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PUBLIC RECORD OFFICE
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PUBLIC RECORD OFFICE, LONDON
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X.-Reports of Medical Officers engaged in the Extended Investigations.
71.
Mention has already been made of the report by Dr. van Someren upon the conditions along the Buddu coast. This contains the most exact and compre- hensive data of any of these reports which covers a region personally familiar to me, and can be found in the files. Most of those for the lake region are, unfortunately, missing.
72. Many reports from the Northern and Western Provinces are on file. The conditions encountered and described are very different to those prevailing along the shores of Victoria Nyanza, both with regard to the dispersion of the fly and that of the population. The people lived differently, and the fly was often found on the banks of small streams running into the western lakes and the Nile, as commonly as on the shores of the lakes or the banks of the large river. A clear conception of the situation is difficult to one who is unfamiliar with the country.
73. A great deal that one would like to know of it was left unsaid, yet, on the whole, a great deal was said, and none of it indicates that the conditions so exactly described along the Buddu coast and in the village of Dumo were in any manner exceptional. There is abundant evidence that considerable communities continued to live in moderate contact with Glossina palpalis, with infection present or near at hand, and without taking any great harm or none at all.
XI.-" Laissez-faire” in East Africa and Uganda.
74. There is a remarkable divergence of opinion concerning the best manner of dealing with the present situation in Uganda. An argument which represents one extreme is that sleeping sickness no longer afflicts the country and shows no sign of recrudescence; therefore, why do anything! On the opposite extreme it is argued, on the same premises but going a step farther, that the natives are extremely anxious to return to their lands and fishing, sleeping sickness has dis- appeared and shows no sign of recrudescence; therefore, why prevent them from returning?
75. Between the two, Nature (human nature in this case, but it is all the same) is being allowed to take its course no less truly than in East Africa, where laissez-faire was the policy from the beginning. The letter of the Sleeping Sick- ness Ordinance is so strict that it proved difficult to enforce; its enforcement was, therefore, not insisted upon. Sleeping sickness continued to decrease; strict enforcement has, therefore, appeared unnecessary as well as difficult, and, with the strong desire of the natives to return to the lake shore acting with constant force, a movement has begun which will inevitably continue until revision or repeal is decided upon or recrudescence of the disease occurs and the letter of the law is revived-too late to serve its purpose, which was to prevent this very thing.
76. The measures for the suppression of sleeping sickness have been carried out at considerable expense to the Government, and at extraordinary expense to the natives which they were designed to benefit.* To adopt a laissez-faire policy at this late day is to have incurred all this expense without having achieved any permanent good, and it would be a regrettable outcome to an ambitious venture. The best alternative appears to be the revision of the Ordinance and Rules along more liberal lines, which will permit recolonization under conditions which will preclude recurrence of epidemic.
77. At the present time it is believed that the natives would take advantage of such opportunities as would be offered and be willing to help in every way. No more remarkable example of native confidence in European wisdom was ever wit- nessed than their voluntary expatriation on its having been represented to them that they would thus be able to exterminate infection. As long as this spirit of confidence is sustained the situation will be relatively easy to meet, but if it is once thoroughly shaken new difficulties will arise, and it is certain that the natives are The economic loss to the natives, if expressed in terms of days' labour, would amount to enough to have cleared the islands and mainland shore of teetse, not once, but several times over. Even the relatively small item of clearing the overgrown plantations and village sites pre- paratory to reoccupation would probably suffice to exterminate tsetse from the larger islands and vicinity of villages on the mainland. The loss in cattle which died, canoes which were destroyed, huts which were burned, plantations which were abandoned, etc., represents an extraordinary amount of labour in the aggregate.
learning for themselves that unnecessary restrictions are imposed upon their most legitimate desires.
78. This present year the number of deaths from sleeping sickness has dropped abruptly from a small number to one which is quite negligible, and it is doubtful if a more propitious moment for taking action will arise.
79. It has been argued that it is also the most inopportune which could well This is undeniably sound from certain be chosen, on account of the stress of war. points of view, but from another it furnishes its own argument in rebuttal, because it is on this account that the laissez-faire movement has grown so strong. Adminis trative and medical officers have been detached from all but the most necessary duties; the Sleeping Sickness Ordinance has been about the first and the worst to suffer; and precedents are being established on every hand which are sure to become embarrassing in the future. Either recrudescence of the disease or a strong senti- ment in favour of removing all restrictions must follow, and, while revision of the Ordinance would still be possible, it would not be as easy.
XII. Co-ordination of Work in East Africa and Uganda.
J]
80. It is strongly recommended that the "Officer in Charge of Sleeping Sick- ness Administrative Measures should have jurisdiction in all portions of the lake under British dominion or protection, for the following reasons:--
81. There is no reason to suppose that sleeping sickness will ever spread, to become epidemic, except under certain definite conditions, nor any for supposing that it will fail to do so if infectior. is introduced into any region where these conditions occur. It has clearly been demonstrated that if a native population is left to follow its natural bent in the lake region of Uganda and East Africa, and if infection is absent, conditions favourable to a great epidemic will come
about.
82. In East Africa the disease appears to have become endemic, and under such circumstances epidemic is very unlikely. In Uganda it has been practically exterminated; temporary immunity has led to indifference, on the part of natives and Europeans alike, and recurrence of the epidemic is much more likely to happen than in East Africa.
83. The surest preventive is continued presence of infection, but it is not necessary that is should be present everywhere, if only the danger appears to be imminent. It is as with smallpox (in America); if an epidemic is reported from a distant city a few persons will be induced to take the ordinary precautions, if it approaches nearer more will do so, and if it breaks out in the immediate vicinity It is the public sentiment will demand compulsory vaccination of everybody. same with plague or any other contagious or infectious disease; unless some danger is recognized no precautions will be taken, and unless it is recognized by the public, as well as by their health and administrative officials, these may ask in vain for confidence and co-operation.
84. It is conceived that an object of the European administration of African countries is to help the natives to help themselves, to the ultimate benefit of all concerned. That which is required in respect to the sleeping sickness is to teach the natives how to live in a manner somewhat different to that to which they have been accustomed. In East Africa they have learned many things through experi- But the Uganda ence which the populations in Uganda must learn some time. peoples were told, in effect, that they did not need to remember the lessons which their bitter experience may have taught them, but that there was a better way-to exterminate the disease-after which they might return to live as they did before. Unless something entirely unforeseen should eventuate they cannot return to their former manner of living. How nearly they may safely approach it no one, as yet, knows, and they have no means of finding out for themselves save by experience. It will be the duty of the official in charge of any recolonization scheme that may be approved to help them learn their lesson, and to interpret for their benefit the knowledge gained by technical research as well as that which the Kavirondo people have learned for themselves.
85. Application of technical knowledge to conditions as they are assumed to exist in East Africa would probably help the natives to ward off an evil which they can see and appreciate to reduce their death-rate, and to make it possible for them to occupy portions of the infected zone which have been naturally depopulated and latterly avoided. Success in such directions would give the official in charge a