21

A resurvey of the children in these villages carried out in 1928 gave the following results :—

Hosh Komor and Radma Tayiba Barak at Abdel Rahman

2 (new infections in a different village) 0 1 4 (3 new' infections and 1 recurrence) 1 (fresh infection)

Seeing that in any community the children are always the most likely to be infected with bilharzia, this resurvey would seem to indicate that up to the present there is no appreciable infection of the villages in these older irrigated areas.

Source of possible infection. There are two principal potential causes of infection:—

(i) The Takroori (the genuine West African pilgrim)

(ii) The wandering westerner from Wadai.

An endeavour is made to examine and if necessary treat all immigrants entering the Gezirah from the west, at quarantine stations at Kosti andEl-Dueim. During the year under report nearly 20,000 Takrooris and Westerners passed

through these two quarantine stations.

This quarantine, although diminishing the danger very considerably, does not exclude the entry of all infected westerners because :—

(i) the disease may have been latent at the time of inspection.

(ii) the immigrant may have escaped the quarantine station. At the end of December 685 westerners sleeping on the river bank in Wad-Medani were rounded up and examined ; 85 were found to be infected (i.e. roughly 12 per cent.).

Further measures to be adopted, (i) The Takrooris, althoughmigrants, have definite villages where they live during the period of their stay in the Gezirah. They have sheikhs and a village organisation, and can be dealt with in the ordinary way. These villages are now being examined for bilharzia cases and all detected cases are being treated either at the neighbouring block dispensaries

or by a travelling dispensary hakim. Many of these villages are in close proxi¬ mity to canals. It is hoped to be able to move them away from the canals to the neighbourhood of a well-water supply.

(ii) The Westerners are more difficult to deal with. They have no villages nor any settled abode, nor have they any sheikhs or tribal or village organisation. There is no way of persuading these men to attend for treatment or to remain in hospital except by forcible detention. To meet this difficulty a bilharziasis camp hospital is being formed, in which all infected immigrants who can give no guarantee of regular attendance will be detained until cured.

There are two other less important potential sources of canal infection:—

(i) Natives of the White Nile Province come across in large numbers to help in the cotton picking ; many of these are riverain people and a considerable proportion of the riverain population are infected with rectal bilharziasis, but it is

not possible to prevent their free entry as they are living on both sides of the river and constantly crossing from bank to bank. To protect the canals against this source of infection it is only possible to rely on the strict enforcement of regula¬ tions against fouling the canals and bathing in the canals. These people only come for a period of three months while the cotton is being picked. As soon as