South Pacific Health Service

First Meeting of the Controlling Board

(From our own Correspondent )

Suva, October 25 AVERY important step in the care at native health in the Territories of the South Pacific was taken to-day, when the first meeting of the South Pacific Board of Health was formally opened here by Sir Alexander Gran tham, Governor of Fiji and High Com missioner for the Western Pacific.

The Board is the directing body of

the South Pacific Health Service, estab lished in September to co-ordinate all activities devbted to native health in the Territories of Fiji, Gilbert and Ellice Colony, Solomon Islands, Western Samoa and Cook Islands.

The Inspector General of the Service (Dr. J. C. R. Buchanan) presided and the other members present were Dr. T. Rit chie (Deputy Director of Health, New

Zealand), Miss Lamble (Director of the Nursing Division of the New Zealand Health Department), Dr. R. J. Snodgrass (Acting Assistant Director of Medical Services, Fiji) and Mr. H. H. Vaskess (Secretary to the Western Pacific High Commmission).

THE Governor said the South Pacific Board of Health was planned several years ago—exactly when or by

Members of South Pacific Health Board at the inaugural meeting, opened in Suva, on October 25, by Sir Alexander Grantham, KCMG. The Board will direct the activities of the South Pacific Health Service.

Front row: Dr. J. C. R. Buchanan, Inspector - General, South Pacific Health Service; Sir Alexander Grant ham; Dr. T. Ritchie, Deputy Director of Health, New Zealand.

Back row: Dr. R. J. Snodgrass (Fiji), Miss Lambie (NZ), Mr. H. H.

Vaskess (Western Pacific High Com mission).

whom was not known. The Rockefeller Foundation, in 1922, recommended a joint medical service in the Pacific. In

1927, Makogai opened its doors to lepers from Islands territories beyond Fiji. In 1928 the Central Medical Board, Suva, accepted students from other territories.

Meanwhile, the scheme of co-operation whereby the New Zealand nursing divi sion supplied Fiji with nurses was in augurated. The Director of Fiji Medical Services became the Central Medical Authority for the Western Pacific High Commission. In 1943 Dr. McGusty (then Director of Medical Services, Fiji) wrote a memorandum advocating an organisa tion similar to that now formed. This

was strongly reinforced by the report of Dr. Watt and Miss Lambie on the same lines. These two reports were the foun dation of the South Pacific Health Ser vice. In 1944, on Dr. McGusty’s motion, the Fiji Legislative Council approved in principle the Watt-Lambie report. The Fiji Governor made a draft agreement. * The first executive step was the ap pointment in April, 1945, of the Inspector General of the South Pacific Medical Service. The final agreement was signed in Sept. 1946. In the intervening year discussions took place, ideas were clari fied, and there was practical co-opera tion between the various Islands terri tories. New Zealand and Fiji agreed that, instead of having two distinct and separate officers for Inspector-General, South Pacific Health Services, and Direc tor of Medical Services, Fiji, the two officers would be combined in Dr. Buch anan, who holds both posts. The pro posal to have one centralised training school for Island nurses in Fiji was abandoned in favour of training them in their home territories.

The Agreement is to run for two years in the first instance and is then to be reviewed. Other governments may wish to join in—Tonga and Australia are con sidering the matter. The United States and France are expected to be inter ested. This South Pacific Health Service could be too unwieldy and cumbersome — it might be better to have separate Ser vices, with co-operation between them.

This was a question that could be de cided in a moment.

“But whether it is to be one scheme, or several schemes, the South Pacific Health Service is the model for them all,” concluded His Excellency. “It is you who are here to-day who blazed the trail and showed the way in a practical and positive manner.”

THE complexity of the medical prob lems presented in the scattered island groups of the South West Pacific was referred to by Dr. Buchanan.

“No modes of life, for instance, could be more dissimilar than those of the popu lation in the urban areas of Fiji, the tribes who inhabit the hinterland of the New Hebrides and the lonely communi ties living under self-imposed constitu tional rules in such islands as Pitcairn,” he said.

“How vastly different, too, is the struggle for existence on an atoll such as Palmerston, where dietetic custom is dictated by nature, from the comparative ease of living in a fertile country such as Samoa.”

Financial resources depended on vastly different sets of economic circumstances, Dr. Buchanan added. There was no uni versal language and no common medium for the interchange of ideas. In the area covered by the Service there were almost countless variations in the vernacular, presenting a complicating factor even within closely circumscribed areas.

