CO885-(23-24) — Page 650

PUBLIC RECORD OFFICE

Reference :-

། ། ། ། ། mmi mhimC.O. 885

24 PUBLIC RECORD OFFICE, LONDON

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

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3. The duties of microscopists and clerk are scheduled in the appendix.* 4. By headquarters is meant the offices of the Commission at Marine Villa, St. George's, which are open on weekdays from 9 a.m. to 3 p.m., except on Saturdays, when the hours are from 9 to 12 a.m.

5. For the purpose of obtaining convenient access to the people for treat-

ment and sanitation of premises the island is divided into

32 centres of location;

the centres are placed in

8 groups

with 4 centres in each.

One day in each successive week for three weeks is to be devoted to each

centre.

Four days a week will be occupied in field work; Monday and Saturday are reserved for office and laboratory work; and the head office, with a Medical Officer, clerk, and microscopist, is open all the time.

In six months the whole island will have been gone over once.

This includes Carriacou, to which it is intended to devote one month at a time, which month may be taken after Grenada is finished or inserted at any month otherwise convenient.

The arranging of the order of attack has been made according to the disease necessity of the districts as inferred from personal investiga- tion and the hospital and medical returns,

This infection necessity has also had to be co-ordinated with the exigencies

of travel and the distribution of population.

The groups as placed in appendix may require to be modified from time

to time.

The locations are meant in the main to be in the close neighbourhood of

the schools.

I claim for the grouping as it stands these points in its favour :—

I. It gives preference in order of infection.

II. It conveniently supplies the whole island.

III. It allows the whole island to be covered within reasonable time. IV. Adjacent locations are visited during the first campaign at different times, allowing, if necessary, double opportunity of attendance at a convenient location.

V. Six months is a reasonable time to allow between each series of

treatments before revisitation takes place.

VI. Revisitation takes place before enthusiasm has died down.

6. Method of Travelling :-

I suggest that the most economical means of arranging the visiting of the district locations is for the Commission to purchase (or hire) a pair of mules and tilted van.

The van should be capable of carrying the office staff; should convey the material for examination, lectures and demonstrations, litera- ture, etc.; should have accommodation for demonstration pur poses, for receiving patients, and for medical examination if required; should have a platform from which the people may be addressed; and have other items of accommodation not necessary here to detail.

7. Sanitary Inspection

One of the most important items in my scheme of operations is efficient inspection of the homes of all patients treated, so that the faulty conditions of their surroundings may be ascertained and pointed out; the means of alleviating them indicated; and assurance of something done obtained.

To accomplish this I shall give all the personal attention possible, but On the estimate of expendi- a capable assistant is necessary. ture--the allocation of which I presume is provisional and not verbally limited-there is set aside a sum to allow of three or four microscopists. Two are sufficient for actual microscope and demonstration work.

* Not transmitted to Colonial Office.

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I should like to use the funds available for the appointment of a man capable of the suaviter and fortiter necessary for such a position, and whom I should train to the duties of a Sanitary Inspector. 8. Sanitary Improvement:

(a) At the home:

--

It is my intention to bring about so far as possible that at the home of each person treated for ankylostomiasie a satisfactory closet ensuring safe disposal of excrement is erected.

In an appendix* are given my views definitely on the type of latrine

service capable of practically general use in the island.

The general sanitary condition of home and surroundings will also be

criticized.

(b) At the school:

The schools should be made an object lesson in sanitary matters, and I suggest that they be dealt with each on its own merits, so that desired improvement may be brought about in as far as funds permit.

At present there is in some cases evident attempt to conform to a satis- factory standard; but the system recently adopted allows too many loopholes for defective operation.

My suggestions individually in respect of the schools are in the main a counsel of perfection; and if finance stands in the way I am prepared to suggest modifications in cases, which should render less serious infection through the defective operations referred to. Every opportunity should be taken in the extension of water supply schemes to have water laid on at the schools; and where remote- ness from a supply and expense make this not feasible rain water might be collected, as is well done at Grand Roy and Mount Moritz. Teachers should be encouraged to set off a corner of the schoolroom for their own lavatory arrangements, and children made to use a standpipe in the playground for washing. A towel for children running about at school in the tropics is unnecessary.

The educational advantage of direct practical observation of cleanly

habits is invaluable.

(c) On estates:

There seems to be no difficulty in the matter of getting the question of latrine accommodation on estates economically and satisfactorily settled.

I propose to make it a personal matter to investigate and advise where

necessary.

9. Education will be attempted by

Demonstrations of material, diagrams, models, etc.

Lectures and lantern demonstrations preferably to small bodies, church

guilds, teachers, Sanitary Inspectors, and all interested. Leaflets some are prepared, others are in course of preparation and will be issued from time to time. These will as far as possible be read and explained. House to house visitation--by the Sanitary Assistant and by the Medical Officers. The educative and suasive force of getting at the people in their homes is the most effective of all sanitary

measures.

10. Medical men :-

I have seen most of the medical men in general practice in the island, and expect them all together to discuss the work on an early date. They are mostly District Medical Officers in the Government Service. The arrangements explained to them have been accepted as satis- factory, and any apprehensions indicated to me have been allayed.

* Not transmitted to Colonial Office.

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