A.—4

30

The Administrator, on the advice of the Board of Health, has, by notice in the Gazette, added the following diseases to the infectious-diseases schedule of the Samoa Health Order: — (1.) Venereal disease (gonorrhoea, syphilis, soft chancre, venereal warts, venereal granuloma). (2.) Dysentery (bacillary dysentery, amoebic dysentery). Beriberi has been made a notifiable disease. (b.) Sanitation. (1.) Water-supplies. —ln Apia and several of the Native villages gravitation water-supplies have been installed. In a few villages where such supplies are not possible storage tanks have been constructed. The Natives appreciate the advantage of a permanent and good water-supply, and the number of villages desiring such is increasing. (2.) Disposal of Excreta. —In Apia the crude sanitation of the past is being gradually replaced by modern installations of septic tanks, &c. In the Native villages propaganda is necessary in order that the enlightened co-operation of the Natives may be obtained. This matter is again referred to under (c) (1) Uncinariasis. (3.) Disposal of the Dead. —In the past the Native burial customs have not been interfered with to any marked extent, but the question of enforcing the use of common burial-grounds situated in selected areas is under consideration. (4.) Food Sanitation. —The New Zealand Sale of Food and Drugs Act, 1908, with all regulations made thereunder, is in force in Western Samoa. (c.) Endemic Diseases. Of the more important tropical diseases only three are prevalent in Western Samoa, viz.—(1) Uncinariasis ; (2) frambcesia tropica ; (3) filariasis. Influenza, of the ordinary inter-epidemic type, and measles must be considered as endemic in the Territory. Uncinariasis. —-It is estimated that over 90 per cent, of the Natives harbour hookworms. Although the percentage of infected individuals is high, the degree of individual infection is comparatively low ; but, notwithstanding this, the almost universal infection has without doubt a debilitating effect. The worm most commonly found is the Necator americanus, the Ankylostoma duodenale being rarely found. The work of the International Health Board (Rockfeller Foundation) has been closely studied, both in their reports and in the field in Queensland and Fiji, and the work of bringing hookworm under control in these islands is being carried out on the same lines. The Board has kindly supplied lanterns, slides, charts, and a hookworm film at cost price. The work has already commenced in Savai'i, and a second unit will take the field in a few weeks. The islands are being taken systematically, village by village, the procedure being an illustrated lecture in the evening followed by treatment with carbon tectrachloride early the next morning. It is anticipated that this systematic campaign will be completed before the end of the year. Preventive measures —the installation of sanitary latrines —will be carried out in conjunction with this campaign as far as possible. (2.) Frambcesia tropica. —This disease is very prevalent, especially amongst the younger members of the community. The Samoans, however, now recognize the value of treatment by arsenical injections, and are freely offering themselves for treatment. (3.) Fihriasis. —The report of the special investigation of this disease carried out by Dr. O'Connor, of the London School of Tropical Medicine, will give an exhaustive survey of the whole question. Its publication is awaited with interest. (d.) Epidemic Diseases. There are ample powers for dealing with an outbreak of epidemic disease. On the appearance of any infectious disease the Medical Officer of Health, on the authority in writing of the Administrator, may exercise any or all of the wide powers conferred on him by sections 19 and 20 of the Samoa Health Ordinance, 1921. Under the Samoan Quarantine Order, 1920, ample powers are given for dealing with shipping from overseas, both as to infectious diseases and any other disease the introduction of which into Western Samoa might constitute a danger to the public health. Weekly radiograms as to health conditions in New Zealand, and, when occasion arises, as to conditions in the other island groups in the Pacific, are received from New Zealand. The fortnightly health bulletins received in New Zealand from London are also forwarded for our information. 2. What provisions are made for medical assistance ? The provisions made for medical assistance during the year under review were the same as those reported in last year's questionnaire. Reorganization of medical finances, and also of the Medical Service, has made it possible to extend the activities of the Department, and therefore it is advisable to give not an account of the organization of the past, but what is now being carried out and will be completed in a few months. The accompanying map shows the position of the various stations.