PUBLIC RECORD OFFICE
Reference :-
UPCO. 885
23 PUBLIC RECORD OFFICE, LONDON
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PROFESSOR HALDANE: I should like to ask Mr. Rose whether he thinks that the work in these West Indian islands would come out in the same way, would In the Southern be of the same nature, as the work in the Southern States?
population States you are dealing with an English-speaking population, and a mostly white and controlled by whites. There you must have very different conditions.
MR. WICKLIFFE ROSE: Very.
PROFESSOR HALDANE: And a lot of other sorts of diseases mixed up with ankylostomiasis; is that so?
MR. WICKLIFFE ROSE: That is so, and even in the British West Indies them- selves you will find that the work will have to be different in the different Colonies. The conditions in British Guiana, for example, are very different from the condi- tions in Grenada.
DR. SHIPLEY: Mr. Harcourt has asked us certain questions which we must try to answer about the doctors, and about the microscopists. Is it your idea to take them from England or from your Rockefeller Institution?
MR. WICKLIFFE ROSE: I suppose these positions would be English positions. DR. SHIPLEY: Someone or other ought to say something about the extra- ordinary generosity of the Rockefeller Institution in taking on this work and financing it. I think it is a new move in the world's history that a great financial institution should come forward and help in this way, but in order that we should consider the questions which we have been asked by Mr. Harcourt, we ought to consider whether we can find the men, or easily find them. We could very easily find microscopists, I think, because there are so many laboratories now in which the boys are trained up until about twenty, and then they want to get married, when they have to get some position outside. These boys I refer to many of them clever and some of them reading French and German and well-trained boys -are not University graduates but the assistants, and there would be no difficulty About the doctors I do not know. I dare say Mr. in finding a staff of them. Read and Dr. Bagshawe could tell us whether it is easy to find doctors for the Colonies.
MR. READ: That is a point we have gone into with our Medical Committee here.
SIR F. HODGSON: As far as the West Indies are concerned with regard to microscopic examination, that could be done by men trained there.
MR. READ: Yes.
SIR F. HODGSON: The only question about the West Indies would be as to doctors, and in many cases I think they could find the doctor, provided his place is taken by somebody.
MR. READ: Yes, but of course there is a great scarcity of doctors at the present time, partly on account of this insurance scheme, and partly because there is a falling off in the number of men going into the medical profession.
CHAIRMAN: Is that so?
MR. READ: That is so. We find that in West Africa at any rate. Of course it has a certain reputation, but we really find that we are getting to a stage when we shall have to raise our terms in order to attract men. We can still get them for places like East Africa, and I daresay for places like the West Indies too we should have less difficulty, but there is a great scarcity of them at the present time.
CHAIRMAN: On the other hand is there not a much larger number of people in India receiving complete medical training, some of whom would be quite capable of doing this work, especially in the case of Colonies where the East Indian coolies go? I should think in British India they get a very good medical train- ing and many of their men would be sufficiently up in this kind of work to do it, and probably would take lower salaries.
MR. READ: I do not know anything about the Indian Service; Sir Havelock Charles, the representative of the Indian Government, is not here or he would have been able to tell us. Probably Sir Henry MacCallum would tell us.
SIR HENRY MCCALLUM: I should think if it was properly managed by the Indian Government there are a number of young men quite skilled there with the microscope who would be forthcoming for places like the Malay Peninsula and Ceylon. On the other hand they would be chiefly used for the treatment of the Tamil coolie and others, because the Ceylon population do not like the Indians: they would not be popular appointments, and in a case of this sort you must have the medical man a popular man.
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CHAIRMAN: You mean among the native Cingalese ? SIR HENRY MCCALLUM: Yes.
SIR F. HODGSON: We had two Indian doctors sent out to the Gold Coast to form a Government Medical Service there, and they did very well.
CHAIRMAN: They would be rather better fitted to stand the tropical climate than a doctor from England or from North America, I should have thought.
SIR F. HODGSON: I think so.
MR. GRINDLE: We went into this question of Indian medical men with a view the con- to manning an independent West Indian Service, and I think we came clusion that we should get no cheaper man from India, that the terms would be, if anything, higher, and, that being so, it seemed hardly worth while to go as far as India to get doctors, so that I do not know that there is very much in this suggestion as regards the medical service.
DR. SHIPLEY: There is a tremendous excess of doctors over the demand at present in Austria, Vienna especially; I do not know why, but in the last two years the medical schools have been absolutely flooded with people, and they have been asking for legislation to refuse to enlarge the schools at all.
SIR HENRY MCCALLUM: In order to complete the establishment there is not much benefit in bringing young doctors for this thing from India, and the Ceylonese do not care for them. The Ceylonese young men are extremely good men.
CHAIRMAN: There was a case the other day where a Cingalese doctor per- formed a very difficult operation on a friend of mine for appendicitis, and saved him, although he was 76 years of age.
SIR HENRY MCCALLUM: There is a Medical Officer called Dr. Paul, of Colombo, who carries out an average of three operations a day and has only lost one case the whole time.
DR. SHIPLEY: It is historical, is it not, that the Cingalese have always been good doctors.
MR. GRINDLE: There is just one other point I might mention in connexion with getting doctors from India. Of course the doctors would have to influence not only the coolie, but they would have to bring a good deal of influence to bear on the estate manager and proprietor, and he is much more likely to listen to a white man than to an Indian, I think.
SIR HENRY MCCALLUM: Certainly.
SIR F. HODGSON: Undoubtedly that is so.
SIR HENRY MCCALLUM: The district surgeons would have to co-operate and
get the planters interested, but the planters are very good in Ceylon. They take
a great deal of interest in this matter, and not only in this, but in other diseases also, and give every help to the medical people.
CHAIRMAN: I was thinking of the cases where there are Indian coolies in the West Indian Islands, say in British Guiana. Of course the Cingalese population is different, but even there naturally the white plantation owner would not be so amenable.
SIR HENRY MCCALLUM: If you go away into the country districts there is no place to stay except some planter's house, and, that being so, the Englishman prefers to entertain the white man.
MR. GRINDLE: The same thing would come up very much in the West Indies. SIR F. HODGSON: Is the work so heavy as to necessitate an increase in the number of doctors in a particular Colony? I should have thought these district Medical Officers would have done almost the whole of the work, I was going to say. SIR HENRY MCCALLUM: They could not do it in Ceylon, they are too heavily worked now, and the distances are so far. There are incessant cries for additional medical men to do the work while the medical men are away; they have to go thirty or forty miles to attend to a case, and for Ceylon you must have a special staff.
DR. SHIPLEY: Besides, from what I have heard you, want to start this thing with Some of the doctors who some young fellows who believe they can do something. have been there for some time do not quite believe in the existence of the disease, and I think you must start it with many more of them do not believe they can do much. someone who has a firm belief that he is doing some good.
MR. WICKLIFFE ROSE: I think I might offer a suggestion or two for the con- sideration of the Committee. I think the matter of selecting the officers is to be one of the most important matters connected with the whole work, and in selecting them I should like you to keep this in mind-it seems to be very important in our exper- ience of the States-the man at the head of this work in each Colony will have to