CO885-(20-21) — Page 27

PUBLIC RECORD OFFICE

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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Enclosure 3 in No. 4.

SLEEPING SICKNESS IN SOUTH KAVIRONDO.

MEETING held in the Provincial Commissioner's Office, Kisumu, on the 30th November, 1908, between the Provincial Commissioner and the Acting Prin- cipal Medical Officer, to consider certain proposals received from the District Commissioner, Kisii, Dr. Wiggins, and Mr. Northcote, dealing with the locating of natives from the infected areas in South Kavirondo.

1. The scheme referred to by Mr. Northcote as the "third" scheme, and suggested by Mr. Hemsted and subsequently referred to in Mr. Hemsted's letter, No. 457/-XVIII/181, of the 13th November instant, is the one we accept. The, locations described on the map as "C" and "D_1," D 2," "D 3," and "D 4,"

under Scheme III. should therefore be utilized as far as possible.

2 At first the people of the infected areas, Kadem, Kanyamkago, and Suna, should be dealt with, commencing, by preference, with the people of Kadem. This is desirable because the above-named people have already been reported upon by the medical authorities.

3. It is hoped that when the areas named in Clause 2 have been cleared, the other areas mentioned by Mr. Hemsted can be dealt with.

4. Doctor Baker to proceed to Kisii and there consult with the District Com- missioner and settle arrangements; he to go then to Merindi and start his camp. Mr. Northcote is to accompany Dr. Baker under the original instructions.

5. The particular areas to be handed over for the occupation of the people from the infected locations must be arranged by the District Commissioner, and the Medical Officer and Assistant District Commissioner attached to the sleeping sickness undertaking informed.

6. Every endeavour is being made to obtain a surveyor. It is, however, pos- sible that there will be some difficulty and considerable delay in this connection, as no one is available for the duty at present. In the meantime the work of removal and re-settlement must proceed, and the Administration to erect temporary beacons showing boundaries.

7. It will be necessary to provide food for the people of the different locations as they are moved. It is sincerely hoped that the District Commissioner, Kisii, will be able to arrange for the natives themselves to bring supplies of food with them; as, however, it will be undoubtedly necessary to provide some food at points for distribution to those who will not be supplied, the District Commissioner will arrange, in conjunction with the Medical Officer and the Assistant District Com- missioner, to purchase supplies of food to be stored at convenient centres for dis- tribution. To meet this, the Acting Principal Medical Officer agrees to a sum of £400 being expended as required on this account. Should it subsequently be found necessary to make fresh and additional provision in this connection, further arrange- ments will require to be made.

8. The natives concerned should build their own huts and bring with them their own cooking pots, and all their other belongings. In cases where any of the people are too ill to do such work, the Administration can possibly arrange for it to be done for them by those of their people who are able-bodied,

9. As soon as ever the people are settled on the new locations, they should commence to make their shambas, and where necessary and desirable the Govern- ment might issue seed.

10. The question of any compensation is to be avoided, as the work now being undertaken is solely for the benefit of the people concerned, and the Government has no funds available for distribution in this connection.

11. Police guards, &c., must be supplied where the District Commissioner considers necessary.

12. Chiefs and headmen should be induced by every means possible to help in the general scheme.

13. Force in any form must be avoided in carrying out the removal.

14.

All vouchers for expenditure undertaken will pass through the Medical Department, and must bear the signature of the Medical Officer in charge.

15. In explaining to the natives concerned the action of the Government care should be taken to warn them that a certain percentage of the natives who may take advantage of the scheme will arrive at the different selected settlements already infected with trypanosomiasis, or showing obvious signs of sleeping sickness. These, though then placed in healthy surroundings, will sooner or later go from had to

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worse, with the usual fatal termination. Of the others, in whom on their arrival at the settlements the symptoms are not discernible, a still further percentage will undoubtedly develop obvious signs of the disease. This cropping up of cases may go on for months or years, as it is not yet known how long the trypanosome may fie dormant in the system before incubating into an acute attack. So the mere fact of removal from an infected district into sanitary surroundings should not be held out as affording any sure means of escaping the disease, except to those not already infected.

JOHN AINSWORTH,

Y

Provincial Commissioner.

A. D. MILNE,

Acting Principal Medical Officer,

Kisuniu, November 30th, 1908.

Enclosure 4 in No. 4.

INSTRUCTIONS TO THE MEDICAL OFFICER IN CHARGE OF SLEEPING SICKNESS SETTLEMENT IN SOUTH KAVIRONDO.

1. You will proceed as soon as possible to Kisii Station and place yourself in communication with Mr. Hemsted, District Commissioner, and Mr. Ñorthcote, Assis- tant District Commissioner, with the object of forming a permanent camp at Merinde. This will be the headquarters of the proposed sleeping sickness settle-

ments.

2. For the present Mr. Northcote will accompany you as administrative officer in charge of the camp.

3. Your line of conduct will, so long as the services of an administrative officer are available, be the same as if you had been placed in medical charge of a station with certain special duties superadded. generally with the management of the camp, I would refer you to the attached For further details connected memorandum of procedure drawn up by the Provincial Commissioner and myself.

4. One of the primary ideas in the formation of this camp is to afford natives dwelling in fly-infected districts a concrete example of the value of dwelling in sur roundings free from the presence of tsetse flies. It should, in the first place, be a focus which will attract natives to cluster round and forsake the dangerous localities in which they formerly dwelt.

It will, therefore, be no inconsiderable part of your duties to endeavour to make the native mind grasp the connection between tsetse flies and sleeping sickness, and, in particular, pointing out the part played by the Glossina palpalis in the trans- mission of the disease.

The hazardous nature of such avocations as fishing in fly-haunted rivers, the drawing of water from, or the tilling of shambas alongside of, streams known to - contain Glossina, should all be insisted on.

5. As it is certain that the natives will arrive at the camp with the dominant idea of being treated for and cured of the disease, while holding out no hopes towards this end being achieved, part of your duties will consist in the selection of suitable cases for treatment by one or other of the atoxyl products, or such remedies as may from time to time be selected. It would further be as well to give a placebo by mouth as a matter of routine.

6. An outdoor dispensary for the relief of all ordinary surgical and medical complaints will be established.

7. On arrival at Merinde you will at once proceed to select the actual site of the settlement. A commencement will be made by clearing a portion of the ground

of grass, trees, obstacles, &c., proportionate to your immediate needs.

8. Full latitude will be allowed you in deciding on the arrangement and plan of the camp, but you should remember that if it turns out a success, this temporary measure of relief may become a permanent native settlement, necessitating its eleva- tion into one of the administrative stations of the Province. The laying out of the camp, therefore, ought to be done, keeping this end in view, on hygienic and sani- tary lines, with a due regard for its orderly administration afterwards.

9. The building of the camp should be proceeded with more or less in the following order :—

(i.) Banda as consulting room, microscope room, and office, with division at

one end so as to form a dispensary and store.