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STORIES OF THE

WORLD HEALTH ORGANIZATION

IN THE

'ESTERN PACIFIC

Published by the

PUBLIC INFORMATION OFFICE WESTERN PACIFIC REGIONAL OFFICE

WORLD REALTII ORGANIZATION MAN I L A

1955

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FOREWORD

This mimeographed booklet entitled STORIZS OF THE ~P~D

• HEl'.1TH ORGANIZ!~TION FROH THE HT'...3TEllN PACI7IC is not a full ac-

count of what ihe goverrunents in this region, other international.

organizations engaged in health \.ork, and ~mo have accomplished

together during the course of 1955. The record of that achieve­

ment is covered in my 0I-.'I1 report to tho ReGional Committee. vlhat

is intended here is to tell the story of som3 pheses of our "rork

in human terms - thet is to s:J.Y - in t,erms of tho efforts made

by the men in the field, both the national an:! international

counterparts, showing the difficulties they encounter and how

they approach each particular problem. Our aim is to sec that

programmes are successful, but success can only be achieved

through the great effort and devotion of the field i.orkers in

carrying out their work.

show.

That is ~mat our stories attempt to

I hope you ,,!ill enjoy reading these stories as much as I

havo. They speak for our region. They carry the message that

evary effort is being made in this part of the world to see that

the people in the Uestern Pacific 11ill "attain the highest pos­

sible level of heal th".

Hay all these efforts continue even with greater force in

tii3 years to conc. Hith this thought I also send you my greet­

ings and best Wishes for the coming year.

November 1955

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I. C. FArm, H.D. / Regional Directo:if

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TABLE OF CONTEm'S

FOREI.-10RD Dr. I. C. Fang . . . . . . . . . . . . . . . .. . . • •• i

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HI FIJI ISLANDS ADVENTURE Dr. Friedrich C. Tross · . . . . . . .. . .. . .. . . . 1

HHAT HAPPENED TO THE IlVUNmAIII Dr. Friedrich C. Tross •• · . . . . . . . . . . . . . . 6

THE STORY OF GEORGE Evelyn llatheson . . .. .. . . .. . . . .

HOof I1ANY TIIIES HAVn: YOU BEEN POLITE TODAY?

. . . .. . .. .. . . 11

Dr. Anton Oeser •.... . . . . . . • • . .. . . . . • 16

HY UORK m HONGKONG Betty. A1 t .. • . .. .. .. • • . . • . . . • . .. .. . . • 19

A HAPPY DAY Dr. Olav Idsoe ~ . . . . .. . . . .. . 23

'i'O'iTARDS THE CONTROL 0:'" SCHISTOSONIASIS Dr. Nelson G. Hairston •. .. • • • • • 'Z7

TOl"TAPJ) B:!:TTER NURSrm lWUCATIOrI 'rJllhelmina Visscher · .. . . . . . . . . . . . . 30

A l-mO SPEC:::ALIST IN TillJAE Dr. Donald J. Pietsch •••••••••••..•••• 36

YAltlS CONTROL TIl LAQS Dr. Edmond J. Douvie r ... .. . • . .. • .. . • • .. • • • • 38

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BY

DR. FRIEDRICH C. TROSS

On i!ovember 22, 1954; an

Intorn.:'..tional Team of the vlorld

Health OrGanization 2xrived by

air in Suva, capital of the Fi­

ji Islands. It consisted of

the team leader anc writer of

this story, Dr. F. C. Tross and

the International Sero1o~ist,

Dr. N. J. i-Jhelan. They were ac­

compcnied by Dr. D. R. HUC:rinB,

Reeional V. D. Adviser, who had come with them from Hanila to

usher them into a new area of WHO activity: a Yaws Control Cam­

paisn in various Pacific Islanc'. ,;roups which was to stQrt in the

Fiji IslC'nds.

At Nausori Airport, the small airstrip near Suva, they

were received and ::;reeted by the Colony Director of the Yaws

Campairrn, Dr. L. I. Verrier. A week later, after various pre-

/liminary Ciscuss ions ••••

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l:L1linary discussions and introGuctions, it was decided to visit

the Island of Vanua Levu, northe~st of Viti Levu. The southern

part of this isle.nd, D. e.istrict cnlled Savusavu, uns chosen as

the site for the Pilot Project of the Campai?n anc for the field

headquarters.

So one beautiful morninG durine: the 12.st c1nys of Nov­

ember, the te~ accompanied by Dr. Verrier, boarded a small

II Dr over II plane of the IIFiji Airways!! at ITausori end after an

hour I s flieht mru::e 2. smooth lanclin,:; on the small airs trip on Se­

vusavu Bay •

•• • Savusavu Bay is very much uhut most people ime,--ine

when they think of the South Seas. A lovelYj peaceful bey, sur.-

rounded by hills, a small Mangrove 2.11(1 coconut ;:>clm borderec is­

land in the midcle of the bay, frienCly people livine in their

pretty e;rMshuts ar,d small trc.c1inc; stores run by Inc:ians ane.

Chinese •

••• Durinr. the next few da~~ we traveled alone the coast

of Savusavu visitinc planters, villacers, medical facilities,

etc. We went either by C2.r or by launch •

•• • After 1ve hed thus m~de the necessary contacts with

the chiefs of the district the day of our e.eparture came •

•• • One noon down on the jetty we sew the Government I1e­

c~icaJ. Vessel IlVuniwai ll , a 70-foot ketch with diesel enLine. She

had come to t~e us back to Suva. On board were the master of

the Ship, the Fijian Captain Taito end a crew of 10 derk-skinned

seamen uho were busy to :;:et her ready for departure... 1'Jhen we

left, a biC crowe; of fa:nily members e.ncl friends s tooc: on the jet­

ty to wish them and us a cood trip. Ue left at seven p.m. under

Diesel eneine and soon were out in open waters. There was u mo-

/derate swell and ••••

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derate swell and breeze and some scattered rain showers fell CM:!r

the horioon... All together fairly good HeatiBr... The weather

report vTas favourable... I decided to retire into my cabin soon

after dark. The cabins were small but comfortable and soon I

dozed off... Shor tly after midnight I was awakened by a grinding

noise deep down in the boat, some jolts foHOl.od by some jerl'Y,

unnatural motions of the ship. Then I heard a voice cry out,

"Stop engine, engino fully reversel" Thero Has commotion every­

lihere on board ane_ it did not take r,:e long tD realize that vlO

,-,ere hard agrot:nd on one of the dreaded coral reefs. First I Jal

a sid:ening .fGeling in my stomach and pictures of a ship sinking

like a stone to the bottomless depth of the South Pacific before

m;r eyes. Sharks 1iere the ooxt thought. He ;.ad caught a fairly

good sized one a feu days ago on a f':_shing trip with one of the

plantors.

But then I pulled myseLf to,'!(Jthcl', got into my clothes,

threw my Lcica car.1era, money and paa.:;port into Q. .f.:urly water

protective bag, checked the I'rae ;~est a...-rl then went out to see

what tho situation vTas like.

The first queetion ifas- Did l-re spring a leak? A look

d01ffi the hatch of too engine room shOWDd thnt 1b::; floor .lC.Ll cov­

ered w.i th black o;U wh.oo:; ori~in I did not know at first. The cre't.

was busy to let tho launch and tho ~;haleboat to ~-later J uhich was

a hard job since the 117uniwai" un;; :;-,;:;r.Lng ,lard from one side to

the other. The .. uroleGs ope!' ator vii.:S calling "SOS" but received

no answer. On tho n:ap wo saH that we wore on -the notoriOUS \va-

kaya Reef J a coral roef of tllO Stlape of a long drawn number B.

Within th e next fifteen minutes \ie made a [C'W im!1ortant disco,rc­

rios; that -there ,-las no loak yat, that the angine lias all right,

that we were only a feu yards .from tho edge o.f too reef where it

Ifallc o:r ......... .

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falls off vertically into deep water J thQt the tide was recedine

and that dead low tide we..s dUG in ['.bout five hour s. So we ell' op­

ped <:'.n <:'.nchor on the stern side ['.nd after a few futile attempts

to drac: the IIVuniw~ill off the reof, wo became resi::;ned and wait­

ed for the next ris me tide.

IISOS" was sent out every fifteen minutes but no ar..SI-;er

tole us that we were heard. \-lith tho lowerinz of the tide the

ship keeled over to each side in ever vlider circles until firrJly

she settled down firmly in an awkward an:;le at dead low tide ..

Thero was nothiur: we could 0.01 so VIe settled dmm ns well as we

could, chewed biscuits, drank tea and smoked. And waited for

daylif~t to come.

It came at about

our spirits. We coulc~ see

five a I clock and helped a :'.ot to lift

the reef below us, and un island

about eic:ht miles off. And we coulc~ sec the fins of the sharks

cruisinG up and down the roof, as if they were wcitin~ for some­

thin!,,:. Then our Whaleboat ren ar:rounc. and wc.s fillod with wa­

ter the next moment ':!y a ~::reaker. Unimpressed by the sharks, some

of our crew jumped oV8rboard, Wac.el~ over tl t;:c ::;)c.t :-.L:~' emp"tied

it out aC:Qin. This w<:'.s rather herd to do because it filled fas­

ter than they could empty it. But they finally succeedec:. ~Hth

the risinr: tide we all trj.~.d anew to r,et the I1Vuni~vcitl off the

reef, but she WC!.S restin!? now in a scrt of ceep bnthtub .. rithin

the reef and it was impossible for us to drar. her with the force

and means at our disposaJ..

Atei:;ht thirty A.'1. ,·re rGceivGc~ <:'.!l answer from Suva

by wireless nne. were told that a flylnc boat woulc~ come over to

our aid if necessary and that a number of boa iE hr.d been ordered

out to rescue us. So all we had to do 1IlceS to wait afain.

ISoon the flyin£: boat ••••

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Soon the flying boat was evor us studying the situatim.

Sho did not COIOO down, sinco the soa uas too choppy and it did

not seem that we liere in imminent dan~r. ~;i th the ris:iJlg tide

the ship began to l)ound harder and harder on tho roef and it be­

came unpleasant on board. lie began to HondoI' tmcn she would

sj,;,art coming apart. Finally, around noon, vIe saw a fast motor

launch approaching frombohind -chc] nearby islam. :ct vJaS tho

launch IIOvalau" which had raCed to our rescue from Levuka, for­

mer capital of tho Fiji Islands. !It tre same time, a cloud of

smoke in the south indicated to us tl!nt the larger rescue ship,

too "Dogoi", iV'as approaching. Soon the "0valau" was dropping

anchor a feli hundred yards away on thG other side of tho reef

and we Here able to 1'0;'; '~10 whaleboat over the reef to her.

Hhon we turned nnd headed back for Ovalau Island, we

saw the IIDegei" had arrived on the sceno am started to nork on

t:'10 "Vuniwai 11.

This onded our first visit to one of the Fiji Ialands.

110 wore ono o..'Cperience richer. 1'11(' "Vuniwai" 1fas fina.lly dragged

off the reef amI 'vas docked in Suva for repairs. Sho hD.d suf­

fered only minor dm;lages and we hoped to be on board again for

another journey before long •

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"VUNIWAI"

My first story ended with the statement. that the Govarn­

ment Medical. Veasel, the 70-foot ketch "Y.uniwaill had been taken

to Snva for repairs after it had been dragged off the Wakaya

Reef.

I am glad tu be able to tell you that she is back in ac­

tio~ ass.igned as a floating base of the Yaws Control Team here

in Sa1OlS.avu. She has been repaired, camplete1¥ .overhauled,

sporm a new coat of paint and has a new master., Captain Filipi.

Captain Taito, the forner mater, 'Has withdl!awn by the Govern­

ment after the boat hit the reef some mon.ths ago. After thia

introduction, I will now try to take • .you along with us on a

day's work llf the Yaws Control Team along the coast of Southern

WaiJ.evu. Wailevu is a IItikita" (district) situated west of "ti­

!dna" Savusavu where our field headquarters is.

Everybody :in Savusavu is awakened by the lIal~mB" of the

!'.lal.in~ the b;g wooden drum of the Fijians. The mornings here

are beautiful. From the verandah of my house I have a wide

view over the still waters of the bay which in the early hours 1£

the morning sleep :in the shadows of the surrounding mountains.

IAfter breakfast I ••••

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After breakfast I walk the short distance from my house to head­

quarters .,here my teams are retting ready for the day's work. On

this particular day there will be two surveyine teams and one

follow-up team caine out. One of -;;he surveyine teams will use

the IIVunhrai!' to r.e2.ch one of the villaces and I shall [SO alone.

These surveJ~nG teams consist of two assistant medic21 practi­

tioners and two assistant nurses.

(The Assistant Modical Practitioners - which are called

AEPS - are Southsea Isle.nc:ers who have stuc~iec: medicine for four

years at the Central Nedical School in Suva. The Assistant

Hurses I called IJTs are in most cases Fijian Cirls who have

taken an extensive course in :'·:ursinc;. The War Ie. Heo.lth Orp,ani­

zation, by the way, is workine to:-;ether with the Fijian Govern­

ment of Fiji in c.ttemptine t:J raise the s tanclarcls of the :;rad­

uates of the Central Nedcal Sch:)')l and has assif:ned two lectur­

ers there.)

Nakas1l, the villar;e we are [oinE: to survey is about seven

miles away on tho other side of the cay and it will take some em

a.'1C one hilf hours tO'make the crossine.

In the :Croac'. stern of the "'Yunimd ll .. m discuss the mat-

ters pertaininr:; to the campair:n. "He also try to catch fish b"'.r "

trollinG -- and a number of lines tr til the nVuniwai ". Fis hin,;

is a sort of perm2.nent lion the side" occupation here. ~','henever.

one cets ncar water one tries fishinG. Since it is impossible

to carry alonE a lot of tackle all the time, no one uses rod and

reel here. But ever;:'one carries a spool in his pocket with seV­

eral hunCTed yoxds of Fylon line ,lOund around it. Hooks, sinker

and bc.it are carriee, sdely in 1l sm"'-ll tin box. In this manner

one is ready for fishinG at a moment's notice.

jI:Je soon reach ••••

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We soon reach ~ shore of Nakasa and after ca.ref'ully ma­

neuvering .:throu.~ a small opening in tho conl.:·reef that ru.ns

along the entire coast we drop :::nc:lor c. fon hW1clrc.d ym'ds from

shore.

Our cinghy brings us to loti. thin a hundred yards of the

beach from lJmre 1-re wade through shallou "\'Jater until He reach dIy

land. '.i'here the "Turaga ni Koro" (village chief) and his reti­

nue are already awaiting us. After general handshaking and the

\Vords "Ni sa bula" ~~:re you well?") lVO are led to the village1s

meeting place. There the '1ura8a sits d01ffi on ono Side, his men

sitting behind him, while 1-1e sit just across from him. ~oJe i€1DI'O

the cha.:ilrs brcught for us and sit dmm cross-legged on the mats

just like the others. This gesture is apprec:ia ted by the Fijian

villagers and after a few minutes of complete silence, the Tu.ra­

ga givos a sign and the ceremony of \Volcome with the presentation

of Yanggona or Kava begins.

Yengeon~, or ll:ava, "s it is called, has a great traditio­

nal importance. The Turaga speaks "Tords of \-J clcollXl in Fijian

uhile his retinue murmurs agreement ffi1C~ clap their hands rhyth­

mically in sign of approval. Our oldest assistant medical prac­

ti tionar then 'fulks over to t.'w bundle of yanggona roots, puts

his hands on thClm as a sign of acceptance and speaks words of

thanks on our behalf.

After this is done, I addrQss t.llcm in English, explaining

the reason fo::: our coming.and expressing thG ,nsh that they might

got the greatest benefit from wh.:-.t lie arc going to do. AftGr th:is

ceremony, lfC begin our Hork. Our eqUipment is spread out on ta­

bles, and syringes and needles arc boiled. The villagors now

pass b0forG us, one faluly aftGr another, the eldGst of each

/family introducing •••

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family introducine each member of his clr.n or explaining the

whereabouts of those missine. The assistant medical practition­

ers nne; ti1e assis knt nurses fEl out personc.l data forms and 3Sk

qUGstions c.':out former £'.ttacks of :ra.ws, treatment received be­

fore J etc. 'i'ben each person unc'.ereoes physical eXCJ1lination 2..110.

a blood srunple is tclren at the next table. ;:!henever a c:::se of

clinicc.l yaws is diacnosec'" the patient is immediately given his

full treatment of penicillin in one shot. Some da}~ later, a

follow-up team will revisit the villcJ"e, trentin~ cases which

_vere diaGnosed to be sufferin:; from latent ya.TS accoroine; to the

outcome of the serolof:ico.l exwnination of the blooc~ sc.mples ta­

ken. One half of the latent cases and all persons who are appa­

rentl:r free of ~T2.WS are left untreated for control ::mrposes.This

method is emplo:'ed on1:T in the Pilot J<..rea.

