1909] on the Campaign against Malaria. 611 



"West Africa. An ill-judged and ill-conducted experiment at Mian 

 Mir has done much to paralyse all efforts in this direction, and I 

 gathered that anti-malarial campaigns were not popular among 

 certain officials. Neither the Indian Grovernment nor the Medical 

 Services can be congratulated on the result. 



Some years ago the Secretary of State for the Colonies issued a 

 circular to the Governors of Crown Colonies asking for information 

 as to what had been done in each against malaria and other mosquito- 

 borne diseases, and statements on the matter from twenty- one 

 Colonies were published in the Report of the Advisory Committee 

 of the Tropical Diseases Research Fund for 1907. I have criticised 

 these statements in detail elsewhere. Only those furnished by seven 

 Colonies, namely, Southern Rhodesia, Papua, Mauritius, British 

 Central Africa, Gambia, Ceylon, and Southern Nigeria, showed 

 evidence of any real interest in the matter. Those from Bahamas, 

 Barbadoes, Jamaica and St. Kitts-Nevis showed, to my mind, nothing 

 but neglect of public duty, while those from Northern Nigeria, St. 

 Lucia, British Honduras, Grenada, Somaliland, Straits Settlements, 

 and Sierra Leone gave no decisive evidence of the result. 



For a number of years I have had very good opportunities of 

 learning the truth as to what is really being done in many of these, 

 and other, dependencies. It may generally be summed up in two 

 words — very little. Festering pools which might have been cleared 

 years ago for a few shillings or pounds are left in the heart of 

 important towns to poison all around them ; quinine prophylaxis is 

 neglected, and house-screening forgotten. Few efforts are made even 

 to estimate the local distribution of the disease, much less to organise 

 any serious efforts against it, although it may be causing, perhaps, 

 half the sickness in the place. 



Want of funds is always an excuse which is urged, and is always 

 a false excuse. Much can be done at almost no expense, and the 

 men who have actually carried out the work successfully in Panama, 

 Ismailia, the Federated Malay States and Italy have expressly declared 

 the cheapness of it. Many a town could be kept clear of malaria for 

 the amount, say, of the salary of a single European official. I 

 estimate that a sixth of the medical and sanitary budget should 

 generally suffice to reduce a disease which often causes half the 

 sickness. But instead of doing really useful work which would 

 benefit everyone, the authorities too often fritter away their funds 

 on trifling schemes. I maintain that the health of the people has 

 the first claim on the public purse. 



Another excuse is that the possibility of preventing malaria has 

 not been proved ; but when one questions the sceptics one generally 

 finds that they have not troubled to study the literature. 



The fact is, that the neglect of which I complain is due to quite 

 other causes. I do not think that, as a rule, the blame is to be attached 

 to the rank and file of the medical profession in the tropics. Men on 



