A.—4a

2

General Survey of the Work of the Year. The arrangement made at the beginning of 1923, whereby, at the request of the Natives, a yearly medical charge of £1 per adult male was imposed, and free treatment of all Natives instituted, has proved a marked success. The Natives recognize the value of the new system, and make full use of the opportunities for treatment available. In addition it has enabled the Administration to carry out systematic campaigns against yaws and hookworm, with satisfactory results. The training of boys and girls at the hospital for work in dispensaries and outlying districts las so far proved a success, but it is at times difficult to obtain suitable ones for training. This difficulty will probably grow less as the effects of the present educational system manifest themselves. By arrangement with the Education Department, classes for the Native cadets and nurses are held at the hospital in order to improve their education and so make them better fit to absorb their medical training.

Public Health. The previous year was marred by an epidemic of bacillary dysentery, but this year has been the most satisfactory one experienced for many years. The Territory was singularly free from serious illness or even minor epidemics. The figures given in the table of attendances at the hospitals and dispensaries throughout the Territory do not indicate any increase in sickness. The Natives freely avail themselves of the facilities offered for treatment, and report for very minor complaints. Infectious Diseases. The return given does not include all cases of infectious diseases occurring in the Territory, but only those which have been reported by European Medical Officers Enteric fever .. .. 28 Leprosy .. .. 5 Tuberculosis —pulmonary .. 42 Puerperal fever .. .. 2 Pneumonia—lobar .. 37 Chicken-pox . . .. 5 Pneumonia—broncho . . 29 Mumps .. . . 4 Measles .. .. .. 2 Tetanus .. .. 3 Dysentery .. 8 Gonorrhoea .. 8 Influenza .. . . ... 16 Erysipelas . . 1 Note. —Of the twenty-eight cases reported as enteric fever, in only eight was the diagnosis confirmed by bacteriological or serological investigation. Of the forty-two cases of pulmonary tuberculosis reported, the vast majority are cases diagnosed clinically. Ankylostomiasis.-—During 1923, as reported in last annual report, slightly over eighteen thousand Natives were treated for hookworm. Treatment was then discontinued, as the pressure on the Department for treatment of yaws made it impossible to carry out both campaigns with the staff