MATE KOHI COULD BE WIPED OUT by Dr. R. S. R. Francis I think it may be a good thing to begin this article with a little history. There is no evidence that tuberculosis existed amongst the Maoris before the pakeha arrived. Only the very fittest of people could have survived the privations of the long canoe journeys made by the original Maori voyages to New Zealand. Anyone with T.B. could not have survived such an ordeal. So far as I know no ancient Maori bones have ever been found which showed any signs of infection by tuberculosis. We know the ancient Egyptians had tuberculosis because mummies have been found which showed T.B. of the bones; but nothing like this has ever been found here. I think we can safely say that Tuberculosis came with the Europeans and that it was not long before it affected the Maoris. As early as 1827 Tuberculosis was beginning to be evident. In that year August Earle, of the U.S. ship “Beagle,” was shocked at the ravages of tuberculosis among young Maori women. By 1850 tuberculosis had become a real scourge, and so it remained for many years. However, little was done to cope with the problem until 1900 when the Department of Health was set up. A further step forward was made when Dr Pomare was made Health Officer for the Maoris. In his first report in 1902 he stressed the seriousness of tuberculosis amongst the Maoris and the need to take steps to control it. The steps he suggested were a better standard of living and better hygiene. These two points still remain an essential part of any programme to defeat tuberculosis. We all know that tuberculosis was a heavy burden on the Maori people, but real statistical proof was lacking until 1920. In that year the figures for Maori deaths from tuberculosis were first available. The Maori death rate for tuberculosis was shown to be astonishingly high, well over 300 deaths per 100,000. The European death rate from T.B. was only one fifth of this, i.e., about 60 per 100,000.

Maori T.B. Investigated In 1935 Dr H. B. Turbott, new Assistant Director-General of Health, made a study of tuberculosis amongst the Maoris of the East Coast, Nurse Wehipeihana assisting him in his research. This study revealed that we were up against a very big problem. As a help to over-come infection in the homes he recommended the use of T.B. huts in order to keep sick cases out of the homes and so prevent the spread of infection amongst the rest of the family. It is certain that, where properly used, these T.B. huts do save a lot of infection, and they are still available and used for this purpose. The principle of using the huts is sound when treatment is refused or is not likely to lead to a real cure of the disease. Though chest clinics had been operating in the South Island for quite a number of years prior to 1935, it was not until that year that chest clinics for the country districts of the North Island were begun. There had, of course, been chest clinics in the main centres, but there was nothing for the smaller places. However, in 1935, Dr Hugh Short and myself began these country chest clinics. We tried to do what is now done by at least 8 doctors and the clinics were admittedly inadequate, but at least it was a start. The size of the problem of T.B. amongst the Maoris was soon apparent, as Dr Turbott had discovered. To cope with Maori tuberculosis was to be a very big task. In 1944 the chest clinic service began to be more adequate. Dr Short went to Hamilton to do chest clinics for the Waikato, Bay of Plenty, Rotorua and Thames districts and I took over the East Coast, Wairoa, Hawkes Bay and Wairarapa districts. Soon after this Dr Priest went to Wanganui to do the West Coast (North Island) and Main Trunk areas. Later Dr Webb went to North Auckland, Dr Tyler took over the Rotorua and Bay of Plenty districts and I handed over the northern half of my district to Dr Simpson. The value of the Chest Clinics has, as a result, been greatly increased. Much greater individual cure of cases has been made possible. In addition, B.C.G. Vaccination, a most valuable form of protection, especially for infants and children exposed to infection, has become much more readily available and has already shown its very great value. It would be a good thing if all Maori children had B.C.G. Ask the District Nurse about it.