DurinE! the colony-vride mass cnmpair:n which is to st~t in

a few weeks, everytod~r .vill receive treatment whether he suffers

from :raws or not.

'"/hile we are Horki.ne:, the Tur8.c;a sees to it that we have.

sufficient refreshments. Tea, fresh coconuts, bananas and papc.:. ...

yas e.re offered to the teaw. He notice a woman c~r:yin5 a chic­

ken to the Itcookinf. house". At",noon we t'..re invited to the Tura.,..

Cals b~& (Fijian hous~where we are served a fine meal of chic~

ken soup, chicken with taro, casse.va ::mcl verretables cooked ineo­

conut cream. It is a little difficult for mo to eat sittine

cross-le?:,~ec: on a mat and some of the ryo.vy falls on my shorts.

But the meal is c.elicious, nevertheless. ltJhile we eat, Sirls

stand behind l.:S chasinr tho flies away from the food with f~.m;

made from palm leaves. After a short rest, "18 fa back to work

until the sum has eone down.

/The day has been •••

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The day has been a typical one of the Yalffl Control Cam-

paign in th: Fiji Islands. Many cases of yaws lIers found. Somo

persons suffering from painful "wet crabya.vs" could hardly walk.

They used a stick or fastened pieces of coconut shell under

th;,:ir painfuJ soles of their feet to prevent them from touching

the ground.

vIc saii many children cov.::red with the typical papillomata

lih:'_ch gives yaws its scientific name of framboesia (th3 rastberr:v

disccwe). These forms of yat-TS react drar.Jatically to penicillin

treatment. In one villaEe the chief told us that most of the

persons liho '\-lere unable to walk when we first tr'.ated them walked

painlessl~' the following morning.

After canpleting our work and storing our equipment wo go

back to ilie shore and get aboard thJ "Vuniwai /I. Tho entire vil­

h,gc accompanies us and 1-Tades with us to whore too dinghy is

waiting. They present us with fruits, beautiful shells and

seastars, ','hich troy drop into the dinghy as tokens of their

appreciation.

The; Kord IIVinaka", nVinalca" (thanks, thanks) is heard ma­

ny times. Then as our dinghy pulls nHe.:r, the y wave farewell un­

til the liVunil,ai" ;:;'is appears in the '-,istance on its way to C'.no­

thor village.

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Iy EVELYN MATHE-SON

AB YOt' talk, you study your sixteen listeners some.

olive sldIUled, sQme a . .cocoa brown, all with the dark, in-erest­

ing eyes of the Ea.st and you wonder - l'Wby am I here - what am

I accomplishing - am Lmeating the needs of these students of

the School of NurSing, Sandakan, North Borneo?" Your eyes tl'a1el

from face to face. Yun Fah is looking at you quizzically, Paul

is inElJ..'Plicably amused, Winnie has "lost" you, Mary Jane I s mis­

chievous ~winkling eyes look directly into yo~, Susie looks

t:ired and appears lost in cDntemplation of the landscape, Han is

obviously bored, Boniface appe~s intent on catching your every

word .and George •••• George answers the __ question which you have

just asked yQUl'self __ Georgets puzzled, anxious, eager expression

tells you that you are here because you are needed, that you are

contributing towards the deyelopment of his knowledge,~_skLDB,

his per.sonaJity- and you realize that you are doing the same for

his cla.ssmates.

/Who is George? •••

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vJho is Georee? He tells his story much more effectively

than can this writer:

"!\ly full nrune is Gcoree Labaclin. My race is Dusun. My

father I s neme is Sabirrlil. By mother WOoS dead in 1944. I

have Got me.ny brothers and sisters, we are nine in all. I

have sot three sisters and we brothers six uut one of my sis­

ter was dead in 1949 and also one brgther wes dead in 2Jrd of

June 1954. I am one of my father's youneester son and I

am the only have cot school. But in case that my father can­

not afford me futher school, I passed only secondary one. Af­

ter tha..:b, my father ordered me to find job and first of all I

have to do is to obey my father I s will. Host of all I

like to be this job as Probationer Dresser. I was apply in

14th July 1954 and ",as ap9roved end Matron baa send me in Hos­

pitel Jesselton to be Medical examination. After that, I

received a letter and from thet I know that I was accepted to

be a Probationer Dresser. I went to start in 3rcl of January

1955 and there I had caxried a bedpan and bedmakinc for one

1.eek. After that, I heaxd that I have trunsfere to this p1:lce,

Sandakan~ therefore, I have two c:ays holiday to wishing good­

bye to In;,r beloved father, brothers anc~ sisters. I am very

sorry to have part from them, but in ny Hatron, will I must

obey. l1y hocby is pla;rine: football. I like to joint this

service because I 1-mnt to lC2.rn medicine and hospital usinG.

I will try to (,Gscribe my home IIk=ponc ll • Now to beCiro

Penampan::- is .ny home k=ponf.. The people there in Penampang

are farmers. They livec: in villaGes~ and do their own works l

as cultivate the 1r-.nds, usine plOUGh nne: ouffa10es bccL'.use no

machine to:)l to do this. lmen the pac:dy Grown up and ripe,

they garther the seeds, in doinr; this they used knife to cut

/pnc~dy .•••

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paddy.

I lived in a small house,

also have big building church.

\uth my father. Penampang

This church was made of oon-

oret and stained a white colour. There is ~ school, too.

But this school Nas made of planks rud its roof was zinc. I

have beon studied in this school for the period of seven

years.

It was a very nice town in Pcnampang. Hany people there

are working for the Govornment. They mc.ke "Ro(l.d p!:ogresa".

The Government imports rubber to other country a."J.d tr~

:from other transport fran other country and sorne other thing!.

The people who were 1i v:J.ng too re .tere many kinds. Sana of

them I know: Dusun are toore in groups to produce paddy and

Malay, Bajaus for fishingmen, Chinese for merchants and

r.nglishmen. The CXluntry was governed by the English people.

I only describe the place which I actually knmi. I have

no nore to write. I am very sorry that I don't know hOlf to

,.jrite correct &lglish. I .. rould like to ask pardon of~ gram­

matical English. I em very low education."

This is George - George, 1.ho, with his classmates, is be­

ing prepared to J7\eot the health ~eods of his country - a country

of apprOximately 400,000 people, of 29,388 squarc miles, which

is largely covered by dense forest, has central mountain ranges

traversed by valleys and occasional plaioc and t-rn3rc an exten­

sive system of rivers ::;:oVides too only highways in many parts

of the country.

The needs of Geor go's countrymen are described by 2. fel­

low Dusun student dresser:

jll!oly purpose of •••••

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"Ny purpose of becorainr; a (.resser is to be under the con­

trol of doctors who c.re fishtins 1:'.;~;ainst dise1:'.se. Unfortun­

ately" illness ene: diaease 1:'.re very common ae;ainst us. Lvory­

e\a~rl in every land" people e.re sufferine from many kind of

illness. Disease is much less common than it used to 'oo-t

we live in ~J€tter houses than the people of lone; aeo and we

ect better food then they did. l-Je e.re more careful about

clean clothes ane: cleem bodies the.n they used to be. These

things have helped to ree:uce the amount of sickness in the

world. But, even nowadays, people who are icnorant, me~ of

them believed th1'.t ma"ic would cure their illness. 8specially

in my villw;e called Kinuta, When a man is sufferinE from any

disease, he "oes to 11 witch or to 11 wizard e.nd he is E'.ive me­

cicine mac~e up of all sorts of unusual thinpsJ even such

thin[;s as snakes' skin and the hair of mice. '.r!hile he is

c~rinkinf: itJ he has to pronounce certe.in words. They do not

understcnd, they are afraid. Their fear is led them to put

their trust in_useless macic. As I am the first ('_rossor from

KeIl1pons Kinuta" I must my bost to study hard so that one day

1ihen I ~:ecome a senior staff I may be able to viSit the peo-

pIe in Kinuta 11nc~ ter..ch them the vmnderful works

tors ane: perhaps they will believe it anc: (,ecide

of the doc-

to send

their chil(~ren to s cho'Jl to s tUl~~r their personal lives also."

To prepare him for the role th2_t is to be his, Georce is

enrolled in the basic nursin- ec~ucation prOENlll1ll1e in Sandake.n.

This pro.c:rClmme is 1)2in~ conducted b;y the Government with the

2.Ssistance of a "JI-lO nursinc: education team. It was one of the

members of this team who was askin~: herself - Ills it worthWhile?

Is the job beinc done?tI

/Tha problems •••••

-14-

The problems encountered in corxluct:ing such a programe

arc many: shortage of trained personnel :in all departments, in

all agencies; shortage of equipment and supplies. students who,

like Goorgc, have poor basic educational backgrounds; the many

difficulties of a country that is but starting to recover from

the extensive darrage of Vlorld Ivar II. Houover, it is recogni:!lCi

that no assistance is too great, no job :Ls so small that it does

not make a contribution, no effort una~prGcia ted when George

writes:

III 0J!l very sorry to learned from some of my friends that

that you are go ing home. If you are go ing home, thon uho is

going to taka your place to -ce.:?ch us? I think we all stu­

dents lilcci your teaching and advice. I like you very muc h

to teach us, Sisters, but if you are going, what can be

help. '.Ie thank yru very much for your goed teaching and.

advico tOHards us. I dare to write ;you this poor and simple

English to lot you know about my opinion tOl1ards you becalm

I knou very much that you arc kindly sisters whom I never

mot since m:r life. I knoh' very little knowledge because my

father did not prolong my study on account of lack of money,

but I 1.'2.11 try very !:luch to study and do hope to lm01i li tt:lJ::

more experience abO'.1 t this job. Hillions of thanks for uhat

you did toward poor G_orge. mllions of thanks for you, for

your kindness toward all studonts. God may bless you and

on the way to your home."

One's efforts are mado Horth"hile by the very worth of

Goorge and all otmrs like him.

-15-

.~'

...

1

HOW MANY TIMES HAVE

YOU BEEN POLITE TODAY?

Dr. ~NTON GESER

For the lest three years I have spent my life among the

Chilc'.ren of Asia, first in carryine out BCG vaccination campaiGIlfl

ane durinG' the past year as lead.er of the WHO/UNIC:GF Assessment

Team.

The BeG l.asessment Team with which I am connected has as

its main purpose to map the frequency of t~berculosis and to

measure the response of chilGren to BCG vaccination. Hy teem,

which was composed of two Danish nUJ."ses, Hiss ::::Va Friis and

lirs. R. Ecemose-Nielsen, myself I plus the national counterparts

(of each country) worked in Indonesia, Notth Taiwan and certain

parts of Cambodia, Vietnam and the Philippines, All tocether

we examined and vaccina -ted some 50,000 child1'en.

I am not coine to give you our scientific findines. Our

assessl1lallt and whatever we coulc~ contribute to BCG work will all

be carefully written in a report .Thich will be made available by

WHO to those technicians who are interested in our findin.:;s.

This short story is to tell you about my impression of

the children we have been in contact with in Asia. They are

children that I will never foreet for their lova1..::le qualities,

/their couraee and •••••

-16-

their courage and their beautiful attitude toward life. Day

after day as they linec1 up for their injections I h""d the oppor­

tunity to admire their ense and cOP~idence.

The aEe did not matter. vlliether they were trree or five l or sevenJ when the time came for the injections they would

courteously raise one of their arms wi thou t the slichtos t pro­

test nnd without crying. In many c<'.5cs) they smiled as if to

sa~r I hope I run not f:ivinC you too much trouble. That was

in contrast with the children of :c urope who" C:urinr: the mc:ss

campai[}1B" were seen turninc pale) c;roppinC ou·\:' of the line and

some times faintinG for a moment.

You m<:.y think that perhaps this lack of fear for injec­

tions amonc; Lsiatic chilc'cren mi::ht be due to the fact that in

::urope chil(~ren knov, whnt to expect. But· thD.t is not so. In

many of the schools testec1 by the Lssessment Terun in Asia, as

many as from four to six injections ,,;ere siven to the srune child

at different perioc$. That s~e child did not chanr.e its atti­

tude after the first and subsequent injections.

The Team also o'Jtained ac~ditional evidence of the relaxed

minds of the happy lookinc children in these tropicat countries

when the vaccination work was occaSionally carried out in class­

rooms where the teacher, after a friendly smile of welcome, often

woule continue teachin~ with the full attention of her pupils

w~i1e the intruders went ~lonc their business in a corner of the

class.

One of the thincs I c~nnot forcet and perhaps may sive

you a clue fo~ understandins the attitude of these children and

on the national char~cter of the people is what I was able to

see nne hear curine my visits to Filipino schools. Time and

/acain I overheard ••••

-17-

1'1

again I averreard the teacher ask her pupil: "How many times

have you been polite today?" And the boys and girls would

enthusiastically r1lise tmir hands to reply proudly: IlMany times,

I have been polite today."

In this gr cceful atti tude of the happy, uninhibited ani

all 1 d hildr b I t the question, "'.Thy natur y re axe c en may e a c ue 0 ..

didn't they faint?" .And at the same time also the answer to

the problem of why psycho-neurosis and other minor men tal dis­

turbances, so frequent in tomperate overstressed ccuntries, arc

rare in at least rural dis tricts in Asia.

-18-

rrty W~ Ltt

ft¢N~ ~<>N~' by BETTY ALl

To the tOU1'ist~ Hon;:konc: will rc,·~,dn a memorable picture

of a modern city, a very busy port, overflowine with people (it

has an estimated population of 2,300,000 persons with a density

of over 2,000 persons per square mile in some places), with

shops overflowine with every :ilnn[ine.~.)le ware, with flowerine

trees ane' beautiful temples. One never foreets the ricksha

boys in the streets, the boats, fishinr: junks and sampans ~

its ~ictU1'esque harbor with the mountains in tho backproun~

Nobody who has stayed in Honckone for more than a day will for­

eet the industry of its people ••• and its vitality as a city.

As a health worker, who arrived in this city in 11arch

of 1954, on an assir:nment as a public hee.lth nurse of the World

Hce.lth Orp,anize.tion, to help the Government in its maternal and

child health prosramme, I have come to know e~other Honf,kone

also. The Honekone of the pe.tient Chinese who sits on tho

pavement all day and sloops there by nicht, of the boy with

lean face ane! the scrawny body with a rackinG cough, of the.

mother in dirty rae:s holc:inr~ a baby WTe."?ped in a filthy cloth,

of tho berr[;ar who is found in almost every street corner. It

is that HonEkone the:. t has bee orne a par t of my daily life.... and

/has revealed to me •••

-19-

haa reveel.ed to me that like:my other overcrowc!ed city in the.

world, it has its share of pro:'lems arisine from poverty, ienor­

ance anc: ill-heaUh.

I beran my work in Honekone by conductine a survey o:f its

maternal and chile health facilities and proeramme. For :four

monthel with the assistence of Dr. S. Y. Cheng ane Hiss H. Chow

of the HeclicaJ. anc', Health Services of Hon::konCI I visited aJJnost

every nook and corner of the cit~', [ntherinc the information I

neGued, availin!: myself of all times o:f the excellent cooper2.tim

of the various covernment a~~encies whose work had somethine to eb

with mine.

The result o:f the survey showed the creat effort of the

Gove:'nrnent in the promotion of me.ternal Mel child health end

welfare. It also confirmed~ however, the many difficulties

which it faced.which I had been told about earlier, like its

l::.c!: of suffici::nt s k.fi r.n': the o7ercJ:oToK~e<l conc'i tions o:f its

health centres l hospitals end dispensaries. It made me realize

that the work still to be done to improve the health of mothers

anC. chilc:ren in Honckone was enormous inclose:.

In accordance with a plan of action prepared by the

Government with the advice of the 1-Torld Health Or£anization,

work in two selected health centres was started which made these

centres the focal points of an educational and demonstration

proGramme, the teaching of covernment personnel ~nd private

practitioners~ the e~ucation of parents in the basic principles

of self-care nne child care and the stimulation of community

interost and participation in the Government's mnternal and

chile hedth prosremme.

