Pike Report GEA – Appendix H


6 March – Accompanied by Serjt-Major Jardine, I embarked at Dar-es-Salaam on HMT Huntscliffe for Kilwa.
This boat also embarked 200 natives for repatriation to Durban and was to pick up a further 200 at Kilwa.
7,8,9 March – Ship awaiting orders to put to sea.
10 March – All passengers ordered to disembark and ship sailed with the crew only for Durban.
11 March – Obtained special authority for myself and Jardine to proceed per HT Clan McPhee, embarked at 3 p.m. and sailed at 5 p.m. Only ourselves and ship’s personnel on board.
12 March – Arrived at Kilwa Kisiwani, disembarked in afternoon, slept on shore, heavy storm during night. Saw Capt Douglas, Medical Officer, from whom I gathered that health of Cape Boys was bad, his hospital was overcrowded and he was short of staff.
There were 260 boys in the Railway Camp here 20 of whom were unfit for further service.
13 March – Proceeded by car to Kilwa Kivinji, where I arrived at noon. Lieut-Cherrington in camp assisted by a Private loaned from the SAFA. Serjt Kebble being in hospital, 540 boys in depot all more or less in low condition. Pitched tent at depot.
14 March – Accompanied by Lieut Cherrington, I called on the Post Commandant, Major Eustace, and explained my mission, after which I visited the Animal Transport Depot, saw Capt Robertson, OC, who informed me that of the 560 SA Natives in his camp he considered only 30 as really fit for duty. A medical officer visited this camp every morning and examined all boys reporting sick, those who were considered subjects for admission were sent down to the hospital some two miles distant by wagon. I then called on Lieut-Colonel Manifold, SMO, and discussed the situation with him, in course of which he stated that he was of opinion that the only thing to be done was to get these men out of Kilwa, that his hospital was overcrowded and a number of his staff were sick, and that he needed more Cape Boy orderlies if he could get them, these I promised to supply if possible. Subsequent events however proved that I could not muster enough fit men to attend to the ordinary camp duties in my own depot.
15 March – Two boys died in depot during the night. Wired IGC on situation vide my telegram L317 of this date. At this period deaths were averaging 4 per diem in the Kilwa area.
16 March – Disturbed during night by natives wandering round camp delirious, procession each day of boys from my camp to hospital and discharges from hospital to my camp, where some arrived in exhausted condition after short walk of 600 yards.
Arranged for a supply of medical comforts, ie tinned meat, rice, soup squares, and brandy, also stock of quinine, Epsom salts and caster oil. Lieut Cherrington seedy and both NCOs complaining.
17 March – Wired IGC giving numbers of all boys for evacuation from various points, also stating that men would require medical attention and comforts on ships conveying them, vide my L323 of this date. Personally informed Post Commandant and SMO of what I had done. Also wired Natlab, Johannesburg, stating condition of boys and requesting that special arrangements be made for their reception on arrival at Durban, vide my L324. Sent 8 stretcher cases to hospital, SAFA man recalled to join his unit. Unable to get sufficient boys to cook and carry out camp duties, paraded all boys in camp and after going carefully through them could only pick out 42 capable of doing any sort of work, this was out of a total of 560 who paraded.
18 March – Walked to Railway Camp on Red Hill, three miles off, and inspected boys in this camp, saw Serjt-Major Robertson in charge who informed me that of 300 boys he had a sick parade of about 23 per day and that even those who were not actually sick seemed to be incapable of any exertion, in other words they had become listless and indifferent. He had worked many of these same boys at Dar-es-Salaam previously and he was therefore in a position to note the difference, which he attributed as entirely due to the presence of malaria in their systems.
Sent Lieut Cherrington to hospital on a stretcher.
19 March – Rescued two boys delirious who had wandered into the sea, sent eight stretcher cases to hospital, obtained further supply of medical comforts, segregated all the weakest cases and made special arrangements for feeding them. Obtained supply of clothing, etc, from Ordnance for issue to boys who required it; boys all uncomplaining and utterly indifferent as to what happened to them, greatest difficult in inducing them even to wash themselves, in fact the greater number had to be nursed like so many infants. Wired Director of Railways on position, vide my L326.
20 March – Ten deaths reports, and 17 stretcher cases from my camp to hospital. Captain Maflin, OC Tram-Line, called reference to my proposed withdrawal of natives employed on construction of tram-line to which he was opposed. Natives being discharged from hospital scarcely able to walk to my camp, whole situation most distressing. Received supply from Director of Railways, vide his telegram D213.
