H.- -31

4

The District Nurses have undoubtedly been responsible for discovering many cases which would otherwise have been unnotified, especially in the Maori settlements mentioned above, and in this connection the following extract from a letter from Mr. Jones, Judge of the Native Land Court at Gisborne, may be read with some interest: — " Many Natives have died, mostly, I think, from the neglect of proper treatment in the outset; and here I would like, if I might be permitted, to say a word of commendation of those brave and noble women sent out by the Department to assist in nursing the Natives. Apart from the ordinary risks of their profession, they take their lives in their hands, and put up with hardships and discomforts which only one who travels the same roads and crosses the same rivers can realize. And all this they do ungrudgingly and with a good moral effect on the Natives, whom they are continually schooling in the necessity and practice of sanitation. Were there more of these nurses available I think the course of the fever epidemic among the Natives would be checked if not stayed." Plague. 5. Attention is particularly directed to Dr. Makgill's interesting report on the outbreak of plague in Auckland during March, April, and May of last year. Fortunately the outbreak was limited to eight cases, one being a nurse who contracted the disease while on plague duty. To the credit of the nurses be it said that there was no difficulty in obtaining volunteers for this duty. Only two of the cases proved fatal. Though no cases have been reported since the Bth May, 1911, neither the Department nor the municipal authorities have relaxed any of the precautions considered necessary, though some of the surburban authorities have been somewhat apathetic in the matter. In connection with these the Department was particularly fortunate in having the assistance of the Mayor, Mr. C. J. Parr, who has ever been an enthusiast in sanitary matters, and who realizes that it is of little use to attempt to deal with a disease of this sort in a spasmodic and half-hearted manner. Auckland is a much cleaner city than it was this time last year. Measles. 6. In addition to the infectious diseases notified, mention may be made of an epidemic of measles which was fairly general throughout the Dominion. The District Health Officer for Wellington (Dr. Chesson) refers to the carelessness displayed with regard to the precautions taken against this disease: " There is too great a tendency to look upon this as a childish complaint from which all children must suffer." Nevertheless measles was the cause of forty-one deaths in the Dominion last year. Administrative. 7. Much of the time of the District Health Officers was taken up in arranging with Hospital Boards as to the assumption of their new duties as local authorities under the Public Health Act. Almost without exception, the necessary officers—principally Sanitary Inspectors—have been appointed by the Boards. The new scheme is working well. The advantage of vesting the responsibility for the prevention as well as the treatment of disease in the hands of one local authority '(the Hospital Board) in each district is quite apparent to those who have given any attention to the subject. In addition to their duties as Sanitary Inspectors, these officers are also Inspectors under the Sale of Food and Drugs Act, and their reports on the circumstances of those in receipt of charitable aid in their respective districts have in several instances been the means of preventing considerable abuse and imposition. Water and Drainage Schemes. 8. It will be seen by the District Health Officers' reports that local authorities—urban and rural —throughout the country are showing considerable enterprise in these directions. A full list of the water and drainage schemes in existence, and those in contemplation, is set forth in an appendix to this report. Laboratory Work. 9. Special attention may be called to the reports of Dr. Champtaloup and Mr. Hurley as to the amount of work done in the Dunedin and Wellington laboratories during the past year. The use that medical practitioners are now making of these officers' services is such that their time is severely taxed —so much so that in the early part of the year it was feared that Dr. Champtaloup's health would break down under the strain. Fortunately, however, the recent appointment by the North Canterbury Board of Dr. Patterson will to some extent relieve Dr. Champtaloup of the bacteriological work of that district. Dr. Champtaloup's suggestion that local demonstrations should be given to medical practitioners with regard to the more simple laboratory methods of diagnosis and treatment, and in the modern uses of bacterial vaccines, sera, tuberculins, &c, is one very well worthy of consideration. Vaccination. 10. Early in this year a report was submitted to the effect that the vaccination law has practically become a dead-letter in the Dominion. Though the births in the Dominion were 26,354, only 1,078 vaccinations were performed —viz., children under one year, 415 ; children over one year, 627 ; adults, 36 : total, 1,078, or 1-6 per cent, of the total births ; whereas the exemption certificates numbered no less than 6,754. In view of our increasing trade with the East, this neglect on the part of parents to have their children vaccinated becomes all the more serious. The Dominion has had one or two warnings of the danger that it is incurring— e.g., the "Knight of the Garter" during the past year. It will not always be possible to discover smallpox patients before they land in the country.