The Straits Settlements medical report.

Straits Settlements. Medical Department.

Date:: [1915]

Catalogue details

Licence: Public Domain Mark

Credit: The Straits Settlements medical report. Source: Wellcome Collection.

54/120 (page 54)

ESTATES AND ESTATE HOSPITALS. I. The health of the labour staff on the Estates has been fairly good during the year 1915. 2. With the exception of two Estates—Bakap Plantations and Caledonia—there was complete freedom from acute infectious disease. On Bakap there occurred five cases of Cholera in May and June and on Victoria (Caledonia Group) there occurred one case of the same disease in June. A single case of Cholera also occurred in the Christian Tamil Lines of Caledonia Estate in June. In none of these cases could the history of the primary infection be traced. The cases at Bakap all used water from a certain well which came under suspicion. I had this closed and no further cases occurred. The pipe-line from Bukit Panchor Reservoir passes close by this Estate and I recommended the utilisation of this source of supply. But I regret that up to the present it has not been found possible to make effective my recommendation. 3. I have a strong suspicion that the figures for Ankylostomiasis do not loom as large in the Return of Diseases as they should. I have good grounds for believing that the majority of the cases of this disease are still unrecognized. The Dressers in immediate charge of the Estate Hospitals are untrained in microscopic work and many Estates are unprovided with microscopes. The Medical Officers employed by the Estates have such a large amount of work to do—some of them have as many as eight or ten Estates to look after and others have large private practices—that attention to such minute details as the inspection and microscopic investigation of coolies’ motions can hardly be expected of them. And yet this is the only way to discover and stamp out this disease which, under present conditions, it requires no particular shrewdness to predict will cause in the near future grave weakening of the labour force of the country. The grounds on which the above opinion is based are as follows 1. In the Government Hospitals patients seek admission for “ fever,” “ weakness,” “dropsy,” “anaemia,” “diarrhoea,” “nondescript symptoms”—may be only “malaise.” A recent examination of the motions of all such cases in the three Government Hospitals revealed the following :— Butterworth.—Out of 44 patients 11 had Ankylostomes. Bukit Mertajam.—Out of 38 patients 23 had Ankylostomes. Sungei Bakap.—Out of 31 patients 11 had Ankylostomes—making an average percentage of infection for the three districts of 40 per cent. The prevailing type of parasite is the Necator Americanus. 2. In a recent visit of inspection to one of the Estate Hospitals, I saw a girl patient with unmistakable evidences of profound anaemia and a diagnosis of “ Asthma” on the bed ticket. She was being treated with antispasmodics such as Lobelia. Her motions had not been examined, nor her blood, though she had been a w'eek in hospital. Her doctor was one of the most capable private practitioners I have ever met, but how could he be expected to spare the time from a busy practice to make a microscopic examination of blood and motions in a case like this ? The Dresser-in-charge on whom this duty should have devolved was quite innocent of the knowledge necessary for the task. The above is, by no means, an isolated instance.