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CONTENTS.
PARA.
I. Introduction
.
.
.
.
.
.
.
.
.
.
.
.
.
. 1—3
II. Malaria in the villages
.
.
.
.
.
.
.
.
.
.
.
. 3—6
III. Anopheles of the Andamans
.
.
.
.
.
.
.
.
.
.
. 6—11
IV. Malaria among the Labouring Convicts .
.
.
.
.
.
.
.
.
. 11—25
V. Considerations upon the nature of malarial infection in different communities in the
Andamans.
25—29
VI. Sickness .
.
.
.
.
.
.
.
.
.
.
.
.
.
. 29—34
VII. The death rate
.
.
.
.
.
.
.
.
.
.
.
.
. 34—42
VIII. Summary and conclusions .
.
.
.
.
.
.
.
.
.
.
. 42—44
IX. Recommendations
.
.
.
.
.
.
.
.
.
.
.
.
. 44—47
Malaria in the Andamans.
I.—Introduction.
T HE Andaman Islands are situated in the Bay of Bengal two hundred miles
from the nearest point of the mainland of Burma. They consist of
three large islands and a multitude of smaller ones, the total area being about
4,000 square miles.
At the south end of the southern Island is the convict settlement of Port
Blair, a small area of not above twenty miles in longest diameter, which is
from our present point of view the Andamans. Beyond the confines of the
settlement the whole land, hill and valley alike, is trackless forest.
An important feature in these islands is the evidence of isolation shewn by
the flora and fauna. With the exception of wild pig there are no indigenous
large mammals. There are no crocodiles in the swamps and rivers, and though
the country is clothed in forest there are no monkeys. The question of what
species of anopheles occur in these islands is therefore one of considerable
interest.
The aborigines are of an extremely primitive type resembling the Bush-
men of Africa and are quite unlike any existing neighbouring race. They lead
a nomadic life, do not till the ground and are so few in number, being estimated
at under 2,000 for the whole Andaman group, that they cannot be considered
as forming a population in the ordinary sense. With the exception of a few
who are supported by Government at the Andamanese Home at Port Blair
these primitive and hostile people are rarely or never seen.
Around the settlement for a distance of about ten miles the country has
been partially cleared. The most conspicuous feature of this area is a long
ramifying inlet of the sea, the harbour of Port Blair, around the shores of which
the various stations and villages of the Settlement are situated. The country
consists of low forest clad or partially cleared hills between which lie long flat
swampy valleys or the ramifying arms of the harbour and its tidal mangrove
swamps. Wherever possible portions of these tidal swamps have been re
-claimed and they then form the chracteristic salt swamps of the locality.
Near the embankment which protects them these swamps are liable to be
flooded at high tide and there are stretches of mud and open water. Further
inland they are covered with a growth of coarse grass or some form of under-
growth and are planted with cocoanut palms from the cultivation of which is B
2
derived a considerable revenue. The extent and general characters of these
salt swamp lands will be gathered from the map of the settlement and the
photograph accompanying this report.
Behind the salt swamp and in almost every valley there are in addition
extensive fresh water swamps sometimes entirely, at other times partially,
converted into paddy land.
On the hill slopes are small mountain streams and an abundance of
swampy patches and small pools. Even the tops of hills during the wet season
are more or less waterlogged and pools are everywhere present.
2. The few partly civilised Andamanese within the settlement, at most a
few score, are supported by Government and live in an isolated position in the
Andamanese Home. They in no way influence conditions as regards transmis-
sion of malaria among the convicts. Apart from these few aboriginals the
population of the settlement is entirely an immigrant one and is restricted to
the convicts and those whose work is connected with them.
The convicts are of two classes, the labouring convicts still under modified
prison discipline, and self-supporters who are ticket-of-leave convicts, allowed,
with certain restrictions, to lead a free life on the Island.
The former, numbering from 10,000 to 12,000, are housed in large
barracks, the various collections of which form the so-called stations of the
settlement. These barracks are located at various points around the harbour
and for the most part are built on elevated sites, often high bluffs overlooking
the sea, which have been chosen with a view to health.
The self-supporters numbering about 2,000 live in villages which, owing
to the necessities of rice cultivation, are scattered more widely over the settle-
ment and are often situated several miles from the shores of the harbour.
Some villages, like the stations, are on the tops of low hills, but many are in
low-lying situations close to paddy land or swamp.
Besides the self-supporters there are about 2,000, free residents either time-
expired convicts or the offspring of convicts. These live a life very like that of
the self-supporters in the area to the south of the harbour (Eastern District).
3. It is among the labouring convicts, judging from the statistics, that
malaria is most prevalent. Also it is among the labouring convicts, more
directly under the care of the medical authorities, that we especially wish to
ascertain the conditions in regard to malaria. But for several reasons the
labouring convicts do not form a very suitable community for determining the
facts regarding malaria transmission. Above all the fact that they are liable to
frequent movement from one station to another interferes with investigation on
this point.
