'Reports of administration for 1918 of divisions and districts of the occupied territories in Mesopotamia. Volume I' [‎176r] (356/470)

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APPENDIX B.
Medical and Sanitation at ‘ Alt Gharbi.
The Civil Surgeon at ‘Ali Gharbi writes :—
" The Hospital. The statistics of the Civil Hospital are few and somewhat misleading, so it will
be better to consider them first. During the past eleven months there have been about 10,200
attendances at the hospital; the number of patients attending daily is, therefore, about 33. But of
this number about 10 are children, most of whom require treatment for their eyes. Six others are
‘ dressing cases,’ while another six are old chronic cases, four or five more have minor complaints. The
remaining four or five may be called itinerant patients, who just come to the hospital as they are
passing through ‘Ali Gharbi. At times the number of these latter, or ‘ birds of passage,’ quadruple
or sextuple itself, especially when a donkey or camel caravan is passing through on its way to the hills.
Now, out of these groups of patients only about 18 attend the hospital regularly, so that much of one’s
work is undone and treatment becomes in many cases symptomatic and not radical. The most
cheering feature in a morning’s work is the regular attendance of the children. Something (if only a
little) can be done for their eyes, but the principal thing which encourages one is that by systematic
scolding and example they are induced to be cleaner, and that in 20 years’ time this pioneer work will
bear fruit in a healthier generation. Acting on this assumption there has been instituted for the past
month a regular inspection of school children every Tuesday. In this way one is not only able to detect
the affected children, but also it compels them to wash their heads at least once a week.
“ There have been about 80 operations this year, and every operated case may be considered as
a success, for surgical cases (whether major or minor) amongst the Arabs are more satisfactory to
treat than protracted medical cases.
“ In prophylactic medicine about 500 children have been vaccinated.
“ No maternity work has been done so far, but the women are becoming much less reserved, and
in particular the Jewish women.
“ Incidence of Diseases. —The number of deaths reported up to date is 87, the number of births
being 34. The discrepancy in these two figures is accounted for by fact that in many cases the full-
timo women leave the town and do not return until some time after the birth of the infant. Both these
figures are below the actual birth and death rate, as it is difficult to obtain the exact figures.
“ There is one thing which, although not mentioned in any nomenclature of diseases either military
or civil, should be placed first in the list of Mesopotamian maladies, as it holds a place of paramount
importance, being the father of all diseases. This is dirt. It is the dirty face and body and the dirty
clothes and houses that are responsible for more than half the sickness amongst the Arab, Kurd and
Jew alike.
“ Concomitant with the above are the two commonest diseases, one being diseases of eyelids and
conjunctivee and the other, septic wounds and sores. It is out of these two conditions that the Civil
Surgeon gains most of his satisfaction and loses most of his temper.
“ Of the infectious diseases, pneumonia may be placed first as a terminal event.
“ This year the influenza epidemic reached ‘Ali Gharbi in the beginning of September, and a
month later there was a second wave of infection. Many of those who were affected in the first attack
suffered from a second attack.
“ Tuberculosis is more common among the Arabs and Kurds than one would be led to expect.
Pulmonary tuberculosis is the most common, then probably tuberculosis adenitis, with Pott’s disease
close behind it.
“ Syphilis.—Although there are no direct figures bearing on syphilis (I believe), it is not nearly so
common as it is supposed to be in this country. This is certainly the case in this neighbourhood.
“ Gonorrhoea. Gonorrhoea is, of course, seen among the men only; so far I have not seen a case
of ophthalmia neoatorum.
“ Dysentery. Dysentery does occur among the Arabs, but it seems to be comparatively uncommon
when compared with the dysentery among the British and Indians.
“ Malaria. As endemic, does not occur in ‘Ali Gharbi, cases of malaria treated in the hospital
generally come from the hilss or from the mahailahs. . . . .
“ No cases of plague, smallpox, relapsing fever, cholera or cerebro-spinal fever among the local
inhabitants have come under the notice of the Civil Surgeon. No bilarzia ova were discovered in the
urine of out-patients complaining of hamiaturia. About 20 cases were examined, which is too small
a number from which to draw conclusions.
“ Sanitation .—The latrines are divided into two groups :
“ (1) Public, some being away from the town in the desert, others being off the main
thoroughfares, near the outskirts of the town. . , „ , .
“ (2) Private These are burnt, brick-lmed cesspits m the courtyards of houses. About
100 of these have been made this year. They are cleaned out at intervals by Jew sweepers
from ‘Amarah.
“ There are two groups of incinerators to burn latrine refuse and two little incinerators are being
constructed.^ ^ plaoed in the streets and are cleared daily by donkey boys.
“ Fiminre —It is verv difficult to arrive at an estimate for the future requirements of the Civil
Hosnital as all money matters have been dealt with by the Assistant Political Officer, and due to the
Hospital, s p r-J i officers Some of the hospital expenses have gone under the heading of
Miscellaneous, while some sanitary charges have come into the Hospital Account. The money granted