For four da~~ a week~ I alternate between these two health

/centres tryinG to •••

-20-

.,J I

.. ~

.. -~-• 1

1

.... .,.-

..

centres tI"',ling to share with my fellow workers of the local

health services my experiences ani knowledge in order that we

may be able to demonstrate and teach to an ever growing number

of people the modern methods of maternal and child care within

the re~ources of Hongkong and suitable to its cultural back­

gllound •

The work is far from being easy. There are so many thing!

to do, all of them needing i.rnm:ldiate attontion that I wish every

now and then that there were 48 hours in a day and 10 days to a

l.eek and that I had trIO pairs of hands. One day, my concern

is to devise ways and means as to hOi-; tm records of examina.­

tions made at ante-natal clinics can be kept accurate and ~

Another day, I am busy lecturing to a group of staff members of

the health centres as part of the in-service training programme

on maternal and child health. Then, there are the weekly infant

welfare anI mothercraf't sessions which I help to organize.

These sessions are one of tho most important phases of the work

in maternal and child hGaJ. th for the belief in certain cus toms

and tho lack of basic knOivledge on mother and child care contri­

bute greatly to the significant number of deaths and illness

among them. Tho many dialects of the refugees require us to

plan lessons in picblros in order that the work move on and tre

mothers understand.

There are many phases to my _"ark. For instance, some

times before I give a lecture I feel forced to go to one of the

local markets to learn first hand the prices of vegetables

and fruits and other fruits so that I can recommend what the wo­

men should buy in view of their limited purchasing power.

\Vhen after a hard day!s work I go to bed, it is a rare

/night indeed that I .•.•

-21-

night indGed_ that I do not see ... ,he tired faces that Lhave met

dUl'ing the course __ of my work p~u'ade befor e my eyes. Ea.ch face

is a challenge,. and it gives me a certain feeling of ·satisfac~

tian to mow that I am doing my share to help improve theu

health.

-22-

.. I

.' ,

..

~ DR. OLAV IOSOE

The day had been hot and dusty Old we were tirod. It was

rather late in the afternoon ani we wore looking forward to tak­

ing a shower, haVing a good [ilGal o.nd a night1s rest ill a cool

Japanese-styled hotel.

My national counterpart and I were on a trip in the west­

ern part of Tail-J-aIl for the purpose of inspecting the vemreal di­

sease control "lork being carried out at ·~hc various Health sta­

tions in that region. Vie had had some encouragement and some

disappoirrtIoonts. Some of the stations had already established a

well-working venereal disease control service and the personnel

had demonstrated great interest in the new project which the Go­

vernment had initiated to improve and strengthen the health of

the people. Some of tt.e stations had met With a number of dii'­

ficul ties, others lacked enthusililBm.

Now, the re was only one moru station left in our list. It

was si1oun-ood at some distance up jn a mountain area, and served

a mountain tribal population. The road was bad :md although

none of us said it, I think We all folt the SaDIO and expressed

one ldsh: "I shall be glad woon we are on too way dwn., I am

sure that this particular station will mot show any remarkable

accomplishments ." We sat in the station wagon in silence, kepi;

/thewindows tight •.••••••

the .. 'i.ndows tight to protect us P.g2inSt. the dust and could not

really enjoy the wonderfUl scenery we passed'~long our w~y.

lIB we reached the her.lth st2tion, the doctor :md the ptb­

lic hefl~th nurses welcql1ed us outside the door. I iJnmediately

recognized the doctOl! pS having c'ltten:l.ed ane of our: trcining

COUllSes. I pl'!rticuJE.rly renember.ed him becl'!use even at tht'.t 11:16

I had my doubts about him. He Nas .::'.b-::ut sixty years of age,

short and slba. He always ha.d a cigarette hanging from the left

side of lUs mouth, the slde "Whi~h dropped dONn a bit. He . Hore

spectacle s • 1clliile co nduc ting the course. La.lways remember him

sitting down find listening to me with a strpnge dr~ smile.

I was .. never able to decide what he thought of the COUl1se • • ifuether it was so much nonsenae unworthy of r.eceiving much at-

tention, Hhether I was just p fumy individua~, or whether. he

really enjoyed our. course. Sometimes he closed his .. ojEls as if

to truce a short nap, but he always kept his Mona Lisa smile.

I ree~ly did not expect very much at this station. He had

not received .. advl1nce notice .. of our arriv;u, so I wondered what

he would hnve to show. us about his 'Tork. l.fter. we t!rrivod

there were the •. excilange of polite greetings so chara.cter~tic of

the Chinese, nn approach which makes life more ple2sant. vIe

s tapped imide the heplth station and my firs.t surprise was to

see the ne!~t mld apotlessly clean office. Tea was brought in ..

I1y counterp.:>l't clr~ttered ond joked with the doctor and his nurse,

.for lJlY caunterppxt ruWl'yB. lmows when to joke. ."nd when to .. be ser­

ious. He took his tim:3 A.S he flJways does :md I spt patiently

and wldted the next turn. At laa.t ,Ie were 2sked to go into the

consulting r.oom. It WI'.5 clep.n and orderly p~though the equip-

ment Wl'.5 scpnt. But the instruments they did have were clel'n

jl'nd neatly placed ••

-24-

-- ""'"": ; I

T

and neatly placed on· shelves. The examination table was very old

and out of date, but it too had been very well washed. Even the

papers on his desk were arranged neatly.

Then he produced his records and I was_ most. pleasantly

surprised. There they were, complete in every detail, showing

the result of examinations, skin tests, treatments. "iliat was

still more important and the thing W3 Yiere looldng for rlere the

records of family contacts of the infected per sons were to be fa],.

lowed UP. and examined. These records were so well kep"\:. that they

might have served as model. Uy counterpart began to cross exa­

mine him ••• why did he do that ••• what 'Tas the result of that •••

why did he not treat this case •.• why did he not treat that oiber

c.:l.Sa... And the old doctor, vhom I had suspected of hal.f sleep­

ing through our training course was a match for all of my coun­

terpart's q,testions. He explained his <:rJ.swers with gesttres, and

tiith our mimeograp-lwd manual on VD control methods which he kept

on his desk, pointed to this and the other sentence lmich he had

underlined. He had euccGGded in giving blooe examinations to

all pregnant WOJ!len in the villaee and hQd even traced some sour­

ces of infection from a nearby to,n. The doctor's nurse who had.

als 0 attended our crurse, ~Tas just as eager and well informed.

There was no doubt that this doctor and his nurso "ero putting

into practice eVerything 1'1'0 had taught them. I could not have

felt happier than to seo this result of our work. vJhatever dis­

apyointmcnts I had suffered melted away on that day. Hare, in

an isolated area in Talwan, among mountain tribes, uas the liv:ing

embodiment of people l,ho had made our efforts in Taiwan worth­

Hhile. Probably, the old doctor had been rlOrking in th£.t lonely

village fo:!" many, many years after his graduation from medical

school, idthout tho benefit of being able to absorb now medical

/knowledgo a~d technicues •••

-25-

lmowledge and techniques. Medical literature was expensive and

rare, the world has undergone a.medical revolution with poni­

cillin, the other antibiotics, ather drugs and new techniques~

while he sat in his .. li ttle village far away from it all. Maybe

this.Doctor has always been looking for something more than the

IIcurativell aspect of medicine.

Now a public health conscioos GoveI'IllOOnt got things ml4V­

ing, and with the aid of the United Nations Children's Fund and

the ~orld Health Organizatio~.had opened new ho~zons for such

men and women as this doctor and his nurse. Laboratories wi;th

modern equipmflnt had been established for the serVice of IOOdical

personnel to assist in diagnosis, •. equipment and supplies for

treatment facilities had been made available and technical laww­

ledge had been offelled through international experts. This doc­

tor and his nursa had received it all with open arms. They had

utilized well what had been offered them in their small communi­

ty in the mountains.

Through these two persons I began to aee a... dreal.1l. come

true. Up .. there a tree had been planted. Many hands assisted

in the planting. The .. tree had been placed in good soil. It

would cartainly • .graw and grow for many years after w£1 had JAt'.t

the island of Taiwan 2nd after we had been forgotten as individ-

uals.

OUr work had been fin:iBhed. Vie SI'.id goodb¥e to the d.Qo"

tor 2nd his nurse. 11. few . .minutas later mycoW1terpart and I:were

on the way down the mountain road. The sun . .was 'OOginning to set..

Lcould sse the mountains, the trees" the lakes and the streams

painted in that wonder.fu1 hue of colors one sees in the :tropics.

n. all looked very be2.utiful. It had turned out to be a happy

day.

-26-

'. -

NELSON G. HAIRSTON

- . . -_. _. 0"-

- -~ ~ .":'-::

-.:. ~ -. -~ -

Theoretically, controlling schis-i;.osomiasiB is easy. Since

tho parasi to must have a particular kind of snail to complete ita

life cycle, eradication of th& snail .. lOuld mean eradication at:

tho disease and there aro chc~p, cOllJIllOreially available chemicals

that .. lill ldll snails ~lhen applied in tho low rate ot: 1 kilogram

per 100 square metors. vmy then can't we simpJy go ahead and

buy enough chemical and kiD. all of the snails in Layte? One

answer is that even t:.hough the chemic.il. is cheap the aroa inhab­

ited by snails is very large. Ii'or example, in Pr,lo, 1-m.ere all

of the snail inhabited areas are known, about 1/13th of the total

aroa 1-lOuld havo to be treated with the chGJllical. Ii' this figure.

is representative, about 200 square kilometers of land would re­

quire treatment in Loyto alone, entailing an expam e at: well ov­

er half a million pesos t:or chemicals. This figure does not in­

clude too painstaldng and highly technical job of .t':lJJding all

/snail habitats ••

-2:7-

BUil habitats nor the l:,bour of. aI'pljdng the chemical. A second

and importC'nt drawb"ck is .the .:t.:"lCt that the chemical inter1'el!es

Wi th the growth of rice pU'.n ts ~1')j about 1/2 of the snails are

in places whe..re rice is cultivp.-ted aither continuously or once

t: .•• year. Firullly, nnt cll the snails are killed and the survi'Uls

can repopulate the area within a few . .months.

'WOuld not be once but severr>.l times a yep.r.

The expense then

Our job in ~.lo is to find a way out of the dilemrl'.a. We

are trying to discover the lLUlnerablc spots in..the transmission

of schistosnmiasis so that ~dva.ntages caIl be t?ken of them in.tams

of a National Control Progrrunrne. This requires 1'.n unbelie..vable

amount of information. Surveys bP.ve to be peJ:!formed so that we

con know the extent of .. the disease and the dmnage done. to the

peopJa. This a.gr>in maans that we must __ be able to separate the

effect of schistosomiasis. from that caused by ather diseases,.

hookworm, tuberculosis and malnutrition for exa.mple. This in­

volves the habits ?nd agricultun.l p1'?ctices of •. the .. peopla and

this in tu.rn their social .and economic status, all C'. series of

widening circles of information concerning the hU!1l".n host.. But

E.~:l :iJ: .. not tl:0 0:'.11 source of infection. Domestic animals and

wild ra.ts c?rry the disep.se C'nd our sunreys include information

on theae reservoir hosts" as they are c~led. The impo.rtanc.e of

i.hese aniJnala will mve 'm effect upon the success 01' 2!ly sanit­

ation that ma.y be carr ied out.

Concerning the snails, we are trying to find out· when

I'M where they.: p.r.e most likely to be infected and hence when the

conditions that make them more or. less. dangerous. Since chemical

control costs too much~ some practical method .. of eradication

needs to be fiOWld. l-J.hat do they need.. and how can we •. depr:i..ve

them of it? Here we 1'.1'e trying to learn to think like a snail

I ani the mas t •••••

-28-

and the most detailed information concerning their distribution,

life history and habits is being collected. To evaluate all of

tho information, detailed maps are essential and we have on ocx:a­

sian resorted to aeriaJ. photogralils as well as maps of our 01m

engineers. What have we faun:!. so far? We knou how many people

are infected and the age when they becomo infected, in an area or intense transmission such as Palo, Lcyte. He are fairly certain

that aani tary moasur es will decrease the infection in snails,

reducing the chances of thJ parasite. We know that "the snails

are sensitivo to any disturbance of their habitat, whether thru

removal of vegetation at' whether through plmdng of the rice

fields ~ vIe have made a start towards an understandi. ng of what

Bet of conditions make for the transmission of the disease both

to people and to snails. Our chn.nces of success in this project

are greatly incroased by two factors. Tho first of this is the

goodwill and friondliness of tho peoplQ of Loyte, vmo have given

splendid cooperation to all of our roquests many of vlhich must

seem very peculiar to tmm. The soco;xi factor is the presence

of the alert, enthusiastic and 'Hell trained staff of the Divis­

ion of Schistosomiasis of tho Department of Health of the Phil:lp­

pines, tre tochnicians, helpers and supervisors, '-'Tho actually do

the work of the project. vTithout tho roliable results that they

obtain daily, the project could not possibly succeed.

lTe do not have any final answers yet, but ole are learning

to ask "tin right ques tions. 7horo ma;;r not be ansHers to s orne of

them but vIe are certain t.lJ.at the information that is piling up

v7i11 eventUally be v.il.. uable in establiShing control methods be­

cause HO havo started where ue must - at the bottom.

-29-

..

~#er~rs/n? Edvct2hOh

b~ WILHElMINA VISSCHER

In December 1951, two nurses of the l'iorld Health OrBaniza..,

tion went to Cambodia as the first members of a nursinB e duc a..."

tion team to assist the Government iu.estaJlishine a basic nurs­

inG and midwifery education proeramme.

As. you know, Carr.bodia is one of the three states of Indo­

China and is situated between Thailand and Vietnam.

It has a population of four milJion people of which 600;00

are livinB in Phnom-Penh, the capital. The relieion of Cambodia

is for the treater part Buddhism and it is a colourfUl picture

to see the monks in their bri[,ht yollow habits walkine one after

the other when they lee.ve the temple.

The main river which runs through Phnom-Penh is the Mek­

one. One brrnch is cdled Tonle' Se.p. At the chane'e of see.sons

from the wet to the dry the Tonle' Sap clk".nees its current and

great water festivals are held. For two or throe days boat ra­

ces in old fashioned boats 0allec piroques) take place. The days

are finished with national de.nces, performec: by the dencine ci.:da

at the RoyaL Palace and we are usually invited to attend these

/festivi ties •••

-30-

festivities.

The national costume for the women is a jacket and a sam­

pot (skirt) and these are worn 9Y those men mlo have not yet ta­

ken to Hearing western clothing.

The working class women wear a towel round the head for

protection from the sun. This. towel is often used for all kinda

of purposes, e.g., shopping bags, baby hammock, cleaning towel,

e~. ~

Life is. peaceful and ea_s~ going tor the .. Cambodiana and

their needs are . .few... The normnL temperature varies from 30-33

degrees contigrade and the prOVision of clothing for children ;I.s

not a problem. One can see many children running abru t as na­

ture has made them. Rice is a staple food and the Mekong River

provides enough fish.

Most at the education in the pasz has been given by the

bonses, who are the. Buddhist rriests" and only boys were .. allowed

to attend classes at thll.t..t:iJne. Education for girls was not

thought to be JZ:ery necess1'.ry. Some changes .. have taken place'l

girls are now attending the public schools and unde~ the 1aAder­

ahip of a..few educated ones, women have begun to participate in

a very small nn asure in community affairs.

The infant mortclity rate .. is very high and it is not unus­

ual tn bave mothers tell..you that from the 10 to 12 children she

has had, only a few are alive.

The Goven:unent realizes the necessity for improving Lhe.

health of the na.tion. This will require ~,.urses who will be cap­

able of a.ssisting the mothers <>nd children to keep well.

Two Cambodian nurses, one male am one female, were as-

fsigned as national ••

-31-~-

•

signed as national counterparts to thG Horld Health Organization

nurses. lve started to war k with them in an informal way ani

slowly introduced them to tl:e con::ept of modern nursing. A

health centre called a "dispensaire" whioh gives out-patient SEr­

vice was made available by tro Government to be usod as a demon­

stration centre for all public heclth actiVities.

-~ell baby and pre-natal clinics were started. The nursos

.rere given a special course in public health and home visits !-me

started. Hore than a hundred pcti.ents ca~ in daily to seo the

"0i'ficiJr de Sante" who is 11 loccl1.y trained doctor. The popula­

tion do not oonsider him a good doctor if he does not prescribe

at least ono injection of some kind .. so every patient receives

an injection.

