PUBLIC RECORD OFFICE
Reference :-
MC.O. 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH—NOT TO
22
The following is an extract from the Medical and Sanitary Report of the Gold Coast for the year 1910 (p. 47) :-
"A sleeping sickness hospital was completed and opened at Anum during the early part of the year. It consists of two mosquito-proofed rooms, measuring respectively 314 feet by 18 by 12 and 15 feet by 18 by 12, and capable of accommodating eight to ten patients. The staff consists of a Medical Officer and a dispenser pupil. The attendance was disappointing. For many months the wards were entirely empty. The native seems to make light of the disease, and it is difficult to persuade him to come for treatment. A sleeping sickness hospital was also erected at Kintampo. Here there were eight admissions and three deaths during the year. A fly-proof room was set apart in the native hospital at Coomassie for the treatment of these cases. There were four admissions and two deaths in the twelve months.' This seems to point to a reluctance of the native, at least of the Gold Coast, to enter hospital for treatment of sleeping sickness. This reluctance may be attri- buted to the fact that many feel well, and that the results of treatment of this disease have not always been such as to inspire confidence in European methods. It is not a question of a few weeks' treatment, but often of many months. Recent methods may be found to cut the period short, but on this point there is not yet sufficient evidence.
7. I would point out that we have no knowledge of compulsory segregation In Uganda, when the disease was for sleeping sickness in British dependencies. epidemic and a very serious menace to the well-being of the country, no native was compelled to go to a segregation camp. Of course, the Principal Medical Officer of Sierra Leone is in a better position to judge than I am, but I question whether compulsory segregation will achieve its objects, which are, I take it, to remove all or at least the majority of, infected persons to a fly-free region, and treat and keep them there until their blood is certainly free from trypanosomes. The difficulty of diagnosing early cases makes it probable that many would remain undetected, even if the co-operation of the natives was obtained. If, however, he believes he can attain this object, he is justified in pressing his recommendation.
8. If a special Medical Officer were seconded to determine the incidence of sleeping sickness in the Colony and Protectorate, he could, by treating those found One speaks, of infected, render them harmless to their fellows, for a time at least. course, with diffidence when one has no knowledge of local conditions, but it is ́ matter for discussion whether a series of dispensaries in affected districts, where natives could attend for treatment on stated days once a week, would not meet the case as well as the proposed segregation camp. A similar proposal was made by Dr. Rice in the Gold Coast in 1912, as an alternative to compulsory segregation.
**
9. In conclusion, I see no reason to modify anything in my letter of 16th February, with the exception, of course, of the last sentence of paragraph 2, and the addition that, as I have stated above, it would certainly be to the advantage of Sierra Leone to have such an investigation as that made by Dr. Kinghorn in Western Ashanti. I should expect the result to show that the state of sleeping sickness in Sierra Leone is very much the same as in the Gold Coast, and that in In any event the mat- neither case is it so urgent as to require drastic measures. ter could then be carefully considered in the light of the new data obtained.
I have, &c..
ARTHUR G. BAGSHAWE,
19002
SIR,
No. 14.
SIERRA LEONE.
Director.
TROPICAL DISEASES BUREAU to COLONIAL OFFICE,
(Received 25th May, 1914.)
[Copy to Governor, 29th May, 1914. No. 253
L.F.1
Tropical Diseases Bureau, Imperial Institute, London. S.W.,
23rd May, 1914.
Ix reference to my letter of 5th Mayt in reply to yours of 28th April (14461/1914),‡ I have the honour to say that I wish to make clear that the objection
* No. 4.
! No. 13.
* No. 11.
23
1 have raised to Dr. Rice's proposal of compulsory notification and segregation is not to segregation itself, but to the compulsion. Compulsion implies penalties for non- compliance. Penalties lead to evasion. Evasion in this case is easily practised and may make any regulation nugatory. If, however, a suitable place can be found, either fly-free or capable of being made so at reasonable cost, and the conditions of life can be rendered so attractive that natives in whom the disease is detected will voluntarily resort there and remain (with leave, perhaps, to visit their friends at times when their blood is non-infective), the formation of a camp for segregation and treatment will have all my support. Whether, however, the incidence of the disease will be thereby diminished we do not know; this must depend partly on the propor tion of undetected cases to detected cases, and partly on factors of which we are ignorant. That infected persons should be sought out and in one way or another given the opportunity of treatment by recent improved methods must be agreed on
all hands.
25082
I have, &c.,
No. 15.
ARTHUR G. BAGSHAWE,
GOLD COAST.
Director.
THE ACTING GOVERNOR to THE SECRETARY OF STATE. (Received 9th July, 1914.)
[Copy to Imperial Bureau of Entomology, 18th November, 1914. L.F.] (No. 496.)
SIR,
Government House, Accra, 24th June, 1914. WITH reference to your despatch No. 281, of the 5th of May,* I have the honour to transmit, for your information, two copies of a report by Dr. A. Ingram on the occurrence of human trypanosomiasis in the Northern Province of Ashanti. 2. The submission of this report has been delayed pending the preparation by the Public Works Department of sun prints of the maps prepared by Dr. Ingram. Four copies of the mapt are forwarded under separate cover.
I have, &c.,
W. C. F. ROBERTSON,
Acting Governor.
Enclosure in No. 15.
REPORT ON THE OCCURRENCE OF HUMAN TRYPANOSOMIASIS IN THE NORTHERN PROVINCE OF Ashanti.
THE Northern Province of Ashanti bears some resemblance in shape to a trefoil; so irregular, however, is its outline, that, while its maximum length from north to south extends from about 8° 50′ N. to 7° 22′ N., its minimum extends only from about 8° 12′ N. to 7° 56' N.; there is an even greater difference between the extremes of width from east to west, the maximum in this direction being from about 2 W. to 2° 38′ W., while the minimum, measuring across the northern pro- jection of the Banda District, is equivalent to only a few minutes of longitude. The total area of the Province in all probability does not exceed 7,500 square miles. Physical Configuration.-All the streams and rivers of the province are tribu- taries of the Black Volta River, which forms the northern boundary, or of the Volta River, which is the boundary on the eastern side. There are three main rivers, the Tain, with its tributary the Tomme running north to the Black Volta, the Pru, running in a north-easterly direction and discharging into the Volta River, and the Sene or Berasu, taking a course almost due east, forming in the whole of its length a portion of the southern boundary of the Province and emptying itself into the Volta River.
* No. 12.
Not reproduced.