$3
PUBLIC RECORD OFFICE
Reference:
885/25
PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
COPYRIGHT PHOTOGRAPH-NOT TO
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9. If the precedent established at Bukakata and the conditions formerly existing on the southern Buddu coast could be accepted as a standard to measure up to in clearing operations elsewhere, various reaches of shore could be reopened with scant ceremony, and really valuable boating and fishing privileges be restored with hardly a restriction. The worst infected reaches of shore and islands would needs remain closed to actual habitation for the immediate present, but, if unin- habited, there would be no regular canoe traffic to them. Furthermore, if numerous fishing grounds were open there would be far less temptation than at present for natives to trespass on forbidden waters.
10. It is undesirable that too many natives should come too quickly to live in the reclaimed region, but the movement could be restricted by imposition of a surtax on huts located in the region, the proceeds of which would be expended in extending and maintaining clearings so that, to the extent to which the population returned, additional safety could be secured.
11. No part of the region now closed ought to be reoccupied until it has been surveyed and permission granted (under conditions which would vary with circum- stances, and which would not be met in all cases). European inspection and super- vision would be necessary. This would add to the administrative cost of govern- ment, but, it is contended, the cost would not be much greater than if the present regulations were to be strictly enforced.
12. This is, in bare outline, a scheme which would needs be put to actual test to determine its practicability, but which is wholly impracticable if the Could it be proved standard set by the clearings at Entebbe port is adhered to. that the "Bukakata standard" is really safe the question would become one of administration and of the extent to which native co-operation could be secured, but, without special pathological investigations, the question of safety will remain unanswered, and the objections to the Bwendi experiment must be considered as well taken.
13. Concerning the question of immediate action, or of further delay, much might be written. There is one strong argument against action at this time- the state of war-opposed to which are very many in support of such a course.
14. The depopulated areas are fast reverting to jungle, and becoming the haunt of increasing numbers of game, and, on the whole, increasing numbers of fly. Extensive reaches of shore which were fly-free in 1906 are now densely infested, To have kept owing to the growth of bush following dropping of the lake level. these clear of bush would have been relatively simple-to clear them now more Other reaches of difficult to clear them a few years hence more difficult still. shore now fly-free will be densely infested in a few years more unless the lake again rises to the level of 1906 or measures to check the growth of bush are undertaken.
15. The amount of clearing which would be required to-day to put the old plantations under cultivation would probably be as much as would have been required to have cleared the whole lake shore of fly eight years ago, and in a few years it will be greater than it is now. Consequently, as years pass, there is less and less inducement for the population to return, and more and more difficult task ahead of it when it does.
to.
16. By no stretch of the imagination am I able to conceive a cheaper method for fly suppression than by partial clearing, and, unless some one comes forward with an entirely different idea than any yet suggested, it appears likely to remain the cheapest. If it does, to adhere to the principle of complete suppression of fly is practically to prohibit the native population from reclaiming its lands for ever. 17. But it is a fairly safe prophecy that the principle will not be adhered As you truly remarked, in one generation the natives will have forgotten the lesson taught by the epidemic. It is equally true that changing administrations will forget. To officials like yourself who have lived through the epidemic it remains fresh and vivid in your recollections. To others who have come on later, and who have your personal recountal of conditions then prevailing upon which to base judgment, a dim idea of them can be secured. But to others coming still later, when all of the older generation of officials shall have retired or been trans- And if ferred, the sleeping sickness epidemic will be little more than a tradition. it chance that the disease does not recur under continued, tacitly permitted, viola- tions of existing regulations, in one way or another a combination of circumstances is likely to arise which will make for a repetition of epidemic under conditions much as before.
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18. It seems eminently desirable that a policy should be formulated which takes both the past and the future into account. In doing this active participation by the diminishing number of officials to whom the past is a vivid memory is indis- pensable. For this reason alone delay is to be deplored.
The Principal Medical Officer,
ہو
Entebbe.
(5)
I am, &c.,
W. F. FISKE.
SIR,
Entebbe, Uganda, 8th September, 1915. I HAVE already expressed the opinion that the safari into East Africa, previously proposed, would not be productive of results of practical value unless provision were made for pathological as well as entomological and bionomic work. A visit to Kisumu, where I had the privilege of an extended interview with the Commissioner for the Nyanza Province, has confirmed me in this view. The main facts concerning the epidemic of sleeping sickness in East Africa appear to be as follows:-
Sleeping sickness became epidemic shortly after assuming that condition in Uganda, and in 1908 depopulation of the infected regions was seriously contem- plated. Forcible action would have been necessary; authority was lacking, and it was not undertaken. A sleeping sickness camp was established in South Kavirondo District, to which an officer of the Administration was attached, who endeavoured to persuade the natives to move to other locations. His mission was a failure.
Meanwhile thousands of natives in this and other districts had died, and certain regions were practically depopulated. These did not include all that were infested by fly and infected by disease. The lesson was severe, but the natives learned it, and by 1909 or 1910 a voluntary movement was under way--not so much from the infected to the non-infected regions as from the more dangerous to the safer localities in the infected zone.
By 1911 it was apparent that the disease was no longer spreading, and by 1912 that the population in the infected districts was actually increasing naturally, in spite of continued mortality; figures indicative of this were presented by the Pro- vincial Commissioner in his annual report, and, while complete figures for later years are not immediately available, it is believed that this increase has continued. The natives moved back in numbers into the infected regions-even into those which were practically depopulated. No restrictions or conditions have been imposed. Precautionary measures have been urged, and men have been sent to see whether or no they were carried out. Some clearing work has been done-how much I cannot say.
The disease is still causing many deaths, but, if I interpret the situation, the natives are now thoroughly conversant with the cause, and every death which occurs serves to emphasize the need of continued caution. A natural balance of a sort has thus been struck between the human and its parasitic organism, which appears to be quite stable, i.e., a recurrence of epidemic appears to be unlikely because continued heavy, but not excessive, mortality has inspired caution rather than fear. As is natural, the birth rate amongst the depleted population has risen: so much so that it has, possibly, not only offset the unusual mortality, but so that the actual rate of increase in population is greater in the infected than in the non- infected districts. (The Kavirondo population, unlike the Baganda, is increasing steadily and rapidly.)
The policy outlined above would not have succeeded in Uganda, where the lake shore is more densely and generally infested by fly, where the natives are notoriously unprolific, where the epidemic gained greater headway. The problem is now com- plicated still further by the fact that, through enforced immunity to the disease, they have lost much fear of it, and would not voluntarily adopt such precautionary measures as the Kavirondo appear to have done. To pursue the simile of the balance, one pan has been held firmly depressed, and if it were now suddenly released violent fluctuations are likely to ensue. Were it possible to impress upon the native chiefs the need for caution (which continued heavy mortality in Kavirondo
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