21 March – Further wire to IGC, vide my L328, also to Director of Railways, vide my L327.
82 on sick parade and 10 stretcher cases to hospital, 20 deaths reported since 1st instant in Kilwa area. Obvious that to keep these men in this area any length of time would prove disastrous. SMO informed me that even though they were evacuated deaths would continue for some time but could not be worse than matters were on shore where there was no hope of improvement; it therefore became a case of choosing the lesser of two evils.
22 March – 50 boys sent to hospital 10 admitted. Serjt Kebble returned from hospital very weak, excused duty for four days.
23 March – One boy died suddenly in my camp from cerebral malaria, several other cases bad sent to hospital.
24 March – Serjt Kebbel sent back to hospital. IGC wires 1,400 boys can embark by Aragon about 28 instant.
Difficulty in transportation from Kivinji to Kisiwani distance 17 miles by road.
25 March – Interviewed Post Commandant who suggested I go to Kisiwani and find out about water supply there, also see OC Tram-Line and ascertain how many men they can transport daily from Kivinji to Kisiwani by tractors. Went down by car, saw Naval Transport Officer who stated water was short and he could not supply any men, nor was there any shelter for boys. OC Tram-Line informed me he could not move more than 100 men per diem.
Returned to Kivinji and informed Post Commandant accordingly, with whom I arranged that, in view of water shortage at Kisiwani, it would be as well to move as many men as possible to Mpara, halfway to Kisiwani, where there was shelter and sufficient water. Post Commandant asked me if I was sending anybody to take charge of the boys on the Aragon. I informed him that I had nobody to send, but that I had approached Capt Webb and Lieut Emery who were willing to travel by boat and they had both promised to do all they possibly could. These officers belong to the personnel of animal transport ships and have on previous occasions voluntarily rendered valuable service in looking after Union natives travelling on these ships. Major Eustace approved of this arrangement.
26 March – Sent off 98 boys by tractors with rations to Mpara to await there arrival of Aragon at Kisiwani, also arranged with Supply Officer to send bread and fresh meat ration to these boys every morning.
27 March – Post Commandant arranged for cars to convey further batch of boys to Mpara, it was anticipated these cars would do at least 4 trips, heavy rains fell however and they only did two trips in which they conveyed 82 boys.
Transport Officer, Capt Robertson, picked out 230 of the strongest boys of his lot and sent these on foot to Mpara, they had one day’s rations with them, and the balance of rations in charge of 20 other boys was to have come on by tractor that evening. I went by car to Mpara and fixed up all the boys from my camp in the bandas at the Remount Depot, Mpara, also taking them a further supply of meal, coffee and sugar. I also met the boys from the transport who were walking and fixed them up in the old Askari Barracks about a mile on the Kivinji side of Mpara and arranged that when their rations came along they should be dropped at a point near this camp. I returned to Kivinji that night.
28 March – Picked out 100 of the strongest boys in my camp and sent them off at 7 a.m. on foot to Mpara. Wrote a memo to Post Commandant informing him of the position and asking him if I could use tram-line that night, vide (p79) my memo dated 28/3/17 and his reply, also telegram K28 from DDR Kisiwani, saw supply officer, Capt Dunbar, and asked him what provision to make for food and water for boys travelling by dhows, he infomed me that dhows had certain quantity but not sufficient, that dhows would probably sail at 2 a.m. the next morning and should reach Kisiwani about 3 or 4 p.m. At the Aviation Camp I was fortunate in finding a number of Shell petrol tins with screw tops of which I secured 45 to hold two gallons each. It was about 11 a.m, I called in at the transport depot and discovered there had been a washaway on the tram-line the day before consequently the 20 boys with the rations for 230 boys sent to Mpara by the Transport Officer had never gone forward. The Transport Officer secured five porters and these he sent off on foot to Mpara with a bag of mealie meal each. I then returned to my camp bringing down the tins for the water in the car. I warned all boys in my camp (with exception of about 30 whom I considered unfit to undertake the journey and whom I sent to hospital the following morning) to fix up their kits and to take as much cooked food as they could with them and be prepared to leave the camp at 4 p.m. to embark on the dhows at 5 p.m., in addition to this I instructed Serjt-Major Jardine to have all the petrol tins filled with water also two 8 gallon drums which I had in the camp and further to have 4 gallon tins of porridge cooked dry or stiff and together with a packet of sugar these were to be taken