5

A.-3

EXTRACT FROM REPORT OF DR. R. S. TROTTER, CHIEF MEDICAL OFFICER, RAROTONGA. During the year ended 31st March, 1920, 307 visits were paid to Europeans upon the Island of Rarotonga, and there were 519 attendances by Europeans at the Hospital; the corresponding figures for Maoris were 1,838 and 8,994. This gives a total of 11,658 visits and attendances for the year. The only outstanding feature as regards sickness was an outbreak of hemicranial neuralgia in the month of May. The nerves chiefly affected were the facial, supra-orbital, great auricular, and occipital. I am unable to account for this unless the cold winds prevalent at the time hael something to do with it. It did not seem to be associated with anaemia, rheumatism, gout, any specific fever, or other disease. It attacked men, women, and children of varied types. The in-patients at the Hospital during the year numbered seventy-three, with an average stay of twenty-three days. The number of operations performeel was 163, mostly of a minor surgical nature. Forty-two confinements were attended during the year. The Matron of the Hospital, Miss L'Amie, very kindly assisted at several cases. She also carried on the work during the illness of the Assistant Medical Officer in my absence, and did the work in a very satisfactory manner. The inspection of vessels coming to and leaving the port involved a cemsiderable expenditure of time and trouble, as at times the arrangements for inspection made aboard the vessels were faulty. Sixty-three vessels were inspected. There is considerable inconvenience attached to this work, too, as the steamers rarely arrive at the time stated in the wireless messages, and other work has to be put back or rearranged so that vessels may not be unduly delaj'ed. It seems strange that time and distance are not calculated accurately when a vessel is within a day or two of the island. In only one instance was it found necessary to quarantine people after the arrival of a vessel. This was fortunate as our facilities for quarantine at present are limited. Sanatorium : A site for a sanatorium for tubercular oases near Black Rock on a ridge over 200 ft. above sea-level has been tentatively chosen; nothing has been definitely settled until it can be elecided by boring whether a sufficiency of water is obtainable. Quarantine station: There is none. An island at Ngatangiia, opposite Muri, would be as suitable a place as any, all things being considered. Outer islands : These islands have not had the medical attention they should have had during the past year. I visited Mangaia in April. The Assistant Medical Officer visited Aitutaki, anel was there from the 27th April until the 24th May. I visited Mangaia, Mauke, Mitiaro, and Atiu in June, July, and August, but had to return earlier than anticipated owing to the illness of the Assistant Medical Officer. Since then no island was visited by the Medical Officers until I was able, through the courtesy of the parliamentary party, to pay a flying visit to Mangaia on the 24th February. The time spent on the islands was —Mangaia, thirteen days; Mauke, two clays; Mitiaro, eight days; Atiu, forty-four days; Aitutaki, twenty-seven days. The total number of visits and attendances was 949, split up as follows: Mangaia, 223; Mauke, 17; Mitiaro, 66; Atiu, 378; Aitutaki, 265. The following islands were not visited at all by the Medical Officers during the year : Manuae, Palmerston, Pukapuka, Nassau, Rakahanga, Manihiki, Penrhyn, and Suwarrow. This was unfortunate, but it could not be helped, as for various reasons the journeys could not be fitted in. With one Medical Officer travelling from island to island and staying as long as he can in each it is difficult to give the outer islanels anything like their fair share of medical attention. When one Medical Officer is off duty or unable to travc;! this difficulty is accentuated, as was the case this last year. It is to be hoped that better provision for the visiting of these outer islands will soon be made. Aitutaki : The District Nurse (Miss La Fontaine) reports from time to time in regard to her work on the island. These reports indicate that there has been little sickness of a serious nature em the island during the year beyond a number of cases of chronic illness. Other islands : From reports received from the Resident Agents there has been no serious outbreak of disease on any of them. The Rev. Father Joachim very kindly attends to the needs of the sick in. Manihiki, and the Rev. Mr. Wicks was good enough to help the sick at Pukapuka during an extended stay there this last year. Mrs. Wicks helped at Aitutaki during the absence of the Resident Nurse. Lepers : None of these were seen by me eiuring the year except one local case. The Assistant Medical Officer saw those on Aitutaki. There is no increase in the numbers repeated from any of the islands where lepers are segregated.

Vital Statistics. Return of Births, Deaths, and Marriages.

Births. Di laths. Marriages. Island Main is. Period. .Maoris. Europeans. Europeans. Maoris. Europeans. | Rarotonga Aitutaki Mangaia, 155 5 60 63 88 43 40 J 78 2 43 14 To 31st March, 1920. To 31st December, 1919. 1st January, 1919, to 31st March, 1920. To 31st March, 1920. To December, 1919. To October, 1919. Atiu . . Mauke Mitiaro Manihiki Rakahanga Penrhyn Pukapuka* I ) ) 46 19 5 4 . 29 10 2 10 10 2 9 8 5 ! :: 1 To December, 1919. .. . I 159 1 2 Totals 366 , 5 234 *Ne 1 I i returns to J hand. S. Savaue, Registrar.