12-A.G.H., A.I.F.,
WELISARA.
14.3.42
MEMO:
C.O. 12- A.G.H.
- Herewith is furnished a summary of the salient sanitary features of the area included in the 25-mile wide band extending from Colombo to Matara.
- It is to be borne in mind that ,whilst the statement is believed to be as complete as it consistent with brevity, certain insuperable difficulties associated with security, limitation of time and lack of personal knowledge of the terrain, may have introduced unsuspected errors into the application of generalisations to particular localities.
- The area concerned includes the Southern portion of the Western Province, the Western half of the Southern Province, and a narrow strip along the Western border of the province of Sabara Gamuwa.
- The first section forms a band some 18-miles wide, extending along the coast Southward of Colombo, to a point a little North of Berwula. The greater part of this area lies at sea level to 100 feet, with a few elevations to 500 feet and isolated peaks towards the East rising to 1,000 feet.
- The second section extends around the South-West corner of Ceylon, from a little North of Bentota to a point East of Matara. It too lies chiefly at sea level to 100 feet, rising, however, north of Matara to 500/1,000 feet.
- The third section consists of a strip some 6-miles wide along the Western border of the Province Sabara Camuwa. It is for the most part high ground 500/1,000 feet, though Patnapura lies in a valley at sea level to the Eastward.
- The low country is similar to that in the neighbourhood of Colombo; it is well watered, studded with native villages and given over to the cultivation principally of rice and coconuts. On the higher ground, rubber and tea are also grown.
- With the exception of a strip about 5-miles wide extending from slightly West of Galle to the East of Matara (75”) the whole area lies within the so-called wet zone, and has a mean average annual rainfall varying from 100” on the coast to 200” in the highlands.
- First-class roads are limited to the vicinity of the coast, and good roads become less and less frequent to the Eastward, the Eastern border being serviced only by a few second-class roads subject to flooding.
- The details of the population of the area were not obtainable in the time available.
- Water Supply: The villages derive domestic water from shallow wells and surface waters. As far as can be ascertained, excluding Colombo the only reticulated supplies are-
Galle – Upland Surface water, not chlorinated
Ranapura – ditto
It would appear that the sub-soil water is adequate to meet considerable demands in most period.
- Sanitation: With the exception of Colombo, none of the towns in the area have the water-carriage system of nightsoil disposals, though privately installed septic tanks exist here and there. In larger towns there is a conservancy system effected directly or under contract by the urban council, but most villages rely upon cesspits or have no special provision whatever.
- Malaria: it is not epidemic in the area, which in common with the rest of the wet zone only experience epidemics when the monsoon fails. This is to be explained by the breeding habits of the predominant vector, A.culicifacies, which exists only in small numbers in normal seasons and only breeds up to numbers of epidemiological significance when its clean, small, breeding pools are not flushed out or disturbed by heavy rain such as usually falls at frequent intervals in the normal season. Localised outbreaks of malaria may be due to human interference – drainage works, road construction and the like creating and maintaining new suitable breeding places. A.hyracnus is numerous throughout the low country, particularly in the ricefield areas, but being principally an animal feeder it is not ordinarily regarded as of epidemiological importance.
- Malaria is, however sporadic in the area, and carrier of plasmodia are to be found in the local population. Any factor, therefore, which favours the breeding of A.culicifacies is likely to precipitate an epidemic. This may prove of considerable importance, having regard to the probability that the inadequacy of roads in the area may demand, for military purposes, a considerable amount of road construction apart altogether from other engineering works. All such works should be carefully controlled by medical supervision.
- It should be mentioned that the prevalence of A.hyrcanus or large number of mosquitoes other than Anophelenes may induce the controlling authority to drain certain swamps. Unless this drainage is carefully and properly done, it may produce large numbers of suitable breeding places for A.culicifacies so that a dangerous malaria vector maybe substituted for harmless species.
- A small portion of the area – the narrow strip in the 75” rainfall belt to the East of Galle, lies outside the so-called wet zone. The annual rainfall in this area is often so disposed as to favour the breeding of A.culicifacies to an extent greater than obtains in the wet zone. Malaria is therefore a somewhat greater problem here than elsewhere in the area.
- Filariasis: The incidence of filaria is very erratic. In the vicinity of Galle and inland the microfilaria rate ranges from 2 to 3%. N isolated areas North of Galle it is much higher, elsewhere in the area much lower.
- Dysentery: As might be expected from the association of imperfect nightsoil disposal and the domestic use of shallow well-water, dysentery is wide spread and frequently epidemic. During the month of December 1941, the latest figures available, cases notified from the area under study, excluding Colombo and district, totalled 45% of the cases notified throughout the Island including Colombo and district.
- Enteric: Similarly during same period the same limited area produced 20% of the total cases of Enteric notified throughout the whole Island.
- Typhus: whether urban or rural, is not officially admitted to exist in Ceylon. It is, however, credibly stated that cases have occurred along the East Coast, south of Trincomalee, and might be expected I the country East of Matara.
- Dengue: Aedes Aegypti, the vector of Dengue, is common in all coastal urban areas, but especially in Calle. Prevailing conditions do not usually favour its prolific multiplication in rural areas, but camp conditions and engineering construction unless adequately controlled, would create a serious problem.
- No information regarding helminth infection or other diseases has been obtained to vary the statements made on those subjects in report dated 30.7.1941, which should be read in conjunction with this report.