A.—3.

10

been done by way of clearing hospital-grounds. The morgue has been extended as a dispensary. Accommodation has been built for the leper, who is now under rigid segregation. Concrete paths have also been laid down. Visits to the dispensary numbered 738; 159 visits have been made to outside villages, and 452 patients seen ; 337 injections of salvarsan have been given ; twenty-one major and a large number of minor operations have been performed. The most notable improvement- in the health of the island has been in connection with specific disease. In every case where salvarsan injections have been given there has been a speedy drying and healing up of the conditions. Some of the cases have been of twenty-five years' standing, ■although nowhere have I seen the loathsome cases of destruction that were to be met with in the Cook Croup. For months past we have had no cases for dressing at the dispensary, whereas previously some thirty cases of destructive yaws required daily dressing, besides a large number in the villages incapable of coming to the dispensary, to whom dressings were given out. In view of the high mortality amongst the infants (which in the' past has been more than double what it is in New Zealand) special energies have been directed towards their care. Artificial food is prepared in Hospital and given out to those babies requiring it, which cases are kept under strict supervision. Several cases have been treated in Hospital, in e.vc-ry case with satisfactory results, due in a large measure to the care and attention bestowed on them by our Matron, Miss Peers. For the quarter just ending only one death has occurred on the island in children under twelve' months. This case, unfortunately, did not come under our supervision. Amongst the youth and middle-aged, of primary importance is the toll exacted from tuberculosis -in fact, it is common at all ages -pulmonary and gland tuberculosis in the youth, and peritonitis and general tuberculosis in children. The dissemination of the disease I attribute to (1) climatic conditions —the moist, oppressive, hot atmosphere of the island, whereas the essential of sanatorium treatment is a dry rarified atmosphere ; (2) European clothing and the tendency of the Native to sit about in wet garments; (3) the crowding-together in their houses and the shutting-out of the air at night, together with the habit of lifting their mats and spitting under them. Several cases have been treated in Hospital on sanatorium lines with marked benefit, and the patients on their discharge exhorted to continue: living under (he same hygienic conditions as when in the institution. Assistance in this connection is also given in the schools, where a course of simplified hygiene is now part of the curriculum. A igst the aged and infirm, destructive yaws and climatic conditions have rendered them prematurely old. Succeeding generations must benefit materially from the campaign instituted against the former. The tendency of the Nativess is to neglect their old, and I think the establishment of an old-age pension would make it worth their while for the young to foster their old people. The sanitation of the island has been carefully attended to by a systematic examination of all the houses and villages in respect to general cleanliness and the destruction of the, breeding-ground of flies and mosquitoes. Some of the villages are good and some are indifferent, but on the whole they are far superior to what I have' in the Cook Group. Our Ordinances make provision for such things as earth-closets, which must be kejrt in a proper sanitary state, the compulsory notification of gonorrhoea, &c. The latter disease is always traced back, and the individual who conveyed it also treated. It is an offence here to transmit this disease. Apart from urgent calls, all the villages are visited weekly, two days being devoted to this, when the sanitation and sickness are attended to. Many surgical operations have been performed, principally in connection with those cases of filariasis and tuberculosis which lend themselves to surgical measures. In this connection I am indebted to the skilful assistance rendered by my predecessor, Dr. Ellison, as an anaesthetist for some weeks before his departure. The assistance of an anaasthertist here would greatly facilitate the clearing-up of some old-standing surgical conditions. An inter-island shipping service would also be a benefit in this connection, and would give an opportunity to those old-standing cases of elephantiasis and tuberculosis in the Cook Group to come to either Samoa or Niue for surgical treatment. An examination of the school-children has been made this quarter, and all requiring treatment have been attended to. The chief conditions requiring attention have been yaws, dental caries, and skin-diseases. Education. Satisfactory progress is being made both at Hakupu and Tufukia Schools. The equipment of both schools is now adequate, and we are looking forward to an uninterrupted year. Both schools have suffered through the sickness or the transferring of teachers, but there is no reason to anticipate any further breaks in the work. Mr. Reeves has reorganized the work at Tufukia, and considers that he can peach the New Zealand Sixth Standard. At Hakupu Mr. Bolton is to try and bring the work up to New Zealand Fourth Standard level. This school has had little more than two years' actual work, so that it will be some time before that standard is reached. Other village schools which may be opened will proceed on the same lines, and the most promising pupils from each will come finally to Tufukia, for a couple of years. From these it is hoped to draw our teachers and other officials of the future A scale of salaries for Native teachers as follows has been drawn up, and present salaries adjusted in accordance with it : First year —first six months (probation) £24, second six months, £30 ; second year, £36 ; third year, £42 ; fourth year, £48 ; fifth year, £60 ; sixth year, £72 ; seventh year, £84 ; eighth year, £96; ninth year, £108; tenth year, £120; eleventh year, £132; twelfth year, £144; thirteenth year £t5O (maximum). There is a block at £84, to surmount which a test must be passed and also the teacher must be married. There is a further block at £120, which will mean a fairly hard examination, and no doubt £120 will prove to be the maximum for most of the assistants. Increases may be withheld in cases of lack of progress or of misconduct.