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to the coolies the work has still to go forward, so that as long as it is in progress
there is continual migration of new labourers to fill the gap3 caused in the
labour force by sickness, desertion and death. This continual imigration is a
further source of mischief, for the constant introduction of gangs of susceptible
new comers into camps which already are hot-beds of disease, increases the
trouble just as the addition of fuel to a glowing fire increases the blaze,
231. The conditions briefly described above or some slight modification of
them are the cause of the epidemic outbreaks almost universally attributed to
soil disturbances. But some of the minor outbreaks attributed to this cause ara
merely the occurrence of relapses among labourers already infected, as the result
of arduous work or exposure to the sun and rain. If such epidemies of relapses
occur among the labourers of a labour camp where camera of malaria abound
new infections will increase proportionately.
232. A consideration of these facts shows that temporary aggregations of
labourers may often be a most potent cause of increased malaria in placas where
the infection and the carrier already exist ; and the occurrence of even quite
small labour camps is sufficient to produce an appreciable effect. In Bombay
in 1909 a small collection of coolie3 belonging to an Indian contractor were
working in a part of Chowpatti. There were only about 23 of them and they
were housed in the most miserable of makeshift shelters. They had been
working there for some time, and there were a few open wells close by infested
with larvæ of N. stephensi. Examination of the blood of these people showed
that 35 per cent. were infected with malaria parasites, an index far exceeding
that of Chowpatti as a whole. Not only did these people suffer from malaria,
but a foreman and an overseer who belonged to Bombay and who had a small
office on the site of the works, in which they often stayed till late at night,
both contracted malaria, most probably in the course of their work.
233. In the case of the New Dock Works large numbers of labourers
were brought together and many of them were camped down on the site of
the work. A number of temporary frame huts were provided for these
people, but besides these, many little shelters were built here and there by the
coolies themselves. A good supply of water was laid on from the City mains,
latrines were provided, and arrangements made for medical treatment of the
sick. It is probable that but for these precautions disease would have been
even more prevalent amongst the labourers than it was ; but there is no reason to
suppose that special precautions were adopted against malaria at the commence-
ment of the work. It is probable that if it had been generally known that
malaria was prevalent in the North Fort, which adjoins the dock site, efficient
preventive measures would have been instituted from the first; and the most
simple measure would have been the removal of the labourers from the site
of the work after night-fall.
234. It is recorded that, when the road between Colombo and Kandy was
being constructed a fearful epidemic of malaria occurred amongst the labourers
employed, who were encamped along the site of the line. Villages near the line
also suffered severely. Because of this outbreak, arrangements were made at
a later period, during the construction of the railway, to convey all the
labourers to and from the work by special trains. The labourers were housed
in Colombo and Kandi away from the site of the work. As a result of this
measure an outbreak of disease was avoided.
235. Education in relation to Malaria in Bombay.—Celli has pointed out
that education has a most important influence in modifying the severity of
malaria. Usually other things being equal malaria tends to be most prevalent
among the poorest and more ignorant classes of the community, and in pro-
portion as the spread of education leads people to seek proper treatment for the
disease and to adopt methods for its prevention malaria will become less and
less common. At the present time large numbers of the educated citizens of
Bombay are familiar with current ideas regarding malaria and it is probable
that the majority of them on occasion seek the advice of qualified medical
practitioners for their children and themselves and adopt minor precautions
against malaria, such as the use of mosquito nets, etc., at night ; though it is
probable that mosquito nets are more often used because of the discomfort of
mosquito bites, than with the idea of escaping malaria.