17

H.—3l

very great deal of work has been required to accommodate the fifty cases with which it is proposed to begin. Thus, a wing containing a kitchen and offices, servants' bedrooms, scullery, store-rooms, and so on, has been added, and another wing containing a specially constructed ward and verandah for the reception of some of the cases. For the remainder, a series of open-air shelters is being built— sixteen being small, to hold one patient each, also three double ones, and a larger one for four beds. These shelters have one solid wall turned towards the south-west—the prevailing wind—while the other sides can be fully opened. They are roofed with stained shingles, and the eaves are wide, the result being rather picturesque. The water-supply presented some difficulty, as the source was from a stream in a gully some 200 ft. below. A storage-tank has been built on an elevation 40 ft. higher than the main building, the water to be pumped up by means of an oil-engine. We shall thus have a constant-pressure system. The drainage is disposed of in a septic tank and filter-beds, the effluent running through the bush to a gully on the opposite side of the hill from the watersupply. Asphalt pathways are being laid between the shelters ; hen-yards and cowsheds erected ; and with bath-rooms, lavatories, closets, and the general internal fittings a vast amount of work has been done under difficult conditions, owing to the distance the material has to be carted. The existing road was very rough and badly graded, and on the hillside, and this is now being improved by the Roads Department. But the rainy weather is having the effect at present of making the new parts almost impassable for the winter, and it will be absolutely essential to have the road metalled to meet the heavy traffic which will ensue when the institution is opened. The lighting of the main building and shelters requires consideration. Oil-lamps are scarcely suitable for the open shelters, being dangerous, besides involving much work cleaning and filling. It is evident that electric lighting would be better, and probably cheaper—after the initial outlay—and it is to be hoped this may be approved. To Mr. Vickerman, District Engineer, and to his assistant, Mr. Cummings, every praise is due for the manner in which the alterations have been planned and executed, and for the time and patience they have expended in making the additions to the original scheme which have been found necessary as the scope of the undertaking became apparent. Nor can too much be said of the assistance of the Matron, Miss Rochefort, whose experience and foresight has been invaluable. In addition to the ordinary work of nursing the patients, and the housekeeping duties, on her shoulders has fallen the organizing of the internal economy, the furnishing, in itself a heavy item, bookkeeping, and a large amount of correspondence, not to mention the superintendence of the garden and farming operations. It is very evident that when the institution is fully opened these duties will be far beyond the powers of one person, necessitating the appointment of a house steward to take the clerical work, superintend the farming and outside work, arrange for food-supplies, &c. The farm is an important item in the working of the institution, since a good milk-supply has to be kept up, necessitating a large herd of cows, so that grazing-land and fodder have to be provided. This has recently been placed entirely in the hands of Mr. Clifton, Chief Stock Inspector, who had previously given us every assistance in purchasing cows, horses, and poultry. The grass land on the property is at present insufficient, and much work lies ahead—breaking in new ground, preparing land for crops, and so forth. Thus the advantage of having such matters in charge of such an authority as Mr. Clifton cannot be exaggerated. A few patients have been admitted from time to time since last December. For their accommodation tents were erected, and this plan has proved very satisfactory. These tents were specially made for the Department; have wooden floorings, and a widely projecting fly, while the walls are made separately, lacing at the corners, so that any side can be closed or opened, according to the weather. In all, fourteen patients have been treated, of whom five have been discharged cured or greatly benefited; one has died; and one was discharged at friends' request, being in too advanced a condition to benefit by the treatment. The remainder are progressing in a very satisfactory manner. Dr. Roberts, of Cambridge, has been appointed medical officer, and has been unsparing in his attention to the treatment of the cases ; and, being in direct telephonic communication with the Sanatorium, the fact of his residing in the township has proved no disadvantage so far as the patients are concerned. But it already makes a heavy call on his valuable time, and while it will be inadvisable to lose the services of one so experienced in the treatment of tuberculosis as Dr. Roberts it will be necessary when a larger number of patients are under treatment to appoint a resident medical officer as well. Besides Miss Rochefort, the only permanent appointment to the nursing-staff so far has been Sister Duffin, whose work has been beyond praise. The nursing-work will be more arduous than in an ordinary hospital, since the cases are not concentrated in wards, but scattered about singly in shelters. Some considerable distance will require to be covered in making the rounds, and a proportionately large nursing-staff will be necessary in consequence. Thus two charge nurses and three probationers will be the least number admissible. The domestic staff so far appointed consists of three housemaids, a cook, kitchen-boy, and porter ; while for outside work there are the gardener, the driver or farm-hand, and the general utility man. Of course, at present much of the work in which they are occupied is constructive. It will be necessary later to add a laundress ; a night porter ; and, if the electric-lighting scheme is carried out, a man to look after the engine. The work in connection with the Sanatorium has occupied a very large share of my time. In connection with the domestic staff alone, some sixty applicants have been dealt with ; and, owing to the difficulty of obtaining and keeping good servants in a country district, constant changes are made, involving fresh advertisements and more persons to be interviewed. Plans have had to be gone over with the Public Works Department, applications from prospective patients dealt with, tradesmen interviewed re supplies, contracts prepared, tools and various fittings obtained, and so on in endless succession, while frequent visits have to be paid to the Sanatorium itself. Certainly more assistance will be necessary to make it a self-administered concern. 3—H. 31,