PUBLIC RECORD OFFICE
6
Reference :-
TILICO. 885
24 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH—NOT TO
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4. In paragraph 65 an important summary is given of the conclusions arrived at, as the result of experience up to the present date, in regard to the extent and nature of infection and the results of treatment.
5. Dr. Macdonald's recommendations for following up the work of the Inter- national Health Commission by enforcing suitable latrine accommodation, as alluded to in his previous report, and referred to in the Secretary of State's despatch Miscel- laneous, of 5th March, 1915,* and for the necessary amendment of certain Ordi- nances, have been embodied in a "Report on Sanitary Necessities," a copy of which appears in Appendix C. The report is still under consideration by the local Advi- sory Committee, and comments on it would be premature at present, although it may be indicated that steps to give effect to most of the recommendations will be taken as early as practicable.
6. The financial arrangements, I regret to state, have not been quite satis- factory. An increased budget was rendered necessary by the change to the inten- sive method, but, owing to a misunderstanding, the International Health Commission revoted the same budget as last year, amounting to £1,856. The expenditure for the past quarter, amounting to £571 approximately, has been specially authorized by the Directors, and, by a curtailment of the intended programme, the estimated expenditure for each of the remaining quarters of the year has been reduced to £545. This is £81 in excess of the quarterly allocation of £464 from the vote of £1,856. It does not appear to be possible to make any further reduction without endangering the success of the work, and representations have been made to the International Health Commission with a view to special authorization of the additional expendi- ture until the next annual budget can be considered.
His Excellency
SIR,
Sir G. B. Haddon-Smith, K.C.M.G.
Governor of the Windward Islands,
St. Lucia.
Enclosure in No. 100.
I have, &c.,
H. FERGUSON,
Administrator.
REPORT OF THE Medical OffiCER IN CHARGE FOR THE QUARTER ENDED 31ST MARCH, 1915.
Grenada, International Health Commission, 31st March, 1915.
I HAVE the honour to present, for the consideration of the Governor and for transmission to the Secretary of State, a report on the work of the International Health Commission (ankylostomiasis campaign) in Grenada for the quarter ending 31st March, 1915.
2. This report reproduces the monthly reports laid before the Advisory Com- mittee for the months January and February, and summarizes the work performed up to the end of March.
3. There are added a copy of the Sanitary Necessities Report, presented on request to the Advisory Committee by the Colonial Surgeon and the Medical Officer in charge; copies of minute and health leafletst which supplement the report for October. 1914, where, in paragraph 62, section 8 (a), an appendix on latrine ser- vice is promised: copies of various correspondence;t and details of work on formal schedule.†
Report for the Month of January, 1915.
4. Following on the representations of the Medical Director for the West Indies verbally made during his visit in December, and confirmed by communication received 6th January, the routine visiting of locations as put forward in the original scheme of campaign was discontinued after the month of December.
5. Rearrangement of the scheme of operations has been pushed forward as rapidly as possible during the past month. The most important point to be estab- lished in this rearrangement was the budget for the current quarter, which was com- pleted in the early part of the month and provisionally adopted by the Advisory Committee at the monthly meeting of 12th January ultimo.
* No. 77.
↑ Not printed.
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6. This budget has arranged for the working of two "intensive" areas in different parishes and for the continuance of the head office at Marine Villa as a centre for general examination, treatment, and education, without restriction of area; and as a laboratory for the study of ankylostomiasis and inevitably associated pathological conditions.
7. Though the per capita cost of head office, so far as concerns treatment and cure of ankylostomiasis, will, probably, bear no comparison with the per capita cost of the areas "intensively" operated, I believe the mean of the combination of endeavour will be such as to justify the maintenance of the head office for the purposes detailed.
8. Independent of any such demonstrable per capita estimate, however, I am of opinion that the hygienic advantage to the Colony of this arrangement will be definitely furthered in ways not obviously or immediately demonstrable, which, nevertheless, are undoubtedly in harmony with the aims of the International Health Commission.
9. The rearrangement of operations could only be made after the visit of the Medical Director, but his valuable advice in the undertaking of intensive work in selected areas and in the construction of the necessary budget has enabled that the scheme is now definitely being pursued in the Mount Moritz district of St. George and in the parish of St. David.
10. In each case the teachers in the schools throughout the area have been selected as part-time assistants and nurses for census taking, collection of samples, distribution of literature and medicines, and for general educative and recording work. One whole-time assistant is also in each area appointed to a district for similar work and to collect for the field office material from the other assistants.
11. The field work in St. David's is carried on by the Assistant Medical Officer with two microscopists, subject to the supervision of the Medical Officer in charge. 12 The Mount Moritz district and the other work at head office is being carried on by the Medical Officer in charge with three microscopists; and on Mondays and Saturdays it is arranged, meanwhile, that the Assistant Medical Officer attends at head office to carry on pathological work, for which facilities in the field are wanting.
13. During the month the treatment of patients was restricted to those visiting at head office; and the results were satisfactory.
14. The interest that has been aroused is evidenced in the fact that the patients have come from every parish in the island, and it is clear that a distinct dread of
the disease has arisen amongst the people.
15. The actual figures for the month's work are here summarized :—
Treatments.
Number Seen. Examinations.
Cured,
1st
2nd
3rd
4th
Bth
6th
7th
8tb
Total.
1,873
16
1,941
802 281 79 24
4
1
I
1
1,198
98
The proportion marked off as cured will naturally increase with time, and more certainly as the control of the "intensive" method is manifested.
17
During the month, in response to the interest of the proprietor, an estate
in St. Andrew parish was visited by the Medical Officers and a microscopist. One hundred labourers were examined, lectured to, and all were treated, as over ninety of the hundred were found to be highly infected.
This is the most intense infection yet ascertained in the island in a group of labourers not selected in any way.
18. A certain amount of dyspepsia, anæmia, and cardiac dilatation was recorded by clinical examination; but no gross disease was in evidence, in spite of the obviously intense infection in practically all those found infected.
19. Lectures have been arranged, and three have been delivered during the month by the Medical Officer in charge on hygienic subjects generally, to which chiefly head teachers and the local sanitary inspectors have been invited. Out of thirty-six teachers in the section of the island to whom invitation was extended nearly all have been able to attend each lecture.
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