A..—3.

Return of Imports and Exports for the Ten Years 1915 to 1924, inclusive.

Medical and Public Health. On the whole, general health conditions in all the islands have been satisfactory during the year. The work of altering and extending the hospital at Rarotonga and erecting the out-patients department is well under way. The building of a new quarantine station has been approved, and will be put in hand shortly. Arrangements are being made for a report from a competent engineer as to proposed extensions to the water-supply systems in the various districts, and also the provision of suitable filter-beds at the intake of the Avarua supply. We have under consideration a proposal to transfer our lepers to the well-equipped and efficient leper station at Makogai, Fiji, and if this is carried out it will solve our problem of dealing with the twenty-three leper patients now segregated at Penrhyn, Manihiki, and Rakahanga, in the Northern Cook Group. An important step in health matters is the arrangement just entered into with the Health Department of New Zealand whereby a qualified dentist is to be provided for the Cook Islands, in order that the teeth of the children may be properly attended to. Under the arrangement referred to we shall also be able to train our own dental nurses in the dental clinic in New Zealand. After nine years' good service Dr. R. S. Trotter, Chief Medical Officer, is retiring in a few months' time. The following are extracts from the annual report of Dr. Trotter : — " There was no outstanding epidemic throughout the year, but in the month of November there were numerous cases of catarrhal conditions and of diarrhoea amongst the Maoris. June also was a heavy month for minor sicknesses both amongst Europeans and Maoris. The most outstanding feature during the year was the continuous prevalence of various diseases produced by worms (round, thread, hook, &c.), causing a great deal of sickness and fever, particularly amongst children. There was less itch, ringworm, and kindred skin-diseases than in former years, but tane, a form of pityriasis, may be said to be almost universal amongst certain classes of the Maoris, causing considerable expense in treatment, owing to the carelessness of the people in changing articles of clothing with each other and in neglecting to have their clothing boiled whilst undergoing treatment. Filarial infections of various kinds and degree gave a good deal of trouble from time to time, particularly filarial abscesses, which at times, after having been opened, took a lot of dressing and clearing up. There was a fair amount of pneumonia and of pulmonary tuberculosis, and a few sporadic cases of enteric fever. " The number of new in-patients admitted to the hospital during the year was eighty-six, and their average stay therein was eighteen days. " The following outer islands were visited by the Medical Officers : Mauke (four times), Manuae (once), Atiu (thrice), Aitutaki (twice), Mitiaro (once), Palmerston (once), Pukapuka (once), Rakahanga (three times), Manihiki (three times), and Penrhyn (twice). Nassau was not visited, nor were Suwarrow and Takutea. Yaws was dealt with particularly in Aitutaki, Atiu, Mauke, and Mangaia. There was an outbreak of typhoid fever in Mangaia, which apparently was taken there by pilgrims from foreign islands who were attending the London Missionery Society's centenary celebrations in Mangaia. It is regrettable that this disease has got into Mangaia, as the Mangaians are a difficult people for a stranger to handle, and it will be no easy task to insist upon segregation of the sick. " There was an outbreak of a severe type of infective catarrh in Manihiki and Rakahanga whilst I was there. Nearly every person on both islands was affected, and my time was well occupied there, fortunately with good results for the islanders. " After we had left Penrhyn, and before we got back, Mr. Wilson, Resident Agent there, had to deal with a similar outbreak, and did the work well. " The Rakahanga cases which I was unable to go back to treat last year had, as ordered, been segregated by the Resident Agent. Injections were given to them, and when we returned from Palmerston and Pukapuka they had cleared up and there were no further cases. Those dealt with last year in Pukapuka had recovered, and there were no new cases on the islands. It is to be hoped that these islands will again be free from infection, as they had been for several years. I was much disappointed when I found that these cases had been taken up there, as we had managed to keep them free for so long. Pulmonary tuberculosis, too, is nearly stamped out in these Northern Islands. It is to be hoped that no encouragement will be given to the inhabitants to build the abominable coral limestone houses. Their own type? rt\ houses are much superior.

5

Year. j Imports. Exports. Total Value. £ £ £ 1915 .. .. .. .. 65,590 63,057 128,647 1916 .. .. .. .. 58,478 68,146 126,624 1917 .. .. .. .. 80,061 60,190 140,251 1918 .. .. .. .. 99,632 82,708 182.340 1919 .. .. .. .. 142,925 127,729 270,654 1920 .. .. .. .. 177,911 94,697 272,608 1921 .. .. .. .. 112,974 69,301 182,335 1922 .. .. .. .. 116,726 135,802 252,528 1923 .. .. .. .. 131,590 118,710 250,300 1924 .. .. .. .. 138,202 154,554 292,756