:{2 



SLEEl'INO SICKNKSS IN TlIK ANGIiO-KOYl' TIAN SIDAN 



C;ises 



rffKirtccl from 

 tliu Western 

 l!:ihr-i;i- 

 Ghazal 



Qiiaraminc 

 Ordinance 



Clearing of 

 river banks 



tho Yei llivur route to llie Bahr-El-Ghazal from the Lado, and the Nile route from 

 Uganda, can bo controlled by Inspection Posts at M'volo and Mongalla respectively, and 

 measures were at once taken to have Medical Ofiicers stationed at each of these places 

 for that purpose. 



Beyond rumours (alluded to in Captain Anderson's report) of sleeping sickness in the 

 Liido, and information obtained through the courtesy of Dr. Errara, of the Belgian 

 (iovurnment Service, nothing further was heard of sleeping sickness in the southern Sudan 

 until October, I'JO'J, when the Senior Medical Officer, Bahr-El-Ghazal, wired, saying that 

 the Medical Ollicer at Ragaa had reported that there were some suspected cases at that 

 station, which is near the western boundary of the above-named Province. He asked 

 permission to proceed and investigate, and for the services of the British Medical Officer 

 engaged on sleeping sickness work. Captain C. M. Drew, R.A.M.C., attached to the 

 Egyptain Army, was despatched to the western Bahr-El-Ghazal in December, 1909, and 

 Captain (now Major) Ensor, D.S.O., R.A.M.C., who was going to the Bahr-El-Ghazal 

 as S.M.O. in i-elief of Major Carroll, accompanied liim. 



Both Officers were appointed members of the Sudan Sleeping Sickness Commission. 

 Captain Drew was ordered to visit as much as possible of the western Bahr-El-Ghazal and 

 to enquire into the prevalence of sleeping sickness, to map out fly areas, and to devise 

 measures for the prevention of a possible invasion of the disease from the infected districts 

 of the French Congo. 



Major Carroll and Captain Ensor met at W'au and, in consultation, sent in 

 reconnnendations as to the precautions that were necessary with regard to traders, porters, 

 and other persons crossing the frontier, which were embodied in an Ordinance whereby 

 all porters are stopped at the frontier posts and turned back, animal transport being used 

 to convey the goods subsequently. 



By reference to Figs. 6 and 7 it will be observed that Isolation Camps have been 

 established at Ragaa and Dem Zubeir, and Inspection Posts on the main trade routes from 

 the French Congo to the Sudan, viz., at Dem Zubeir, Sabun and Said Buldas respectively. 



This scheme of quarantine has been found to deal adequately with the supervision 

 of all classes except refugees. All the merchants and the majority of the natives use the 

 roads, but the refugees make their way through the forests and avoid the posts. The only 

 way of detecting and dealing with them is to insist on the Sheikhs and Sultans bringing all 

 new-comers to their villages to the Government Posts for medical examination, after having 

 been thoroughly warned of the danger of harbouring such people. This arrangement has 

 been carried out and has been the means of detecting one case of sleeping sickness. 



In addition to the above methods, clearing the fords of palj)alis-ha,unted khors on 

 the main road from Wau to Katia Kiugi (roughly 400 miles) was carried out, and extensive 

 clearing done at the Quarantine Camps at Ragaa and Dem Zubeir, and the Inspection 

 Posts at Biri and Said Buldas. The banks of the river at Ragaa were cleared for about 

 three miles, and, 300 yards back, similar extensive clearing was carried out at Said Buldas 

 — these clearing operations will be carried out twice a year, in future, by local arrangement. 



DiscovKKY OF Sleepinu Sicic.VESs Cases in the Wksteun Bahu-El-Ghazal 



Only two cases of sleeping sickness were found by Captain Drew at Ragaa, although 

 it is thought likely that a few cases had already terminated fatally before he got there. 

 They wore all in natives who had come from the French Congo, the two positive cases 

 being found among natives wiio had been detained in the Quarantine Camp by order of 

 Major Carroll. 



