and see to the provision of such material resources as would permit the work to be carried out on a greatly enlarged scale and with a wider scope.

The result of this collaboration speaks for itself. From May 1, 1920, to January 20, 1921, 248,370 prisoners were exchanged. Fifteen steamers, plying between Stettin, Narva, Bjorko and Riga transported the greater part of these prisoners, while other ships, sailing from Hamburg, went to Vladivostok to bring back such prisoners as came from Siberia, and to fetch the Germans, Austrians and Hungarians, as many as were still left in those parts, to Trieste.

At the same time, realising that, in spite of every effort, it would not be possible to repatriate from Russia in Europe and in Asia all the prisoners before the winter, Dr. Nansen, after an arrangement with the Soviet Government, founded an organisation called the "Nansenhilfe" to provide warm clothes and supplementary provisions to prisoners who were to be repatriated. As Dr. Nansen pointed out on November 18 to the League of Nations, the cost of repatriation by the Baltic route was remarkably small. Naturally the expenses involved in the Vladivostok scheme were considerably greater, but it was carried out on a correspondingly lesser scale. In order to find the necessary resources for repatriation, he had to appeal not only to those countries directly interested i. e. the Central Powers and the Soviet Government- but also to the countries which were members of the League of Nations. It was with contributions of the first kind mentioned that the International Red Cross Committee had started repatriation operations. It persuaded the German Government to advance sufficient money to cover expenses for the total number of prisoners, regardless of nationality, asking, likewise, from the other countries concerned, sums in proportion to the number of their prisoners to be repatriated. Austria, Hungary, Italy, Poland, Roumania, Czechoslovakia, Turkey and Yugoslavia were also invited to contribute. By January 31 the following contributions had been received:

Germany paid direct the repatriation expenses of her prisoners. On September 1, the League of Nations assumed the responsibility of feeding the non-German prisoners and of their transport by sea. It also undertook to repay to the International Committee some part of its previous expenses. In order to undertake this burden of expense, however, the League appealed to its members and by November 9 had received the following contributions:

On that date the following sums were yet to come in :

When all the money promised has been received, repatriation will be assured including expenses incurred in the taking of preventive measures against the danger of typhus, which it may be feared the prisoners will carry with them.

Taking the above facts into consideration, it will be seen that the repatriation of prisoners is well advanced and should be completed very shortly, if it were not for various obstacles which threaten delay. The chief obstacle to be feared is the holding up of shipping in some of the Baltic ports which are ice-bound and blocked during several months. The port of Narva, for instance, which hitherto has been the most used, will have to send its prisoners for repatriation to Baltishport which is open for navigation during the greater part of the year.

Taking these difficulties into account, Dr. Nansen asked the permission of the Soviet Government to alter the route for the winter and to repatriate prisoners by way of the Black Sea. On November 20 his request was refused; but he was discouraged. He continued to demand from Moscow the necessary authorisation, and in the meanwhile, at his suggestion, two delegates from the International Red Cross Committee left for Constantinople in order to be ready to set out for Novorossisk as soon as the authorisation should be forthcoming. According to latest reports (February 1), the Soviet government has consented to the constitution of a Russo-German committee for transporting prisoners from the Caucasus and from the Kuban to Novorossisk.

At Vladivostok, repatriation has been carried out on a less extensive scale. On September 6 Dr. Montandon, a delegate from the International Committee, signed an agreement with the government of the Far-Eastern Republic dealing with the evacuation of the last remaining prisoners. At the present moment Dr. Montandon is on his way back to Europe, travelling via Omsk and Moscow. Besides the German, Austrian and Hungarian missions, etc., working, at Vladivostok there are representatives of the American Red Cross, which has contributed a sum of a million dollars towards repatriation by this route.

At Dr. Nansen's request, a new delegate of the International Red Cross Committee, M. Georges Werner, left for Vladivostok at the end of December, arriving at Tokio a month later.

In all probability the work of repatriation will be brought to a successful conclusion during the course of the first few months. of 1921.

INVISIBLE FRONTIERS.

By Knud Stouman, Chief, Department of Vital Statistics.

HE strongest impression received by a stranger visiting Europe, is one of sullen dissatisfaction and nervous restlessness. Europe has counted her dead and contemplated her ruins; with a heavy heart she has now commenced to repair what was destroyed. But it is easier to destroy than to construct, and people find that the continued devotion and self-negation required in the task of rebuilding demand more strength of character than the heroic exaltation of the war.

Most of the international frontiers are now defined, and the problems and outlook of the peoples outline themselves. Northern Europe has returned to fairly normal conditions and the nations. of western and southern Europe make evident progress towards a stable economic life. The fields approach their pre-war yield, the mines increase their output, industries return to life, and the transportation services improve. A rebirth of intellectual life is noticeable and even the mute masses begin to think more keenly.

A shadow is cast over the western world, however, by a menace from the east, which is not in the form of conquering armies but is a silent menace of hopeless poverty, social disorganisation and loathsome diseases. Few prayers are said, but if no help is given the wave of misery will reach our very doors and quell that return of activity which we so fondly saw dawning.

