SLEEPING SICKNESS 227 



whole of the Rusisi-Kivu District, which is about as 

 large as England without Wales, there are two 

 doctors ; for the Manyuema District, which is 

 roughly the size of Ireland, there is one doctor. 

 So it frequently happens that an unfortunate 

 official, who falls ill in a remote station, is twelve or 

 fourteen days' journey from the nearest doctor, who 

 arrives only in time to find him either recovered or 

 in his grave. It is only fair to say that the doctors, 

 who are mostly Italians, work most nobly and 

 perform wonderful feats of travelling by day and 

 night ; but it is manifestly impossible for them 

 to devote much time to the study of native 

 diseases, or to take very active steps towards 

 preventing the spread of sleeping sickness. On 

 our way down the Congo I visited three or four of 

 the State lazarettos, which (with one exception) 

 were well conducted ; but with such a splendid 

 highway as the river itself forms, it is excessively 

 difficult to check the movements of infected but 

 unrecognized individuals, who are a constant source 

 of danger wherever they go. It is a lamentable 

 fact, but one which cannot be gainsaid, that civiliza- 

 tion must be held responsible in no small degree for 

 the spread of sleeping sickness during the last few 

 years. In the old days, when every tribe and almost 

 every village was self-sufficient, and had no inter- 

 course with its neighbours, except in the way of 

 warfare, it might very well happen that the disease 

 became localized in a few districts, where its 



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