BRIGHT OUTLOOK

Evening Post, Volume CVIII, Issue 83, 4 October 1924, Page 8

BRIGHT OUTLOOK

FOR SAMOAN NATIVES

AMERICAN MEDICAL EXPERT'S

REPORT

PRAISE FOR NEW ZEALAND ADMINISTRATION.

In Samoa we have a long-visioned Administration which is giving every support to a strong Native Department and a modern Department of Public Health, these two working hand-m-hand. Yaws is well under control, and may be eradicated in the near future. Hookworm control measures are well advanced, and will now be prosecuted with the vigour given to the yaws campaign. Adequate sanitation, proper latrines, and pure water supply are gradually being installed in all villages. Definite plans are undertaken for child welfare work in native villages with the new year. Even thus early, these measures are being reflected in increasing populations of healthy, happy Samoans. A few years and they, will mean dividends on the investment for the country, which after all must be the criterion pf the success of a humanitarian effort if it is to be enduring.

In these yords, Dr. S. M. Lambert, an ; expert on tropical diseases, of the staff of the International Health Board of the Rockefeller Foundation, sums up his valuable health survey of Western Samoa—governed by New Zealand under mandate under the Peace Treaty.

In 1923 the Administration of Western Samoa invited the International Health Board of the Rockefeller Foundation to make a health survey of Samoa, with special reference to hookworm disease. The invitation was accepted, and the survey began on 24th July, 1924, and erided on 18th August, 1924.

"The Department of Health of Western Samoa," states Dr. Lambert, "is headed by the Chief Medical Officer, who is also the Medical Officer of Health. He has a staff of six I qualified /medical practitioners, two health inspectors, one of whom is'_ a registered pllumber ' with qualifications in sanitary science, a matron, and eight other qualified European nurses, nine Samoan nurses trained and graduated from the Apia Hospital, eighteen Samoan nurses' in training, one European dispenser, with one native assistant, and eleven medical assistants and medical cadets in training. Apia is situated in the most populous part of the territory. There is a hospital in Apia which is modern,' and which will accommodate 14 Europeans, 60 Chinese, and 100 Samoans. This is staffed by. four medical officers, the matron and eight European nurses, and the nurses and cadets in training. Two of the medical officers take care of the hospital^ one attends to the outside- calls of Apia and. district (there are no private practitioners in Samoa), and the fourth one spends most of his time visiting out-districts. The matron and one nurse, at least; must be qualified maternity nurses. At the eastern end of Upolu, in tho Aleipata district, and in the Faasaleleaga district of Savaii there are district hospitals, each under the control of a European medical officer who is assisted by a native medical assistant and two trained Samoan nurses. At four populous centres thero are four trained Samoan nurses, who centre at mission stations and act as dispensers, and at ono such centre there is a native medical assistant who acts as dispenser. At one centre there is an unqualified European dispenser, who .from years of training is competent to deal with minor ailments. Four other mission stations are provided with free drugs. As trained nurse 3 become available they will be allotted to these stations.

Dr. Lambert gives an outline of the activities of the Health Department, and furnishes details of the Native Health regulations.

The valuable work already accomplished by the International Board of Health of the Rockefeller Foundation includes, amongst other activities, the stamping out of hookworm in many tropical countries throughout tho world. Hookworm is one of the most common and most devastating of diseases of native peoples in the tropics. Dr. Lambert acknowledges tho splendid organising work which has been carried out by General G. S. Richardson, the Administrator, and his staff, and as an independent medical expert, Dr. Lambert speaks in high praise of the labours of the Health Department. , YAWS AND HOOKWORM CONTROL.

In 1920, Dr. F. W. O'Connor, of the London School of Tropical Medicine, states Dr. Lambert, carried out a preliminary survey which showed that hookworm infection among the Samonns was almost universal. He reported that he found an infection rate of 85.1 in 286 examined, 'but this was in some cases from one specimen only, and that among thoso examined for filaria, the eggs of hookworm were eventually always forthcoming. The largest number' of worms found by him wero 113. Tho institution .of free treatment in April, 1923, made it possible to commence_ a: systematic campaign agaiijst this disease. Tho campaign was based on the International- Health Board model, which had been studied in Queensland and Fiji, and with films, lantern slides, and charts purchased from them, a commencement was made lo educate the native to the necessity for treatment and for better sanitation. This continued till October, by which time 18,057 mass treatments had been given. The work went slowly at first. This was probably due to lack of confidence on the part of the natives, who still had a vivid recollection of the havoc wrought by the introduction, during military occupation, of influenza in 1918, in which many thousands of lives were lost. In the first three districts treated, with a population- of 7924, only 4526 offered themselves for treatment, a percentage of 57. ' In the next five districts,' with a population of 14,444, they became more alive to the value of the treatment, and there was no difficulty in treating 13,004, pr 90 per cent. Nine hundred and twenty-five other people were treated in hospitals. These were all treated with carbpntetrachloride, two minims to the year to the apparent age of fifteen, when the adult dose of forty-five minims was given. At first this dofe was given followed by a purge of magnesium' sulphate in two hours. Later the, drug was administered in saturated solution of magnesium sulphate.

