A—3

VI. MEDICAL AND PUBLIC HEALTH The staff of this Department consists of two European Medical Officers, seven Native medical practitioners, a Hospital Matron, three European Sisters, 26 Native nurses, a European Dental Officer, and two Native Dental Nurses. Six Native Inspectors are also employed on mosquito-control. In accordance with the provisions of the Cook Islands Act, 1915, all Cook Islanders receive free medical and surgical treatment in their villages, in the hospital, and in the sanatorium. Native patients in the hospital and the sanatorium and all school-children receive free dental treatment. The following summary shows the amount expended on health services during the past five, years: — f " , .

Hospital statistics for the same period are tabulated hereunder : —-

The Dental Department has treated patients as follows : —-

General health throughout the Group has been good. The outbreaks of poliomyelitis in Rarotonga, cerebro-spinal fever in Atiu, and trachoma in Atiu, Mauke, and Mitiaro mentioned in the last report died down early in the year under review. In June and July, 1946, influenza became epidemic in Rarotonga, and there were also some cases of chicken-pox and meningitis. A second wave of influenza occurred in August and a third wave in October, but neither of these was as severe as the first wave. In February and March, 1947, there was an epidemic of Bornholm disease or epidemic pleurodynia ; the number of cases is not known, but it was widespread, and, fortunately, there was no mortality. The Director, Division of Public Hygiene, New Zealand Department of Health, inspected Rarotonga and all other islands of the Lower Group in September, Tuberculosis continues to be the main medical problem. The new sanatorium is in full operation and provides valuable training for Native nurses in the proper methods of handling tuberculosis cases. Patients themselves are taught how to live in their

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'— 1942-43. 1943-44. . 1944-45. 1945-46. 1946-47. Amount expended Population Amount per head '£10,370 14,079 14s. 9d. £10,116 14,150 14s. 4d. £16,202 14,506 £1 2s. 4d. £24,535 15,005 £1 12s-. 8d. £25,295 14,821 £1 14s. 2d.

7 ~r~ ' '' 1942-43. 1943-44. 1944-45.' 1945-46. 1946-47. In-patients 405 570 446 469 ] 638 - Out-patients 12,541 8,574 8,603 6,895 9,029 Visits 1,915 1,382 1,374 1,145 . 2,016 Injections, all types 438 360 577 453 348 Ansesthetics— General 64 42 52 30 99 Local .. 340 152 336 377 53 Operations — Major 9 9 101 26 43 Minor 464 254 467 440 109 Confinements 24 30 63 43 29 Artificial pneumothorax 16 12 X-rays 173 "31 39 77 248 Dental extractions 89 63 91 95 32

— 1942-43. 1943-44. 1944-45. 1945-46. 1946-47. Extractions Fillings Cleaning, &c. 953 935 157 1,130 1,964 37 1,533 1,382 38 1,713 915 239 828 489 1,622