H.—3l.

Dr. L. S. Davis, Medical Officer of Health, Gisborne, in his report discusses problems of Maori Hygiene, and in doing so comments on the growing measure of co-operation from the Maoris :— " The measles epidemic of last year which created an absolute necessity to avail themselves of nurses' treatment has tended to break down the last threads of reserve of these people, and an entrance to practically all their homes is now assured for the district nurses. The reluctance on the part of many of the Natives to seek treatment, which has been gradually disappearing during the past few years, has now almost completely gone, and I feel that this will herald a period of greater progress in Maori hygiene, for it is the superstitious class of Maori who has in the past provided the nucleus for outbreaks of such diseases as typhoid and dysentery." Opportunity is being taken to point out defects in sanitation and have them corrected if funds are available. Enteric fever is much more prevalent as one might expect amongst the Maoris than the Europeans. On this point Dr. Cook, Medical Officer of Health, Palmerston North, writes :— " The incidence of 4 European cases in a population of 180,000, and 22 Maori cases in a population of 10,600 illustrates one of the penalties of an unhygienic life. The problem in this health district as affecting Maoris is interesting, because the incidence is considerably higher than was my experience in the North Auckland district over a period of six years. The disease is particularly prevalent in the Hawke's Bay and Horowhenua areas, which are alike in that they are flat, alluvial plains where conditions are prone to lead to overcrowding of land, and soil and water pollution. Other than these peculiar physical features in Hawke's Bay and Horowhenua areas, Native housing conditions do not vary to any degree throughout the health district. In North Auckland, where the Maori population is considerable, to some extent the same phenomena occurred; the incidence was highest in the flat alluvial valleys or other flat alluvial ground. " A similar epidemic, in my opinion due to overcrowding of land and soil pollution, was experienced in Tangoio, where over twelve cases occurred in a small crowded settlement, formed as a temporary measure of relief following the disastrous flood of April, 1938. After a few cases of the disease had occurred in one household, investigation revealed that one urinary carrier had been the cause of the whole epidemic, the spread having occurred, no doubt, by infected hands in the home, but outside of this probably from soil contamination, despite the fact that there were ample privies in the settlement. The experience of this health district, as elsewhere, has demonstrated that typhoid fever is due to the failure of the application of well-known hygienic principles, but it would appear that the incidence of the disease is highest in particular areas where overcrowding and soil pollution due to certain physical features enable the failure of hygienic principles to operate more freely." Dr. C. B. Gilberd, Medical Officer of Health, Wbangarei, points out: — "... The histories of contacts with typhoid-fever cases illustrates the complexity of the problem of locating them all, and the large number of contacts who move rapidly over a wide area being potential foci of infection. The absence of epidemics under these circumstances clearly illustrates the protective value of T.A.B. inoculations, especially when the lack of sanitation in many areas, is taken into consideration." In the East Coast Health District a number of cases appear to have originated from an actual carrier. Three cases were traced from eating shell-fish from an infected source, two of these being from the beach near the Gisborne sewerage outfall. Dr. Turbott, Medical Officer of Health, Hamilton, in a report included in the Appendix on the progress in prevention of typhoid in Maoris, shows the value of yearly inoculation campaigns, reinforced by sanitation drives in lowering the incidence of preventable intestinal diseases amongst the Maoris. With an improving standard of sanitation and water-supplies, extended use of public hospitals and of the services of our district nurses, the extension of the School Dental Services and milk-in-schools scheme, we may look forward to improvement in the health of the Maori people. SociAij Security. Medical, Hospital, and Allied Benefits under Part 111 of the Social Security Act. The preliminary work which had been undertaken in relation to benefits under Part 111 of the Social Security Act was outlined in the previous report. In accordance with, the Government's decision at the beginning of the year covered by this report, initial administrative efforts were directed to the introduction of maternity benefits and hospital benefits, which were duly brought into operation. The main details of the arrangements for these two classes of benefits are set out in this report. Maternity Benefits. This class of benefits was made available on 15th May, 1939, in respect of the following types of services :— (i) Treatment in maternity hospitals maintained by Hospital Boards : (ii) Treatment in the State St. Helens Hospitals (at Auckland, Wellington, Christchurch, and Dunedin) : (iii) Treatment in licensed private maternity hospitals : (iv) The services of obstetric nurses in the home : (v) The services of medical practitioners.

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