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9
Smith. This being so it can readily be understood why the population, which is
exceedingly widely scattered, hesitates to incur the expense. What: is very
commonly done is to arrange lor an officer with a staff of one or two inspectors
and possibly a nurse to combine the duties of health officer of some small town
with those of the county. This is an arrangement that works very well, and it is
here that the best results are obtained.
Typhoid in counties so dealt with has been verv greatly reduced, and hookworm
disease has been practically wiped out, almost entirely as a result of
substituting a sanitary form of convenience for a bad form or none at all. Hookworm
disease is practically non-existent in Great Britain but here, in the South,
it has been and is responsible for a vast amount of ill-health, the sufferers though
able to go about being so weak and languid as to be incapable of physical exertion.
As a result their homes and farms get into a dreadful condition and they and their
families starve. In some places 1 have seen so much of it that now I can almost
invariably tell the individuals who are victims of the disease merely by noting their
bearing. The effect of treatment on the patients and of minor health works at their
homes is the bringing about of a miracle. The individual is given a new lease of
life, and in a short time he is able to pull his place round. It was to fight this
disease particularly that Rockefeller gave such large sums of money some few
years ago.
In very many counties malaria (chills and fever) has been a curse for ages.
Jamestown, one of the earliest settlements, was abandoned because of it and to-day
is left as a memorial of lost endeavour. It is chiefly, of course, in the low-lying
coastal areas, the counties round about Norfolk, Newport, etc., in which we have
been for the past week, where marshes are numerous and extensive (the "Dismal
Swamp" lies between Norfolk and Suffolk) and mosquitoes abound, that the
problem is most acute. Drainage, which is the chief and best method of dealing
with the marshes, is so costly that it cannot be done on a large scale, but by
spraying with oil, by screening the windows and doors of the houses and inducing
the inhabitants to take quinine, much can be done and has in fact been done.
Thousands of people indeed, because of these things, have been completely relieved,
and 1 saw quite a number who told me that whereas formerly there was never a
year but they had numerous attacks, now they do not know what a "chill" is.
On the whole I am very greatly impressed by what I have seen. The work
is, of course, very elementary and only the fringe of it has been touched. It will
go forward, however, mainly because the people themselves are beginning to
realise its value.
The coloured problem is a very interesting one and may become a prominent
one. The relations of the whites and the coloured in Virginia, and throughout
the South as a whole, 1 suppose, are most peculiar. The whites behave as though
the blacks do not exist. They speak to them, of course, and are waited upon
and served (very badly) by them, but otherwise do not recognize them. Theoretically
they have equal rights, but by an amendment of the constitution and the
introduction of an "educational qualification" the coloured have been in effect
disfranchised. The coloured folks apparently quite quietly accept all this but have
their revenge, since much of what they get in the way of advantages of civilization
they do not pay for; they are a continual threat from the health point of view
on account of their careless habits, and more important still, they are keeping the
white children back so far as education is concerned.
This last happens because though education is compulsory it is in fact not
enforced, the main reason being that if enforced at all it must be enforced in respect
of both races. To enforcing it in respect of the coloured there are many objections,
social mainly, one being that the assistance of the coloured children is required
for a great part of the year by the farmers.