to the landing place and issued to the boys as they embarked. These instructions were subsequently carried out to the letter by Major Jardine (with the assistance of a conductor loaned to me for the day by the transport). I instructed to parade all the boys and check them with the nominal rolls at 4 p.m. to march them up to where they were to embark. I was much concerned about the 230 transport boys at Mpara being without rations so at 3 p.m. I decided to take a supply in my car to them. I called at Capt Dunbar’s office on my way, but as he was not in I left a note on his table stating I had gone to Mpara and that I had left instructions for all my boys to be at the landing stage at 4.30 p.m. with supply of food and water and that I expected to be back at 5 p.m. when embarkation took place. I overtook the five porters about halfway to Mpara and relieved them of the bags of meal, this together with the coffee, sugar, and meal I had also tins for cooking, I delivered to the 230 boys at Mpara, at the same time warning them to cook sufficient food to last them next day and to move off to Kisiwani at daylight next morning. I also warned in similar terms the other 280 boys who were accommodated at the Mpara Remount Camp. I then returned to Kivinji where I arrived at 5.30 p.m. Here I found 200 boys from the transport camp and 400 form my camp waiting to go aboard the dhows, about 60 of the transport boys had already embarked. There were present watching operations, Major Eustace, Post Commandant, Lieut-Colonel Manifold, SMO, Capt Dunbar, Supplies and Tranport, Capt Robertson, Transport, Capt Overbeck, Capt Barnard, Capt Van Velden, Capt Gunningham, Political, and Capt Rennie who was working the motor boat, Serjt-Major Jardine and the Conductor in charge of my boys and several conductors with the transport boys. Capt Dunbar informed me that 200 transport boys had neither been provided with food or water for the journey. I asked him if he could not supply biscuits, to which he replied he could not, but he could give me mealie meal so I decided to issue my 400 boys with the cooked meal I had prepared and to cook fresh supplies for the 200 transport boys on the spot. I got wood and had a fire made and started cooking operations at once. Major Eustace then asked me if I had got his note which he had sent to my camp. I replied that I had not been at the camp since 3 p.m. and had just returned from Mpara. The boys had, owing to the low tide, to walk into the water up to their knees and climb into boats which were then towed out to the dhows, which were lying about 300 yards out. These operations continued until about 7 p.m. when the tide became so low the boats could not be worked, and it was decided to discontinue embarking until 4.30 the next morning. Several hundred boys were still on shore, everybody else had left with the exception of myself, Lieut-Colonel Manifold, Capt Dunbar and Capt Gunningham, and Serjt-Major Jardine. I proposed that the remaining boys be allowed (p80) to sleep where they were, as it was a clear starlight night. Col Manifold however suggested that it might rain and offered me the use of a section of his hospital tents, which were then empty, to this I agreed and the boys were placed in these tents for the night, in the meantime cooking operations were still going on. I dined with Capt Gunningham and at about 9.30 p.m. he went with me to see how much meal had been cooked. We found that the cooks had run short of water, we then went to where the boys were sleeping and tried to turn out a fatigue party to carry water. They however were reluctant to move. I warned them that they would go short of food and they replied they did not mind that; this will show what state they were in, so I did not press the point. Capt Gunningham came to the rescue and offered to send for his boat boys to carry water which they did.
29 March – At 1 a.m. after all that was possible to be done had been done I returned to my camp. Serjt-Major Jardine turned the boys out at 4 a.m. next morning and I arrived on the scene at 5 a.m. and found Major Eustace and Capt Dunbar there. At 6.30 all boys were on board and some of the dhows had already put to sea. At 7.30 I left by car for Kisiwani picked up several boys on way between Mpara and Kisiwani where I arrived at 10 a.m. and found all the boys waiting with the exception of a few stragglers, secured some rations for them which they cooked and ate whilst waiting to embark. I here took a further 200 boys from the Railway camp and by 2 p.m. I had the whole 700 odd on board the Aragon. Capt Webb was already on board with a staff of Conductors and the boys were all placed on the main deck. I saw Mr Heher who was acting OC Troops and introduced Capt Webb as the officer in charge of the natives. I was then informed that there was no medical officer on board the ship and only a very limited quantity of drugs. With the Supply Officer at Kisiwani, Capt Cotton, and OC Troops I saw the Captain of the ship on the question of rations, my orders were