H.—3l

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A comparison between the births ami deaths shows a steady increase of births over deaths, except for 1918 :— Increase. Decrease. 1914 ... ... ... ... ... ... 196 1915 ... .. ... ... ... ... 159 1916 ... .. ... ... .... ... 223 1917 ... ... ... ... 448 1918 857 Maori Health Organization.. The results of thi! second wave of influenza in 1.918 showed the urgent necessity of some organization amongst the Maoris themselves to assist Health officials and medical men. Maori villages were circularized to form Health Committees to assist in combating epidemics. It was felt, however, that the Maori Councils with their Village Committees were the proper channel for such work. A clause was subsequently included in the Native Land Amendment Act, 1919, with the view of bringing the Councils into closer co-operation with the Health Department and increasing and better defining their duties in health matters. Model by-laws have been drafted to suit Maori requirements, and it is hoped that by reviving and strengthening the Councils and putting them directly under the Health Department much good will result. Sanitary Inspectors. Some years ago a number of Sanitary Inspectors were appointed from amongst the chiefs and leading men in various Maori districts. They did invaluable work, in their day in overcoming prejudice and opposition by means of their personal standing with the tribes. The system, however, was allowed to lapse. Sanitary Inspectors are now needed of a younger and more energetic type, and sufficiently educated to learn the scientific details of their work. Authority was given for the appointment of three Inspectors for Maori work, and one, Inspector Leaf, a returned officer who had distinguished himself in the field with the Maori Battalion, was appointed for liokianga. Two others are to be appointed. Inspector Leaf has fully justified his appointment. Native Health Nurses. One of the most important branches of Native health work is that being done by the Native Health nurses. They see patients at their headquarters and visit the schools and villages in their districts. By health lectures and practical instructions the preventive part of their work is as important as the actual nursing of cases. In epidemics their services are invaluable, and have saved Hospital Boards much worry and expense. In typhoid cases where it is difficult to transport Maori patients to hospitals they have started camps in the affected villages and nursed eases throughout. Not only has this got over the repugnance of the Maoris against entering hospital and parting from their relatives, but it is hoped that the general routine with regard to nursing, feeding, and disposal of excreta, &0., will prove of great educational value to the people. The Maoris realize and appreciate the good work being done by the nurses, and many districts are asking for nurses to be appointed. As the nurses have a very strenuous time in many of the back districts, it is necessary that at least they be comfortably housed. Some Hospital Boards have assisted, but many do not. If the housing problem could be solved, more nurses could be placed in districts which need them urgently. During the year nurses have been appointed to new districts at Dargaville, Opotiki, and Tolaga Bay. The nurse at Pakotai, Whangarei district, has done invaluable work amongst the Maoris during the influenza recrudescence. The Board nurses at Whangaroa find Mokai do work amongst the Maoris. During the year the Hospital Board built a cottage at Taumarunui for the nurse. At Hapua, in the farthest-north settlement, the Natives collected money which assisted in building a small cottage, which Nurse Fergusson, of Kaitaia, makes her headquarters for the district, during regular visits. Nurses are needed at Wanganui, Taranaki, Mohaka, and other districts. I consider the nursing branch of the Maori work the one that should be assisted and pushed on more than any others. Subsidized Medical Officers. Subsidized medical officers are maintained in many districts by the Department. It has been found necessary to define their working-radius, as different conditions exist in various districts. Native-school teachers in parts remote from medical men are supplied with stock medicines by the Department for the common ailments prevalent amongst their pupils. They do a considerable amount of work in their own time, and the assistance and support they give the Department is very great. Miss Bagley, Superintendent of Native Nurses, in my absence attended a Conference of Native-school teachers held in Auckland, and addressed them on the Department's work amongst the Maoris. She was assured by the Conference of their hearty co-operation. General Health. The general health of the Maoris for the past year has been very good, and with the exception of some typhoid outbreaks and mild influenza the districts have been fairly quiet. Infectious Diseases. Influenza. —The type of influenza has been mild, and there was no recrudescence of the type of 1918. In the districts where Native Health nurses are located their reports show that they saw and nursed 563 cases. As a result of the heavy mortality of 1918 the Maoris are much more