CO885-(18-19) — Page 48

PUBLIC RECORD OFFICE

Reference :-

mmimmimi C.O.88

885

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

18 PUBLIC RECORD OFFICE, LONDON

90

Of this sum £50 is to cover the cost of any special material, books, or instruments to be purchased by a newly appointed medical officer..

I forward a memorandum explaining my views as regards necessary measures of prevention and precaution.

The Secretary,

British South Africa Company,

2, London Wall Building, E.C.

I am, &c.,

ROBERT CODRINGTON.

APPOINTMENT Of Medical OffiCER to direct Investigation and Preventive Measures with regard to Sleeping Sickness in North-Eastern Rhodesia.

Term of Appointment.-Two years (dating from arrival at Fort Jameson). Salary £400 to £500.

l'assage. First class from London to Fort Jameson free. (Half-pay from date of departure from London to date of arrival at Fort Jameson.)

pon Expiry of Engagement.-First class passage to London free. (Half-pay

from date of leaving Fort Jameson to date of arrival in London.)

Quarters Provided.-Wherever possible, otherwise camp equipment. Medical Officer.Is required to work under the directions of the Principal Medical Officer.

THE THREATENED INVASION OF NORTH-EASTERN RHODESIA BY SLEEPING SICKNESS. LINE OF PROBABLE ENTRY.

The line to be guarded stretches from the German boundary on the east of Lake Tanganyika along the British coast of the lake and thence along the Congolese boundary to Lake Mweru, along the Lualupa River and the Congo-Zambesi water parting. Five hundred miles of this line are included in the North-Eastern Rhodesian frontier, but only in certain places is there much danger of invasion.

Section 1.-The Southern Shore of Lake Tanganyika.

The southern shore of Lake Tanganyika is not yet invaded. The population is scanty and there is hardly any communication with any other part of the coast. Toetse fly is not present except in small inland patches, and in these the palpalis variety has not been observed. A memorandum received from the Liverpool School of Tropical Medicine was published in the local "Gazette" of July last, and has served to draw attention to the possibility of invasion and the preventive measures which should be adopted. This memorandum, however, takes a pessimistic view of the danger to which the southern shores of Tanganyika are exposed and predicts the invasion of Lake Nyasa, even, within a few months of May last; but the supposed traffic and movement of natives in these regions on which this prediction is based is practically non-existent, and as no suspicious case has as yet reached the British shore of Tanganyika, any very special precautions seem unnecessary. I am of opinion that the Medical Officer at Abercorn co-operating with the various medical missionaries of the London Missionary Society can keep the Tanganyika shore under observation and that no case of infection would remain undetected.

Section 2.-The Congo Boundary between Lakes Tanganyika and Mweru. A case has been reported at Mvua on the Tanganyika shore just north of the boundary and another from Lukonsolwa on the western shore of Lake Mweru. Tsetse fly is widespread in these regions and the palpalis variety has been observed at two places. The two cases of sleeping sickness mentioned were imported from endemic areas, being infected soldiers introduced by the Congo Government, and it is hoped that the disease has now disappeared and has not left any focus of infection. There is fortunately very little movement of natives in these regions, and I am of opinion that the line from Tanganyika through Lake Mweru and as far up the Luapula as Kazembe's village can be, for the present satisfactorily kept under obser- vation by a medical officer at Kalungwisi acting in co-operation with the medical missionary of the London Missionary Society at Mbereze.

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Section 3.-The Luapula River,

It is along the Luapula River for a stretch of about 150 miles from Kazembe's to the 12th degree of south latitude that the danger seems really great. An imported case of sleeping sickness, also a soldier introduced from the endemic area by the Congo Government has occurred at the Belgian post of Kasenga, but it is hoped that no focus of infection has been established. Tsetse fly is widespread and the palpalis variety has been observed in several localities. For many miles along the Luapula there is an unbroken succession of villages, mostly consisting of refugees from the Congo, and these people ply their canoes across the river. At Madona is the regular ferry for traffic to and from the Tanganyika Concessions sphere of work and in a lesser degree to and from the railway and mines in North-Western Rhodesia, at least 20,000 natives passing there every year.

It is to this section of the frontier that most attention has been given. A special medical post has been established at Madona and investigation and invigilation is being consistently carried on in conjunction with the medical officers of the Tangan- yika Concessions and the professed co-operation of the Congo Government.

PREVENTIVE MEASURES AND GENERAL PRECAUTIONS.

As regards Section No. 1 of the threatened frontier, the south shore of Tan- ganyika, I have nothing to suggest. The disease is not there and may never come. The danger of invasion is realised and any southward approach on the Congo or German coasts will be noticed and any suspicious case in British territory imme- diately placed under observation. Natives are ordered to keep out of the Congo and German spheres, where, as a matter of fact, neither business or inclination are likely to take them, and at any time by a slight increase of the numbers of native constabulary at the disposal of the Magistrate, control of the movements of natives can be effected and inspection posts established.

As regards Section No. 2, the Congo boundary from Lake Tanganyika through Lake Mweru to the Luapula, I suggest that a medical post should be established at the Government Station at Kalungwisi. The medical officer on this section, acting in conjunction with the medical missionary at Mbereze, would watch for any renewed outbreak on the Congo side, and for any suspicious cases on ours. The movement of natives across the border is already forbidden and the order is probably well obeyed, but, should it appear necessary at any time, a system of constabulary patrols would be easily and inexpensively established.

As regards Section 3, the Luapula River, I suggest that the medical post at Madona and the present system of invigilation should be maintained. This system is as follows:---

Local traffic across the Luapula is discouraged as much as possible, but as long as the Congo State bank is free from actual disease no definite prohibition will be attempted. Natives passing to and from British territory to the interior of the Congo State are required to cross at the Madona Ferry, where all natives returning to North-Eastern Rhodesia are examined by the medical officer. Should any sus- picious case occur, the man will be detained and segregated, and if the case is diagnosed as sleeping sickness, the man will be removed to a place in North-Eastern Rhodesia out of the fly-belt. Native Commissioners are instructed to assist the medical authorities by keeping records of all natives returning from the interior of the Congo and by keeping them more or less under observation after their return. Special attention will, of course, be given to any natives from the Tanganyika Con- cessions who may be reported by the medical officers of that Company as having been exposed to infection or as having entered the endemic area. that the Madona Ferry and the inspection there is being evaded, constabulary patrols If at any time it appears will be instituted along the river, but I do not consider this necessary at present.

I have no faith in preventive measures in the Congo, however satisfactory they may appear from official reports and regulations. These preventive measures have been in force for some time but did not prevent the introduction of infected soldiers from an endemic area to an uninfected and fly-infested region, and their detention there after the disease had declared itself; and I have little doubt that, whatever we may do, the Congo side of the Luapula will become infected during the next two or three years, when the invasion of the whole Luapula Valley will le inevitable. Meanwhile, do not consider that there is sufficient immediate danger to justify

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