The villages of the self-supporters, where there are a certain number of
3
children, all or nearly all born on the spot, and where the whole population is
a fixed one, are on the other hand eminently suitable for our purpose. Hence
the question of the prevalence and distribution of malaria in these villages will
first engage our attention, the more complicated question of infection among
the labouring convicts being postponed until we are in a better position to
understand the general principles underlying the transmission of malaria in this
particular locality.
II.—Malaria in the villages.
4. The results obtained from an examination of children and adults in the
villages are given in Table I. So far as possible all the children in the settle-
ment were examined and though the number living in some of the villages
was small it is possible to draw some very definite and important conclusions
regarding the natural history of malaria in the Andamans.
TABLE I.
SPLEEN RATE,
CHILDREN.
PARASITE RATE,
CHILDREN.
SPLEEN RATE,
ADULTS.
PARASITE RATE,
ADULTS.
C h i l d r e n e x a m i n e d .
N u m b e r w i t h e n -
l a r g e d s p l e e n .
S p l e e n r a t e .
C h i l d r e n e x a m i n e d .
N u m b e r w i t h p a r a -
s i t e s .
P a r a s i t e r a t e .
P e r s o n s e x a m i n e d .
N u m b e r w i t h e n -
l a r g e d s p l e e n .
S p l e e n r a t e .
P e r s o n s e x a m i n e d .
N u m b e r w i t h p a r a -
sites.
P a r a s i t e r a t e .
Villages close to the sea—
Female Jail .
. .
30
7
...
—
—
...
—
—
...
—
—
...
Bindraban
.
.
9
5
...
8
2 ...
—
—
...
—
—
...
Bamboo Flat
.
.
16
4
...
16
2
...
22
4 ...
—
—
...
Kadakachang
.
.
3
3
...
... ... ...
24
4
...
— —
...
Ogra Baraij .
.
15
4
...
15
4
...
9
1
...
—
—
...
Port Mouat .
.
.
12
7
...
11
4 ...
33
7 ...
32
0
...
Shouldari
.
.
.
8
2
...
—
—
...
—
—
...
—
—
...
Baighalsingpura. .
.
7
0
...
7
0
...
24
3 ...
17
0 ...
Dhani Khari.
.
.
4
0
...
4
1
...
28
6
...
— —
...
104
32
32
61
13 21
145
25 17
49
0
0
B 2
4
TABLE I— contd.
SPLEEN RATE,
CHILDREN.
PARASITE RATE,
CHILDREN.
SPLEEN RATE,
ADULTS.
PARASITE RATE,
ADULTS.
C h i l d r e n e x a m i n e d .
N u m b e r w i t h e n -
l a r g e d s p l e e n .
S p l e e n r a t e .
C h i l d r e n e x a m i n e d .
N u m b e r w i t h p a r a -
s i t e s .
P a r a s i t e r a t e .
P e r s o n s e x a m i n e d .
N u m b e r w i t h e n -
l a r g e d s p l e e n .
S p l e e n r a t e .
P e r s o n s e x a m i n e d .
N u m b e r w i t h p a r a -
s i t e s .
P a r a s i t e r a t e .
Villages some part of which
approaches the sea
—
Phœnyx Bay
. .
10
2
...
—
—
...
—
— ...
—
— ...
Aberdeen
.
.
. 90
4
...
—
—
...
—
—
...
—
— ...
Jungly Ghat
.
.
15
1
...
—
— ...
—
— ...
—
— ...
Lamba Lines
.
.
20
3
...
—
—
. . .
—
—
...
—
— ...
Stewartganj .
.
.
11
1
...
11
0 ...
—
—
...
—
— . . .
Mitha Khari
.
. 12
2
. . .
11
2
...
11
3 ...
—
— ...
Namunagahr
.
. 16
2
...
16
2 ...
12
0 ...
12
0 ...
Maymyo
.
.
. —
—
...
— —
...
34
8 ...
19
0 ...
174
15
9
38
4 10
57
11 19
31
0
0
Inland villages—
Wimberleyganj
.
.
16
0
. . . —
—
...
52
0 ...
...
. . . ...
Cadellganj
.
.
.
2
0
. . .
—
— ...
—
— ...
. . .
. . . ...
Anikhet
.
.
.
17
0
...
17
0
... —
—
...
...
... ...
Tusanabad .
.
.
32
0
...
32
0
...
41
1 ... ...
. . . ...
Hobdaypar .
.
.
16
2
. . .
—
—
. . .
— —
...
...
. . . ...
Manpur
.
.
.
4
0
...
—
— ...
—
— ...
. . .
. . . ...
Templeganj .
.
.
9
0
. . .
—
—
...
— —
...
. . . ... ...
School Lines .
.
.
30
0
. . . —
—
...
—
— ...
...
. . .
...
Pahargaon .
.
.
22
0 ...
—
—
... —
—
...
. . .
. . .
. . .
Austenabad .
.
.
22
0 ...
—
—
...
— —
...
...
... ...
Protheropur .
.
.
19
0
...
—
—
. . .
— — ...
