THEIR FACES SHOW IT

Dominion, Volume 19, Issue 118, 12 February 1926, Page 10

THEIR FACES SHOW IT

HEALTH CAMPAIGN IN PACIFIC CHILID-SLAYER ROUTED IN SAMOA & COOK ISLANDS BUT SOIL-POLLUTION REMAINS An independent expert witness of international status tells how New Zealand Administrators in Samoa and the Cook Islands arc routii a disease so disfiguring that i. has been mistaken for leprosy—an infection so deadly among babies that it has been the prime cause of heavy infantile mortality among natives. At the same lime, a more rigorous latrine campaign is asked for in the Cooks, where the configuration ohstacks arc great and the financial resources small.

Through Dr. S. M Lambert, M.D., the International Health Board of the Rockefeller Foundation is putting on record an independent test of the health of Pacific peoples and the quality of the health administrations in various groups. Surveys of the mandated territory of Western Samoa (under the New Zealand Department of External Affairs) and of the Cook Islands (under a New Zealand Minister, Sir Maui Pomare) have been made by Dr, Lambert, who is an expert in tropical medicine, and he has sent to his board illuminating reports, copies of which are delivered to the Administrations concerned.

The ravages of three outstanding diseases—yaws (framboesia), hookworm, and filariasis, have been measured as far as possible. Very great progress has been made against yaws; a most promising campaign against hookworm ' is in progress; but much has still to be ascertained about filariasis before its complete conquest can be relied on. In Samoa further study of the prevention of filariasis is being made by the London School of Tropical Medicine. A Human Monument.' These successes of the two Administrations—which, though separate, are both New Zetland Administrations—in the Mandated Territory and in the Cook Islands are things of which New Zealand mav be proud. “Yaws,” writes Dr. Lambert, “is probably the greatest cause, direct and indirect, of death among tlie Pacific races in the first two yelfrs of life. Its tertiary effects are the cause of much suffering and .illhealth throughout adulWlife. The treatment of this condition in Pacific Islanders is probably the finest demonstration to them of the value of Western medicine.” Packed away in those sentences is a whole heap of tragedy, now j to be mostly—perhaps wholly—averted. Yaws was the child-slayer, hardly a single Samoan reached adult life without having suffered from it; it was the cause of visible disfigurement; it proclaimed itself in the very faces of the people—so much so that, until comparatively recent' times, most laymen (and some doctors) mistook it for venereal, or even for leprosy. But already there is sn improvement visible to the most casual observer, if he knew the Islands in other years. In fact, the increasing' triumph of the public health authorities is already writ large in the Polynesian countenance. And what greater monument could a health administration ask for!

The degree of victory secured over vears is deservedly emphasised in the report. Concerning Western Samoa, Dr. Lambert writes: “Yaws is well under control, and mav be eradicated in the near future.” Concerning the Cook Islands he states: “Yaws, on the whole, has been handled well. If present plans as outlined bv the Medical Department .are carried out. yaws will cease to exist except in a sporadic form as carried into the group.” Defects in the Cook Islands. But though much has been done, there is much to do. People in New Zealand cities, used to modern drainage, can hardly realise the position in the tropics without even latrines. The control of so many diseases depends on sewage-disposal and soilsanitation that this subject necessarily looms large in both Dr. Lambert’s reports. Of Western Samoa he writes: “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.” But the Cook Islands present, of course, a different problem, and concerning them Dr. Lambert is careful to remark: “Myremarks on sanitation in the Cook Islands must be interpreted in the light of the fact that it is a young colony with small means. One may sav that as yet they have not gotten around to the proper consideration of. this most important of all subjects in the tropics. In Avarua there arc some septic tanks in connection with their

good reservoir water supply. I was surprised to see that the schools in Avarua had nothing of the kind. I estimate that half of Rarotonga has no latrine accommodation of anv description. In the other islands the Europeans have unflyproof, shallow, pit privies; the natives nothing except in the rarest of cases. Disastrous epidemics must follow in the wake of too long neglect of this item. However, Jud re Ayson, the Commissioner, realises this need and promises his usual energetic action. He discussed with me the plans adopted bv other groups, and as soon as possible will go forward with an adequate latrine system for the whole group.” “Lock the Stable Door.” Another quotation from the report reads: “Because the Cook Islands have never experienced a great .epidemic of typhoid there is no reason for supposing that it cannot occur. . . . Shortly there will be the condition that has prevailed in Tonga, which has a latitude to the Cooks, and in Tonga typhoid is a dire problem. . . . Lock the stable door in the islands where the typhoid thief has not arrived. Build suitable latrines throughout the Cook Group.” Dr. Lambert also writes that in all probability hookworm and similar parasitic diseases could be eliminated —as an economic factor—in the Cook Group, “by two thorough mass treatments separated by an interval of a year. Adequate instruction in the dangers of soilpollution and ‘the installation of simple, inexpensive latrines should prevent its return as an economic factor.” Also, the school system should include simple hygiene—"any other system of education in the tropics is incomplete.” The following comparative note in the Cook Islands report is of interest:— “There is not heavy infection of hookworms in the Cook Islands. The rate of infection is higher than in Tonga (which is in the same latitude), but not so heavy as in Samoa or Fiji—probably corresponding to the rainfall, which is higher in Tonga, but not so high as in Samoa or Fiji.” The key to the conquest of filarihsis has yet to be found, so far as the CookIslands arc concerned: “Filariasis cannot be treated with our present knowledge; and profhylasis—the suppression of the mosquito—is, with our present knowledge, probably out of range of the Cook Islands Treasury.” Dr. Lambert sums up in the follow-; ing words: —“On the whole, the Cook Islands have no grave public health problems to face except the serious one of soil-sanitation.”