CO885-9 — Page 366

PUBLIC RECORD OFFICE

Reference :-

།། ། ། ། ། mimimmiin.c.O. 885

9 PUBLIC RECORD OFFICE, LONDON

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

First ap-

pearance

of the disease in Uganda.

Sugges-

tions for

measures.

Proposals

102

undue danger to health, and with far less expense than would be involved by the removal of the seat of Government to Kampala.

I am, &c.,

47917

No. 100.

UGANDA.

R. L. ANTROBUS.

COMMISSIONER HESKETH BELL to THE EARL OF ELGIN.

(No. 218.) MY LORD,

(Received December 29, 1906.)

[Answered 28 March, 1907, No. 83 (47917).]

Government House, Entebbe, Uganda, November 23, 1906. In this despatch I beg leave to draw your Lordship's attention to the necessity for energetic action in connection with trypanosomiasis, the disease commonly known as "Sleeping Sickness," which is still decimating the population of this Protectorate.

2. It is almost unnecessary to say that the urgency of this problem was apparent to me as soon as I assumed the administration of this Government, and that it has been the subject of my most careful consideration. I was reluctant, however, to make any recommendations until I could feel that my local knowledge was sufficient to warrant their submission. and I only do so now in the belief that the views which I have formed are in complete accord with those of my medical advisers.

3. A short review of the history of this matter may not be out of place and afford some explanation of the various causes which have allowed this terrible disease to rage almost unchecked during the past five years.

may

4.

The source from whence sleeping sickness was originally imported into Uganda is a matter of doubt among experts, and while it is considered by some to have come from East Africa, it is more generally believed that it was introduced from the Congo basin and that it gradually made its way up along the western shores of the Victoria Nyanza. In July, 1901, Doctor Albert Cook, of the Church Missionary Society Hospital at Kampala, noted eight cases of a mysterious disease. Six months later he reported that over 200 natives had died of it in Buvuma, one of the islands on the Usoga shore, and that thousands appeared to be infected. Reports of the prevalence of the disease came in from all the districts bordering the lake shore and the mortality speedily reached an appalling degree. The malady resisted every kind of treatment and appeared to be universally fatal. Its causa- tion baffled the investigations of the local medical staff, and it began to be feared that the whole population might be doomed.

5. On the assumption that the disease was of a contagious character, Lord Lansdowne, in April, 1902, directed that all patients should be isolated with due preventive regard to the sentiments of the natives. The Uganda chiefs were requested to take the necessary steps, and some rather perfunctory attempts at segregation were made. The native population was not, in those days, under the degree of control which has since been exercised over them, and, in many cases, the attempts of the Government to adopt the proper measures were resented. The people of Buvuma declined to accept directions as to segregation, while the Baganda simply drove their sick into the bush there to die of starvation or to be devoured by wild animals. 6. In May, 1902, Colonel Sadler reported that over 20,000 people had died for a segre in Usoga alone and that the disease was spreading rapidly. Towards the close of that year, it was proposed to segregate all persons, suffering from sleeping sick- ness in one of the islands of the Sesse Group, and Buvu was chosen for the purpose. Colonel Sadler in a despatch to the Foreign Office gave details of the plan and esti- mated that an expenditure of £1,500 would be required for buildings and that the annual cost of the station for staff and maintenance would amount to about £5,200. He anticipated no reluctance on the part of the natives to send their sick to the island. It should be borne in mind that, when these recommendations were made, the disease was believed to be of an infectious or contagious character and it was hoped that the segregation of those affected would prevent the spread of the epidemic. Colonel Sadler's scheme received the approval of the Secretary of State

gation camp in one of the Sesse Islands.

103

and preliminary arrangements were being made for carrying it into effect, when he was informed that the Royal Society had offered to send out a Commission to enquire into and report on the disease. It was decided to await the arrival of the experts, and the preparations at Buvu were arrested. By the middle of 1902, the deaths from sleeping sickness numbered over 30,000, and in Usoga, Kyagwe, and the Sesse Islands the mortality was spreading with alarming rapidity.

Com-

7. In July, 1902, three medical officers, Doctors Low, Christy, and Castellani, Royal sent by the Royal Society, arrived in Uganda and at once commenced their inves- Society's tigations. A laboratory was placed at their disposal in Entebbe and every facility mission. was afforded to them for the bacteriological study of the disease. Towards the close of the year two of these gentlemen returned to England, but the services of Doctor Castellani, who appeared to be on the track of an important discovery, were retained for a further period of six months.

Bruce of

8. Through the instrumentality of the Royal Society, the services of Colonel Discovery Bruce were also enlisted for the investigation of sleeping sickness, and he arrived by Colonel in Uganda in February, 1903. On the 28th of April he announced that he con- the agency sidered the disease to be due to a kind of trypanosome conveyed by the Glossina of the palpalis, a species of tsetse fly. This announcement indicated that Europeans tsetse fly. could no longer consider themselves immune from infection, and caused much con- sternation. Tsetse flies abounded to such an extent along the whole of the lake shore that any attempts at their wholesale destruction appeared to be hopeless. The theory propounded by Colonel Bruce was strongly supported by the fact that the disease was almost everywhere confined to the localities infested by the fly, and there was every reason to believe that any cases which were found in places further inland, had been contracted by the victims during visits to the lake shore. The fly-belt could be defined with considerable precision and the area of danger was rarely found to exceed a depth of more than a mile or two from water.

9. It was soon ascertained that tsetse flies specially favoured places where there was abundant shade, and that they swarmed wherever large trees hung over the water. It was suggested that the elimination of the conditions favoured by Sugges the flies might result in driving them away, and experiments in that direction the elimin- were carried out along the foreshore of 'Entebbe, The results were most satis- ation of factory, and in a few months the European settlement was practically, freed from the tsetee tsetse flies.

fly.

10. Unfortunately, the shore along the whole of the northern coast of Lake Victoria is bordered by a dense forest growth, and the cost of clearing is so great that operations on a very large scale appeared to be impracticable. In order to drive away the fly completely it would not only be necessary to cut down the forest, but also to remove all bush and to keep the land perfectly clean. The resources at the disposal of the authorities only permitted of such work being done on a compara- tively small scale, and, during 1903 and 1904 it was restricted to the immediate vicinity of Entebbe.

11.

tions for

the disease.

Colonel Bruce's discovery seems, for a time, to have almost paralized all Progress of cfforts at repressing the spread of the disease among the natives. The people abso- lutely refused to leave the fly-infested localities on the lake shore and displayed a remarkable fatalism. Buvu, the island selected for the segregation camp, was found, like all others of the Sesse Group, to be swarming with tsetses, and all idea of carrying out the original scheme seems to have been abandoned. In the mean- time, the disease raged unchecked. By the end of 1903 the deaths numbered over 90,000, and the lake shores were fast becoming depopulated. Whole villages were completely exterminated, and great tracts in Usoga, which had formerly been famed for their high state of cultivation, relapsed into scrub and forest.

12. During 1902 a hospital, or more properly speaking, a refuge, for those afflicted with sleeping sickness was established by the "White Fathers" Mission at a spot called Kisubi, about 10 miles from Entebbe. Even at the time when the disease was believed to be highly infectious, these missionaries collected as many of the sufferers as their means permitted them to maintain, and nursed them with much devotion. Various remedies were fried, but all without avail, and every single patient perished. During the last four years the White Fathers have maintained White an average of nearly a hundred inmates in their refuge, and a pathetic commentary Mission on their work is the fact that their cemetery contains over 500 graves, of which Refuge. 256 were filled this year. During the last two years the mission has received from

Fathers