CO885-(23-24) — Page 159

PUBLIC RECORD OFFICE

سلسل.

Reference :-

CO 885

23 PUBLIC RECORD OFFICE, LONDON

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

72

2. In accordance with this agreement I visited Antigua on November the 7th and 8th.

I inspected all the records bearing on the subject of ankylostomiasis in the Island; I conferred with the medical officers who have had experience with the disease.

With Dr. McDonald I inspected about fifty cases of infection in the industrial school, the prison, the Government hospital, the poor-house, and the insane asylum.

3. The microscopic and post mortem examinations made by Dr. McDonald at Government hospital demonstrate the presence of ankylostome infection in Antigua. His recent finding by microscopic examination that 44 of the 70 boys in the industrial school are infected, taken in connection with the hospital records, indicates a probable prevalence of infection throughout the Island.

The medical officers whom I met agree that the known facts indicate that the infection is prevalent.

4. As to the effects which the infection is producing, there is difference of opinion. Basing his judgment on the deaths caused by the disease, on his observa- tions of cases in hospital, and on the clinical diagnosis of the 44 cases in the industrial school, Dr. McDonald asserts with emphasis that ankylostomiasis is a serious menace to the health and efficiency of the people of Antigua. Other medical officers are of opinion that, although the infection is prevalent-probably very pre- valent-its effects may be slight, even negligible.

My own hurried observations indicate to me that the infection is producing varying degrees of anæmia. I saw no cases as severe as I have seen among the whites in the States and among the Indian coolies in Demerara and Trinidad; but many of the cases I saw are clearly below par; some of them give the typical clinical picture of ankylostome anæmia, some of them I should call even severe types. The impressions here received have been much strengthened by my later and more extended observations of the disease among the blacks of St. Lucia and Grenada.

But to determine the question definitely as to Antigua calls for the collection of a larger body of facts and for some kinds of facts not now available.

5. It was agreed, therefore, at our final conference, subject to the approval of all authorities concerned, that we would undertake to organise and conduct a systematic investigation to determine the facts as to ankylostomiasis in Antigua. This investigation to include:-

(a) Microscopic examination of stools to determine the prevalence of the

infection, and

(b) Blood test to indicate the degree of anæmia being produced by the

infection.

6. If this investigation shows that the infection is not a menace to the health and efficiency of the people, the work will end there. If, on the contrary, it shows that the infection is prevalent and is a menace to health, we will then consider measures for its control.

7. For this investigation we agreed, as I understand, that it would be advisable to begin with one man aided by two microscopists; the man to be the best available, to be chosen with reference also to his availability as administrative head of the work for the control of the disease, if the inauguration of that work should be found necessary; the force thus organised to devote its whole time to the work.

8. If the proposition thus stated in broad outline should meet with Your Excellency's approval, the details may be completed at Your Excellency's pleasure. If, when completed, it be sent to me in budget form, the Secretary of State for the Colonies approving, I shall be glad to lay it before our Commission with recommen- dation that the necessary funds for the work be appropriated.

9. Funds appropriated for the work will be sent to the Treasurer of Antigua to be expended according to the budget, to be disbursed and audited as Colonial funds are disbursed and audited.

His Excellency the Governor,

Antigua.

I have, &c.,

WICKLIFFE ROSE, Director, International Health Commission.

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GRENADA.

TENTATIVE OUTLINE OF PLAN OF WORK AS AGREED UPON IN CONFERENCE BY HIS EXCELLENCY The Governor, DR. HATTOŊ, DR. PATTERSON, Dr. Orford, AND THE DIRECTOR.

I. Medical Officer in Charge.--To be young man trained in School of Tropical Medicine, competent bacteriologist, administra- tive ability, to reside in St. George's, to have direction of the whole work for the Island, to take charge of work also in field in St. George's and adjoining parishes :-

Salary

(To be increased to £450.)

Expenses

Passage

£400

50

35

£485

II. Assistant Medical Officer-To be trained physician directly responsible to the Medical Officer in Charge, to devote his whole time to work in the field :-

Salary

(To be increased to £300.) Expenses

III. Four Microscopists.

Salary (each) Expenses

IV. Clerical force.

Clerk Copyist

£250

50

£300

£70 to £85 30

£280 to £340

£75 35

£110

V. Equipment.--Six microscopes, two of them to have oil immersion lenses, two lanterns and slides.

The Government to furnish medicine, stationery, &c. VI. Contingent Fund

£100

£100

Total (minimum)

£1,275