། ། ། ། །
PUBLIC RECORD OFFICE
6
Reference :-
C.O. 885
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
24 PUBLIC RECORD OFFICE, LONDON
138
03. The figures of actual work done for the month of March arė :—
Patients Treated-Number of Times.
Location.
Patients Been.
Number Examined.
1
21
Total Treatments.
To l
Cured.
More
B
+
6
than 5
Headquarters
879
562
185
110
87
48
35
30
490
122
Mount Moritz...
2,087
1,894
670
626 648
43 20
15
2,022
76
St. David's
8,797
8,862
1,655
297 679
144 42
14
2,831
149
Grand total...
6,768
6,948
2,510 1,4871,010
230 97
59 5,843
841
64. The next table gives a summary, in the same form, of the work done over the three months ended 31st March instant:-
Patients Trea:ed - Number of Times,
Location
Pallents
teen.
Number Examined.
Total Treatments.
Total Cured.
More
1
2
3
1
5
than 6
Headquarters
8,754
2,689
677 1,285
953
105
50
2,508
403
Mount Moritz...
8,897
8,808
1,144
766
697
80
30
2,741
120
St. David's
6,109
6,181
2,427 1,088
219 555
63
4,875
157
Grand total...
18,260
12,128
4,856 2,526 1,605
404 148
90
9,624
686
888
ཙྩཱཏྟཱ, ✖ཨྰཿ
65. A brief summary of the extent and nature of infection, of the results of treatment, and of sanitary improvement to date is here given:-
1. Age-All ages are infected, but, except in definite districts, infection
is uncommon under 10 years and rare under 5.
2. Sex.-Adult males are infected in greatest number.
3. Occupation.-Practically all are or have been engaged in agricultural pursuits (barefoot); and infection seems to date from leaving the home garden to work elsewhere.
4. Situation.-Infection varies widely between different districts, chiefly the result of differences of soil, cultivation, and perhaps of water supply. Infec- tion in the town is low; and in all cases of town infection the patient has resided in the country at periods ranging as high as twelve years previously.
5. Soil. The red clay bears a high infection, while also a high infection is found in definite districts on light, ashy, or sandy soil, over "tiff," con- glomerate, and tough basalt.
6. Meteorology. The more moist windward side of the island probably carries a higher infection.
7. Cultivation. The densely cacao-shaded areas have a high percentage; open cultivation of recurrent or rotation crops (corn, peas, tannia, potato, etc.) in definite districts also bears a high infection.
8. Complicating Diseases. From casual blood examination it is evident that malaria is widespread in the island, and is responsible for much morbidity. The comparative debilitating influence of the ankylostome and the malaria parasite will be discussed in a later report.
9. Water supply. The water supply is mainly from streams and springs. This district bears a high In one definite district the supply is from ponds. hookworm infection and a high malaria infection. The nature of soil and cul- I have examined samples of tivation suggests little chance of soil infection. water from four ponds in the district. The water of all is grossly polluted. There is suggestion of possible water infection, which would explain the con- tradictory conditions enumerated above under 1, 4, 5, and 6. This investiga, tion is being continued. The district is that within the Mount Moritz area, embracing Hermitage, Belair, Mount Moritz, Mount Melville, Cherry Hill, Fontenoy, and Grand Mal.
137
10. Education. Actually 7,906 persons of all ages and both sexes have been reached by the officers during the quarter, mostly at the centres, and a certain number at their homes.
The same general hygiene instruction as previously detailed has been given, and special explanation has been made in regard to sanitary needs in the pre- vention of hookworm infection.
Public lectures have been delivered in St. George's and St. David's by the Medical Officers. The general theme is :-
(i) The interest of their Sovereign in the welfare of his subjects. (i) The origin and operations of the International Health Commission. (iii) Hookworm disease: its nature and dangers; its easy discovery; its
its easy cure; easy prevention.
(iv) Discovery and cure are to be effected free to everybody, but the means
of prevention are a domestic and individual matter.
(v) Appeal to the decency of the people not to imitate the beasts of the field in their habits; to the gratitude of the people to do a little for them- selves in return for what is done for them
(vi) The simplicity and costlessness of what is required, and a description
of the simplest and other latrine systems.
(vii) Practical illustrations and demonstrations.
11. Sanitary improvement.-No attempt at a census of sanitary improve- ment has yet been made.
Legislative suggestions have been presented.
There is general effort on the part of the people throughout the districts operated and in other districts to construct satisfactory closets.
12.
Several good
pit closets have been erected; many pits have been dug and fenced round, which are better than nothing and will act during the dry season, but the first shower When the areas have been of rain will demonstrate their uselessness. exhausted in treatment a sanitary census will be taken, and, while there is Already undoubted improvement, there is little prospect of a complete revolution taking place, which would be necessary to keep pace with the intensive work. Treatment. At first the drug given, in the usual routine dose as already detailed in treatment rules, was thymol. Cure was rarely effected with four treatments.
On account of exhaustion of thymol locally and its prohibitive price, B/naphthol has since been used. At first few cases were cured with four and more treatments, but a new stock of B/naphthol has lately come in operation and cure results usually from three treatments and apparently sometimes from The actual number of treatments given during two and from one treatment
the quarter is 9,624. This has meant the use of some 60,000 powders of B/naphthol and Epsom salts.
For the preparation of these and stock in hand the two dispensers employed at head office at the expense of the Government have used 594 lbs. of Epsom The actual salts, 20 lbs. carbonate of magnesium, and 58 lbs. of B/naphthol. number of powders manufactured was 96,793.
66. In order to accommodate the expenditure to the modified budget that secins, from the letters of the Medical Director, to be inevitable, the assistants in the areas have been given notice of the termination of their engagement at the end of April.
67. No notice has yet been given to any microscopist, as I hope to retain them They have all given all; some to act as assistants in the outdoor work of the areas. satisfactory work, and are valuable to retain if possible.
68. The financial statement for the quarter ended 31st March, 1915,* is here presented, along with an estimate of the expected expenditure in the quarter ending 30th June, 1915.*
69. I am anxious to obtain as early as possible a settlement of the budget, the continued feeling of uncertainty being unsatisfactory to all concerned,
I have, &c.,
ANGUS MACDONALD,
The Honourable
The Colonial Secretary,
Grenada.
Not printed.
Medical Officer in Charge.