After we had walked all round the camp and got well soaked with the ordinary Togo afternoon shower, of which none of us took any notice, we went back to the kiosk for more refreshment, and here we found waiting us one of the Roman Catholic Fathers from Palime. He was a fair-bearded man in a white helmet and a long, white-cotton soutane, which somehow, even in this country of few clothes, gave the appear-ence of extreme poverty and self-denial. He had come up on a bicycle and had a great deal to say about the sleeping sickness. A day or two before he had been travelling two days west of Palime and he was asked by a native if he could speak English, and, when he assented, was taken to see a sick man. The man was a stranger to the people round and could only make himself understood in pigeon English. He told the Father he lived six days away, in British territory, and as he talked he perpetually took snuff. “Why,” asked the Father, “do you take snuff when you talk to me?” Because, the man explained, he had the sickness, and unless he took the strong, pungent snuff into his nostrils he could not talk, his head would fall forward, and he would become drowsy at once. This, he went on to say, was his reason for being here, so far from his home. He had heard there was a doctor here who could cure the sickness, and he was journeying to him as fast as he could. It is sad to think after such faith that he had probably left it too late.
“It is very difficult, indeed,” said the doctor, “to be sure of a cure.” The patient is discharged as cured and bound over to come back every six months for examination, and if each time his blood is examined it is free from parasites, all is well. He is certainly cured. But he has gone back to his home in an infected district, and if after six months or twelve months the parasite is again found, who is to say whether he has been re-infected or whether there has been a recrudescence of the old disorder? Occasionally, says the doctor, it is impossible to find the parasite in the blood, while the patient undoubtedly dies of sleeping sickness; the parasite is in the brain.
Since 1908 there have been four hundred cases through the doctor's hands. Of these 19 per cent, have died of sleeping sickness, 67 per cent, have been sent away as cured, and about 3 per cent, have died of other causes. Only ten of those sent away as cured have failed to present themselves for re-examination, and in this land where every journey must be made on foot, and food probably carried for the journey, it speaks very well, I think, for both doctor and patients that so many have come back to him. He is far kinder, probably, than the natives would be to each other—too kind for his own convenience, for the natives fear his laboratory, and will not come there at night, because when a patient is dying and past all other help he has him brought there to die. “Why?” I asked. “I may be able to help a little,” he said. “But how kind!” He shrugged his shoulders with a little smile. “It is nothing, it is doctor,” and he waved the thought aside as if I were making too much of it.
The disease comes, so says Dr von Raven, from west to east, and was first noticed in the Gambia in 1901. As long ago as 1802 a Dr Winterbottom described the sleeping sickness, and in 1850 a slavetrader noticed the swelling of the glands and refused to take slaves so afflicted. Undoubtedly cases of sleeping sickness must have been imported to the West Indies or America, but owing to the absence of the glossina palpalis to act as host the disease did not spread. That it is a ghastly, horrible, lingering, and insidious disease, that every man who has it where the glossina palpalis abounds is a danger to the community among whom he dwells, no one can doubt. They say that after a certain time the natives of a district may acquire immunity, but as this immunity comes only after severe suffering, it is perhaps better to stop the spread of the disease. The Germans have no hesitation in restricting the movements of the native if he is likely to become a public danger, but the British Government is very loath to interfere with a man's rights, even though it be the right to spread disease and death. Dr von Raven and the English Dr Horne met in conference a few months ago with the object of urging upon their respective Governments the absolute necessity for allowing no man to cross the Volta unless he have a certificate from a medical man that he is free from sleeping sickness. They contend, probably rightly, that a little trouble now would ensure the non-spread of the disease and assist materially in stamping it out. The Volta is a natural barrier; there are only two or three well-known crossing places where the people pass to and fro; and here they think a man might well be called upon to present his certificate. Against this is urged the undoubted fact that large numbers of the people are at no time affected, and, therefore, it would be going to a great deal of trouble and expense to effect a small thing. But is it a small thing?
“You write,” said the doctor as he bid me farewell; “you write?”
I said I did a little.
“Then tell the English people,” said he, “how necessary it is to stamp out this disease while it is yet small.”