CO885-9 — Page 360

PUBLIC RECORD OFFICE

Reference :-

། ། ། ། ། ·། mwimminic... 885 /

9 PUBLIC RECORD OFFICE, LONDON

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

96

V.-CONSIDERATION OF PRECAUTIONARY AND PREVENTIVE METHODS.

Condition I. (See Table.)

The first condition, where the host (man) and the fly are present, exist now in this country in the "fly belts." There are three methods of dealing with the

case.

(1) To remove the villages from the "fly belts" into places where there is no fly. This would certainly be the most effective method of dealing with it, and especially applies to some of the places around Chienji.

64

"1

(2) To remove the “:

"fly as much as possible from contact with the host, for should an imported case of sleeping sickness settle in any village, the fewer the flies" present the less the danger of infection to others. That cleared areas round villages, &c., is effective may be seen at Kipaila, where the Belgians have built a Customs House.

In the cleared area a tsetse fly is rarely seen although the woods round about swarm with them and this place previously swarmed. The clearing is about 100 x 80 yards.

霄

(3) The careful and complete burning of the grass in "fly belts " must kill large numbers, not only of the fly itself, but of the pupae the reproduction of these flies is still uncertain. Colonel Bruce, R.A.M.C., has studied the matter in one species, but it is known that the method of reproduction varies in different species of the same genus in the Order Muscidae.

It was noticed that where the grass was burnt between Chienji and Sumbu "Blies" were scarce or absent in places where they are said to be present by Mr. Lyons and other observers. Again to the south of the Luapula District the same thing was observed.

Condition II.

This hardly requires consideration in regard to sleeping sickness. Other hosts than man appear not to be very susceptible. Should, of course, man be absent the infection of cattle, game, &c., might occur, and, if it did, there is no reason why men would not be re-infected again from them (see page 95). The solution of this would mean the destruction of domesticated animals and game in the region where the fly was infected.

Condition III.

Here the actual disease is to be dealt with as, for instance, an imported case in a district free from "fly."

(1) It has been suggested by Dr. Todd, in an article in the "Lancet," July 7th, 1906, that infected persons should be sent from uninfected parts to infected parts; certainly the immediate danger is removed, but if fly is present in the parts to which they are sent, it is simply like adding fuel to the fire.

(2) If they are sent where there is no fly there can be no danger-and I may speak from personal experience in Uganda. I had charge of a number of infected persons, they were kept together and fed and looked after until they died. There was no fly in the part where they were kept and there were no fresh cases.

(3) Destruction of the parasite by drugs, serums, &c. Only two have been found to be of any service in prolonging life and none have cured the disease. These two drugs are arsenic and trypanred.

Condition IV.

In this we have the worst condition possible-the condition that obtains in the endemic areas. The only course is to remove all infected persons to areas where there is no fly and quarantine the apparently healthy with them or the disease will continue. If this is done, then Condition II. would exist.

2. Drugs may be useful in destruction of parasite.

3. Measures for destruction of fly also might be of use.

VI.-RECOMMENDATIONS.

(1) That it be represented to the Congo authorities the great danger of recruiting their soldiers in infected areas and allowing them to be stationed in areas

97

quite free from the disease. This is undoubtedly the greatest cause of the spread of the disease.

(2) That a medical post should be established on the Luapula-the most con- venient place being Madona, for the following reasons:-It is the headquarters of the Agents of the Tanganyika Concessions, Limited, the Northern Copper, the African Lakes Corporation; it is the ferry for Kambove. It is the nearest point (5 hours by the Congo road) to Kasiwas and adjoining villages. Mweru can be reached quickly once a month by the Belgian steamer from Kasenga.

(3) That powers be given the Medical Officer to examine, detain or quarantine any persons coming from the Congo until he is satisfied that they are free from the disease.

(4) That a record be supplied to the Medical Officer of all natives returning from North-Eastern Rhodesia from the Congo Free State with their villages and chiefs.

and

(5) That some control be arranged regarding the ferry between Kasenga the British side-especially if cases of sleeping sickness are not removed.

(6) That all employers of labour, North-Eastern Rhodesia, be responsible that

all their labourers are certified by their medical officers to be healthy and have or have not been exposed to infection, as the case may be, when they return to this country.