to place 7 days rations on board which the boys would have to prepare for themselves. It was realised that with so many men this was practically impossible so it was arranged that if sanction could be obtained the ship should feed the boys giving them the ordinary soldiers ration. Capt Cotton went ashore to arrange for necessary authority which was obtained. Lieut-Colonel Manifold came on board about 3 p.m. I explained the situation to him and he, the acting OC Troops and myself discussed the matter with the result that Lieut-Col Manifold promised to return to Kivinji and to arrange for a Medical Officer to travel by the ship and to supply the necessary drugs etc required for the voyage. I then proceeded to select a number of reliable boys, these I handed over to Capt Webb to assist him, also two or three boys who had experience of hospital work, and Capt Webb with the assistance of Lieut Emery immediately started to arrange some order among the boys. As dhows had not arrived I stayed on board the night. One native died during the night.
30 March – At 9 a.m. there was no sign of dhows, at 9.30 Col Praal, MO, of the Hospital Ship Gasconi, came on board to view the body of the deceased native, he remarked on there being no doctor on board and promisd to send a few drugs. I went ashore with him, where I understood he was going to see the MLO about about matter. At about 10.30 we received information that the dhows were becalmed in the bay opposite Mpara and that one native had died on board. I saw the MLO and Naval Transport Officer, Capt Williams, to whom I pointed out the serious plight of the natives in the dhows, and he agreed to take the responsibility of going out with the tug Garth. I obtained four cases of milk from the supplies, biscuits or bread they had none. I went out with the tug and at about 14 miles from Kisiwani by sea we found the dhows lying at anchor. We had water on the tug so mixed the milk with water and filled a number of tins on each dhow, sufficient for each native to have a good pint. The dhows were then all attached to the tug and towed into Kisiwani, reaching the ships side about 3 p.m. Many of the boys were in a state of exhaustion and had to be carried up the gangway. At this time there was no doctor on board. Serjt-(p81)Major Jardine arrived from Kivinji. I stayed the night on board. One dhow was missing.
31 March – I left ship about 9 a.m. and went back to Kivinji, met Capt Dunbar on road and he informed me that one of the dhows had missed the tide at Kivinji and was consequently delayed 12 hours, that he had taken all the boys ashore and given them a good feed before starting them off. I arrived at Kivinji about 2 p.m.
1 April – Left at 6 a.m. for Kisiwani where, on arrival, I found 16 boys who reported that their dhow, which had been delayed with Kivinji, was now becalmed in Mpara Bay and that they had waded ashore and walked to Kisiwani, that 2 boys were dead on the dhow. I saw the Naval Transport Officer and he informed me that he could not assist with the tug. I phoned Major Eustace, and he requested me to arrange with the MLO Lieut Kenny-Dillon, to send a party of Carriers across country to the dhow. Arrangements to do this were just about completed when I received wire from Major Eustace to say that the dhow had returned to Kivinji. I later ascertained that there were 2 dead boys and 19 others who had been admitted to hospital on return of dhow to Kivinji, during the afternoon 58 more boys walked into Kisiwani, these were also part of the number on the missing dhow. When I took these men on board, I met Capt Miller, Medical Officer, who I understood had arrived at 3 p.m. the previous day, and between him and Capt Webb I gathered that things had been knocked into shape and I was satisfied all that could be done was being done for the natives. I went ashore at 5 p.m. My car driver had been admitted to hospital so I had to spend the night at Kisiwani.
2 April – With Serjt-Major Jardine I fixed up all the nominal rolls and handed them over to the MLO. Here my responsibilities ceased as far as the Aragon was concerned, so we returned to Kivinji on the mailcar. Lieut Cherrington returned from hospital.
3 April – Wired Natlab, Johannesburg, also IGC vide my telegrams, L336 and L337. Selected new site for camp and arranged with Post Commandant for transport to move all camp equipment.
Heavy rains fell almost every day during this period, making transportation by road almost impossible, and had it not been for the unfortunate fact that the dhows were becalmed trouble would have been saved.
Under ordinary circumstances these dhows should have done the journey in from 12 to 14 hours in which case it would have been the most comfortable and safest means of transporting such a large body of men, particularly in the condition they were in.
I remained in Kivinji and assisted Lieut Cherrington with fixing new camp, etc, and returned to Dar-es-Salaam on 13 April.
Aragon did not sail until 9 April.
TE Liefeldt, Major
Controller Union Labour, EAEF