1,VO learned to ImoH tm people in their homes and tho dif­

ficulties they had. The Cambodi<m people like to make you happy"

and all qmst.ions are ansi'rered with 1fyesll as t!1C:' do not like .to

disagree with you. Negative questions cun never be asked for

they .. 'ill answer llyes" E,nd you are s·dll as puzzled as you 'trcre

before.

The giving away and adoption of babies are common practices

and are treated vcrJ' casualJ,y by all concerned. A mother will

tell us fuat the baby is not groliing too well. . After we have

heard that she does not nurse 'her baby, thc value of breast feed­

ing is .explained. She listens very patimtly. After the expla­

nation has gone on far 10 rnJ_nutes, HO then discover that the ba­

by is not her own be.by but ".as been adopted from one of her

neighbours.

In the hospital we . assisted \·ii th the opening of a child­

renl S lVard and fue nurses had to be trained to care for the ba­

bies. !Nursing as it is .•.•.•.

-32-

Nursins as it is known in most countries has been unknown

in Cambodia in. the p2.St. TreC\tJnent as prescribed by the doctor

woule: be Given, but the actual beclsicle nursinc care W1'.S left to

the relatives. They wouIe: sae th1'.t the pe:t.ient -eras mac~e comfor­

table ane: l<JC::ulc' i-mah him, if they felt it to be necess2ry.

The patient W2,S tr.ken to the hospital as a last resort.

Hany methoc:s of curine the patient such 2S elrinkin:: a concoction

of different herbs or the ac'ministration of other unknown mecic ..

ines were first taken, so that by the time the patient was admi~

ted, he was often in a c ri tical condition.

Slowly tr.e people have bE;;un to re2JJ ~e that the has pi tal

is there to help them~:et better.

The nurses have been taucht how to cure for the babies"

how to bathe them, how to prepare the feedincs and how to feed

them. They have leurnec' that milk should be civen to thE. bnby

after it he.s been heated, anc: that the hot water bottle should

be placec_ next to the premature baty rather than on top of the

child. The mothers now have confidence in the hos)itd st~.ff.

The 1;';orlc: Health Orc;Ocnization nursinr team has Crown ancl

now consis ts of 4 nur s inC r.nd mic:1Jifery ec~ucZ\ tors. 3ach of us

has 1'. national counterpart, .. lho works "With us J who Will erac:uill.;y,

assume. more and more resI'onsibility for the procrmnme. At pres­

ent pre-fabricatec~ '.::uilc~incs are servin::; as school '.::uilc;ings 9-nd

a b2.sic nursin:; course is 'cein,: ,~ivcn to 13 selectee: s tuclents.

vlith the assisto.nce of ;iInerican fun~ls, a nursinG school is

beinG :.:uil t.

Teachin:: materials have already arrived. He hope that the

status of nursin,: in Cmnboda will be raisec anc~ thRt better ed­

ucatec' "irIs anl: '.::oys will :Je attractec1 to tc:ke up nursinG.

jIn July this year ••••

-33-

I I

I I

--""'! I I

I I

I I

...

In July tl-J.s year two of our male nurses attended the

'florId Health Organization Nursing Seminar ,·:hich was held in Fiji...

Their meeting ,dth tho delegates from nineteen other countr:IDs

provided an opportunity for thcao nurses!:,o acquire a wider ap­

preciation and knowledge of tlw philosophy, policies and practi­

ces of prcsent-day nursing.

1fe do hope that viith the assistance of the \'iorl<i Ho31.th

Organization, Cambodian nurses ,rill one day be able to taka their

right place in the ranks of tID nursing profession.

-34-

•

•

b~ DR. DONAtO J. PlETSCH

As a malaria specialist 'lith the vlorlcl Health Or:::a.nization

it has been my privileee to participate in the malaria era~ation

proje9t now [oine forward in the Province of TaiwanJ Republic of

China. The proeress achieved in that proGTamme has resulted

from painstakineJ sustained effort on the part of many people.

The 700,000 houses shelterine five and one-half million people in

Taiwan 1 s malarious areas have been trcQted, one by one, with a

residual sprayinG of DDT. 1,';e expect that malaria will soon :;0-

come a medical oc'dity in Taiwan, anc: this unusual achievement wiJ1

mark the cl~ax of an international cooperation which beean some

elent years o.Eo.

Durin~ the period from 1946 to 1949 the Rcckci'ollcr Foun­

dation sent several malaria experts to Tf'.it.an, and undertook the

c~ifl'icult task of trr.ininc local personnel for the chrJ.lcneinc

battle a[:ainst the spectre of malaria. The private lives of 10.",.

cal ~oP~f).:J..o.! mosquitoes lVere iITVD.ded to find points of weakness ....

PhYSicians were trdned to me<lsure the nmount of malaria by feel­

inE: the spleens of school chilcxen ane: adults. Blood i;echnici<lJlS

le2,rned to (~etect ane', identi.fy the ipsi.dious malaria parasites

lin blooe: smears •••

-35-

in blood smears from persons throughout the island. An able and

enthusiastic cadre of malaria fiellters began to appear, and the·

Chinese government gave encouraeement by establishing the Taiwan

Provincial Malaria Research Institute.

The Rocketeller Foundation completed its local training

efforts in 1949 but financed the several physicians in advanced

malaria studies in the United States. But there was no hope of

:iJnmediate large scale attack on the problem in Taiwan, and the.

workers in the newly established Malaria Institute could onlyre­

main at their microscopes and dream of a t.iz:le when their lmow ....

ledge cuuld free their people from the. onciont curse of malaria.

Even the machinery for a DDT plant, donated by UNRR.A. went unused

for lack of a specific plan and adequate financing. At this

state, a Chinese-American organization, the Joint Commission for

Rural Reconstruction, recognized the urgency of malaria control

in Taiwan, and kept alive the new-born Malaria Institute. Funds

were advanced for the trainine of anti-malaria technicians in-the

local health stations which were bein8 established throughout

Taiwan.

By late 1951 the unsolved malaria problem had become in­

creasingly conspicuous and the untapped resources in the Malaria

Institute were cryine for exploitation. The Chinese Government

therefore embarked on an island-Iude malaria eradication project.

The World Health Organi:1.ation was invited to send three malaria

specialists to work with the local personnel. A bilateral agree ..

ment wi th the United States made DDT, sprayers and vehicles aV­

ailable for the all-out fir.ht. The Provincial GoveJ'Tll11.ent or Tai ...

wan contributed local funds, and indiVidual townships in malar­

ious areasaC the island gladly offered one New Taiwan dollar per

capita to defray labor and other costs of the campaign. The

/handful of physicians ••

-36-

handful or physicians and technicians in the Malaria Institute

was obviously inadequate to undertake the spraying operations for

five and one-half million people, so the foremen and spraymen of

cach township's spraying squads were recruitod in the individual

communities and trained for the battle to protect their neighbaE

and thellL$elvas. The response of the people l.as so onthusiastic

that the extension of the .rork to all malarious areas of the is­

lam was accomplished during the third year of field operations •

. Detailed studies of the ma.laria-ca.rrying mosCluitoes, and of the

malari/!. parasites in the blood of children o.nd adults have rem­

oved any dcubt as to the succesS of the programme. No one ,rould

now Give the sl ightest thought to interruption of the work al­

ready started, until malaria has disappeared from every field and

mountain of Taiwan. But those who look back in later years on

this fasCinating story of rnm l s conquest agains t disease m8¥ well

wonder which was the more unusual feature of the campaign -- the

technical and SCientific achievements of the malaria experts, or

the blending of national and international efforts in the elimi­

nation of human suffering from a Significant segment of the

earthls surface.

-37-

...

,

YAWS CONTROL 0

tit LAOS -.. ---~ -,

/--

r Dr. EDfv\UND J. DOUVIER

One cley in Hovem"!::er of 1954 a Gaunt~ tired man walked into the lJor1c: Health OreD.nization's Reeional Office for the Hestern Pacific in }fa­niln. His name was Dr. J:dmonrl J. Douvier, a wliO Hec1ical Officer in Laos. He had come to make his final report on the WHO-assisted Yaws Control Campaign of the Government of Laos with which he had been connectod since April 1953.

Below is the brief story of the campaiCU1 as Dr. Douvier dictD.ted it at the time. Fo1-lowinf. are extr2cts from his monthly reports durine the c~pairrn, which translate his curt references to a IIcritical situationll into terms of the hazards of 1'il-ill - tric~ces blown UP1 vil­laees cut off; 1-JEATHL:R floodS cuttine; off all access to some vill::.c;es, and SICI~r:'sS among the hare-worked yaws team.

-38-

- -. -~ ... --,,;.~-

The Story by Dr. Edmond J. Douvier

---------The agreelll3nL signed between vlHO and Laos provided es­

sentially for the tr~ining o!workers nnd assistance in a CPJn­

paign far the treatlll3nt of yaws cases and their contacts.

In point of . .fact~ no one knew the prevalence of yaws in

Laos, nor it.s geogrzephicaL.distribution there. Indeed, it is rot

common in Laos far a medical worker. to leave the main towns or

the dispensaries to visit the villages md to establish statis­

tics. Nor eover , the state of war did not encourage workers to

go into the villages.

The Laotian staff put..at the disposal of the WHO expert

included one Hedic a1 Officer and six young men..of about..l8 years

of age. The. young man had no professiona.l..tr~ining whatsoever ..

The only meare of transport were twO WHO landrovers which were

expected from Saigon. We had to start from zero.

li.t the beginning of •• pril 1953, ten..weeks .. after the villa expert had arrived in Laos, the necess "ry Ill3 "ns and the funds

were obtained and tha ten of us piled into the two landrovers

.. lith s.tocks of food and petrol and laft for the Kengkok district

to start mrking during the rainy se;oson.

In theory, the work.. Wrul eXceedh'1g1y .I.l:iJllple, bc lUL~in:;

those two main points: to . .assemble the population" to examine

and to give treatlll3nt to cases and contacts in their fami1i~s.

Arriving aar1y in the morning in the Village, we set.t1ed

down in the pagoda until evening while the population came along

to be examined.

Everybody" however, wanted to be given e. shot the

jpeople suffering ••

-39-

I I

. , II

, ,

I:

"-'

. ;>

people suffering from yaws, from rheuruc.tism, those who had scab­

ies and til: ones vIho Here woll- 2.nd wo found it very difficult

to explain to them that only ya1Ts cases md fc.mily contacts could

be given treatment.

After t1-10 months He found thc.t despite administrc.tive

help, despitc the eo.r;crncss to be trco.kd, we he.d not J:1anaged to

cover more than 70% of ti'Ja population.

-;'Je Here for cad to chc.nge our methods. I decided that

henceforth we would sky in evory villc.,:;e and remO-in there until

He had oxrur.ined practicC'.lly the ,mo:.," popule.tion.

This method WM [',11 ri ght anc~ H we s tc.rted Gxamining rur

first "customers" in thcfirst light of the morning, and the lant

with the light of a kerosene le.mp, we obtained r0sults we 'l'Je.nted

und we reached c. rate of 90%.

OpcTc.tions orgmi zed in this Ho.y ,continuod and in June

1953, He roC'.chod tlE district of Phe.lanc am., in July, Dong Hene,

,-mere for the firat time \10 n;t somo members of tho Viet Hinh

forces. Surprise was equal on both sides and both p.:\rtios con­

cerned ste.rted a rapid strdegic retreat.

In August arc1 S"ptonbcr work Hns cnrried out in the Sa­

ve.nn~het (;istrict Illld t,o;v12.:'ds the ond of tho yonr in tho Lo.han­

run...£onckhonc dictrict. vl}lGn we returned to S~Vc..rul,0-.hot for tho

Chri:::tmcs holi:~C'.ys, tho Viet ;Iinh forces invaded the province.

Na:.; the guns spoke and from thnt moment until the end of

hostili ties in Augw t 1954, tho crunpaign could be continued only

,-lith tho groatest difficulty ani for S01l10 time, it Has interrup­

ted completely.

In spite of the critical Situation, ~l villaeea were

/visited betwoen •••.

-40-

visited between April 1953 and the beginning of November 1954.

We. examined..132, 000 persons inclucling 64,000 children, and 7, fff7

yaws cases and 1,]48 contacts ,,-ere treated.

The. total rate of contl'.gious yaws we found to be 0.36%

and the rate of non-contagious ~aws 5.:~. Thus the treatment of

patients and their contacts is adequate.

S~ied DUt with reduced means and in a country ~t war,

this c.ampaign..h1'.s, nevertheless, enahJ.!ld us to est:iJnate precis.el'

the rate of yP.ws endemicity in the Savannakhct province,.to tre.at

patients even in too most remote vilhges and to educate and

train people who will be able to continue the work.

The following ?re extracts fram Dr. Douvier' s report

made to WHO Regional Office for the Western Pacific.

~-------

AI'riL1953: The programme started in the S;:vl1l11mkhet

province, Champhone district, sixty kilometers from Savannakhet

an 8 April. The area is sufficiently secure for us to go without

armed protection.

Thene axe very few ronds or tracts. Bridges have been

destroyed..md after .:the reins the coun.try will be flooded and in­

accesaible ••• We have only two WO landrovers.

Twenty-nine villages. have becn.sisited in thc •• course of

the month, 8,903 pers.ons have been examined and 452' Cl'\ses of y~

havo been tre?ted in addition to contacts.

June: Difficulties of travel were increased by heavy -rain.

The pr' oblem of ..finding 90% af the popul1J.tion for examin-

ation obliged us to start our work a~l over again for the whole

/area where 60% •••• -41-

I I

, ,

aroowhere 6(J/, only of the popul~tion had been found at our first

visi t. Later on the 90/~ of the popul2.tion was reached in nearly

all villages, thanks to the personal help of the Chief of the

Phalano District ••.

vlork was c~rried out ~lithout any interruption, evon on

Sundays, and control operations in t his District completed.

July: Phone Phang village ifaB visited by the torun lead­

or under the protection of three armed guards. Upon encountering

four C'.mod Viet Minh agents it had to return in order to avoid

falling into a trap. The team 'iCnt to the northern part of Dong

Hem under protoction of 20 Tifles, to continue its work:in thc:a:3

villages.

September-October: Thero ,lOre considerable absences due

to malaria among tho staff.

Security in the Dong Hene r.rea demmdod Qr:'lJc: protoction,

but only seven villages of the Dong lieno coxea were visitoc:.

February 195f.: From January 15 to February 15, thanks

to the motor-boat, we were a.ble to to nork up and dOt·m stream at

Savan.."lakhot end complete surveys in Savannakhet and Sompoi areas.

During the period Viet Mi::h attacks ","Gre made dong road

No. 9 towards Ann am , C'..'1d bridges ,1EJro b1oi-ID up· from Pha1a.ne to

Tchepone. Anoth,r .::tto.ck c1Gstro~'Od all bridS03 on the Co chin-

China route, C'.ltt~:'.:: :::'.l G)rImun:'.cc..tiots betwoun Gav2nnclchet and

Pclree.

Rosul ts 0:: treatment ure oxcel1·:ont. nl all of the conta­

gious cases treated, c.. 100;; cure vms noted (:uri no relapse has

been found. Among contacts trea·~ed during the first survey vi­

sit, no contamination was noted.

/Thc excellent results .•

-42-

The excellent results obtained with only one PAM inject­

ion have gre~tly :iJnpressed the popuhtion. During the. checking

up on the first persons hn'lling received treatment many others

c1'.lne volunte.!'ily from iaol1'.ted farms, theae being the

refused to be bothered at the previous e~ndnation.

same who

April: <-rmed patrols were given .orders by the L1)'os Gov­

ernment to ensure the security of tr..a te?.m, but the numher is in ..

aufficieni. to en."'.ble the . .nurses to visit 1'. 11 the IT.ilh.ges. Thw:!e

are no roads to .the vill.:>.ges in this whole region ;cnd the to:'1ll

members either walk or use bicycles.

l·fuy: The cl'mpdgn goes on in the L'lh1'.nl'm-Songkhone I-bmg.

Too nurses .. mve cont:inued to visit the villages on foot (petrol

supp1;iD s h."d been cut off).

In spite of Rl'med_.protection it wns not possible to vis­

it six villages in the cnnton of Bung Xa.!l& owing to the presence

of numerous Viet Minh agents.

The c~paign was continued, with difficulties in the La­

hr.nl'm-Songkhone District up to 10 M1'.Y. Thirty-three village.s

were :Ilisited r.m 5,275 persons were exnrnined - 92.8% of the t.ot.."..l

popu]. ... tion.

