HEALTH AND MEDICINE GENERAL 489 



vided 14 beds for Europeans, and 535 for Africans. There were 180 

 European and 5,270 African in-patients, and 474 European and 

 1 10,524 African out-patients. In addition to the staff already men- 

 tioned there were 7 European nurses and 3 sanitary superintendents, 

 the African subordinate staff of about 160 included 39 dispensers, 

 3 health visitors, 42 sanitary inspectors of different grades, nurses, 

 and mid wives. 



Estimated government medical expenditure for 1 936 was -{^66,894. 



The medical department of the Gambia is in charge of the Senior 

 Medical Officer, Dr. A. M. W. Rae, and the staff is concentrated 

 in Bathurst, there being few medical facilities elsewhere. Of the 

 African staff totalling about 40, only 1 1 are posted outside Bathurst. 

 The Victoria Hospital is the centre of the service, and is probably 

 the only large hospital in Africa in which patients of all races are 

 housed under one roof. The only hospitals in the Protectorate 

 are at Georgetown and Bwiani. There are dispensaries at other 

 centres, including one organized voluntarily by the wife of one 

 of the administrative commissioners, Mrs. R. W. Macklin. A 

 maternity and child welfare clinic has recently been established 

 in Bathurst. 



A special problem, to which much attention has been drawn in 

 recent years, is the sanitary condition of Bathurst. Plans have been 

 prepared with the object of raising the level of much of the town, 

 which at present is scarcely above sea-level and is extensively 

 submerged during the rainy season. As Dr. Rae points out in his 

 report for 1935, the greater part of the cost of curative treatment 

 must be wasted if the patients are to return to living conditions 

 in which a recurrence of their malady is almost certain to take 

 place. An outline of the proposals was published by Professor 

 Warrington Yorke (1937), but the financial position of the colony 

 has not been held to warrant special expenditure on this work from 

 the Colonial Development Fund or other sources. The year 1936 

 showed a considerable development in the work of the medical 

 department. A hospital at Bwiani, chosen on account of the pre- 

 valence of sleeping sickness in that area, and a dispensary at Kaiaf 

 were opened, funds for both having been provided by the Pro- 

 vincial Emergency and Development Fund. Kaiaf dispensary 

 had over 3,000 cases in its first seven months, and Bwiani had 7,000 

 cases and 94 in-patients. A child welfare centre at Sukuta was 