(By Colonel Clemesha, IMS)

The early history of this outbreak is, at present, not a matter of certainty, as no report has been received from Nairobi, when the infection came originally.
The following facts are certain:-
1. There has been a recrudescence of plague in the Town of Nairobi, 59 cases have been reported since 12 May. Vide table.
2. On 9 August a death from pneumonic plague occurred at the KAR Depot at Nairobi. This was reported to Medical General Headquarters by wire, the message arriving on 11 instant.
3. On 9 instant a party of men left the Depot and proceeded to Mombasa. They embarked on the Barjora on 11 instant with a mixed lot of men from different units, the total being 12 British, 121 Indians, 932 Africans. The boat proceeded to Zanzibar where she arrived on the 12th. Here one Naval rating wounded and one (p82) askari, King’s African Rifles with mumps, were disembarked. She then proceeded to Dar-es-Salaam and took on 82 British, 45 Indians, 23 Africans, disembarking the Shopping Controller and his Secretary.

There was a considerable amount of sickness of a mild nature on board; this was reported by the Senior Medical Officer Barjora to Deputy Director of Medical Services, Lines of Communication, by letter; the Ship then sailed for Kilwa.

On 13 August the Barjora arrived at Kilwa and reported seven cases of pneumonic plague amongst natives ex Nairobi. These cases reported sick on the evening of the 11th, within two hours of embarking. All cases were from drafts of 2/2 King’s Africa Rifles. From two of the above cases, bacteriological preparations were made of the sputum, and these contained a pure culture of a bacillus, which shewed a marked bipolar staining, and in every way resembled that of plague. The majority of the cases had the classical symptoms of true pneumonic plague. Of the first seven cases four died soon after admission to hospital.

As soon as the nature of the disease was known all communication with the shore was stopped; troops that were to have been disembarked were not landed, and the vessel sailed next day for Dar-es-Salaam, where the whole ship’s company could be isolated on the Quarantine Island. A wire was sent to the Port Health Officer, Zanzibar, concerning Seaman Marsden and Askari Johannes, and information on the outbreak was telegraphed to the Deputy Director of Medical Services, Lines of Communication, Dar-es-Salaam.

