WEBVTT 00:00:00.000 --> 00:00:17.840 [National Library of Medicine HF 0175 This transfer made: 06/24/05 Length: 00:23:30] 00:00:17.840 --> 00:00:26.970 [Drumming] 00:00:26.970 --> 00:00:31.670 [Firestone presents] 00:00:31.670 --> 00:00:38.270 [MEDICINE in the TROPICS] 00:00:38.270 --> 00:00:43.770 [Produced by Lemris Sound Films] 00:00:43.770 --> 00:00:48.270 [Production Supervision CHARLES MORROW WILSON, Direction...JOSEPH KOHN] 00:00:48.270 --> 00:00:52.270 [Photography...VERNON LEWIS Editing...WILLIAM M. NELSON][Narration...HUGH JAMES] 00:00:52.270 --> 00:01:09.070 [Technical Advisor K.H. FRANZ, M.D. Narrative and Continuity William M NELSON and Charles Morrow WILSON] 00:01:09.070 --> 00:01:11.670 [LIBERIA] 00:01:11.670 --> 00:01:18.430 [Narrator:] On the great western bulge of Africa is Liberia, Africa's only Republic. 00:01:18.430 --> 00:01:24.230 During the past quarter-century, Liberia's importance as a rubber-producing nation 00:01:24.230 --> 00:01:29.430 has gained for her stature and recognition throughout the world. 00:01:29.430 --> 00:01:34.570 In Liberia today are millions upon millions of rubber trees, 00:01:34.570 --> 00:01:44.300 the majority of which produce more latex than any other trees anywhere. 00:01:44.300 --> 00:01:47.230 To operate the immense plantations on which these trees are grown 00:01:47.230 --> 00:01:53.470 requires the combined skills and labor of tens of thousands of workers, 00:01:53.470 --> 00:01:59.870 the health and well-being of whom are vitally essential to the welfare of the nation as a whole. 00:01:59.870 --> 00:02:10.930 Safeguarding the health of the rubber workers is both an economic necessity and a moral obligation. 00:02:10.930 --> 00:02:15.730 In a very real sense, the development of research in, and practice of, 00:02:15.730 --> 00:02:22.730 tropical medicine in Liberia is a by-product of her ever-expanding rubber industry. 00:02:22.730 --> 00:02:33.730 As rubber is vital to Liberia's economy, so is an adequate medical program essential to her progress and prosperity. 00:02:33.730 --> 00:02:43.000 In order to understand the nature of the medical program that is today underway in Liberia, one must first examine the country itself. 00:02:43.000 --> 00:02:52.700 Located barely above the equator, on the edge of the vast rainforest of Equatorial Africa, Liberia's climate is humid and generally warm. 00:02:52.700 --> 00:03:10.470 The rainfall is heavy, between 90 and 160 inches each year. 00:03:10.470 --> 00:03:15.600 The abundant streams and rivers resulting from this heavy rainfall keep the numerous valleys 00:03:15.600 --> 00:03:22.800 fertile and burden and provide favorable conditions for the growing of almost any crop. 00:03:22.800 --> 00:03:29.830 Even the three or four month dry season fails seriously to retire Liberia's abundant agriculture. 00:03:29.830 --> 00:03:37.000 For even then, there are usually enough showers and light rains to maintain favorable growth. 00:03:37.000 --> 00:03:46.870 With a climate so ideally suited to agriculture, it is not surprising to find Liberians an agrarian people living close to the land and engaged in 00:03:46.870 --> 00:03:52.530 pursuits that are intimately related to the necessities of everyday living. 00:03:52.530 --> 00:03:57.970 Most Liberians are tribespeople who work and live very simply. 00:03:57.970 --> 00:04:03.570 Their daily activities are devoted largely to taking care of their immediate needs. 00:04:03.570 --> 00:04:22.630 In these respects they are typical of native inhabitants of many tropical climates. 00:04:22.630 --> 00:04:31.230 Agriculture is inherently easy because of the soil's fertility and the fact that crops are not severely restricted to seasons. 