CO885-(23-24) — Page 102

PUBLIC RECORD OFFICE

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FICO. 885

23 PUBLIC RECORD OFFICE, LONDON

Mosquito nets and wire gauze may be strongly recommended for Cyprus in public notices, but they will only be used there, as elsewhere, by the more well-to-do classes.

On the whole, therefore, Cyprus is most suitable for a pretty thorough mosquito reduction combined with a certain amount of quinine distribution, especially in the schools; and I will now proceed to make detailed recommendations to this effect.

At the same time, these measures are not likely to be carried out effectively unless Government reorganizes the whole of its Sanitary Department. My recommendations will therefore con- template, not only an anti-malaria campaign, but a general effective Sanitary Department throughout the Island; and the suggested expenditure should therefore be viewed in the light of this remark.

13. Recommendations. These are briefly as follows (they will be discussed seriatim in Section 15):-

(1) To convert the present post of Chief Medical Officer into that of Chief Medical and Sanitary Officer, with an addition of £100 a year to his pay.

(2) To give him the services of an Assistant Sanitary Officer costing up to £100 a year.

(3) To appoint seven whole-time Sanitary Inspectors, with free travelling allowances; namely, one Sanitary Inspector for each district, costing, with travelling allowances, an average of £100 a year each; and one Sanitary Inspector to act directly under the Chief Medical and Sanitary Officer, and costing, with travelling allowances, up to £150 a year,

(4) To appoint a whole-time permanent Sanitary Engineer under the Chief Medical and Sanitary Officer, with a salary of £200, rising to £300 a year, and free travelling allowances, costing, at present, altogether an average of, say, £300 a year.

(5) To allot an annual sum of money for actual sanitary works in every centre of population, amounting to an average of £3 a year for each centre. The number of such centres of population is 738, according to the Census of 1911; and the cost will therefore be £2,214 per annum for the whole Island. In addition to this, the cost of culicicides and tools, &c., may be put at £286 a year, giving a total of £2,500 a year for actual sanitary works in all the centres of population. This sum is to be in addition to the sanitary expenditure of, municipalities under local government, and in addition to all large sanitary works which may hereafter be required. It should be expended by the Government of Cyprus; but with the view that after two or three years the centres of population will themselves contribute the bulk of the fund, or more if experience shows that more is necessary.

(6) To make arrangements for a wide distribution of quinine, partly by sale of Government quinine and partly by free issue, at a total cost, in addition to profits of sales, not exceeding £500 a year in excess of the present vote, including preparation and despatch.

(7) To arrange that the Government Analyst shall conduct analyses and experiments and do other scientific work for the Sanitary Service at a cost not exceeding £50 a year.

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(8) To increase the pay of the District and Rural Medical Officers by 20 per cent, for active assistance in the sanitary work of the areas allotted to them; but only on condition that they first produce satisfactory certificates of attendance at accepted courses of instruction où diseases of warm climates in Britain, France, Athens, Egypt, India, or elsewhere; leave for attendance at such courses, and fees in payment for the instruction, to be given by Government ou engagement to serve for at least three years afterwards.

(9) To consolidate and amend the various Acts referring to public health given in Appendix III.

(10) To take power to assume temporarily and permanently the sanitary duties, and a corresponding share of revenue, of Muni- cipal Councils and Commissions, which, in the opinion of Government, accepted by the Secretary of State, may not at any time pay sufficient attention to this part of their duties.

14. Approximate Present Cost of Recommendations in Addition to Existing Allotments.-This is:

£ a Year.

(1) Chief Medical and Sanitary Officer... (2) Sanitary Assistant, not exceeding

100

100

(3) Seven Sanitary Inspectors, not exceeding

750

(4) Sanitary Engineer, not exceeding

300

•

(5) Sanitary works in 738 centres of population. with necessary tools, &c., not exceeding...

2,500

(6) Quinine distribution, not exceeding (7) Government Analyst, not exceeding

500

50

(8) Increase of pay to District and Rural

Medical Officers, say at present

200

...

Total

...

£4,500

Of these, Item (5) should fall much less heavily on Govern ment if arrangements can be made in the future by which the 738 centres of population will take their share of paying for their own sanitary works as they should do. Item (6) should also be gradually reduced if Item (5) is successful enough. Item (8), however, will increase up to about £600 if all the Medical Officers obtain required certificates. It is anticipated that the other items will remain fairly stationary.

The cost of the proposed Sanitary Department (£4,500) is 19 per cent. of the total expenditure of Cyprus, exclusive of tribute, in 1911-12 (£235,256); and 35 per cent. of the Medical and Quarantine expenditure during the same year (£12.794). It amounts to nearly fourpence a year per head of population (275,000 persons). With this new addition, the total Medical, Sanitary, and Quarantine expenditure will reach about £17,300 a year, or about 74 per cent. of the total expenditure in 1911-12. As stated in Section 5, the same figure (74 per cent.) is the average ratio of Medical and Sanitary to total expenditure in twenty colonies, so that the proposed addition will only bring the Cyprian expenditure under this heading up to the standard,