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PUBLIC RECORD OFFICE

Reference :-

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m2 C.O. 885

23 PUBLIC RECORD OFFICE, LONDON

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

3030

No. 2.

SIERRA LEONE.

THE ACTING GOVERNOR to THE SECRETARY OF STATE.

(Received 26th January, 1914.)

[Answered by despatch No. 97, of 24th February, 1914, transmitting copy of No. A.

(No. 18.)

Government House, Sierra Leone, 8th January, 1914. SIR,

WITH reference to my despatches, Nos. 14 of the 7th instant,* and 17 al to-day's date, I have the honour to transmit herewith a copy of a memorandum by the Principal Medical Officer on the subject of sleeping sickness, several cases of which have been discovered or reported as existing in the Colony and Protec- torate during the past few months.

2. It is, of course, impossible to say whether this disease is more prevalent now than formerly, or whether our attention has merely been drawn to it of late owing to the inquiries which have been instituted by the Medical Department. In any case it appears to be advisable to consider some scheme for dealing with the disease should this be found necessary.

3. With regard to the Principal Medical Officer's suggestion to create a fly-free area on the site of the sanitary station at Cape Sierra Leone, a Medical Officer will shortly be sent to reside at the Cape for two to three weeks in order A plan of the Cape will to collect flies and report on the position generally. also be prepared and submitted to you in due course.

I have, &c.,

A. C. HOLLIS.

Acting Governor.

SIR,

No. 3.

SIERRA LEONE.

COLONIAL OFFICE to TROPICAL DISEASES BUREAU.

[Answered by No. 4.]

Downing Street, 12th February, 1914.

I AM directed by Mr. Secretary Harcourt to transmit to you herewith a copy of a despatch* with enclosure from the Acting Governor of Sierra Leone, on the subject of sleeping sickness in that Colony.

2. Mr. Harcourt will be glad to have an opportunity of considering your views upon the Acting Governor's despatch.

5968

SIR,

No. 4.

I am, &c.,

H. J. READ,

for the Under-Secretary of State.

Enclosure in No. 2.

FROM THE PRINCIPAL MEDICAL OFFICER to THE HONOURABLE THE

COLONIAL SECRETARY.

I UNDERSTAND that it is the intention of Sir E. M. Merewether to discuss the subject of sleeping sickness in this Colony with the Secretary of State and the Advisory Committee whilst he is on leave.

I wish now to draw attention to the fact that during the period extending from the 18th of July to the 28th of November of this year seven cases of sleep. ing sickness have been admitted to the Colonial Hospital. Freetown, five of which were infected in the Colony and Protectorate, two in Fernando Po. These cases are at present treated in mosquito-proof cages in the wards of the General Hospital. Patients in an advanced stage of the disease do not object to this, but those in whom the disease has only been discovered accidentally in the course of treat- ment for other diseases do, and it appears to me, therefore, that it is time to cou- sider whether some permanent provision ought not to be made for the accommoda tion, isolation, and treatment of such cases. As you are aware, proposals are under consideration with regard to altering and increasing the accommodation both at the Cape sanitary station and at Kissy, and I am of opinion that this question should be considered at the same time. Judging from the reports sent in there appears to be little reason to hope that a suitable fly-free area will be available in any part of the Colony or Protectorate, and we may be placed in Possibly the most suitable site the position of having to create a Hy-free area.

for this purpose would be the Peninsula, now occupied by the Cape sanitary station. Sleeping sickness flies (Glossina palpalis) are known to exist there, but it would not be difficult to clear the Peninsula of all low scrub and possibly to rid it of fly. However, as so much work has been done and so much experi ence gained in other parts of Africa in dealing with sleeping sickness. I ask that the matter be referred for the opinion of experts.

THOMAS E. RICE,

Principal Medical Offeer.

SIERRA LEONE.

TROPICAL DISEASES BUREAU to COLONIAL OFFICE. (Received 17th February, 1914.)

Tropical Diseases Bureau, Imperial Institute, London, S.W.

16th February, 1914. I HAVE the honour to acknowledge the receipt of your letter of 12th February (3030/1914)† with a copy of a despatch from the Acting Governor of Sierra Leone on the subject of sleeping sickness in that Colony.

2. 1 enclose for the information of the Secretary of State a reprint of a paper, "A note on Trypanosomiasis in Sierra Leone," published by Major Grattan in 1906. From this it will be seen that between July and December, 1905, he diagnosed eighteen cases of sleeping sickness microscopically in Sierra Leone, and Their other cases which were met with were undoubtedly the same disease. distribution is shown on the map on page 7, from which it is seen that many of the patients live near Freetown. The Principal Medical Officer of Sierra Leone seems to be unaware of the existence of this excellent paper.

3. Judging from Major Grattan's work and the results of investigations elsewhere on the West Coast of Africa, there can be little doubt that the discovery of the recent series of cases is solely due to the activity of the Medical Department and that the disease has existed in Sierra Leone, as elsewhere on the Coast, for an indefinite and probably long period.

4.

Whether it is practicable and advisable to clear of scrub, and keep clear, an area where infected natives can be treated is a question which can only be answered locally. A hospital for natives infected with sleeping sickness was put up in the Gold Coast but I believe it was useless because the infected natives could not be induced to enter it. Compulsion in the case of a disease which, on the one hand, may exist unsuspected in a native for a long period and, if recognized, can be readily concealed from the authorities and on the other hand requires pro- longed treatment though the victim may feel fairly well, must, in a British colony, defeat its own ends. It may be, however, that the Medical Officers of Sierra Leone are so persuasive or the natives so docile that the scheme has a good prospect of succeeding.

5. I do not think any scheme for controlling the disease should be adopted except after careful consideration and consultation with the authorities in the Gold Coast and perhaps the Gambia. It is probable that sleeping sickness is but a slight menace to the prosperity of Sierra Leone and that any serious attempt to eradicate or control it, with our present knowledge, might cost a great deal of money and be quite ineffective. In fact my own feeling is that Sierra Leone would do well to await the result of the co-ordinated study of the bionomics of

* No. 2.

+ No. 8.

Not reprinted here.

2nd December, 1913.

* No. 1.

}

No. 26 in African No. 1013.