PUBLIC RECORD OFFICE
6
· Reference :---
TLC.O. 885
24 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH:MOT TO
59537
(No. 12.) SIR,
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No. 35.
JAMAICA.
THE SECRETARY OF STATE to THE GOVERNOR.
Downing Street, 7th January, 1916.
I HAVE the honour to acknowledge the receipt of your despatch No. 509, of the 11th December, enclosing a copy of the report by Dr. H. H. Howard on his investigations into hookworm disease in Jamaica:
I have no doubt that you will reopen the question of adopting Dr. Howard's recommendations when the financial position of the Colony permits.
have to inform you that the information which you desired was not available in the Colonial Office, but is being sought from the Governor of Fiji, whose reply has not yet been received.
I have, &c.,
As regards the third paragraph of your despatch,
10597
No. 36.
ST. LUCIA.
BONAR LAW.
REPORT BY DR. S. BRANCH ON THE WORKING OF THE HOOKWORM ERADICATION CAMPAIGN IN ST. LUCIA DURING THE HALF- YEAR ENDED 318T DECEMBER, 1915.
(Received in Colonial Office, 4th March, 1916.) International Health Commission Office, 24, Micoud Street,
Castries, St. Lucia, 14th January, 1916.
SIR,
I HAVE the honour to submit, for the information of His Excellency the Governor, the Acting Director for the West Indies, and Your Honour, the follow- ing report, with tables and appendices, on the working of the hookworm eradication campaign in St. Lucia during the half-year ended 31st December, 1915.
2: The area of campaign was confined to a portion of the Castries valley, the southern boundary running along the Morne ridge from Point Courbaril to the Quatre Chemins, the northern along High Street in the town itself. The area is thus naturally divided into two portions, one purely urban and the other suburban; the surburban portion is further artificially subdivided into localities east and west of Carrington's Peak. It cannot be said that any work was done in the "country" in the same sense as work in the Cul de Sac valley entailed.
3. The Director was absent on leave for four weeks in July and August. During his absence the work of the office and the supervision of the census-taking was carried on by the clerk. Early in September, after conversation with His Honour the Administrator, I seconded one of my series of nurses, and put them to carry out the duties of field inspection, to make an accurate survey of the sanitary condition in the surburban portion of the area, and to endeavour to instal pit latrines for each household. These duties have been carried out to the end of December. From January, 1918, the Commission has approved the appointment of a special Field Inspector, to be paid out of its funds.
Further experience has led me to make changes in my series of nurses. They are no longer worked in couples, a nurse and an assistant nurse; each individual employee on the nursing staff is required to run by himself whatever area is allotted to him. This increases the capacity and efficiency of the office.
It is gratifying to me to have to report that I have had no reason to make any changes in the personnel of the staff. They have all worked well, and taken an interest in what they are doing. A judicious introduction of a little rivalry in the work among the employees is helpful in weeding out the slackers.
4. The work during this period has differed considerably from that in the first half of the year. The population has been more consolidated, and thus easier to handle. A very small percentage, 17 per cent., have refused examination. This is not a wanton refusal, but is in great part due to the timidity of the old school,
* No. 84.
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whose modesty revolte at the mere thought of such examinations. Only in a single household have I had the most insistent refusal from the male parent to allow any of his family to be examined. The most disappointing part of the campaign is due to the migratory habits of the labouring population. They are here to-day and gone to-morrow; change of residence at all periods of the work. I have availed myself of the system of classification of the work as recommended by Dr. Washburn of Trinidad. This shows up in a remarkable manner the continuous loss that occurs
in each area from this particular habit. The recent introduction of an Ordinance to curtail prostitution in Castries has somewhat increased the sudden and necessitous migrations.
5. The establishment of a central office in Castries which is opened to the public during its working hours has had a definite educational value in spreading the knowledge of the disease, its cure and prevention. The people from the town and country often come in to consult us. Opportunity is taken to give individual lectures on the hookworm chart, or to demonstrate the presence of ova or embryos in their specimens. In fact we have established an out-patient department, apart from the area of campaign, and have received specimens from outlying parts of the Colony as well as from neighbouring islands of Martinique and Dominica. During November and December there were fifty-four persons examined, eighteen found infected, seven cured, and the rest under treatment.
6. Lectures and demonstrations have been held in all primary schools in Castries. I have tried to gain the sympathetic co-operation of the managers and teachers to overcome the apathy and procrastination, the long delays before and after treatments and re-examination, which is very common among the children of school age. The percentage of persons remaining over under treatment is composed chiefly of children.
and
Through the courtesy of the Chief of Police I have also been able to lecture to the Police Force in Castries. When the lantern arrives I hope to be able to carry out further lectures with its aid, more especially in the large villages of the Colony. 7. At the request of the Administrator I undertook the examination and treatment of the body of men recruited throughout the Colony for military service under the British Empire. I was pleased to avail myself of the opportunity, the summary of the work done then is attached as Appendices A, B, C. The batches for treatment were confined to barracks from 9 p.m. to noon the next day, and the treatments were personally administered by a nurse on our staff. demonstrates the safety, ease, and rapidity with which eradication can be effected under favourable circumstances. The first examination was made on 4th September, 1915, and the contingent left St. Lucia on 4th October, 1915, and during this time 82 per cent. of the infection was cured.
It
I have also campaigned through the Police Force and Royal Gaol, and a few from each are still under treatment.
8. Perhaps the most interesting part of the work of this period has been in connexion with the sanitary survey and the possibilities of remedial measures to prevent soil pollution.
9. The town of Castries is a low-lying flat, an old crater bed, roughly in the shape of a right-angled triangle; the hypotenuse lies along the sea front, nearly all reclaimed land; from the angles roads run northerly, easterly, and westerly to cross the spurs and ridges which separate the Castries valley from the interior. The only flat extension of land follows the eastern road, and constitutes the largest suburb of the town, properly known as the Marchand district. Through this district winds the Castries river and the many rivulets which take off the storm water in the basin. All this area has been classified as east of Carrington's Peak. The area west of the peak lies on the hill-side of the Morne from the seashore to the summit; the more thickly populated parts here are known as Four à Chaux on the coast line, and the Pavé on the hill-side.
The water supply of the town is good and abundant. The low-lying nature of the ground renders a water sewerage impracticable. The system adopted is removal by pails. Every night at 9 p.m., at the sound of the horn, the pails are paraded through the streets to the one and only sewage barge anchored at the river guide bank. The parade is allowable to 6 a.m.-receptacles of all descriptions, with imperfectly fitting lids, poised on the heads of irresponsible persons, often children, Various by-laws and regulations are in force to try and ensure an economic and efficient removal.