During this voyage every possible care was taken to prevent the spread of the malady, suitable arrangements were made at once for the isolation of the sick, separation of contacts, inoculation of immediate contacts, the Medical Staff and others on board.

The Barjora arrived at Quarantine Island, Dar-es-Salaam, on the morning of 15 August. Disembarkation commenced on the same evening, and by an early hour on the 16th the ship was clear of troops, medical personnel and equipment. The Barjora proceeded to Zanzibar for thorough disinfection and Claytonisation, meanwhile the ward used for the sick having been roughly disinfected with Hydrarg. perchlor. solution as a measure of safety. Captain Varvill accompanied the ship to Zanzibar as Medical Officer.

On the Island suitable sites were selected for hospitals, for plague patients, for suspects, and for other diseases.

The work of inoculating the remainder of the troops was carried out as quickly as possible.

A portion of the Island was allotted to each unit and a self-contained camp constructed, each with separate latrines, incinerators, cook-houses, etc. In a very short time each unit had fairly comfortable quarters. Supplies of water, fuel, etc, arrived each day and were placed on the beach, but care was taken to avoid all communication between the coolies and the former occupants of the Barjora.

Among the personnel of the Barjora were:-
1. Major Hemsted, Senior Medical Officer, HT Barjora
2. Captain Varvill, Royal Army Medical Corps
3. Captain Crofton, RAMC
4. Captain Mulvey, RAMC
5. Captain Cantor, RAMC
Major H Hemsted was appointed Senior Medical Officer, Quarantine Island.

A large number of cases more or less resembling pneumonic plague continued for some days after disembarkation.
Below is a list of the numbers on each day:-
On the 11th 7 cases
12th nil
13 nil
14 2 cases
15 nil
16 1 case
17 2 cases
18 10 cases
19 nil
20 2 cases
22 3 cases
23 1 case
24 1 case
25 4 cases
26 nil
Total 32

2 King’s African Rifles 21 cases
3 King’s African Rifles 4 cases
4 King’s African Rifles 1 case
Porters 5 cases
Indian 1 case
Total 32

In addition to these 32 actual cases, 71 contacts and doubtful cases were under observation. Most of these exhibited symptoms of bronchial catarrh, sputum tinged with blood, and some rise of temperature, but did not develop the typical characteristics of the disease; they were nevertheless carefully isolated from the genuine cases, and from the healthy members of the camp.

The Assistant Director of Medical Services (Sanitary) visited the Island daily and specimens of sputum of the doubtful cases were brought away on sterile swabs and examined bacteriologically.

It soon became apparent that the disease was becoming milder in type, and was increasingly difficult to diagnose. The difficulty of being quite certain as to the true nature of the disease in any particular patient was increased by the fact that there were some rather debilitated men on board who suffered from malaria, cough, and chest troubles.

On the 24th, two Indians shewed some suspicious symptoms of pneumonic plague, the diagnosis in one case being confirmed by examination in the laboratory, the other gave a negative result.

As the British Officers, Non-Commissioned Officers and ranks had remained free from pneumonic plague, though several had suffered from malaria and other diseases, all who were fit and could be spared, were on the 24th sent over to a neighbouring island. The object of this was to eliminate all chance of this party becoming infected with plague and to permit of their early return to duty. Up to the time of reporting, no sickness in any way resembling pneumonic plague has occurred on Lighthouse Island.

One death from cerebro-spinal due to pneumococcus occurred on the 23rd, there were also about six cases of mumps amongst the African while on the Island.

On receipt of the information of the outbreak, rules were drawn up to protect the Forces from Nairobi and the centres of infection in that neighbourhood. A copy of these is enclosed for information.