00:04:31.230 --> 00:04:41.200 Even on casual inspection of the landscape, it is evident that here almost anything will grow. 00:04:41.200 --> 00:04:48.130 On the one hand, this lush productivity resulting from the climate and rainfall is a blessing. 00:04:48.130 --> 00:04:51.370 On the other, it is a threat. 00:04:51.370 --> 00:04:53.600 A menace and a liability. 00:04:53.600 --> 00:05:01.040 For the same conditions that make for an abundance of vegetables, forest products, and flowers are also favorable 00:05:01.040 --> 00:05:17.630 to the growth and development of the micro-organisms that cause ruinous diseases. 00:05:17.630 --> 00:05:24.100 For example, while some of Liberia's streams are pure, others play a grim role as carriers 00:05:24.100 --> 00:05:29.430 of malicious dysenteries and many other waterborne diseases. 00:05:29.430 --> 00:05:39.030 To help prevent these and to reduce the continuous hazard of malaria, Liberia's sanitation program today calls for almost incessant spraying 00:05:39.030 --> 00:05:47.570 of surface streams and the land around them. 00:05:47.570 --> 00:05:52.930 Before the advent of the Firestone Rubber Plantations, swamplands and stagnant pools 00:05:52.930 --> 00:05:59.630 provided ideal breeding places for anopheline mosquitos, the carriers of malaria. 00:05:59.630 --> 00:06:05.500 Today with a broad medical and sanitation program in progress, this stagnant water is methodically 00:06:05.500 --> 00:06:11.130 drained to prevent the formation of larvae breeding pools. 00:06:11.130 --> 00:06:21.230 Foliage and trees along rivers and streams are cleared in order to fight trypanosomiasis or African sleeping sickness, at its source. 00:06:21.230 --> 00:06:27.530 This kind of growth provides shelter and breeding areas for the tsetse or glossina flies, 00:06:27.530 --> 00:06:33.570 several species of which are the carriers of this baffling and frequently fatal disease. 00:06:33.570 --> 00:06:54.230 Agricultural projects, such as the growing of rubber trees, also aid in the elimination of the tsetse fly breeding areas. 00:06:54.230 --> 00:07:04.530 Today in heavily populated plantation areas, water is impounded, filtered, and chlorinated to make it usable for cooking and drinking. 00:07:04.530 --> 00:07:08.920 Preventive measures like these are doubly important on the rubber plantations 00:07:08.920 --> 00:07:14.000 because of the congestion that accompanies both working and living. 00:07:14.000 --> 00:07:20.830 On the plantations, thousands work together in close proximity. 00:07:20.830 --> 00:07:25.400 In the interior, many native villagers are frequently overcrowded. 00:07:25.400 --> 00:07:33.160 Once it takes hold, almost any disease becomes a potential epidemic. 00:07:33.160 --> 00:07:40.430 It is with this realization that sanitary preventive measures, like the daily inspection of latrines, 00:07:40.430 --> 00:07:46.200 have been instituted on the plantations and are rigorously enforced. 00:07:46.200 --> 00:07:51.070 But by far the most effective preventive factor is immunization. 00:07:51.070 --> 00:07:57.800 For example, twice yearly the resident population of the Firestone Plantations, numbering about 40,000, 00:07:57.800 --> 00:08:03.570 is vaccinated against smallpox, which is endemic to much of Liberia. 00:08:03.570 --> 00:08:09.470 Each native village has at least one dresser station, staffed by trained medical orderlies 00:08:09.470 --> 00:08:16.930 who administer first-aid, care for minor ailments, and make simple diagnoses. 00:08:16.930 --> 00:08:21.230 The orderlies also make mass surveys of diseases. 