38 



SLKHriNO SICKNESS IN TIIF, ANOLO-EOYl'TIAN SLM).\N 



Uifticullies 

 on the 

 souihprn 

 fronlior 



In the soiitli tlioic is a long line of fiontiur where the Bahr-El-Ghazal adjoins tlie 

 Congo Free Stiito, tlie houndary line heing the Nile and Congo Kiver watersheds, where, 

 owing to the physical conditions obtaining, any methods of prevention would appear next 

 to impossible. The country is densely wooded, there are no main trade routes, merely 

 small native paths through the jungle ; the rains last for nine months of the year (March to 

 November) and are the chief hindrance to inter-cominunication. Owing to the flooding 

 of swamps and roads and the rapid growth of tropical vegetation which they cause, 

 any inter-tribal communication taking place daring tlie dry season is prevented. This 

 district, moreover, is reported to be now thinly populated, so that short of an emigration 

 northwards of a whole tribe en niamso to escape from sleeping sickness in the Congo 

 Free State (as suggested by Captain Ensor, in his 1907-8 report) the danger on this 

 boundary does not appear to be an imminent one. It is hoped, however, sliould the 

 services of Captain Drew be available later, to send liirn along tliis boundary in order 

 to collect more definite information as to the present condition of affairs. 



Clearing 

 nieasuri'S 

 adopted 



Numl»cr of 

 cases under 

 sur\cillance 



Additional Note 



Since writing the above I have made a tour of inspection in tlie Lado accompanied 

 by Captain R. G. Archibald, E.A.M.C., of the Wellcome Tropical Research Laboratories, 

 Khartoum, and visited the Sleeping Sickness area. 



I found an immense amount of work had been accomplished by Captain R. J. C. 

 Thomp.son, R.A.M.C., and the two Egyptian Medical Officers, Mulazimin Awal Nesib Eff 

 Haddad and Nesib Eff Bas, who are assisting him. 



The majority of the kliors between Loka and Yei, where they cross the Automobile 

 Road, have been rendered fly-free. 



The banks of the River Yei, for a distance of over three miles in the vicinity of Yei 

 itself, have been thoroughly cleared of all vegetation. (Fig. 10.) During my stay of 

 five days in Yei not a single flj' could be found, unless an excursion was made on to 

 the uncleared river bank, where there were plenty of palpalis in evidence. In addition to 

 tiiis, much clearing of vegetation, and drainage, have been carried out in and around Yei itself. 



Kagelu Government Farm, some six miles west of Yei on the Automobile Road, has 

 also been rendered fiy-free. 



Many of the villages in the sleeping sickness area have been dealt with, tools have been 

 lent to the various Sultans and Sheikhs, and they have been encouraged to clear all trees 

 and undergrowth from the neighbourhood of watering places. 



At Yei, Captain Thompson has built an Isolation Camp and a good hospital for 

 sleeping sickness cases (Fig. llj. There were 40 of these in camp undergoing treatment 

 at the time of my visit. 



Treatment. — This has consisted in intravenous injections of a special preparation of 

 metallic antimony, which was kindly given us for experimental work by Mr. H. G. Plimnier, 

 F.R.S. In addition, a certain number of cases were being treated with atoxyl, and others 

 with "606." 



Captain Thompson is of opinion that he has got nearly half of the total number of cases 

 in the sleeping sickness area of the Yei Valley now in camp. I am, however, doubtful on 

 this point, and anticipate it will be found that the number of cases in this area will prove 

 eventually to be nearly double this number. From the evidence of the natives themselves 

 many of the smaller villages have already been decimated by the disease, with which the 

 people ai'e well acquainted, and which they appear to be able to recognise in the 

 earlv stages. 



