Annual medical and sanitary report / Uganda Protectorate.

  • Uganda Protectorate. Medical Department.
Date:
[1918]
Catalogue details

Licence: Public Domain Mark

Credit: Annual medical and sanitary report / Uganda Protectorate. Source: Wellcome Collection.

    24/46 (page 24)
    The result of the above tour indicates the need for more Medical Officers to deal with epidemics. In Teso and Bukedi there are District Medical Officers but their duties confine them to a great extent to their stations, and they cannot be always on tour. Smallpox and Vaccination. Smallpox.—The inferior lymph and the inadequate Medical Staff, as predicted last year, has failed to check the spread of smallpox in many parts of the Protectorate and a heavy death rate has been the result. The main focus of the disease was at Bombo which was attacked in November, 1917, and by April, 1918, had become the centre of a severe epidemic. A large training depot had been established here with above 2,000 recruits and outside the cantonment were several settlements of discharged soldiers and families of men at the front, so that altogether about 5,000 people were concentrated in about 5 square miles. In the early stages of the outbreak cases were concealed in these settlements and therefore the cantonment boundary was extended to include these and bring them under military control. A cordon of strong military pickets was formed round the boundary through which no one was allowed without a permit from the Medical Officer, but in spite of this the disease not only spread into the surrounding district but many rejected recruits carried it to their homes in outlying parts of the Protectorate or fell sick on the way. Later these were quarantined in a special camp for 16 days before leaving the cordon. All persons within the cordon were vaccinated but the Medical Officer in charge reports that not more than 10% showed a typical vesicle: this low percentage cannot in this case be ascribed to faulty technique; the Military Medical Staff was increased to cope with the epidemic and all possible precautions taken to prevent error. A large camp under civil control, under the direction of Dr. Collyns, was established outside Bombo where sick and direct contacts from the Depot as well as natives from the surrounding country were collected. An outer cordon enclosing a large tract of country round Bombo was established under civil control to enforce the Rules under the Infectious Diseases Ordinances, but in spite of this the smallpox spread into the adjoining district round Kampala and also to the branch Military Depot at Entebbe. The thickly populated districts in the Eastern and Northern Provinces all suffered severely from smallpox. In the Chua District the District Commissioner reported that the natives practised smallpox inoculation which spread the disease until it. was checked. Vaccination.—A certain amount of lymph which was obtained from Daressalaam gave good results but the Nairobi lymph continued to be unsatisfactory and some batches appeared to be entirely negative. It was reported that successive series of arm to arm vaccinations had improved the quality of the lymph in some instances. I therefore advised that this should be given a further trial, but it was difficult to obtain a primary vesicle. Dr. C. H. Marshall reported that at Mbale he had failed to get a single typical vesicle in some thousands of vaccinations performed by him personally. It was decided not to enforce universal vaccination until a reliable lymph could be obtained so as to avoid spreading the mistrust of its prophylactic value which natives have displayed. Col. A. Balfour, c.b., c.m.g., who made enquiries on the vaccinations on his way through the Protectorate gave his opinion that the failure was greatly due to faults in technique in vaccination performed by Native Vaccinators. That the work of the men who are sent to remote places with little chance of supervision becomes faulty is admitted. But the poor results of vaccination done by unquestionable hands justifies the opinion that the fault lies with the material rather than with the agent.