124
2. For the other two members of the Commission we have selected (1) Dr. Samuel T. Darling, of the Isthmian Canal Service, who, as you may know, made an enviable reputation for himself with General Gorgas in the Canal Zone, and (2) Dr. Marshall Barber, of the Bureau of Science at Manila, Philippine Isles. Dr. Barber has done good scientific work in the Philippines, and seems well qualified for the work of this Commission.
3. Dr. Darling has just reached New York from Panama, and Dr. Barber is expected to arrive on the 17th. It is hoped that they will be ready to sail for Singa- pore on 21st April via England and the Suez Canal. I shall ask Dr. Darling to call upon you in London so that you may have personal acquaintance with the American members of the Commission, in whose work you will be interested.
Mr. H. R. Cowell,
Colonial Office,
20700
(No. 127.) SIR,
London, England.
No. 95.
Very sincerely yours,
WICKLIFFE ROSE.
LEEWARD ISLANDS.
THE GOVERNOR to THE SECRETARY OF STATE.
(Received 3rd May, 1915.)
[Answered by No. 101.]
Government House, 8th April, 1915.
I HAVE the honour to forward, herewith, six copies of a useful and interest- ing report by Mr. E. S. Marshall, M.R.C.S., detailing the results of the investiga- tion which he made last year into the alleged prevalence of ankylostomiasis in Antigua.
2 It appears that the disease is prevalent to a serious extent, but that its incidence varies much in the several districts of the island. In areas where a lime. stone formation prevails, and where the drainage is good, the disease affects the people so slightly as to be almost negligible. In the central plain, where a heavy clay soil predominates, Dr. Marshall found a fairly high rate of infection, while in the volcanic areas, where the soil is rich and vegetation abundant, more than 50 per cent, of the people were found to be the hosts of hookworm.
3. Dr. Marshall attributes the spread of ankylostomiasis to the "entire absence of sanitary laws or regulations" and to the dirty habits of the Antiguan negro. 4. It is, in the first place, hardly correct to say that sanitary laws and regu- lations do not exist in Antigua. There are, on the contrary, several laws bearing on the subject, but the necessary machinery for enforcing their provisions has always been more or less ineffective or absent. The personal habits of the average Antiguan negro are certainly dirty, and his disregard for even the elements of It must be borne in sanitary requirements is as notorious as it is lamentable.
mind, however, that there is nothing to show that he has become worse than he used to be in this respect, and it is the general opinion that his carelessness as regards the disposal of focal matter is no greater now than it was when he came from Africa several generations ago.
5. It appears also to be difficult to say, with any certainty, whether ankylosto miasis has spread or increased in these islands of late years, or whether the propor- tion of infection now found among the people may not be the same as that which existed fifty years ago. The conditions in which they live are much the same. their personal habits have not varied, climatic conditions have not changed, and I find it difficult to see why this particular disease should be more prevalent among the coloured folk now than it used to be.
6. The main points, however, appear to be beyond a doubt. It is certain that a large proportion of our labouring population is infected by a disease; that that disease militates against their economic usefulness; and that it lowers their vitality and general well-being. It appears also to have been proved that this disease call easily be eradicated and that very satisfactory results have followed the steps which have been taken in that direction in other countries.
* Not reprinted.
125
7. I consider, therefore, that every practicable effort should be made to carry out the main recommendations contained in Dr. Marshall's report. The members of my Executive Council are, however, strongly averse to the compulsory treatment of persons affected by hookworm, and I agree with them. Anything in the nature of compulsion is likely to have a very undesirable effect on the labouring classes, especially at the present moment, when war has raised the price of all food and has increased the poverty of the people. We cannot afford, at this stage, to give a handle to malcontents or to do anything which might unsettle the labouring
classes.
8. Dr. Howard, the West Indian Director of the Rockefeller Health Com- mission, who recently conducted an experimental campaign against ankylostomiasis in British Guiana, visited Antigua in November last and informed me that he did not consider compulsory measures to be necessary. He recommended that the three villages of Bolans, Jennings, and Roses, in which a large proportion of the inhabi- tants are affected by hookworm, should be taken as an experimental ground, and that the people of that area should be used to illustrate what could be effected later on throughout the island.
9. The details of this experimental campaign have recently been fully dis- cussed with Dr. Howard, and the International Health Commission has approved of the plan of action and of the budget which has been drawn up.
10. I attach a copy of the estimates of expenditure, as supplied by Dr. Howard, The and -it will be seen that the outlay will be on a scale of about £1,450 a year. medical officer, or "Field Director as he is to be called, will be supplied by the International Health Commission, and it is hoped that trained microscopists may be obtained from British Guiana. This Government has agreed to enforce special and adequate sanitary measures in the villages which are to be dealt with and to provide latrines for the persons who are too poor to make the necessary arrange- ments. It is hoped that the scheme will be in full working order by the end of the current month, if not before.
11. It is almost unnecessary to say that everything will be done to assist the interesting and valuable experiment which is about to be made and that the people of this Presidency duly appreciate the generous intentions of the International Health Commission.
I have, &c.,
H. HESKETH BELL,
Governor.
Enclosure 2 in No. 95.
10th March, 1915.
BUDGET FOR Eradication OF ANKYLOSTOMIASIS IN AREA No. 1, Antigua. Staff :-
(2) Actual travelling expenses not to
(1) Field Director
$3,000.00
exceed
600.00
(3) Two microscopists at $40.00 month
per
($80.00)
960.00
(4) Two nurses at $25.00 (850.00)
600.00
(5) Two assistant nurses at $12.50 per
month ($25.00)
300.00
(6) One caretaker at $7.00 per month
84.00
$5,544.00
27.50
75.00
25.00
65.00
2.50
100.00
Equipment:-
(7) One camera
(8) One typewriter
(9) One centrifuge and accessories
(10) One magic lantern and accessories (11) One hookworm chart
(12) Office furniture and utensils
(13) Laboratory outfit already purchased
by Dr. Marshall
295.00
1
PUBLIC RECORD OFFICE
Reference :-
C.O. 885
24 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
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