HUMAN DISEASES 521 



helpful. The importance of such work was stressed by Colonel 

 James (1929) who visited East Africa in 1928 to advise on anti- 

 malarial measures. He concluded that at least a million, and 

 probably many more, people in Kenya are constantly suffering 

 from malaria and not more than one in 60,000 is within reach of a 

 medical practitioner. In the native reserves of Kenya the disease 

 is endemic in from 30 per cent to 80 per cent of the people; in 

 the Eastern Province of Uganda the percentage of children with 

 parasites in their blood was found to reach 80 per cent and of 

 those with enlarged spleens 96 per cent. He concluded that the 

 only way to improve the situation is by education and by raising 

 the standard of living. The same method of attack applies to 

 practically all diseases, and malaria cannot be tackled separately 

 except in isolated areas, such as townships like Kampala, where 

 mosquito control measures are possible. The special malaria 

 research unit in Tanganyika has published important informa- 

 tion in its two reports (R. Mackay 1935, and D. B. Wilson 1936), 

 while other studies on malaria in African populations have been 

 carried out by Barber and Ollinger (1931) in Southern Nigeria, 

 and Thomson (1935) in Nyasaland. 



Another important work on malaria, concerned particularly 

 with the white farming community in South Africa, is that by 

 Professor Swellengrebel (1931). Prophylactic use of quinine and 

 screening from mosquitoes were found definitely to reduce the 

 incidence of malaria: thus the spleen rate among children was 

 88 per cent in unscreened farms and 44 per cent in screened ones, 

 even though the measures were far from perfect. Swellengrebel's 

 recommendations include the formation of an administrative 

 control unit and a research field station, the instruction of school 

 teachers and future farmers' wives in the principles of hygiene 

 and anti-malarial measures, and a system of medical examination 

 of recruited labour before acceptance, so that malaria carriers 

 may be detected and excluded. The prophylactic use of quinine 

 and other drugs has special bearing on the health of non-native 

 races in malarious districts and has been in dispute for many years. 

 Evidence in favour of or against this practice produced by medical 

 officers and others throughout Africa, seems to justify a definite 

 investigation as to its advisability. 