If there is no end to hostilities r>.S!1 result of the Ge­

navn :or.,.ferenc.e, it will be impossible for us to continue our

cn.se-finding md trcdment c['1TJpaign.

June: In the cours.e of the qU1'.rtar we lk".ve visited: six -villr>.ges in April, thirty-three in Hay, md twelve in JWl3 •••

JJ..1 villages situated in the secmi ty !'.ren h1'.ve been vi­

sited, for the present, with Lhe exception of six. The percent-

1'.ge of persons eXl'mined WI'S maint".ined nbout 90.

-43-

,.

The rainy season has now started.

August: Since 7 August, when hostilities ceased in Laos,

the team. has visited 22 villages in the Lahanam. district, whicl'\

until recentiy, was in a danger area.

The team also 'Tisited, on the way thrrugh, the villagos

of the Phalane district which had be(m visited in June 1953 in

order to check results, 'Thich were found to be excellent.

The te?Jl1. did not firo a single nev' contagious case. In

the Lahanam district 3,036 persons were examined (94% of the to­

tal population).

Septgmbcr: (From Dr. Douvier1s Quarterly report): The

Government have decided to continue, after I leave in Docembor,

the work undertaken ani to give this campaign the scope origin­

ally planned •••

October: vTork ·was continued in the Lahanam - Songkhone

district. Three villages of tl1C Sanhek cwton were visited, ltIi.ch

could not bc seen in December 1953 owing to hostilities, and 31

villages "Thich constitute the Honei liun canton.

This canton is particularly isolc.ted an::! can be ranched

only on foot. This field trip v.oant considerable physical stram

for everybody.

Owing to tm shortage of rice in those villages, it was

necessary to to.ke food supplies for tho 111101e field trip the

population accept and even request the presence of . nurses but

refuse to give any help in the trc.nsport of food supplies and

equipment.

Four thousruld cif;ht hundred anc~fifty-nine persona were

examined (91+.02% of the ,-mole population).

-44-

SOf'lETHING ABOUT 'IRE AUTHORS OF TEES'; STORIES

Dr. FRIEDREH C •. TROSS is the i:HO Medical Officer lmo was

in charge of ilie Yaws Control Pilot PrOjGct (carried out by the

Government vii th vJBO/UNICEF aid) in Fiji. A similar projGct has

been s tz.rted by him in Hestern Samoa.

Hiss EVELYN HATBESON "ras the \·mo Senior Nurse Educator in

the WHO-assisted Nursing Education Project in North Borneo.

Dr. ANTON GESER was the Ti!HO Hedical Officer uho helped

the Philippine Gov~rnment in initiating its mass BCG vaccination

campaign. He was also the leader of the WHO/UNICEF BCG assess­

ment team -which visited countries of the VTestern Pacific and

South East Asia Regions.

}liss BETTY AtT (her full name is Grace E. AU) is the 'W11O

Senior ~jurse Educator in the ~mO-assisted Maternal and Child

Health Project in Hongkong.

Dr. OLAV IDSOE was the villO Medical Officer in the Venereal

Disease Control Project in Taiwan.

Dr, Nli:LOON G. HAIRSTON is the \·;HO Zoologist attachod to

the Schistosomiasis Control Pilot Project in Palo, Leyte,

Philippines.

Hiss liI~L.mNA VISSCHER is the fmO Senior Nurse Educator

in the HHO-c:ssisted Naternal anG Child Health Project in

Cambodia.

Dr. DONALD J. PlliTSCH "as the 1:HO Entomologist and Team

Leader in the Halaria Control Project in Taiwan.

Dr. EDMOND J. DOWlER was tre 'fMO l'1edical Officer at-

tached to the Yaws Control Project of the Government of Laos.

~ torleS 0 t e \VI WORLD HEALTH ORGANIZAT "'-"'", ,,-,

.' 0

._ c:- Q

1956 edi·tlon - V

//,

" o tv'· 'V' •

Q o 0 0,

n· ;, IN THE WESTERN P.

<> •

STORIES OF THE

WORLD HEALTH ORGANIZATION

IN THE

WESTERN PACIFIC

1 9 5 6

Pub I i8hed by the

PUBLIC INFORMATION OFFICE WESTERN PACIFIC REGIONAL OFPICE

WORLD HEALTH ORGANIZATION MAN I L A

1956 • Vol. II

FOR E v[ 0 R D

Las t yew's collection of STORIES OF THE WORlD HEALTH ORGA­

NIZATION IN THE rJESTE.f1.N PACIFIC provod to be very successful am

several printings of it had to bo made to satisfy the heavy

damand fbr copies. In this new collection for the yoar 1956 we

have again tried to ShOll in human terms some phases of the battJe

for. goai health in this Region. These stories do not give a

full report of our activities or of the great efforts being made

by the various governments of the countrios to .. ,wds the attain-

ment of tho higmst possible level of health. They do, honover,

give a glimpse of what mcm ad women in the field, both national

and international counterparts, arc doing Md of their devotion

to their work.

With these stories ;Usa go my grectll1gs to you and best

wishe s for th3 c aming year °

Novmber 1956

-i-

,-0 C?« . I. ·C. ~JU' , Mo:;no Regional Dire c

i _

:

TliJ3LB OF OONTENrS

FOREiIlRD Dr. I. C. Fang •• . • • • • • • • • • • • • • • • • • •

* THE GREA.~'T HUMl\NlTJJlL\N EFFORT S OOE TH& ABOLIrrON OF SIl,VERY

Sir ~thony Foster Abell, K.C.M.G. • •••••

* EtJU,Y nt.YS TIl THE WESTERN PACIFE, TRl\ VEL 1I.ID T UBERCUI.<JS IS

AJR

Dr. Lawrence O. Roberts • • • • •• • • • • • • •

* MAROONED ON ORCHID ISLlJ{) Pastor S. Echavez • • • • • • • • • • • • • •

* LTIl1 MEOW CHI1i. Mt~KES HISTORY Margaret J. Chalmers ••••••••

* BOILDING 1\ DENTJU, H.El;.LTH SERVICE IN THE PH.n..IPP INES

• • • • •

i

1

5

13

19

Dr. J. IJ.ewellyn Saurrlers • • • • • • '.' • o. 24

* THE STORY OF A WHO MliLE NUP.sE John Waterer • • • • • • • • • • • 0 • • • • • 30

* THE FIDHT !\.GiuIDT TRl-llmMt~ TI-J Til. NAN (CHINA.)

Dr. Ida Mann • • • • •• 0 • • • • 0 0 • • • • 35

* THE liS IVAn CAMP1I.lGN Dr. Friedrich C. Tross •• 0 • • • • • • • •• 39

* lAND OF SUN PND SNCYil Dr. J. Bierdrager • • • • • • • • • • • • • • •

* DR. TW.GlllOO THROOGH Dr. Fumihide Koike Dr. Hiroshi Yamamoto • • • • • • • • • • • • •

* TIE '\iIlRK OF THE M1I.TERWU, J.:!D CHILD HEA,LTH TEAM IN VmTNl..M

Dr. J. l~. Stroink ••••••••• 0

Roberto Rendueles • 0 • • • • • • • •

• • • • •

• • • ••

48

52

61

SOMETH 00 ABOUT THE AUTHORS OF THESE STORJES • • • • • • • •• 68

-u-

I

l

,

~~"1ESl "U"~M'TARIAN EF "t"~~"90Ul'ON OF SLAVER~ .~ ,~ 1"~ ''I e,\"~ SIR ANTHONY fOSTER ABElL,KGM&

.~

:,V: (EXTRACTS FROM AN OPENING ADDRESS AT A WHO ANTI­W/,Ald-,,",·· MALARIA CONFERENCE, KUCHING, SARAWAK)

I would rank this malaria COl}-

trol project, if it is carried

through to the virtual eradicationof

malaria, to be the greatest contri­

bution to the welfare of the peoples

in the under-developed areas of the

world since the abolition of slavery

more than a century ago. It seems to

me to be one of' the truly great am

entirely beneficial advances made b.1 science during our generation.

Bef'ore I came here I worked for

20 years in a COIl ntry in West Africa

wi th a higher incidence of malaria

than Borneo. I have seen there"

and here, the deadening ef'fect it

has on man's energy, the inabilityto

concentrate for long, to sustain

an effort - the listless children,

the high infant mortality. At times,

one despaired of' ever lifting the

people out of their lethargy, of

givir:g them the will to make a sustairod ef'fort to help them-

/selves •••••••

-1-

selves. Everyone knew it was malaria, but how cruld we help? We

hadn't the funis to drain the swamps. All we could offer was 5

grains of quinine. Ul that has changed now, an:J. the reports r

have read from the lUI) field officers tell the ir own exciting

story. As you read these reports you can feel the excitement and

WOMer of the writer almost amoW'lti)"€ to disbelief. He knows he

is Witnessi)"€ the transformation of a people. It is not only the

statistics which III.lSt gladden the heart of al1Y doctor but the ge-

neral and Visible improvement in heal~h and morale and prospects

of the people whose whole outlook on life has been changed.

What is more, ani perhaps unusual, is that your efforts are

appreciated now by the very geroration you are helpiI€. That haS

not happened ver,r often in history. If al\Yone should doubt this

r would like them to have been ~'1i. th Ire at theMarudi Regatta some

two years ago. From all the rivers in that distIi ct" from the

Baram, the Tinjar and the Tutoh, men, wanen and children cane to

the pri ncipal town to enjoy themselves on the great holiday event;

of too year. But on this occasion, there was a difference; they

soon showed that they had not come only to see t.h:l racing and

cheer on treir favourite local crews; they had also COIOO to pay

their respects to Dr. de Zuluetall"and his family mo were shortly

to leave the country for a mll-carned holiday. After dark, they

CallE! up in SwarmB f'rom the bazaar, headed by the formidable figure

of the Temo)"€gong '.Uld they swarmed over t he doctor's house

/through his •••••

* Dr. Julian de Zulueta was the \'fI0 nalariologis t ass igned as pro­ject leader of the Sarawak I4alaria Pilot Project f'r0lll its inoept.iDn in July 1952 until. he was taken iLl. about two years later.

-2-

through his windows and his doors like a monstrous pack of bois-

terous puppies. It was one of the most astonishing and heart-­

wa.rm.ing sights I have ever seen. It was certainly a compliment

to Dr. de Zulueta as a person, but any member of the World Health

Organization wuld have been proud and happy to see how much its

work is appreciated. For the fact ·was that the people recognized

that Dr. de Zulueta had done great things for them and they were

cured of an age-old malady.

I would like the field officers to know -- people like

Francois Lachance and Joseph Yong - that ~ know that it is an

uncomfortable and hard life demanding real devotion to duty,

toughness of spirit and determination. They have to travel light;

very often in wet and difficult and even dangerous going. They

have to keep on at it because time is an important factor. And

when the day's journeying is done, and the day's work completed,

there is another kind of toughness required of them. I remember

reading in one report a particularly pathetic cri du ~

from an officer who regretted that he did not measure up to his

predecessor's party* stamina. No - it's not all beer and skittJss

but it must be wonderfully rewarding work.

/This country •••

*Ma1aria specialists, visiting the various areas to check on the progress of the campaign, are offered overwhelming hos­pitality when they stay overnight in the "longhouses" -long wooden structures which house entire cormnunities. The vi­sits are made the occasion of dancing and a "party" which often goes on until dawn. These festivities appear to have no "morning after effect" on the local people.

- 3 -

This Ca.lIltry am all of what we call British Borneo, is, I

know, very grateful to the World Health Organization for tlrls

great wark. It lIllSt be pressed on with all our reScUl'Ces to a

conclusion. 1 hope that t he Organization will fini it possible

to send us hore an additional malariologist So that we can com-

p]ete our programme wi. th the max:imum. !:peed am efficiency.

*** The younger nations of South East Asia and S0100 of the oot

BO young, awear to be un:luly sensitive about patronage in gene-

raJ.. It is C£ten, r am afraid, the case that the more generously

they are treated, the less they are prepared to recognize. UNlCEF

am 'IilO, as intermtional bodies, on tho whole avoid this taint,

and I can assure them tm t t rere is nothing but gratitude for

their wark in Sarawak but, nevertheless, I feel it is important

that we should identify these cOlntries with their efforts. The

work i6 so important and results So far reaching, that the people

shoo.ld not be al101'ied in the future to feel that trey 'l'lere denied

an opportunity to Inake their contribution to an operation that

has affected the:ir future BO deeply. I do not mean by this that

I am inviting VIO to ask for a larger financial contri1::ution,

that in:leed might get me into trouble ani raise difficulties, but

I do hope that it will be possible for more Sarawak men who may

be !'orthcom~ in the future to join this great work unier the

auspices of the mo. The follow-up and its proper s upervis ion

Will be of very great impcrtance ani I hope that -we as a country

can claim to have taken an active part in it.

-4-

-

EARLY DAYS Uv ~ WESTERN PAClrIC: AIR TRAV£L ~ TU8ERCUtOS/5

i DR. L. O. ROBERTS

'!he general saluted aM I raised ~ ha.t.

"It's a converted bomber," said. the generaJl. with a genial.

Wave of the hani. "One of the safest planes in the <hinese air

force."

I eyed it with distaste. Superinposed on the converted

bomber was a mental image of the, WHO Manual.

"The truth iS,1I I e:xplained, "that rru regulations forbid JII3

to give direct counselor advice to the Mllitary Forces of ~

country; furtheroore, I am not supposed to go on unscheduled air

flights without cabling ~ Office twenty four hours in advance --

insurance, you know."

"You'll be doing us a real service by visiting this group

of tuberculosis hospitals and giving our doctors all the latest

infonnation about prevention and treatment," another general put

in.

"We won't tell your Regional Director," smiled ~ civilian

counterpart.

-5-/Thare was a ••••

There was a briet struggle between duty to the ManuaJ. and

duty to Tuberculosis. I got in.

Later, I loBS tol:l. that the visit to Chia yi in Taiwan had

been greatly appreciated, and I received an official letter of

thanks from the Surgeon General.

·You're a fool," I was told afterwards. "If you break your

neck on an unscheduled flight, what can we do for you? No insur­

ance."

* * In the early days of the lI3stern Pacific Region, it was of-

ten like tha ts an unscheduJe d flight or nothing. Since 1953,

travel has been completely organized; before that, high spirits

am a senae of adventure often replaced the Book of Rules.

"Look here," I exclaimed angrily, "II\Y Office booked me on

this flight to RallEPon. Here's II\Y ticket."

"Very sorry," replied the Flight Superintendent politely,

"but; the plane is full am your 118m is not on the J:a ssenger list,

as you can see."

"There's been some mis take: a mistake made by your agent in

lIanila."

He shrugged his shoulders. The plane took off and left me

staming there. Am Kai Tak Airport, Hongkong, on a wirxiy Novem­

ber mrning is a draughty place. I was fwn:iJlg.

"You nmst find me an alternative flight somehow," I told

the Oro und Superintendent. "'!he l3C G Conf erence starts tOiOOrrow

mrning am I must be in Rangoon tonight." Before I had drunk

/the first cup ••

-6-

the firs~ cup of coffee (I am conVinced that air travellers, as a

group, drink more cups of coffee than arv other group on earth)

he was back.

"-_ Airways can give you a lift right now."

"An unsched~d flight, I suppose," I mumbled ungratefully.

"Natura~. What else did you expect?ft

__ Airways were not, if I may say so, world-fruoous for

careful maintenance of their aircraft. In fact, one of their of­

ficers told me, with charming frankness: "If a pilot of a major

airline won't take an aircraft up because he thinks itt s unsafe,

they change the ship. In our show, they change the pilot."

"How long have I got to decide?" I enquired ..

·She takes off in 15 minutes."

Mentally, I raised rrr:/ hat to the co~ilers of the Manual..

They Jleanli well, but what is the good of attending a conference

after it is finished?

It ~s sheer bad luck that we encountered, over the Burma­

Thailand border, the worst aeria:L storm I have e"Oer experienced.

The plane bucked an:!. side-slipped and pitched and rolled; some ..

times she apparentlg remained quite still and shook allover llke

a dog; sometimes she fell vertically like a lift. The lightning

flashed, bl~k clouds drifted past the windows am no doubt the

thunder clashed although the .racket inSide the plane prevented

anyone from hearing it. I tho~ht she must break up in the air,

and certainly the scene inside the plane suggested that this event

had already occurred' Lips murmured inaudible prayers in hali'

/a dozen languages •

.. 7"

a dozen languages and those mo were too ill even to pray, vomited

piteously into their little paper bags.

