A.—4a

2

Public Health. The year was marred by an epidemic of dysentery, which investigation showed to be due to the B Dysenteric (Shiga). This caused an increase in the number of deaths for the year of approximately four hundred. For a comparison of this year with other epidemic years, see the report on vital statistics.

Antylostomiasis. — A preliminary survey carried out in 1920 by Dr. O'Connor, of the London School of Tropical Medicine, showed that hookworm infection amongst the Samoans was almost universal. The institution of free treatment at the beginning of 1923 made it possible to commence a systematic campaign against this disease. The methods of the International Health Board (Rockefeller Foundation) had been studied both in Queensland and in Fiji, and, with lanterns, slides, and film obtained from the Board, a commencement was made to educate the Natives to a recognition of the necessity for sanitation. In each village an illustrated lecture was given at night, and early next morning every one who desired treatment was given a dose of carbon tetrachloride and magnesium, sulphate. This continued, until October, when, owing to doubt as to the purity of the drug, the work was temporarily abandoned. By the time new supplies arrived other factors made it impossible to recommence the work for some time. During the period April-October over eighteen thousand Natives were treated —most of them in Savai'i. Attention is now being given to the provision of latrines in the villages of the various districts, and as each district builds a sufficient number, systematic treatment will again be instituted. A photograph is given (Fig. 1) showing the " outfit " used for treatment. Framboesia. —This disease is so common that practically no Samoan reaches adult life without having suffered from the infection. Usually the primary stage appears during the first few years ol life. With the introduction of free treatment the demand for treatment was so great that, with the staff available, it was found impracticable to carry on both hookworm and yaws campaigns at the same time. Tho treatment of yaws is one of the best ways of driving home to the Native the value of our methods of treatment of the sick as compared with theirs, and it was therefore reluctantly decided that the campaign against hookworm would have to be postponed until treatment has been given to all those suffering from yaws in the Territory. During the year over 32,000 injections of novarsenobillon wore given—each sufferer, as far as possible, being given three injections at intervals of a week. Approximately half these treatments were given at the Apia Hospital and the remainder in the outlying districts. With periodic inspections of the area and treatment of those found suffering from the disease, especially the young children with primary and secondary lesions, yaws should in a few years be well under control. One difficulty experienced in this campaign has been that the Natives are unwilling to produce for treatment those young children in whom the disease is still in the primary stage. According to popular belief, treatment at that time will only " drive the disease in " and so injure the child. But so satisfied aro the Natives as to the value of our methods that thoy are willing to have stringent regulations passed for tho control of tho disease, and such regulations have now been prepared. Filariasis. —The researches carried out hero by Dr. O'Connor from 1920 to 1922 have been published (" Research Memoirs of the London School of Tropical Medicines," Vol. iv, 1923). A second expedition, under Dr. P. A. Buxton, arrived in January of this year to continue tho work. The expedition expects to remain in Samoa for two years investigating this and other tropical conditions. Child Welfare. The statistics for tho year show clearly that the majority of deaths in Western Samoa occur , during the first few years of life. Of the 1,398 deaths, 719 were of children under two years of age, and the majority of these were between the ages of six months and eighteen months. The dysentery epidemic experienced during the year was responsible for a number of these, but apart from this there is a considerable wastage of child-life between the ages given, a wastage which is preventable,

Europeans. Samoans. Chinese. SolomonIslanders. Total. Pneumonia and lobar pneumonia Pulmonary phthisis Pulmonary tuberculosis Broncho-pneumonia Enteric fever .'. Typhoid fever Bacillary dysentery Measles Beriberi Influenza Mumps . . Leprosy .. .. Tetanus Tertiary syphilis .. Chicken-pox .. ■-■ .. '• 2 2 1 1 70 2 25 16 3 4 3 8 124 1 7 12 2 29 19 4 5 10 8 206 2 12 31 10 5 1 2 1 19 4 9 4 4 1 12 3 2 1 2 T