CO885-(21-23) — Page 162

PUBLIC RECORD OFFICE

། ། ] [ ཏ། །

Reference :-

MC.O. 885

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

22 PUBLIC RECORD OFFICE, LONDON

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no means beyond the bounds of possibility that any attempt to make gland-punctur- ing compulsory might be interpreted by a large section of the native population, more especially in Ashanti, as an organised effort on the part of Government to keep their numbers within convenient limits; and I need not expatiate upon the serious trouble which the prevalence of such an idea might occasion among a warlike people, who have only come under our control during recent years.

9. With reference to the alleged inadequacy of our co-operation with the Government of Togoland in the matter of sleeping sickness, I find that a Medical Officer was stationed at Anum for the special purpose of carrying on investigations in close proximity to the German border. Under date January 4th, 1912, Dr. P. D. Oakley, writing from Anum, reported as follows:-

10.

•

In regard to sleeping sickness prevention, I can only embody the reports which I have submitted monthly. I beg to state again that during the nine months I have been here I have been unable to find a single case of sleeping sickness. There was one suspicious case in hospital, but I never once was able to demonstrate the trypanosome by blood examination or gland puncture. The man ran away from the hospital, and I was unable to trace him, but I eventually heard that he had died about a week after leaving Anum. In my opinion it was a case of epilepsy, although he presented many signs of trypanosomiasis, but which, at the same time, are common to epilepsy. The two cases I reported as being suspicious last month have been "further examined, but the result has been negative.

"It seems to me to be an extraordinary thing that in the German sleeping sickness camp in Togoland there are nearly 80 cases, and yet in this Colony, which is only one day's march away from the German isolation camp, there appear to be no cases. This fact alone, I think, points out the necessity of some local laws to enable the Medical Officers to enforce gland puncture, a fact I brought before your notice in my last report.

The people have shown a fair degree of activity in clearing round the water and villages."

In March of this year a quarterly report from the Medical Officer at Anum came before me, and I was struck by the sketchy character of this document, and enquired whether the Medical Department had no further information to supply on the subject of sleeping sickness. To this the Principal Medical Officer replied:-

There is really nothing to report of any interest, as there are no cases of sleeping sickness occurring in the neighbourhood," viz., of Anum.

."

11. I personally find it impossible to believe that, whereas a certain small percentage of the natives belonging to the Pekki Tribe, unnaturally divided by an arbitrary boundary from their main stock, are proved in Togoland to be suffering from sleeping sickness, the rest of the tribe, whose members live in the P'ekki District of this Colony, are free from the disease. I attribute the failure of successive medical men to discover cases of sleeping sickness in this part of the Colony to the fact that all suspected cases are studiously concealed. This is rendered comparatively easy by reason of the more dense population on our side of the boundary, and by the fact that we cannot resort to methods of compulsion which commend themselves to the German authorities. The desire to conceal such cases is, of course, stimulated in this district by the knowledge which the natives possess of what in this matter has befallen their friends and relations in the neighbouring districts of Togoland.

12. With regard to the question of fuller co-operation between ourselves and the German Government in future, I see, for the reasons already explained, very Considerable grounds for fearing that co-operation of a kind which Dr. von der Hellen, for instance, would regard as adequate, cannot wisely be attempted in the Gold Coast at the present time; and I further submit that the gravity of the danger to which the existence of sleeping sickness exposes the native population of this part of the Colony is not sufficient to warrant Government in resorting to the stringent

methods which alone would satisfy medical enthusiasts.

13. There appears to be every reason to believe that the type of sleeping sickness found in this part of West Africa is much milder than that which prevails on the other side of the continent; that it exists and has long existed in an endemic form: that the general run of the indigenous population, if not immune to it, are, at any rate, highly resistant; and that there is no evidence that it is spreading in any

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abnormal manner. In these circumstances, I venture to deprecate any precipitate action which, though designed for the benefits of the native population, may result in widespread dissatisfaction and exacerbation of their feelings.

14. Turning next to Dr. Wade's valuable and comprehensive report, I think that a study of it will tend to bear out the conclusions set forth in the foregoing paragraph. With regard to the floating, as opposed to the indigenous, population in Ashanti, he remarks:-

"This class, among whom are many trypanosomiasis-carriers, are, I believe, at the root of the human trypanosomiasis in this (the Western) Pro vince, and I may add that this remark applies to that portion of the Central Province which I had the opportunity of examining last year."

He also notes that the improved tracks which we have caused to be made through the country, in the place of the old, dark and narrow bush-paths, favour tsetse flics; and he adds

The view I take is that the disease follows the main trade routes and traffic, and that residents becoming infected in these villages on the main roads act as reservoirs for disseminating the disease to susceptible persons

iti the neighbouring villages." Dr. Wade also quotes and endorses the following passage from Dr. Kinghorn's report written in 1910-

"I am inclined to think this trypanosome in the course of time has lost much of its virulence by being compelled to pass through a long series of resistant individuals after the susceptible ones had been swept off, and this has gone on to such an extent that it can now only establish itself in these natives with some difficulty."

Dr. Wade further gives it as his opinion that the carriers from the north, instead of bringing the disease with them from their own country, become infected in the endemic areas through which they pass.

15. With reference to Dr. Wade's recommendations, the most practical step which can immediately be taken is, I think, to enforce clearing, and the maintenance of clearings, in the immediate vicinity of the villages and zongos, more especially in the neighbourhood of the main trade routes.

16. I propose to consult the Chief Commissioner of Ashanti as to the liest measures to be taken with a view to carrying out this recommendation, and I hope personally to look into the matter when I am in Ashanti in January-March next.

17.

I consider, however, that the enforcement of clearing regulations should be entrusted to the administrative staff, and not to Medical Officers; but I agree in thinking that the Medical Officer at Sunyani should be given every facility to travel. 18. I consider that segregation is a measure which cannot be resorted to wisely at the present time; but if you will permit me to do so, I will postpone reporting to you on this subject until I have been able to discuss the matter fully with the Chief Commissioner of Ashanti and his officers, and with the Ashanti chiefs on the spot.

19. Similarly, I propose to bring the other recommendations proposed hy Dr. Wade to the notice of the Chief Commissioner of Ashanti, and to address you further concerning them when I have had the advantage of studying his opinions and proposals.

20. I have much pleasure in directing your attention to the valuable work which Dr. Wade has done, and the thorough manner in which his investigations have been conducted. In this connection I have the honour to enclose, for your considera- tion, an application which Dr. Wade has addressed to the Principal Medical Officer for an increase in his consolidated allowance of £10 per mensem. I think that in the circumstances described £15 per mensem would be a more equitable sum, and I would ask your approval to allow Dr. Wade to draw at that rate from the date upon which he was seconded for this special service.

I have, &c..

HUGH CLIFFORD,

Governor.