I wish to draw attention to the excellent service rendered by the whole of the Medical Establishment on the Island. They have all done their duty fearlessly and well. To Major Hemsted the Senior Medical Officer of the Barjora and the Quarantine Island, is due the credit for the arrangements on the island and ship. Assistant Surgeon Tobin has also greatly distinguished himself in the way he has worked.

Medical General Headquarters, Dar-es-Salaam
18 August 1917

To: The Deputy Director of Medical Services, Lines of Communication, Dar-es-Salaam

Reply your memorandum 157/17 of 17/8/17
The following precautionary measures are necessary to prevent the spread of plague amongst the forces from endemic centres such as Nairobi:-
1. Appointment of Major Southon, Indian Medical Service, to be plague officer of Nairobi. He will report on such points as the quantity and kind of plague in the Bazaar, where infected areas are. Whether Nairobi is to be considered infected or not, will be settled by Deputy Director of Medical Services (Sanitary) in consultation with Major Southon.
2. A careful examination by Medical Officers of Regiments prior to leaving the Depot, disinfection of all kit by spreading in the sun to be carried out when possible. All doubtful cases of bronchitis fever should be kept back.
3. As long as Nairobi is considered infected, detention of troops and carriers, at Voi or some other suitable place, for a period of five days. Should cases of plague occur (p84) amongst the detained troops, the detention for the unit to be settled with the Assistant Director of Medical Services (Sanitary).
4. Careful inspection of the troops at the camp at the end of the five days detention, before allowing to proceed.
5. Loading the troops on the steamer at Tanga instead of Kilindini which is an infected port. Should the journey via Moshi and Tanga be found impracticable, troops should be railed to Kilindini and proceed on board at once on arrival. On no account be allowed in the bazaar.
6. Inspection by Port Health Officer at the port of arrival.
(signed) WW Clemesha, Colonel
Indian Medical Services
Assistant Director of Medical Services (Sanitary)

Date Military Civil
Week ending 12 May – –
19 – 2
26 – 5
2 June – 4
9 – 2
16 – 4
23 – 7
30 – 3
7 July 4 2
14 2 2
21 – 5
28 – 4
4 August 1 5
11 – 3
18 – 2
25 – –
Totals 8 51
Military 8
Civil 51
Total 59

(By Colonel Clemesha, IMS)

For a proper understanding of this outbreak of plague it is necessary in order to trace the source of infection to go back to the last week of July, and to scrutinise the cases that occurred amongst the civil population from that date. It will be remembered the cases amongst the King’s African rifles drafts commenced to appear on 11 August in the evening. Particulars of import and groups of cases are given below:-

