A..—4A

Then the women's committee is called upon to report to the Medical Officer. The members come forward in front of the table and describe conditions in the village. They report all cases of illness. Children and adults capable of walking to the Native hut are brought in for medical attention. Those too ill to be moved are visited by the Medical Officer after the meeting. The babies are next weighed on the portable scales carried by the Medical Officer, and the weights entered in the records. The records show the name, weight, age, and sex of every child under two years. At each weighing the child's weight is publicly announced, and if there is any gain the mother is praised. If any loss is recorded an investigation is made at once for the cause. The mother, if at fault, is admonished, and special note is made on the record to check the weights very carefully the next visits. After the weighing, medical attention is given to those requiring it. Common medicines are dispensed from the motor-car, prescriptions are written for drugs not on hand, patients requiring hospital treatment are sent to the Government Hospital at Apia. Finally, the work of the Pulenuu and the women's committee is reviewed. An effort is made to create a spirit of emulation in the village and between villages. Attention is called to villages especially diligent in sanitation and kindred matters. The Natives are praised or criticized according to their work. The next call is but a repetition of the foregoing. Village after village and week after week the work continues, in an effort to supplant the Native faith in Samoan cures for driving out devils with a knowledge of the common diseases in this field and more enlightened methods of treatment. EPIDEMICS. Progress has been considerably hampered by epidemics and threatened outbreaks of infectious diseases. The Samoans live a community life. Many occupy the same house, sleeping side by side on the floor. They cook and eat together. Articles of clothing are freely exchanged and worn by many persons. The Natives are very fond of travelling, and journey from village to village, stopping at many places. Consequently when there is an infectious outbreak the disease spreads rapidly around the islands. In 1925 an epidemic of whooping-cough broke out in the district and increased the death-rate. Many of the deaths were only indirectly due to the disease, and other immediate causes were credited with the increased mortality. In the early part of the year 1926 there was an outbreak of dysentery on the Island of Savai'i and at places in Upolu. The quarantine restrictions placed on travel stopped the spread of the infection. Redoubled caution was exercised in the Apia-Falefa district, and fortunately the disease was not introduced into that section. While the danger was imminent daily inspections were made by the committees, and the officer met the village officials and committees more frequently than as arranged in the schedule. In August, 1926, an influenza-like disease appeared simultaneously in Vaiala and Solosolo, two villages about nine miles apart. From these points it spread rapidly throughout the Samoan Islands. From one-third to one-half the people in a village would be down at the same time. The period of incubation was very short, sometimes only twelve hours. Fever lasted from three to four days. The disease was very mild, with no complications. The symptoms were those of influenza of the respiratory type with leucocytosis instead of leucopenia. At first it appeared from the highly contagious nature of the infection that famine would follow the disabling of the plantation workers and others responsible for the village food-supply. Happily the period of disability was short, and sufficient numbers remained well enough to gather food-supplies until the first contacts were recovered. Relief measures were promptly taken. Three Native assistants were drafted for duty. The motor-car was stocked with medicines. The officer travelling from village to village left medical supplies with the Village Committee and Native officials. They were instructed in the care of the sick and nature of the disease. The mild nature of the infection was emphasized, and the complete recovery of the first patients was stressed to stop wild rumours tending to create a panic in the Native population. While the Medical Officer was with the Native Committees, village officials, and high chiefs, the Native assistants proceeded from house to house making a rough estimate of the number of patients, and instructed the well members of the household to go to the central dispensary for medicines. At first an effort was made to distribute medicine to the patients, but as the number grew this was abandoned for the plan of temporary central dispensaries in each village. The visit of the Native assistant in the house was more to reassure the sick and prevent panics. The few seconds' visit of a representative of the Medical Department, and the words " Send to the Pulenuu's house for medicine, plenty is available," was of great importance psychologically if not of much value clinically. In the midst of the influenza epidemic thirteen cases of measles were discovered in the village of Laulii, about five miles from Apia. The infection was traced to a passenger arriving from American Samoa. Immediately a conference of high chiefs and women's committee was called in Laulii. Quarantine measures were explained. The co-operation of the village was promised when the situation was understood. All measles patients and contacts were isolated in two big Native houses. All travel through the village was stopped. The inhabitants of the village were restricted to the village and their plantations. The village officials and women's committee faithfully carried out the orders of the Medical Officer. Complete success was the result of the quarantine measures. Not a case of measles followed the Laulii infection. Other cases occurred in Savai'i, but these also could be traced to passengers arriving from Honolulu and American Samoa. The Government did not establish the measles quarantine at Laulii. It was adopted by the Natives themselves, and the rigid enforcement was left entirely to them. Such incidents as the foregoing lead one to believe that progress is being made and that all the efforts to teach the Samoans sanitation are not wasted,

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