95 — Officer of Health of Khartoum. The population of the three towns is estimated at 139,315, that of the rest of the province at 73,870. This post for the last six years has been combined with that of the Assistant Director, Sudan Medical Service, but the combination of offices, initiated for reasons of economy, is found to be no longer practicable and a separate Medical Officer of Health has been approved.

In the other provinces the Medical Officer of Health is the senior medical inspector of the Province. In these provinces it is necessary, in order to ensure economy of effort and the maximum efficiency in the use of personnel, that the administration, both of preventive and curative medical work, should be combined under a single head. This is not only the case in the less developed provinces, but is felt to be even more important in a thickly populated area such as the Gezirah irrigated area. For instance, the two most important health problems in this area are bilharziasis and malaria. In both one and the other the measures to be taken are :— (i) against the disease in the human host.

(ii) against the propagation of the mollusc or the insect host.

(iii) to prevent the transmission of the disease from one host to the other.

(iv) propaganda.

No (i) comes under the head of curative medicine, Nos (ii), (iii) and (iv) under the head of preventive medicine and yet it is only by a just appreciation of the importance of all four methods of attack and the economical use of staff,, hospitals, dispensaries and equipment to carry out all these measures that the diseases in question can be successfully combated.

In addition to his medical staff of various grades which he uses to the best advantage to achieve the objects of preventive and curative medicine, the pro¬ vincial Medical Officer of Health may have under him one or more British sanitary inspectors. These men are especially employed for the supervision of town sanitation and conservancy and for anti-malarial w ork in the important irrigated areas. The British sanitary inspectors supervise a subordinate native sanitary staff of sanitary overseers and mosquito men.

The distribution of British sanitary inspectors is as follows :— Headquarters (travelling) . . . . • • 1 Berber Province . . . • • • • 3 Blue Nile Province . . . . • • • - T Kassala •• • • •• •• Khartoum Province . . . • • • • b Red Sea . . • - • • • « • • 2 Total .. .• •. • • 17 An additional British sanitary inspector has been approved for vmrk in Kassala Province and on the Kassala-Gedaref railway.