Papuan Pigs, Tuberculosis, And Whatnot
pp. 50-51 · Read in the full issue
Letter to the Editor
AN article in your July issue, “T.B. in Papua”, by “Daika”, calls for com ment.
“Daika” appears to have written about something of which he knows nothing, and about which he has made no enquiries in the proper quarter. Every time he feels himself getting a bit out of depth, he throws the onus on to his meat-inspector pal. Bill.
There are four types of wogs belong ing to the family mycobacterium tuber culosis —viz., the human, bovine, avian and piscine. Of these the first two can cause tuberculosis in man.
Mycobacterium tuberculosis hominis is almost solely found in man, and, for all practical purposes, is the only cause of pulmonary tuberculosis (phthisis). This apparently is the disease that “Daika” refers to when he speaks of black brother spitting around the place. Myco bacterium tuberculosis bovis, which is al most solely the cause of tuberculosis in animals, can also cause T.B. in man, but this type of T.B. usually only affects children, the germs affecting the glands, joints, bones or internal organs. It does not cause, pulmonary tuberculosis.
It therefore follows that pulmonary tuberculosis, the only type of T.B. re ferred to by “Daika”, cannot be caused by T.B. wogs from animals. are certain exceptions to this, but for all
practical purposes these exceptions can be discounted. In most countries, the only serious vehicle for the spread of bovine infections is by infected milk. However, under Papuan conditions, it is probable that there are other avenues for the spread of this type of T.B.
IN 1935, Dr. F. W. Clements, then of the Sydney University, at the request of the late Sir Hubert Murray, carried out an extensive tuberculosis survey of the population of Hanuabada village.
From* his report, published in the “Medi cal Journal of Australia”, February 22, 1936, we can gain the following informa tion.
Of 2,000 natives examined the follow ing figures were obtained: 8 cases of pul monary tuberculosis. 14 cases of sus pected pulmonary tuberculosis. 20 cases of non-pulmonary tuberculosis. Of the latter 20 cases, 18 were cases of T.B. affecting the glands of the neck.
Of these, it is only the 20 cases of non pulmonary tuberculosis that would likely be infected with bovine T.B. According to world figures and the ages mentioned in Dr. Clements’ report, it is likely that only about 10 of these cases were of bovine origin.
From the above it will be seen that Hanuabada village has a high incidence of T.B. This is not due to pigs, as sug gested by “Daika”, but, in the first place, to European contact, and is now being spread by the unhygienic mode of life of the natives. The above figures apply only to Hanuabada village and are out of all proportion to the true incidence of T.B. in Papua, which must be very much lower than what it is in most European countries.
Some interesting figures regarding T.B. may be quoted. Medical recruiting commissions in England during the last war estimated that one person in every hundred had pulmonary tuberculosis.
Only one person in every sixty infected with T.B. feels ill or develops active tuberculosis. Up to a few years ago T.B. held pride of place as the greatest killer of mankind. However, it is now on the decline. It is still the greatest of in fective diseases. Pulmonary tuberculosis (caused by human type) causes nine tenths of total deaths from T.B. De pending on locality, 50 to 100 per cent, of all Europeans become infected with T.B. at some stage in their life. In an extensive survey of 4,000 post mortems, 40 per cent, showed evidence of tuber culosis which had undergone spontaneous cure.
T.B. is rare in wild animals, so it is fair to state that Europeans were also responsible for introducing this type ol TB. in Papua, by diseased animals, etc.
T B. is said to be the most widely-spread disease in domestic animals. T.B. is rife among millions of Europeans who only see a pig after it has left the frying pan.
TO realise the difficulties ahead of those trying to deal with the T.B. ques tion, once the disease has reached a high incidence in a Papuan village, it is well to consider some of the living conditions of these people: Living in houses which are perfect incubators for most pathogenic bacteria; consumptives spitting on the floor, and everywhere else, where people live and children crawl; everyone using the same spoons, lime sticks, etc., smoking the same pipes and cigarettes; mothers feeding their infants with bolus from their own mouth. I have only spent a few days in Port Moresby and do not know Hanuabada village, but I take it that conditions are much the same there as in other parts of Papua,
The reduction of the incidence of T.B. in Hanuabada village now depends on educating the natives on the same lines as Europeans are being educated, at a colossal expenditure of energy and money.
The natives will have to open up their houses; let the sunshine in and keep the dust out. They will have to be scrupulous about spitting and the disposal of excreta.
Community limesticks and smoking will have to disappear. Native mothers will have to be taught not to infect then children. Standards of living will have to be raised. Then the avenues of bovine T.B. infections in children should be in vestigated and checked. It will be then that the incidence of T.B. in Hanuabada will begin to decline, as it has been do ing in most European countries of recent years.
Can the above be accomplished in a Papuan village? Let those who know the Papuan native best, answer this question.
In the circumstances, the Government and the L.M.S. Mission have taken the only apparent possible step, that of establishing a hospital for the treatment of infective cases, on Gemo Island. This, I imagine, is costing the Government in the vicinity of £l,OOO per annum, and it is costing the L.M.S. nurses, who are voluntarily staffing the hospital, a sacri fice that cannot be measured in money.
A pamphlet on “The Prevention of Tuberculosis”, dated June 4, 1937. was written by Dr. W. M. Strong, then Chief Medical Officer of the Territory, and printed in English and Motuan, and dis tributed throughout Papua. Dr. Strong did everything possible to educate the people regarding the prevention of tuberculosis and Dr. F. J. Williams (pre sent Chief Medical Officer) is continuing this work.
“Daika”, apparently, considers that no body in Papua has taken the question of T.B. seriously.
RETURNING to the eating of the flesh of the porker as a potential source of bovine T.B. infections in child ren: The T.B. germs in pigs are usually in the organs of the chest and abdomen.
If the meat is well cooked, or boiled, the germs will be destroyed. Recent research work has accumulated a great deal of evidence (but no definite proof) that active T.B. infections in the great major ity of cases are caused by repeated in fections following at short intervals. So the occasional ceremonial eating of a pig, with the remote possibility that live bovine T.B. germs will be swallowed by a susceptible child, and the further re mote possibility that such germs will cause an active, serious T.B. condition, can be discarded as of no importance.
Pigs, through other means, may be one of the channels of bovine infections in Papuan children.
There is a case for the pig. By his partiality to a diet of human excreta, the village pig acts as the village sanit ary man, and is very effective as such Many diseases, including T. 8., can be transferred through contamination by infected faeces. Many of the pathogenic wogs ingested must be destroyed in the alimentary canal of the pig. In some villages it is a matter of which is the more desirable, human or bovine excreta.
The latter is often cleaned up by the
village people, but never the former.
A more important point in favour of the pig is that in most districts it is the main source of native wealth, is the centre of most important festivals, and plays a big part in marriage! transactions, etc. The removal of the pig would mean a great disorganisation of the community life of the native. Such a move is likely to have dire consequences.
I am, etc.
Tam Aiai.
Papua, August 10, 1940.