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5. Make a sanitary survey of the selected areas, to locate definitely the sources of infection. These foci of infection, when located, to receive special attention.
6 Carry on experimentation with latrines, to discover a type of latrine which will be effective in putting a stop to soil-pollution about the lines, and which the coolie may be induced to use.
7. When a successful working plan has been thus discovered and the demon- stration made, gradually enlarge the work to cover the whole infected area of the island.
11.-Work in Southern India,
1. Examine microscopically all the coolies passing through the Government camps in Southern India.
2.
Record the findings, positive or negative, on the coolie's record card, and file
a duplicate record card.
3. At the end of the year, from these record cards make a map of the Madras Presidency, showing the geographic distribution of the infection.
Note.-1. The coolie's record card, which he presents on arrival on the estate. will show the planter whether or not he needs to be placed under treatment.
2. The map of the Madras Presidency will show the pockets of heavy infection and the areas which are relatively free from infection. This will have the twofold value, indicating the areas to be sought and the areas to be avoided in recruiting labourers; and it will serve as a basis for an intelligent campaign against the infection in Southern India.
III.-Working agencies.
1. An ankylostomiasis committee, to be composed of representatives of Govern- ment and of the Planters' Association, to serve as advisory committee in the conduct of the work.
2. Medical Officer in Charge: To be an Englishman; trained in tropical medicine; strong in personality, tact, and administrative ability, who can work in the spirit in which Dr. Hunt and Dr. Lunn are working.
3. One English Assistant Medical Officer, to have immediate charge of the work at the camps.
4. At least one English Assistant Medical Officer, to assist with the work in Ceylon.
5. Microscopists and other needed assistants to be natives locally trained. The number of these to be determined by the Medical Officer in Charge as the work develops.
6. Equipment-microscopes, lantern and slides, specimen containers, drugs, record forms, stationery, postage, etc.-to be budgeted by the Medical Officer in Charge after study of the situation on the ground.
7. The whole force to devote its entire time to the work.
33676
No. 21.
CEYLON.
MR H. R. COWELL (COLONial Office) to MR. WICKLIFFE ROSE (International HEALTH COMMISSION).
DEAR MR. ROSE,
Downing Street, 15th September, 1914.
I AM much obliged for your letter of the 24th August* enclosing a copy of the working plan for the ankylostomiasis campaign in Ceylon.
Mr. Harcourt is much interested in the progress of this work, and is awaiting fuller details from the Ceylon Government. It must, however. be feared that the present situation in Europe will seriously hamper operations by limiting the supply of medical men competent to carry them out; and some delay is to be anticipated on this account.
Very truly yours,
H. R. COWELL.
35692
19
No. 22.
MR. WICKLIFFE ROSE (INTernational HEALTH COMMISSION) to MR. H. R. COWELL (Colonial Office). (Received 18th September, 1914.) [Acknowledged 23rd September, 1914.]
725, Southern Building, Washington, D.C., DEAR MR. COWELL,
8th September, 1914. WITH the enlargement of the work of the International Health Commission
it has become necessary to appoint a number of directors, each to have charge of
Dr. II. II. Howard has a geographical division of the Commission's business. been appointed Director for the West Indies and will have charge of our business with all countries in that geographical division.
Mr. H. R. Cowell,
Colonial Office,
London, England.
36991
Very sincerely yours,
WICKLIFFE ROSE.
No. 23. SEYCHELLES.
THE GOVERNOR to THE SECRETARY OF STATE. (Received 21st September, 1914.)
[Copy to International Health Commission, 12th October, 1914.
[Answered by No. 49.] (No. 109/1914.)
See No. 40.]
SIR,
Government House, Seychelles, 24th July, 1914. I HAVE the honour to acknowledge the receipt of your despatch No. 22, of 2nd April last,* on the subject of the prevalence of ankylostomiasis in the islands of this Colony.
2. I called on the Chief Medical Officer for a report on the disease, and beg to attach a copy for your information. I was not satisfied with this report, as it proposed no remedial method, so I appointed a Committee under the Chairman- ship of the Honourable W. M. Vaudin, I.S.O., with the Chief Medical Officer, and Dr. Power, Assistant Medical Officer, as members, to make recommendations as to the best means of combating the disease, more particularly as regards the island of La Digue, where it is so very prevalent, and a copy of their report is attached.
3. It will be seen that the initial cost of the scheme recommended by the Committee would amount to £270-Rs.4,050, and the recurrent expenditure to £110 or Rs.1,650. This would be a heavy addition to our budget for 1915, and I am not at present in a position to say if the full sum could be found out of revenue. We might, however, make a commencement with La Digue, which would bring the initial cost to £60 or Rs.900, and upkeep to £60, a further Rs.900. I think we should be able to make provision for these amounts in the coming estimates.
4. The more I see of the island of Mahé the more I am impressed with the extreme difficulty, without a large expenditure of money and a considerable staff, to adequately supervise sanitary measures in the country districts. The Seychel- lois build their houses and buts in all sorts of small spaces cleared on clefts of rock, and almost invariably surrounded with dense jungle and undergrowth, Many are very difficult of access, which grows so luxuriantly in this climate.
high up on the hillsides or in small valleys, and for generations the people have been accustomed to defæcate in a haphazard way. Nearly all the people go about their daily avocations with bare feet, boots being only worn on ceremonial occa- sions, and the children play about with scanty clothing in close proximity to the soil. The people, too, are very impatient of any sanitary control, as they and their domestic pigs have for generations lived in close contact.
5. I should, indeed, be very grateful for any assistance as regards a work- able scheme from the International Health Committee to aid us in combating this disease, which has to my mind been overlooked for far too long.
I have, &c.,
C. R. M. O'BRIEN,
• No. 20.
Lieutenant-Colonel, Governor.
*No. 88 in Miscellaneous No. 304.
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