H.—3l

34

PART VIII.-MAORI HYGIENE. I have the honour to submit a brief annual report for the year ended 31st March, 1922. SECTION I.—NATIVE HEALTH. Maori Health Councils. The reorganization of the old Councils created under the Maori Councils Act, 1900, has been carried out. Under section 61 of the Health Act, 1920, the twenty existing Council districts become Maori health districts, and the Councils with their Village Committees are administered through the Department. As the duties of these bodies are those of the local authority amongst the Maori people, special attention has been paid to the sanitation of the settlements and the prevention of the spread of epidemics. Model by-laws have been drawn up and gazetted for each district. A large number of copies have been distributed to ensure that all members of the Council and Village Committees have a set. Some of the by-laws will be difficult to put into immediate operation, but they provide a standard and objective towards which Village Committees must aim. In this way they remedy the general character of the old by-laws, and give the committees the detail they so much require in various branches of sanitation. Copies with lists of Council members and Village Committees have also been made available to Medical Officers of Health, Inspectors, and Maori district nurses, in order that the Divisions of Public Hygiene and Maori Hygiene may co-operate and assist each other. The reorganization of the Councils with their committees has entailed much travelling about and considerable correspondence through my office. Instructions re supervision of accounts, and a quarterly statement showing receipts and expenditure, returned to the division, has helped to improve tho haphazard finances of the past. Questions and requests for advice and assistance come from all parts, and the answering of these in the Maori language is no unimportant means of improving health conditions. Tho co-ordination of our nurses and Inspectors throughout the country, combined with personal visits and advice from the office, is, I am convinced, resulting in a great amount of good to the health of the Maori. The Maoris at the present time, with few exceptions, are ready to carry out as far as they can the requests of the Department. We understand the Maori and he understands us, and thus a spirit of co-operation is established between the office of the Maori Hygiene, Division and the Maoris throughout the country that has already proved an enormous factor in dealing with these people. Native Health. On the whole the health of the Maoris has been better than during the previous year. Typhoid fever broke out at Hauhora, Whangaroa, Bay of Plenty, and Levin districts, with odd cases in other parts. Though the mortality in the Levin cases was high owing to the obstruction to hospital treatment, we may say that the cases are becoming less, with a lower mortality. This is largely due to the work done by the Maori district nurses, combined with there being less obstruction by the Maoris to hospital treatment. Typhoid Inoculation. The preventive effect of anti-typhoid inoculation continues to be borne out by the reports from districts where it has been done and where previously typhoid was endemic. Our policy has been to treat settlements and districts where typhoid occurs or has occurred, as it is impossible to do the entire Maori population. During the year the Levin district, from the Manawatu River to Porirua, was done ; also the Bay of Plenty, parts of the North Auckland Peninsula, and Taupo districts. Where so many cases of typhoid have occurred in the past there must be a certain number of typhoid carriers amongst the Maori people, and though sanitation and water-supply must be attended to, the svstem is incomplete without anti-typhoid inoculation. The Maoris are generally amenable to treatment except where they come under the influence of ignorant pakehas. Tangis and Huis. The conditions surrounding Maori gatherings have greatly improved. Where some years ago not the slightest attempt was made to provide latrine accommodation, it is now a recognized thing. The Council by-laws provide for this. I was greatly pleased with the large Maori gathering in the Bay of Islands to celebrate the anniversary of the signing of the Treaty of Waitangi. This was attended by over two thousand Maoris. Ample fly-proof latrine accommodation was provided for both sexes, and additional urinals. The washing-up water was conveyed by pipes from the washing-up sinks to covered-in pits which were provided with field grease-traps. The meat was stored in a roomy meat-house thoroughly ventilated by the sides being made of scrim. The waste food was emptied into receptacles, promptly collected after each meal, and conveyed on trollies running on rails to the pigsties placed at a safe distance, where it was effectively disposed of. During the whole gathering there was not the slightest sanitary fault to be found, and the organization would have done credit to any military camp. Wo find that the Maoris are ready to accept advice and assistance in their gatherings, and though some are slow to move, if the Department lays down the law it is accepted and carried out. Maori Health Nurses. These nurses continue to do good work, and are a great comfort to the people when typhoid is about. At some of the larger huis we have adopted the principle of getting the district nurse to attend with a few simple remedies in case any outbreaks should occur. There is no doubt that by the nurses visiting settlements and any rumoured or reported cases of sickness, typhoid is prevented from spreading through entire settlements as it once did, and many lives are saved.