PUBLIC RECORD OFFICE
Reference :-
C.O.885
7
PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC» COPYRIGHT PHOTOGRAPH-NOT TO
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One may venture to remark that the best means of preventing the continuation of malarial fever and other mosquito-borne diseases is by the annihilation of the insect concerned with their spread. This is quite possible at Kismayu. We have an ill- watered district, a sandy soil, a cleanly African people, brackish wells, and an active police force. (1) By establishing local regulations enforcing the weekly cleaning of the wells, and offering the alternative to obstructive owners of closing them down; (2) By frequent inspection, of houses, their contained utensils, and their private wells (where such exist); (3) By treating malarial fever as a specific infectious disease (which it is) and enforcing notification and isolation of affected persons during the attacks and for some time after; (4) And, by the destruction of all cesspools, pools of stagnant water, and unused wells, I believe and trust that a future generation will grow up free from malaria and this mosquito-borne disease, so long as they continue to reside at Kismayu.
While endeavouring to carry out the above, the European official must not be unmindful of his own retainers' peculiarities. The kitchen and adjoining ground should be inspected daily, and all accumulation of water more than sufficient for the day's requirements should be forbidden. The constant emptying of pails in one spot leads finally to the formation of pools of stagnant water, and might well be discouraged. The attention of the house-boy should be directed towards the necessity of sweeping and dusting all things daily, leaving no sheltered spot unexplored. I have noticed mosquitoes (the anopheles variety) in houses at Yonte taking advantage of any cover where they might rest during the day undisturbed. Sunshine and ventilation should be freely taken advantage of. African servants require constant supervision, and an implicit trust in them leads not only to discomfort, but actual illness at times (e.g., Pulex penetrans).
Finally, in the devising of means based on known data whereby future generations of protecting Europeans and objecting Africans may be ridden of a scourge, the unhappy, infected official of the present seems to have become forgotten. When one thinks of the numbers within the past few years who have been invalided or died, and considers that malarial infection has, to an appreciable degree, been concerned in their physical downfall, it may not be presumptuous to remark that Government might dis- play a reasonable selfishness in promoting investigation directed towards an elucidation of some method whereby infected public servants might be freed from their burthen. Loss of memory, deafness, mental irritability, failing vision, anæmia, eczema, phle- bitis, nephritis, splenitis, hepatitis, polysarcia, neuralgia, and devitalised tissues are surely not desirable in the European official resident for any time in a malarial country and therefore experienced in the duties of his position. A striking instance of the far-reaching effects of the disease came under my notice some years ago in a home hospital. The patient, a sailor employed on the Trinity Lights steamer, was brought in suffering from a comminuted fracture of the right tibia sustained while his ship was entering dock. The limb was put up in the usual way. He informed us, when inquir- ing into his previous history, that he had had a severe attack of malarial fever in British Guiana some twenty years before. In the course of time it was noticed that there was no attempt at union on the part of the fractured bone. All possible surgical causes had been eliminated during the course of more than one close investigation. Finally, after some six or eight weeks, he was placed on a mixture of liq. arsen, hyd. and quin. sulph. Within a short period callus began to form, and some two months subsequently the patient was up and about.
Another instance may be quoted, to wit, that of a man who came to hospital suffering from bronchitis. Years before he had been resident in a malarial country and had become infected. All ordinary remedies absolutely failed, and the patient. finally recovered under the administration of mixt. quin.
Recently I had a case under my care, an Ashari, whose right humerus had been fractured in an encounter with a crocodile at Mfudu. Although a certain amount of callus was formed, the fracture did not become firmly united until acid. arsen. had been administered for some weeks.
Many other instances of a like kind might be placed on record. The above, how- ever, are sufficient to indicate the influence of malarial infection over other forms of disease and injury.
The East African Protectorate is happy in the possession of uninfected uplands in the Ukamba Province, which might well be used for the recuperation of coast officials whose healths have been impaired by fever. Their presence might be taken advantage of either (1) by the establishment of a sanatorium, (2) by the granting of two months'
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privilege leave yearly to officials resident on the coast (who are, as far as I know, all infected), or, (3) by a yearly "general post." To the last may be urged the objection that it is desirable that officials should gain the confidence of tribes with whom they have official dealings by means of permanent residence among them. To this, however, one may respond, in all humility, that the fitness of an official for promotion might well be dependent on the variety of his experience; otherwise, his advancement must necessarily be confined to the province wherein he finds himself stationed.
I have sent more than one European on sick leave to the Ukamba Province and with the happiest results.
October 27, 1901.
Dr. HARAN to Dr. MACDONALD.
J. A. HARAN,
Medical Officer.
SIR,
Kismayu, November 3, 1901. I HAVE the honour to acknowledge the receipt of your letter of the 22nd October, 1901. I have already posted Memorandum of the 27th October, 1901, together with a Report on Kismayu, and am at present engaged in making a similar Report on Yonte. With regard to the former I have the honour to request that you will convey to His Majesty's Commissioner the intelligence that I have just discovered anopheles' larvæ in a disused stagnant pool situated within the borne of a house belonging to the Somali Yusuf Husein. Having secured specimens of the water and the larvæ therein, I filled in the pool. On microscopic examination I found larvæ both of anopheles and culicida. This is the only pool in which I have yet found them. I await the advent of the rains to enable me to make further observations, as I noticed at Yonte that anopheles entirely disappeared during the dry season.
Up to the present I have been engaged in inspection of used wells and in the filling in of all unused wells, pools, tanks, and cesspits.
I have, &c.,
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No. 81.
TRINIDAD.
2
J. A. HARAN,
Medical Officer.
GOVERNOR SIR C. A. MOLONEY to MR. CHAMBERLAIN.
(No. 111.)
SIR,
(Received April 11, 1902.)
Government House, March 24, 1902.
REFERRING to your circular despatch of the 20th of April last,* I have the honour to transmit, herewith, a copy of a report by the Surgeon-General on the subject of the connection of malarial fever with mosquitoes.
I have, &c.,
ALFRED MOLONEY,
Governor.\
Enclosure in No. 81.
REPORT by the SURGEON-GENERAL.
HONOURABLE COLONIAL SECRETARY,
I HAVE the honour to report on the action which has been taken with regard
to the circular despatches from the Secretary of State on the subject of the connec tion of malarial fever with mosquitoes.
I. The memorandum "On measures to be taken for the prevention of malaria," drawn up by Sir Michael Foster, K.C.B., F.R.S., M.P., which accompanied the
• No. 11.
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