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PUBLIC HEALTH. The outstanding features in regard to the health of the community during the year were an outbreak of dysentery, due to the B. dysenteries shiga, in the early months of the year, and an influenza epidemic which spread rapidly throughout the Territory during August and September. In spite of the presence of the two diseases just mentioned, the death-rate for the year was the lowest, and the natural increase the greatest, on record. The ordinary routine work of the Department was interfered with to a considerable extent by these outbreaks, and also by changes in the staff. During the year seven new out-stations, with Native nurses in charge, were opened. The provisions now made for medical assistance to Natives are as set out below. .All Natives receive free medical attention and treatment. The points at which such treatment is available are shown on map No. 1 accompanying this report. At the census of Ist January, 1926, the Native population of Western Samoa was 36,688, of which 24,052 were resident in Upolu and 12,636 in Savai'i. The distribution of this population, on which partly depends our arrangements for medical assistance, is very unequal. The topography of the country is another factor which has an inevitable effect on such arrangements. In the following account of the provision for medical assistance which has been made to date, the reference to districts refer to the numbers shown in the map accompanying this report:— Upolu— Area. Population. Districts included. (a) Apia Hospital area .. .. .. .. 15,807 1, 2, 3, 4, and western portion of 10. (b) Aleipata Hospital area .. .. .. .. 4,855 6, 7, 8. (c) Lefaga-Safata area .. .. .. .. 2,628 9 and eastern portion of 10. (d) Fagaloa Bay .. .. .. .. .. 762 5. Savai'i— (e) Tuasivi Hospital area .. .. .. .. 5,681 1, 2, 7a, 6b. (/) Safotu Hospital area .. .. .. .. 3,439 3a, 3b, 4. (g) Salailua-Asau area . . .. .. .. 3,516 sa, sb, sc, 6a, 7b. (a) Apia Hospital Area. —The whole of this area is within easy reach of Apia by motor-car, and therefore the 15,807 Natives living in this area have the Apia Hospital within reasonable distance to them. This hospital is now well equipped to deal with any conditions likely to present themselves. It is adequately staffed, not only for the treatment of the sick but for the training of Native girls as nurses to staff the dispensaries in various out-districts. A number of Native boys are also under training as medical cadets, and, under arrangement with the Government of Fiji, the most suitable of these are sent there to undergo a course of training in their Native medical school. The hospital is now electrically lighted, and this year an X-ray plant presented by the New Zealand Government has been installed. The bacteriological laboratory is the largest and best equipped in the South Pacific islands. There are also four dispensaries in this area, in charge of Native nurses —at the Methodist Mission at Lufilufi, at the London Missionary Society's headquarters at Malua, at Mulifanua, and at Fasitootai. (b) Aleipata Hospital Area. — The district hospital at Lalomanu, in the Aleipata district, was opened in April, 1924. It is in charge of a European Medical Officer, who has a staff consisting of an interpreter-dresser and two trained Native nurses. There is also a dispensary in charge of a Native nurse at Satalo, an outlying district in this area. Horses are kept at the hospital, to enable the Medical Officer to cover his district at frequent intervals. (c) Lefaga-Safata Area. —This area is served by two dispensaries in charge of Native nurses, one in Safata and one in Lefaga. (d) Fagaloa Bay. —This small area, with a population of 762, is isolated from the surrounding districts by high hills, and communication with the outside world is by means of boats or over very rough and steep tracks. During the year a Native nurse has been stationed here, with a small dispensary. (Ie) Tuasivi Hospital Area. —The district hospital at Tuasivi, built in 1921, was the first out-station to be opened in Western Samoa. It is staffed in the same manner as the Aleipata Hospital. The area contains 45 per cent, of the population of Savai'i, and, although such areas appear large, communication with all parts is easy. A Native nurse is stationed at the Methodist Mission at Satupaitea. (/) Safotu Hospital Area. —This area is a comparatively small one, bounded on either side by lava fields. It is in charge of a Native medical practitioner, who is assisted by a trained Native nurse. (g) Salailua-Asau Area. —This is the most difficult area in Western Samoa to deal with. The population is scattered in small communities along a rooky coast-line with very few landing-places. Water-supplies and sanitation are both problems not easy of solution. For the past few years a nurse has been stationed at Salailua, the most thickly populated area, and this year stations in charge of nurses have been opened at Samataitai and Sataua. The opening of dispensaries in the out-districts depends on our supply of trained Native nurses. Each year sees a further advance, and during the past year we were able to open six-—at Fagaloa, Poutasi, Lefaga, Samataitai, Sataua, and Fasitootai —and in addition to station a Native nurse, trained in child-welfare work, at Fagamalo, Savai'i.

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