81
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44. (6) In the course of an informal discussion which took place at the Colonial Office on 10th-11th January, 1908, between the British and German dele gates to the International Sleeping Sickness Conference, Professor Koch "endorsed the Uganda report and recommendations of 1906, but considers that nine (segrega- tion) camps will not suffice for the Protectorate, as probably 60,000 natives are infected." No one seems to have questioned this estimate at the time.
The number of deaths returned from the entire Protectorate from 1st January, 1908, onward to 31st August, 1915, although undoubtedly less than the actual number, is yet significant. It is 10,832, or about 18 per cent. of Professor Koch's estimate.
The real number of infections at the date when it was made and deaths of which have been returned cannot have been much over 4,800, or 8 per cent of the estimate.
45. (c) Captain Gray, R.A.M.C., in a report upon the work done at the sleeping sickness camps up to the end of November, 1907, states: "I am inclined to a belief that, if a systematic examination was made of the inhabitants of these (Buvuma) islands, the percentage of infected persons would be found to be 95 per cent., if not more." This is probably the basis for the statement contained in Sir Hesketh Bell's despatch, of the 9th of December, 1907, No. 197,* reporting on the progress of the sleeping sickness measure, in which he attributes the estimate to Dr. van Someren.
The systematic examination was not made, but the returns of deaths from Buvuma are as follows :—
most cases.
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The Mount Elgon region has recently been cited to me as an exception, but this is specifically cited as being infected in 1906.
50. The Western Province, including the populous districts of Ankole and Toro, was the principal region into which epidemic appears not to have spread previous to 1906. Here it has since appeared, and, judging from the death returns, it is increasing slowly and steadily at the present time in Ankole. There has been, I am informed, heavier mortality than is shown in the returns, and there is some doubt if the deaths now recorded as by sleeping sickness are really attributable to that disease. A depopulation measure was carried out some years ago, but it is not known with what success.
As far as can be judged without more careful study, danger of the epidemic spreading inland was either too small to be a factor of real consequence or else the measures taken to prevent it have failed of their purpose.
Table VIII.-Deaths from Sleeping Sickness in the entire Protectorate of Uganda.
Province.
Ankole.
Toro,
Nile.
Year.
Buganda.
Busoga
Bunyoro.
1908
5,304
849
369
1907
3,407
593
170
1908
1,723
1,478
461
1909
925
603
254
1910
527
698
277
37
1909
667 258
=
For the period subsequent to the removal of the population from the
5.5 per cent. 2-3
1911
253
1,013
168
1912
82
747
84
11
"
1913
57
554
41
21
29
1914
24
354
15
65
1915.
2
170
9
73
islands.
206
1.9 per cent.
For the period during which the population remained on the islands subject to infection.
1908.
16288
*Baà¦||||
PUBLIC RECORD OFFICE
T
Reference :-
CO.885/25
PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
1910 to 1914 Total deaths returned subsequent to the time when the estimate was made (excepting December, 1907).
1,131
9.7 per cent.
Probable proportion of inhabitants actually infected at time when esti- mate was made: 6.5 per cent.
46. It was largely on such expressions of opinion as the above, made in perfectly good faith, and unquestionably in accord with facts as they were observed and interpreted, but very far from being in accord with facts as they really existed, that the seriousness of the whole situation was judged. Those chosen as illustra- tive are possibly extremes in their way, but they are such as found their way to England through official channels, and it was upon such that people wholly un- familiar with the situation were obliged to rely. Naturally impressions concerning the gravity of the situation thus created led to expression of opinions, from the other end, no less out of accord with the true situation in Uganda.“
(D)—Danger of Epidemic extending into other parts of the Protectorate. (See paragraphs 18 and 29 of excerpt, also paragraph 6 of this paper.) 47. In Buganda, as shown by Table II., the number of deaths in interior Bazas, which had risen year by year until 1906, suddenly dropped, and thereafter fell rapidly, until, in 1909, only one death was returned. Plainly the conditions in the interior of this Province were wholly unfavourable to the spread of the disease, and the islands the source of little danger to the mainland.
48. Very little dependence can be placed in the returns of deaths for most districts outside Buganda, but such as they are they are presented in Table VIII. From these, and from such other information as is at hand, it appears that the fear The mischief had expressed in paragraph 29 (as excerpted) was well justified. already been done as far as most regions outside of Buganda were concerned.
49. Returns from the Nile Provinces and the outlying districts of the Eastern Province are particularly untrustworthy, but it may be stated without much fear of contradiction that infection had already found its way into all districts where conditions favoured epidemic, or that it has since done so in defiance of the measures undertaken for its control. It is probable that it had already done so in
* No. 1 in Miscellaneous No. 224.
(E)-Apathetic Attitude of the Natives.
(See excerpt, paragraph 21.)
51. It is well to recall, in this connexion, that the sleeping sickness was a strange disease, and that the native originally possessed no such empirical know- ledge of its epidemiology as flight from the lake shore would imply. Furthermore, he had no more assurance than had the European that to move inland with his sick might not result in starting new centres of epidemic. Until it could be shown that Glossina palpalis was the only vector to be feared, and until the range of this insect had been delimited, not even the European scientist could advise any such move, and it was natural that the native should have preferred to remain in his own country than to seek problematical safety elsewhere.
52. Moreover, this attitude of the natives was not only natural, but, it may be argued from certain points of view, quite sound. Impressions concerning the outcome of the laissez-faire policy adopted in East Africa, gained by perusal of the papers bearing on the subject in the files of the Commissioner of the Nyanza Province,t are summed up in the following excerpt from a letter addressed to the Principal Medical Officer for Uganda :-
Excerpt from a Letter from W. F. Fiske, Esq., to the Principal Medical Officer, dated 8th September, 1915.
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 Kavi- rondo District, to which an officer of the Administration was attached, who en- His mission was deavoured to persuade the natives to move to other localities.
a failure.
* Up to end of August, 1915.
↑ I desire to express my gratitude to the Honourable John Ainsworth, Provincial Commissioner, for his great kindness in affording me access to these records, and otherwise.
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