CO885-(23-24) — Page 648

PUBLIC RECORD OFFICE

Reference :-

TELCO. 885

24 PUBLIC RECORD OFFICE, LONDON

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

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The six parishes of the island form suitable units of population for general administrative purposes; and for operations directed to attracting the people to convenient centres there is no doubt that the schools throughout the island afford natural centres around which the population is grouped.

Without labouring the figures in detail, I may say that a study of the census returns of 1911 and of the roll records of the schools, taken along with knowledge of the situation of the schools and the location of the dwellings in their neighbour- bood, fully justifies any arrangement of the population for practical purposes according to school areas.

The employment of the people may be said to be practically entirely agricul- tural; their work mainly seasonal employment on estates, and continued work on their own gardens or small holdings. Only a few estates retain barrack buildings for housing their permanent labouring staff and families; on some estates permanent labourers are housed in cottages scattered throughout the estate with certain more or less liberal allowance for garden cultivation of their own; but the large majority of the agricultural population live on their own holdings.

Purely urban conditions may be said scarcely to exist, for rural conditions intimately affect the habits of life even in the small towns.

The people are housed mainly in thatched or shingled timber cottages and in the out-of-the-way districts, possibly amongst the poorer classes, small thatched huts of daub and wattle are frequent. Ventilation is generally allowed for, though by night it is rarely taken advantage of; overcrowding is frequent, and in many

cases must be intense.

Latrine accommodation is practically absent throughout the island except in the towns and in the homes of the better classes. Amongst the people the bush, the cornfield, the cacao patch, at large, or sometimes in a restricted spot, are the common latrine. The use of the wayside for this purpose is remarkable by its rarity in some parts and frequency in others. In seaside communities special Ordinances control disposal in the sea, and the domestic situation in the day time between permitted hours is lamentable.

Of domestic animals the pig, dog, and chicken are most common; the ass and goat are not in great evidence. Disease amongst domestic animals, to judge from casual observation and hearsay, is common,

The health of the people is good on the whole; the returns of the Registrar- General indicate a death rate low compared with the average death rate of tropical communities. The deaths from intestinal diseases account yearly for one third of the total death rate. Otherwise amongst children serious sickness, as well as minor ailments, are not in excess. Skin troubles are well known; "chauffé" being a general term for eczematous and pustular affections. Domestic convenience, the demand for the children to work in the fields in sowing and cropping seasons, to go to market, etc., affects school attendance more than illness in childhood.

The customs, prejudices, and superstitions of the people are in no wise greatly different from those of the native population in other parts of the West Indies. Customs are based on imitation, tradition, and convenience. Supersti- tion exists to probably no greater extent than amongst the rustic population of any part of the world, although the visitor amongst strange peoples makes more of it for Press and romance purposes, not having studied the similar conditions at his own door.

I find the native as I have found him elsewhere in the West Indies-open- minded, ready to learn and imitate, willing to obey if he sees the right of it, but sensitive to any suggestion of oppression.

The East Indians in the island are few and of long residence.

II. Conditions Favouring the Occurrence of Ankylostomiasis, Crudely speaking, Grenada may be said to be an ideal forcing house of the ankylostoma.

The high mean temperature; the narrow range; the humidity; the nature of the soil over a large part of the island; the type of cultivation, dense cacao growth through whose leafy roof the sun's rays barely filter, and the habits of man, make perfect conditions for the development and spread of ankylostomiasis.

At the same time, I am of opinion that there are favourable points also in the nature of the soil which can be taken advantage of.

The result of a casual record of the anæmia indicator of ankylostomiasis amongst school children gives evidence of more intense and more widespread infec- tion amongst the children residing in districts where the soil and subsoil is of a

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porous, sandy nature, than where the heavy clay prevails. The physical explanation of this is simple and need not be discussed here.

Again, the analysis of the last hundred cases recorded as ankylostomiasis at the Colony Hospital gives fifty from St. George and twenty-five from St. John, which are parishies containing probably more open soil than the rest of the parishes, from which only twenty-five cases are recorded. This indicates greater facility of ankylostoma eradication in the large area of the island where the clay is under cultivation.

As things are at present, however, this favourable factor of soil, while it would give good results on large estates, is discounted by the large number of small holdings on the clay, on which the cultivation of ankylostoma may well be termed intensive.

From careful survey and study of the conditions of labour and cultivation on the large estates, I am satisfied that the chances of infection thereon are infini- tesimal compared with the chances of infection on the grounds of the peasant proprietor.

Independent of the soil and subsoil factor per se, the almost absolute absence of any latrine service throughout the island is the root factor in the causation and spread of ankylostomiasis.

Infection is got from polluted soil, either by entry of the worm at a certain stage of its existence through the skin (the people naturally go barefoot), or into the stomach on fruit, vegetables, or in water.

Skin infection from polluted soil is regarded as the usual mode of infection. But the conditions here are such that it would be surprising if infection from water, As yet my investigations have not either by skin or stomach, were not_common.

definitely established the common mode of local infection.

It is evident that in the absence of latrine accommodation defecation takes place on the soil; and on small holdings where families are large and there prevails a belief in the manurial value of the human fæces the amount of soil pollution is extreme.

The difference is evident to the senses between the estate and the small hold- ing. One may ride or walk for miles through the paths in a large cocoa planta- tion with pleasure to every sense from the natural surroundings; but too frequently in passing by the small-holder's patch of cocoa and corn under the morning sun the In the one case there fæcal odour exhaled therefrom is disagreeably evident.

is routine manuring of the soil with human fæces, in the other there is but scattered pollution from casual defæcation of labourers.

Towns of any size are small, and the conditions are little less rural than in the actual country. The absence of latrine accommodation is frequent; yards are soiled evidently by adult as well as by child; the pail system of closet is carelessly handled, disposal too often being made on the surface of the ground instead of in a pit, on the foreshore instead of in the sea; pit closets are rare, water closets rarer still. Without by any means implying carelessness over other communities, it is evident that with ankylostomiasis present the absence of latrine accommodation makes certain the opportunity for its maintenance and dissemination.

The opportunities afforded in public conveniences by local authorities are in different places suitable and ample, but a few public conveniences cannot supply a universal domestic need.

While the conditions at home are thus favourable to the spread of infection amongst the children, it is worth consideration whether the conditions at school are much more favourable, and in this relation I shall summarize briefly my findings in regard to fifty-one elementary schools recently visited.

On the whole it may safely be said that the school buildings are well situated, most of them on elevations overlooking the sea or a stretch of country, well venti- There are some exceptions, lated, and supplied with suitable open space around.

which are specifically pointed out in the appendix, where the situation is ill chosen, ventilation is deficient, and the building is closed in by bush or plantation.

Probably most of the schools are built on the deep red clay formation, as St. Paul's, Crochu, Pomme Rose, etc.; some are upon "tiff" or schistose or sandy soil, as Mount Moritz, Happy Hill, and Woburn; and a few are placed amongst the boulder débris on the clay, as Beaulieu and Belmont. I shall later emphasize the importance of the nature of the subsoil.

I found only a few schools where advantage was being taken of holding classes in the open; and, as practically all the schools consist of one room, it is