PROGRESS AND PROMISES IN HEALTH.

Auckland Star, Volume LX, Issue 243, 14 October 1929, Page 6

PROGRESS AND PROMISES IN HEALTH.

The New Zealand Health Department's report issued this year is a model of thoroughness and comprehensiveness. That this country already has the lowest death rate of any would lead one to suppose that there was not much scope for improvement, but our officials, aiming at perfection, have found much for criticism and ample room for suggestions for betterment in all directions. The birth rate is now 19.5G, the lowest, yet. The Director of Public Hygiene says that early marriage induces large families, and if an increasing birth rate means a higher infant death rate there will nevertheless be a net gain in population. Quite gaily, too, he suggests a partnership between the public and the general medical practitioner to encourage preventive medicine and eliminate disease. There is 110 hint given as to how the general practitioner is to make a living when disease is eliminated. Altruistic medicine means the suppression of all commercial ideas, and the G.P. of the future must have a private income or State aid.

Hope is expressed that the maternal death rate (slightly higher this year) may soon be reduced and as New Zealand stands below thirteen other countries in which mothers are safer thero should be more than a hope; there should be a grim determination. Auckland tops the New Zealand list of cases of puerperal fever. Dr. Jellett says: "If a second attendant, i.e., the medical practitioner, whose profession necessarily brings him into contact with many sources of septic infection, can be eliminated it seems obvious that the septic death rate will fall." And "it i 3 well to remember that the essential part of the medical practitioner's duty is ante-natal care and diagnosis, and his presence during the final stages is not essential." Here, again, is expert advice to imitate the health authorities of Holland and throw all maternity work into the hands of thoroughly trained midwives. This is, indeed, the teaching given throughout the report from which we quote. Perhaps undue stress is laid upon asepsis (as against antisepsis) considering that aseptic treatment has failed to affect the death rate. Reference is made to the "free" articles issued to tlie Press by the Health Department. Up to now these have lacked strength of purpose, ignoring as they do the public need for definite instruction. Vague generalities are not assimilated by indifferent readers. Here is a useful quotation from a London Health report used by Dr. Valintine: "It is manifest that a healthy childhood of sound physique is the genesis on which alone preventive medicine can be established. The school doctor is laying the foundation of national health." If our school doctors are wise and sympathetic a happy future is promised for our children and for theirs. It is not a little surprising to find influenza coming but tenth on the list of causes of death. It is probable that it looms largely in at least two other directions, namely, chest diseases and suicide, as causes of death, for influenza leaves its victims subject to otherwise escapable dangers. High blood pressure comes fifth on the list, topped by heart disease and cancer. The true interrelation of diseases is so little understood that these arbitrary divisions are mostly misleading. Cancer, however, stands out alone as a cause of death apparently sui generis. Infant mortality has a good record compared with past days. It was 30.18 per 1000 for the year. Under one month the chief cause of death was premature birth and this as being usually the result of mental stress or emotion (if not the result of accident) is not easily dealt with, although antenatal care will do much. Perhaps it is result of unemployment that seven per cent of school children are reported to have been suffering from "subnoßmal nutrition," a health report term for semi-starvation. School teachers do not escape comment. Out of G57 who applied for posts last year twenty per cent suffered from spinal or other deformity, the same number from dental diseases, eight per cent from obstructed breathing, sixteen per cent from goitre and thirteen per cent from defective eyesight. Overstudy is suggested as a cause of eye trouble, although England's great oculists say that exercise strengthens the eyes and when the fatigue point is reached the eyes refuse further work and demand rest. The conclusion is that there should be a higher health standard for teachers. —PERITUS.