CO885-(16-18) — Page 830

SIR,

Enclosure in No. 2.

(Annexures Nos. 11 and 12.)

The British South Africa Company,

2, London Wall Buildings, E.C., December 22, 1906.

I AM directed to inform you that the Board has considered at considerable length the subject of sleeping sickness and its possible introduction into Rhodesia. Correspondence has, in consequence,, taken place with the Colonial Office and with various scientific associations, notably the Liverpool School of Tropical Medicine.

As a result, I am directed to forward to you, under separate cover, the following publications issued by the Liverpool School of Tropical Medicine :-

(a) Memoir XXI. of the Liverpool School of Tropical Medicine. (b) Reports of the Expedition to the Congo, 1903-5.

(c) Report on Trypanosomes, Trypanosomiasis, and Sleeping Sickness. I am further directed to enclose with this letter a copy of my letter to the Colonial Office of the 13th instant, and to inform you that I shall shortly forward further information relating to sleeping sickness, especially an abstracted transla- tion of the preventive measures which are being enforced by the Congo Free State.

With reference to the publications now sent to you, it appears from the Report of the Expedition to the Congo, 1903-5 (Memoir XVIII. of the Liverpool School of Tropical Medicine), that the disease follows the main lines of communication, and that it can be carried into new districts by infected persons.

The preventive measures suggested are, briefly :-

(a) The establishment of posts of inspection along the main routes of com- munication to prevent the entrance of infected persons into uninfected districts; and

(b) The removal of infected persons from posts in uninfected districts to places in areas already infected, but as free as possible from the tsetse flies which transmit the disease.

The writers of the article own that the application of these measures will involve much expense, and that there will be great objection to (b). At present there appears to be no case of the disease in Rhodesia, and it will, therefore, be unnecessary to consider the suggestions in (b), and the efforts of the Administra- tion must be concentrated on (a).

The method of ascertaining whether a person is infected with the parasite is to feel the glands of the neck to see whether they are enlarged. Should this prove to be the case, it is understood that the individual, however healthy he may appear, should be considered to be infected with the disease until the contrary is proved.

It is suggested that police patrols should be stationed on the boundaries of the territory at all the principal points of entry, and the Directors will be glad to hear if it would be practicable in any way to prevent natives from entering at any other points.

The Directors understand that it will eventually be unnecessary to have a medical officer at every point of entry, since any intelligent non-commissioned officer, or other official, is quite capable of applying the proposed test. The proposal put forward by the Liverpool School of Tropical Medicine is that any native with swollen glands who seeks to enter Rhodesia should be turned back at the frontier.

I am to add that every possible step must be taken to prevent the entry of the disease into Rhodesia, and the Directors will be glad if-you will forward your recommendations at the earliest possible moment as to what preventive measures you recommend and the estimated cost of such measures.

I am, &c.,

His Honour

The Administrator,

British South Africa Company,

Kalomo, North-Western Rhodesia.

D. E. BRODIE,

Secretary.

(NOTE-A similar letter to the above was despatched to the Administrator, North-Eastern Rhodesia.)

1580

No. 3.

UGANDA.

THE COMMISSIONER to THE SECRETARY OF STATE.

(Received January 12, 1907.)

(No. 234.) MY LORD,

Government House, Entebbe, Uganda, December 15, 1906. WITH reference to Your Lordship's despatch, No. 243, of 25th August last,* and to subsequent correspondence respecting the prevalence of sleeping sickness in the Entebbe peninsula, I have the honour to transmit herewith a Memorandum by Doctor Hodges, the Acting Senior Medical Officer, which, I feel sure, will be read with interest and satisfaction.

2. In the despatch* above quoted, and in a telegram dated 1st November,‡ I was informed that the Bishop of Uganda had drawn Your Lordship's attention to the fact that the attraction of labourers to Entebbe from non-infected districts in the interior was causing the spread of the disease into localities which might other- wise be spared. This statement placed such a responsibility on this Administration that I requested my Senior Medical Officer to make most careful enquiry into the matter and to ascertain, if possible, the grounds upon which the Bishop had made his allegations.

3. Doctor Hodges's Memorandum amply indicates the thoroughness with which he conducted his investigation. The statistics given by him show that Bishop Tucker has been misinformed, and that the danger to which he drew attention is so small as to be almost unworthy of attention.

4. A house-to-house investigation was effected throughout the peninsula, with the result that, among a total native population of 2,817, only 41 cases of sleeping sickness were discovered. It was found that, out of the heavy death-rate of past years, the overwhelming majority of cases occurred among natives who had come from the deeply-infected Sesse Islands, and that they had probably been diseased long before they came to Entebbe. The result of Doctor Hodges's enquiry was unexpectedly favourable, and he is of opinion that the facts and figures obtained would compare very favourably with those that might be collected at any other point on the lake shore.

5. The possibility that sleeping sickness might be spread into uninfected districts through the return home of labourers who might have contracted the disease while working in the peninsula, was made the special object of the Senior Medical Officer's enquiry. He has obtained statistics showing the number of labourers who have come to Entebbe from other districts during the past five years, and from these he finds that whereas the number of deaths from sleeping sickness among the whole population of the fly-infected or lake shore districts showed a ratio of 40 per cent. to the number of labourers supplied by them, the number of deaths from sleeping sickness in the inland districts showed a ratio of only 2.6 per cent, to the number of labourers supplied. These figures can only represent the death-rate among these imported labourers if it be supposed that all the deaths reported were due to sleeping sickness contracted at Entebbe, which is absurd. But even on this supposi- tion the percentage for the inland or non-infected districts is not high.

6. In Unyoro, Toro and Ankole, from which a yearly average of 6,175 native labourers have visited Entebbe, no deaths directly attributable to the Victoria Nyanza epidemic have yet been reported.

7. Doctor Hodges's Memorandum is accompanied by a map, which shows very clearly the danger belt round the peninsula of Entebbe. In my despatch, No. 218, of 23rd November last,|| I have already indicated to Your Lordship the measures which I propose to take for the removal of all natives who are now living in fly. infested areas to localities that are free from danger, and I trust that, by strenuous action consistently maintained during the next two or three years, we may completely eliminate from the peninsula all danger from sleeping sickness, and greatly reduce it in other localities bordering the lake shore.

No. 73 in Miscellaneous No. 178.

† See Appendix E to enclosure in No. 10. No. 84 in Miscellaneous No. 178.

§ See Map No. V. in No. 10. [ No. 100 in Miscellaneous No. 178.

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