Paediatrics in Freetown, Sierra Leone.

The Colony of Sierra Leone originated in the sale and cession of a portion of land to Captain John Taylor in 1788 which was placed under the protection of the British Government. The main purpose of the Colony in its inception was to secure a home on the African continent for a number of natives of Africa and some others who, due to various circumstances, had been separated from their countries of origin and were destitute in and about London. Within a few years their numbers had been increased by Africans returning from the New World, notably the West Indies and Nova Scotia. Today 25% of the Africans in the Colony, which now covers an area of 256 square miles, are settlers and their descendants. Apart from these, the African population is tribal, mainly Mende and Temne (Colonial Office List, 1959). Freetown, the capital, is a seaport with a fine natural harbour and a population approaching 100,000. There are two distinct seasons: the dry season from November to April, and the wet season extending over the rest of the year, the heaviest rainfall occurring in July and August. According to my own rain gauge at Hill Station, a residential area about four miles out of Freetown and 800 feet above sea-level, the annual rainfall varied from 144 to 177 inches during the four-year period that I was in Sierra Leone. The observations recorded in this paper were made at the Connaught Hospital, Freetown, from October 1955 to September 1959, with a detailed analysis of admissions during the last six months, during which period, through a temporary shortage of staff, I had undivided control of the children's medical ward. The Connaught Hospital was built in 1912 and although it has a number of unsatisfactory features by modern standards, such as lack of water-borne sanitation, the hospital has served Colony and Protectorate well for nearly half a century. It is a general hospital of about 250 beds, in which there is a paediatric medical ward of 19 cots, an eight-