Russia, where the most stupendous upheaval, since the French revolution, has taken place, remains under a heavy cloud, and we cannot distinguish, as yet, exactly what is occurring or how the new society will develop. But between Russia and western Europe is a vast stretch of territory in very unstable conditions, which is perfectly open to us and where help is urgently needed. These countries from the Baltic in the north to the Adriatic and the Black Sea in the south have been the theatre of war for six years and have suffered all the consequences thereof. When peace finally was restored it liberated the people from foreign masters, but in so doing it changed all frontiers and upset the existing economic intercourse thus further accentuating the difficulty of returning to normal conditions.

Geographical maps show the political frontiers only, and these are fixed in the mind of the public to the exclusion of other fac

tors which are equally important in determining the destiny of peoples. Among such little known but highly important conditions worthy to figure on every map may be mentioned the mineral resources, the yield of the soil, the location and nature of industries, the natural and artificial systems of communication, the per capita wealth of the various districts, and the degree of popular instruction. We need finally a clear graphical representation of the most important diseases, bearing in mind that these are not confined by national frontiers but depend much more upon the above conditions.

The two most important units of this territory are the basin of the Vistula and that of the Danube. Particularly the latter has been divided by many new custom frontiers which make the former interchange of products exceedingly difficult. The western regions. from the plain of Lodz over Silesia and Bohemia to the Austrian Alps is essentially an industrial country very similar to central or western Europe. South-western Poland has important textile industries, and the Upper Silesian coalfields, which extend into Poland and Moravia, are second to none in Europe. Bohemia has important coal, lignite and iron mines and highly developed industries. Austria depended largely on its commerce and industries for which no raw materials are now available.

It is of particular importance that in most of these regions, that is west of the German-Russian frontier of 1914 and west of the former Austro-Hungarian frontier from the Tatra southwards, the percentage of illiteracy is extremely low. In Czechoslovakia west of the Carpathians as well as in German-Austria the proportion of illiteracy averages thus only from two to three per cent. East of this line conditions change immediately and the proportion of illiteracy varies there from thirty to seventy per cent of the population over ten years of age. This fact is of great importance when chosing methods for public health campaigns, and it is certain that the general cultural standpoint of the population has considerable influence upon the spread or the control of various diseases.

Reconstruction of the normal economic life is the fundamental pre-requisite of any permanent sanitary progress in these newly constituted countries of the near East, and it is evident that in order to improve living and working conditions, the normal commercial inter-relations of the entire region must be re-established. So long as conditions of famine continue to exist it is obviously impossible to bring about any lasting improvement of the health. conditions. The economic problems are of such a vast scope, however, that they will exceed the competency of Red Cross activities or of any public health organisations. Trusting that economic progress will be realised during the coming years it will be well now to consider the principal elements of the sanitary conditions obtaining in these countries.

The League of Red Cross Societies has received recent data regarding mortality and morbidity statistics in the near East, and

the preparation of this material is now so far advanced that the main problems are clearly outlined. The sanitation work which is required seems to divide itself into two principal categories: the control of epidemic diseases, and the combating of diseases directly or indirectly due to malnutrition and poverty.

Hitherto, only the epidemic diseases have received any considerable publicity in the daily press of western Europe, a fact which is largely due to the considerable proportions attained by the typhus epidemic in Poland. Exanthematic typhus was endemic already before the war in Eastern Galicia and several districts of Poland; the movement of the armies, the destruction of property and the displacement of a great number of refugees caused it to spread over nearly the entire area here in view. The most serious epidemic of typhus occurred in Serbia during 1915, when it was estimated that 150,000 persons died of it, this being equivalent to about 4 per cent of the population. From the Serbian focus in the south and from Galicia in the north, the disease spread into Roumania, Hungary, Slovakia and Austria without, however, attaining in these countries the proportions of a national calamity. During the last two years the northern typhus area has been more active than the southern, and the potential danger which it constitutes has been seriously considered in the Assembly of the League of Nations.

During 1919, 156,654 cases of typhus with 14,759 deaths were recorded in Congress Poland and 65,700 cases with 7,074 deaths in Galicia. These figures are known to be incomplete and in some districts possibly 50 % too low. To judge from the most recent Polish data in our possession it seems that the typhus epidemic is now declining. In Galicia the epidemic has been the most serious during the winter 1919-20, when more than 20,000 cases were registered each month. From May the number of new cases has been rapidly declining, and during August and September 1920 less than 1,000 cases were notified. It should be remembered, however, that the Bolshevist invasion of Eastern Galicia occurred during this summer, and that records could not be received from several districts in the east where the disease was most prevalent.

The considerable number of refugees transported from the area where typhus is very frequent into the western provinces of Poland, which have been little touched by the disease, constitutes a serious danger, and constant vigilance must be observed in these regions. If proper measures are taken and effective quarantine service established along the eastern frontier we may expect that the typhus will be much less serious this winter than during the past cold season. It might be mentioned in this connection that about one million Polish refugees and prisoners of war are interned, as yet, in various parts of Russia, and that they will commence to return when the peace of Riga has been ratified. The utmost care must be taken that these refugees do not spread the diseases typical for Russian prison camps throughout Poland

From Galicia typhus has spread across the Carpathians into