HEALTH IN SAMOA

Te Awamutu Courier, Volume 53, Issue 3795, 14 August 1936, Page 11

HEALTH IN SAMOA

SERIOUS INFANT MORTALITY. BATTLE AGAINST DISEASE. (Written by the United Press Association’s Representative with the Government Mission to Samoa.) HEALTH. Epidemics of whooping cough and measles have resulted in the loss of between 200 and 300 lives in Western Samoa this year, but otherwise the general health of the population has been good. Whooping cough made its appearance about the beginning of April. It was brought by people from Suva, and soon spread round the islands of Upolu and Savai’i, causing a number of deaths, chiefly from bronchopneumonia. In one or two districts where the infection arrived a little later the mortality rate was lower on account of the employment of modem methods of treatment. Whooping cough has abated considerably, although fresh cases were still being reported in July. Children suffering from measles first came under medical notice on 17th April’, and because of the whooping cough efforts to prevent the ailment from spreading were redoubled. The situation was soon brought under control, the outbreak being confined to three villages, which were placed under quarantine. In its general supervision over the health of the mixed population of Samoa the functions of the Health Department are widespread. The chief medical officer, Dr P. J. Monaghan, with the aid of an efficient staff, is rendering splendid service under very trying conditions. The commonest

tropical diseases are yaws, ankylostomiasis (hookworm), and fllariasis. Eighteen years ago, when Mr D. A. J. Rutherford, of New Zealand, now superintendent of schools, Apia, went to Samoa to take up the work of education there, he reported that most of the youngsters were covered with sores and suffering from eye disease. To-day, thanks to an intensive campaign carried out by medical men in co-operation with the teachers, the pupils are a joy to behold. The fight against yaws commenced in 1923 when, on the recomendation of Dr Ritchie, a tax of £1 a head was agreed to by the Samoans, who were treated free for all complaints. When the Mau trouble developed in 1926 there was a falling off in the number of attendances. Three years later free medical attention was to a certain extent withdrawn, and the Samoans were required to pay for injections and other forms of treatment. In 1932 yaws was again the cause of much suffering. The Rocke'feller Foundation, through its representative in the Pacific, Dr Lambert, set to work to relieve the position, and a vast improvement in conditions resulted. The campaign has been continued ever since. Two years ago Dr Heiser, of New York, made a tcur of the territory, accompanied by Dr Lambert, who later visited Western Samoa with Dr Watt, of New Zealand. The percentage of natives suffering from yaws is now very small. White children living under proper conditions rarely contract this disease in Samoa.

In Apia there is a public hospital with accommodation for a hundred or more patients. The average monthly number of inmates is between 60 and 70. The institution, which has divisions or wards for Europeans, Samoans, and Chinese” has a very competent staff, which includes the chief medical officer and three doctors, a matron, seven trained European sisters, several nurses, two native medical practitioners, or N.M.P.’s, as they are called—a bacteriologist, a dispenser, and a Chinese dresser. In addition, there are four native cadets who are ultimately designed to go to Suva to complete their medical training. Apia hospital is used also qs a training centre for Samoan nurses. One of the difficulties the officials are faced with is the number of resignations through marriage, and as the girls are not easily replaced interruption in training is inevitable.

Excellent work is being done in the village by women’s committees, some 115 of which were established by Dr Turbott, of New Zealand, during his nine months’ sojourn in the territory last year as chief medical officer. The committees consist of women of both political sections who work in harmony for the benefit of their sex. They show a keen desire to obtain as much knowledge as possible. Child welfare workers visit the committees within a reasonable distance, and in addition call on mothers, treat their babies if sick, and give advice about the proper care and treatment of children. When refresher courses are held in Apia the teachers from the schools are lectured on health and preventive medicine. Part of the knowledge they receive is incorporated in the school lessons. Visits to the schools are paid also by the N.MiP.’s, who are performing a most valuable service among their own people. Their duties include regular inspection of the villages under their charge, and the giving of talks on sanitation. Outside of Apia the island of Upolu is divided into four native districts. At Aloipata, the eastern point, there is a small hospital dispensary with a native medical practitioner and two nurses, one of whom has had childwelfare training. In the other districts N.M.P.’s alone are stationed. On the island of Savai’i a hospital dispensary, with two trained nurses and an assistant nurse, meets local needs.

The greatest mortality is among children under the age of two years, and measures to prevent this wastage of child-life in Samoa are being actively undertaken. There is a certain amount of malnutrition among the children up to three years of age; after that age is is very rarely that the doctors find a case. Most of the deaths occur during the weaning stage of the child, and more often than not are a direct result of want of knowledge on the part of the mother. The appointment of district baby welfare nurses is proving an invaluable means of enlightenment, and this policy is being pursued as rapidly as possible. Provision for maternity cases is made at the public hospital in Apia, Europeans and Samoans each having a ward to themselves. A fullyqualified maternity sister has charge. A good deal of her time is taken up in lecturing and teaching. An antenatal clinic was opened a few months ago, and is fulfilling a useful function. ,

Five lepers (three young women and two men) are at present in isolation at the Apia hospital, awaiting the arrival of a boat to remove them to the leper station in Makogai, Fiji. The disease in each case is in its very early stages. Other local diseases are occasional mild epidemics of mumps and influenza, pneumonia, tuberculosis, skin and eye diseases, in-

testinal worms, with rare cases of typhoid fever and tetanus. The chief insect pests of Western Samoa are flies and mosquitoes. Of the latter only one species, the Stegornia pseudoscutollaris, has so far been proved a carrier of disease. This mosquito is the one which is responsible for the transmission of filaria from man to man. Modem methods of sanitation have done much to check diseases which were once regarded by the natives as incurable. The medical officers have, nevertheless, a long and hard row to hoe. The customs of centuries and the unawareness of the Samoan are the chief obstacles, but these, doubtless, will be overcome in time.

“I am very pleased,” said the politician, rising to his feet, “to see such a dense crowd here to-night.” “Don’t be too pleased,” said a voice from the back. “We aren’t as dense as all that.”