Report of the Tuberculosis Commission : presented to both Houses of Parliament by command of His Excellency the Governor-General.

  • South Africa. Tuberculosis Commission.
Date:
1914
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Licence: In copyright

Credit: Report of the Tuberculosis Commission : presented to both Houses of Parliament by command of His Excellency the Governor-General. Source: Wellcome Collection.

    23/390 (page 17)
    time of, or as soon as possible after their admission to a public elementary school, and on such other occasions as the Board of Education directs, and the power 1s conferred to make approved arrangements for attending to the health and physical ecndition of the children. Provision is also made for vacation schools, vacation classes and play centres. Under these powers the systematic periodical medical examination of children is being conducted, and the diseases and defects so discovered are being treated and remedied in school clinics; and children suffering under special disabilities or from certain complaints are drafted to appropriate schools or institutions. Chief among the latter, from our present point of view, is the tuberculosis or open-air school. Also the cleansing of children and the disinfection of their clothing is being carried out and their general conditions of cleanliness improved. While a further resulting advantage has been the teaching of hygiene in schools. To a very great extent South Africa has remained behind in these advances. This has largely been due, we believe, to the rapid expansion of the demand for elementary education entailing an enormous increase in State expenditure, and the consequent great difficulties the several education departments have experienced in merely meeting and financing increased educational requirements, without entering upon measures for dealing with the physical well-being of the increasing number of scholars. CHAPTER III. Tur Present Posttion oF TuBERCULOSIS PREVENTION IN SoutTH AFRICA. CoNCLUSIONS. 44, Having thus briefly reviewed the development of anti-tuberculosis measures in other countries, it is necessary to see what is the present position in regard to tuberculosis prevention in South Africa, and what have been the circumstances which led up to the appointment of the present Commission. Such a survey is of importance, as it will serve to indicate the attitude of local bodies and the general public in the matter of the adoption of preventive measures, and the extent of public co-operation in them that may be expected, as without such co-operation any measures which could be devised would be ineffective. In the Cape Province. 45. It is mainly to agitation in the Province of the Cape, where tuberculosis is of longest standing and widest distribution, that the present Commission owes its origin. It was not, however, until a registration of births and deaths came into force in that Colony, in Januarv, 1895, that the subject began to attract public attention. Up to then but little reference was made to it in official health reports of the time. In the annual reports rendered to the Cape Government by District Surgeons practically nothing regarding it is to be found. In 1893 Dr. T. N. G. te Water, then District Surgeon of Graaff-Reinet, observes that ‘‘ Phthisis among natives is on the increase”’; and in the same year Dr. J. Brown, District Surgeon of Sutherland, says, ‘“ Phthisis, which occurs entirely amongst the natives, is on the increase. It is impossible to say the number of cases in the district.’” But even such passing comment as this was rare. As soon, however, as mortality figures became available by the registration of deaths, the extent of the evil became apparent, and we find Dr. Gregory in his Annual Report on the Health of the Colony for the year 1896, making forcible reference to it. ‘The excessive mortality arising in the chief towns from this cause is worthy of very serious attention. It appears that it is the coloured popu- lation that chiefly suffers from this scourge. So far as the European population is concerned we are very much better situated here than in England and Wales. Moreover, the death-rate among Europeans does not legitimately belong to our own population, much of it being due to deaths of phthisical persons coming to the Colony for relief from the disease. This fact becomes still more evident if the death-rate for the several towns of the Colony are examined separately, for it is chiefly among those which we know to be usuallv selected for residence by the phthisical immigrant that the bulk of the mortality among Europeans occurs. Thus the European death-rate from tuberculosis is in Cradock 6-24, in Beaufort West 7-86 and in Aliwal North. 6-21 per thousand. The cause, however, of the large amount of tubercle occurring among the Coloured population is obscure, but there is no.doubt that overcrowding in insanitary dwellings plays a leading part in the spread of the disease. In the case of many towns in which we know that conditions of overcrowding among the Coloured inhabitants exists to a large [U.G04 14. | . C