has pointed out in paragraph 6 of his minute, sleeping sickness has, by an Order in Council dated the 6th August, 1913, been added to the list of infectious diseases to which section 32 of the Public Health Ordinance, 1905, may be applied. This step was taken on the advice of the Acting Principal Medical Officer (Dr. Collett), but no action has yet been taken under the Order in Council because there is at present no proper isolation hospital or camp. Dr. Rice is of opinion that if such a hospital is considered necessary it should be established in an area which is free from tsetse fly. It is not known at present whether any area in the Colony or Protectorate is, or can be made, fly-free, and Dr. Rice asks that Dr. Bagshawe's opinion may be obtained on this point. Judging from Dr. Young's report, the sanitary station near the lighthouse would not be at all a suitable place. as tsetse flies abound in the immediate neighbourhood.
6. To sum up, it appears that the points on which a decision is required are:- (a) Whether any action is necessary in view of the existence of sleeping
sickness in the Colony and Protectorate; and
(b) If so, what steps should be taken.
I shall be glad to receive your instructions in due course.
7. The enclosure to your despatch under reply is returned herewith.
I have, &c.,
Enclosure 1 in No. 8.
E. M. MEREWETHER.
Governor.
FROM THE HONOURABLE THE PRINCIPAL MEDICAL OFFICER to THE HONOURABLE THE COLONIAL SECRETARY.
I HAVE read Dr. Bagshawe's letter with great interest, and in reply beg to submit the following observations.
2. PARAGRAPII 2. When the existence of cases of sleeping sickness in Free- town was brought to my notice soon after my arrival in the month of August, 1913, the first thing that naturally occurred to me was to make myself acquainted with
* Transmitting a copy of No. 4.
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both the recent and more remote history of the disease in this Colony and Protec torate, and in this endeavour I read the paper quoted by Dr. Bagshawe, and much else, quotations from which will be found in my minute of 7/9/13 in C.S. 345/13.
3. PARAGRAPH 3. The views expressed in this paragraph are practically identical with those contained in paragraph 4 of my minute of 19th September, 1913, and paragraph 9 of that of 7th September, 1913, C.S. 345/13.
4. PARAGRAPH 4. Dr. Young has now been in residence at the Cape sanitary station for about ten days, and will shortly submit a report on the fauna and flora to the of this area; perhaps Dr. Bagshawe will then favour us with his views as practicability of rendering it fly-free.
The hospital referred to by Dr. Bagshawe as having been put up on the Gold Coast and found to be useless because the natives refused to go into it was erected at Anum on the Volta River, about 100 miles distant from the sleeping sickness area in Ashanti; therefore it is not surprising that the natives refused to go into it-- if they were ever asked to.
The further points raised here by Dr. Bagshawe were alluded to in paragraph 8 of my minute of 7th September, referred to above. I may add that the natives of this Peninsula of Sierra Leone have been accustomed to European medical treat- ment for upwards of a century, and that they are always ready to take advantage
of it.
At the present time a woman living in a suburb of Freetown-who has never been out of the Colony--who was diagnosed as having sleeping sickness some three weeks ago, is voluntarily submitting herself to treatment with 1151 (Ludyl) and 1116 (galyl) in the Colonial Hospital in Freetown.
5. PARAGRAPH 5. I scarcely think it will be necessary to consult the authori- ties of the Gambia or the Gold Coast; the measures taken in the latter Colony were largely at my instigation, and in paragraph 4 of my minute of 19th September, 1913. much the same advice will be found as that given here by Dr. Bagshawe.
It will be remembered that in August last an Order in Council was passed adding sleeping sickness to the list of diseases for which persons could be compul- sorily arrested and confined in a contagious diseases hospital, and that it was in consequence of the communication of this measure to me that I wrote the minutes alluded to above.
6.
I now respectfully ask that copies of those minutes may be forwarded to the Secretary of State, together with Dr. Young's report when it arrives.
T. E. R., 13th March, 1914.
Enclosure 2 in No. 8.
Principal Medical Officer.
FROM THE HONOURABLE THE PRINCIPAL MEDICAL OFFICER to THE HONOURABLE THE COLONIAL SECRETARY,
I HAVE noted the passing of the Order in Council by which sleeping sickness has been added to the list of dangerous infectious or contagious diseases given in section 33 of No. 15 of 1905.
2. The situation as I understand it now is that, as in the case of the other chronic infectious disease, leprosy, any person found in the Colony to be suffering from sleeping sickness can be arrested and forcibly detained, until his recovery or death, in a hospital for infectious diseases.
3. Having had some experience of sleeping sickness in other Colonies (as a result of a report on the disease in Ashanti in 1909 a Special Service Officer, Dr. Kinghorn, was sent out to investigate it and found one per cent. of those whom he examined, roughly some 9,000 persons, to be infected), my first thought was naturally to endeavour to find out to what extent the disease was known to exist in this Colony and Protectorate. Even from the evidence I have been able to collect during the last few days there appears to be reason to apprehend that sleeping sickness is endemic and wide-spread, both in the Colony and Protectorate. (a) I have attached to this case a copy of a report by Captain H. W. Grattan, R.A.M.C., who in the year 1905 diagnosed 18 cases of sleeping sickness, six of whom had never been out of the Colony or Protectorate; they were distributed as follows:-
One case
Wellington Bonthe Port Lokko Freetown
Two cases.
One case.
Two cases.