CO885(2-3) — Page 206

Despatch, April 22, 1863.

Despatch, May 12, 1863.

Despatch, May 30, 1863.

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60. British Honduras. --Lieutenant-Governor Seymour has not furnished any information in the form required by the circular of 1st of January 1863. respecting the lunatic asylum and public hospital at Belize, but reports that the two Institutions are supported with liberality, and that their inmates are kindly and attentively treated; in proof of which, as regards the asylum, he adduces the fact that a lunatic has recently been released with his mind entirely readjusted. On the other hand he states that both the buildings are unsatisfactory, and that the necessity for a new asylum has been represented by him to the House of Assembly, which recognized the desirability of such a measure, but considered that the state of the public finances consequent on the fire of the 10th of March, 1863, would not justify them in immediately proceeding to give effect thereto. Governor Seymour further states that Dr. Young, the late public Medical Officer, before his death, destroyed the records of all the public boards with which he was connected. That he should have had it in his power so to destroy all records, points to the inefficiency of the system of management and supervision.

61. Turks Islands.—There is no lunatic asylum in Turks Islands,

The state of the hospital seems to be generally good, but there is no sufficient information as to details. It appears that there is no artificial sewerage, and the wards are too much sub-divided. The average space allowed to each patient is apparently under 700 cubic feet, an amount which is too small, but is said to be supplemented by good ventilation.

The attention of the President and Council should be particularly directed to the sewerage, and to the expediency of throwing down the partitions between the three sick male wards, and also those between the three sick female wards, an alteration which would give some additional cubic feet of air to each patient, and would greatly assist ventilation. It seems also desirable to provide some system of out-door medical relief.

62. British Guiana.-There are in British Guiana three hospitals and asylums-n hospital and an asylum at Georgetown, Demerara, and a hospital at New Amsterdam, Berbice.

The Georgetown hospital is extremely defective in its sanitary arrange- ments. The water supply is insufficient, and of bad quality in dry seasons; the sewerage consists of open brick gutters, and the latrines are allowed to be offensive for want of a pump or a water-lift. No more than an average of about 700 cubic feet of air are allowed to each patient, without any other means of ventilation than small windows, and at the date of the despatch there were no baths. The internal management is obstructed by indiscriminate admission, and the retention of numerous chronic and incurable cases. The total proportion of nurses is only as 1 to 16, and there are no more than 2 night nurses for 3,144 annual admissions. The supervision is merely nominal. Visitors are appointed for each month by the Directors, but they visit rarely, and the Governor had visited but once since his appointment in 1861.

The asylum at Georgetown is very much worse even than the hospital, but the frame of a new building has been completed, and a vote has been passed for the necessary funds. No condemnation could be too strong for the present structure; a collection of confined cells wholly unsuited for a tropical climate, almost without means of ventilation, with sewerage and latrines con- fessedly "faulty in the extreme," without sufficient lavatories and without baths. No records of restraint are mentioned. There are absolutely no pro- visions for employment or amusement, and for exercise nothing but some small covered yards. There are no religious services. Some land which might be planted or cultivated is suffered to lie unused. Nor is this state of things to be wondered at where there are no inspections by superior authorities, and no information is required by or furnished to the Governor.

A new building will avail little if it is to inherit the bad management and the want of supervision of the old.

These two institutions are consolidated and governed by one board of administrative directors, who make the rules. The Colonial Surgeon- General is the chief of both, and has the patronage of the inferior offices.

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At New Amsterdam, Berbice, there is a hospital, which is also a poor- house, and contains four cells in which maniacs are temporarily confined.

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This also is to be given up when a new hospital shall have been built on land and with funds already appropriated.

The site of the present structure is bad, and the buildings in utter dilapidation, happily beyond the possibility of repair. Each patient has about 800 cubic feet of space, not supplemented by ventilation. The sewerage and drainage are "very bad indeed." The latrines are mere soil-boxes. There is not sufficient accommodation for nurses, and there is only one doctor, who is non-resident and not restricted, and aided only by a resident dispenser, for an average of 116 cases under treatment. The management is vested in a board of seven members, three ex officio, and four nominated by the Governor and the Court of Policy.

63. Barbados.-The drainage of the Barbados hospital is on the surface, Despatch, and the sewage is collected in cesspools. Nothing is said of hot baths. Out- May 16, 1863. patients are treated only on one day in the week. There is no information as to whether the rules for visitation are observed, and there do not appear to be any reports of actual condition and requirements.

The asylum is without sewerage or any but surface drainage, and its latrines are merc pits annually cleared, and which it is vainly attempted to deodorise by lime, soil, and dry leaves. There are no lavatories, and the only accommodation for bathing is in a single closet 6 feet by 74. The most roomy wards give 958 cubic feet per head, but there are eight berths with only 450, and six with 453. There are no day rooms. The wards are much overcrowded, the ventilation very imperfect, and the west rooms (the smallest) have no windows. Employment is found for only ten out of lifty-eight inmates. Restraint by manacles and by seclusion appears to be very frequent. There are no religious services, and no regular visits of inspection.

64. Trinidad. The state of the hospital of Port of Spain, Trinidad, is an Despatch, honourable exception to the general condition of West Indian hospitals. June 29, 1863- Dr. Mercer was appointed resident surgeon in 1857, and since that date great reforms have been made in every part of the institution. The last deficiencies, imperfect sewerage and the want of hot baths, will have by this time been supplied through his representations. It only remains to provide for the continuance of the present good management by the introduction of a more complete system of inspection and reports.

The hospital of San Fernando is governed in the same way as that of Port of Spain, but is less satisfactory. There is at present no proper water supply, but better arrangements are in progress. There is apparently no artificial sewerage or drainage, and the latrines are mere boxes emptied daily by the convicts. It is inevitable that they should be offensive and unhealthy There are no lunatic asylums in Trinidad.

67. St. Vincent.-There is no asylum.

Despatch,

The hospital is very small, containing only 20 beds. The size of the June 11, 1863. wards allows only 600 cubic feet per head, but the ventilation is said to be perfect. The sewerage is open, and the latrines are merely deep pits, deodo rised by lime.

Besides general improvements it is in particular desirable-(1) That a hot bath should be provided; (2) that the sewer should be covered in and the latrines flushed with water and made to discharge into the sewers; and (3) that the salary of the doctor should be increased. He receives only 501. per annum for attendance on the hospital, the almshouse, and the out-patients. In other respects this seems to be a satisfactory establishment, though very small for the population.

68. Grenada. In the hospital of Fort George there is accommodation Despatch, for 42 patients, but the numbe treated does not exceed 27. The sewerage May 12, 1863. and drainage are said to be naturally good, but it is impossible that they can be sufficient without artificial arrangements. The system of visits and of reports is insufficient.

The lunatic asylum is governed by the board of Guardians of the poor. It is a very small institution, and not satisfactory. There is no provi- sion for sewerage or drainage, or, apparently, for latrines, for hot baths, or for employment, unless in menial services. The doctor is non-resident, and visits only once in forty-eight hours; the immediate care of the lunatics being vested in a keeper and a matron at 751. 12s. per annum seemingly divided between the two. There are no regular reports, and visitation is rare.

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