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PUBLIC RECORD OFFICE

C.O.

Reference :-

885

20 PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-

COPYRIGHT PHOTOGRAPH-NOT TO

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(ii) Bandas for Medical Officer and for Assistant District Commissioner. (iii) Hospital banda for reception of moribund patients, or patients under

close observation.

(iv.) Bandas for compounder and Indian artisan.

(v.) Huts for interpreter, native staff, boys, orderlies, police, &c.

To erect these you are empowered to engage such native labour as is necessary, paying them at the current rate of wages. An Indian carpenter will be provided to assist you.

10. The area proposed to be settled is a wide one. While, therefore, these buildings are going forward for administrative reasons, it may be deemed advisable to occupy first that portion of the area furthest from the headquarters' station. This may entail your forming a temporary camp in the location reserved for the Kadem natives for so long as may be advisable.

11. In the management of the camp it must be clearly understood that.com- pulsion is not to be used. Where this would seem to be desirable, it must be left to the chiefs to enforce, to whom the object of the camp will be explained by the District Officer so that they may instruct their people to take advantage of the facilities and treatment afforded.

12. Lunatics may require to be put under restraint; they should be handed over to the care of their friends or, if necessary, placed in a special hut under guard. Doubtless, desertions will be frequent, but no physical effort should be made to retain or recapture the offenders. Their chiefs should be instructed to see to it that the deserters do not return to the fly-area. Should they do so, the chiefs should make every effort to clear them out, but not necessarily bring them back to the settlement.

13. You will be responsible, further, for the sanitary condition of the camp. This should be kept in a cleanly condition. Sweepers should be appointed, latrines dug, and dumping holes made, and all refuse regularly burnt. One of the worst plagues in Kavirondo is flies; cattle and sheep bomas should accordingly be situated at a convenient distance from camp.

14. At the end of each month a report will be submitted to the Principal Medical Officer on the work of the camp.

This report should summarize

(i.) The total number of admissions to camp;

(ii) when cases of sleeping sickness arrive at the camp they should be thoroughly examined, and, according to their symptoms, divided into four classes as follows:

Class A.-Those who present the following symptoms :—

Fever, gland enlargement with trypanosomes present in the glands. Very often such cases complain of headache and pain in the stomach. There is no tremor. The patients on admission generally say that they are well, do not think that they have sleeping sickness, or they may give a history of a month or two's illness.

Class B.-Those presenting the following symptoms :

History of fever and some drowsiness. Think that they have got sleeping sickness; say, as a rule, that they have been ill several months. Marked gland enlargement. Impotence of some months' duration, as a rule, or else amenorrhoea. Skin generally dry. Some slight wasting. Tremor of tongue but not of lips or fingers.

Class C present the following symptoms:-

Well-marked cases of sleeping sickness. History of illness for the last year or more as a rule. Tremor of tongue, lips, and fingers. Wasting. Dry rough skin. Generally the feet are swarming with jiggers. Such cases walk with difficulty, and are obviously ill. Are very often either imbecile or else maniacal. Often marked ædema of the limbs and around eyes.

Class D. Very advanced cases of sleeping sickness. Such cases are drowsy and have to be carried to camp. Are generally a mass of jiggers and in a very filthy state. Food is only swallowed with difficulty.

(iii) The number of deaths and the causes thereof.

(iv.) The number of desertions.

(v.) The number under restraint.

(vi.) The total number remaining.

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All cases of sleeping sickness will be transferred to a special register in which every particular concerning them will be entered.

The ordinary out-patient register will also be maintained to record all cases presenting themselves for medical or surgical treatment-everything but sleeping sickness. From this will be compiled the ordinary monthly statistical return (which, however, should include the numbers of sleeping sickness patients presenting them- selves for treatment, so that it presents a complete return of all the month's work). The usual forms connected with the routine work of a hospital will also apply to your dispensary.

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15. All vouchers connected with the expenses of the camp will be certified by you as correct before payment, and a copy forwarded to the Principal Medical Officer each month.

Nairobi, 9 December, 1908.

2172

(No. 325.)

MY LORD,

A. D. MILNE,

Acting Principal Medical Officer.

No. 5.

NYASALAND.

THE GOVERNOR to THE SECRETARY OF STATE. (Received 19 January, 1909.)

[Answered by No. 8.]

Government House, Zomba, Nyasaland Protectorate,

HAVE the honour to transmit for consideration an Ordinance entitled "The

11 December, 1908. . Epidemic and Contagious Diseases Amendment Ordinance, 1908," duly authenti-

cated under the Public Seal of the Protectorate and by my signature.

2. The proximity of sleeping sickness to the Nyasaland Protectorate, and the discovery of an imported case of the disease within its borders, as reported to your Lordship in my despatch, No. 310, of the 27th of November,* have made imperative the issue of special rules under "The Epidemic and Contagious Diseases Ordinance 1903," but the penalties provided by that law for breach of rules made under it were so small as to be out of proportion to the gravity of an offence which might result in the dissemination of sleeping sickness within the Protectorate. The Amendment Ordinance now enclosed has been drawn in order to remedy this defect in the original Ordinance by increasing the penalties for breaches of rules.

3. The Ordinance received the unanimous approval of the Legislative Council: it received my assent on the 16th of November, and has been promulgated in the Gazette of the 30th of November, as No. 10 of 1908.

4. I enclose a certificate and a report on the Ordinance by the Acting Attorney-General.

(No. 174 of 1908.)

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I have, &c.,

ALFRED SHARPE,

Governor.

Enclosure 1 in No. 5.

I assent to this Ordinance this Sixteenth day of November, 1908.

NYASALAND PROTECTORATE.

ORDINANCE.

No. 10 of 1908.

ALFRED SHARPE,

Governor.

THE EPIDEMIC AND CONTAGIOUS DISEASES AMENDMENT ORDINANCE, 1908."

Enacted by the Governor of the Nyasaland Protectorate, with the advice and consent of the Legislative Council thereof:-

1. This Ordinance may be cited as "The Epidemic and Contagious Diseases Short title. Amendment Ordinance, 1908."

• No. 2.