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and more use of the hospital. We were very fortunate in securing the services of Miss T. Butler, for Lome time Matron of the Apia Hospital, to replace Miss Peers. Both these officials have been indefatigable in their efforts to save infant-iife. Unfortunately, infants are usually in a precarious condition before they are brought to the notice of the Medical Officer, and the strain on the staff is thereby greatly increased. The hospital treatment and suitable feeding give wonderful results, and the loss of a case is extremely rare. ( Dr. Boyd's report, which deals in detail with the work of the year, is attached. Extract from Report of Resident Medical Officer. During the past year the general health of the island has been good : that is well borne out by the fact that there was a record death-rate. The most of the deaths occurred amongst those advanced in years. It is pleasing to note that there has been a reduction in the infantile mortality. My predecessor, Dr. Dorset, began the treatment of hookworm disease, and before leaving he administered tetra-chloride to over a thousand people. On my arrival I completed the treatment of the rest of the island. Over 3,500 people have been treated. Beneficial effects are to be noticed in many cases where profound amemia existed. It is to be hoped that the disappearance of the ansemia in the cases of many females will be shown in an improvement in the birth-rate. Previously on this island yaws had a powerful hold on the people ; now this disease is well under control, and the extensive ulceration due to this disease is not to be seen : since I have been here 1 have seen only one bad case. Most cases which come up for treatment exist among children, and are only minor ones, and it is pleasing to note that they are becoming fewer in number. There is no doubt that the treatment of yaws with salvarsan has greatly helped towards the improvement in the general health of the people which has taken place in the past four years. Injections of salvarsan given during the past yeai numbered 288. Venereal Disease. —There is quite a considerable amount of gonorrhoea amongst the people, and during the last few months forty-six cases have been under treatment. A pamphlet has been written and translated on this disease, advising the people against hiding the disease, and urging them to come up for early treatment. All single males have been inspected, and the Native police have greatly helped by bringing suspects to the hospital for examination. Most cases have given the names of those from whom they received the complaint, and in this way more cases were discovered. Syringes and the necessary drugs have been left at the different villages in the hands of reliable people where the males could receive daily treatment. All females, and even cases in males, arc treated in hospital. Those in the outlying villages come under my notice once weekly during the island round. The greatest difficulty with the disease is that those suffering tend to hide their complaint. Several deaths have been due to pulmonary tuberculosis. There is also a small amount of glandular tuberculosis in young children. With the vifrw of combating this disease attention has been paid to houses. Most of the people sleep in houses which when closed at night have little or no ventilation. Now all houses have to have a ventilating space of 8 in. left between the top of the walls and the roof. Skin-diseases, of which there are a large number, are receiving special attention. These diseases exist mostly amongst young children. In this connection the school-teachers are rendering help by sending all cases that come under their notice for treatment. In view of the fact that infants had previously played a large part in the death-rate, special attention has been paid to children under one year. All weak infants and their mothers have been brought to hospital, and it is gratifying to see how the children pick up. The cause of death amongst most infants has been due to malnutrition and the loading of weak infants with an excess of indigestible food. Where artificial feeding has had to be resorted to, those in charge of the children have received instruction to enable them to carry on after leaving hospital. In this connection many .old injurious customs have to be fought against. During the months of January, February, and March there has been an epidemic of conjunctivitis, which was highly infectious and of a severe form. As many as fifty cases were being treated daily at the hospital, while in the outlying villages there were people instructed in the washing of eyes who administered the lotions to those suffering in their villages. It is gratifying to note that the people are beginning to realize the importance of the hospital and are taking less persuasion to come in. Of late many, especially those suffering from eye conditions, have walked many miles and asked to be admitted. They are also realizing the good that is done for infants at hospital. At the hospital the dispensary and the surgical out-patients department were well patronized. Many minor and several major operations have been performed. At hospital 181 patients, with an average stay of eighteen days, have been treated, while there were 2,319 visits to the dispensary and out-patients department; 401 visits were made to houses on the rounds. Rev. C. Beharell, London Missionary Society missionary, publishes monthly a small paper. He kindly offered a page to the Medical Officer, and this opportunity was accepted. Short articles on house-ventilation, care of the infant, &c., have been written with the view of educating the people on subjects necessary for the preservation of the general health. One cannot close this report without making special mention of Sister Butler. Her experience in Samoa has greatly helped in the management of the staff of Native nurses, who have worked admirably. Much praise is due the sister in the treatment of infants, where she shows unceasing attention. Public Works. Roads.—The section of road which links Hikutavake with the main road round the island, and which was referred to in last year's report, was completed early in May, and has since stood heavy

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