POOR WATER SUPPLY AND POOR SANITATION Because a large percentage of the Maori population is rural, we find that water supply and sanitation is much below the standard of the European community. In 1947, the average household consumed 40 gallons per head per day. In our hospital, we use 80 gallons per head per day. These figures are an impossible attainment in rural areas dependent upon limited tank supply. But here again, I do not think these problems would be unsurmountable if we were to return to the methods and ways of our ancestors and consider the limitation of families. I think it is still possible to attain a reasonable level of hygiene with limited water supply, if sufficient skill, thought and money are applied to the problem. But the larger the family, the more difficult it is to attain a reasonable level of cleanliness. It is believed that in pre-European days, birth control was fairly rigidly practised by the Maori. You can see this if you know your whakapapas very well, and if you can trace your family tree back, you will understand just how small most Maori families were in the old days. When the Victorian Europeans landed with their large families of eight, nine or ten children, the Maoris looked at them with astonishment. They could not understand these people with their large families. It is thought, however, that when they found easier methods of producing food, when food became more plentiful, that they quickly forgot their methods of control, because the Maori has always loved his children. And when there did not seem to be any necessity to limit families, the methods by which they were limited were lost.

LACK OF EDUCATION We should consider the use of a magazine such as Te Ao Hou for educational purposes, so that we can have the same pressure of propaganda directed at Maori women, as is directed at her European counterpart. “Have you a lump in the breast?” “Have you got a discharge?” “Are you suffering from irregular bleeding, or spotty bleeding?” Then see your doctor. “Have you got chronic indigestion?” “Are you losing weight?” All these things the majority of Europeans know as danger signals, a need to see their doctor.

GROUP DIFFERENCES Over and above these causes are certain group differences. 1. The feeling that all illness arises from an interference with personal tapu and that this state renders a person susceptible to evils which include illness. A very large section of the Maori people believe that their illness should be managed by the local tohunga. It is unfortunate that tohungaism has been made illegal because the only way to deal with this sort of thing is for the local doctors to work in with the tohunga. The tohunga is the person to whom the propanganda should be directed and this is the way they are trying to deal with this sort of thing overseas. We must remember that to lots of people tohungaism is a religion, that these people feel they have become ill because they have offended against the sacred laws of their gods. 2. There is often a reluctance in the rural areas on the part of the people to invite nurses or doctors into their own sub-standard dwellings. And it is here important to make sure that there is room provided for a clinic, in the meeting houses. 3. There is a very great reluctance on the part of Maori women to go to men doctors with any intimate ailments. The whole picture of physical ill-health points to poor housing, over-crowding, lack of knowledge, and a life-time of bad or indifferent health which is tolerated and endured, so that when something serious does happen to the people, they do not realise that these are danger signals which must be observed. They are so used to enduring their pain with a stoical indifference, and they do not notice when something serious happens to them.

MENTAL ILL-HEALTH This is an aspect which has held very little interest until recently and is often not recognised for what it is. We find that every country in the world has the same problems, in different forms, as we have here. (1) Intelligence Quotient level. When we think of mental ill-health, we must think of the child in the beginning, and among the Maori people, you have a tremendous proportion with depressed I.Q.'s. People with normal intelligence quotients are said to have an I.Q. of 100. Very frequently, when Maoris, especially from rural districts are tested, they are found to have an I.Q. level much below what is normal. This is partly a cultural difference in that it shows, I feel, that the Maori is not able to perform in the different European culture as well as he might if he were left in his own Maori background. Not only has the Maori difficulties in contending with different cultural background, but he also suffers from the difficulty of being bi-lingual. It is not easy for him to answer questions which rely on language skills. When a person is bi-lingual, although he has advantages in social intercourse with the two races, he usually learns a much smaller vocabulary. This vocabulary tends to be much larger in a mono-lingual person. It has also been found that even where two races are brought up with fairly similar cultural backgrounds, there will be an I.Q. that is not de-