H.—3l.

Assistance rapidly came from nearby towns until within less than twenty-four hours there were in the area more medical men and nurses than could profitably be employed. Much good work was done by this willing group of volunteers, not the least of which was that they were able to take over the actual care of the sick and injured, so giving the local doctors and nurses a much-needed rest. As soon as transport facilities permitted, the evacuation of patients was commenced. The relatively scanty accommodation at Waipukurau and Dannevirke Public Hospitals was soon filled, and it became necessary to send patients further afield. The Palmerston North organization proved invaluable at this stage. Not only did Palmerston North Hospital itself absorb approximately one hundred of the injured, but the Board organization was used as a clearing-station for the distribution of patients amongst other public hospitals. This work was exceptionally well done, and the Palmerston North Board has received a special letter of appreciation from the Department. The efforts of the Department in the first instance were directed towards ensuring that an adequate number of doctors and nurses and adequate medical and surgical stores were despatched to the stricken area. The next step was to organize on a better basis the temporary hospitals which had been set up at Napier and Hastings Racecourses. A military field hospital with tent accommodation for some two hundred and fifty patients was dispatched from Trentham the night of the earthquake, and the following day was erected at the Napier Racecourse, so supplementing the accommodation already available there. Members of the staff of the Department then took over the duties of the Medical Superintendent, Matron, and heads of various departments of the Napier Hospital, so enabling these officers to leave the area for a brief and much-needed rest. The Department next had to organize the work in connection with the evacuation of the patients and their reception in the various public hospitals. That this work was carried out, so expeditiously and smoothly reflects great credit on the ambulance workers, the Railway Department, and the staffs of the hospitals handling the patients. Sanitary problems in the earthquake area also threw a severe strain on the departmental organization, but again were met successfully. The damage to sewerage systems and to public watersupplies in both Napier and Hastings constituted a severe menace, but the action taken proved adequate in preventing any outbreak of typhoid fever or other infectious disease. Fortunately the water-supply in both Napier and Hastings was obtained from artesian wells, but despite reasonably satisfactory chemical and bacteriological tests it was deemed advisable to chlorinate the supply in each instance. Chlorination is still being practised, as in Napier the pressure in the mains varies considerably and the whole of the reticulation has been so damaged as to render contamination an ever-present danger, whilst in Hastings chemical tests indicate a slight suspicion of sewage contamination. The whole Division of Public Hygiene —Director, Medical Officers of Health, and Inspectors — did yeoman work in dealing with this phase of the earthquake damage. They received invaluable assistance from the engineers and sanitary staffs of neighbouring boroughs. The satisfactory results obtained are due to their painstaking efforts. The total number of Hawke's Bay patients accommodated in the public hospitals was 536. Of these, 82 were patients who, at the time of the earthquake, had been under treatment at the Napier Hospital, and who had been evacuated without earthquake injury. In addition, of course, there was an unknown number of people who suffered from minor injury not necessitating treatment as in-patients or who were treated privately by their own doctors. The total number of fatalities was 261. This figure includes 245 who were killed outright or died shortly after the earthquake, and an additional sixteen who died after admission to public hospitals. It will be seen, then, that the earthquake was most disastrous, and that the tragedy was of a magnitude unparalleled in the history of New Zealand. I have already referred to the fine work of the medical and nursing professions, of Hospital Boards, and of engineering and sanitary staffs of various municipalities. Before concluding this section of my report, I should like to express the Department's sincere appreciation of and gratitude for assistance freely rendered by the St. John Ambulance, the Red Cross Society, the Wellington Free Ambulance, the Wellington Automobile Club, and many other organizations and individuals too numerous to mention by name. School Hygiene. A feature of Dr. Ada Paterson's report is the evidence of special investigations by officers engaged in school medical inspection. Dr. Turbott's reports on " Maori Susceptibility to certain Infectious Diseases " and " The Nutritional Value of Milk " are of much interest, as is also Dr. Henderson's comparative health-study of Maori school-children. Other important activities drawn attention to in this report, such as preventive tuberculosis work, will doubtless be read with considerable interest by those concerned with the welfare of our school-children. Dental Hygiene. Mr. Saunders' report signifies a busy year, as shown by the increasing number of school-children receiving treatment and by the 155 additional schools which have been brought under systematic supervision. This service is being extended as fast as the economic conditions will allow. Credit is due to the Director and his officers for the high standard of work maintained by the dental nurses.

3