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hospitals, where they already conform to it, should not be imposed upon them; I understand that in Mauritius and British Guiana this has been secured without any great difficulty, and it should not be insuperable here. I think the "non possumus" attitude has been too readily accepted as an answer to this recommenda- tion advanced here more than once, but almost invariably set aside because alleged to be impossible in operation owing to caste and other East Indian prejudices and habits. I regard the above as the most essential and the most radical procedure to exterminate the disease amongst indentured immigrants, who constitute at least one of its most fertile sources here; the Honourable Protector of Immigrants has already pointed out that if the sub-sections of Section 90, or Sub-section 5 of Section 130 of the Immigration Ordinance No. 161 do not constitute this particular offence to be a nuisance, or attach penalties to indentured immigrants who wilfully con- taminate a plantation indiscriminately, then a small verbal addition in the following terms to Sub-section 4 of Section 90" or any other part of the plantation except in the place therefore provided" would furnish sufficient powers to deal effectually with offenders.

I suggest also that future allotments of immigrants to estates should be made conditional upon the proprietors agreeing to provide beforehand suitable and sufficient latrine accommodation to the satisfaction of the medical authorities, at the barracks, at the estates hospitals, and also in the fields where the labourer spends about half of his indentured life.

Attention must be devoted also to the infected native labourer who, with the indentured immigrant, is a potent factor in the dissemination of the disease, and possibly one still more difficult of control. It is a counsel of perfection to advise that every peasant's hut should have its privy adjacent, but efforts in the direction of this desirable result might be attempted, and Sanitary Inspectors might be induced to encourage the provision and use of such necessary adjuncts of civilisation, and to devote more attention at the same time to their supervision of existing accommoda- tions.

It is not too much to expect that public conveniences should be provided in populous centres and maintained under efficient control if for no other purpose than to serve as object lessons to the class most likely to use them; and also that in the new Public Health Ordinance now drafting at the hands of the Special Committee, there should be found sections prohibiting the occupation of any new premises as a residence until it is furnished with sanitary accommodation to the satisfaction of the Medical Officer of Health. Next in order of my outline scheme comes

2. I have ascertained that a majority of estates proprietors is willing to provide at their hospitals small microscopes and other simple apparatus required there for accuracy of diagnosis, and at my instance a supply for distribution to them has been ordered through the Crown Agents.

3. Efforts should be set on foot and encouraged in every possible way to instruct the labouring class in the nature of the disease--the simplicity of the pro- cedure recommended to control its extension, the success of which so largely rests with themselves. The small handbook on Elementary Hygiene in the Tropics- approved and shortly to be placed in the hands of Government school teachers, is now under revision prior to the issue of a second edition, and a section in it on ankylostomiasis will be elaborated and made easily intelligible. Every public school house throughout the island should be a centre for the active dissemination of hygienic precept, and should provide in its sanitary accommodation an object lesson to its pupils, valuable just to the extent that it is made so by the schoolmaster and Inspector. There was recently brought to my notice the case of a Government school, having a daily attendance of 70 pupils, where the privy accommodation was filthy, and the School Master complacently admitted it had not been cleansed since he had charge-during a period of three years! In districts known to be infected, the distribution of leaflets briefly and simply describing the disease, its symptoms and prophylaxis might be useful.

4. At first I think the treatment of individual cases of the disease must be confined to those that present themselves to medical officers in the ordinary course of practice; routine methods of approved efficacy might be suggested for general adoption, and as yet I do not recommend special dispensaries or hospitals, which would necessarily involve increase of the medical and subordinate staff.

5. Similarly the treatment en masse can be effectively managed at present only on estates and amongst their regular labouring populations. The preventive value of tar and of some form of foot-wear will again be brought to the notice of estates

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RETURI

1901 190 1903-190 1906 190 1907-190

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87658