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I would strongly recommend to the consideration of the authority the various suggestions, particularly with regard to the water-supply, which I have thought it my duty to embody in this report. The report is prefaced by a short description of the island, the peculiar configuration accounting for some of the conditions affecting the health of the inhabitants. I am indebted to the Rev. J. Hutchin, of the London Missionary Society, for kindly placing at my disposal a room for use as a dispensary. My most sincere thanks are likewise due to Takapi, the Native missionary at Mangaia, who was able to assist me in many ways. Area of Island; Physical Features; Water. The area of Mangaia is about 30 square miles, circumference about 30 miles. A fringing reef encircles the island at a short distance from the shore, there being practically no lagoon. At a varying distance inland from the shore an almost perpendicular wall of dead coral rises —the so-called " Makatea." This wall of coral runs right round the island, and is of an average height of about 100 ft. The top of the Makatea averages about a mile in width. The interior face descends precipitously in some places, or slopes down gradually in others into a valley of swamp land, and from this the land rises again in a succession of low hills to a central plateau about 650 ft. high. The interior of the island is well watered hj streams, which percolate through the base of the Makatea and pass into the sea by underground channels. There are no streams traversing the flat'belt of land between the Makatea and the sea. Settlements; Population. There are three settlements or villages in the island —Oneroa, Ivirua, and Tamarua. At the last census (April, 1911) the total population of the island was 1,466, of which 916 were adults and 550 children under fifteen years of age. The following synopsis of the census figures shows the distribution of the population in the three settlements : — Adults. Under fifteen. „, . , Males. Females. Males. Females. J- 0 "" 1 *- Onerua ... ... ... ... 242 264 163 159 828 Ivirua ... ... ... ... 109 111 87 55 362 Tamarua... ... ... ... 98 92 42 44 276 449 467 292 258 1,466 ~~916~ ~~ 550~ Housing. The majority of the Native houses are purau, but there are a few concrete and a certain number of wooden houses. The purau house is, in my opinion, the ideal one for Native dwellings; the thick pandanus thatch keeps the house cool, and the free ventilation and plentiful admission of light probably soon destroys any pathogenic organisms. In addition, these houses are not costly to erect, so that there is no temptation to overcrowding, and, when old and possibly insanitary, destruction does not involve any material loss. Wooden and concrete houses have many disadvantages as compared with the purau house. The) ait- usually dark, and the ventilation is poor, especially at night, when the Natives are accustomed to close all windows and doors. The rooms being dark, it may be inferred that they are dirty in the majority of cases, and as such houses aire costly to erect the tendency is to overcrowd. The roof is usually of corrugated iron, so that the house is hot, and this combination of heat, bad ventilation, and darkness must profoundly affect the health of the inhabitants, at the same time furnishing many of the conditions necessary for the multiplication of the organisms of disease. Water-supply. Water for drinking is derived almost entirely from rain collected from roofs in tanks of various kinds. On the beach at Onerua a well has been sunk, and water tapped at a distance of 15 ft. below the surface. This well affords a useful supply, of washing-water to a certain number of the inhabitants of this settlement, but as the water is brackish it is not much use for drinking purposes. The European residents and some of the Natives possess proper galvanized-iron tanks, suitably screened to prevent the entrance of obnoxious material, but in many instances the water is collected in old barrels, kerosene and biscuit tins, &c, open at the top, so that it is frequently seen to be polluted by dead cockroaches, decaying leaves, &c, while the larvae of mosquito and other insects are usually numerous. As few of the Natives possess tanks of sufficient size or sufliciently numerous to provide water for washing purposes, the women arc accustomed to carry the soiled clothing over the Makatea to the central valley beyond, where at most seasons the water is plentiful. From the arduous nature of the journey it may be surmised that as little washing is done as possible, and it is a fact that many of the adults and the majority of the children are attired in garments which are, to say the least, very dirt}-. The scarcity of water in settlements, with the consequent lack of cleanliness of the Natives, is, of course, answerable for much of the ill health among them. The majority suffer from a form of body-ringworm which is propagated by filth, and a large proportion have sores of various kinds, which, being rarely or never bathed, give rise to loathsome and evil-smellin" discharges, attracting the numerous flies which assist in spreading the diseases.