00:08:21.230 --> 00:08:27.330 Here they are making preliminary tests for African trypanosomiasis, or sleeping sickness, 00:08:27.330 --> 00:08:33.070 by examining the cervical glands in the back of the neck. 00:08:33.070 --> 00:08:38.430 Unless acutely ill, tribespeople rarely seek medical aid. 00:08:38.430 --> 00:08:43.030 An unbalanced diet accustoms them to fatigue and low metabolism, 00:08:43.030 --> 00:08:49.040 and few are able even to recognize the presence of early symptoms of disease. 00:08:49.040 --> 00:08:54.770 This plantation worker complaining of an acute abdominal pain which he has suffered for four days, 00:08:54.770 --> 00:09:01.670 has come to his local dresser station only because the pain is intense. 00:09:01.670 --> 00:09:06.140 The orderlies, unable to diagnose the case adequately, send him to the 00:09:06.140 --> 00:09:13.370 plantation base hospital for further examination by an American doctor. 00:09:13.370 --> 00:09:18.390 Once daily, or more frequently if necessary, a hospital bus whose route 00:09:18.390 --> 00:09:31.700 covers all plantation dresser stations transports such patients to the base hospital. 00:09:31.700 --> 00:09:34.380 To the hospital come many abdominal cases. 00:09:34.380 --> 00:09:40.530 Physical illnesses such as hernias, sprains, bruises, and fractures are common. 00:09:40.530 --> 00:10:38.130 Partially, this results from an unbalanced diet, which is frequently deficient in proteins. 00:10:38.130 --> 00:10:45.830 [Narrator:] Patients referred to the hospital by the local station orderlies are examined first in the outpatient department of the hospital. 00:10:45.830 --> 00:10:52.230 The native medical personnel on the Firestone Plantations are about one hundred in number. 00:10:52.230 --> 00:11:33.870 All of them have been trained by American doctors and nurses who direct the hospital staff. 00:11:33.870 --> 00:11:39.630 In the outpatient department, a competent American doctor examines the abdominal case 00:11:39.630 --> 00:11:54.730 and diagnoses it tentatively as amebic abscess of the liver. 00:11:54.730 --> 00:12:02.470 After diagnosis, the doctor orders the patient admitted to the hospital for surgical treatment. 00:12:02.470 --> 00:12:08.830 In the early part of the medical program, natives were dubious of what they termed foreign doctors. 00:12:08.830 --> 00:12:23.560 But their doubts and fears were dispelled as a result of cures effected and the obvious efficiency of modern medical techniques and equipment. 00:12:23.560 --> 00:12:53.970 From the outpatient department, the abdominal case is admitted to the surgical ward in this base hospital. 00:12:53.970 --> 00:13:15.700 First, blood samples are taken, from which blood counts and blood tests will be made. 00:13:15.700 --> 00:13:21.870 The blood tests themselves are made in the hospital laboratory by skilled native technicians. 00:13:21.870 --> 00:13:50.100 The laboratory facilities in the Firestone Hospital in Liberia are completely modern in all respects. 00:13:50.100 --> 00:13:55.230 An x-ray examination is made to confirm the preliminary diagnosis. 00:13:55.230 --> 00:14:01.370 The pattern of common diseases is such that the preliminary diagnosis is generally accurate, 00:14:01.370 --> 00:14:11.470 but there have been instances where x-rays have altered the early diagnostic examination. 00:14:11.470 --> 00:14:18.730 In this case of abscess of the liver, surgery was considered advisable. 00:14:18.730 --> 00:14:28.000 Equipment, sterilization, and medical skills attendant upon surgery in the Firestone Hospital compare favorably with those existing anywhere. 00:14:28.000 --> 00:14:38.800 The extremely high percentage of successful surgery attests to the validity of modern medical techniques in primitive surroundings. 00:14:38.800 --> 00:14:45.570 Amoebiasis, here undergoing operative treatment, is highly prevalent in most tropical countries. 00:14:45.570 --> 00:14:49.870 A waterborne disease, it is a development of chronic amoebic dysentery. 