THE PANDEMIC

Dominion, 14 March 1919, Page 5

THE PANDEMIC

EVIDENCE OF THE MINISTER FACTS ABOUT THE NIAGARA REORGANISATION OF THE DEPARTMENT FEUD WITH AUCKLAND The Minister of Public Health (tho Hon. G. W. Enssell) gave evidence before the Epidemic Commission yesterday. Sir .Tohn Denniston presided, and with him wit the Hon. E. Mitchelson and Mr. DM'Larer.. Goorjje. Warren Russell, Minister of Public Health, at the outset enumerated tho portfolios he held in addition to that of Public Health. He mentioned those, lie said, because he wished to show that ho had such a great amount of work to do th-.t lie could devote on y about onefourth of his timo to Public Health. Formerly there were two branches of the Department—Hospitals and Public Health. As o result of this thero were two professional men at the head, ono attention to public health and the other to the hospitals. In 1909, for the. sake of economy, the positions were united, and now one officer had to attend to both sets of duties. In . his opinion this was false economy, and should never have been carried out. Payment for Merit. "I know," he said, "that the people of New Zealand are not willing to piiy for brains and scientific training. 11ns ap•nlie? especially to those Bopartrnoms where science is brought to hear, lhis countn'. in my opinion, needs educating up to tho idea that specially qualified men for high public servico can only bo obtained by paying them adequate remuneration." A Division of Labour. When he took charge of the Department he found that the professional men were required to do duties which could be quite well discharged by competent laymen. The Health Officer had to do work which could well he done by a good sanitary inspector. The result fit placing this detail work on the health officers robbed these professional men ot opportunities . for. studying which should have. . The Deputy Chief Health Officer was chairman of tho Plumbeis Registration Board, and he considered it his duty to attend every examination ot plumbers anywhere in the Dominion. I ho same officer, Dr. Frengley, had for years had to spend a lot of time in overlonkin» and revising plans of hospital buildings. So long ago as April last he (witne?s) gave instructions that the Depot trmrnt bo divided into two sections—a professional side headed by the Chief Health Officer, and a business side headed by Mr. ICillick, now chief clerk. At the samo time be projected a scheme for an increase in the number of health rtistrieU. for he had always held that four health officers could not control the health of this counti7. It had always eeemed to him that important centres of population like Wanganui, Napier, Timaru. and Invercargill should have resident health officers. In exactly the 6ame w-iy he laid it down that chief sanitary inspectors in cities were to be raised in status in order to relieve the health officers of routine duties. His opinion was that there should be an Inspector-General of Hospitals to supervise hospitals and a Chief Health Officer to care for the health of tho country as a whole and to keep abreast of knowledge and progress in Dublic health science. He thought all health officers ought at least once in five years to have leave to go abroad to study public health affairs. This should be considered a .part of their continued training to fit them for carrying on their important duties. A Depleted Staff. The Minister spoke of the absence with tho Defence Department of Dr. Valintine and Dr. Makgill—Dr. Valintine engaged here and Dr. Makgill 011 war service abroad.. The position was that when the | epidemic came these two officers were away from the Public Health Department. Dr. Frengley was Acting-Chief Health Officer until Dr. Valintine resumed on November 19. The Department had sacrificed itself to assist the Government in the task of winning the war. Two of its best officers were loaned to the Defence Department. The Minister read, j a number 01 newspaper extracts from the j London "Times" to show that with such j a widespread epidemic raging all over the world, annihilating space, New Zealand, an insular country which could not be fenced in, could scarce hope to escape. No warning was given to him_as Minister that it was necessary that New Zealand should take steps to prepare for a possible visitation. On September 27 he received a letter from the Seamen's Union pointing out the danger, and suggesting such precautions as quarantine and fumigation.. At that date the letter referred to the crews of several ships trading to New Zealand which had suffered severely from the disease. All the crew of the Moana save, four, and all the crew save two of the Mokoia (from Australia), had been down with the complaint. He referred this letter to Dr. Watt, acting for the Chief Health Officer, and the reply of that officer was that there was nothing new in the disease from which New Zealand was then suffering, and that, the fatal cases were, few. Dr. Watt rejected also the suggestion that ships should be isolated. To be effective this precaution would mean the holding up of every ship in every port in the country, aud this drastic course of action was impracticable. This was on October 10, two days before the arrival of the Niagara. The Niagara, At the time the Niagara arrived 110 telegraphed to the Health Officer at Auckland ordering that before the Port Health" Officer cleared the Niagara or permitted