CO885-(18-19) — Page 4

PUBLIC RECORD OFFICE

ग. य 'ग

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Reference :--

C.O.885

18 PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO

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usually be removed only a few hundred yards in order to be, with proper care, safe from fly, yet, as a matter of policy and administration, in dealing with African natives, there will be no safety except at a-much greater distance, at which moreover it is possible that some form of concentration may be feasible, and this, as His Excellency the Commissioner has pointed out, would be a great advantage in the application of any form of successful treatment which may be discovered; it would, moreover, be favourable for purposes of supervision, and for keeping statistical records. Any form of concentration near the lake shore or within easy distance of Hy-ranges I consider in the highest degree inadmissible.

The protection of the native employees engaged in occupations such as rubber collecting, which may in some places expose them to the attacks of the fly, is also mainly a question of clearing, and would be met by inserting provisions in leases and concessions which would insure the clearing by the employers of such landings, camps, collecting and storing stations, &c., as are situated in the fly-range. Native labourers should also be encouraged to wear a more efficient covering in the way of clothes as a protection against the fly, but this would be of very little use to them until they have learned to avoid or resist its bite, which they are only just beginning in a few places to regard at all. It is still common enough, where the fly is plentiful, to see half a dozen or more flies feeding quietly and unnoticed on the nude body of a native.

The dangerous occupation of fishing should be discouraged as much as possible and should be forbidden altogether in those localities in which it is impossible to restrict it within fly-free areas, or where no such areas exist of sufficient extent to allow of its proper regulation. Certain villages, as I have mentioned, are only or mainly in contact with Glossina palpalis through this occupation, while the fish trade is the chief, or one of the chief, causes of the traffic of the hinterland villages with the lake shores.

I fear that little can be done with reference to the regulation or selection of hours of occupation within the fly-range, since there is no absolute safe margin of time either in the morning or the evening during daylight. Some use may be made, however, of the fact that Glossina palpalis is much less active before 8 a.m. and after 4.30 p.m., especially by villagers for such purposes as bathing, drawing water or washing clothes, and by travellers for camping and breaking camp; and also, for some purposes, advantage might be taken of the fact that they are almost entirely inactive in wind and rain.

The term "local segregation" of the sick I have already used and briefly explained above. It consists in the removal of the sick of each hut, village or settle- ment from contact with the local fly-range, prohibiting them from visiting the water- side and supplying them with water and also, where necessary, with food as well. I showed in my above-quoted report (Note I.) that this could easily and with little or no expense or hardship be carried out by each village or chief separately, because, so far as the fly is concerned, the removal of huts and of patients need be, in very many cases, only from the waterside to the next hill or open space behind the forest fringe, often only a few hundred yards. I fear, however, that, in most parts of the Protectorate, the natives could not be trusted to carry out even these simple measures sufficiently strictly or for a sufficient length of time to produce satisfactory results. I am confident, however, that in some parts, where the natives are more intelligent and more under European control, as in the Uganda Kingdom and possibly Usoga, the advantages of these measures will be eventually understood and that a fair number of villages would undertake them if supported by their chiefs. Any general application of segregation to the Protectorate as a whole would, however, have to be undertaken by Government.

The plan is very simple in itself, and I consider it of equal if not of greater importance than clearing both in its suitability for general application and as a preventive measure, and that every effort should be made and every assistance requested from all classes of Europeans and from the higher and more intelligent chiefs to induce the natives to acquiesce in it, even where they do not take it up actively themselves. For, even if it were only partially carried out, it would enormously diminish the risks for many people, and also the chances of infection and constant re-infection of large numbers of flies, and would tend to increase the safety not only of the villagers wherever it is adopted, but also of travellers passing through. The less the natives undertake it, however, i.e., the less "local" it can be

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made, and the more the Government are obliged to take it in hand, the more con- centration will be required, and the more it will probably cost to carry out.

There is, of course, the difficulty of detecting the disease in its early stages, but, on the other hand, it is the advanced and easily recognised cases that, lying about torpid near the waterside, present by far the greatest opportunities to the fly. Further, the detection of early cases is much easier to the natives themselves, since they are able to note, in their relations and acquaintances who are under their constant observation, those changes of mental attitude or habit and the intermittent symptoms which occur so very early in the disease, with far more certainty than can a medical man in isolated examinations. The more heartily, therefore, the natives can be persuaded to enter into any such scheme, the more completely will infectious case be removed from infective areas.

This measure, in fact, in common with others of any magnitude, has the dis- advantage that, even if it be undertaken and supervised by Government, it cannot be thoroughly carried out without the co-operation of the natives, and, since it is so important in all preventive measures which may be attempted, including the enforcement of precaution on individuals for the sake of the community, that native co-operation should be obtained, I have compiled an address to natives on the subject of sleeping-sickness, the fly, and the measures of clearing and of segregation, in which I have tried to explain the present situation as simply as possible. I propose to get this address translated into the languages of the more intelligent natives, and afterwards printed and circulated wherever there is a chance of its being read and understood. (It is already being circulated in Luganda. Appendix D.). A copy has already been submitted to you for approval, and one will be found attached to this report. The importance which I attach to native co-operation or, at least, acquiescence, is manifest in the address itself.

Where the villagers are unable or disinclined to segregate their sick and to take the other precautions recommended to them, which I fear will be the case in most places outside the Uganda Kingdom and in not a few within it, I am of opinion that measures should be taken to deport them to such parts of the interior of the Protectorate as are free from fly and, since our investigations show that fly-free country is available in each county and district affected by sleeping sickness, there need be no question of removing them far from their friends or native soil, for a centre might be found in each chieftainship, county or district for segregation of the sick and for deporting, from within the fly-range, those who are refractory or so apathetic as to be a danger to others.

The removal of huts and villages from contact with the fly range has already been alluded to in connection with clearing. The Medical Officers of the Sleeping Sickness Extended Investigations are investigating this range and, as soon as it is determined any place, the removals should be carried out without delay. In Uganda and other places where the chiefs are intelligent it should, theoretically, present little difficulty, yet unless the removal is to the interior, it must be accom- panied in most cases by clearing the fore-shore and a way to the water-supply, and the natives can seldom be depended on, without periodical inspection, to keep up this clearing over any prolonged period. In many parts, especially the Nile and parts of Unyoro, where they are backward and full of suspicion, they cannot be depended on to do anything at all for themselves, so that removal to safe localities is the only course remaining open, and should be carried out where possible. The conditions in the Nile Province do not point, as I have already stated, to the like- lihood of the occurrence of a very great epidemic, such as that on the Victoria Nyanza, though the eventual loss of life will probably be large as the disease smoulders, perhaps for years, among the scattered villages. Not the least obstacle to the general application there of any measure lies in the frequent and indis- criminate and probably as yet uncontrollable crossing and recrossing of the river by considerable numbers of the natives to and from the Nile Province and the Congo Free State. It is quite possible, indeed, that by this channel the infection first found way into the Uganda Protectorate, as I have hinted elsewhere, in speaking of the medical officer's reports.

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The experiment of reducing the number of flies locally by capture has been tried incidentally at Entebbe. Here flies were captured for scientific purposes by from two to six fly-boys, who brought in on an average perhaps 100 to 150 each per day, almost daily, for several years. These boys went almost always to a certain part of the fore-shore where flies are plentiful, and I was able to examine

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