31

A.—4a

IX. PUBLIC HEALTH. 1. What steps are being taken in the Territory lo provide for public, health, sanitation, and to combat endemic and epidemic diseases ? (a.) Public Health Administration. A preliminary survey of Western- Samoa in 1920 showed the necessity for the establishing of a Division of Public Hygiene in addition to the Division of Clinical Medicine and Hospitals already established. By the Samoa Health Order, 1921 (N.Z. Gazette Extraordinary No. 17, of 16th February, 1.921) a Board of Health was constituted, and the Medical Service divided into the two divisions mentioned above. The work of the Division of Public Hygiene commenced with the arrival of the Medical Officer of Health in May, 1921. The Ordinances of the German Government, and those of the old Municipality of Apia, were found to be inadequate for present-day purposes, and were therefore, replaced by the Samoa Health Ordinance (No. 19, 1921). The Board of Health constituted under the Samoa Health Order, 1921, is empowered to make regulations for the conservation and promotion of the public health, and in pursuance of the powers thus conferred it has made regulations as under : — No. 1 : Regulation for tho Sale of Intoxicating Liquors.—These regulations prescribe the procedure necessary to obtain alcohol for medicinal purposes. No. 2 : Regulations for the Purpose of Preventing or Checking the Spread of Infectious Diseases.—Those regulations deal with rats and their destruction. No. 3 : Regulations providing for the Registration of Births and Deaths of Samoans.— The system of registration in force since 1905 gave very little information except the total number of births and deaths. The age at death was so crudely indicated as to be of no practical value. That approximately 70 per cent, of the total deaths are of children under the age of fifteen or thereabouts indicated the advisability of obtaining more detailed information, and the new regulations, which are similar to those governing tho registration of births and deaths of Maoris in New Zealand, arc expected to furnish the information required. In addition to the above, the following regulations are at present under discussion: — Regulations as to Rubbish and Refuse Containers. Regulations in respect of Buildings, Drainage, and the Structure and Cleansing of privies. (/;.) Sanitation. Sanitation of Native villages is intimately associated with hookworm-control, and is dealt with under the heading of " Uncinariasis." (c.) Endemic Diseases. Of the, more important tropical diseases only three are prevalent in Samoa—uncinariasis, framboesia, and filariasis. Uncinariasis : Of the total Native population of 33,000, over 90 per cent, harbour hookworms, and of these only a small percentage receive treatment. Fortunately, although the percentage of infected individuals is high, the degree of individual infection is not as great as would be anticipated. The problem of coping with this disease and bringing it under control is primarily one of introducing sanitary conditions in the Native villages, and at the present time arrangements are being made for carrying out a propaganda campaign. The International Health Board (Rockefeller Foundation) has offered to co-operate in every possible way, and the Administration, taking advantage of this offer, is purchasing the materials required, from the Board. The work of this Board has been studied in their reports, and also in the field, and the intention is to carry out the work in Western. Samoa on. the same lines. Framboesia : This disease is very prevalent, especially amongst the younger members of the community. The Samoans, however, now recognize, the value of treatment by injections of novarsenobillon (the preparation in use in Samoa for this condiltion), and as the Medical Service extends to the more outlying districts this disease will speedily be brought under control. Filariasis : It is estimated, that filarial embryos tire present in the blood of about one in four of the Native, population, but tho effects of their presence tire not evident in all those affected. Until a satisfactory method of dealing with this parasite has been discovered, little advance in combating this disease is to be expected. Hookworm and framboesia are at present more pressing problems than mosquito-control. (d.) EriDEMic Diseases. Western Samoa has been, free from epidemics since the influenza epidemic of 1918, with the exception of a mild one of measles in 1921. Most of the population had been rendered immune by previous epidemics in 1911 and 1916, and by sporadic cases occurring at intervals.