00:14:49.870 --> 00:14:54.430 The surgical objective is that of draining the hepatic abscesses. 00:14:54.430 --> 00:15:10.530 Amoebiasis affect an average of 40 to 50 percent of the entire native population because of polluted water. 00:15:10.530 --> 00:15:15.070 The phrase "tropical medicine" indicates cosmopolitan medicine. 00:15:15.070 --> 00:15:25.070 It comprises the great majority of diseases common to the temperate climate, and in addition, a relative few which are peculiar to the tropics. 00:15:25.070 --> 00:15:31.400 The deep tropics are the most abundant of all pathological laboratories. 00:15:31.400 --> 00:15:39.370 After surgery the patient is removed to the convalescent ward, where the care he receives differs little from that offered in hospitals 00:15:39.370 --> 00:15:49.070 in Des Moines, Hartford, Tucson, Portland, New Orleans, or San Diego. 00:15:49.070 --> 00:15:55.870 The plantation hospital is staffed by American doctors and nurses and is supplement ed by native personnel, 00:15:55.870 --> 00:16:02.230 most of whom have learned readily and function devotedly at a highly competent level. 00:16:02.230 --> 00:16:13.470 The cases most frequently encountered in the general wards are malarias, schistosomiasis, carried by water snails, yaws, hernias, goiters, 00:16:13.470 --> 00:16:31.530 intestinal worms, dysenteries, filariases, traumatic injuries, and pulmonary, bone and skin diseases. 00:16:31.530 --> 00:16:35.830 In pleasant, easy surroundings the patient recovers rapidly. 00:16:35.830 --> 00:16:41.870 The period of convalescence for this type of operation is usually ten to fourteen days. 00:16:41.870 --> 00:16:58.530 During the time he is convalescing, the patient also receives intensive medical therapy. 00:16:58.530 --> 00:17:05.230 When discharged, this young man is an ambassador of goodwill for modern medicine in the tropics. 00:17:05.230 --> 00:17:15.030 For back in his tribal village he will report good food, good care, and a speedy recovery. 00:17:15.030 --> 00:17:20.500 As elsewhere, many diseases encountered in the tropics require isolation. 00:17:20.500 --> 00:17:31.060 The beds in this isolation hospital on the Firestone Plantations are frequently filled with such highly contagious diseases as smallpox and tuberculosis. 00:17:31.060 --> 00:17:35.100 Of these, smallpox is the more common. 00:17:35.100 --> 00:17:39.960 Here are three typical cases. 00:17:39.960 --> 00:17:55.230 In this case the disease is in an early stage, as indicated by the cutaneous lesions or skin eruptions. 00:17:55.230 --> 00:17:59.770 This case, a middle-aged woman is more advanced. 00:17:59.770 --> 00:18:09.070 This is a confluent hemorrhagic type of smallpox and is characterized by the formation of large pustules over the entire skin surface. 00:18:09.070 --> 00:18:25.330 This case was reported late and terminated fatally. 00:18:25.330 --> 00:18:30.300 The third case, a young boy, is recovering from the disease. 00:18:30.300 --> 00:18:40.660 The depigmented areas are typical of the recovery stage. 00:18:40.660 --> 00:18:55.220 In the general hospital are always a variety of diseases, some cosmopolitan, some exclusively tropical. 00:18:55.220 --> 00:19:01.370 Here is a rare case of sarcoma of the clavicle, a cancerous bone tumor. 00:19:01.370 --> 00:19:15.970 Following the failure of surgical and x-ray treatment, the patient died. 00:19:15.970 --> 00:19:23.170 Elephantiasis, a complication of filariasis, is an almost exclusively tropical disease. 00:19:23.170 --> 00:19:29.720 This elephantoid scrotum, weighing 42 pounds, was successfully removed by surgery 00:19:29.720 --> 00:19:47.270 and the patient discharged mentally and physically improved. 