communication with the shore the Port Health Officer should report to him whether the disease was pu're influenza similar to that prevailing in New Zealand, and report also the number of deaths. Tie communicated also with His Excellency the Governor-General, informing him that the ship could not be quarantined for influenza, which was not then a notifiable disease, and that if it were considered desirable to impose quarantine His Excellency would be asked to sign a proclamation mailing the disease notifiable. This His Excellency said lie would do. Tho Port Health Officer ■ reported that only one deatli had occurred on the ships from broncho-pneu-monia following influenza, that only two passengers for New Zealand were affected, and that the sickness was "simply pure influenza." When he received this message from the Port Health Officer he j (the Minister) telegraphed to him, "Ship may bo cleared." Witness had previously warned Mr. Massey and Sir .Toseph Ward that quarantine might be necessary. Inadmissible as Evidence, Witness went on to deal with the condition of Auckland before the Niagara arrived. He produced an article from Hie "Herald" of October 9 headed "Epidemic of Influenza," "Virulent Form in Auckland." This articlo spoke of the epidemic as being widespread, and somewhat severe—threo days before tho Niagara came. The.'chairman would not allow the Ministi"' to go on with this evidence. Tho Commission bad direct evidence on the state of things in Auckland at that time. Tho Minister could not seok to establish facts on the evidence of newspaper statement. The Minister then produced,a report fro.ll the Registrar showing the number of deaths in Auckland from respiratory diseases from May to December, 1918. \The figures were:—May, 9; .Tunc, 1; July, 12; August, September, 27; October, 31: November, 037: December, 129. For Wellington the figures were:—May, 9; I .Tune. 11; July, 22; August, 20; Septcm- ; her. 15: October, 30; November, 1G; December 506. ' Sir .Tohn Denniston said the Commission had 110 doubt of the existence of • sporadic influenza in New Zealand be--1 fore thj arrival of the Niagara. The ■ only, question was as to, whether this 1 ordinary form developed into the moro serious form or whether the more severe sickness was brought into New Zealand by this ship. Mr. Russell went on to discuss the powers of looal authorities under the law, be-

fore and aftor tho amending Act of last ] ye.v\ His purpose was to show that municipalities had power to deal with insanitary conditions, slum areas, and so <111. He submitted fo the Commission a series of articles which appeared in tho Auckland papers showing that thero wero dirtv slums ill that city when the cpidouiic was raging. These extracts, lio said, were tho foundation and, 110 claimed. the justification, of tho telegram which ho sent to tho Mayor of Auckland, to which telegram so. much exception lmil been taken. Tho chairman reserved in the meantime the question as to whether theso extracts wero admissible as evidence. Tho Minister then nsked whether in tho event of tho printed matter being rulv'd out, the reporters who wroto the matter should be summoned boforo the Commission to give evidence I This tho ohairman said could not. be done. t TUo Reneral question of tbo admissibility , of ail this matter was disoussed and dccided bv the Commission in committee. 1 1 Makura, Measles, and the Mayor. t When tho Commission resumed, 1 Tho Minister proceeded to refer to his 1 oon-esptmdence with the Mayor of A,uck- I land at the tinio of tho arrival of tho , Maicura on November 22. . Mr. Gunson, ; ho said, had mado a strong demand that the Makura should bd quarantined. Witness was unable to give any assurance except that' tho matter would ho carefully investigated, and this assur- ' ance lis save. When the information ] was wirelessed that measles coses wero oh board the ship, measles was not a notifi- ! abb disease. But he had information j that the sickness was in Auckland. It < wns then that Mr. Gunson made his de- < ciaralion that tho statement of the Min- < istor thai measles were rife in Auckland ' was contrary to fact, and that if the Minister would not protect tho public < health of the city, he ■ (Mr. Gunson) < wjuld take «ny measures to protect tho ! city. Witness sent his telegram to Mr. < Gunson regarding tho insanitary condi- ' tie.w in Auckland (which has smco been < (he subject of so much comment). He bas"d his statements in that telegram I or. the information conveyed to him in f Auckland, and on the articles appearing in the Auckland papers, as to the in- ' sanitary conditions under which the people were living. The truth of thess statements he accepted. So much was he impressed with the seriousness of things in Auckland that lie dispatched Dr. Frengley to Auckland on a few hours' notice, and a day or two afterwards went to Auckland himself. From what he saw there he was satisfied that tho organisation developed by the ] Mayor end. citizens was very, efficient. The work of tho Mayor and his committees was beyond all praise. Ho wished to say this as a matter of justice. ( Quarantine Impossible. The Minister said it was easy to bo wise after events, and he would be ft foolish Minister of Public Health who would not have learned some lessons from the experience of tho epidemic. There . were at the time of the outbreak no quarantine stations at Auckland, Weilipgton, or Port Chalmers, as