A.—3

10

readily to treatment. Gonorrhoea is apparently a common disease in Mauke, and many cases appear to be infected at an early age —fifteen years or thereabouts. Tuberculosis does not seem so prevalent as in Rarotonga and Mangaia. Hookworm treatment given to all willing to receive it. but the numbers were small, only 175 being treated. " Atiu. —Dr. Brass visited Atiu from the 13th September to the 23rd September. As in Mauke, the general health of the people was found to be good. There were numbers of cases of yaws and scabies treated, and, apart from these, most of the cases seen were of a minor nature, skin-diseases predominating. One suspected case of leprosy was seen. " Mitiaro. —This island was visited in November. The general health of the people was reported as being good. Cases of minor illness and of skin diseases only were seen. " Northern Group.—With the exception of Pukapuka and Nassau, the islands of the Northern Group were all visited between December, 1928, and March, 1929, in the course of a cruise of the schooner " Tiare Taporo," by which I was a passenger. In May, while on a leper cruise on the N.Z.G.S. " Hinemoa," I was ashore for a short time at Penrhyn, Rakahanga, and Manihiki. During the cruise of H.M.S. " Dunedin," in August, the Surgeon-Commander and a dentist went ashore at Pukapuka, Rakahanga, Manihiki, and Penrhyn, and rendered medical and dental aid to the natives. An official report from these two officers reached us later via New Zealand, and it was therein stated that, while the sanitation and general cleanliness of the settlements was good, further assistance in both medical and dental matters should be afforded. The first of these —medical assistance —should be to some extent provided by the Native medical practitioners mentioned above. If finances permitted, the most satisfactory solution —for thfe present, at any rate —would be the engagement of a third European Medical Officer. The Group is so scattered and the time occupied in travelling so great that the amount of time that can be given to each island yearly is not really satisfactory. " Pukapuka,—While at Pukapuka the " Dunedin " was able to render assistance in dealing with an epidemic of mild influenza, apparently introduced there from Apia by schooner. Though extensive, the epidemic could not have been very virulent, as only three deaths were attributed to the disease in three hundred cases reported. This island is, unfortunately, not to be reached directly from Rarotonga, as there is no communication by schooner. This makes it impossible to visit the island unless a ship is specially chartered. Communication exists by schooner between Apia, Samoa, and Pukapuka, and arrangements have been made for the forwarding from Samoa of drugs and dressings required by the Resident Agent. The latter reports (22nd January, 1929) that the health of the island is satisfactory, except that yaws and ringworm are prevalent. The cases are being treated with supplies received from Apia. " Rakahanga and Manihiki. —These two islands appear always to be kept in a very good state as regards cleanliness and order in the settlements. No cases of yaws were seen, and there are no known lepers, though several suspected cases were examined. On Manihiki the people are fortunate in being able to build drop latrines over the sheltered waters of the lagoon ; but in Rakahanga this is not possible, as the coast by the settlement is open to any big sea that may come up. On this latter island I consider it would be best to construct pit latrines of the Tongan type as modified in Samoa. Plies are a nuisance on Rakahanga, more than in any other island of the Northern Group. It was reported to me that there had been a good deal of sickness of gastro-enteric type amongst babies and young children during the year. This sickness was probably fly-borne. On Manihiki there are some cases of pulmonary tuberculosis. " Penrhyn. — Both settlements at Penrhyn were visited at various times. The health of this island also has been good during the year. The leprosy cases from Tetautua, thirteen in number, were removed to Piji last May, and there have been no further cases recognized up to date. Many suspects were examined, as if there is the least suspicion of the disease the patient or parents immediately wish to have an examination. The fact that several cases have returned cured from Fiji is no doubt largely responsible for this. Yaws was not seen, and fortunately pulmonary tuberculosis is not common. Hookworm treatment has been given the last two years in Penrhyn. " Suwarrow and Palmerston.—The former is at present uninhabited, the labour gang having been returned to their own island, Palmerston, in January of this year. The settlement on Palmerston is taking shape again after the storm of March, 1926, several new houses in the Native style having been erected and one European house. The health of the people was reported as being good. Only minor cases of sickness were seen. There' was no yaws seen. " Infectious Diseases. " Quarantine. —During the year thirty-eight vessels from overseas were inspected. The mailsteamers from Papeete, from November until February inclusive, were not granted pratique, as there was an epidemic of measles in Tahiti. No passengers were allowed from the latter place. Fortunately, the epidemic in Tahiti has ended, and so far there have been no cases of measles in Rarotonga. " Leprosy. —In May the N.Z.G.S. " Hinemoa " made a cruise, calling at Rarotonga, Aitutaki, Penrhyn, Rakahanga, Manihiki, and Apia (Samoa) for the purpose of transferring lepers to the hospital at Makogai (Fiji). In all, twenty cases were taken from the Cook Group, these being all the known lepers at that time. During the year seven cases have been returned as cured. Of these, four belong to Penrhyn, two to Aitutaki, and one to Rakahanga. Five died at Makogai during the year. The number of Cook Islands cases remaining in Makogai is eighty-eight. " Yaws. —This endemic disease I have mentioned under the different islands. It is more prevalent in the Southern Islands than in the Northern. " Typhoid Fever. —Fortunately we have had no cases of this in Rarotonga or the outer islands during the year.