Case 1 30 July – An African personal servant of Mr Gowan of the National Bank died of pneumonic plague.
Case 2 3 August – An African Shamba Boy, servant, resident at Salisbury House died of pneumonic plague – visited case one.
Case 3 5 August – An African Shamba Boy, servant of Mr Gowan of National Bank, died of pneumonic plague; had close connection with Case 1. Here this series ended, no further cases occurring.
Case 4 31 July – An African personal servant of Major Salmon-Sanderson died suddenly of pneumonic plague. No history as to where infection came from.
No connection with Case 1 as far as is known.
The personal servant of General Llewellyn visited this case after, or about the time he died and removed some blankets. He did not, however, contract plague. The blankets were recovered and disinfected.
Case 5 7 August – A suspicious case occurred in the Bazaar. The man rapidly recovered and was probably not a case of plague.
Case 6 3 August – An African stranger from outside came to see a friend in the Carriers, stayed the night, became ill and died of pneumonic plague.
Case 7 10 August – An African Mess Boy of 3 King’s African Rifles was found dead not far away from the Mess at 7 p.m. evening of the 9th, having died of pneumonic plague. He was known to be ill a day previous and was (p85) absent from the Mess. Apparently he was not in his hut but in the King’s African Rifles’ Lines during his illness. He was a Carrier, a Kikuyu, and not an askari of the Regiment who were Yaos. No history of source of infection can be given. Five other Carriers resident in the same hut did not develop the disease. The hut was burned down. Case Group 8 on board the Barjora evening of the 11th, seven King’s African Rifles, all reported sick within an hour of each other. An eighth case reported sick on the morning of the 12th. All these men had been in Nairobi for the ten days before they started and they left that station on the afternoon of the 8th. It will be necessary to refer to this group in greater detail shortly. From a careful study of all the circumstances made on the spot, it is practically certain that case 6 – the Mess Boy – was in no way responsible for the infection of the askaris in case group 7. Firstly, the Mess Boy lived apart from the askaris. He would not eat, sleep, parade or be friendly with them. Secondly, if the Mess boy had lived long enough to infect anybody – which he did not – the occupants of the Mess or his own hut, would have been most likely to contract the disease.
From a careful survey of these facts combined with a knowledge of the general characteristics of pneumonic plague, the following deductions are permissible:-
1. That in a period of ten days, five separate outbreaks of pneumonic plague made their appearance (vis, Cases 1,4,6,7 and 8) and as far as investigation shows, none of these could have contracted the malady the one from the other; the presumption is therefore that they all received the infection from a common source.
2. That cases 1,4 and 7 were personal servants of Europeans. Group 8 were Askaris and would be likely to behave much in the same way as servants in some respects. Consequently, if we can show that a centre of infection and pneumonic plague existed in the town, and that centre presented attractions to this particular class of men, we shall go a long way towards establishing a working theory of the outbreak and also finding the true source of the mischief.

Outside the Municipal limits of Nairobi is a small settlement known as Kila Liswa. Being situated beyond the town limits, it is not under regular supervision, deaths are not reported regularly. The Police complain that the inhabitants are notoriously troublesome, illicit drinking houses are to be found in the settlement and doubtless prostitutes also live there. Many house servants of Europeans make a regular practice of visiting the place probably because they have more money than is good for them.

Cases of plague were reported from this settlement on 12 July, pneumonic; 18 and July, bubonic.

On 25 July, the headman himself died of the disease. 16 August another case of bubonic occurred. Considering that there were at least four cases reported from this village in July, and one subsequently, it is highly likely that others which did not find their way into the Municipal Register also occurred, so there can be no reasonable doubt that Kila Liswa was a potential centre for the dissemination of the disease immediately prior to the outbreak in early August. This combined with the reputation it enjoyed as the home of illicit drink and other attractions is strong presumptive evidence of the theory that it acted as the chief disseminating centre of this outbreak. It is impossible at this date to get a more accurate account of the epidemic in this village. Several attempts were made earlier without success. Kila Liswa is only about 1 ½ miles from the lines and was not out of bounds. Consequently soldiers visiting the village would run no risk of being caught by the Military Police. The parts of the town of Nairobi placed out of bounds were free from infection from plague at the end of July and beginning of August.
A study of the facts connected with the draft of the 2nd Regiment of the King’s African Rifles also supports the theory that the first seven cases at any rate were infected from a common centre, and that centre was not the Lines. The whole draft consisted of 205 2/2nd, 28 1/2nd, 23 3/2nd; total 253 men. All had lived in the Depot after 28 July. Hence the Camp at Mbagathi could not be the source of the disease. Of the first seven attacked, all sickened within an hour of each other. 2 were 3/2nd, 3 were 2/3nd, 2 were 1/2nd regiments respectively. No cases of plague occurred amongst the women left behind, no dead rats were found, and no bubonic cases have occurred since.
Had the Lines been the source of infection more cases would have probably occurred amongst the 2/2d for they were 8 to 1 more numerous than the other regiments and certainly rats would have been found, and dropping cases would have been reported amongst the women after the departure of the draft.

Taking all these facts into consideration, it seems highly probable that these men visited Kila Liswa the evening before they started, and were all infected in a drinking shop or brothel. No other explanation will account for the facts as satisfactorily.

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