“Perhaps the only feature common to all is the extreme difficulty of placing the teaching and practice of modern medicine within the reasonable reach of every individual —or even communities — living, as they do so often, in almost absolute isolation,” Dr. Buchanan said.

He continued: “All these variations in conditions, while appearing to -call for multiple systems of health administra tion, actually, if viewed in broad perspec tive, constitute the strongest reason for overall co-ordination. After all, unity is strength. Under a system whereby ex perience and resources can be pooled, unsuccessful ventures should not be re peated, and special features developing successfully as the result of local experi ence can readily be grafted on to exist ing procedure elsewhere.”

(Continued on page 57)

“I would say in summary that our ob jective, as a Board, is to promote the in terests of positive health in its widest sense among the peoples of the island territories of the South West Pacific. We aim to serve all administrations with equal impartiality, and to develop that knowledge of individual characteristics and requirements which will enable us to do so with understanding and effici ency,” Dr. Buchanan concluded.

DR. RITCHIE said that he regretted that Dr. Watt, one of the two or three people responsible foK the foundation of the South Pacific Health Service, had not been able to attend the first meeting of the Board.

Referring to his own experience in the tropics, Dr. Ritchie said that he had brought the first lepers from Western Samoa to Makogai in 1922, and he was head of the Health Department in that Territory when the Administration de cided to join in the scheme for training native medical practitioners at the. Cen tral Medical School in Suva.

“This was a step that was all to the good for Samoa,” Dr. Ritchie added.

He said that when he first came to the Islands territories of the South Pacific he had been struck by the effect of the tremendous impact of Western civilisa tion on the Islanders. The introduction of foreign diseases had, for instance, led to progressive depopulation. In Fiji and in other Territories, where even simple medical measures were available, the depopulation had been arrested.

He recalled that 1946 had seen the signing not only of the South Pacific Health Service Agreement, but also ol;

the Agreement setting up the World Health Organisation of the United Nations. It was a happy coincidence that two organisations had come into exist ence together, both with the same ob ject, the betterment of the people medi cally. 9

Details of Agreement

rE agreement establishing the Service was signed on September 7 by the Prime Minister of New Zealand and the Governor of Fiji.

The Controlling Board, with head quarters in Suva will comprise the Inspec tor-General; the Director-General of Health, New Zealand; Director of the Nursing Division, NZ Department of Health; one representative of the Inter national Health Division of the Rocke feller Foundation (if the Foundation desires such representation) and one representative each from Fiji and the Western Pacific High Commission.

The Board, which will be advisory, will assist the participating Administrations in the more effective control of disease and the promotion of health within their Territories. It will also assist in the selection and posting of the staff, includ ing Native Medical Practitioners, Nurses, Sanitary Inspectors, and auxiliary per sonnel.

The chief executive officer of the Board will be the Inspector-General, South Pacific Health Service. The Inspector- General will visit all territories regularly, thus ensuring co-ordination of the various Health Services in’ the South Pacific.

The central secretariat of the Board in Suva, will under his direction, compile returns of infectious diseases and prepare reports on medical, health and allied

problems whenever necessary. Subject to the general direction of the board, the Inspector-General will arrange transfers and secondment of personnel.

The agreement envisages the establish ment of a Medical Centre in Fiji, includ ing a new Medical Centre School and Nurses’ Training School. The New Zea land territories will continue to make use of these institutions and of the Central Leper Hospital at Makogai.

A POOL of Medical officers, to be re cruited in part from New Zealand and in part from the Colonial Medical Service, is to be established by the Board. A medical officer in the pool will be appointed in the first instance to the territory in which his services are required, but he will be liable to transfer or temporary secondment to the other participating territories, his salary being paid by the Administration in which he is serving at any time.

Each Administration reserves the right to appoint to its own health service officers who were born in its territory.

The secondment of New Zealand nurses to Fiji and other territories will be arranged by the Director, Division of Nursing, New Zealand, in consultation with the Inspector-General.

The agreement is provisional, being subject to review from time to time. It will, in any case, be reviewed on Sep tember 7, 1948.

Mr. George Aumuller, who went to Papua for Burns Philp & Co. Ltd., nearly a year ago, as general manager, has returned to Sydney for medical attention.

He is at present an inmate of the Scottish Hospital there. He has undergone two operations, and is severely ill.