00:19:47.270 --> 00:19:54.800 Here is a rare clinical example of gynecomastia, the development of a female mammary gland in a man. 00:19:54.800 --> 00:20:09.800 This developmental anomaly was corrected surgically with complete success. 00:20:09.800 --> 00:20:17.870 A dangerous disease largely confined to tropical Africa is trypanosomiasis, or sleeping sickness. 00:20:17.870 --> 00:20:22.030 Unless treated early, this disease is usually fatal. 00:20:22.030 --> 00:20:26.980 Here, a medical technician punctures a lymph gland of a native worker 00:20:26.980 --> 00:20:36.830 whose listless appearance and enlarged cervical glands are symptomatic of sleeping sickness. 00:20:36.830 --> 00:20:48.900 In this particular case, the glandular smear subjected to microscopic examination revealed the trypanosomes which identify this disease. 00:20:48.900 --> 00:20:56.060 Besides being a public health problem, certain types of trypanosomiasis constitute a major economic drawback 00:20:56.060 --> 00:21:01.470 because they destroy draft animals and other valuable livestock. 00:21:01.470 --> 00:21:05.790 For more routine public health measures, some forty dispensaries 00:21:05.790 --> 00:21:11.470 staffed by hospital-trained attendants serve the population of the plantations. 00:21:11.470 --> 00:21:18.130 Evidence of the success of the entire medical program it found in the confidence is has engendered. 00:21:18.130 --> 00:21:34.630 Many who once feared the techniques and paraphernalia of modern medicine are today willing and eager to accept its benefits. 00:21:34.630 --> 00:21:39.900 Much of Liberia's progress in medicine and public health is due to the industrial statesmanship 00:21:39.900 --> 00:21:51.130 of Harvey S. Firestone, founder, and Harvey S. Firestone, Junior, now head of the worldwide Firestone organization. 00:21:51.130 --> 00:21:55.860 A gift from that organization enables the American Foundation for Tropical Medicine 00:21:55.860 --> 00:22:02.870 to establish in Liberia a permanent research center for service to tropical medicine generally. 00:22:02.870 --> 00:22:10.130 Mr. Firestone's approval of the model for this Liberian institute was a milestone in tropical medicine. 00:22:10.130 --> 00:22:21.730 World-famous medical authorities and educators have agreed to assist the American Foundation for Tropical Medicine in directing the Liberia institute. 00:22:21.730 --> 00:22:28.830 Continued research, increasing facilities, and the application of the best available skills 00:22:28.830 --> 00:22:35.030 are vitally important to life and progress both in the tropics and out. 00:22:35.030 --> 00:22:45.830 For tropical medicine, whose scope at first glance may appear limited, is actually of basic importance to all peoples and all economies. 00:22:45.830 --> 00:22:52.530 The work already accomplished in Liberia has extended the horizons of general medical knowledge. 00:22:52.530 --> 00:22:59.800 Progress in tropical medicine means progress for business, for science, for humanity. 00:22:59.800 --> 00:23:06.500 The goals are the maximum that can be attained. Better health, better housing and food, 00:23:06.500 --> 00:23:13.170 improved agriculture and trade, adequate water supplies, and general sanitation. 00:23:13.170 --> 00:23:19.170 Yes, even better transportation and more efficient labor. 00:23:19.170 --> 00:23:25.070 In short, the objectives of tropical medicine are those of all medicine. 00:23:25.070 --> 00:23:27.070 Healthier and happier people. 00:23:27.070 --> 00:23:32.970 Living better with a firmer grasp of the present, and confidence in the future. 00:23:32.970 --> 00:23:39.060 A future which the skills of modern medicine will have made increasingly secure. 00:23:39.060 --> 00:23:44.060 [THE END A Firestone Plantations Company Production]