"تقارير إدارة أقسام ومناطق الأراضي المحتلة في بلاد الرافدين لسنة ١٩١٨. المجلد I" [ظ‎‎١‎٣‎٨] (٤٧٠/٢٨١)

258
medical practitioner; in the remaining cases it is not claimed that a diagnosis is
possible from the vague histories of illness obtained by the inspector, but a rough
grouping of the commonest fatal illnesses is as under :—
‘Ashar.
Basrah.
Total deaths analysed -
_
1,225
1,465
Respiratory diseases* -
-
124
49{
Intestinal diseases!
-
73
694
Senile decay
-
95
894
Malaria and “ fever ” -
-
95
59{
Cholera
-
107
63
Plague
-
71
121
Small-pox
-
58
31
Influenza
-
279
450
(12) The death rates both for ‘Ashar and Basrah compare unfavourably with
the 1917 figures, the rise being due to an outbreak of cholera in May and of influenza
in September and October.
The average weekly deaths in ‘Ashar and Basrah respectively were 14-0 and
11-0 in the first quarter, 30-0 and 28-5 in the second, 16*2 and 23-9 in the third,
and 36-0 and 51-8 in the last quarter of the year.
Crude death rates have been calculated on the basis of the December census
figures, although it is probable that these figures were exceeded during the second
and third quarters of the year by two or three thousand. These crude death rates
are, for ‘Ashar: 50-9 per 1,000 for the first quarter, 109-1 per 1,000 for the second,
58- 8 per 1,000 for the third, and 130-9 per 1,000 for the last quarter, or 85-2 per
1,000 for the whole year; and for Basrah: 22-5 per 1,000 for the first quarter,
59- 3 per 1,000 for the second, 49-7 per 1,000 for the third, 107-9 per 1,000 for the
last quarter, or 58-6 per 1,000 for the whole year.
(13) Infantile Mortality .—In the absence of any reliable record of births, it is
regretted that the infantile mortality rate, which is presumably high, cannot be
calculated; but 14 per cent, of the registered deaths occurred in' infants below the
age of 12 months. A rough classification of the causes of death in these infants
shows 67 per cent, to have been due to inanition, 6 per cent, to intestinal diseases,
12 per cent, to respiratory diseases, and 8 per cent, to small-pox. The appointment
of two additional w*omen health visitors wall enable advantage to be taken of future
notifications of births, in that advice and instruction will be given on infant care
as well as on the general sanitation of the house.
(14) Infectious Diseases. The scheme of notification of infectious diseases bv
medical practitioners, mukhtars and others, instituted by order of the Military
Governor, dated 26th October 1916, remains in force. Notification is not vet
satisfactory, but consistent attempts have been made throughout the year by pro
clamation, by adveitisement, and by prosecution of defaulters, to bring home to
the public the importance of complying with the order, and it is believed that some
improvement has been effected. Further, an article on vaccination was written
for the local newspaper at the time small-pox was prevalent, and Arabic leaflets,
giving advice on precautions to be taken, were largely distributed during the cholera
and plague seasons.
(15) After notification, a search is made in the neighbourhood for unreported
cases, and the patients and, where necessary, the contacts—are removed to the
civil isolation hospital. Remaining contacts are treated bv vaccination or inocu
lation if applicable, and the usual disinfection is done by" this Department 4t
present the Department relies on the Military for the loan of a motor ambulance for
removal of infectious cases, and arrangements for purchase should shortly be made.
(lb) The unsatisfactory situation and structure of the present civil isolation
hospital were pointed out in the last annual report, and in February the Military
Governor and A. D.M. S., Base, approved the suggestions of the Civil Surgeon and
the Health Officer as to the minimum alterations required to put the hospital on a
more satisfactory basis. These alterations were in part carried out; but during
the rams m November a large portion of the hospital collapsed, leaving only 20
beds avail able. In vi ew of the fact that earlier in the year accommodation for
* Including phthisis, excluding influenza. finding cholera,
f Figures for six months only.