A.—3

6

Return of Imports and Exports for the Eleven Years 1915 to 192-5, inclusive.

Medical and Public Health. General health conditions in all the islands have been satisfactory during the year, the only sickness of an epidemic nature being a very mild outbreak of chicken-pox affecting Rarotonga, Aitutaki, and Mangaia. The new out-patients' building at the Rarotonga Hospital, which contains dressing-room, dispensary, consulting-room, dental surgery, laboratory, and storeroom, is now completed, and the alterations and additions to the main hospital buildings are almost finished. These comprise new side and back verandas of a width of 18 ft., giving a floor area of 1,508 square feet, which is available for convalescents, tubercular cases, &c. ; the enlarging of the operating-theatre, the provision of an additional European ward, new lavatories, bathroom, and other conveniences, together with the widening of the front veranda to 16 ft. These alterations and extensions have now given the Group a central institution well equipped and of modern design, and sufficient for the needs of the people for some years to come. Dr. S. M. Lambert, of the International Health Board (Rockefeller Foundation), made a health survey of Rarotonga and all the Lower Group islands during the months of November, December, and January last, and his report, which is printed as an appendix to this report is a most valuable one, and will be of great help to us in dealing with hookworm, yaws, filaria, and other tropical diseases. The removal of our lepers from all islands of the Group to the Fijian Leper-station at Makogai, where they will receive up-to-date treatment with every prospect of cure, has now been rendered possible by the recommissioning and transfer of the " Hinemoa " to the control of the Cook Islands Department. Arrangements have accordingly been completed for the transfer of these afflicted people in May of this year. The provision of the dental clinic which opened in June la.st has proved of great convenience and benefit to both adults and children, the latter receiving particular attention. From June to December of last year, and from February to 31st March, the attendances totalled 1,550, involving 2,106 operations. Two local probationers are now being trained at the dental clinic in Wellington, with an arrangement that when qualified their services shall be made available to the people of the Cook Islands. The following are extracts from the annual report of Dr. J. P. Donald, who has acted as Chief Medical Officer since Dr. Trotter's retirement last June :— " Dr. R. S. Trotter relinquished his appointment as Chief Medical Officer in June, 1925. Dr. L. L. Burton acted as Assistant Medical Officer from June to November. We will welcome the arrival of Dr. Ellison, the newly-appointed Chief Medical Officer, in Rarotonga, early in May. " Good service has been rendered during the year by the Matron of the Cook Islands Hospital, Miss Sisley ; and by the resident nurses —Miss Walshe in Aitutaki, and Mrs. McGruther in Mangaia. " For his work on hookworm disease Dr. S. M. Lambert has the gratitude of Maoris and Europeans, in that he has paved the way for a campaign against this disease, which is to be commenced immediately on the arrival of the necessarily large supply of drugs required for mass treatments of the whole population. Dr. Lambert's work and advice on other disease conditions, such as yaws, filariasis, &c., has also proved of great value. " Chiolten-pnx. —In Rarotonga, between September and December, there occurred an epidemic of chicken-pox, which affected both Native and European children. The disease ran a very mild course, there being very little constitutional disturbance. Only one case was observed to show febrile symptoms, the temperature reaching 100 deg. F. In August a similar mild epidemic occurred in Aitutaki; in October and November a few cases were reported in Mangaia. " Enteric Fever. —There were six cases in Rarotonga during the year, and all were admitted to hospital for the sake of isolating them. All recovered from the attack of the disease, though one died two months later from pulmonary tuberculosis, which he had contracted previous to the attack of enteric fever. " Tetanus. —No cases have occurred. A number of cases of earth-infected wounds have been given prophylactic injections of anti-tetanic serum. " Tuberculosis —Glandular and Pulmonary.—From the return showing causes of deaths under ' Vital Statistics ' it will be seen that pulmonary tuberculosis is responsible for 39-5 per cent. ; but

Year. | 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 .. .. .. .. 116,726 125,802 252,528 1923 .. .. .. .. 131,590 118,710 250,300 1924 .. .. .. .. 138,202 154,554 292,756 1925 .. .. .. .. 130,609 151,939 282,548