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PUBLIC RECORD OFFICE

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PUBLIC RECORD OFFICE, LONDON

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

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circular despatch, dated 17th November, 1900, was laid before the General Board of Health on the 8th January, 1901, when it was resolved that it "be printed and distributed to Government Medical Officers, wardens, and owners or managers of sugar and cocoa estates for their guidance."

II. Copies of this memorandum were distributed in accordance with this resolu- tion during March, 1901.

III. A copy of the special malaria number of the "Practitioner " has been pre- sented to every medical man in active practice in the Colony.

IV. Copies of the chart, "Malaria, its cause and prevention," drawn up by Dr. Manson, C.M.G., which accompanied the circular despatch dated 20th April, 1801, have been distributed to the wardens and other public officers in the country to be posted for exhibition, accompanied by a circular, No. 6496/1900, containing specific instructions for dealing with pools of stagnant water.

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V. After careful consideration I beg to submit the following observations on the suggestions of the Committee, contained in the circular despatch dated 20th April, 1901, which have reference to local conditions, and would at the outset state that in my opinion, in this Colony, the rational prevention of malaria will be more certainly obtained by the diffusion of the facts of the dependence of the spread of malaria on the mosquito than by the carrying out of special experiments, and the measures detailed above have been adopted with this end in view.

(A) The value of the suggestion contained in (A) of the circular despatch is borne out by local experience and the necessity for its adoption is insisted on whenever opportunity offers.

(B) Suggestions (B), (C), (D) are dealt with in the memorandum, drawn up by Sir Michael Foster (vide paragraph I.), which has been widely distributed.

(c) Suggestion (E) has been given effect to, and the method adopted (vide paragraph IV.) is calculated to bring it into wide and general notice.

(D) Suggestions (F) and (G) are closely allied. I am, however, of opinion that no practical demonstration of any value can be undertaken unless systematic experiments are carried out, and as I have stated in (30) this would entail the appointment of some officer or officers to devote themselves exclusively to this work.

A practical test might, however, be attempted when a suitable opportunity offers of building mosquito-proof quarters in a notoriously malarious district.

VI. I would remark in this connection that malaria, though very prevalent in this Colony, is usually of a benign type. During the ten years 1891-1900, of 130,610 admissions to the Colonial and District Hospitals, 17,915 were cases of malarial fever, giving a proportion of 1 case of malarial fever to 7.29 of all diseases treated.

During the last three years malarial fevers have been differentiated at the Colonial Hospital, Port-of-Spain, as to type, and the cases treated give a proportion of 1 malignant to 10 benign cases. The severer forms of malarial infection, such as blackwater fever, are of rare occurrence.

The mortality returns for the Island of "Trinidad taken from the annual reports of the Registrar-General for the ten years 1891-1900 show that the mortality from malarial fever has declined from 3.67 in 1891 to 2.11 per 1,000 in 1899. In 1900 the rate was 2.227 per 1,000 (vide chart).

March 20, 1902.

15717

SIR,

No. 82.

J. A. DE WOLF,

Surgeon-General.

FOREIGN OFFICE to COLONIAL OFFICE.

(Received April 24, 1902.)

Foreign Office, April 22, 1902. WITH reference to your letter of the 18th of May last,* I am directed by the Secretary of State for Foreign Affairs to transmit to you, to be laid before the Secre-

• 15261: not printed.,

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tary of State for the Colonies, the accompanying copy of Reports on the subject of the Prevention of Malaria, by the Medical Officers of the British Central Africa Protectorate, together with a copy of a letter from Dr. Ronald Ross, giving his views thereon.

ŠIR,

(B. 250.)

I am, &c.,

CLEMENT LL. HILL.

Enclosure 1 in No. 82.

Medical Headquarters, Zomba, December 5, 1901. In reply to the suggestions of the Right Honourable J. Chamberlain's Malaria Committee, I have the honour to enclose to you the reports of two of the Medical Officers to whom, as requested, I forwarded copies of the Circular.

My own comments on the nine suggestions are as follows:-

(a.) "That all new buildings, as far as possible, and with due regard to expense, be located away from native quarters, clear of jungle, at a distance from stagnant waters, and, where possible on high ground." The Committee's opinion on this is to the point. All the important and permanent stations have now got their various buildings erected, and it would be a great expense to shift them, although in the near vicinity of a number of stations which are now in unhealthy sites there are places where they could be transferred to if such a course was called for. Failing the transference of these stations these places could be used as sanatoria for frequent temporary residence.

Where, in the following remarks, mention is made of a sanatorium, I will use the word as meaning a properly constructed residence in the healthiest procurable site, and in reasonable proximity, to which officials can resort to recuperate lost energies after illness, or which can be available for frequent occupation for rest and change from work amidst the less healthy surroundings and situation of the Station.

I some time ago went into the question of the sites about to be mentioned with a view to sanatoria and, though I have not personal knowledge of them all, the Chief Surveyor and other officials whom I have been in communication with to the description given.

agree

(1.) Chiromo. This station, apart from the question of native quarters, is a very hot and unhealthy one. During the hot and rainy season, the additional moist vapours from the two rivers, and the absence of any breezes, make it a most enervating place. Residence in this station predisposes to sickness composed as its population is, of young men in the prime of life, who go there in a healthy condition, the sick and death rates are abnormally high; there are very few residents there who do not suffer from fever, anaemia or cachexia, and the myriads of mosquitoes which are also there, and are hopelessly ineradicable make it one where a better residential site would be most beneficial to the officials. From the nature of the work (Customs, &c.), the offices would always have to be on the riverside, but, in order to give the officials a comparatively healthy residence at no great distance, there is a good site on the other side of the Shire River, four miles away, at the Namalambo Hill, which has the Tangasi River flowing past it. This hill is almost a thousand feet high, but flattens out, and the ground is suitable for houses at 700 feet high. A gradual ascent commences about two miles from the riverside, and there are very few natives at present round this site. A week-end residence could easily be made here, and it might not be impracticable for any officials (who were in need of change)—to live there, and attend at the offices daily.

(2.) Port Herald.-A new house for the official carrying on the work of this station has been built on the Nyamaseri River. The official who is stationed there finds the elevation (1,500 feet to 2,000 feet) has made this post a much more healthy one than it used to be when the house was about a quarter of a mile from the river bank, and at an elevation of about ten feet above the river.

(3.) Chikwawa.-The same remarks with regard to extreme heat and moisture and mosquitoes in Chiromo, apply to this station. Very few officials are able to stand it. Severe cases of fever have occurred there, and it has a bad reputation for Blackwater fever. A suitable site for a sanatorium for frequent use would be on the hills in the vicinity of the Likabula River, where, only about four or five miles away, an elevation of 2,000 feet is available. The native villages are nearly all on the Shire River; only very few are round this site. The surrounding ground is thickly wooded