"statt members intending to travel by unscheduled air

flight," I quoted lI\Vself', "must intOI'lll the Regional Ottice by

cable at least twenty-four hours in advance to enable the appro­

priate insurance to be affected."

But lI\V salutations are due to - Airways. we reached Ran-

goon with nothing "w«irse than a shaking am I attended the opening

session of the BeG Conference.

** the Western Pacific Region is geographically enormous,

stretching from Korea in the north to New Zealand in the south

and from Singapore from the West to Tahiti in the east. J.ir tra­

vel is the on~ possible mthod of getting round it effectively­

by scheduled flights, if possible. And nowa~s scheduled flights

are possible everywhere. It was only in the early days that we -took risks to do an effective job. Perhaps I may mention a few

more?

In 1951. I had to travel from Singapore to Penmg tor an ur-

gent meeting wi th the Govornment, but the planes were ruJ.l for

several days ahead. The captain 0 f a plane belonging to one of

Singapore1s biggest newspapers offered me a lift next morning and

I accepted provi.sionally although the take-off was only 12 hours

ahead (shades of the Manuall) because he was an experienced pilot

aM had made such £lights many times in safetyr. At the last JIIOoo

1I¥3m. - I canno-t expla:iJl w~ - I refused to go. The plane £lew

/North am hit ••

- 8-

North and hit a ItrJlUltain and tJla four people on board were all

killed. It was in this crash that l.w Boon Haw, the multi-million­

aire of Tiger-Balm fane" lost his son.

* * . Smith was not his real name but it will do. He was a free-

lance pilot" hired to fly a Catalina to Indonesia on charter.

-I'll give you a lift part of the way, doc," he offered,

liaS youl re stranded."

But -men. a few days later, he was ready to leave in the

Catalina, ~ work was unfinished and I stayed oohind. I never

clear:q umerstood what "lent wrong. He and his two companions

took the plane for a trial flight rolUld the harbour and it dived

into the water and shot straight under the surface. Three conse­

cutive miracles saved their lives: the impact split the fuselage

open, and they were able to get out of the wreck at an estimated

depth of 40 feet ani reach the surface before they were drowned;

a police Ja IUlch happened to be near and picked them up before

they ~re eaten by sharks; and the authorities got them to the

hospital before they bled to death. I visited captain Smith in

the hospital afterwards and found him in a philosophical I'OOOd al­

though his left leg had been amputated.

"Fortunes of war, doc," he sa:id with a grin. -Glad you

waren't with me."

So was I.

* *

lIt is good •••

- 9 -

It is good to retlect that duri~ these years tuberculosis

am IDO projects wem started in ten countries ot this Region.

Am, at the tiIOO 0 f writing, 13 million children have been tuber­

culin tested, 6 million roO-vaccinated and many cases of tubercu­

losis prevented. This work was carried out by the gove~nts

'ld.th aid from the United Nations Children's Fund and the Wbrld

Health Organization. Most of this was accomplished by steady

work and uneventful travel on the part of many people, but that

does not make a story.

Even the oldinary scheduled flights of the recognized air­

lines can, if you have enough of them, provide an occasional. in­

cident that sticks in the memory •. There was the -Dakotaa taking

off from Bacolod airstrip in the Philippines, which hit a Wffalo

that someone had allowed to stray onto the runway. There was the

fligh t over Cambodia, a t the em of which I found II\Vselflo st

in the jUllt1e, completely alone and not even lmowing which way to

start walking. I still rcmmber the terrifying feeling, like a

ton of lead suddenJ.,y deposited on 0 no's diaphragm, when I shouteid

and shouted and there was not a sound in repJ.,y except the SOuM

of the rain falling in the forest.

I wish I could claim as II\V own an incident that actuaJ.J.,y

happened. to II\V colleague, Dr. Donal.d Huggins. WhilG flying over

Thailand, the pilot got off course and quite fronkJ.,y did not know

where he was. FortunateJ.,y, he noticed a railw~ and, by swooping

down very low, was abJ.e to get his bearings by reading the name

on the sign-board of a station.

ITre ninth of •••

-10-

North and hit a lOOuntain and the four people on board were all

killed. It was in this crash that A.w Boon Haw .. the multi-million­

aire of Tiger-BaJJn from, lost his son.

* * Smith was not his real name but it will do. He was a free-

lance pilot .. hired to fly a Catalina to Indonesia on charter.

-1111 give you a lift part of the way, doc," he offered,

"as you're stranded."

But when, a few days later, he was ready to leave in the

Catalina, ~ work was unfinished and I stayed rehind. I never

clearq unierstood what vlent wrong. He and his two companions

took the plane for a trial flight round the harbour and it dived

into the water and shot straight under the surface. Three conse­

cutive miracles saved their iives: the impact split the fuselage

open, and they were able to get out of the wreck at an estimated

depth of L!o feet am reacl1. the surface before they were drowned;

a police ]a unch happened to be near and picked them up before

they were eaten by sharks; and the autho rities got them to the

hospital before they bled to death. I visited captain Smith in

the hospital afterwards and found him in a philosophical mood aL­

though his left leg had been amputated.

"Fortunes of war, doc ,II he sam with a grin. -Glad you

waren't wi. th me." So was I.

* *

fIt is good •••

- 9-

It is good to reflect that duri~ these years tuberculosis

am reG projects were started in ten countries of this Region.

Arxl, at the time 0 f writing, 13 million children have been tuber­

culin tested, 6 million B::G-vaccinated and many cases of tubercu­

losis prevented. This work was carried out by the govel'llll2nts

with aid from the United Nations Children's Fund and the Vklrld

Health Organization. Most of this was accomplished Of steady

work and uneventfUl travel on the part of many people, but that

does not mako a story.

Even the o.rtl.inary scheduled flights of the recognized air­

lines can, if you have enough of them, provide an occasional. in­

cident that sticks in the melOOry. There was the -Dakota" taking

off from Bacolod airstrip in the Philippines, which hit a buffalo

that someone had allowed to stray onto the runway. There was the

fligh t over Cambodia, a t the eOO of which I fouOO II\Yself 10 st

in the jungle, completely alone and not even knowing which way to

start walking. I still remember the terrifying feeling, like a

ton of lead suddenly deposited on onets diaphragm, when I shouted

and shouted and there was not a sound in reply except the sound

of the rain falling in the forest.

I wish I could claim as lI\'f own an incident that actua.l.1y

happened to II\Y colleague, Dr. Donald Huggins. WhilG flying over

Thailarxi, the pilot got off course and quite frankly did not know

where he was. Fortunately, he noticed a railwa,v and, Of s'WOoping

down very low, was able to get his bearings by read:ing the name

on the sign-board of a s ta tiona

/Tb£J ninth of •••

-1O-

The ninth of April 19>1 .is a date to be I18rked with a black

stone. Kai Talc airport at Hongiro ng, surrounded by hills and a

headache to pilots at the best of times, was blanketed by a fos­

Two planes were circling around trying to get down through the

murk. My own eventually landed sai'el¥ but the other finalJ¥ ran

out of fuel and plunged into the sea and avery soul on board was

drowned in those shark-infested waters. At least, I hope th~

were drowned. The Thai consul was standing at th e airport: his

wife and four little children were lost in the plane. I saw his

face - I can see it still. '!hey say Orientals are inscrutable.

Well •••

* * The last of ll\Y unscheduled, uninsured flights were done :in

Dutch New Guinea in 1953. On one occasion, flyingJrom Hollandia

to Biak in a 003, we had to deliver a bag of mail. to an island

off the coast. 'lhe pilot did not bother to land for this purpose.

He brought the plane down to tree-top height mile the steward

opened the door in mid-air and held the bag ready. As we streaked

over a clearing in the jungle, the steward flung the bag into

spece and sJ.ammed the door and then we zoomed up to 1,000 feet

again. It was quite exciting, but I dOl,lbted if' an insurance com­

pany would approve.

** '!he pilot vilo flew me from Sorong to Biak lIlUst have been a

hedge-hopping hero left over from the war. For a distance of five

or six miles, he flew at zero feet over the sea and paraJlel to

/ the beach: •••••

-ll-

the beach. we were so low that we could see straight into the

doorwqa of the palm-leaf huts on the shore. Present.J¥ we cam

to the wreck ofa stealOOr ~ng in the shallow water ani the pi­

lot banked to prevent the port w:lllg from hitting it. Tho star­

board wing came so near the water that I thought we were f:in:i::heda

it was, wi. thout exception, the most hm-raiaing flight I have

ever mode. Hedge-hopping may be run for the pilot, but it does

things to the passengerts blood pressure.

'then I visited the country three years later, scheduled

airline flights were everywhere replac~ tOO old system. And

the OOG caq>aign began on tine.

** It is good that the old order has passed aoo that it is no

longer necessary to take unreasonable risks to get the job done,

but sometiIOOs I look back on the beginning of the Western Pacific

Region and reflect that it had its moments lIltlich will never come

again.

***

- 12 -

.-

'MA~OON ~ P.g.ECUA

I worlt as a public health engineer with tre Malaria am In­

sect Control Project which is run by the ProVincial Goverrment of

Taiwan with aid from the United States and the World Health Orga­

nization. Our headquarters is in C hao-C how , Pi~-Tong, Taiwan.

This is the story of a trip made by some merilers of tIe team

to Lan-Yu, also known as Orchid Island (because these flowers are

so plentiful) south east of Taiwan. The island is only about 22

scpare miles in extent.

Ther.e were seven of us and we set off from Kaohsiung harboJr

one December afternoon, about four days before Christmas.

After 15 hours of rocking on the sea (during which time three

members of the party were helplessly seasick) our old tub finally

made Lan-Yu amid shou-ts of . "Kokaii" - the word for "welcomell

from the crowds of islanders on the beach.

Next day we set about recruiti~ am training eight operat-

lora for our ••••

-13-

ors for our Dm:' spraying operatiom - tre reason for our caui~

to the isl ani.

The natives of this island are :Malayans an:!. belorg to the

Yamese tribe. They are brcwn-skinned ani have straight dark hair

(though SOm'l are red-headed due to being bleached by sea water in

their daily exposure when £ishirg).

The struggle for their day-to-d~ existence is their chief

concern. Their only other food in addition to fish are t'lO types

of yam called taro and ~ and sweet potatoes, which are practic-

ally the only crops grown on their eroded and

slopes.

woather beaten

They use a sort of iron bar as a hoe. The women till the

soil since the men devote most of their time to fishing, ~ich is

dore by use of darts am small circular nets in the shallow wai:enl

of the coral reefs.

Their clothes, which are very scanty, are made from cloth

woven from a native shrub fibre. The looms are small and port­

able.

Recently, quantities of old clothes have been brought in by

missionarres and through church organizations and as the December

of our visit was cold the people put on whatever clothes they

could obtain. Since th~3 did not know the difference

men's and womentl drass~ we saw some startling Sights.

between

The houses of trese people are dug into the ground and look

/like air ••••••

-:14-

II

-"

like air raid shelters. Oddly erough" each family bad three hou­

ses. One is for the summer season, one for the autumn season,

and the main one for the Winter. MaJV of them look: like al"ll\Y luis.

.As a Filipino I found their language very interesting. They

referred to me as a Batan (a native of Batanes, in too northern

part of the Philippines). MallY of their words are fwnd in the

Visayan dialects which I speak. They were very hospitable and

invited me to the:ir houses where they served betel nuts ama

special le af 'l'h ich they chew after putting on some lime kept in a

gourd.

In spite of the scarcity of food in the island" food still

h.aB its genders and taboos. Some fish, for eXaIll?le, can be eaten

only by women and other typoo of fish only by men. Fatty fish is

for Women and lean fish for men.

1 went along wi th the spraying crew to soma of tbl Villages.

Crossir€ the islaId is rather taxi~ because of the steep h:il.ls.

The wind was blowing hard so we had to crcuch to keep from being

blown into the shallow caWOns.

We had other difficulties, too" such as th3 question of pro­

per food, which began to be a proolem.

When we left Kaohsiu~ on 21 December, we eJqlGcted to re­

turn on the 27th, the date when the boat was supposed to call at

the islam. ltv cwnterpart, who had been put in charge of obta:l.n­

iq; the necessary food supplies had in turn delegated this duty

Ito another •••••••

-JS-

to another member of the team who was not too rorperienced in sup­

plying even such modest expeditiom.

The resuli:. was that we found (men it was too late) that he

had bought only rice, some local sausages, sardines and a few care

of pickles. The rice was sufficient fer ten days but there were

only enough sardines am. sausages for about two days.

On DeCElllber 27 there was IX> sign of a boat returni~ for us.

storm signals were 115" and 11611 - and unless the signal is "4" or

less, no boat stops at the iSland. It looked as if we 'I'Oulrl have

to stay on tho island until ai'ter t he New Year.

The wims began to blow ••• stro~ arxl cold winds. The room

We slept in was full of holos ani crevices. Even with all our

clothes on we rwni our canvas cots too cold for sleeping in aIXi

turned out on to th3 "tatami "(straw mattress floor) which was Wa,IlleI'.

On tre third da,y of our stay we began our rice, fish ani

vegetable diet. The vegetables were grown by the health station

staff on the banks facing the shoreline. Yam leaves.f which could

be eaten when cooked, were also available. The native helpers

often nanaged to catch from 50 to 200 grams of coral fish, with

their darls. 'ie also caught eels at night.

''Alen our supply of rice began to dwimle we turned to eating

more yam and sweet potatoes. But our anxiety grew as the

passed ani too weather grew colder and colder.

At eight in the evening of January 6 a boat was sighted

land everyboqy •••

-36-

. -

an:!. everyboqy became very excited. We all packed in a hurry and

started to sing goodbye to Lan-Yu. But the boat mereJ.;y

approached the island ani disaPfSared over the horizon.

The weatmr improved by Jam ary 11 and we heard that a boat

might call the following day. But no boat came.

For the past five days even tm meagre fishing had failed us

ani our only food consisted of rice mixed 1ii th sweet potatoes.

This diet was· very good for Il\Y waistline m ich was reduced by three

inches. However, lack of vitamins made Il\Y skin begin to scale.

January 13th care and still no boat. Since the weather was

now good we went fishing with the islanders. We limited our ac­

tivities to watching them tumble amid the rolllng waters as they

launched their darts at the small coral fish.

Suddenly a small boat appeared on the horizon. From tha

watch tower the message came that this was the boat that usu~

made the run. Counting our own contiq:ent, there were aboo.t tl'lElll­

ty axci ted people 19'&1 ti~ on tho beach - a number of them had been

anxiouslJr awaiting the chance to go to Taman to celebrate the

Chinese New Year.

Everybody ruShed to get on the boat. The men got on first.

The women, with their little children who had to be breast-fed

came next, barely squeezi~ into the boat. It was like bedlam.

One old man got pusb:ld into the water and barely escaped being

drOWll3d.

/~t last, •••••••••

- 17-

P.t last, however, all passengers were squeezed inter the

til'\V' craft and we said Sayunara (goodbye) to Orchid !Blam.

P.s. Dun ng our stay in Lan-Yu, we did accom­

plish our mission. Our team sprayed 'I'd th IDT

all the 412 houses am structures on the is­

land am when we left, the total population of

1,444 had been completeJy protected from mala-

r.i. a.

-l8-

'LV~~ M~~w t¥-h~ ~ htt,~

b'1 MARGARET CHALMERiiiL":::"~~~~

Mother's No. NaIW Age

1 Qoh Bar Hel'€ 23

Grav- Date of id.* Delivery

5 13.9.55

Sex Weight Attendants

81M Lee Miow Lan Malo 7 100. M. Chalmers

At first glance, this could bo an entry in any labour ward book#

but look at the number - One.

The partirulars are those of the first baby to be born un­

der tm Domiciliary Delivery Service attached to the Kaniang Kerbm

Hospital" Si~apore.

Ani wtu" you may ask" is this an occasion to write about?

Singapore had a birth rate of 48.68, and just under one

third of its babies are born in Kandang Kerbau Yaternit;r Hospital.

In 1915, 174 women had their infants within its wards ani in 1953

tho figure rose to 17,,958 aal in 1954 that figure had become a>;n.

