Report of the Medical Officer of Health / Municipality of Colombo.
- Colombo (Sri Lanka). Public Health Department
- Date:
- [1929]
Licence: Public Domain Mark
Credit: Report of the Medical Officer of Health / Municipality of Colombo. Source: Wellcome Collection.
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![dumps and the many grassfields within the town, which are stealthily manured with horse and Cfittle dung or with town refuse stolen from dust bins or purchased from scavenging coolies for a small consideration, also provide excellent breeding places for flies which after feeding on the dejecta in pail latrines invade houses and infect the food of the people. Colombo still has 8,500 buckets conserved daily, and these pail latrines not being fly proofed are a source of potential danger. When one takes into consideration the large number of undetected carriers, the number of undiagnosed cases and the number of cases diagnosed late and the cases in the incubation stage when the faeces is infective it is not difficult to appreciate what an important role this method of transmission plays. Diagram IV. shows the great improvement effected in the incidence of typhoid fever in Colombo since the introduction of the water carriage system. The drop in the curve is marked since the adoption of the aided drainage scheme in May, 1925, whereby drainage of premises to sewer has been speeded up. Out of a total of approximately 21,800 separately assessed premises, only 7,794 or about a third of the town has been sewered. The provision of public lavatories numbering 08 at the end of 1929 in the crowded parts of the town where tenement compounds and surface drains were freely abused has contributed in no small measure to lowering the incidence of typhoid fever. (3) Water-Mouth. Contaminated water plays an important role in the dissemination of typhoid where public water supplies are drawn from lakes or rivers liable to contamination from sewage effluents. In Colombo the public water supply is above sus|)icion ; it is derived from a carefully protected upland surface catchment area situated at Labugama, 28 miles from Colombo ; it is regularly examined both chemically and bacteriologically and has given, so far as I am aware, no indication of any suspicious or dangerous contamination. As a source of infection it may therefore be unhesitatingly excluded. The graph in Diagram IV. also sui>ports this view, for in spite of a very wholesome water supply the town has enjoyed for many years the incidence of typhoid fever has kept high and has been lowered mainly ])y the introduction of the water carriage system and consequent proper disposal of excreta. Water however does play, I have no doubt, a certain though not very important role in Colombo. The whole of Colombo is not supplied with pipe water from the public mains. In the outlying parts of Colombo like Rajamalwatta, Kolannawa, Yakbedda, &c., a pipe supply is not available within easy reach, and people living in these areas still depend upon shallow wells for their drinking water. The majority of these wells are exposed to contamination from excreta deposited on the ground in the neighbourhood of wells or from latrine washings polluted with urine and faeces percolating into these wells. Typhoid bacilli have been shown to survive in water for varying periods of time which increase directly with the purity of the water. Though marked multiplication does not take place in water which is inisuitable as a culture medium yet a resistent minority has been found to survive for several weeks or months and be capable of producing infection. In 1929 ten cases of typhoid fever occurred among the people living on the Crown land behind the Welikada prison. This area is devoid of latrines, the ground is highly polluted, and the drinking water is derived from shallow wells. The source of infection may possibly have been these contaminated wells. In addition to these shallow wells the water of which is used for drinking there are in Colombo 137 bathing wells. Though a large number of public lavatories have been provided liy the Municipality where a bath in wholesome water is available free of charge yet a large number of people still prefer a bath in well water which is believed to be superior to pipe water. This belief is due, I imagine, to the fact that well water is much cooler than water convej’^ed in metal pipes under metalled streets, and a bath in lukewarm pipe water is not so cooling or refreshing as a bath in cooler well water. Other advantages the private bathing wells offer are hot water baths for a small payment and greater privacy. These bathing wells have been examined from time to time and some of them have been found to be polluted but owing to the opposition of vested interests and their popularity with a certain class of people they have not been abolished. The argument against their abolition is that though the water may be unfit for consumption it is good enough for bathing, but it has been proved that rinsing the mouth or brushing the teeth in contaminated Avater is attended Avith the risk of infection. Knowing the habits of the people here it may be assumed that some cases of typhoid fever are due to this source. Other sources of infection are the river, canals, and lake. Large numbers of people living in the neighbourhood of these Avaters regularly bathe in these AA^aters Avhich are grossly polluted with sometimes unadulterated sewage. In 1925 a number of cases Avas traced to bathing in the river Avhich is being polluted by the imperfectly treated seAvage effluent discharged into it. The Avaters of the lake and canals are also still very impure and the risk of infection from these sources is probably considerable. In spite of prohibitory notices people Avill bathe in them. Regular police picketing is necessary to stop this, but that is expensive and not ahvays available. (4) Water-Food-Mouth. Another method of transmission is by contaminated Avater to food to mouth. Contami¬ nated Avater may be used for— (rt) Adulterating milk. Unregistered vendors of milk are especially guilty of this. Not having proper dairies Avith a town Avater supply they use AA^ater from any source. A vendor Avas once detected using lake Avater. (5) For Avashing milk cans. An unregistered vendor Avas once detected using Avater from a road side drain. (c) Washing or watering green vegetables eaten uncooked. The majority of the vegetiible gardens in Colombo use Avater from shalloAV aa'cIIs Avhich are polluted.](https://iiif.wellcomecollection.org/image/b3149528x_0041.jp2/full/800%2C/0/default.jpg)
