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PUBLIC RECORD OFFICE

mihim

C.O.

Reference :--

885

20 PUBLIC RECORD OFFICE, LONDON

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20

JAMAICA.

I have the honour to present the following report on leprosy in Jamaica to the Second International Conference on Leprosy to be shortly held in Bergen, Norway, under the distinguished presidency of Dr. G. Armauer Hansen, Director of Leprosy, Norway.

The number of known cases is given as the admissions to the Leper Asylum from 1897.

1897

1898

1899

1900

1901

1902

1903

1904

1905

1906

1907

1908

Year.

Now Cases,

Donths.

Bemaining.

31

16

106

35

13

127

15

118

21

122

18

15

120

7

14

110

16

17

108

117

23

114

16

14

115

13

15

113

12

14

105

33222222222

90229ERRICH

My predecessor, Dr. J. F. Donovan, presented a report on leprosy to the Berlin Conference in 1897.

I was appointed as Medical Superintendent of the Jamaica Leper Asylum in August, 1898, and I have prepared a report on the admissions of new cases from that date to the 31st March, 1909. A map has been prepared which demonstrates the localities where the disease has been acquired, males marked in red, females in

blue.

Geological Formation of Jamaica.-This can only be summarized.

County of Surrey.-The coast formation is white and yellow limestone, the interior consists of metamorphosed and trappean with carbonaceous shales and con- glomerates. In St. Andrew purple shales and conglomerates occur to a consider- able extent. At Hope, galeña is found with caledonite. On the north side at Low Layton, exist the traces of an extinct volcano, which is supposed to have been active before the close of the pliocene period.

County of Middlesex.-St. Mary exhibits a great diversity of formation, con- sisting of limestone, marls, sandstone, conglomerates, and, in a small area, igneous formations. In St. Catherine the formations are more limited. Calcareous and igneous rocks prevail. A vast alluvial deposit covers a great area, and is a con- tinuation of the alluvial plain of Liguanea, St. Andrew. In North Clarendon, metamorphosed trap rocks and conglomerates prevail. In the Vere district there is an alluvial flat consisting of 132 square miles. This is the largest continuous flat land in the island. Manchester and St. Ann consist principally of limestone.

County of Cornwall.-St. Elizabeth consists of limestone, with an extensive alluvial area. The Nassau Valley is an extensive flat in the north-east part of the parish.

Westmoreland consists of extensive alluvial deposits and marl beds. Northwest is found trap rocks and yellow limestone. The "black grounds" of Trelawny consist of the debris of the trappean series of shales and conglomerates. The parish consists principally of limestone. The Queen of Spain's Valley is a very large expanse of alluvial deposit. St. James consists of trap formation, with yellow limestone and cretaceous marls. Alluvial deposits exist around the coast. Hanover consists chiefly of white and yellow limestone, black shales, with metamor- phosed rocks.

Not reproduced.

21

The question of soil is not a factor in the etiology of leprosy in Jamaica. There are cases occurring on all variations of geological formations, including por- phyritic and other igneous rocks, cretaceous and conglomerate deposits, marls, clays, sandstone, and gravel.

With reference to Jamaica I can safely state that climatic or telluric influences, hygienic conditions, habits, food, or water supply have nothing to do with the causation of leprosy. interior as the littoral, from high elevations as from the lowlands. There are cer Quite as many cases are admitted from the tain localities where leprosy does not occur. littoral as follows:-Kingston and Port Royal, Montego Bay, Port Antonio, and Cases have been admitted from the Alligator Pond.

From long distances from the sea-board :-Mandeville, Chapelton, Bull-head, and Ulster Spring,

From high elevations:-Norway, 3,000 ft.; Christiana, 2,563 ft.; Ballynure, 2,150 ft.; Mandeville, 2,130 ft.

Those affected are principally the negroes and coloured population. Amongst the white, certain Jewish families are leprous. suffer, apparently not in the same proportion to those indentured in Trinidad or A few East Indian immigrants British Guiana.

A glance at the map will demonstrate the fact that singularly few admissions have been made from Hanover, Westmoreland, Portland and St. Thomas, the four parishes at the extreme east and west of the island.

From the county of Surrey there are 30 admissions, being a rate of 165 per 10,000 of the population and one leper for every 25'5 square miles.

From the county of Middlesex we received 97 lepers, a rate of 2:59 per 10,000

of the population and one leper for each 198 square miles.

From the county of Cornwall 32 lepers were admitted, a rate per 10,000 of population of 1·14 and one leper for every 47 square miles.

The Blue Mountains divide the island in its extreme length into the north and south sides. The north side, with an area of 1,729 square miles, gives 47 lepers, equal to one leper for every 368 square miles. The south side, with an area of 2,463 square miles, gives 112 lepers, being one leper for every 22 square miles. This is interesting, and requires further investigation and research.

It must not be forgotten that these admissions cover a period of nearly 11 years, and the results of the figures show that leprosy is no longer a serious matter for Jamaica.

I do not think that any focus of infection exists in Jamaica. from the isolated cases admitted to the asylum, and from enquiries submitted from I gather this time to time to Inspectors of Police and District Medical Officers.

Immigration. It does not appear to me that sufficient attention is paid to this subject as one of the causes by which leprosy is increased in any country. In the year 1854 472 Chinese immigrants were introduced in Jamaica, principally from Colon, where they had been working on the Panama Railway. Several of these, broken-down and destitute, died of leprosy at the Healthshire Asylum. A small number of East Indians suffered from leprosy shortly after their introduction. The table of admissions for the past 11 years shows the number of Jamaicans who have acquired the disease in Colon and Central America.

Notification of Cases.--The disease is not notified under the Compulsory Noti- fication Act.

The malady is dealt with under a special law to be referred to later. Segregation. The first leprosy law passed in Jamaica was 28 Victoria, Chapter 13 (Law 13 of 1865). Provision was made for the establishment of asylums for dealing with leprosy and kindred diseases.

A leper settlement was built on the Healthshire Hills, in a locality most inac- cessible during the rainy seasons, either by land or sea, and one existed also at Montego Bay.

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