25

A.—4.

Main Diseases. Yaws. —Regular malagas (tours of inspection) were made in each Native medical practitioner's area, besides a day each week being spent at his headquarters for N.A.B. injections. Not many bad cases are seen in the outlying districts. The number who received N.A.B. treatment during the year was 11,382. Enteric. —A number of cases still occur and come to the hospital for treatment from various surrounding villages. There were outbreaks during the year at three outlying villages. A quarantine was enforced by the villagers and the epidemic soon subsided. Tuberculosis.—lt is a difficult matter to obtain these cases early enough for treatment and education. By the time they come under the notice of the hospital doctors they have already done harm in their family circle, the danger they constitute not being realized. The cases which arise are mostly confined to Apia and the more closely settled places to the west of Apia. Beri fieri. —There were two cases treated in hospital during the year. Leprosy. —Two recent cases have been discovered and are now isolated at the Apia Hospital. As many as possible of the relations of known lepers are examined periodically, as also are those discharged as cured from the Makogai Leper Station. Jaundice. —A number of cases occasionally occur. The cause of this is not yet known, but one outstanding fact is that they occur in villages in which poor water, bathing facilities, and sanitation obtain. Native Medical Practitioners. During the year 16,000 fale were visited and 1,820 villages inspected. The Native medical practitioners are giving admirable service to their own people. During the year one Native medical practitioner returned from the Suva Medical School, where he had been undergoing a refresher course. There are at present six Samoan students in training at the school, of whom two will have completed their course of studies by December, 1938, and will then return to the Territory to take up active medical work. Women's Committees. During the year three further Women's Committees were formed, bringing the total to 125. All these Committees render excellent service, and by close co-operation with the medical authorities materially assist in the promulgation of sanitary education. Answers to the questions asked by Count de Penha Garcia( 1 ) are given below: — (1) Declaration of Deaths and Classification of Diseases. —The record of deaths for measles and whooping-cough last year were compiled from records specially kept by the Native medical practitioners. The usual procedure is for the Pulenu'u of each village to make a quarterly report of the number of deaths in his village. The Pulenu'u does not give cause of death (being in most cases unable to do so), and the classification of the cause of death devolves upon the Native medical practitioner for the district. (2) Isolation of Infectious Diseases.—lt has been the experience of the medical authorities that local quarantine of villages, unless heavily policed, is in most cases unsuccessful. Although considerable progress has been made in the medical education of the Samoans, it has not yet been possible to inculcate a consciousness of the necessity for quarantine precautions in cases of infectious diseases ; and consequently quarantines are broken from the inability of the Samoans to understand their necessity. (3) Comparison of the Number of Villages with the Number of Women's Committees.—As mentioned on page 2 of last year's report, there are 192 villages in the Territory. There are 125 women's committees. Participation by Missions in Medical Work. All missions purchase stocks of drugs and dressings at the Apia Hospital dispensary from time to time, and use them in their schools. Dental Clinic. In February, 1937, a dental officer was appointed and at once commenced a preliminary survey of the dental health of the school-children, over 1,500 Government school-children being examined. A modern, fully-equipped dental clinic has been established adjacent to the public hospital. There are six Native dental cadets, all picked lads, undergoing training for a period of three years. The scope of the clinic work must necessarily be restricted during this period, and for the present, therefore, the main effort will be directed to this training of the cadets who are showing a remarkable aptitude for the work and are very keen students. In addition systematic preventive work will be carried out as far as possible in respect of pupils attending the European school at Ifi Ifi, and all pupils of Government schools will be eligible to attend the clinic for urgent treatment —i.e., extractions, &c. Attention is also being paid to dental-health education by means of articles and talks along simple preventive lines delivered to the school-children and school teachers during their refresher courses. Courses are also being given to the Native medical practitioners and Native nurses on preventive dentistry.

(*) See minutes of the thirty-third session of the Permanent Mandates Commission, page 62.

4—A. 4.