A—3

There are no local facilities for training medical or dental staff; however, two Niueans are at present being trained at the Central Medical School, Suva, whilst four Niuean girls are receiving nursing education at the Government Hospital, Apia, Western Samoa. Niue was- without the services of a European Medical Officer from June, 1947, until September, 1948, when the present Medical Officer commenced duty. During this time, his duties were carried out by three successive Native medical practitioners. The Administration maintains a hospital at Alofi. This hospital contains sixteen beds, but averages many more patients during periods of epidemic or serious illness. There is also at Alofi an x-ray unit, a dispensary, an out-patient clinic, and a dental clinic. A regular weekly visiting service is maintained in all outer villages, and to assist in this work a mobile clinic is at present under construction. School, shipping, and public health inspections are held, and there is a child-welfare clinic in each village. The out-patients dispensary at Alofi. is open each morning, and special calls are made by medical staff as required. The aged people of the villages are under the protective surveillance of the police, with Church authorities, in some cases, assisting with supplies of food and clothing as relief. The amounts expended on health services during the last five years are as follows :

All medical and dental treatment, including hospitalization, is provided free of charge to the Niueans. The money for this expenditure is provided by subsidy from the New Zealand Government. Vital Statistics Births for the calendar year 1948 . . . . . . 169 Deaths for the calendar year 1948 .. .. .. 142 Births per 1,000 of population .. .. .. .. 41-23 Deaths per 1,000 of population .. .. .. .. 33-02 The number of deaths under one year of age for the calendar year 1948 was 47, the infant-mortality rate per thousand live births being 284 ; this high rate was due to the epidemic of whooping-cough. ' Table 1 shows how the deaths were distributed according to age throughout the population :

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1944-45. 1945-46. 1946-47. 1947-48. 1948-49. Amount expended Population Amount per head of population 4,200 17s. 5d. £5,305 4,271 £1 4s. 9d. £8,211 4,328 £1 17s. lid. £7,293 4,318 ! £1 13s. 9d. £8,019 4,333 £1 17s. Od.

Number of Percentage of • Deaths. Total Deaths. Under one week 4 1 2-8" 1 1 week to 1 month .. 7 I 1-4-9 1 month to 3 months 8 h 47 5-6 !>32-9 3 months to 6 months . . .. 12 j 8-4 6 months to 12 months 16 J 11-2 j 1 year to 2 years 16 11-2 2 years to 3 years 5 3-6 3 years to 4 years 4 2-8 4 years to 5 years 2 1-4 5 years to 10 years 2 1-4 Over 10 years 66 46-7 Totals 142 100-00