CO885-(23-24) — Page 467

PUBLIC RECORD OFFICE

19

Reference :-

MICO. 885

23 PUBLIC RECORD OFFICE, LONDON

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

8

2. When Mr. Wickliffe Rose was here I had many conversations with him on the subject of the projected campaign, and the memorandum drawn up by Dr. Durrant, after consultation with me, now submitted with this minute, embodies a scheme of operations the general outline of which was conceived whilst Mr. Rose

was here.

3. A suitable man being available, I am strongly in favour of the arrangement which places in charge of the campaign a man with thorough experience of local conditions and of the people with whom he has to deal. It would take a new man coming fresh to the Colony at least six months to obtain experience of local condi- We have in tions and the people, and, even then, he might not turn out a success. Dr. Durrant a man who, I feel certain, will make a success of the campaign, and who can start straight away, unhampered by the disability of newness to his surroundings. He has, moreover, the qualifications regarded as essential by Mr. Rose in paragraph 7 of his letter to Your Excellency.

4. The problems of sanitation are so closely interwoven with this campaign that I regard it as important that Dr. Durrant should remain at the head of the Government Sanitary Department which is being formed. He will thus control all the elements of the situation, and when this big campaign is concluded he would be in the position to maintain in sanitation matters a continuity of policy that had been evolved gradually during the campaign.

5. Dr. Durrant would, of course, continue to hold the position as adviser on medical questions to the Government. This duty takes up very little of his time and is nearly all connected with sanitation problems.

6. With regard to the proposed salary to Dr. Durrant from the Commission of £500 per annum and £50 travelling allowance, I may state that Dr. Durrant at present receives pensionable salary of £300 and £50 travelling allowance. He is also allowed private practice bringing him in something like £150 to £200 a year. If he is appointed Medical Officer in charge of this campaign he will have to surrender all his private practice, and this he quite understands. The other con- ditions of this appointment laid down in his memorandum are, I consider, only fair and reasonable, and I recommend their acceptance.

7. Under the proposals outlined there will be no saving and no additional cost to the Government, apart, of course, from the additional amount that the Govern ment intends to spend in any case on the formation of a Sanitary Department. Dr. Durrant's present salary, £300 a year, will go to defray the salary of a surgeon for the Colonial Hospital (who will also be in charge of the Kingstown District and have private practice). It should be possible to get a man of the type we require on a three years' engagement, passage paid here and back, £300 a year and perhaps another £100 to £150 in private practice and fees. A young skilful surgeon is what we want from one of the London hospitals, who does not desire to A man with settle down in the Colony, but merely wishes tropical experience. bacteriological experience also would be still more useful. But the first qualification is the more essential. He would have no pension rights, because these would be retained by Dr. Durrant. He would also require no travelling allowance as he would not have to go outside Kingstown, except on matters connected with his private practice. Therefore the £50 now paid to Dr. Durrant as travelling allowance could be allocated to the latter (Dr. Durrant) as remuneration for his duties as head of the Sanitary Department and Medical Adviser to the Government.

9. It is believed that the campaign may take about five years, but, of course, it is not possible to make any definite surmise in this connexion until it has been in operation for some little time.

10. I have had no time to bring the whole matter before the Executive Council yet, but I am sure that they will not take exception to the proposals as now submitted.

C.G.M.

21st December, 1913.

HIS HONOUR,

Colonial Hospital, St. Vincent, 19th December, 1913.

As the result of an interview with Your Honour to-day, I beg leave to submit the following scheme for a campaign against ankylostomiasis in St. Vincent, conse quent on the proposals of the Rockefeller International Health Commission, through their Director, Mr. Wickliffe Rose.

I had several interviews with Mr. Rose during his stay in St. Vincent, when the question of the possibility of carrying on such a campaign was discussed, and as a result of these conferences it was agreed that there was evident necessity for such a campaign, and that incalculable benefits would accrue.

9

The main points of the scheme which I submit for approval may be outlined as follows:-

Dr. C. H. Durrant, at present the Medical Officer of the Kingstown District, as recommended by Your Honour and concurred in by Mr. Rose, should be in charge of the campaign as Director at a salary of £500 per annum and a travelling allowance of £50 per annum.

His services would be wholly devoted to the campaign and to the sanitary work attendant on it throughout the Colony.

He would be assisted by (1) a head microscopist (locally trained) at a salary of £84 per annum and a travelling allowance of £40 per annum, and (2) by an assistant microscopist (locally trained) stationary at headquarters, at a salary of £60 per annum. These two microscopists would perform between them all the necessary clerical work.

These three officers, with a laboratory attendant at a salary of £12 per annum, and a "field assistant " at a salary of £50 per annum, would comprise the staff of the head office.

The "field assistant," whose travelling allowance is included in the salary of £50, will have to travel on foot to places inaccessible to horse or conveyance, insti- tuting, under direction of the head office, the simpler sanitary measures required to prevent soil pollution.

In addition to this staff at headquarters it is proposed to enlist the services of the District Medical Officers (6), nearly all of whom have been previously supplied with microscopes, in the microscopic examination and treatment of cases, and it is suggested that these be paid at the rate of 28. for each case examined. This will entail an expenditure, divided among these Medical Officers, of about £500 per

annum.

It is felt that by enlisting the services of these Medical Officers general interest in the campaign will be ensured, and as the disease will be being attacked at several different foci at the same time, the work will be more speedily and effectually done. These Medical Officers will furnish weekly returns of the cases treated by them on the "prescribed forms for entry into the ledgers at head office, from which the quarterly report of the International Health Commission will be compiled, while the staff of the head office will push their investigations and efforts generally throughout the Colony and in the medical districts, especially where the work appears to be at all backward.

On the staff at head office will fall the duty of giving lectures, illustrated by lantern slides, object lessons and educational instruction on the subject in the schools, and generally in small towns, village centres, etc.

With this staff at work it is estimated that about 8,000 cases can be dealt with annually. These form the main points in the evolution of the scheme, but to enable these to be carried out provision will have to be made to provide a Medical Officer for the Kingstown District for such time as the present holder of that office is engaged in ankylostomiasis work.

The new Medical Officer should be a skilled surgeon, selected by the Secretary of State on a three years' engagement, to be placed in charge of the Colonial Hospital, and Kingstown district, at a salary of £300 and private practice allowed. He would have no sanitary work to perform; his passage money being paid out and back.

The £300 for this officer's salary would be transferred from the present salary of the Medical Officer of Kingstown district. The £50 horse allowance, given to the present holder of the office, would be retained by him, as compensation for the general sanitary work of the whole Colony over which he would have control, and which is intimately bound up with the question of ankylostomiasis. In the event of the pro- posed Government Sanitary Department being created and a trained Inspector being sent out by the Secretary of State for the Colonies, this new officer would be under the supervision of the head of the Government Sanitary Department.

Personally, while I am prepared to accept the position of Director, and take charge of the ankylostomiasis campaign, as has been recommended, at a salary of £500 and £50 travelling allowance, and £50 as head officer of the Government Sani- tary Department, I feel that certain stipulations, which are fair and just, should be considered, viz. :—

1st. That for such time as I may control the proposed campaign, my salary should count for pension rights up to the amount of £300 at present drawn by me.

;