CO885(2-3) — Page 207

PUBLIC RECORD OFFICE

Reference :-

C.O.885

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-

COPYRIGHT PHOTOGRAPH-NOT TO

PUBLIC RECORD OFFICE, LONDON

Despatch,

Feb. 28, 1863.

Despatch, April 22, 1863.

Despatches,

Oct. 29, and

Nov. 4, 1863.

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69. Tabayo.-Tobago has no public hospital or tunatic asylum. There is an asylum at Fort King George for from 12 to 15 aged and infirm paupers, which is under the direct control of the Government.

70. St. Lucia.—In St. Lucia there are five hospitals:-three at Castries, one at Soufrière, and one at Vieuxfort. There is also one lunatic asylum at Castries.

Asylum, Castries. It would be difficult to find any institution more defective in almost every requisite than this. It appears to be completely under the control of the Government, and is supported from the general revenue, but the Government delegates all its powers without supervision to a non-resident and unrestricted physician, who for a salary of 1701. per annum visits this asylum weekly, and also attends at the Poor and Yaws asylums and the Immigrant hospital, and has out of that sum to provide all medicines and surgical appliances for the three institutions. There are in general only seven inmates, but their paucity cannot justify the absolute want of sewerage, drainage, latrines, baths, and lavatories of any kind. Three acres of land are annexed, but only one-twelfth of this is under cultivation, and "there are no enclosures, airing-courts, nor other places available for out-door occupation."

." Strait-waistcoats, manacles, and (what has no parallel in any other colony) even chains, are used for restraint, of which no records are kept. The two chief attendants receive the very insufficient wages of 121. and 71. Ås. per annum respectively, besides rations. There are no religious services. There is an annual report and a meagre record by the visiting physician, and occa- sional visits are paid by an inspector and by the officer administering the government. It is not strange that whilst the annual admissions are stated to average two on the last five years, there have been eight deaths as against six discharges.

There are in Castries three institutions of the nature of hospitals, namely, an Infirm Poor asylum, a Yaws asylum, and an Immigrant hospital.

The Poor asylum is entirely unprovided with sewerage or drainage, and for latrines are substituted certain jars in a shed. There are no baths, nor any lavatories except tubs. The visits are occasional; the reports annual and numerical only.

The Yaws asylum is similarly destitute of sewerage, drainage, latrines, baths, and lavatories, and of proper reports.

The Immigrant hospital is on a par with the other two in sewerage, drainage, latrines, baths, and lavatories, and, in addition, very ill-ventilated."

No sufficient information is given of the amount of space allotted to each patient in these three institutions, or of the system of interual government. There is one doctor for all three, together with the asylum, who is non- resident, is not restricted from private practice, and has to provide all medicines out of his salary of 1707. per annum.

The hospitals of Soufrière and Vieuxfort are devoted chiefly to immi- grants.

The first of these has no artificial sewerage or drainage. There are no latrines, but jars. Tepid baths are provided, but in an out-house. The space allowed to each patient is insufficient, being at the rate apparently of about 600 cubic feet per head. There are two doctors, non-resident, who besides the care of 218 annnal admissions, have the charge of about 700 labourers on estates, some of which are distant sixteen miles from Soufrière.

The Vieuxfort hospital stands below high-water level. The water is bad; there is neither sewerage nor drainage; and the latrines are pits in the dead-house. There are no baths, and the space per head is only 281 cubic feet.

There is no information as to the government of these two hospitals, but the visits and reports do not appear to be necessarily insufficient.

It would appear to be desirable that the hospital at Vieuxfort should be abandoned and its funds applied to the improvement and, if necessary, to the enlargement of the others. The smallness of the Island suggests such a measure, and the natural disadvantages of site and the smallness of the wards point out this as the building to be sacrificed.

71. Antigua.—In an earlier despatch it was reported that both the hospital and asylum were in a completely satisfactory condition, but no answers were made to the interrogatories, except a statement, from which it appeared that

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there were in the hospital on October 21st (?) forty-seven patients, and that the asylum on the 19th contained forty-nine inmates, with à mortality of five between June 18th and October 19th.

The actual answers to the interrogatories were not forwarded till November 4th, and are in many points not consistent with the former despatch. It appears that the only provision for medical attendance is the daily visitation of one non-resident and the occasional visitation of one consulting physician, and there are but two resident nurses. The sewerage and the drainage are

very "imperfect," though from the nature of the site they could easily be made efficient. There is but one lavatory for both sexes. With reference to latrines, as well as to many other important points, there is no information. The wards are excessively sub-divided, and so far as any meaning can be gathered from the answers, may be conjectured to afford no more than from 500 cubic feet of space in the best to 330 in the worst berths to each patient, even this amount apparently including the whole thickness of the walls and partitions.

This hospital appears to be governed by a board of directors composed of the Bishop and members of the councils. They are said to visit weekly, the Governor occasionally. No mention is made of the powers or responsi- bility of the board or officers.

"The lunatic asylum now affords room for about forty-eight patients. Twenty-two of these are allowed less than 640 cubic feet per head. Strait waistcoats, straps, manacles, and confinement are the means of restraint, and are used at the discretion of the superintendent, who reports to the doctor. The doctor is non-resident, and visits regularly only twice a-week. The patients appear to be employed chiefly in menial services.

The Governor will have, by this time, drawn the attention of the Legis- lature to the drainage of the Holberton hospital. The other particular reforms which seem to be most necessary are, (i) with reference to the hospital, the formation of proper lavatories, the removal of the partitions which hier ventilation and multiply labour in the wards, the increase of the staff of nurses, and the appointment of a resident medical officer with full power and responsibility: (ii) with reference to the asylum, the disuse or enlargement of the smaller wards.

72. Neris.-Nevis has at present neither hospital nor lunatic asylum. Despatch, There is a small institution for aged and infirm paupers, supported by 1507. June 19, 1863. per annum from the general revenue; and certain port dues will be allowed

to accumulate for the purpose of erecting an infirmary for seamen, but no general hospital seems to be proposed. Two persons acquitted of capital charges on the ground of insanity are confined in the gaol in all respects as the ordinary prisoners, with whom they suffer the ill effects of the failure of the Prison inspectors to perform their duties with regard to visitation and reports. It is to be desired that these lunatics should be transferred, upon terms of fair payment, to an asylum in some one of the adjacent islands, where they would have a chance of curative treatment.

73. Dominica.-A Poor asylum at Morne Bruce with about eighty-nine Despatch, patients, a lunatic asylum at the same place with from three to six, and an July 28, 1863. infirmary at Roseau with about twenty-one, are under the control of one board of Guardians nominated by the Governor, which frames rules and regulations. All three are supported wholly from the general revenue.

The poor asylum is managed by a master at a salary of 801. per annum, and a matron, his wife, at 301. ~ There is no resident doctor. The visits and reports are very insufficient. There is apparently no provision for sewerage, drainage, latrines, or baths. Rain water from the roof is preserved for drinking.

The lunatic asylum is an old military prison, wholly unfit for its present purpose. It is managed by the medical officer of the Poor asylum, but directly by the master of the Poor asylum, and by a resident keeper at 431. per annum without allowances. Sewerage and drainage do not exist, and there are no baths, nor apparently any artificial latrines. The six cells, of which only three are at present occupied, contain only 300 cubic feet a piece. There are no airing courts or other provisions for employment or amusement. Female lunatics do not seem to be admitted, though, to judge by other islands, they must preponderate in number. The only register is kept by the Master of the poor-

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