THE COOK ISLANDS

Otago Daily Times, Issue 22632, 25 July 1935, Page 13

THE COOK ISLANDS

MEDICAL PROVISION URGENT NEED FOR ASSISTANCE Mr H. D. W. Brewer, of Dunedin. who has just returned from a month's visit to the Cook Islands, gave some extremely interesting impressions of his trip to an Otago Daily Times reporter yesterday. The group is, he said, an ideal place for a holiday at this time of the year. It has a congenial climate and has settings of remarkable beauty. So far as natural conditions were concerned, the islands were a little Paradise, but he.had been deeply concerned to find that the provision for medical services was entirely inadequate. This could easily be seen from the fact that the group had a population of about 12,000 —including about 200 white people, most of whom lived in Rarotonga, a town of 4000 inhabitants —and the needs of all these people, who lived in 11 scattered islands, had to be attended to by one medical officer, a qualified surgical nurse, two native medical practitioners, and four native nurses. Previously there had been a second medical officer, but his services were dispensed with owing to the depression. It was understood that arrangements were now being made to have this position filled once more. At present, however, the whole responsibility rested on the shoulders of the medical officer, Dr a native of Otago. On his health depended the lives of the population in case of emergency, as he alone could undertake surgical operations. ' HOSPITAL ACCOMMODATION . During his visit Mr Brewer made investigations into the position, and ho is convinced that the time has arrived for eome definite policy to be laid down in regard to the medical matters. The present hospital at Rarotonga was built in 1904, and the number of beds is at present 18, two of which have been added recently. In Norfolk Island the hospital allowed for 10 beds per 1000 head of i population, and this was the basis of provision in most city hospitals, even although in those places there were other private hospitals to relieve congestion. Working on this basis, said Mr Brewer, provision should be made for at least 30 beds. At present the hospital would not accommodate cases in times of epidemic, nor would it provide sufficient accommodation for the many who came from the outer islands. The result of this lack was that many acute cases had to be treated in their homes, where the patients were liable to interference from the native " devil doctors." The equipment of the hospital also needed modernising. Operations, for instance, were conducted under acetylene light with the assistance of electric torches. He "also thought that the appointment of an additional fully qualified nurse to the hospital was warranted. If necessary, she could be stationed at Titikaveka, where as a district nurse she could greatly relieve the work of the hospital by attention to child welfare, ante-natal examinations, confinements and general nursing. Regarding outlying islands, there was a district nurso on Aitutaki, an island with a population approaching 1000. Filariasis, among other conditions; was causing much concern there, and the position called for the assistance of a native medical practitioner.

SUGGESTIONS FOR ASSISTANCE In regard to native medical practitioners, Mr Brewer said that the local authorities had studied the position for some time and it was thought that six appointments could be made by which the entire group would be covered If this were done arrangements would be made to have. these men at Raratonga for a certain period each year for refreshed courses* An alternative would be the appointment of an assistant medical officer who could undertake visiting and . superintending the work on the various islands. The appointment of such an officer could be justified by several arguments, said Mr Brewer. The native medical practitioners required constant supervision. A routine must be established "and adhered to and only a professional person could criticise the work done and advise the best course to be undertaken. .It was absolutely necessary that a fully qualified medical officer should be free to leave Raratonga 10 make a periodic inspection of the whole group, and at present it was impossible for the officer to leave for long since there were many operations of a major nature to be carried out as cases from, throughout the Islands went there to be treated. It was not intended that the native practitioners should be called on to carry out serious operations or skilled treatment in the main hospitals. They were only expected to do ordinary routiue work and emergencies. Failing the appointment of an assistant medical officer, Mr Brewer thought f liat the position could be met by arranging with the Health Department to send a relief fojr six months of the year, from October to March, so as to cover the hurricane season in alternate years.

'ln conclusion, Mr. Brewer said that it was not right that the position should exist as it did at present. lie spoke as a disinterested observer and he expressed the hope that the Government would be moved to take action in the near future.

By way of contrast, Mr Brewer added that the provision for education was admirable, there, being IS schools with a total of 2800 pupils. The teachers were enthusiastic and performed their work well. A feature of the school training was the attention given to interesting the children in the native crafts, such as mat-making and wood-carving. Mr Brewer, in conclusion, paid a tribute to the Union Company for the way it had catered for the passengers during the cruise. The food, he said, had been excellent throughout, and the officers had gone out of their way to see that all on board had been kept amused with games and competitions. Everybody had been more than satisfied with the courteous treatment they had received.