CO885-(18-19) — Page 578

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I have, &c.,

J. HAYES SADLER.

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for a prolonged period, but if one case of trypanosomiasis comes back in a fly- infested region after depopulation, it is sure to invalidate the whole measure.

I am, &c.,

59

to do the same in North Kavirondo, where the presence of a segregation camp will,

it is hoped, materially aid as an incentive to the natives to desert the fly-infected lake shore.

A. H. Milne, Esq.,

B 10, Exchange Buildings,

Liverpool.

A. BREINL.

PUBLIC RECORD OFFICE

།།།།།

ستاسيس

Reference:-

C.O.885

19 PUBLIC RECORD OFFICE, LONDON

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

21729

(No. 252.) MY LORD,

No. 12.

EAST AFRICA PROTECTORATE.

THE GOVERNOR to THE SECRETARY OF STATE. (Received 16 June, 1908.)

Governor's Office, Mombasa, May 25, 1908. I HAVE the honour to submit a report by the Principal Medical Officer drawing attention to the increase of sleeping sickness in Southern Kavirondo, where the disease is reported to be spreading along the river Kuja and its tributaries.

2. The introduction of this disease in this part is of recent date, but the comparative rapidity of its movements and the percentage of people reported to be infected show that the mortality will assume large proportions, and measures must be taken to check it as far as possible.

3. Attached is a Memorandum of the discussion held at Kisumu in connec- tion with sleeping sickness in Kavirondo on the 27th of last month. The report of Dr. Milne referred to will follow. In Northern Kavirondo it was hoped that the disease was dying out, and though this is probably the case, recent investigations have revealed the fact that there is a large area of fly-infected country bordering on the lake and that the disease is still prevalent.

4. The measures proposed to deal with sleeping sickness on this side of the lake are noted in the enclosures to this despatch.

5. They comprise the general movement of the people from the infected areas and the establishment of segregation camps in clear country. In Southern Kavi- rondo it is thought that many of the people can be got to move without difficulty after the crops are reaped in August next.

6. In Northern Kavirondo there will be greater difficulty. In November last instructions were issued to the District Officers to endeavour to get the people in Northern Kavirondo to move away from the vicinity of the lake, but with very indifferent results, and the difficulty is enhanced by the absence of responsible chiefs with an authoritative hold over their people. I have never been in favour of actual coercion en masse, which would be à difficult and costly measure to carry

But out and would require preparations beforehand on an extensive scale. consider that a great deal may be done by systematic persuasion, at first in South Kavirondo, watching the effect, and afterwards, if necessary, moving village by village to fly-free country and gradually depopulating the fly-infected areas.

7. A meeting of the chiefs of the infected areas is being arranged at Kisumu by the Provincial Commissioner, and I am sending a medical officer and a sur- veyor to select a fly-free area, and a site for a segregation camp, and afterwards to do the same in North Kavirondo.

8. In the meanwhile I would ask your Lordship to sanction the expenditure of £2,000, which I shall be able to meet from general savings on the year, to provide for the medical and administrative measures it will be necessary to take before the anticipated move can be commenced and to carry it on to the close of the financial year.

9. I would request that a temporary medical officer be engaged at once for the segregation camp and be sent out as soon as possible. It is with great difficulty that the Principal Medical Officer can spare Dr. Wiggins for the purpose for which he is now being deputed. Your Lordship will observe that I propose to start operations in South Kavirondo as soon as the next harvest is reaped in August next, arranging beforehand to impress on the chiefs the object of, and the necessity for, the measures we propose to adopt, and selecting the area to which the peoplo can move. Having started operations thus in South Kavirondo I would propose

(No. 39/1908.)

SIR,

Enclosure 1 in No. 12.

Principal Medical Officer's Office, Nairobi, 16 May, 1908.

I HAVE the honour to direct attention to the presence and extension of sleeping sickness in Kisumu Province, more especially in South Kavirondo.

The discase was introduced among the people living along the shore of Kavi- rondo Gulf some five years ago from Usoga, and since then has gradually crept along the castern shore of Victoria Nyanza as far as the Anglo-German boundary. Three years ago isolated cases were reported near the mouth of the Kuja River, and during the past year it has rapidly spread along the Kuja and its tributaries, the Angotche, Myunyo, Magori, and Oyani. These rivers have more or less steep banks, thickly wooded or covered with scrub, in which the Glossina palpalis abounds. The districts affected are locally known as Kadem, Suna, and Sakwa, and comprise an area of, roughly, 110 square miles.

The population of this area is at present estimated at 13,200, and as a result of a recent investigation of sleeping sickness in this district it was found that 45 to 50 per cent. were infected with trypanosomiasis.

The number of deaths that have occurred from the disease in this area could not be ascertained, but, judging from the following facts (1) that it is of com- paratively recent introduction, (2) that no marked diminution in the population has been reported by the District Commissioner, and (3) that the Medical Officer who has just investigated the disease in this area states in his report that he saw cases in various stages ranging from a few weeks up to a year, and says "the vast majority of the cases gave a history of two to four months' sickness," I do not think that as yet the mortality has been very great. As already stated, 45 to 50 per cent. of the people are infected, and there can be no doubt that in the near future the death-rate will be appalling.

The comparatively rapid spread of the disease is doubtless due to the fact that the people spend a large portion of their time in fishing, for, although they are rich in cattle, sheep, and goats, and are also keen agriculturists, they (men women, and children) will walk 8 or 10 miles to these rivers, and, wading in the water, fish the whole day long.

To preserve these unfortunate people from being completely wiped out I would strongly urge the necessity of moving them as early as possible from their present location to a part of the country fly-free, and where they would not have easy access to these rivers, and the establishment of a segregation camp in their new locations. There is ample suitable land available, and the Administrative Officer in charge of the district does not consider there would be much difficulty in I do not think it would serve any useful purpose to carrying out their removal. establish a treatment camp among them in the infected area, because, so far, no known method of treatment has been successful, and even were any method suc- cessful, they would be constantly exposing themselves to re-infection.

The only hope of saving those not already infected lies, in my opinion, in their early removal to another locality, and this should be commenced as soon as their present crops are reaped. I would also propose opening a segregation camp in the new locality for treatment as soon as their removal is begun.

They are aware of the measures which have been adopted by the German authorities, and are eager for treatment; in fact, some have been under treatment by the German doctors at Shirati and their symptoms have been temporarily ameliorated. The establishment of a camp would act as an inducement to them to abandon their present habitations and would doubtless materially assist in their entire removal.

These proposed measures would, however, entail the expenditure of a certain sum of money for which no provision has been made in the current year's estimates.

An extra Medical Officer would be required, also an Indian hospital assistant and subordinate and menial staff.

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