PUBLIC RECORD OFFICE
Reference :-
wwimmtm C.O. 885
24 PUBLIC RECORD OFFICE, LONDON
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11. When we first started there was a general appreciation of the free treat- ment, intermingled with some suspicions aroused from the financial state of the Colony; it was short of funds and increased taxation was being discussed; they looked on us as agents of the Government to find out who could be taxed; this almost became a certainty in their minds as we numbered their houses in our process of census-making. A little later another idea began to permeate. They thought Mr. Rockefeller had given a large amount of money to help the black labourers, and that This ran as a certain sum was to be given to each person that took the medicine. high as five shillings a head; many refused to take the treatment if they did not receive the money, and even went as far as accusing the staff of themselves pocketing it.
In a
I fancy this idea was begotten of the improvement in their general health after a first treatment, when the appetite went up in leaps and bounds; and they openly objected to subsequent doses as they had not the means to feed themselves. valley with innumerable bread fruit trees this improvement in appetite was expressed in terms of the numbers of bread fruit one could eat at one meal after treatment.
12. It was unfortunate that at the start of the campaign the containers had not arrived from New York, and there was some delay in getting examinations. A small supply was borrowed from Grenada. Luckily the International Health Com- mission allowed us 20 lbs. of thymol, which we used in capsules bought locally. Cap- sules filled with thymol ordered by cable from Parke, Davis & Company were only supplied four months after the cable. Towards the end of the second quarter I had to fall back on beta-naphthol or suspend the campaign. The dosage of thymol used was a maximum of 40 grains for adults, in two doses of 20 grains each.
13. One of the most obstinate factors in the progressive treatment was the natural teadency of procrastination of the native; he keeps on putting off taking his dosages. If the patient is very ill and quite incapable of doing any work owing to the intense degree of infection. he will, as a rule, take his first dosage quite quickly Luckily this stage of infection is by no means common. The percentage of infec- tion is high, but the degree of infection slight or just sufficient to render the patient less capable of earning a full wage. He is, therefore, less desirous of sacrificing a day's pay, small though it is, and we were driven to utilize Sundays more than I had thought would be likely. A general public holiday was. at times, useful; but any thing of the nature of an ecclesiastical festival was fatal to our work, and there seem to have been an exceptional number of such festivals during the first quarter. If heavy rain fell on the evening when the first dose of salts was to be taken that was another excuse for delay. No house has a privy, and many have no accommo- dation in the form of "pot chambre "; consequently, it is unfair to drive your patient to tramp in the rain and wet to deposit his excreta in the grass behind his house, where he may again infect himself a few days later.
14. The number who have actually refused either examination or treatment is relatively small. The greatest objecters to examination have been among the white people, who, though possibly free of infection, are too modest or proud to have the fact definitely known. Some of the blacks who have refused treatment after examination have told us that they have no intention of getting rid of any worms they may have inside them, that this kind of treatment did not exist when they were younger, and there can be no necessity for it now. "There is no fool like an old fool.' A very typical case of this kind is the baker attached to the factory pro- vision shop, an old man of about 65, whose mother and father were true-bred Africans. Definitely infected with hookworm, of the most filthy habits, I cannot imagine a more fruitful source of oral infection if such a manner of infection exists. With unwashed hands he kneads the dough and handles the loaves after they are baked, with his hands in the same unwashed state after his morning call in the grass behind the oven.
It has not often happened that persons have directly refused because they would not forgo their tot of rum. nor have there been any accidents through taking of alcohol during the treatment. Rum is extensively used through the valley even where there are no licensed retailers; hucksters make a tidy sum by carrying their bottles in baskets around the habitations. I have not observed any sign descriptive of the contents of the bottles, as the "bay leaf" was formerly used in St. Vincent to designate "mountain dew."
15 The migratory habit is not noticeable among the barrack-rooms, chiefly at Crown Lands and Soucis. I personally did the field work at Soucis, and was struck at the frequent changing of locality among the labourers there. There were no
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deaths at this settlement, but during a period of ten weeks no less than 22 out of 188 ceased to reside in the barrack, and a further ten could not be induced to take the treatment; none of these, it is true, so heavily infected as to incapacitate notice- ably their wage-earnings.
16. For the purpose of classification I have separated the non-cures, apart from those who have left the locality or have refused treatment, into two classes- those who have taken three treatments or more and those who have not had three treatments. In a large percentage we are in need of re-examination after treat- If all the re-examinations had been possible the actual number of cures would. I am sure, have been greater. Already since I have left the area I have had the opportunity of re-examining two cases that had been under treatment and are now residing in the present area of work, and found both free of infection.
ment.
In Table 6 it will be noticed that a large number are classified as not having taken three treatments. This is not due to any direct abandonment on their part, but to the fact that three months does not appear long enough in which to overcome the procrastinations of the native. It must be remembered that the work of the first quarter was extended into the second quarter.
17. There are five primary schools in the area. Those at Ciceron and Bexon are attended only by children from the area in which we worked; those at Forestière and La Croix Maingot tap areas outside our sphere. The Forestière school is almost entirely attended by East Indians. The schools are mixed, boys and girls. In not one was there any latrine accommodation for the children. I am glad to say a latrine has been now erected at Forestière, but unfortunately there is not enough careful provision made for keeping it clean.
The
18.
The expenditure of each quarter has been well within its budget. start of the hookworm campaign began too late in 1914; expenses incurred then and brought forward to 1915 have had to be met from the budget of these two quarters. This gives an apparent increase of expenditure over face value of these budgets.
19. Our experience leads us to the opinion that it is harder to eradicate hook- worm from the East Indian than from the native West Indian. When we first worked in the valley it was general to find the East Indian, when not actually at work, squatting in the sunshine, avoiding places of shade. This, they explained to us, was because they always felt cold. Soon after treatment we found them taking the shade places to rest in. At both Soucis and Crown Lands the poor relief grant among the factory labourers hitherto too ill and feeble to work has appreciably diminished.
The result of the first six months' campaign has, I maintain, been satisfactory. As the work is backed by legislation and further education, we will arrive in a short time, I hope, in a condition when soil contamination, even with a West Indian peasantry, will be an impossibility and the general sanitation of the island consider- ably improved.
I have, &c.,
STANLEY BRanch, Medical Officer, Hookworm Campaign.
Table 1.
Classification showing Infection per age, sex, and race in area worked during the First Quarter, 1915.
While.
Under 5 years.
Race.
Male.
Female.
5 to 15 years.
Malo.
16 to 60 years.
Over 50 years.
Total.
Female.
Malo.
Female.
Male.
Female.
│11
1
2
9
|
~ | |
|
***
3
23
I
8
===
!
Census Examined Infected...
Coloured,
Censu
114
106
201
199
429
504
21
19 1593
Examined
112
103
206
200
426
490
18
10
Infected...
26
23
178
157
430
429
2
15
1565 1260
East Indian.
Census Examined Infected...
21
18
45
42
104
87
21
17
45
42
103
87
4
43
30
90
76
22
444
00+
**
222
00:00 -
8
329
8
325
7
2
259
C 2
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