CO885-(20-21) — Page 644

PUBLIC RECORD OFFICE

Reference :-

C.O.885

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

21 PUBLIC RECORD OFFICE, LONDON

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are nominally mosquito-proof, but in the other yellow fever patients are placed in the general wards. hospital there is no mosquito proofing at all, and although at In this latter one time one ward was screened for them, the gauze was all removed almost immediately after Dr. Thomas had left on his way home, as it happened."

Even if anti-yellow fever work were carried on by the Authorities in a more satisfactory way, both personal observation and hearsay, to believe that there I have reason, from are many cases of the disease which are not called yellow fever.

Panama.

23. Yellow fever, which, only a few years ago, was so rife in this part, has now and for some considerable period been completely eradicated as a local disease, so that all real auti- yellow fever measures have for some time been merged in the general sanitary work.

24. Time Taken to Obtain Results.-In Panama itself the whole town was gone through by the fumigating gangs, and every house fumigated three times before any result which could be considered satisfactory was obtained, but the present condition has fully justified to the lay mind the severance shown, and the large and continued expenditure of money.

per-

In fumigation, which is done with sulphur in the usual way, flowers of sulphur is used in preference to the roll form, as it burns better and quicker, and therefore sooner gives a greater density of fumes. It is burnt in the usual manner--- in an iron pot standing in a larger one containing water (sometimes the iron pot which contains the sulphur cracks). A layer of dry earth is placed in the iron pot underneath the sulphur, as it prevents sticking and very considerably facili- tates cleaning.

Tin measures which hold the quantities necessary for definite amounts of cubic space are used for measuring out the sulphur.

Habana.

25. The anti-yellow fever measures which at one time were necessary in this city have, except as regards hospitals, been merged for a long time in the methods adopted for general sanitation in the tropics.

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HOSPITALS. Para.

26. In Para there are four hospitals where yellow fever patients are accommodated and treated.

The yellow fever hospital proper, which is under the Yellow Fever Commission (the Doming F. Hospital), is situated out- side the town and some distance away from all buildings. It was erected in 1899, and at a later period was made mosquito-proof from roof to basement.

The hospital itself is on one floor raised above the ground with a basement underneath at the ground level. All the wards, of which there are large and small, are beautifully large (as regards bed space), lofty, light, and airy. In all places where the mosquito screening is liable to damage by patients, &c., it is protected by half-inch wire netting placed an inch or more from it.

There are three other hospitals, all of which have mosquito- proof wards for yellow fever patients, and similar rooms for observation until a definite diagnosis can be made.

27. General Wards. In the general wards of the hospitals only a certain proportion of the beds are provided with mosquito nets. These are hung on a circular disc which is suspended from the ceiling and can be raised or lowered as desired.

In the daytime they are simply hoisted up, leaving a cir- cular cylinder of net open at one end, and at night are let down and opened out so as to surround the bed.

In no instance during my journey did tucked in or even arranged for tucking in, and only once did see a mosquito-ner I see a net used in a manner which I considered satisfactory. In these hospitals the operating theatres were of an up-to- date character, and large sums must have been spent on their erection and equipment.

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28. Small-poz and Leprosy.—There is a small-pox hospital outside the town and also one for lepers, but segregation of the latter is not compulsory.

29. Nursing.-All the hospitals are nursed by sisters of the religious orders in the town.

30. Entrance Doors.-The entrance to all mosquito-proof wards is through a double door. A small compartment,

about 4 to 6 feet long, is made in the doorway, usually half inside and half outside the ward, which has a door at each end opening outwards from the compartment, both being fitted with springs to keep them closed. In addition there is