57
(2) The existence of numerous permanent breeding places of Neocellia
stephensi in the hundreds of open house wells and a less number of masonry
tanks and iron cisterns in the North Fort, adjoining the area in which
construction work was being undertaken.
(3) The settling down of many coolie labourers in temporary huts on
the site of the new dock-works.
(4) The formation of many pools of water on the upper surface of the
works (not excavations) in the vicinity of the labourers' huts.
(5) The gradual spread of Neocellia stephensi from the North Fort to
these new breeding places.
(6) The gradual spread of infection among the labourers, at first
chiefly from the North Fort but afterwards from one to another.
(7) The occurrence in 1907 and 1908 of climatic, economic and other
conditions favouring an epidemic outbreak of malarial disease.
128. There is plenty of evidence to show that malaria existed in the North
Fort long before 1904 when the docks were commenced.
A medical man born and brought up in the Fort volunteered the inform-
ation that he well remembers possessing an enlarged spleen as a boy and being
treated for it; and ten years ago Europeans resident in flats near Elphinstone
Circle repeatedly suffered from malaria, some of them so severely that they had
to leave the neighbourhood.
As residents in the North Fort contracted malaria years ago, it is certain
that the transmitting agent must have been present. Neocellia stephensi, the
transmitting agent of most of the malaria in Bombay, was found in the city in
1901, and the presence of over 600 wells and other collections of water in the
North Fort, 300 of which were infested with it in 1909, makes it reasonable to
assume that it has been concerned in the spead of malaria in this area for a very
long period.
129. The settling of large numbers of coolies in temporary huts on the dock
site was a mistake in view of the danger of epidemic disease occurring amongst
them. The rule that, in malarious countries labourers should not be housed on
the site of large excavation works, was first laid down by Colin over 50 years
ago and it has been endorsed by many other authorities since then.
Fayrer in 1902, emphasizing the precautions previously laid down by
Colin, states:-
"The draining of marshes, the making of canals, railway cuttings,
"roads, embankments, fortifications and such like, and the cutting down of
"jungle, should be executed with great precautions, and if possible at the
"healthy season; the labourers are to be protected by proper shelter,
"removal from the seat of labour at night,* and the free use of quinine and
"proper diet while they are at work."
It is probable that the failure to remove the labourers from the site of the
work at night and the omission possibly of sufficiently drastic measures of
prevention at the outset have been responsible for the severity of the outbreak
of malaria in the neighbourhood of the new docks.
130. There is no reason to suppose that the labourers brought much infection
with them, as the examination of newly arrived coolies living on the works has
usually shewn them to be free both from enlarged spleen or parasites in their
blood; but those resident a few months shew a considerable amount of infec-
tion; and among those over a year at work nearly everyone has an enlarged
spleen. In 1910 the headman of one gang volunteered the statement that of
300 working coolies who came with him from their district (Mrwr) one
hundred had died and another hundred had deserted their work during the
preceding eighteen months. He ascribed the occurrence of fever and enlarge-
ment of the spleen among his men to the water they drank at the docks and
stated that in his own village the people did not suffer in this way. His ideas
regarding the water were of course an error, but the examination of a dozen
* The italies are mine.-C. A. B.
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