H.—3l.

Dr. Bakewell reports with regard to Wellington : — " The health camp at Otaki has been open throughout the year, except for a period of six weeks during October and November when the building was closed, partly for cleaning purposes, partly on account of an outbreak of mumps and measles. An average of sixty to seventy children has been maintained, the number being increased to ninety-odd during the Christmas holidays. Cases have been admitted from Taranaki, Gisborne, Napier, Dannevirke, Wanganui, Palmerston North, Masterton, and Otaki, as well as from Wellington and suburbs. More cases are being recommended by general practitioners and hospital doctors, which is more satisfactory, and helps to prevent people taking unfair advantage of the institution. The Smith Family and Returned Soldiers' Association also nominate and pay for cases known to their organizations. " The weight chart is still taken as a gauge of general improvement in health, and is probably as good a guide as any, though this does not record improvement in behaviour and mental alertness. Improvement is often dramatic, especially in cases of wrong and under feeding with no organic complications ; such a child can put on 7 lb. or more in a fortnight. When the malnutrition is severe and chronic so as to cause definite ill-health, improvement is considerably delayed. Albert, aged twelve years, recently took thirteen weeks to gain J lb., then, for no apparent reason, put on 4 lb. in a month. It was unfortunate that in order to make room for others he had to be discharged just at this point. Another four months under the same regime was apparently necessary, and would have made an interesting clinical study. " A preliminary drop in weight for the first week or so occurs in many cases, due presumably to necessity for adjustment and sometimes nostalgia. Annie, aged twelve years, lost 1 lb. the first week then gained 11 lb. in a month. Cases of malnutrition and wrong feeding do best ; astbmatical cases continue to do surprisingly well, but are chiefly those in which the neurotic element is uppermost as a causative agent, and removal from the home environment is probably the main factor. Children suffering from chorea do better than they did at first, but are difficult as behaviour problems and tend to cause disturbances among the other children. A number of cases admitted suffering from debility after measles or mumps, or both, did very well, and to have established satisfactory convalescence and return to health in a child after such infective diseases is, one feels, of great value and importance. The same daily routine has been adhered to. Regulated sunbathing has been instituted ; the children respond well and there is less trouble with severe sunburn. " The minimum period for residence in camp is still fixed at six weeks, and, unless in exceptional circumstances, this has been observed for all cases. More often than not this period has had to be extended up to three and even four months before improvement takes place. I am sorry that a systematic ' after care ' investigation has not been possible to ascertain ais to the permanency of the improvement produced." Tuberculosis Contacts. An effort has been made to continue the work of supervision of tuberculosis contacts, as to the value of which there is ample evidence especially from the preventive aspect. To do so ensures that the general nutrition of most of the children is satisfactorily maintained, and, by earlier diagnosis and timely treatment, those who develop definite signs of tuberculosis are placed under conditions which greatly facilitate their recovery. Apart from the humanitarian aspect of the work, on the lower basis of economy its value is easily seen, since a larger percentage of these children without this care would certainly develop the disease and become a charge on the public funds. Reports have been forwarded from various districts with reference to groups of tuberculosis contacts.Dr. Henderson reports upon 236 children contacts in the Auckland District, of whom 134 are in the Waikato area, and states that approximately some 184 homes were visited by the school or district nurse. In the Gisborne area Dr. Turbott reports on twenty-seven children who are kept under constant supervision. In Taranaki Dr. Champtaloup states that there are on her roll 109 contacts of school age. Dr. Stevenson gives information with regard to 455 contacts under supervision in Otago. Dr. Abbott gives the following details with regard to 259 children, of whom 104 are in Invercargill : " During the year fifteen contact children have shown definite signs of tuberculosis ; four have gone to sanatorium, one has died, the others receiving treatment at the Southland Hospital or being treated at home. Two are now back at school.' Dr. Bakewell's report summarizes the amount of work done in the Wellington District. The same association with the Tuberculosis Clinic under Dr. Short at the Wellington Hospital has been maintained and specialist treatment of various types arranged when necessary. Of twelve cases who after examination and X-ray were considered by Dr. Short to show some signs of tubercular infection, six were sent by him to sanatoria, where they are still patients, six were treated at home by tuberculin and general measures, and three (non-infectious) have been sent to the health camp. Twenty-six orphanage children with unfavourable family history are being kept under observation with the co-operation of the local medical practitioner. Special supervision is being carried out with regard to Maori children living in the pa, the visiting school nurse reporting that unfavourable influences are overcrowding, deficiency in diet, especially with regard to vegetables, gross dental caries is common, and there is considerable difficulty in arranging for adequate treatment.

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