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PUBLIC RECORD OFFICE

TIT

Reference :-

C.O. 885

20 PUBLIC RECORD OFFICE, LONDON

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

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Dr. Stannus in Blantyre, if not required for other duties, be instructed to examine the lake shore between the Bua River and Bandawe, and then either palpate the natives in the Atonga district, or, if the presence of another medical officer is required in the Karonga district for "control" His movements will, however, depend upon whether he is required for duties other purposes, to proceed to that district. than those connected with sleeping sickness. In my opinion all "control" duties should be performed by a Resident acquainted with the people and the district he has to administer. I would therefore urge that for the effective control of the boundary to be established in the Karonga district, as a second line of defence, a Resident should be specially selected for this work and relieved from all other duties. The experience of Dr. Spillane in North-Eastern Rhodesia was that this was the only method of making the control of any border effective. The medical officer in the district would then be entirely free to devote the whole of his time to the expert duties he is sent to perform, viz., investigations into the distribution of fly and the palpation of natives; whereas, if he had both these duties and that of controlling a long frontier to perform, he would waste his time and do neither in a satisfactory manner. The most urgent point upon which accurate and immediate information is needed is: is Gl. palpalis to be found within the Protectorate borders? and, if so, the limits of its distribution? and the further point-the presence or otherwise of imported cases of human trypanosomiasis in the villages. These points can only be determined by the medical officers, and it is to this specialised work they should at present devote all their energies.

IV. The segregation of all cases of human trypanosomiasis. done by the different medical officers visiting each village systematically and apply- This will be ing gland palpation and puncture.

Each medical officer specially engaged in sleeping sickness investigations has been instructed to examine all the villages in the localities where he is conducting investigations into the distribution of tsetse fly, and to keep an accurate record of the localities and villages he visits. When the work on the distribution of the Glossina is completed he will then systematically visit all other villages in his district and apply gland palpation and puncture, giving preference to those localities where G. morsitans is abundant. As soon as cases are discovered they will be at once removed to a segregation camp for treatment.

For this purpose a segregation camp has been established in the neighbourhood of Dowa. Dowa is very convenient for this purpose.

It is situated on the high plateau, tsetse flies are absent, and the distances from the nearest point on the lake to which cases may be brought is not great.

To prevent the possibility of infected persons acting as disseminators of the disease on their way to the camp, a full dose of atoxyl will be given, which is said to drive the trypanosomes from the peripheral circulation for at least 30 days.

The patients there will be under the supervision of a medical officer, who will be responsible for the sanitation and health of the camp and for the carrying out of the proper therapeutic measures.

Instructions on the details of the working of the camp have been prepared and will be sent to the medical officer under whose supervision the camp will be.

V. If Gl. palpalis is found, to remove all villages within the limits of the range of this fly, en bloc, into fly-free country. This, in the light of our present knowledge, is the most important preventive measure that can be undertaken.

For this purpose the medical officer should be empowered to order the removal of any village if either of the following conditions are present

1. The presence of Gl. palpalis.

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2. Wherever the conditions necessary to the establishment of an endemic foci are present, namely, an infected case and the presence of Gl. palpalis, the following rule should be made: The medical officer may declare any village to be in the fly range of Gl. palpalis or to be infected, and thereupon the Resident may order all the inhabitants to remove to such place or places as may be selected, and they shall so remove forthwith.

A rule should also be made giving the right of entry into any house, village,

or compound and of examining any person found therein, and empowering the medical officer. if any such person is found to be infected, to remove such persons to the segregation camp.

28 October, 1908.

SAM. K. NORRIS,

Acting Principal Medical Officer.

•

990

No. 3.

BECHUANALAND PROTECTORATE.

THE SECRETARY OF STATE to THE HIGH COMMISSIONER FOR SOUTH AFRICA.

(Sent 4.45 p.m., 9 January, 1909.) TELEGRAM.

9 January. No. 1. Your telegram 8th January, No. 1.* probably be to ask British South Africa Company to allow Dr. R. U. Moffat, C.M.G., Best course would who is now at Bulawayo, go up to infected area and make preliminary report and take any immediate steps that may be necessary. He is fully qualified for this work, as he was Senior Medical Officer in Uganda, and has directed preventive measures and conducted scientific investigations there.-CREWE.

2023

No. 4.

EAST AFRICA PROTECTORATE.

THE GOVERNOR to THE SECRETARY OF STATE. (Received 18 January, 1909.)

(No. 015.) MY LORD,

WITH reference to my despatch, No. 262, of the 29th May last, I have the

Governor's Office, Nairobi, December 22, 1908. honour to transmit herewith a copy of a letter from the Acting Principal Medical Officer, giving cover to a report by Dr. Wiggins, the medical officer detailed to select a site for the formation of a settlement in South Kavirondo for the natives whom it proposed to move from the fly-infected districts.

2. I also enclose copies of the minutes of a meeting held at Kisumu between the Provincial Commissioner and the Acting Principal Medical Officer, and of the instructions issued by the latter as to the management of the settlement.

3. From this correspondence your Lordship will perceive that everything is being done to give a fair trial to an experiment which it is hoped will be productive of satisfactory results.

I have, &c.,

SIR,

Enclosure 1 in No. 4.

J. HAYES SADLER.

Principal Medical Officer's Office, Nairobi, 9th December, 1908. I HAVE the honour to lay before His Excellency the Governor Dr. Wiggins's report on the choice of a site suitable for the formation of a sleeping sickness settlement in South Kavirondo.

2. Dr. Wiggins, in company with Mr. Northcote, Assistant District Commis- sioner, made an extensive investigation of the infected territory south of the River Kuja, the smaller infected portion north of the same river (shown on the accom- panying mapt as enclosed in green), and examined the fly-free country to the east of this area.

3. As a result of his tour, four localities were fixed on as feasible sifes for occupation-marked A, B, C, and D (and enclosed in red on the map). Of these four areas the small plot marked C, and the much larger one D 1, 2, 3, and a proposition put forward by Mr. Hemsted, the District Commissioner-were unani- mously decided on by all three officers as fulfilling the medical conditions laid down in choosing a site, and practicable from an administrative point of view.

4. In order that the settlement of these lands might be systematically pro- eceded with and as soon as possible, I met the Provincial Commissioner at Kisumu, and a plan of action was agreed on. attached.

A copy of this memorandum of procedure is

• No. 1.

16996

Map not received in Colonial Office, but see map facing page 21.

† No. 13 in Miscellaneous No. 224.

B