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Shipping. The following is a return of overseas shipping at the Port of Avarua, Rarotonga, for the twelve months ended 31st December, 1928 :— Calls. San Francisco mail-steamers .. .. .. .. .. 26 S.s. " Waipahi" .. .. .. .. .. .. 6 Auxiliary schooner " Tiare Taporo," from Tahiti .. .. .. 2 N.Z.G.S. " Hinemoa " .. .. .. .. .. .. .. 1 Motor-ship " Beulah" .. .. .. .. .. .. 1 Danish research-ship " Dana " .. .. .. .. .. .. 1 37 Medical and Public Health. General health conditions throughout the whole Group have remained satisfactory during the year under review. The only sickness of an epidemic nature was an outbreak of mild influenza in Rarotonga last November, which spread to the islands of the Lower Group. The departure of schooners for the Northern Group was postponed until the danger of carrying infection was past. An outbreak of measles at Tahiti in November, resulting in a large number of deaths, caused considerable anxiety, but the enforcement of very strict precautions in regard to the mail-steamers passing through Rarotonga until February of this year prevented the disease from reaching the Cook Group. In May last the N.Z.G.S. " Hinemoa " visited both the Northern and Southern Groups and took away to the Fijian Leper Station at Makogai the remainder of our leper patients, and so for the first time during New Zealand's connection with the Cook Group the Islands were free from known cases of this disease. Two incipient cases have since been discovered, and no doubt such cases will manifest themselves from time to time. Now that leprosy has been removed from the Group, and campaigns against yaws and hookworm successfully carried on, our efforts should be concentrated on tuberculosis, which is prevalent in Rarotonga and the islands of the Lower Group. The Medical Officers have been asked to gather data as to the ravages of this disease, and it is proposed to go thoroughly into the question of the erection of a sanatorium or a separate hospital for the treatment of tubercular patients. There is no doubt that such provision should be made as soon as funds are available, but the difficulty will be to provide the necessary money for lands and buildings, and for the subsequent cost of staffing, upkeep, and maintenance. Attached is the report of the Chief Medical Officer : — " During the year the various outlying islands of the Group have been visited wherever possible. The presence of only one Medical Officer in Rarotonga from March until May, and then the trip of the " Hinemoa.," which took a Medical Officer on the cruise, both rather interfered with the visiting of islands in the Lower Group. Still, Aitutaki was the only one of the larger islands where a Medical Officer did not remain for a period, and it was visited on some five or six occasions for a short stay of one to two days. " Two Maori youths have been sent to Suva as students at the Suva Medical School. They should qualify as Native medical practitioners in 1932, and should be of considerable assistance to the administration, particularly in the outlying islands and in the Northern Group. " Following is a brief survey of health matters for the year on the various islands : — " Rarotonga. —The health of Rarotonga during the year has been, on the whole, satisfactory. The inter-village competition for the Au-Vaine Cup, inaugurated during the year, promises to be a useful institution. Points are awarded for planting of food and export crops, and also for cleanliness and sanitation of the various settlements. To judge from the amount of interest shown by the Natives and the provision they have made of clean cook-houses, individual house latrines, &c., this competition should result in an improved condition of the Island generally. " The most serious problem on the island at present is, I consider, tuberculosis, particularly pulmonary tuberculosis. I have made further mention of this matter under the heading of Cook Islands Hospital. Another disease unfortunately prevalent on this island is gonorrhoea. This presents a difficult problem at present. In this, as in many other forms of illness, the Maori of Rarotonga has an exaggerated belief in the efficacy of the treatment of his own Native medicine-man, and it is therefore not easy to get patients to come up for treatment in the first place, or to continue coming when the cure is not immediate. In April mass treatment for hookworm disease was offered in each of the villages, but the response was poor, only some four hundred people taking the treatment. " Aitutaki and Mangaia. —These two islands are the most fortunate of the Lower Group, in that each has a trained nurse in residence. Dr. Brass was at Mangaia for four weeks in July and August. He reports the only infectious disease existing to any extent to be tuberculosis, particularly pulmonary tuberculosis. Only tertiary cases of yaws were seen, but of minor skin-diseases there was a number of cases. Two of the schools showed 20 per cent, of the pupils affected, and the other school, Ivirua, 45 per cent. He considered the shortage of fresh water for washing purposes to be a contributory cause. Cases of skin-disease responded well to treatment. During the year Nurse McGruther has given mass treatment for hookworm disease at Mangaia. " Mauker —This island was visited for two weeks in August and September. The general health of the island is reported as being good. Three cases only of primary yaws were seen, but a larger number of secondary and tertiary cases. Skin-diseases of a minor nature were common, but responded

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