HEALTH AND MEDICINE — GENERAL 497 



By a compulsory system of attendance and full recording systems, 

 a medical census has been made in much of the area. Furthermore, 

 the movements of natives in all sleeping sickness districts are under 

 full control by a system of medical tickets, obtained at hospitals 

 after examination. Without one of these it is impossible for a native 

 to buy a railway ticket or to make use of other regular forms of 

 transport. 



Among medical missions the American and French missions 

 figure prominently. Together they have a staff of 1 1 qualified 

 doctors, 46 European fathers, some of whom hold medical diplo- 

 mas, and a trained African staff of 1 74 infirmiers. In 1 936 the 

 missions maintained 8 hospitals with two more in course of con- 

 struction; hospital beds numbered 752 and dispensaries 37. 



The Laboratory Service is centred at the Institut d' Hygiene at 

 Douala, which comprises laboratories for bacteriology, serum 

 work, entomology, parasitology and chemistry. 



In 1936 hospital in-patients numbered 220 Europeans and 15,728 

 Africans; out-patients 3,834 Europeans and 453,270 Africans; the 

 dispensaries treated 356,276 Africans, the centres medicaux 9,601 in- 

 patients and 134,316 out-patients, and the mobile units a total of 

 596,555. At the end of 1936 the European population was returned 

 as 2,324 and the native as 2,377,125. In 1935 the total ordinary 

 expenditure was 57,798,926 francs, and that of the Service de Sante, 

 8,978,269 francs. 



In Togola?id the medical staff in 1936 included 13 Europeans, 

 10 being qualified doctors. The African staff included 6 auxiliary 

 doctors trained at Dakar, 12 midwives, and 185 other assistants 

 such as aides medecins, infirmiers, etc. There is one central European 

 hospital, at Lome, with 10 beds, and there are 9 African hospitals 

 with 318 beds, 5 centres medicaux, 21 dispensaries, of which 7 have 

 some 25 beds each for African patients, and 5 maternity centres. 

 Sleeping sickness was dealt with in 1936, as usual, by one equipe 

 de prospection, followed by 7 treatment detachments, which dealt 

 with over 15,000 new cases. A special sanitary service has been 

 established in Lome to reduce the incidence of plague by a cam- 

 paign against rats, of rabies by destroying stray dogs, and of 

 malaria and yellow fever by mosquito control measures. A 

 laboratory attached to the Lome hospital is entirely for routine 



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