Annual report / Medical Department, Fiji.

  • Fiji. Medical Department.
Date:
[1946]
Catalogue details

Licence: Public Domain Mark

Credit: Annual report / Medical Department, Fiji. Source: Wellcome Collection.

    3/40 (page 3)
    19. The necessity for large scale refurnishing and re-equipping in all units was very apparent, a result of the curtailment of all non-essential purchases during the war years which had resulted in a grave deficiency of many refinements and, indeed, essentials. Apart from expensive surgical appliances, microscopes and similar items, mucli of the material essential to the comfort of patients has become worn out and it lias not been possible during this year to do much in the direction of relieving substantial additional expenditure which will become essential in the immediate future. 20. The total value of drugs, instruments, appliances, clothing, bedding and equipment issued from the Medical Store during 1946 was £39,281 14s. 3d. Of this total £117 Os. 9d. repre¬ sented free issues to Missions and £2,358 6s. 8d. was issued on repayment to the Western Pacihc High Commission territories and other private accounts. The 150 tuberculosis beds in Tamavua Hospital, a new commitment in 1946, was responsible for some £3,550 of the total issues. 21. In order to control the issue of drugs to rural medical units and to systematise indenting and stock-taking, a schedule of all items authorized for these units was devised and the revised system, which is expected to effect considerable economy, was in operation by the end of the year. II—PUBLIC HEALTH. (1) GENERAL REMARKS. 22. The general trend of morbidity in the mass of the population is represented by returns submitted by Assistant Medical Practitioners in charge of Rural Medical Units. The recording system in force is based on the diagnostic facilities generally available and does not envisage any fine diagnostic classification of general diseases. It is, nevertheless, designed to portray with reasonable accuracy the incidence of communicable and other notifiable diseases, to give a practical indication of morbidity trends and to portray the overall rate of minor sickness. 23. The returns from the Colonial War Memorial Hospital, Tamavua Tuberculosis Hospital and District Hospitals where medical officers are stationed follow the normal colonial system. They can be accepted as accurate, and with certain qualifications connected with racial distribution of population density to which reference is made below, are representative of the disease incidence in the Colony. 24. With the exception of outbreaks of measles, influenza and gastro-enteritis, the first of which assumed major epidemiological proportions, there was no untoward occurrence affecting the health of the population as a whole. In a world of tightened belts the peoples of Fiji can consider themselves fortunate that they were able to face these epidemics in a robust physical condition begotten of a plentiful and varied food supply and an equable—if at times in terms of rainfall in certain areas an exasperating—climate. (2) GENERAL DISEASES. 25. All indications from returns submitted by rural units point to a satisfactory state as regards the primary and secondary manifestations of yaws, so much so, that it can be said with some assurance that the disease is rapidly coming under complete control. Skin diseases, especially the tineas (“ Mata ni solo ” of the Fijians) remain unpleasantly prevalent particularly in the more isolated areas. Hookworm, also, is undoubtedly common, but normal returns do not accurately represent the infestation rate, and no cross-section or mass surveys were carried out. Respiratory disorders, minor injuries, myalgias and the common run of minor maladies and injuries, constitute the bulk of the condition for which advice and treatment were sought in the rural units. 26. A return of diseases and deaths consolidated for the Colonial War Memorial Hospital, the Tamavua Tuberculosis Hospital and the District Hospitals of Labasa, Lautoka and Levuka are recorded in Appendix II, and a summary of out-patient attendances at, and inpatient admis¬ sions to, all hospitals and dispensaries together with a record of beds available is tabulated in Appendix II. There is a substantial increase in attendances over previous years, accounted for partly by epidemics but in the main by natural tendencies such as population increase, urbaniza¬ tion, improved transport facilities and a growing appreciation of hospital services. I he com¬ parative figures for 1945 and 1946 briefly summarized are:—- 1945. 1946. Increase. Total In-patient Admissions .. 13,210 16,622 3,412 Total Out-patient Attendances .. 232,800 254,900 22,100 27. In assessing the significance of the figures in respect of racial incidence, it has to be remembered that, with the exception of Levuka, and to some extent Suva which taps the heavy Fijian population of the Rewa Delta, the areas immediately surrounding the larger hospitals are those in which the Indian racial element predominates. For that reason elaborate correction should properly precede any analysis purporting to depict relative incidence of disease in the various racial components of the population of the Colony as a whole. Even without that refine¬ ment it does appear that there is a definite racial predisposition to certain conditions. In the anaemias, for instance, which account for 1-6 per cent of the total admissions 153 of the total of 161 cases were in Indians and in diabetes mellitus 1-26 per cent—of the total—the Indian cases predominated with 96 of a total of 125. These two diseases constitute a major problem in the out-patient departments as it is impossible to hospitalize any but the more severe cases and closer investigation is needed to clear up certain points in aetiology which may lead to a clarification of the general principles of prevention and after care. The toxaemias of pregnancy, and asthma also occur mainly in Indians. On the other hand in the diseases of the respiratory system- excluding asthma—and intestinal disorders the bias tends towards the Fijian element of the population, and until representative cross-section surveys prove or disprove it, the conclusion must remain that the Fijians are by far the most susceptible of any of the racial groups to pulmonary