'Reports of administration for 1918 of divisions and districts of the occupied territories in Mesopotamia. Volume I' [‎139r] (282/470)

80 patients had been required, it became necessary to take immediate action, and
it was agreed to erect a tented hospital on the same site to accommodate 100
patients. This is looked upon as a temporary measure, and a modern isolation
hospital, with suitable quarters for staff, capable of expansion in times of epidemic
and on a convenient site a short distance from Basrah, is urgently required.
(17) Plague .—‘Ashar had remained free from plague from June 1917 until the
notification of a case from the police station on ‘Ashar Creek on 20th January 1918;
eight further cases occurred in March, and the outbreak assumed epidemic pro
portions in the second half of April. From 1st April until 21st May, 81 cases in all
were reported and all four quarters of the town, together with its purely Arab
environs Umm-al-Dijaj, Mahallat-al-Sai and Qazarah, were affected—a quarter of
the cases arising in the low-lying reed hut encampment at Mahallat-al-Sai. The
notified cases showed a progressive decline weekly during June, in which month 25
cases only were registered, and the epidemic may be considered to have come to an
end in July, although two further cases occurred during August and a third in
September, making a total for the year of 121.
(18) Basrah City continued free from plague from June 1917 until April
1918: nine cases were reported. In May, however, the disease flared up, and the
weekly notifications until the end of June were, respectively, 12, 35, 39, 40, 23, 30,
21, 14 and 7; seven further cases occurred during July and August, with a doubtful
final case in November, making a total for the year of 236 cases. The spot map
prepared shows the main infected areas to have been Suq-al-Dijaj in the centre of
the town, and Mujasah in the north-west quarter.
(19) Apart from the outbreaks in the town proper, Akhwat Raznah (a hut
village with population of 2,000 to 3,000) was severely attacked by plague in April
and May, and reports were received of excessive sickness and many deaths. This
village had not previously been under sanitary control, and it needed several visits
to induce confidence ; but, once this was established, fresh cases to the number of 20
daily were discovered. Inoculation was successfully offered, and later, by arrange
ment with the Civil Surgeon, a temporary dispensary was established on the spot.
(20) The above figures compare unfavourably with the 40 cases of plague
reported in ‘Ashar and Basrah during 1917; but, as noted in the last annual report,
with rats numerous and infected foci well scattered it needed but some additional
factor for the production of a really serious epidemic. The usual rat-reduction
measures were carried on throughout the year, but no rat caught after the middle of
June was found to be suffering from plague.
(21) Cholera .—In ‘Ashar the first case of cholera was notified on 13th May, and
this was speedily followed by the sharpest outbreak that has occurred since the
British occupation; and by the end of that month 131 cases were registered, the
maximum in any one day being 17. This outbreak may then be considered to have
expired, although further cases were reported in small numbers each month until
the end of the year, by which time 171 cases had occurred. A study of the incidence
of both civil and military cases was made by the Officer Commanding the Central
Laboratory at the Base, and he reported that the epidemic appeared to have started
as the result of the infection of the ‘Ashar Creek by a military case at its mouth on
12th May; and the subsequent grouping of cases supported his view that the river
and creek waters were the source of the epidemic.
(22) In Basrah the first case was notified on 16th May, but, although 48 cases
were reported by the end of the month, the disease did not assume the proportions
of the ‘Ashar outbreak; 35 other cases occurred during June, followed by odd
notifications monthly to the end of the year. A large part of the Basrah water
supply had been obtained from the municipal stand pipes during the whole of this
year, and to this may be ascribed the slightness of the outbreak, which in general
was limited to the poorer, dirty and careless classes having few facilities for the
clean storage of either food or water—the overcrowded Jews’ quarter in the centre
of the town suffering heavily for this reason.
(23) Small-pox .—The mild outbreak of small-pox which had started in December
1917 died out by the end of January, and ‘Ashar may be said to have been free from
small-pox from then up to midsummer, only 18 cases being reported by the end of
July; from then onwards, however, cases occurred more frequently, the greatest
incidence being in Mahallat-al-Sai village, where the disease originated, in the