A.—4

7

should be erected on the high, level where the conditions are temperate and. bracing. This would enable people who arc beginning to suffer from the, climate to have a chance of picking up, and would also be a place where convalescents from the Hospital could be sent, thus shortening the convalescent period considerably in many cases." Effect has been given to this recommendation in the establishment as a rest-house of a farmhouse taken over from the Germans at Malololelei, at an elevation of about 1,700 ft. above sea-level. The rest-house was opened on the 15th June, and since that date fifty-three guests have taken advantage of the facilities provided for a change from the less bracing atmosphere of the lower levels, their period of stay at the rest-house varying from two to fourteen days. The following statement shows the general attendances and eye attendances at the Hospital from the year 1915 to the 31st March, 1921. The attendances for 1920-21 aro in excess of those for the two preceding years, and are composed mostly of attendances by Samoan out-patients : — General Eye Attendances. Attendances. 1915-16 .. .. .. .. .. .. 6,997 6,808 1916-17 .. .. .. .. .. .. 9,220 5,685 1917-18 .. .. .. .. .. .. 9,020 3,011. 1918-19 .. .. .. .. .. .. 3,650 1,353 1919 20 .. .. .. .. .. .. 4,380 1,188 1920 21 .. .. .. .. .. .. 9,820 1,581 European in-patients. 1920-21 .. ..' .. .. .. 158 Samoan in-patients, 1920-21 .. .. .. .. .. 324 Chinese in-patients, 1920 21 .. .. .. .. .. 388 Chinese out-patients, 1920 -21. .. .. .. .. ..763 Operations performed, 1920-21 .. .. .. .. ..110 In spite of the shortness of staff and other difficulties encountered in 1920-21, the Department has, in the opinion of the Chief Medical Officer, " clearly gained the confidence of the Samoan people. The attendances at the Hospital have considerably increased, and the people are willing to come into hospital when advised, and are content to stay even if they do not understand the treatment." Referring to the year April, 1920, to April, 1921, in the same report the Chief Medical Officer says : " The year under review has in many ways been a disappointing one for the Medical Department. At the beginning of the year it was confidently hoped that this report would show considerable progress. As it is, very little progress seems to have been made." From the foregoing extracts quoted from the report of the Chief Medical Officer for the year ending 31st March, 1921, it will be apparent that he was somewhat disappointed with the progress made in giving effect to the programme laid down by him for the Samoan medical service, in view of this, the following report submitted by him on the 10th August, 1921, is quoted as showing that substantial progress has since been made : — " When the Civil Government took over in May of last year the Hospital and medical services gem-rally were in an unsatisfactory condition. At the request of His Excellency the Administrator I drew up a scheme for a complete medical service for Western Samoa, which was agreed to by the authorities. I think it is a fitting occasion to make an interim report on the work done up to this point. " Speaking generally, there has been a large advance made. The complete scheme has not been carried out, but this I did not expect. However, sufficient has been achieved to show that wo are well on the way to our final objective. The most noticeable change is to be seen at the Hospital. Conditions there have improved very much within the past year. The additional wards, though not yet actually in use, will relieve the strain considerably, and I am sure the Native Hospital will be a model of what such an institution should be. The new laboratory, which is in course of construction, shows the progressive policy of the Administration, and will prove a lasting monument to those responsible for its establishment. The new offices are now in use, and are proving their value every day. The conditions of work in all the branches have been improved greatly, and this is reflected in the more harmonious working generally." This change of viewpoint is largely caused by the fact that public-works construction, delayed at first for material, and. hampered throughout by labour conditions, made quicker progress after the Ist April than antecedent to that date. The work done at the Hospital is considerable, and comprises—White ward mosquito-proofed and renovated ; out-patient department renovated and structural alterations made ; new dispensary and storerooms fitted, up ; eye department renovated and mosquito-proofed ; mosquito-proof room provided for dispenser's quarters ; Chief Medical Officer's office, general office, and consulting-rooms for whites completed ; six large Native fale wards completed ; two annexes for Native wards containing W.C.s, showers, and slop-sinks almost completed ; frames up of four Native fale isolation wards ; operating-theatre renovated and mosquito-proofed ; Chinese wards repaired and renovated ; dining-room, storeroom, and kitchen for Native nurses completed ; showers and W.C. for Native nurses completed; laboratory one-third completed; modern drainage system for whole Hospital compound commenced ; large septic-tank half-completed. On completion of all required construction, and when the extended medical services are satisfactorily established, the beneficial effect upon Samoan life should be very great. The general medical treatment as from the Ist April, 1921, up to and including the 31st August, 1921, was as follows: General attendances, 3,870 ; European in-patients, 96; Samoan in-patients, 217 ; Chinese in-patients, 178 ; Chinese out-patients, 778 ; operations performed, 70. E DUOATION DEPARTMENT. These islands owe the deepest debt of gratitude to the missions, to which almost altogether the work of education has been left in the past. The London Mission Society, the Methodist Mission, and the Roman Catholic Mission principally, and to a lesser extent the Seventh Day Adventist Church