E.— GEOGRAPHY. 119 



1900 and 1924. Such •decline was due to two main causes. First, the 

 great sleeping-sickness epidemic of 1902, which caused the death from 

 this disease alone of 300,000 out of 3,000,000 in one year. The second 

 cause of decline was undoubtedly venereal disease. This was particularly 

 striking in the Principality of Bunyoro, where until active measures were 

 undertaken by the British medical stafl: it was estimated that 90 per cent. 

 of the population had become infected by syphilis. Thanks to the energy 

 of the medical administration the tide has now turned, and during the last 

 two years it would seem that there has been a slight increase — but very 

 slight — in the population. 



But, broadly speaking, in East and West Africa the principal cause 

 arresting the natural growth of population is infantile mortality. It has 

 been estimated that in the purely native district of Tanganyika Territory 

 between Tabora and Lake Victoria there is an infantile mortality rate 

 under the age of twelve months of anything up to 400 per 1,000. I 

 was recently given the estimated figure of 250 per 1,000 in more than 

 one part of West Africa. 



The main cause of this very high mortality would seem to be mal- 

 nutrition both of mothers and babies, and the continuance of barbarous 

 superstitions in connection with childbirth and early rearing of children. 

 Further, it must be remembered that in many parts of Africa it is the 

 native custom that the women should perform a very large part of the 

 agricultural work on the native holdings. This undoubtedly is afiecting 

 the infantile mortality, which has always been abnormally high. 



The medical care of the natives, hygiene, sanitation, and preventive 

 medicine are only just beginning to operate in many parts of Tropical 

 Africa. In many places the natives first resort to the witch doctor or the 

 old women, and only come to the European medical officer as the last resort. 



It is not surprising, therefore, that in countries where infective diseases, 

 many of them insect-borne, are rampant progress is slight. We must 

 remember also that in many parts of Africa — South-Eastern Nigeria for 

 example — the native methods of agriculture are still so primitive that the 

 existing native diet is quite inadequate to provide the stamina necessary 

 to withstand the attacks of disease. The great prevalence of septic 

 ulcers is due partly to the unhygienic habits of the natives and partly to 

 the low general health and resistance, due to malnutrition. The 

 investigations now being undertaken by Dr. Fisher and others in Kenya 

 into this problem of native diet are most important. 



We must admit, however, that over and above these endemic causes 

 the coming of settled rule and civilisation has aggravated the problem. 

 Before we established roads and railways and suppressed the tribal wars, 

 communities lived in comparative isolation. There was little trade or 

 intercourse between neighbouring peoples. Now, however, the old 

 barriers are broken down and natives travel all over Africa comparatively 

 freely, with the result that they carry infection with them and diseases 

 have far more opportunities of spreading than heretofore. 



I think I have said enough to show what a vast task we have before 

 us in increasing the number and well-being of populations for whom we 

 have become trustees, and I now turn to some of the more important 

 social problems that are arising as a result of rapid economic development. 



