A. —4

32

(a) Apia Hospital : Established about 1904. Consists of European, Samoan, and Chinese sections, operating-theatre, laboratory, and offices. It has a staff of three medical officers, eight qualified nursing sisters, with Samoan cadets and nurses in training. (b.) Tuasivi Out-station, Savai'i : Opened in 1921. Stafl —one medical officer, one Samoan cadet, and two trained Samoan nurses. (c.) Aleipata Out-station : To be opened as soon as the buildings have been erected. Staff—as for Tuasivi out-station. (d.) Fagamalo Out-station, Savai'i: To be opened in .May, 1923. Staff —a Native medical practitioner who has had eleven years' experience in the Apia Hospital. (c.) Dispensaries at the mission stations at Malua and Lufi Lufi (Upolu), and Salaelua (Savai'i) : A trained Samoan nurse will be allotted to each of these stations. These mission stations have been provided with drugs in the past, and have done splendid service. Now that Samoans are being given free treatment the work of these stations will be increased. (/.) Dispensaries at the mission stations at Falealupo and Satupaitea (Savai'i), and in the Falejetai, Falealili, and Safata districts (Upolu). (g.) Dispensary at Mulifanua : Worked in conjunction with the Crown Estates' Mulifanua Plantation, All these dispensaries will be visited at regular intervals by a medical officer. 3. What is the actual situation as regards prostitution, and what steps are being taken in this matter ? Section 139 of the Samoa Act, 1921, reads as follows : — " 139. (I.) Every one who keeps a brothel is liable to one year's imprisonment. " (2.) A brothel is a house, room, or place of any kind whatever kept or used for purposes of prostitution. " (3.) Any one who acts as a person having the management, care, or control of a brothel shall be deemed to be a keeper thereof whether he is in fact- a keeper thereof or not. " (4.)-The owner or occupier of any house, room, or place who knowingly permits the same to be used as a brothel shall be deemed to be a keeper thereof whether he is in fact, a keeper thereof or not. Additional Questions submitted by the Permanent Mandates Commission (see League of Nations). —Document C 550, M 332, 1922, page 5, paragraph 3. The questions there numbered 1, 2, 3, 4, and 5 are here renumbered 4, 5, 6, 7, and 8, to preserve sequence. 4. What public health organization for the investigation, prevention, control, and treatment of diseases exists in the Territory ? See 1 and 2 above. 5. What endemic diseases are responsible for the greatest morbidity and mortality in the Territory ? Please supply as complete statistics as possible regarding the morbidity and mortality attributable to such diseases, where possible by months and age and sex. Owing to the scattered condition of the population, the presence of only two medical stations in the Territory, and the conservatism of the Native as regards medical treatment, it has been impossible in the past to obtain even comparatively accurate statistics. Too many of the deaths are of young children, chiefly from gastro-intestinal disorders. A study of the tabulated statistics of patients treated in Apia Hospital (as given in the annual report for 1922-23) gives an indication of the chief conditions requiring attention in Western Samoa. 6. Please indicate the birth-rate, the death-rate from all causes, and the infant-mortality rate for those portions of the Territory, if any, for which such information may be available. The estimated Native population as at the 31st December, 1921, was 33,068. The births for the year numbered 1,622 and the deaths 899. Calculated on the average population for the. year, the birth-rate was 48 - 52 per thousand and the death-rate 26*89; The method of registration of deaths, introduced in 1905, only enables statistics according to age to be grouped as under : — Tamameamea .. .. Infant boy .. Birth to six months. Tama .. .. .. Boy .. .. Six months to adult (16-18). Taule'ale'a .. .. Adult .. .. From 16 to 18 years onward. Teinemeamea .. .. Infant girl .. From birth to six months. Teine .. .. .. Girl .. .. From six months to marriage (17-20). Fafine .. .. .. Adult .. .. From marriage onwards. So far as can be estimated from the returns available, one-third of the deaths are of " adults," and two-thirds are " infants," " boys," and " girls." 7. Describe the measures in force for the collection of vital statistic* in the Territory. As a result of the unsatisfactory conditions existing regarding the registration of births and deaths of Samoans, the Board of Health introduced new regulations in 1922 : " Regulation No. 3—Regulations providing for the Registration of Births and Deaths of Samoans." As the Native officials responsible for the notifications of births and deaths had to be instructed in their duties and the necessary forms had to be obtained, the regulations did not operate until the Ist January, 1923. Each year accurate statistics of the births and deaths of all those born after that date will be available. A copy of the regulations is appended.