Sanitary and other miscellaneous notes for December 1917.
It was found during the course of the journey from Mombasa to Nairobi that the permanent way was being badly fouled by the excreta of patients travelling by hospital train, and especially by sick and convalescent carriers. As a result persons travelling on the line, which is at all times more or less dusty, ran the danger of inhaling or swallowing specifically polluted dust and thereby suffering in health. To obviate this sate of things the Railway Officials were approached and, after some discussion and an examination of the railway carriages and vans, a scheme was adopted whereby the excreta are to be collected in closed metal receptacles fitted into the openings originally occupied by the open cylinders which were used as latrine vents. At certain places on the line these receptacles will be lifted out, removed, and their contents incinerated; clean buckets, which are to be held in readiness, taking the places of those so removed. At the same time, the Railway Officials, who proved very obliging, agreed to construct and employ a Railway Disinfecting Van similar to those in use in Egypt.
A sanitary inspection of a considerable section of the Nairobi township was carried out under the guidance of Dr Radford and Dr Clearkin, the acting Medical Officer of Health. The general condition of the town was found to be practically unaltered from the described by Professor Simpson in his Report to the Colonial Office (1915). The inspection revealed a state of matters which is no credit to British rule, and calls for prompt and thorough amendment.
[App 1 (2)]
The Indian Bazaar is badly arranged, and is generally in a filthy and insanitary condition. It is overcrowded and may at any time become infected with plague. The public latrines leave much to be desired especially in the way of facilities for collecting the floor washings. Their construction is also, as a rule, faulty and they seem to be in a chronic condition of dirt and disrepair.
The large Jinja Market is only partially occupied. Its floor is uneven and there is no proper means of drainage. In its immediate vicinity are stalls where Indians sell offal, fowls, eggs, etc. Those for offal should not be permitted on this site. Dogs seem to have free access to the meat markets. The Native Market is a disgraceful place. Its floor consists of an uneven and stony bit of bare ground, it possesses no tables, no facilities for handling meat or other produce, and has no water supply. There is no sanitary convenience in its immediate neighbourhood. The open irrigation canals are sources of great nuisance and danger, receiving, as they do, sullage water and latrine washings from many premises and used, as they are, for bathing, washing clothes and cooking utensils, and even as a source of drinking water. In places they are overgrown by beds of reeds and rushes and these are said to harbour a species of Planorbis which can serve as an intermediate host for Schistosoma mansoni. Hence there is a distinct danger of bilharzia infection. These canals, two in number, come off the Nairobi river shortly after its entry into the town premises, run along either side of a valley, and supply water for the irrigation of vegetable plots by means of open channels which harbour all manner of refuse. What remains of the water, [App 1, 3] or rather sewage, in the canals, rejoins the river at a point near the slaughter-house.
The street drainage in certain quarters is very defective and there is no surface drainage at all at the Infection Diseases Hospital. The large drainage channels in the European residential quarter are in a very bad condition, choked by aquatic growth and liable to become mosquito breeding places.
A map has been furnished by Dr Radford showing the permanent anopheline breeding places within the area of the township. With the exception of an area along the Nairobi river and near Swamp Road, these are neither very numerous nor extensive and it should not be difficult or costly to abolish them altogether. The species of anopheline present are stated by Mr Anderson, the Government Entomologist, to be ten in number including such dangerous malarial carriers such as A.costalis and A.funestus. A.squamosus and A.mauritianus are also amongst the number.
In short, the greater part of Nairobi is an example of how insanitary a town can become when vested interests are allowed to interfere with necessary reforms, when money is not forthcoming for sanitary needs, when there is to some extent dual control, when a Health Department is starved and a Sanitary Administration run on wrong lines.
The improvements indicated by Professor Simpson are urgently required. The only one of any importance to which attention has been directed is the construction of the New Native Location. Here a beginning has been made and drainage works are in progress. We visited the site and found it in a filthy condition for the labourers employed had not been provided with any sanitary convenience whatever, and were fouling the ground and the very [App 1 4] channels they were constructing. They were also preparing ‘biltong’ and the soil was littered with portions of meat, bones and hides.
An effort was being made to force the hands of the Sanitary authorities and let natives occupy the location before the necessary sanitary works had been completed. We were asked to make representations to His Excellency The Governor on this subject and also on the general insanitary state of the township. This was done with the result that a conference was held at a later date (5 January 1918) which, at His Excellency’s request, we attended, and advised on various sanitary subjects.