...
... ...
Guaracharama
.
.
42
0
...
—
— ...
—
—
. . .
. . .
. . . . . .
Homphrayganj
.
.
7
0
. .
— —
...
—
—
. . .
...
. . .
...
Nowshera
.
.
.
6
0
. . .
6
0
. . .
—
—
. . .
. . .
. . . ...
244
2
2
55
0 0 121
1 1
...
... ...
Small island without ano-
pheles.
Ross .
.
.
.
57
1*
0
. . .
. . .
. . .
. . .
. . .
...
. . .
...
...
* Recent arrival.
5
The most severely affected village was that of Port Mouat. This shewed
a spleen rate of about 60 per cent. and a parasite rate of about 30 per cent.
The station close beside the village also has the reputation of being the most
malarious in the Settlement. The villages of Bindraban and Kadakachang
also shewed a high degree of infection. The situation of these villages is shewn
in the map of the Settlement accompanying this report. None of the other
villages could be considered as spewing hyperendemic conditions.
The villages of Ogra Basaij, Shouldari and Bamboo Flat gave spleen rates
of about 25 per cent. These villages like those already mentioned are situated
close to the coast or to salt swamps that in certain places stretch a considerable
distance inland.
Many villages shewed still lower rates. In some of these infection was
limited to some particular portion of the village so that if this were excluded
the rate was 0 per cent. In the large village of Aberdeen it was only in an
outlying group of houses bordering upon the sea that any enlarged spleens
occurred. The village of Lamba Lines is another example where the children
were negative with the exception of one family living in a house at the extreme
end of the village nearest the sea.
With one exception (Hobdaypur) all the villages lying inland from the
shores of the harbour shewed no indication at all of malaria. Unfortunately
Hobdaypur was not visited as the children had come to a neighbouring village
to be examined, and it is possible that Hobdaypur was not so far from the
influence of salt water as would seem to be the case from the map. Unfor-
tunately also the history of the two affected children (length of residence at
Hobdaypur, etc.) was not ascertained.
With this possible exception, to which too much weight cannot be
attached, not a single case of enlarged spleen occurred in an inland village.
Some of these inland villages are well situated on spurs of hills and it was
thought at first that their situation accounted for their freedom from malaria.
But as observations were extended it was found that a number of inland vil-
lages, notably those to the south of the harbour, were situated on very low-lying
ground, in some cases on the very edge of swamps (fresh water), and that these
were likewise free from malaria.
The village of Guaracharama, where the examination of 42 children failed
to shew any case of enlargement of the spleen, was situated in the midst of low-
lying ricefields. Lamba Lines lies along the margin of a large swamp much
shot over for snipe and is at the same time close to a heavy growth of jungle.
School lines, Austenabad, Protheropur and Manpur are all in situations that one
would have expected to be very malarious. Even the altitude of those villages
situated on spurs, a few hundred feet at most, was not sufficient in an ordinary
way to have been any protection.
6
The village of Aberdeen is situated on low hills about 50 feet above sea
level surrounded and intersected by flat fresh-water swamp and paddy land. A
large area of deadly looking uncultivated swamp full of pools penetrates even
among the houses and lies only a stone's throw from many of them. It was a
great surprise under the circumstances to find that none of the children shewed
enlargement of the spleen. In the outlying portion previously referred to, two
families were found living close together in which four children were found
suffering from enlargement of the spleen. At the time this sporadic incidence
of malaria could not be explained. Later on, when the relation of malaria to
Nsm. ludlowi and salt swamp was ascertained, the explanation was quite simple.
These houses were the nearest to an extensive source of Nsm. ludlowi.
5. A number of the most malarious villages were completely shaded by
Pithlecobia trees planted when the villages were first laid out and it was
thought that this condition might be a factor responsible for an enhanced
malaria rate. But it was not difficult to find healthy villages similarly shaded,
e.g.,T u s a n a b a d .
Again porosity of the soil was considered as a possible factor. But Port
Mouat, the most affected of all the villages, was situated on more than usually
porous soil and no definite connection in other cases could be traced.
Some of the villages were older than others, and in some more cattle were
kept, a condition which experience has shewn favours anopheles. But neither
of these circumstances served to explain the different degrees of prevalence of
malaria.
The one circumstance which appeared to determine the amount of malaria
in a village was propinquity to the sea coast. Considering the circumstances
of the different villages it was possible to say that malaria was confined to
villages within a distance of not above half a mile from the influence of salt
water, and only villages situated within a quarter of a mile were strongly
infected. A free aspect, opening upon the sea, seemed to increase this liability.
TYPE OF PARASITE ENCOUNTERED.
6. The frequency with which the different types of parasites were met with
is shewn in Table VI. It will be seen that at this time of the year the bulk of
infections among the native children in the villages were those of Simple
Tertian.
III.—Anopheles of the Andamans.
7. The following species of anopheles were encountered as a result of
systematic collection of larvæ and adults :—
Neostethopheles aitkeni (James).
Myzomyia albirostris (Theobald).