54 
REPORT OF THE MALARIA EXPEDITION. 
etc. ; and, to crown all, the natives wash themselves openly in the puddles they have made for the purpose. 
The children for the most part use these byeways as latrines. Mosquitoes abound, and the odour is often 
frightful. The huts are made of mud roofed in with leaves. They are overcrowded to an appalling 
extent — 8 or lo persons often occupying a hut 9 or lo feet square. Scattered here and there through this 
district are groups of uninhabited, roofless and often ruined huts. These are used by the neighbouring 
families as places in which to discharge their refuse, and also as latrines. Every now and then one comes 
across a butt or other receptacle filled with stinking water, infested with mosquitoes, and infected with 
bacteria. The latter I was only able to examine microscopically. The former were all of the genus Culcx 
— no Anopheles were found. A complete absence of an)- sj stem of drainage completes what to a European 
eye is nothing but a noisome and a pestilential district. The danger of such neighbours to the white 
population is obvious, and some of the commercial communit}', as I have said, live very close indeed to 
those parts of the town. This danger is, I think, increased by the fact that the prevailing wind sweeps 
over and through these native dens before reaching the houses of the white inhabitants. Public latrines 
have been indeed provicied by the Government on the sea-shore, but I am of opinion that these are 
themselves not wholly without danger. Some are flushed by the sea ; but on October 20 two were 
entirely dry — and that on a day when the tide was of quite average height. Much of the open sea-shore 
is used as a public latrine too ; and it is easy to imagine in such a climate the condition of afi^airs thus 
brought about. Any infective material deposited here is liable also to be carried by the prevailing wind 
straight to the European quarters. The problem of drainage and general sanitation is no doubt a very 
diflicult one to solve in a place which is so flat, and where there is no water supply (the inhabitants are 
entirely dependent on a scanty rainfall). But I venture to think much benefit would result from the 
running of broad streets through the congested districts of the native population, and the destruction of 
uninhabited houses. An attempt is made by the police to keep the streets in a clean and healthy 
condition ; but it is impossible to exercise anything but very incomplete supervision over these unlighted 
rabbit-warrens. All wandering dogs and other animals not properly looked after should be destroyed, for 
that there is a possibility of their carrying diseases I do not think anj'one is inclined to deny. I am 
disposed to think that the sea latrines should be done away with, and earth-to-earth land latrines 
substituted. These latter are used with complete success in some parts of Lagos, though there too there are 
some latrines open to the lagoons. 
The suburb of Christiansborg shown on the map has no such plague spots as I have described in the 
native town of Accra. Here there are broad streets, well kept, and for the most part clean ; the houses are 
not crowded together, and there is a fairly complete system of drainage. The drains are open, wide, and 
made of cement. Between this suburb and Accra there are a few acres devoted to surface pools, which the 
natives enclose to catch the rain for various domestic uses ; and on these pools they are entirely dependent 
for their water supply. Some contained mosquitoes (all Culex, no Anopheles)^ various weeds and algas ; but 
were sweet and clean for the most part. 
It may be surprising that so near Accra a suburb with the above characteristics should exist ; but it 
is easily explained : Christiansborg Castle was at one time the Governor's residence, and Christiansborg 
itself the seat of government. At this time some thousands of pounds must have been spent to produce 
the good result 1 have sketched above. The present Governor is doing everything in his power to improve 
sanitation in Accra, and though, as I have said, he is hampered in various ways, slowly but surely an 
improved state of things is showing itseU. 
The authorities and West Coast medical men generally are now fully awake to the fact that all has 
not yet been done that may be done to improve sanitation, and in the next few years I anticipate a definite 
improvement in this respect, and also a greater activity in scientific medical research. At present any 
research is carried on under almost disheartening difficulties. Instruments rust, microscopes and other 
lenses become cloudy (even the cover glasses and slides which I took out with me became useless), and 
bacteriological research is quite impossible under present conditions. 
Now, however, I think I may say a new epoch is about to begin in the scientific study of 
diseases prevalent on the West Coast. The Government of the Gold Coast has sanctioned a preliminary 
