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PUBLIC

RECORD

OFFICE

TREET

C.O.

Reference :-

885

20 PUBLIC RECORD OFFICE, LONDON

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

From this it will be seen---

(1) That the percentage of labourers harbouring ankylostomes is very con-

siderable.

(2) That in only a small percentage of cases can death be directly attributed

to ankylostomes.

(3) That it is impossible to determine with any degree of accuracy the per- centage of labourers suffering from the effects of ankylostomes. (4) That persons harbouring ankylostomes and suffering from malaria may show themselves resistant to treatment. In the case of other diseases

it is possible that the presence of ankylostomes may retard recovery or lessen the chances of recovery.

As regards the preventive measures to be adopted, I would suggest that a circular be prepared directing the attention of owners and managers of estates to the steps to be taken for the improvement of the sanitary conditions of their estates. It could be stated that sanitation on estates has not hitherto received adequate attention, and that in view of the serious invaliding and mortality from ankylosto- miasis and intestinal complaints the Government consider it essential that on all estates there shall be provided--

(1) Latrine accommodation.

(2) Adequate and properly protected water supplies.

In this country a mere hole or trench will not suffice for a latrine because

(1) In some places at a depth of a few feet water would be met with, and

excreta deposited in this would cause a nuisance.

(2) The heavy rainfall would at times flood the hole or trench.

The trench therefore must be dug in ground which is not waterlogged, and must be protected by a corrugated-iron, attap, or bark superstructure.

A drain must be cut around the shed in order to carry off storm water. this place in the circular plans, &c., might be inserted.

At The latrines are to be situated within reasonable distance of the lines, and those in charge of estates must take steps to prevent defæcation in places other than the latrines. Should the Superintendent of Indian Immigation or a Medical Officer on visiting an estate find evidence of promiscuous defæcation, then the person in charge of such estate should be liable to prosecution.

The water supply should be obtained from a distance and from a source not liable to pollution; by preference it should be brought from the source to the lines in pipes. Where this is impossible, then the wells must be properly constructed and protected; also, if near the lines, they must not be liable to contamination from the latrines.

Persons owning or in charge of estates desiring advice on these matters should consult the State Health Officer.

If it meets with the approval of Government, I shall be glad, in consultation with the Director of Public Works, to draft a circular on these lines.

The circular issued in the Straits Settlements, whilst admirable in many ways, does not, in my opinion, sufficiently instruct those in charge of estates as to what steps have to be taken.

Sanitation on mines also demands attention, but I think that this might be deferred until such time as the work on estates has been satisfactorily initiated.

The use of human excrement in vegetable gardens should be absolutely pro- hibited.

I have, &c.,

H. FRASER,

The Federal Secretary,

Federated Malay States,

Kuala Lumpur.

Director, Institute for Medical Research,

Federated Malay States.

..th

103

Institute for Medical Research, Kuala Lumpur, SIR,

I HAVE the honour to submit a report concerning "Ankylostomiasis among

Federated Malay States, 12th May, 1909. Tamil coolies employed on rubber estates," following the lines indicated in your Memorandum.

2. The delay in the presentation of this report has been occasioned in part by unavoidable interruptions in the work and in part by the difficulties in the way of obtaining material for a sufficient number of examinations to form reliable data.

I have, &c.,

The Director

Institute for Medical Research,

Federated Malay States.

Kuala Lumpur.

A. T. STANTON,

Bacteriologist.

ANKYLOSTOMIASIS AMONG TAMIL COOLIES EMPLOYED ON RUBBER ESTATES.

1. To determine the number of persons harbouring ankylostomes relative to the general population, various estates and estate hospitals were visited and systematic observations made.

(a.) Estate Hospital in Negri Sembilan.

This hospital is a large one, receiving patients from fourteen estates, and is situated in a district where ankylostomiasis is considered to be widely prevalent.

Examination of fæces of 152 patients, taken without reference to the disease for which they were under treatment, gave the following results :—

Ova of ankylostomes alone

Ova of ankylostomes and whip worms

Ova of ankylostomes and round worms

31 36

Ova of round worms alone

Ova of ankylostomes, round worms, and whip worms

Ova of whip worms alone

Ova of round worms and whip worms

Ova of round worms and thread worms

1 20

No ova found

152

Percentage of Estate Hospital patients harbouring ankylostomes, 56.

Examination of 158 coolies, who on the day of examination were at work, gave

(b.) Rubber Estate in Selangor No. 1.

This place enjoys the reputation of being a

very healthy estate."

the following results :-