A.—3,

" The hospital has done a great deal of work during the year, both in the out-patient department and in the wards. There are at present three Native nursing probationers employed at the hospital under the charge of the Matron, and they do their work willingly and well. The total number of attendances at the out-patients department during the year was 9,209, and over a thousand visits were paid to patients in their own homes. The number of in-patients during the year was 205. The attached table shows the nature of ailment, and home, village, or island of each patient, according to the classification of illness adopted for the usual monthly reports. Ten deaths occurred in hospital during the year. Apart from injuries, &c., and special tropical diseases, diseases of the respiratory system easily lead in numbers. This is due in part to the influenza epidemic mentioned above, which led to cases of bronchitis and broncho - pneumonia. The number of cases of phthisis on the island appears to be considerable. The establishment of a small hospital in a suitable part of the island where these cases could receive treatment would undoubtedly prove of great benefit. " On account of the absence of returns to date from other islands of the group owing to the hurricane season, I am unable to furnish a comparison of birth-rate and death-rate for the period. There is every reason to believe, however, that the figures, when they come to hand, will show a satisfactory excess of the former over the latter. The figures for Rarotonga are —Births, 134 ; deaths, 90 : which shows 44 more births than deaths. The total figures available for the whole group are —Births, 331 ; deaths, 265 ; the difference being 66. Dental Department. The Dental Clinic still continues to do good work, and considerable progress has been made in the betterment of oral conditions. The clinic was open in Rarotonga from April to October, and in November was transferred to Mangaia, where excellent work is being carried out, chiefly amongst the school-children. Work will be resumed in the clinic at Rarotonga on the return of the Dental Officer from Mangaia next month. The number of patients during the year totalled 1,180, and the attendances, 2,184. The following operations were performed : Fillings, 1,644 ; extractions, 667 ; miscellaneous, 998 : total, 3,309. The following are extracts from the report of the Dental Officer " The year ending 31st March, 1928, has passed off successfully, and considerable progress has been made in the betterment of oral conditions. " While dental prophylaxis is still an unknown factor (or disregarded) in the lives of the majority of the people, I feel that the children are gradually being instilled with a desire for better teeth, and also with the knowledge of how this desire may be attained. As pointed out in a previous report, it is to the schools that we must look for any real progress in this direction. To rely on the parents, or to expect noticeable results from propaganda work among them (although this work has been attended to), is next to hopeless. When one sees, almost every day, some instance of serious neglect in medical treatment until all Native remedies have failed, it is not surprising to note mouths (which are, after all, comparatively obscure corners) filthy in adults, and neglected in numerous children who have not yet come within the scope of work of the Dental Clinic. Undoubtedly fear is another factor, especially in a place like Mangaia, which has known only extractions until my present visit. Curiosity is a Native characteristic, and may be utilized for eliminating this fear, by "holding a more or less open clinic where the dentist may be seen working. This is possible in Mangaia and Aitutaki, and advantage has been taken of it. As a consequence, a Maori will perhaps stand for several days at the door watching you work, and then be sufficiently reassured to enter for treatment. " The general idea prevalent in the Native mind is that European food is the Utopian diet, and it is going to be a hard idea to eradicate, especially in Rarotonga, where the Native foods appear to be less cultivated than formerly, and where the population is too large for the amount grown. Aitutaki, a comparatively rich island financially, is quickly leaving its native diet. Mangaia, which has better teeth than either of the former places, is poor financially, but shows progressively worse teeth in its progressively richer villages, thus : Oneroa (main settlement, largest export producing area), 60 per cent, good mouths ; Ivirua (exports large quantity of oranges), 70 per cent, good mouths ; Tamarua (poorer land, and less exports), 86 per cent. It therefore appears to be fairly conclusive from the above and similar observations that the more native the diet the better the teeth. If one could find an island with perfectly dentured inhabitants it might be profitable to investigate conditions there. " This year's work compares favourably with that of last year. From March to November, time was fully occupied in treating new pupils and children up to Class 4 in the Avarua School, Rarotonga. Some thirty senior pupils also were completed after school hours. In addition, European and Maori adults received treatment. " In November the clinic was removed to Mangaia, where, at the end of March, 1928, some 320 children had been rendered dentally fit. This makes a total of approximately 600 children completed for the year in Rarotonga and Mangaia. " This current year will see the installation of a casting-apparatus for inlay and necessary crown work, and the addition to the staff of a fully qualified dental nurse."

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