PLANNING MALARIA CONTROL 
293 
by abuse or by not remaining behind 
screens after dark. 
There always remain houses in the areas 
where drainage and larvieiding cannot be 
done which cannot be protected against in¬ 
sect invasion except by major reconstruc¬ 
tion at a cost which neither private owners 
nor local government will assume. In such 
places, medication is about the only thing 
left to recommend. The treatment of game- 
tocyte carriers and of indigents is justified 
by ample precedents in public health prac¬ 
tice and, irrespective of its lack of effect 
upon the intrinsic malariousness of the 
area, should be recommended in the report. 
As an example of comparative malaria 
control costs, the following is abstracted 
from a survey report entitled “A Study 
and Analysis of Malaria in Morgan County, 
Alabama” (1939) by E. A. Philen. 2 The 
drainage of 158 ponds and the larvicidal 
treatment of 46 others is recommended as 
being the cheapest and most effective means 
of control. This would require, if machine 
drainage were employed, annual expendi¬ 
tures of $16,150 for 9 years and $8,075 
yearly thereafter. Hand-labor drainage 
would cost at least $100,000 more and would 
require a longer construction period. The 
annual cost of county-wide, larvicidal con¬ 
trol is estimated to be $20,670; of screening 
and mosquito-proofing, $36,388, plus an 
initial outlay of $181,940; of medication, 
$64,625. 
If the project is to be supported on non¬ 
local funds, there will probably be little 
occasion for departing from the desirable 
sequence of operations suggested by the 
surveyor. If, on the other hand, it is to be 
maintained on local resources, it may be 
necessary to evolve a feasible works pro¬ 
gram based upon joint consideration of the 
control recommendations, the means avail¬ 
able for their fulfillment and perhaps cer¬ 
tain circumstances of local psychology and 
politics. 
Assuming the project to be of the latter 
type, an inventory of all resources should 
be prepared. Local governments may sup- 
2 Made available by the Alabama Department of 
Public Health whose courtesy is hereby acknowl¬ 
edged. 
ply funds derived from special taxes, ap¬ 
propriations or bond issues. In addition, 
they may be able to provide trucks, excava¬ 
tion machinery, cement-mixers, etc. In 
some counties, convict labor is available 
and may be used for physical control oper¬ 
ations. In addition to local facilities, cer¬ 
tain federal agencies may contribute ma¬ 
terially to malaria prevention while working 
towards their own social objectives. The 
names and functions of these will doubtless 
change and perhaps disappear with the 
years, but at present the Works Progress 
Administration, the Farm Security Admin¬ 
istration, the Soil Conservation Service, the 
National Youth Administration, the Civil¬ 
ian Conservation Corps, and the U. S. 
Housing Authority are able to participate 
directly or indirectly in anti-malaria activ¬ 
ities. Not infrequently, private property 
and public utility owners can be prevailed 
upon to supply labor, equipment, dynamite 
or mosquito-proofing materials for use on 
their own premises under the technical 
supervision of local health officials. The 
final malaria-control plan should utilize 
each of these assets to the utmost while 
adhering as closely as possible to the se¬ 
quence and procedure recommended in the 
survey report. 
Certain pressures will be brought to bear 
against the proposed program. These must 
be squarely faced and nullified if effective 
and economical malaria reduction is to be 
accomplished. Wild-life enthusiasts and 
sportsmen will argue against the dewater¬ 
ing of aquatic areas and will urge the sub¬ 
stitution of impermanent control methods. 
Drainage is necessary for certain types of 
land improvement. While such a conse¬ 
quence of malaria-control drainage is de¬ 
sirable, it must not dominate the selection 
of drainage sites. Self-interested land- 
owners will urge drainage of their prop¬ 
erty at public expense with little or no 
actual malaria justification. The accep¬ 
tance of such projects is fatal to the future 
of a malaria-control program. Similarly, 
ditch-lining may provide enhanced facili¬ 
ties for dealing with storm-water runoff or 
pest-mosquito breeding incidental to anoph- 
