133
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The mangrove swamp was intersected by a narrow road running up from the coast to Klang, some five miles away.
:
In the year 1897, a strip of mangrove jungle was felled and work was com- menced by the contractor for the wharves and the Government employees engaged in the construction of the railway, which was continued from Klang to the new anchorage.
While these works were being carried out, the coolies, who were quartered in temporary huts raised above the swamp on wooden piles, suffered occasionally from fever, but no very marked outbreak occurred.
The railway bank running parallel with the shore, as well as the approaches to the wharves and houses, were constructed of earth brought from some miles up the line. In this way a considerable extent of land was partly shut off from the sea and in process of time large shallow pools were formed by rain water* which remained stagnant, the sea water no longer spreading over the land with each rising tide.
As the work on the new port approached completion the cases of fever occur- ring among the labour force increased both in number and severity.
On September 15th, 1901, the port was opened, and was named Port Swetten- ham. Almost immediately afterwards it was noticed that the cases of malaria had increased in number to an alarming extent. Almost the whole of the labour force was attacked, many severe cases also occurring among the crews of the ships lying alongside the wharves.
Of 133 persons living in Government quarters 80 suffered from malaria between September 15th and November 26th.
Of 27 temporary shop houses with 127 inmates, no less than 78 persons, living in 25 of the shops, contracted the disease during the same period.
Some 80 coolies were admitted to hospital with fever and of these eight died.
The types of fever as diagnosed by means of the microscope were as follows:-
Malignant (æstivo autumnal)
Benign Tertian
Mixed Benign Tertian and Malignant
No cases of Quartan fever were observed.
72.5 per cent.
25.5 per cent. 2 per cent.
An examination of blocked drains and shallow pools along the whole of the sea front and by the side of the road revealed large numbers of both Anopheles and Culex larvæ.
The very serious nature of the outbreak having been fully represented to Govern- ment by the Medical Department, a Commission, consisting of three medical men and three civil engineers, was appointed to advise Government as to the best means of improving the sanitary condition of Port Swettenham:
The first meeting of the Commission was held on November 18th, 1901, and tne following recommendations were subsequently made:-
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1. That an extent of about 150 acres of the mangrove jungle be felled and cleared.
2. That levels be carefully taken over the whole of the surroundings of the port.
3. That the space which it was proposed to lay out as a township be divided into four sections, each of these sections being protected by bunds or banks raised to a height of fifteen inches above high flood level. That each section be provided with one or more main drains and necessary subsidiary drains. The outlet ends of the main drains to consist of iron pipes fitted with flap-valves, which, while per- mitting water to flow out of the drains into the sea at low tide, would be automati- cally closed by the rising tide, so as to prevent water passing up the drains on to the protected area.
4. That all low-lying ground and disused drains be filled up and levelled with earth brought by rail from up country.
The recommendations of the Commission were at once acted upon by Govern- ment, and the various works were put in hand without delay. In the meantime, all pools known to contain mosquito larvæ were regularly sprinkled with crude kero- sine oil, applied by coolies with watering cans.
The majority of the coolies working at the port were given a daily dose of 10 grains of quinine as a prophylactic.
* The annual rainfall in the Klang district averages about 100 inches.
By December 10th, Dr. Watson, Surgeon in charge of the district and a member of the Commission, was able to report a marked improvement in the health of the coolies.
SANITARY WORKS CARRIED OUT AT KLANG TOWN.
The prevalence of malarial fever and the urgent need for sanitary improve- ments in the town of Klang were represented to Government early in the year 1901, by means of a most able and convincing report by Dr. Watson, who showed that Anopheles larvæ were to be found in almost every pool and drain in the town, while at the same time the number of cases of malarial fever occurring among the inhabi- tants had increased to an alarming extent.
Sanction having been obtained for the necessary expenditure, a large main drain, with a tidal flap, was constructed, and a carefully-planned system of subsidiary drains connected with it, all pools and low-lying swamps being at the same time filled in with earth brought from the neighbouring hills.
RESULTS OF SANITARY WORK.
The result of the measures taken to improve the health of Klang and Port Swettenham has been most striking, as may be seen from the following figures:—
CASES OF MALARIA TREATED AT THE DISTRICT HOSPITAL, KLANG.
1900
1901
1902
Date.
In-patients.
Out-patients.
Total.
467
737
1,204
807
965
1,772
364
403
767
The above figures show a marked reduction in the number of cases admitted to hospital from the whole of the Klang district.
The following statement relating to the town of Klang and Port Swettenham only is, however, still more remarkable.
NUMBER OF CASES OF MALARIAL FEVER ADMITTED TO HOSPITAL FROM KLANG TOWN AND PORT SWETTENHAM DURING THE MONTHS OF OCTOBER, NOVEMBER AND DECEMBER, 1901 AND 1902.
Klang.
Port Swottenham.
Month.
1901.
1902.
1901.
1902.
October
November
December
Total
24
8
34
3
56
2
79
3
36
1
23
9
116
11
136
15
During the year 1901, 52 deaths occurred among malarial cases admitted to the District Hospital from Port Swettenham and Klang town.
During the year 1902, only nine deaths occurred among cases of malaria ad- mitted from these stations.
The following return is of special interest as showing that while in the town of Klang and Port Swettenham malaria has decreased to a remarkable extent, in other parts of the district there has been a slight increase in the number of cases.
CASES OF MALARIA ADMITTED TO THE DISTRICT HOSPITAL.
From Klang Town and Port Swettenham From rest of Klang district
1901. 1902.
· 610
197
199
202
PUBLIC RECORD OFFICE
Reference :-
1111C.O.885
TH
7
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
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