CO885-24 — Page 464

PUBLIC RECORD OFFICE

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C.O. 885

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24 PUBLIC RECORD OFFICE, LONDON

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To prevent soil pollution, which should be the first step in the control of anky- lostomiasis, we should have:-

(a) A regulation, with penalty for non-observance, requiring the construction and use of suitable latrines at all dwellings in villages, barracks, public institutions (including schools), places of business, factories, etc. (b) A regulation requiring each individual, property owner, or resident within the area to keep his or her premises in a cleanly and sanitary condition by the proper disposal of all refuse, and to secure free drain- age by keeping all drains, gutters, and ditches open. This regulation should also apply to all Government property, schools, street drains, gutters, and roadside ditches within or near towns and villages. (c) A regulation requiring all bush," weeds, and unnecessary vegetation to be kept cleared away on all premises, along all drains, gutters, and roadside ditches within and near towns and villages.

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It then follows that a system of inspection, and a corps for the enforcement of these regulations, is necessary.

Various schemes for the organization of an adequate sanitary force have been tried, with indifferent success, and it has become quite evident to me, from experi- ence and observation, that it is impossible to secure proper inspection, and even a reasonably rigid enforcement of sanitary laws, where such matters are left entirely in the hands of county or parochial boards.

The only really effective sanitary forces that I have seen in operation have been those who had at their head a trained sanitarian, responsible alone to the Colonial Government, who could and would enforce regulations without fear or favour. Under this chief sanitary officer were assistants, often locally trained, bat kept up to the mark by the active supervision of their superior officer. A chief sanitary officer can be had from the Sanitary Institution in London for a reasonable salary.

One of the advantages of an intensive campaign against ankylostomiasis is that, since the area in which operations begin is small, a small sanitary force only is necessary in the beginning, and can be added to as the campaign progressES.

In securing the enforcement of sanitary regulations it is sometimes necessary to use a certain degree of compulsion, and for this reason it is best to keep the sanitary forces distinct and separate from the eradication campaign, where the utmost good will and the voluntary co-operation of the people are essential to

success.

We should not lose sight of the great educational value of these campaigns, where public lectures on sanitation, illustrated with magic lantern views, are delivered to the people, and where house-to-house instructions are given.

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In a recent report from British Guiana, in a district where a cosmopolitan and illiterate population complicated the problem, at the end of the second month of the campaign 50 per cent. of the entire population had voluntarily installed and were using pit latrines and observing other precautions necessary to prevent the spread of ankylostomiasis. In the same report we find several villages volun- tarily assuming the payment of the salary of a Sanitary Inspector because of the very evident value of his services to them.

suitable latrines." By this is meant any Reference was made above to latrine which effectually prevents the eggs of the ankylostome in the excreta from reaching the soil under conditions which will allow them to batch, and the larvæ afterwards to come in contact with their human victims. There are many types of latrines which will accomplish this purpose, but the one type which seems the most suitable for our purpose is the simplest form of pit latrine, because of its small initial cost and its simplicity and effectiveness in operation. This latrine consists of a pit in the ground, of varying dimensions, not less than 3 or 4 feet. in depth, without concrete or other lining, with a fly-proof seat, the opening of which has a hinged cover which remains open only when occupied.

When the latrine is intended for the use of East Indians the seat should be dispensed with, and the covering should consist of the fly-proof “squatting plat- forin," as these people will not use a seat.

In

Care should be taken to prevent the surface water from getting into the pit, by providing proper drainage and by banking up the earth around the cover. addition to the seat or squatting platform a light superstructure, preferably of The wall of this sheet iron, with roof of same material, should be provided. superstructure should project 10 or 12 inches beyond the surface dimensions of

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the pit itself to prevent rain from beating in and finding its way by seepage into the pit. When the pit becomes filled with "night soil" to within a foot or so of the surface another one is excavated and the cover and superstructure are moved to it, and the old pit filled with earth.

Hundreds of these pit latrines are in daily use in British Guiana and the United States, and are proving entirely satisfactory.

In certain localities where the soil is porous and the water supply is derived from shallow wells, the danger of water pollution from these pits may necessitate the use of the pail latrine, in which case a very careful weekly inspection is neces- sary to keep them in good condition.

After a suitable type of latrine is selected, the important question of location remains. I have seen in other colonies and in Jamaica latrines of a fairly good type located so far from the homes or barracks, and in such inaccessible places, that they were not used. They should be so located and of sufficient number to supply convenient accommodation for both sexes, night and day, and in all weather.

In supplying proper latrines to indentured labour, which, I believe, is one of the general regulations governing the importation of coolies," the pit latrine with the "squatting platform" is ideal, and it has been found much better to have a number of small ones conveniently located than to have one large one for each sex, The statement that "the East Indian will not use any type of latrine" is not borne out by our experience in British Guiana and Trinidad, where hundreds are in daily use by the coolies. Many planters dig pits in their fields for the use of their labourers while at work, placing two planks, parallel with each other, across the mouth of the pit. It was this type of latrine which I found being used by the coolies on the Amity Hall Estate, and this was the only instance where I found any evidence of the use of latrines by the indentured labour of Jamaica. manager and headman were both concerning themselves about the matter, as they should, and with good results. The practice adopted by some managers, to impose a fine of one shilling on the individual caught defecating on the ground, has been of great help.

The

I am submitting herewith a pamphlet, "Publication No. 8,"* in which are given in detail the various steps and procedures followed in British Guiana and other colonies, and which will apply equally as well to Jamaica.

As indicated above, and in this pamphlet (Chapter X., Sanitary Measures for Prevention), it is left to the Government to undertake to inaugurate such sanitary changes and improvements" in the areas of operation as will reduce the danger of reinfection to a minimum.

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All "remedial agencies" are financed by the International Health Commission, except that in most cases the Government furnishes the drugs, and supplies all printing, record books, etc. (see pamphlet, Chapter VII., Financial Procedures). Further details on the point have been discussed with Dr. Ker.

To enable us to proceed further with the details of a campaign of eradication in Jamaica I will ask you to kindly indicate in your reply to this communication:— (1) To what extent is your Government prepared to secure the enforcement.

of the necessary sanitary regulations in the areas of operation!

(2) To select a definite area or district for the initial campaign, about which

it will be necessary to have the following information :-

Approximate length and breadth, and square mileage.

(b) Population, and its distribution in towns, villages, and rural popu-

lation as to race.

(c) Topography of district as it affects the question of transportation

of the force engaged.

(d) Approximate per cent. of ankylostome infection.

Upon the receipt of the information a definite annual budget can then be prepared and submitted.

Thanking your Honour for the courtesies shown me while in Jamaica and awaiting the further pleasure of your Government in this matter, I beg to remain,

Your, &c.,

H. H. HOWARD, M.D., Director for the West Indies.

To His Honour

The Colonial Secretary, Kingston, Jamaica.

E 2

* Not reprinted.