'Reports of administration for 1918 of divisions and districts of the occupied territories in Mesopotamia. Volume I' [‎57r] (118/470)

During the year under review, small-pox made its usual appearance and carried
off a good many infants. Only two adult deaths were reported. The district has
a male and female vaccinator, but the vaccine that they have been supplied with
this year has never taken, so far as I have been informed, in a single instance.
The intense dislike all have for any isolation renders treatment difficult, and an
outbreak is invariably characterised by the families concealing themselves.
There is a great deal of venereal disease, and this is especially evident among
the Shabanah recruits. The victims, however, are very willing to be treated.
So far as information is available, infection comes largely from the “ amateur
prostitute.” The professional prostitute is very scarce, probably not more than six
throughout the whole district, and as they carry on their trade absolutely secretly
it is difficult to get any accurate information. Preventive measures are, therefore,
exceedingly difficult.
Prevention of Disease .—Any attempts to deal with this very important part of
general health has been rendered very difficult by the lack of staff. One compounder
acting as S.A.S. can hardly be expected to do such.
All of the inspection work has, therefore, fallen on the hands of the Assistant
Political Officer and his deputies, who, not being medical men, can only make
amateur efforts.
In Jatarah, Abu Sukhair and Umm al Batrur, food inspection has been carried
out daily. This was particularly necessary with regard to the vegetable market,
which disposed of the most awful filth to the wretched poor.
Shop inspection was the next step. This is also a daily occurrence in each of
the municipalities mentioned above.
Both of these measures are, however, insignificant compared with the importance
of opening up roads for light and air. This has been done in Umm al Ba‘rur to a
remarkable extent. The enthusiasm of the Deputy A.P.O. has communicated itself
to the people, with the result that the town, if not a garden city, is at least clean and
healthy; and this has been done entirely by the people themselves.
Ja‘arah being shut in on all sides by date trees, is a difficult problem, but
measures are now being taken to open up a new road through the gardens which will
ventilate the place.
House sanitation is by the cesspit system. These cesspits are, however, mere
pits dug in the ground, and are rarely cleaned. In several cases it has been found
that there is direct connection between the cesspits and the canals.
It will be evident, therefore, that, even for the municipal portion of the district,
the proposed medical establishment will not be by any means sufficient, as it does
not touch the sanitary organisation.
The steps taken to ameliorate sanitary conditions have been the filling in of all
depressions and disused canal-beds, the erection of public latrines, dustbins and
incinerators. The latter were a necessity, as the cesspit system appeared to be
impossible in view of the high level of the water-table.
But at present the sanitary staff is- entirely untrained, and, though its existence
has undoubtedly tended to make life more endurable, it is very far from efficient.
For the coming year sanction has been asked for a cesspit cleaning staff in each
municipality.
As regards public health among the tribes, it is exceedingly difficult to get any
data; suffice it to say that the conditions in the tribal village are almost indescribable.
The sense of cleanliness appears to have been entirely omitted from the tribal
psychology. .
The animals live in the huts with the people; each hut is appallingly over
crowded and surrounded by refuse. In most cases the village is situated on the edge
of a canal or in the middle of a swamp.
Infantile diarrhoea is the rule, and in one case, when a proper examination was
carried out, malarial spleens were found in 93 per cent, of the children examined.
The amelioration of such conditions can only be a matter of the far future, but
the people are anxious for medical attention and European medicines, and are very
willing to bring their children to be treated.
The policy for the future seems to be in the direction of concentration entirely
on the municipal centres, and ruthless destruction where necessary therein.
Only the most sweeping measures will be of use and, in spite of compensation,
will certainly be the cheapest in the end.
That the people do appreciate better living conditions when they are obligatory
is a hopeful sign for the future.