all these places were occupied by the Defence Department. Quail Island at Lyttelton hail for many years been used as a leper station, and the buildings there wero absolutely useless for quarantine. At the time of tho arrival of tho Makura .the passengers could have been quarantined only on the ship, and this would have constituted n danger "of the moat cliefia.ful type." On November 6, the ActingChief Health Officer recommended that the Defence Department be asked to ( vacate the quarantine stations. Ho at ( once conveyed this recommendation to the , Minister of Defence, with an urgent ie- • quest that it receive prompt attention. : From that point onwards responsibility ; for the lack of quarantine stations rest- • ed in other quarters. He paid ft tubute to the good work of Dr. Valintine and Dr. Frenglev, in assisting him at ft time ; of the greatest trial he had ever come through in his life. From every coiner : and village in tho country were coming cries for help. People were djing. Doctors were down; nurses were down. < This was the appalling Dr. Valintine oame back to the jjopaitnsent to take charge. The Emergency Measures. The Minister gave evidence in some de- , 1 tail of the measures taken to-combat the epidemic. (Evidence on this point had already been given by Dr. nliutmeO io tin. appeals made by huu as Mmjstei tlir.ro was a splendid response, and lie believed tho work done by these people had saved thousands of lives. \s to .the control of organisations to fight the sickness, there was n difference iof opinion between himself aml the ! Chief Health Oftcer. Dr Valintine thought the best autlio ity to conti-ul was the Hospital, Board. Tins might be so if the epidemic was ot limned extent. But in the event, of visitation like that of last year it would be necessary to call in the aid of the local governing bodies to develop proper orjranisation. He wished to endoiso the statements of Dr. Valintine, giving thanks to the Defence Department for assistance given. Thut assistance was given cheerfully by everybody m the Defence Department, from the Minister down to the privates of the Medical Corps. At that time, however, a great number of doctors were out of the country on service with the Defence Department. 1 ~, ' ' , The Minister said that ono of the greatest troubles in connection with the epidemic wac in dealing with the native population. They did not understand the need l'or precautions, and also they suffered" severely from the mokness. Taaeis were forbidden. An endeavour 1 was being, made to persuade Maoris to live under better sanitary conditions lest another epidemic should come. The Liquor Restrictions. With regard to the closing of liquor bars. Dr. Frenglev ordered the closing of the bars in Auckland, exercising the powers which he believed the low allotted him. It was the opinion of the At-tornev-General. however, that tho law ' dU not cive him this power, and the matter come before Cabinet. Before coming to a decision, Cabinet obtained the opinions in writing of Snrgcon-Gon-eral Henderson, Dr. Ilay, and Dr. Mak";ll and these gentlemen were unanimously in favour of the closing of bars. The chief reason for the stoppage of the sale of liquor absolutely was that it was the opinion of these incdical men that 110 alcohol-soaked man, who might develop pneumonia, had a chance of recovery. It would bo futile to close the liars merely if heavy drinkers could obtain beer by gallons or lako spirits to lh?ir homes. It was possible, also, that tiiHe people would make up drinking parties, and so spread infection. Medical and Nursing Service. One of tho things revealed by the epidemic experience was tlio dreadful lack of knowledge of home nursing.' Ho 1 thought the Government would lmvo to subsidise the St. .lolin Ambuhmco Association to assist in the instruction of the peopJo in this work. The Women's Nationa 1 Reserve also was interested ,111 this matter, and was arranging ior ■lectures. Ono of the first necessities of the country for the future would ho the establishment of a State Medical Service. He referred to tho bursaries scheme and the requirement that students on graduation should serve as houso surgeons in hospitals. Indeed, he would almost be inclined to suggest to tho university authorities that, a term of service in a hospital should bo a. necessary complement to a graduation course. The experience in a hospital was necessary to tho young m n n about to enter on practice. The Minister said that 110 was not 111 favour of the Makura. being quarantined in the circumstances as they then were. •Mr Massey received a telegram from the Pre*? delegates on the ship, and Mr. Massev and lie agreed that it would be dangerous to the passengers to Keep tlieui on the ship in quarantine. Dr. Valintine was given authority to release the ship from quarantine if lie thought lit;, and with his decision to, do so the Minister wished to associate himself Mr Russell referred last of nil to the "ood' work done by the medical men in ■ the fight with the epidemic. ' To Mr. M'ta'on: The question ol the ■ supplies of medicine in the event of a re--1 crudesconco was under consideration, i Hospital boards wore being circularised 1 and asked to forward statements of tho 1 quantities of medicine and influenza re- ! medies which they had in, hand. The commission will visit the quaran- • tine station at Somes Island to-day, and • will sit in tho afternoon at 2.30.