Gover!1llent had long Since realized the need to make more

/extensive •••••••••

.. 19-

extensive provision for its midwifery problem and soughlihelp from

the World HEAlth Organiution. A midwifery tutor was sent in

1952 to help the local sisters to build up a training scheme for

midwives, and to institute a domiciliary service which 'llculd give

experience in home deliveries to the students.

The intern traini~ programme was SlOOothly carried out, and

now two grades of student midwives are trained - Registered ~­

ses received ore year\:! training while non-rurse pupils train for

two years ani three montm. Many difficulties, howevor, beset

the domiciliary section of the programme •. Lack o:f accomodation,

trarsport and trained staff hampered aqr attempts to s'4rt homo

deliveries, while meantime the hospital delivery rate was rising

alarmingly :fast.

An interim measure was instituted in the form o:f an after­

care service in ardor to cope with the numbers of normal cases

seeking deli very in the hospital. In this service an average o:f

6(JJ women per month are sent hoae 24 hours after delivery ani are

given care for several da;ys in their awn homes by fulJy traired

midWives.

This service was not used. for teaching, but it :formed a sure

foundation for the delivery scheme because ~idwives became fami­

liar with the art of domiciliary techniques and fou n:i their way

about the city. This latter knowledge is possibJy the ~ost im­

portant feature of dotliciliary worie, especially in a coo.ntry vbere

laddresses do ••••

- 20-

addresses do not appear of major importance to many householders.

It has been known for thE:lll, Ylb.e n moving to another home, to take

the number plate from the house in which they have been living am

put it on to their new abode ... quite regardless of the collSequen-

ces.

This service 'proved popular, more and more women sought

ear~ discharge from the hospital, proving that once the bab,y was

safely in their arms, rome was the place they wished to be.

Useful as it was, however, the aftercare service did not

supply the need for eJq)6rience in domiciliary midwifery J ani ef­

forts to begin a proper trainirg scheme were still being made by

the people co merre d.

lEanwhile., a new addition to the hospital building was being

erected, in which would be housed the district root! for domicUi­

ary wO~J trareport ani equipment had been purchased am midWives

trained to act as supervisors in the domiciliary field.

Ani so by August 1955 the Domiciliary Delivery Service was

scheduled to begin.

Only patients who have received antenatal care in tw hos­

pitaJ. clinic are accepted, and all patients coming to the clinic

for the first til!fl are interviewed for domiciliary delivery. Vi­

sits are paid to the homes of selected cases to ensure that their

homes are suitable for too delivery to take place there.

These home assessment visits are most revealing. In the

/words ot: ••••••

wards of tba first studert midwife towom in the domiciliary sel'­

vice,

III! I think the accomodation is suitable, I plt this ques-

tion to themt ''Would you like to have ycur baby at home?' Then

this is where the superstition COIOOS in, and religious matters

intervene. SOlIS mothers-in-law will either say that to have

a baby born at home is unclean, or tbaY will say that they have

asked their gods who say that it is better to have the baby in the

hoSPital, otherwise some misfortune vdll happen to them.

nSome say that they have only one roan where in-laws all

stay together. According to the Buddhist custom when a woman has

a baby at home, the room is said to be unclean, ar:dthe in-laws

will not step in till after the confinement period, ani that is

till after one IOOnth. So they will say 'Where are we going to

sleep?'

IISome have tba 8.ltar in tm sane room as 'Well. They say,

'~se, I cannot have my baby here, it will be unclean, as the

altar and !Iff god and also my ancestors are considered to be sa­

cred. Also in a few days more there Will be a festival, my mo­

ther-in-law has to go to the tenple and pray, and she is not sup­

posed. to step into my room duril"€ my confinement time. So I have

noboqy to help me. I, too, cannot touch any water, and the old

custom is for me to stay in my room for CUl month.'

IIThen other women stay in cubicles where they !'ave to get

/pennission ••••••

-22-

,., pemission from their landladies,and usually they will not give

permission to have babies at home because th~ say that the place

will be unclean ani evil spirits are liable to come or ill luck

will come upon them. II

The dif'fimIties met in persuading women to have their ba­

bies at home are many ani varied. Their reticence to participate

in anything new ma,de bookings slovl for the first month, bJ.t seve­

ral venturesome women were prepared to accept oo.r services. ile,

in turn, were confide nt:. that good care and attention given would

earn for us the reputation needed to give the scheme a firm foot­

ing.

An:!. so it was that little Ling Meow Chua made history. He

was the first babe to make his entry into this world unier the

care of the Domiciliary Delivery Service. That was in Septanber,

and. in six weeks 31 babies have followed his lead, \'/hile 106 p0-

tential citizens of Singapore are lined up to make their entry in

the next 3 months.

-2.3-

J. LLEWELLYN SAUNDERS

.. . , Cd

The Goverrment of the Philippines has embarked on a pro-

gramme to itq>rove the dental health of its people, and in parti­

cular those in the rural areas. This is but one aspect of a COll1-

prehensive Health SerVice designed to reach the common man. The

aim is to have some l300 health units established in the rural

areas wi thin four years. Each unit comprises a physician, a plb-

lic health nurse, a midwife, and a sarUtary inspector, and there

is one such unit for each rural health centre.

The dental component, because of the specialized nature of

its task, and the almost universal incideme of dental disease,

wori<:s to a certain extent independently. It is under the Chief

of the Dental Service, but it maintains a close association 'With

the rural health units.

Although the public health dental service in its present

form is of recant origin (July 1954), it has a numerical stretgth

/of 162 dentists ••••

-2h-

of 162 dentiSts, ani, under recent legiSlation, the number will

short~ be increased to 259. The distril:Dtion of the dentiSts is

based on Congressional districts, there being from one to three

per d.iBtrict, according to populcrliion. \fulle this is a good

start, the number is woeful~ inadequcrlie far the taak of bringillS

dental disease umer control. Consequently, the relief of pain

by extraction tems to be the doninant acti vi ty , azrl it is cer­

tainly welcomed by tre people in these rural areas. But the mere

extraction of teeth to relieve pain could conceivably be contirued

iniefinitdly Without effecti~ arJy improvement in the standard of

dental health.

Of older vintage is the school dental service, which dates

back to 1922. Although under the Department of Education, the

service is financed not by the Govermert, but by a voluntary an-

nual contribution of 50 centavos (25 cents U.S.) per child for

medical as well as dental care. The funis are administered by

the Provincial Superintendents of Public Schools, and there are

265 dentists in the serv:iJ::e. They have a significant part to play

in too dental care of public school children in tre rural areas.

An ap~al was made to t he World Health OrganiZation for ad_

vice and assistance in developing the Public Health Dental bervice,

am thus it came about that the writer was brought into the piC­

ture on a short tem consultantship.

The f:irst thing then was to seo what was already being done.

It involved visiting rural areas, including the barrios or villa-

/ges •••.••••.

-25-

.~

ges •. This was done urrler the guidance of Dr. NUo Gonzalez, Chief

of the Dental Service, Bureru of Health. It was a most interest­

.ing e:xperience, and IW guide was a delightful travelli~ comparrlal.

Of tall anl athletic build, Dr. Gonz;alez holds t he fencing cham­

piomhip of the Philippines, and re is a ranki~ tennis player.

He has a merry twinkle in his eye, a ready Smile, anl a keen sense

of humor. Together we set out on a series of viSits. Our modus

operarxli was to travel by air to distant islands and regiotW, anl

then by je ep or car to explore the local rural. areas. Mostly, the

roads were reasonably goed, but others were not so good. The 1!D­

mile drive in Samar in a jeep, over the roughest road I have ever

been on, was somethiI:f; to remeDber. Then, there was th;) occasion

in Camarines Sur wren we had to get out am walk, because the

holes in the road were ~o deep that the unler-gear of the car was

bumping on th3 grwnd.

Public heal th dEn tists, .both men and women, were found woxi<­

i~ in the most unlikely places. The best accomcdations was in

the muniCipal halla alIi heal th centres, ·where at least th;)re was

a floor of wood or concrete, and maybe even running water wi thin

reasonable distance. But evEtJ. these places held surprises. En­

tering a muniCipal buildi~ one morning, I advanced with heavy

tread and outstretched hand, anl began to greet the dentist in a

hearty voice, -..hen I was net by an awed "SshZ n Only then did I

reali219 that Court proceedings were in progress in the same

/room •••.••••••••

-26-

---------_.

roanJ In another mimicipal hall, the dental clinic had been par­

titioned off lVith wall board, enclosing an area of not more than

eight feet by three, approached by a met! t intricate series of

steps - a trap for the unwary. Fortunately, the hdy dent1Stwas

of diminutive stature, ani seemed to have adapted hers8l. f success­

fully to the restricted space.

Out in the barrios, though, the accomodation was mostly ex­

tremely primitive - too bamboo-floored veranda of a nipa hut, the

mud-floored space beneath too livi~ quarters of a house. To

maintain any degree of asepsis seemed to require considerable in­

gel1lity. To me it seemed to be a matter of "by guess or by Godl"

If either sbaUd fail them, trere were the maki~s of serious

trouble, siroe th:!y were performirg extractions for nearly eveIY

patient. The dental. equipment is of th e simplest, becaus e every

week or so it has to be packod up, transported (by Whatever trarB­

port is available - none is provided), ani set up elsewhere. The

dentists "Whoa e treatment cenlires are cormected by roa.ds are com-

parativel,y well. served. At the worst they may have to

hanging on to the outside of an over-crowded bus, Wi th

travel

their

equipment on the roof. For others again, the only COIllDlIlication

between barrios is by foot-track:s over t he hills, am even aver

mounliairs in some places, ani trey have to carry part at :Ie ast of

their equipment, while pack-horses or boys pressed into service

carry the rest. Others again have 1lpariahes" corsisting of 1s-

llama, eo ••• ~ ••.••••

- 27 -

...

..

lams, between which tooy travel in leisurely roamer by ''b anca "

(out-rigger canoe), or ro.3¥be not at all if it happe~ to be tte

typhoon seasonl I spoke to one dentist who in the course of his

tramfer had to negotiate a dangerous river. Crossing hilISelf,

he said, "When I come to t 00 river, I pr.3¥. Not bocaus e I am

afraid to die - I am not. But I have siX children."

Two things impressed roe on these visits - the competent way

in .ich these public health dentists in their remote outposts

carried ou t their work (limited though it is mainly to extrac­

tions), and tre obvious ly favourable impression that they made on

the local people by their friendly awroach, as v;ell as by their

compete me. 4n:.!. not only on their patients, but on the ever pres­

ent crowd of interested spectators. By their personality an:.!.

their neat profeSSional appeararoe, they seemed to create a dis-

tinctive atmosphere, however unfavoorable the:ir sUn"oundings.

Here then was edue ation of the rural public in a big way - sone­

thing solid on which to build for the future!

I was invited. to address about a hunired publ:ic health dan­

tists ,men and women, assembled in conference in ManiJ.a. We were

carried ~ miles in buses up to Tagaytay Ridge, where there was a

pleasantly cool breeze, and a wonderfUl panorama over Taa! Lake

far below, an:!. to the mountains beyond. We took posseSSion of an

open-air pavilion in a pleasure resort. A loud speaker system lIaS

fitted up, and I prepared to feel for my notes. To roy aston:i.8h-

/ment, it was ••••••

- 28 -

ment l it was announced that the remain:l.er of the morn1~ would be

devoted to daming' J.tr own initial reaction was rot one of entlu-

siasm. - my time was getting short, ani I still had much to do.

But, perhaps, Nilo Gonzalez was w:iBer tlmn I knew, ani something of

a psychologist, too. He knew what I had not realized - that

thesCl deriiists who had carne to Manila at their own expense from

remote, isolated and even inaccessible places over the length ani

breadth of too Philippines, were largelY strangers to one another.

He knew that 162 individual dentists, however competent profes-

sionallY, did not necessarily consti bJ. te a Service. He was deli-

berately setting out to wold tmm into one coherent whole - to

foster a spirit of unity amongst them, so that under his leader-

Ship, thqr would work together towards a common objective. He

aimed to awaken in them a consciousness of that unierlYing spirit

of pride in onels Service, or call it what you will, vd. thout vbich

no organization can be vital or efficient.

It will take a long time to build a truly dental health

service in the Philippines, as opposed to a mere casualty service,

but wi th viSion, patieme and determination, and maybe SOlll3 oot-

side aid, it can be done. At all events, the foundations are

• soo nd, m d the plans for the supo rstructure are taking shape.

- 29 -

~ • I

_, .II I

...

-

, , , , , ,

f I

...

WATERER

For over three years now, I have been working at the School

of NursWg,Pena~, Federation of Mal~ a, as a WHO Nurse Educator

in connBotion wi th a IllIrsing education programme being undertaken

by tm Government with the assistance of the World Health Organi-

aation.

I like to think that I have since then been goi~ throo.gh a

remarkable e;xperience mich I will long rememer.

Let De take you through om day of my work.

At the beginning of a d~, you Ydll fird me riding on my bi-

cycle from the place wmre I live to the School of lilrsi ng.

The journey, if ore can call it that, is about a mila and

mainly down a love~ aV€Ilue of trees. These avenues are a fea1ure

of this lovely island of' Penal'lg, and when passing through their

welcome shade, ore spares a thought for the planners of bygone

years and thanks them for their forethought.

/ AS I go to YO rk •••

-)0-

4IJ I go to work I repeat "Good morning" many times because

I must greot "CJY young J~ian Mems whom we shall Lloet as they

go to school. They would not think me to say "Good coming" in

Tamil (I coul.dntt anyway) because they arc so anxious to greet oe

iA ~.h.Just before we reach the hospital, I shall probab~

pause to smile - this is because I have caught sight of SOIle tri-

~men, or kampong folk taking an early bath in tre river l'hlich

emerges from the Residency grourxis. We don't speak, I would,but

I don't think that they feel it quite proper to talk to a Europlan

on a bicycle - arvway, it unlst look a bit odd, as most lIorang pu-

teh" have cars.

As I approach the school - tre scene of my labours, I see

an archway on top of mich is my classroom.

but non-the-less, a happy place. As I ride underneath I see ray

students preparlq: for tre day. Desks wUl be polished and flow-

ers set ready. Blackboard clean ani all ready for the day's work

at 8 a.m. Before going to class, we teaching staff meet inform-

all;r, and my first job is to groom Jimmie, the school dog. It is

my job, because being a male dog and adult, J:i.mmie has certain

views about being brushed by the lady members of tre staff. They

are best suited to providi ~ breakfast in the shape of a bone. On

the way to class, I usually call on the Senior Tutor, as often

there are pieces of infomnation which will affect the day's pro-

gramme.

Let me introduce IlfjT s1udenl:.s. We ara a veritable II United

/Nations· •••••••••••

-.31-

NatiOnB. U Iiiln and women, MaJ.a;ya, Chinese, Indians and Eurasians

- all le~ together and working 1Il. til one great aim - by learn-

i~. to be good rurses, so raisi ng the standards of health to aJ.J.

communities in llaJ.aya. Most of tllese particular students are pI'&-

paring themselves for the final. examination to qualify them for

registration wi th the Nursing Board of the Federation of Malaya.

Behind them lies three years of study am strenuous practical.

training. They come from moot of the states and SettlemeJ$s of

the Federation. Kedah, Pah~, Sela~or, Perak, Pena~ ard Kelan-

tan are familiar and pictures!.)le-soulliiqJ; names. What a "pot-

pourri", united in purpose, cultural, cOlDllDlnal differences al.l

subjugated to Je arcing tl'B modern ways of health and succour VIi th

which this rew nation may be served. Hardly a day passes without

some ancient; belief being discussed, ani how often found to have

some beariqg on modern theory ani SCientific practice. For exam-

ple, tre local Chinese belief that a certain type of banana will

cause malaria. At first sight this seems absurd, but on further

examination we find that this type of banana grows in swampy

ground - ideal for the breeding of mosquitoes. Also, the lfalays

do not like to drink coffee vlJ.en ore has a cold. How sillJr this

sounds, until they explain that a feverish cold needs rest" and

coffee stimulates. But I am digressiqJ;.

We commeooe our day nth a thirty-mimte reView of previous

work, or play, and discuss the coming events of the day. This

/br~s us to ••••••

•

•

br1JJgs WI to the first formal. lecture of the day, usual~ given

by a visi ti1'€ aJ. rgeon or physician, or ma;vbe one of the other tu­

tors 1Iho is handlil'€ a specialty.

