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PUBLIC RECORD OFFICE

Reference :-

C.O. 885

22 PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-

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(No. 8.)

FROM THE ADMINISTRATOR, NORTHERN RHODESIA, TO THE DUTCH REFORMED MISSION.

February 8th, 1913. Acknowledges No. 7. Says that the last suggestion is impracticable, as com- munications between the stations could not be kept up. Natives move to where they Northern can obtain higher pay, and they cannot be prevented from doing so. Rhodesia has about 1,000 miles of southern frontier, so that prevention of emigration is impossible; if stopped at the frontier they could go through Portuguese territory or to the Congo, where the danger of sleeping sickness is great. Strict supervision is now being made at the border of Southern Rhodesia. The road to the detention camp is less infested with fly than any other road. The recruits are taken from the camp to their destination by fly-free routes and are employed in fly-free areas. The probabilities of sleeping sickness being thus carried to the south are therefore practi- cally eliminated. Recent investigations have shown that infection in Rhodesia is diminishing.

(No. 9.)

FROM THE PRINCIPAL MEDICAL OFFICER, NORTHERN RHODESIA, TO THE SECRETARY,

LIVINGSTONE.

December 13th, 1912. Reports on an examination of the population on and near the Luangwa River. Total number of people seen, 3,430. The adult death-rate was found to be 28 per 1.000, of which 8 per 1,000 probably die from trypanosomiasis. Concludes that there is nothing to show that the disease tends to become epidemic. Suggests that the disease is an old one and that the present restrictions can shortly be modified with safety.

37977

(No. 769.) SIR,

No. 4.

GOLD COAST.

THE GOVERNOR to THE SECRETARY OF STATE.

(Received 3 November, 1913.)

Government House, Accra, 18th October, 1913. WITH reference to your despatch, No. 119, of the 24th February last,* forwarding a copy of a letter from the Director of the Tropical Diseases Bureau, on the subject of sleeping sickness, I have the honour to enclose herewith, for your information, a copy of a report which Dr. C. V. Le Fanu has prepared after a visit paid by him in my company to the sleeping sickness camp at Kluto, in Togoland, last month; a copy of a report by Dr. W. M. Wade on human trypanosomiasis in the Western Province of Ashanti; together with a copy of a covering letter, dated the 8th September, addressed to the Colonial Secretary by the Principal Medical Officer.

2. By Section 3 of the Agreement made between His Britannic Majesty's Government and the Imperial German Government on August 17th, 1911, the Governments of this Colony and of Togoland undertook to :—

3.

*

Treat patients suffering from sleeping sickness and take preventive measures against the disease according to the means at the disposal of the local Governments concerned.'

The measures which the Government of Togoland has taken are described in Dr. Le Fanu's report; and it will be observed from a perusal of Dr. von der Hellen's

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memorandum, which forms an appendix to that report, that it is urged that the Government of this Colony has not co-operated with that of Togoland as effectually and as beartily as the latter considers that it had a right to expect.

4. There is, I fear, on the face of it, some truth in this contention; but an examination of the matter will show that, whereas the Government of Togoland has a comparatively simple proposition with which to deal, the Government of this Colony is in a position of much greater difficulty.

This

5. The situation is rendered simple for the Government of Togoland primarily by the fact that it is concerned with a very small population living in villages the inhabitants of which rarely number as many as 400 souls, where each individual can be marked down and kept in view by the medical authorities, and partly because the attitude of Government to the native population in Togoland differs widely from that which we assume towards the people of the Gold Coast and Ashanti. latter point is illustrated by Dr. von der Hellen's suggestion that persons who some visible frequently cross and re-cross the boundary should have affixed to them mark which would be destroyed on attempted removal, for instance, a band with a leaden seal." In the Gold Coast I question whether many natives would be found willing to submit to such an operation, and it clearly could not be with propriety enforced by legislation.

6. In Togoland, in a word, the clinical question need alone occupy the attention of Government, and it is there rendered peculiarly easy to cope with by reason of the small population with which the Government is concerned. In the Gold Coast and Ashanti, on the other hand, the question of dealing with sleeping sickness must primarily be considered în its political aspects, and the decision as to the action which it is necessary or expedient to take with a view to combating the spread of the disease cannot be solely or even mainly determined by considerations as to what is medically advisable.

7. The Medical Officers in the service of this Government who, from time to time, have recorded their opinions on this subject, as is perhaps only natural, have generally combined to ignore the political aspect of the matter, and have extolled the action of the Togoland Government, which is rendered possible, partly by natural circumstances, but mainly because in Togoland political considerations can apparently be ignored with impunity. In the course of my recent visit to Togoland. however, I was interested to learn that such experienced administrative officers as Dr. Grunner, whose District Headquarters at Misahöhe is within a mile of the Kluto Camp, entertained considerable misgivings as to the effect which the sleeping sickness campaign was having upon the already sparse population of his district, and evidently considered that it was at least open to argument whether the practical good which the campaign was effecting was commensurate with the unrest and discontent and frequent migrations across our frontier which it occasioned.

8. In this connection I submit that it is necessary to take into consideration the standpoint from which the average bush native views our action with regard to sleeping sickness. The percentage of those suffering from the disease is not large, Dr. Wade reports that out of 39,742 natives examined by him in 196 towns and villages of Western Ashanti, only 110 cases or 2 per cent.-were found. The disease is of a very insidious character, and is one with which the natives have long been familiar. The puncturing of glands by a European doctor is an operation from which the natives are instinctively averse, and, though in Togoland fear of authority can overcome this feeling, I am not at the present time prepared to recom- mend that legislation should be enacted to render submission to this experiment compulsory. In many instances, of course, the reluctance of the natives has been overcome through the personal influence brought to bear upon them. Legislation designed to attain this end can only, I venture to assert, be justified if it be necessary in order to relieve the native population from a very serious public danger, and even then its adoption may not be expedient, having regard to the political conditions of the country concerned, and to the degree of enlightenment to which the people have attained. The prejudice against gland-puncture is strengthened in the native mind by the fact that on many occasions persons who were apparently in good health. though they were really suffering from the earlier stages of sleeping sickness, subsequently developed the disease and died, their illness and demise being popularly regarded as the result of the operation which had been performed upon them. It is by

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