(7) That the Medical Officer should ask the Congo Medical Officers to co-operate with him especially, at such places as Kasenga and Kasiwas.

(8) That the possibility of removal of certain villages in fly belts be considered, and, in the event of this not being practicable, the subject of clearing round about and careful and complete burning of the grass in these areas be considered. H. A. E. NOBLE, Fort Jameson,

44563

North-Eastern Rhodesia,

September 24, 1906.

No. 91.

District Surgeon.

MR. J. CATÉCART WASON, M.P., to COLONIAL OFFICE.

DEAR LORD ELGIN,

(Received December 3, 1906.) [Answered by No. 99.]

November 30, 1906.

I SHOULD be glad to know, without troubling you with Parliamentary questions, what has been done, or is under consideration, with reference to Entebbe, which is, and has been for some years, a distributing centre for the spread of sleeping sickness. I think Sir Harry Johnston admits that his selection of Entebbe as the capital was principally for strategic and defensive purposes; that reason has disappeared, and no reason now exists for its maintenance as the capital, except the extreme beauty of the situation, and the expense already incurred by the Government.

There is one point which has been very much lost sight of, and yet is of first class importance, and that is the deplorable water supply. The only method that all persons have of obtaining water for drinking and domestic purposes is by native carriers, who from morn to night are engaged in carrying water in pipkins and kerosene tins. Naturally they take water from the shallows of the lake; necessarily the water is polluted with excreta; consequently water, always a possible conduit pipe for disease, is at Entebbe an ever-present, ever-pressing danger. The Lake being the great breeding ground of the tsetse it is certain that sleeping sickness is spread by this method of conveying water.

Good water at Entebbe cannot possibly be obtained, except by erection of a somewhat costly steam-pumping plant, which would annually cost considerable sum for engineering and fuel, and would entail a capital expenditure of nearly £20,000. Kampala is the natural commercial capital. It is near, but not too near, the Lake. The restoration of the Canal could be easily effected, and would greatly improve both the health and prosperity of surrounding districts.

20376

N

Page 360Page 361

PUBLIC RECORD OFFICE

Reference :-

mathmini CO, 885

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

9 PUBLIC RECORD OFFICE, LONDON

96

V. CONSIDERATION OF Precautionary AND PREVENTIVE METHODS.

Condition I. (See Table.)

The first condition, where the host (man) and the fly are present, exist now in this country in the "fly belts." There are three methods of dealing with the

case.

(1) To remove the villages from the "fly belts" into places where there is no fly. This would certainly be the most effective method of dealing with it, and especially applies to some of the places around Chienji.

(2) To remove the "fly" as much as possible from contact with the host, for should an imported case of sleeping sickness settle in any village, the fewer the "flies" present the less the danger of infection to others. That cleared areas round villages, &c., is effective may be seen at Kipaila, where the Belgians have built a Customs House.

In the cleared area a tsetse fly is rarely seen although the woods round about swarm with them and this place previously swarmed. The clearing is about 100 x 80 yards.

(3) The careful and complete burning of the grass in "fly belts" must kill large numbers, not only of the fly itself, but of the pupae-the reproduction of these flies is still uncertain. Colonel Bruce, R.A.M.C., has studied the matter in one species, but it is known that the method of reproduction varies in different species of the same genus in the Order Muscidae.

It was noticed that where the grass was burnt between Chienji and Sumbu "Blies" were scarce or absent in places where they are said to be present by Mr. Lyons and other observers. Again to the south of the Luapula District the same thing was observed.

Condition II.

This hardly requires consideration in regard to sleeping sickness. Other hosts than man appear not to be very susceptible. Should, of course, man be absent the infection of cattle, game, &c., might occur, and, if it did, there is no reason why men would not be re-infected again from them (see page 95). The solution of this would mean the destruction of domesticated animals and game in the region where the fly was infected.

Condition III.

Here the actual disease is to be dealt with as, for instance, an imported case in a district free from "fly."

