CO885-(19-20) — Page 67

سبليتا

།། ༄། ། ། །

PUBLIC RECORD OFFICE

Reference :-

C.O.885

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

19 PUBLIC RECORD OFFICE, LONDON

28

8. In addition to this Central Institute, it is proposed to establish small local laboratories in each of those Colonies to enable the members of the medical staffs to carry out special pieces of research work.

9. As regards the West Indies, a Bacteriological Laboratory has been estab- lished in British Guiana under the direction of an experienced Bacteriologist, who receives a salary of £600-£700 a year. Much valuable research work has already been done, and it is now proposed to appoint an assistant to the Director to meet the growing needs of the Institute. There is also a Bacteriological Laboratory in Trinidad, which has been recently provided with equipment for research work; and it has been suggested that the islands of St. Lucia and St. Vincent should join with Grenada in contributing a sum of £100, so that there will probably be a total contri- bution from the Windward Islands of twice the amount of the present contribution of £50 from Grenada.

10. With regard to the contribution of £200 from the Commonwealth of Australia, steps are being taken to establish an Institute of Tropical Medicine at Townsville, in Queensland. The Committee of the hospital at Townsville have undertaken to set aside, free of cost, several buildings for research work; and the Government of Queensland have promised a subsidy of £250 a year, and the Common- wealth Government one of £450 a year. A Director is to be appointed with a salary of at least £600 a year, and it is estimated that the initial cost of a passage for the Director and his assistant, for the fitting up of the laboratory, &c., will amount to £1,000, and the annual expenditure will also be about £1,000. There is reason to hope that the Institute will add greatly to the knowledge of tropical diseases, and that its work will be of use not only to Australia, but to the other British possessions in the Southern Pacific, such as British New Guinea, Fiji, &c.

11. With regard to the contribution from the Indian Government, Lord Crewe would remind their Lordships that that Government has vast sanitary problems of its own to deal with, such as the epidemic of plague, which causes an annual mortality of upwards of a million persons; that it has its own research institutions to maintain and research work to provide for; and that it is only as an act of grace that it subscribes to the Fund at all. His Lordship has, however, recently approached the Indian Government through the India Office with a view to obtaining an annual contribution of £1,000, to be devoted with a like amount obtained from the Colonies to expanding the Sleeping Sickness Bureau into a Bureau for all Tropical Diseases, and, in the circumstances, he thinks that it would be impolitic to make any further demands on that Government at the present time.

12. In view of what has been stated above, Lord Crewe trusts that their Lordships will recognise that in one way or another the Colonies are contributing their full share towards the objects for which the Fund was established, and that they will no longer hesitate to sanction the continuance of the increased grant. But there are some general considerations to which he would like to take this opportunity of calling attention.

13. A considerable portion of the money subscribed to the Fund is devoted to the payment of the salaries of certain highly-trained experts at the London and Liverpool Schools of Tropical Medicine, with the result that not only is the quality of the ordinary routine instruction improved, but that provision can be made for advanced courses for those who show the necessary aptitude, and original research work can be carried out by the experts themselves. In fact, the whole status of the Schools has by this means been raised.

14. Without attempting to discriminate too nicely between what are Imperial and what are purely Colonial interests, Lord Crewe would point out that if these Schools were originally established to meet the needs of the Crown Colonies, they have not been without benefit to the Empire generally, and that anything which tends to improve their efficiency is a matter of Imperial as well as of Colonial concern, and therefore entitled to a certain amount of support from Imperial

Funds.

15. The Medical Officers of the Exchequer-aided Protectorates as well as of the self-supporting Colonies are trained at the Schools, and a certain number even of medical officers of the Army and Navy have received instruction at them. But the Schools are open to all comers, and they are valuable training grounds not only for colonial medical officers but for any British doctor who may desire instruction in tropical medicine before proceeding to a tropical country. Taking, for instance, the year 1906, for which figures are immediately available, it appears that of the 95 students who were under instruction at the London School of Tropical Medicine

29

for that period, while 25 belonged to the Colonial Medical Service, there were also 14 missionaries, and no less than 40 private students.

16. Nor are these the only directions in which the Schools benefit the nation generally; for any discoveries in tropical medicine which their own experts or the doctors who have been trained by them may make tend to lessen the mortality from tropical diseases in the Navy and Army, and also throw light on problems of disease in this country, while the increasing efficiency of the doctors practising in the tropics makes the conditions of life easier for British subjects living in those

countries.

17. The two Schools are indeed important national institutions which have conferred great benefits on the Empire generally, have served as models for similar institutions in other countries, and have materially helped this country to obtain the leading position which by general consent it now occupies in one of the most promising and beneficent fields of modern science.

18. Nor have the Schools shown any disposition to make unreasonable demands for assistance from Imperial Funds. It is true that a sum of £1,775 was contributed by the Imperial Government in 1898 towards the initial cost of the buildings and outfit of the London School of Tropical Medicine, but since that date the School has raised by private subscriptions some £20,000 for the purpose of enlarging its build- ings and improving its equipment. It has recently obtained a private donation of £500 for the purpose of again enlarging its laboratory, and further private dona- tions amounting to some £1,500 for research work in connection with the diseases prevalent in Northern Nigeria (an Exchequer-aided Protectorate), while it is now endeavouring to raise a large sum by subscriptions from the mercantile community in London for the purpose of strengthening its staff on the research side, of purchas- ing an experimental farm, and of improving its efficiency in various other directions. Moreover, the tutorial staff gave its services for some years without any remunera- tion whatever.

19. There has, therefore, been no lack of self-help on the part of the London School of Tropical Medicine, and the same may be said with even more force of the Liverpool School, which, up to the middle of 1907, had spent some £60,000 on its equipment, research expeditions, &c., of which only some £3,000 was contributed from public funds, the remainder having been obtained from private sources.

20. In conclusion, Lord Crewe desires to offer a few observations on the argu- ment used in the last sentence of the 3rd paragraph of their Lordships' letter. So far as the ordinary routine of medical and sanitary administration is concerned, he can assure their Lordships that, in the main, the expenditure in the self-supporting Crown Colonies is on a scale considerably in excess of that in the Exchequer-aided Protectorates, but he assumes that their Lordships are alluding more especially to the heavy special expenditure which has been thrown upon Imperial Funds in connection with the epidemic of sleeping sickness in Uganda.

21. Epidemics of this kind are calamities to which all tropical countries are alike liable and which, when they occur on a large scale, entail considerable expendi- ture on preventive measures. But, as our knowledge of the causes of tropical diseases increases, the risk of the occurrence of epidemics on a large scale diminishes, and the outbreak of sleeping sickness in Uganda furnishes a striking illustration of this truth.

22. When sleeping sickness first made its appearance in Uganda nothing was known either of its cause or of its treatment, and whole years had to be spent on its investigation, during which some hundreds of thousands of the population have died, and over and above the expenditure on investigation and preventive measures there has been a considerable loss revenue in consequence of the reduction of population. Many questions in connection with the disease still remain to be cleared up, but enough has now been discovered to enable preventive measures to be undertaken with considerable success, and the epidemic appears to be at last under control. It is for the very purpose of forestalling calamities of this kind, by supply- ing our Colonial Administrators with the means of combating them intelligently, that the Tropical Diseases Research Fund exists, and Lord Crewe can only regret, on the grounds both of humanity and of economy, that the sum at the disposal of the Committee is not far in excess of the present small amount.

I am, &c.,

·FRANCIS J. S. HOPWOOD.