A.—4 a

In February of 1927 eleven cases of bacillary dysentery were found in the populous village of Vaiala, next to Apia. Three deaths occurred. Again a Native village submitted to a voluntary quarantine. Children were stopped from school. Strangers were refused admittance to the village. Contact with Apia could not be completely shut off, for many of the residents of Vaiala are employed in Apia in the shops and along the waterfront. However, contact was reduced to the minimum. The Village Committee made frequent inspections and reported new cases for immediate transportation to the isolation wards of the Apia Hospital. Thirty days have now elapsed since the last case was taken to the hospital. The outbreak was quelled in Vaiala. No cases were reported from any of the neighbouring villages. It appears that the disease was restricted to the infected village. Hookwokm Treatment. Hookworm treatment was administered to the entire population of the district in 1925, and again in 1926. It is believed that very few inhabitants of the district missed the treatment. Yaws. When work first began numbers of cases of yaws were observed. Three injections of Novarsenobillon were given to all cases in the district. Since that round the number of cases in the district has been so small that no campaign has been necessary. Individual cases have been sent to the Apia Hospital for treatment. Each case has been followed up to see if the Pulenuu and the parent have carried out the Medical Officer's instructions. Lectures. Twice a month lectures are given to the Papauta Girls' School of the London Missionary Society and the Piula Training College of the Methodist Mission. The subjects follow those used in the meetings with the women's committees. Very elementary lessons in hygiene and physiology are given. As the majority of the students go back to the villages as pastors and wives of pastors and have positions of importance in the communal life it is believed that the seed sown in the school will eventually bear fruit. Vital Statistics. During 1926 there were 254 live births in the Apia-Falefa district, and the birth-rate per thousand mean population was 55-55, as compared with 52-6 for the whole of Western Samoa. Deaths in the district numbered seventy-four, of which twenty-three were of infants under one year of age. The death-rate was 16-19 per thousand mean population, as compared with 19-36 for the whole Territory, and the infant mortality rate 90-5, as compared with 105-9 for 1926. The mean population of the district was 4,572. Child Welfare. Infant mortality in Western Samoa has been high. Prior to 1924 it was estimated at 200 deaths per thousand live births. In 1924 it was 155. A whooping-cough epidemic in 1925 pushed it up to 186 per thousand, and statistics for 1926 show that it was 106 per thousand live births. The following table shows deaths of infants under one year of age per thousand live births in certain countries: —

As an infant-mortality rate above 50 per thousand is preventable by sanitation, hygiene, and the instruction of mothers, it is evident that there is scope for child-welfare work in Western Samoa. It was primarily for this work the Apia-Falefa district was assigned to the author. Work began in Vaiala. The mothers were keenly interested in the work. No difficulty was encountered in getting 100 per cent, attendance of children under two years. There is an element of competition—weighing one baby against another —that appeals to the Samoan mother. Proper scales were obtained, and as roads were opened up in the district the work was gradually extended to all coast villages. The same keen interest in child-welfare work was found to exist throughout the district. After a few weighings traders in outlying villages reported mothers were taking their children to the store scales to check up on their babies' weights. During the two years approximately 885 babies were weighed regularly : 274 of 301 births in the district were brought to the clinics, and weights were recorded from the first week. Some have been carried through the two-years period and discharged from the clinic. Other are still in the books, and weighing will continue until the children reach two years of age. When the work began children of all ages were brought to the weighings. Definite age information was very difficult to obtain, As explained by the interpreter, " The mother tells you the first figure

18

Country. Year. Kate. Country. ! Year. Rate. . . . . . — - j New Zealand .. .. 1921-25 43 Western Samoa .. .. 1926 106 Australia .. .. 1921-25 58 Belgium .. .. 1919-23 107 Irish Free State.. .. 1920-24 72 Germany .. .. 1920-24 127 Norway .. .. 1918-22 58 Western Samoa .. .. 1924-26 149 Switzerland .. .. 1919-23 74 Austria .. .. 1919-23 150 England and Wales .. 1921-25 1 76 Spain .. .. .. 1919-23 151 United States of America.. 1919-23* j 81 Japan .. .. .. 1920-24 163 France .. .. 1921-25 ' 94 Ceylon .. .. 1920-24 192 ! I I * Registration area.