All through the last few months the work has been steadily growing. Our hospital is splendidly situated. Upstream and downstream, from places hundreds of kilometers away on the Ogooué and its tributaries, sick people are brought here, and the fact that those who bring them can be lodged here is a further encouragement to come in great numbers. And there is yet another attraction: the fact that I am always at home, unless—and this has happened only two or three times so far—I have to go to some other mission station to treat a missionary who is ill, or some member of his family. Thus the native who has undertaken the trouble and the expense of the journey here from a distance is sure of seeing me. That is the great advantage which the independent doctor has over one appointed by the government. The latter is ordered now here, now there, by the authorities, or has to spend a long time with a military column on the march. “And that you have not got to waste so much time on correspondence, reports, and statistics—as we have to—is also an advantage, the reality of which you have not yet grasped,” said an army doctor not long ago, during a short chat with me on his way past.
The hut for the sleeping-sickness victims is now in course of erection on the opposite bank and costs me much money and time. When I am not myself superintending the laborers whom we have secured for grubbing up the vegetation and building the hut, nothing is done. For whole afternoons I have to neglect the sick to play the part of foreman there.
Sleeping sickness prevails more widely here than I suspected at first. The chief focus of infection is in the Ngounié district, the Ngounié being a tributary of the Ogooué about ninety miles from here, but there are isolated centers round Lambaréné and on the lakes behind N’Gômô.
What is the sleeping sickness? How is it spread? It seems to have existed in Equatorial Africa from time immemorial, but it was confined to particular centers, since there was little or no traveling. The native method of trade with the sea coast was for each tribe to convey the goods to the boundary of its territory, and there to hand them over to the traders of the adjoining one. From my window I can see the place where the Ngounié enters the Ogooué, and so far only might the Galoas living round Lambaréné travel. Anyone who went beyond this point, farther into the interior, was eaten.
When the Europeans came, the natives who served them as boat crews, or as carriers in their caravans, moved with them from one district to another, and if any of them had the sleeping sickness they took it to fresh places. In the early days it was unknown on the Ogooué, and it was introduced about thirty years ago by carriers from Loango. Whenever it gets into a new district, it is terribly destructive and may carry off a third of the population. In Uganda, for example, it reduced the number of inhabitants in six years from 300,000 to 100,000. An officer told me that he once visited a village on the Upper Ogooué which had two thousand inhabitants. On passing it again two years later he could only count five hundred; the rest had died meanwhile of sleeping sickness. After some time the disease loses its virulence, for reasons that we cannot as yet explain, though it continues to carry off a regular, if small, number of victims, and then it may begin to rage again as destructively as before.
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