Troubles of an

Amp.

By Bert (Pett) Williams.

rW who have read of the work done by Assistant Medical Practitioners in the Pacific have any conception of the discouraging phases of our job. Yet we must keep patiently hammering at our problems, especially those concerning mothers of young children. If we can stimulate an interest in the well-being of this coming generation, future genera tions will take care of themselves.

It is this care of babies that is our greatest concern, and the one that pre sents the most baffling complexities. To tell the typical island mother that she holds the welfare of a future genera tion in her arms is simply to bring a smile of tolerance to her face and a shrug to her brown shoulders.

From practical experience of the past ten years I know that one of the major contributory causes of retarded develop ment and often death of infants is im proper feeding. Errors in feeding are due mainly to superstition and bigoted ignorance. The average mother too often scoffs at the so-called “white man’s magic” (medical science) and is too prone to ignore us, especially after the old bush doctor tells her that our methods are good only for papalagi (Europeans) because we know nothing whatever of treating diseases of native children.

The talks and lectures we are con stantly giving are usually wasted on un heeding audiences—literally wasted, I say, for no sooner have many such talks been given than we find mothers reverting to their old methods of infant feeding, satis fied with the ridiculous assurance that natives always have been reared in the same environment and exposed to the same conditions that exist to-day.

By comparing the living standards of the past with those of the present we have the example of the last and the present census. In 1940 the population of the entire Samoan group was 62,000; the present estimate is approximately 88,000. Credit for this increase must be given primarily to improved standards of health and living conditions brought about by the untiring efforts of the Pub lic Health Department.

THE most important feature to be reme died is that of malnutrition of babies.

This is responsible for most of the worries and anxieties of consulting prac titioners and has become a dread scourge of infants and children in Samoa.

The average Polynesian mother has no regard for that most important element, time. Therefore she has no understand ing of the value of regular feeding, or the necessity of one feeding being digested before another is given. So, when baby cries, all mother thinks of is putting it to the breast. She simply rolls up her dress over the breast to be used, the organ thus dangling within easy reach of baby’s mouth, while his little form is snugly fitted into the crook of mother’s crossed legs and lulled by a to and fro motion of the limbs, hence not interfering with mother’s share of village gossip.

Mother meanwhile does not realise that this awkward and rigorous feeding has the serious consequences of wind, gas and resultant pains in the stomach result: more crying.

At other times baby’s crying goes un heeded because mother is busy with do mestic duties and does not give her baby the required nourishment, stopping to do so only when she is tired and over heated and her milk unfit for the child.

Yet many mothers rebel at the idea

of weaning the child early, for the “bush doctor” has taught them that this will cause poor growth of teeth and other bones and that weaning is only an ex-

ALTHOUGH most people in the Pacific have a general idea of the work performed by Suva-trained Assistant Medical Practitioners, and can imagine that they encounter many difficul ties, we have heard little or no thing from the AMP’s themselves.

This article gives us just one facet of their fight against their arch enemy—native indifference.

The author, writing from Ameri can Samoa, says that he attended the Central Medical School in Suva, at the same time as Geoffrey Kuper and James Rennie, who have given great service as AMP’s to their own Solomon Islands. After graduation he returned to xvork in Upolu, Western Samoa, for five years; but for the last five has been in American Samoa.

cuse for those errant mothers who would seek amusement and pleasure outside their homes. This belief persists in spite of the obvious tendency of the child to

become emaciated. To my more per suasive arguments I am most often chal lenged by the mother’s remark that the child is thin “because he is growing.”

Mother is very fearful that her new born baby may be exposed to the danger of cold wind, or draught, so in its kapok filled swinging cradle she covers it with a suffocating pile of blankets. Naturally this shutting off of all fresh air results in heat rash which mother calls ‘ mumu” (herpes erythematosus) and forthwith rushes baby to the “bush doctor” for treatment. This condition is believed to be inherited by all Samoan babies and as a prophylactic—begun often as early as the second week of infancy—the baby is immersed up to the neck in cold water early In the morning or late in the even ing. I have often seen lines of mothers parading to the river for this cruel bap tism of their babies, following with the usual massage. I have had the painful duty of vainly trying to save cases of pneumonia resulting from these immer sions. Yet no amount of telling would convince the mothers that the pneumonia was not due to mumu getting beyond their control. I would like to see some of these get a dunking in the cold moun tain streams!

HOWEVER, the ultimate in disgusting forms of child feeding is the pre masticated food. This revolting prac tice still prevails throughout the islands

to-day, notwithstanding hygienic teach

ings and repeated warnings as to its dangers. This consists of the mother, grandmother, or any other adult for that matter, chewing the food into pulp and giving it to the eagerly expectant infant.

Walking along almost any village path toward mid-day one will frequently see the child held up with one arm while with the other free hand an adult is scooping up with the forefinger these “pulps” of chewed food arranged in a

row along the bare leg of the feeder, and pushing it into the child’s gaping mouth.

At every possible opportunity we have protested violently against this abhorrent practice, but ignorant mothers through sheer laziness or unconcern continue the business immediately the medical prac titioner is out of sight, though promis ing smilingly to desist. They actually believe that babies thrive on this food which is already well masticated and which offers no obstruction to free pas sage into the stomach for digestion.

They wonder at the frequent vomiting and stomach upsets—if no worse—among their offspring.

Often a child when able to chew is given a sizable portion of taro, perhaps along with an identical piece of beef or pork. Plies literally feed on the food as w.ell as stud the baby’s face before he gets the food into his mouth. More often than not the taro and pork, in the course of eating, is rolled all over dirty mats where feet have trod; thus the

food is exposed to contamination by soil and this frequently leads to worm in fection, one of the most ravaging diseases prevalent in the islands.

HAMOANS have at their hand some of O nature’s most beneficial soft foods for infants in the form of vaisalo (coconut porridge), suafa’i (banana stew). and ,<PW “ a f h >. !» /tUI more beneficial for baby to take his food first-hand, and to learn the principles of chewing as early as possible. Mother’s milk is, to be sure, baby’s best natural food up to seven or nine months when an augmenting diet may be safely begun, When mothers do comply with our teachings and recommendations and their babies show evidence of proper growth they are proud and happy—and this is our most forcible argument. Perhaps we shall yet find ourselves resorting to the papalagi’s “baby shows.”

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The islanders now have access to the best scientific medical assistance. All fields are covered by the Public Health Department’s drive to place all these services conveniently at their disposal.

Constantly they are reminded against hesitating to place their many ailments in the competent hands of qualified doc tors, practitioners and nurses who handle these problems with knowledge acquired through years of intensive study and training. It remains for them to offer only voluntary co-operation. It costs no thing, except co-operation.

Mr. R. S. Beaumont, accountant of the Methodist Mission’s New Guinea District, left Melbourne on June 12 to return to his work. Mrs Beaumont will follow later.

Ratu Sir Lala Sukuna has been ap pointed Honorary Colonel of the Fiji Infantry Regiment. He has had military associations for almost 40 years. In 1914 he was at Oxford University and at the outbreak of war he joined the French Foreign Legion where he won the Medaille Militaire. In World War II he played an outstanding part organising the war effort of the Fijian people.