34 



SLEEPING SICKNESS IN THE ANOLO-EGYl'TIAN SUDAN 



l^xaniiimtion 

 if Natives 



Sleeping 

 Sickness in 

 the I. ado 



Search for 

 western and 

 northern 

 limit of the 

 disease 



Of Natircs living enfirehj in the Eahr-El-Ghazal , Captain Drew cxaiiiiiiiid 1400; of 

 this iiuinbor, 271 had onlarf^ed cervical j^lands attributable to one cause or anotlier. 



The routine method of examination consisted of gland palpation, examination of 

 fresh and stained blood films, and gland puncture. 



WluMi no obvious cause of gland enlargement was observed, an examination of the 

 fresh l)loi)d was made, altogether 130 blood examinations being carried out; in no case 

 were trypanosomes found or auto-agglutination noted. 



Seventy-three persons coming to the Bahr-El-Ghazal from the French Congo and 

 detained in the Quarantine Camps were also examined. Fifty were merchants and their 

 servants, and twenty-three were natives desiring to settle in the Bahr-El-Ghazal. 



Blood examinations were made in each case and all found negative, except two of 

 the latter in which auto-agglutination was noted^one, an Arab, was obviously in the 

 last stage of sleeping sickness, the other an apparently healthy man with the exception 

 of some enlargement of the glands, and mental dulness. Trypanosomes were, however, 

 found in the gland juice. 



By the terms of an agreement with the Belgian Government, the Lado was 

 taken over by the Sudan Government in Juno, 1910, and a Commission, of which Captain 

 Colin Mackenzie, D.S.O., E.A.M.C, attached to the Egyptian Army, was a member, left 

 Khartoum on April 14 for this purpose. 



It was known that sleeping sickness existed in the Lado, and Captain Mackenzie 

 was ordered, as far as time and circumstances permitted, to ascertain to what extent 

 the disease was pi-evalent in the Yei Valley and other parts of the country. He was 

 met on arrival by El Yousbashi Yusef Effendi Dervish, Medical Corps, E.A., who 

 liad been stationed at Mongalla for some time previously, and who had sent 

 valuable information to Headquarters, which ho had collected from various sources, 

 of the amount of the disease in the Lado. This Medical Officer was sent ahead by 

 Captain Mackenzie to Yei on May 16 to meet Dr. Errara, the Belgian Medical Officer 

 of the Lado, and ascertain from him particulars of the various cases already known 

 at and around the post. These cases were then to be brought before Captain Mackenzie 

 on the arrival of the Commission at Yei in order that he might satisfy himself as to the 

 diagnosis, before the occupation of Yei and Kagelu Posts camo up for decision. 



Captain Mackenzie met Dr. Errara personally, later, and was informed by him that 

 sleeping sickness had existed in the Lado for over two years and that he had reported 

 the matter to his Government. 



On June 8, at Yei, Captain Mackenzie found Dervish Effendi had collected fifteen 

 cases of sleeping sickness, in eight of which he found trypanosomes, the remainder had 

 been treated with atoxyl. Most of these people came from Wata and Lajuba, and eight 

 of them were women or children. The women do most of the water-carrying, and 

 probably were infected when drawing water from the river: "All seemed to take the 

 greatest delight in having their cervical glands punctured, even the children siiowing no 

 signs of fear ! " 



Dr. Errara also stated that, according to native reports, sleeping sickness exists far 

 north in the Yei Valley, and, with a view of ascertaining the western and northern limits 

 of the disease and of G. palpalis, Captain Mackenzie, after leaving Yei, proceeded to 

 Libogo on the frontier, thence along the Congo watershed until the head waters of 

 the River Tor were reached. He followed down the course of tliis river to Fudl-il-Mula, 

 near Kapei on the River Yei, and next proceeded northwards to Waringua, Beringis 

 village near Wandi, which was found infected. From Waringua, he next marched east, 