By October, 1923, the pressure of the natives on the medical staff for the free treatment of yaws became so great that the hookworm campaign had to be temporarily abandoned'for the Jack'of personnel to handle the two pieces of work. At tlie beginning of the year the natives had agreed to an additional tax of one pound per head of adult males for free medical attention, and the treatment of. yaws with its'spectacular results appealed to them more than the hookworm work. Their views had to bs heard to assure the successful collection of the first tas, and to gain their

firm support to the Medical Department.

} The work of sanitation in connection with the hookworm work has progressed steadily, and plans have been definitely made to treat the whole of Samoa with mass treatments during the month of November, 1924. Five units consisting of two men each will be stationed at different points in the islands to cover a definite area, which will complete the whole. population in the I month. The plan is to repeat these mass treatments at intervals of six months till hookworm disease is conj trolled. VALUE OF WESTERN MEDICINE. ''Yaws is probably the greatest cause, direct and indirect, of death among the Pacific races in the first two years of life," states Dr. Lambert. ." Its tertiary effects are the cause of much suffering and ill-health throughout adult life. The treatment of this condition in Pacific Islanders is probably the finest demonstration, to them of the value of Western medicine. During 1923 the demand for injections was so great that treatment was given to all offering themselves. No attempt could be made to fine-comb the whole population. The result of the year's work appealed to the natives so much that the native Parliament of Faipules or chiefs, agreed to the introduction of very stringent reculations for the control of this disease. During the first year of the campaign 32,336 injections were given. The work was recommenced in April, 1924, and duringthe four months ending 30th July, 1924. 12.000 treatments were given. The whole of Samoa ,will have been completed by the middle of October, when tho hookworm campaign will be recommenced.

'-'THE AVERAGE WHITE MAN."

The average white man sits in the shade in the South Seas and talks'-of the lazy native and criticises the Government for not compelling (always the same word) the native to do this thing or that which will benefit him (the white man); with never a thought for the native himself. In the first place,, the native isn't lazy when he is interested, nor when he wants to hold a job. Where Nature is so bountiful and the necessities of life are so easily obtained as in most Pacific islands, natives do not seek hard work any more than whites would under the same circumstances. But where conditions are more difficult, as they are in many districts, then the native has to work__as hard as any white man. In Savaii some villagers have their gardens at a distance of miles, and must carry in their produce on their shoulders. Tn many parts of Fiji and other islands natives have to work and will work at hard labour to support their families*. ■ . .-

Every colony in the Pacific faces the problem of a decreasing native population in the face of a need for an increasing labour supply to develop these islands for their products which have grown to be necessities of the food supply of the temperate climates. The' causes of the decrease of the population nic, broadly, decay of custom and introduced diseases, both due to the entering of white civilisations. .

•- HEALTHY, CONTENTED . NATIVES."

nsv? er is the importation of Asiatics. This is undesirable for political reasons, and in almost all cases it will finally produce a problem more difficult than the present one. And they mean the earlier extinction of tho native races Ihe truer answer to the problem ?£ h,„h'sb, W onei i 8 the care of the health of these peoples, and their protection from new epidemics.while we h% ady ( ; ntFodll«d, and to which they have little immunity, as well as ridding h,t v tw° 0f moro diseases which innVn^ 0" P r? v? lent, among them for an indefinite period. We must gain their confidence, and trust in Western medicine and civilisation. We must instil new ideas and ideals of daily life to take the natiL ,v-H \, 0' • °UStoms M' are in~mpatiblo with their new life. The result of such an effort will be the large n crease of the population and the final pressure of that population on the means of subsistence will furnish labour Tr the development of the islands in an inthem is so large under normal condition? that with a death rate lowered by p re . ventive •medicine, population f.gVes win soon show a large enough increase to produce plenty 0 f Bttr f M ,X_. 6 te white plantations or necessitate an enlargement of their plantation, by the ££_■ «t he- co«ntl 'y- Samoa is well ti£ gwsA° ro- d to * hss happy co»dition with her increasing population of healthy, contented natives." '