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PUBLIC RECORD OFFICE
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PUBLIC RECORD OFFICE, LONDON
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No.. 104.
FEDERATED MALAY STATES.
HIGH COMMISSIONER SIR F. A. SWETTENHAM to MR. CHAMBERLAIN.
(Received October 12, 1903.)
[Answered by No. 110.]
(No. 492.) SIR,
Government House, Singapore, September 12, 1903. WITH reference to your circular despatch of the 28th of May last,* on the subject of the education of Medical Officers in the treatment and prevention of Tropical diseases, I have the honour to enclose, for your consideration, copy of a letter from the Resident-General, Federated Malay States, forwarding a paper on the subject by Dr. C. W. Daniels, Director of the Institute for Medical Research, Federated Malay States.
I have, &c.,
(No. 5624/03.)
Enclosure in No. 104.
F. A. SWETTENHAM.
Resident-General's Office, Taiping,
Malay Peninsula, September 2, 1903. Education in, and Investigation of, Tropical Disease.
SIR,
I HAVE the honour to inform Your Excellency that I referred to Dr. C. W. Daniels, Director of the Institute for Medical Research, Eederated Malay States, a copy of Secretary of State's circular despatch, 26th May, 1903, in connection with the subject of Tropical Diseases, which had been supplied to me under cover of the Honourable the Colonial Secretary's paper, 5551/03, and enquired if he had any comments or suggestions to offer.
D
2. Dr. Daniels has, in my opinion, written a valuable paper in reply, No. 132, of 30th July, 1903, copy of which, and of its enclosure, I have the honour to submit in duplicate, with the suggestion that it should be brought to the notice of the Secretary of State.
3. In paragraph 4 Dr. Daniels refers to the work done in connection with transforming Port Swettenham from a hotbed of malaria into a healthy port. The work was carried out under the advice of a Committee composed of the then Director of the Institute for Medical Research, the State Surgeon, and other Medical Officers of Selangor, and the Director of Public Works, and Engineers of his Department. Dr. Daniels was much struck with the results attained with moderate expenditure of public money.
I have, &c.,
His Excellency
SIR,
The High Commissioner,
Federated Malay States, Singapore.
(No. I.M.R. 132/1903.)
W. H. TREACHER,
Resident-General, Federated Malay States.
The Institute for Medical Research,
Kwala Lumpur, Federated Malay States,
July 30, 1903.
Education in, and Investigation of, Tropical Diseases.
In accordance with the request contained in your letter of July 4th, 1903 (C.S. 4899/03), I have the honour to submit the following comments and suggestions.
* [Cd. 1598], June, 1903.
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2. The need for special education in Tropical Medicine, not only for Medical Officers in the services of the Colonies, but for others practising in the Tropics, was great, and the establishment of Medical Schools for this purpose has greatly improved the situation.
For the average Medical Officer the two months' course suffices for the purpose of enabling him to grasp the general principles and perform the technical processes required for the diagnosis of the known Tropical Diseases. For a certain number of the men a longer course, say three months, would be advantageous, and it should, in my opinion, be possible, in the case of a student who shows marked proficiency, for him to extend his term at his own option, but at the expense of the Colony, for a further period. A Medical Officer on leave should be allowed to take out a second course in special cases.
3. The investigation of Tropical Diseases is required. The better the Medical Officers of the Colonies are educated the less is the necessity for special expenditure in connection with this work. The members of the Colonial Medical Services are professionally quite equal to those of other services, and include some who, even under past conditions, have done good scientific work. Now, with the better educa- tion they receive and the recognition by the local Governments of the necessity of this work, I am convinced that better work will be done locally than by expedi- tions.
It is, in my opinion, unfair to the Colonies and to the members of the Medical Services of those Colonies that they should not be allowed and encouraged to under- take such investigations as are required themselves.
As regards the East, laboratories with competent bacteriologists have been established in Hong Kong and Singapore, and the Institute for Medical Research at Kwala Lumpur is open free to any workers in Tropical Diseases. The Govern- ment have consented to make arrangements for the relief from other work of Government Medical Officers in the Federated States who wish to work at the Institute. If the Governments of other Colonies in the East made similar provisions for selected men to work at the laboratories or this Institute, most of the necessary investigations could be carried out.
Laboratory accommodation, time and opportunity would thus be provided locally, and with a well-educated service there should be only exceptional need for outside help.
4. Special expeditions should be rarely needed and, in my opinion, those undertaken have not all been required. Some of these expeditions are not locally considered as successful as the published reports in England would lead us to suppose (vide Prout's letter enclosed as to Sierra Leone), whilst the more successful undertakings carried out by properly educated local men, though quite ignored in England, have been much more successful (vide Klang). The expenditure in the two instances was about the same.
Some of these expeditions were useful, but only because the advice they gave was taken, whilst similar advice given by the local Medical Officers had disregarded.
It is discouraging to local men who are working on sound lines to have the fruits of their labours taken from them. The members of the Colonial Medical Services by being treated in this manner are discouraged from the investigations of diseases, finding themselves placed in an inferior position, as if they were incom- petent to carry out such investigations. Even as regards the Royal Society Malaria Commission, and the expeditions of the Liverpool School, beyond extending Major Ross's researches, made in India, comparatively little was done. The main fact said to have been discovered by Koch and these commissions, susceptibility of native children born in malarial countries to malaria, had been reported by several Colonial Medical Officers years before. These Colonial Medical Officers had avoided the serious error made by Koch and the members of these expeditions of considering that malaria had little effect on the health of these children; whereas the fact is, as had been previously shown by Colonial Medical Officers, malaria is responsible for a large part of the huge infantile mortality in malarial countries.
5. I am of the opinion that the main needs are :—
(a) Further improvement in the education of those Medical Officers who show distinct promise for research work. Such education not necessarily to be obtained at a School of Tropical Medicine, but, in part, either
at some special laboratory or at such an Institute as the one here or in the foreign Tropical Research Laboratories at Manila, Cuba, &c.