(1) It has been suggested by Dr. Todd, in an article in the "Lancet," July 7th, 1906, that infected persons should be sent from uninfected parts to infected parts; certainly the immediate danger is removed, but if fly is present in the parts to which they are sent, it is simply like adding fuel to the fire.

(2) If they are sent where there is no fly there can be no danger-and I may speak from personal experience in Uganda. I had charge of a number of infected persons, they were kept together and fed and looked after until they died. There was no fly in the part where they were kept and there were no fresh cases.

(3) Destruction of the parasite by drugs, serums, &c. found to be of any service in prolonging life and none have cured the disease. These Only two have been two drugs are arsenic and trypanred.

Condition IV.

In this we have the worst condition possible-the condition that obtains in the endemic areas. The only course is to remove all infected persons to areas where there is no fly and quarantine the apparently healthy with them or the disease will continue. If this is done, then Condition II. would exist.

2. Drugs may be useful in destruction of parasite.

3. Measures for destruction of fly also might be of use.

VI. RECOMMENDATIONS.

(1) That it be represented to the Congo authorities the great danger of recruiting their soldiers in infected areas and allowing them to be stationed in areas

97

quite free from the disease. This is undoubtedly the greatest cause of the spread of the disease.

(2) That a medical post should be established on the Luapula-the most con- venient place being Madona, for the following reasons:-It is the headquarters of the Agents of the Tanganyika Concessions, Limited, the Northern Copper, the African Lakes Corporation; it is the ferry for Kambove. It is the nearest point (5 hours by the Congo road) to Kasiwas and adjoining villages. Mweru can be reached quickly once a month by the Belgian steamer from Kasenga.

(3) That powers be given the Medical Officer to examine, detain or quarantine any persons coming from the Congo until he is satisfied that they are free from the disease.

(4) That a record be supplied to the Medical Officer of all natives returning from North-Eastern Rhodesia from the Congo Free State with their villages and chiefs.

(5) That some control be arranged regarding the ferry between Kasenga and the British side-especially if cases of sleeping sickness are not removed.

(6) That all employers of labour, North-Eastern Rhodesia, be responsible that all their labourers are certified by their medical officers to be healthy and have or have not been exposed to infection, as the case may be, when they return to this country.

(7) That the Medical Officer should ask the Congo Medical Officers to co-operate with him especially, at such places as Kasenga and Kasiwas.

(8) That the possibility of removal of certain villages in fly belts be considered, and, in the event of this not being practicable, the subject of clearing round about and careful and complete burning of the grass in these areas be considered. H. A. E. NOBLE,

Fort Jameson,

North-Eastern Rhodesia,

September 24, 1906.

44563

No. 91.

District Surgeon.

MR. J. CATHCART WASON, M.P., to COLONIAL OFFICE. (Received December 3, 1906.)

DEAR LORD ELGIN,

[Answered by No. 99.]

November 30, 1906.

I SHOULD be glad to know, without troubling you with Parliamentary questions, what has been done, or is under consideration, with reference to Entebbe, which is, and has been for some years, a distributing centre for the spread of sleeping sickness. I think Sir Harry Johnston admits that his selection of Entebbe as the capital was principally for strategic and defensive purposes; that reason has disappeared, and no reason now exists for its maintenance as the capital, except the extreme beauty of the situation, and the expense already incurred by the Government.

There is one point which has been very much lost sight of, and yet is of first class importance, and that is the deplorable water supply. The only method that all persons have of obtaining water for drinking and domestic purposes is by native carriers, who from morn to night are engaged in carrying water in pipkins and kerosene tins. Naturally they take water from the shallows of the lake; necessarily the water is polluted with excreta; consequently water, always a possible conduit pipe for disease, is at Entebbe an ever-present, ever-pressing danger. The Lake being the great breeding ground of the tsetse it is certain that sleeping sickness is spread by this method of conveying water.

Good water at Entebbe cannot possibly be obtained, except by erection of a somewhat costly steam-pumping plant, which would annually 'cost a considerable sum for engineering and fuel, and would entail a capital expenditure of nearly £20,000. Kampala is the natural commercial capital. It is near, but not too near, the Lake. The restoration of the Canal could be easily effected, and would greatly improve both the health and prosperity of surrounding districts.

20370

N