.u-ter this fonnal lecture, a run up and: down the stairs for

ventilation and leg-stretchiI:g, and back for tutorial. This, r

conduct, ani all the usual methods of getti~ facts home are em­

ployed. A. break folloE, for tea, coffee, or what one Will. We

tutors gather together and gosSip, and inevitab~ talk shop during

this period. During thiS time a most popular figure arrives on

the scene - tm postman. Need r enlarge on tm excitement that

too pos·t never fails tc engerrler?

There is one more hour left in the morni~. Maybe, it is

classroom practice or a demonstration, or a lecture on some nurs­

ing specialty - or m~be, seli-study, even a project study. In­

terspersed With classroom studies are visits for bedside instruc-·

tion on the wards. This is directed by our Team Leader. She and

I correlate classroom and ward teachi~. How we Wish tmt more

time cou:kl be spent at the bodside. With the present block sys­

tem of traini~ in operation, we feel the pressure of time. For

mystUf, the amount of classroom teaching required by the rurricu­

lum leaves DE little, if any time for actual case-study. This r

find a great handicap - but thankS to th" efforts of the Team

Leader, liho spends the greater part of her time on too wards,this

h.ar¥iicap is not passed on tc the students.

/Soci~ we •••••••

- 33-

•

. .:.:

Socially we have a wonierful. tilOO. r think one of the most

pleasing features of our relationship in school. is our great cap­

acity for un:iarstanding and enjoying each other's fest1val.s.

In other YO rds, at Chirese New Year we all become very good

"Chinese" and at Christmas everyone is a very good "Chris tian".

This is surely a beginning to a deeper un:lerstan:iing between our

various cultures. How often have we discussed this thrught toge­

ther - ani app:reciatdd that if we can all be happy together, we

can all learn working together on the many problems affecting

people. But r am moralizing. What of the future? How nice it

would be to know, or 1I'01lld it? As each group of students leave

the school" to be widely dispersed" goes the prayer that the prin­

ciples that they have been taught will find expression.

The needs of nankind are So grea~ that, despite convention­

al. thought, despite policies directed to providing our educated

ris ing generation, with jobs" tre re will al.ways be a place for

men am women With a desire to serve. 1tlr prayEr is that aJ.l who

deSire to Serve will fim the opportunity to do so, and that the

legions of men and women serving as nurses will realise that there

is a place for all who will, to join, in this century, the hosts

of men and women, who" since time began have served their fellow­

men in time of sickness.

***

-34-

"~"

The children stood in a mat line, each sleek black head,

wi th hair close cropped, turned towards us with interest, each

pa:lr of shinirg dark eyes fixed on us, on the light, tm lenses

ani the list of" cases. Well they knew what we were doi~. Had

they rot looked attlle wall poster of thc: trachoma demon ani his

evil ways for a year ani studied how to c:ircumvent and rrut him

with tre little tubes of aure~cin which their teachers had

taught them ~ow to use? They knew we" were assessing the reaullis

of a real campaign, how IIIlU\Y people taught to fight for good sight

am cleanliness, how maI\Y' eyes saved. It was the Dragon FestivaJ.

am a holiday but they had come willi~J.y to school so that they

could oolp by letting us turn up their eyelids ani hunt for sigm

o:fthe disease.

Each child, its mme embroidered on the breast of its school

uniform, stepped forward in turn, stood, heels together and made

/a little baw ••••••••

-35-

a little bow, then sat subnissive lIhile tm examination was made,

rose, bowed again, and with a Illl1'IlIUred "Hsieh-hsieh" (thank you),

padded softly away.

1'he examining team was happy for did not th3 records show

that a year ago far more than bali' of tmse children had trachoma

and were in danger of possible lifelong misery am finally blind­

ness? Today, we found only 8% of these are still Slffering from

the disease. We Sipped our tea and smilod at t he children and

each other. This bad been w:>rthwhile.

Ye were travelling tho length of this fertile gentle lam ..

named tID Beautiful (Formosa) by the Portuguese e:xplorers, and

still enchanti~ with its emerald rice fields runni~ up in ter­

races to the tea plantations and the mountains beyond. In the

lIlOuntains lives a rother race, the mountain tribes, with the ta:tlioo

marks still on their faces, and their primitive percussion muSic

still an accompaniment to the ir dan::: es. But they .. too.. have

trachoma md trey, too, await us for our campaign includes them

also. J. hurrlred fifty years ago, they were a fierce people, using

human sacrifice to propitiate their gods. Now they go to school

am the trachoma demon prances on the scl)ool room wall am trey

fight him fiercely ~th anti-biotics.

Just over a hundred years ago a great and good man whose

festival will be celebrated soon and whose story was told me on

th:! long drive south cam to tileir rescue.. Woo Feng was their

/saviour •••........•

-36-

sa.viour. lie Ca.m::l up from the coastal plain from amo~ tOOir con­

querors and lived with them ani taught them of m3rcy and coq,as­

sion and of gentler gods than theirs. They came to love ani trust

him and half beJ.ieved his message. But the old ways were hard to

abanion aId one d~ the chiefs carno to iioo Fe~ and said that a

great celebration was due ani that their gods who had been

starved too long, demanded a human head as sacrifice once more.

They were ill¥Jerviws to reason or pleadings am finaJ.ly, Woo Feng

said, IIYes, once more you mli\Y offer in sacrifice a lruman head but

thus ani thus must you do it and it will be the last human sacri­

fice you will ever offer - Go just before dawn tomorrow to the

rock which is above too village ani there you will see, sitti~

and gazi ng over t he valleys, one in a red coloured gament. Him

you shall slay from behini ani his head is your sacrifice tomor­

row and your last. 1t So he left them.

The dawn carro and the chief stole up to the waiting figure

and the sword sped swift and sure. But wOOn they turned the head,

the benign features of their friend and counsellor confronte:i

them and they urderstood in their appalled !'ecorse all that he

had tried to teach them and have remained true to it.

So we CaIOO, the Trachoma Assessment Team, to their SChool

in the mountains, high above the lovely Sun-Moon Lake. They, too,

were fighting disease but th"lY have a harder campaign than among

children on the coast, for cold and poverty and poor living con-

jditions are •..•...•.••

-37-

ditioJB are 8 till to be conter¥ied With and it is in such an envi-

rorrnent that the trachoma demon bares his claws ant goes to tM

. battJa. TheN he must be frugbt 1Ii.th l\vgiew" with health ins­

truction. with work tmt Naches right into tile families am tre

home life. So tre mountain chilrlren, too, are on the warpath.

, -

-~

Ten p.m. T'IoR>more hours to go until midnigp.t when the small

but sturdy motorlaunch is supposed to leave Apia for the island

of Savai1 (We Saooa). I am sitting in the hall of the Casino H0-

tel dr:i.nld.ng hot coffee out of a therlOOs botUe and listening to

the gusts of wind and rain that sweep over the harbour. What a

queer idea to let a ship sall at such an hour and on such a ~I

But there is no getting around it. OUr yaws teaDS are already

over in Savaii reat\Y to start fieldwork and I am to be there in

the morning. And there is no other boat.

H1dnight finds me at the wharf. !here, a crow of S8JIK)ans

is milling around to see the few off which are going to be ~

travelling companions for the next eight hours. They seem to be

unconcerned about the foul. _ather~ and gay chatter, songs and

guitar play fill the moist midnight air. My courage gradually

returns and a sort of "'What the heck" attitude gains the upper

hand. Soon after midnight our craft feels her way care£uJ.:q

/through the •••

.. 39-

through the SlIlB.ll opening in the coral reef. It is pi tchdarit. I

don't Know how these~seamen do it, but we get through

alright. Once beyorr::l. the caJm waters inside the reef we get a

rough reception by the Pacific (l4l0 has given this Wl~ ocean

this name arJYW'¥ f). ~ roll and tumble through oountains and val­

leys of Wlseen waves mile the rain lashes our deck and onl¥ an

occasional lightning shows us the wilderness aroWld us. I starn

next to the helmsman, who, utterl¥ unperturbed~ manharr::l.les his

wheel trying to keep on a straight course. we are travelling

along the North shore of Upolu in a North Westward direction,

about 1-2 miles away from the reef' edge. A few lights aloqs the

shore remind us that we are not entire4r alone in this world. I

am glad to have swallowed two Avontine tablets before leavjngApia,

for about half of ~ fellow passengers soon suffer heavi4r from

this age old disease of the seas and, present a miserable sight in

the dim light of a kerosene laJrp. The others are ~ing in gro­

tesque positions strewn all over the deck, sleeping in spite of

everything. I finally try for some sleep on ore of the four nar­

row bunks in the steering house, but it is too difficult to main­

tain ~ restful. position, so I crouch do'W[l in a corner and con­

sole ~self with oore hot coffee and ~ pipe.

After two hours of this semi-existence our engine suddenlY

conks out. I had half expected this, 1:ecause it is a rather com­

mon event. I am unsuccessful. in trying to fiM out from the mas­

ter what the trouble is. He probably does not know himsel..f. The

helmsman keeps manhandling his wheel stoically although we are

/ for the time ••••

- 40 -

I I

II

I I

"

for the time being a t the mercy of the current and the wind wch

drive us with inescapable steadiness toward the nearb.1 reef.

Then, all of a sudden, when I had already resigood JlG'Sel£ to aoo­

ther night experience on a coral reef (the last one was:lll Fij1)

the engine starts up again. 1Uld, against all eJCpectancy, it keeps

going steadil3. Relieved of tension I fall asleep.

It is oarly morning men I wake up. Something seems to be

different. lIhat, I cannot make out at first. Then I get it.The

boat is m longer rolling. As I look out of the door I see that

we are inside a reef again and approaching a jetty built of black

Ja va stone. Allk>ng the waiting and waving Saroans on this jetty I

can make out the faces of some of our Samoan yaws team members

and I can see Mr. Maxwell. our admillistrator, Dr. Ramirez our Se­

rologist and Dr. Jepson the National Director. Soon we shake

hands on the jetty an:l rru drowsy mind is attacked lU names of

places which are supposed to be surveyed. Mr. Maxwell then goes

on board the boat in order to proceed to the next district along

the North shore of Savaii where he intends to act as our propa­

ganda agent. The rest of us board our ]a ndrover am a truck and

we are on our way to the villages. 'lhe road is rather rough and

leads along the shore in an Eastward direction. In each village

on the road a team is dropped in order to work there. After some

eight miles we begin carefully crossing a broad Java fiel.d which

stretches over another six miles along the beach coming from an

inactive volcano in the uninhabited JlDuntainous interior. This

was once the site of several fine villages and fertile land. Now

/there is •••••

-41-

there is oothing but this eerie, dead, grotesquely shaped lava,

several. yards deep. Then our car stops am our Saman M;ldical

Practitioners tell me that they want me to see the famous" Grave

of Taupoull • We walk some 100 yards away from the road over the

lava field until we reach a spot where the lava has spared a sna1l

area in its flow. On the bottom of this area is a tombstone , half

overgrown with wild plants. I am told that under this tombstone

are lying the remains of "taupou" (the virgin of honour in each

village which has the privilege to prepare the ceremonial Kava

and marw othertralitional functions). The lava has spared her

grave because bf the fact that sre was a true taupou and a true

Virgin. The Saooans of this area are impressed by this fact and

the story is told frOI:l the !:lothers to the daughters with respect

am alVe. To be a taupou is a. high aiD for a girl.

Finally, in the later forenoon we reach the village wrere I

am supposed to stay with one of our tear:lS, Patanea. I am dog

tired and nv eyes rove longinglJr toward the firo bed which is

prepared for me in a beautifully decorated "fale". But, alas, no

rest yet for tre wickedl I have hardly ti.r.le to look arwnd when

I am remimed by our S.M.P. that official duties are awaiting me.

So I walk with our wan over to another fale (Samoan house) where

the chiefs and crators are already assembled, sitting cross-lamed

aloI:{; tre poles which support the thatched roof. I am shawn r:f1'

place at the head of the assemblJr, strip my s hoes off am settle

/down with a ••••••••

- 42 -

down with a subdued sigh. After having shaken halxI.s from a seated

position with every chief (as is the custom, for once seated a

nen does not get up any roore), the cerelOOnial Kava party of wel­

come goes unier way. Siooe during the first halt' hour I have no­

thing to do but to sit while the chiefs aOO orators exchange the

traditional speeches with 0 ur S. M. P. who acts as ntY orator .. I

concentrate on keeping my eyes open as best r can. At the end of

the hour nv S. K. P. informs me that the chiefs and orators have

expressed their satisfaction about our CXLning aOO may God be with

us. I am tempted to ask him "Is that all you were talking about

during ihe past hour'll' But I know better than that am keep nv

mouth shut. It:is already known to me that the art of ceremonial

oratory is high~ developed amo~ the people of the South Sea and

that they are extremel¥ skillful in saying something over a pe­

riod of half an hour lbich would take a European a short mOment.

to say. '!hen the taupou starts prepar~ the Kava aOO I am served

with the first cup. I remember just in time that I have to let a

few drops fallon the mat in front of me "for the spirits" before

shouting "Kanula" (Health to you') am t.hen ellptying ntY cup. Af­

ter me the chiefs aOO orators receive their cups, one after the

other, according to their rank ~ importance. ~en this is over

it is II\Y turn to address them. I am thanking them fo r their hos­

pitall:~, greet them in the name of WHO and UNICEF and then ex­

plain to 1bem in detail the pUrpoS9 of our coming. Samoans are

not only good orators, but also good listeners and they listen

carefully to rrr:I words ~ich are interpreted to them by our S.M.P.

IAn occasional ••••••

-hl-

An occasional ftMalie" uttered by one chief or another tells -

that they are in agreement wi th 'What I say (Halle .. very welll)

After this part is over, my S.K.P. informs the chiefs that I am

very tired and they cheerfully give me permission to retreat for

a rest. To go to bed is a problem in a fale whiCh offers little

cover tor the privacy of uroressing, blt I am too tired to worry

about such trifling matters, and soon am stretched out on the

fine Kapoc ma ttress. The last thing I take in are the curious

faces of many Saman children lbo stand arouni the fale watching

closely rrry every movement. TIe n darkness closes in on me •••

I must have slept for quite a tew hours, for .nen I awake

the sun is already low. I: feel perfectly refreshed, for, as I

experienced before already, there is no more refreshing sleep

than in the open Samoan fale. After a wash and a shave I walk

over to the fale where our team is busy surveying and treating

the. villagers. They have nearly completed the village, about

two hunired souls. Durirlt; the rest of the work I sit next to them

in a chair and watch them examine and treat 1I1e people. Occa­

Sionally the examining S.M.P. asks lI\Y advice in a doubti.'ul case

before making his diagnosis. Just before darlmess settles in the

work is completed. Our equipment is stowed away in the b:lg moden

box and we all prepare for 1I1e evening meal and the following fia

fia (dance).

Upon request of our terunsI wear a lavalava (sarong) for

these occasion> ani some village girl puts an ul.a of flowers

around ntY neck a nd sticks another flower behing my ear. Now I am

/ accoptable in •

.. bh-

acceptable in their midst and feel at ease. The meal is served

on banana leaves ti'lich are laid out in front of us. We are given

fish, chicken, pork, taro, palusami cooked in coconut cream. A

young coconut provides a refreshing drink and later on very good

cake and Sallllan cocoa is served as a dessert. In accordance with

Samoan customs we eat with our fingers 'Which we had washed before

the meal. While we eat, girls are sitting opposite us· fanning

the flies away. These meals are unhurried and pleasant. When we

had our fill we say "wna" (finished) and a girl comes running

with another bowl of water, soap and a towel and we clean our

hands and mouth. This attention is given us wherever we go.

In a whiffy the remainders of the lIBal are removed from

sight and the fia fia can l:egin. The women of the village, all

unUormJ;r dressed in the colours of their village women1 s comnit­

tee sit down opposite us and quick appraising glances are shot

into our direction. One of the ~men jumps up and directs the

other women in singing and rhythmical clapping of hands. A Ukele­

le and a guitar are underlining the singing which is always very

beautiful and instills a fine feeling of peace, joy and relaxa­

tion, no matter What the day had been like. Soon two, three wo­

men are in the fore moving their legs am arms gracef~ in a

Samoan siva. This dance is full of individuality, quite different

from the disciplined vakamalolo of the Fijians or the eJe gant,

unduJa. ting lIDvements of ihe Hawaiian Hula. Each dancer reveals

her tenperament in the Siva, sone lOMell (and also men) are e:xpert

dancers am it is alwcvs fascinating to mtch them. And watch

/them I do ••••••

-hS-

them I do, very care~a For I shall have to dance the last

dance in each fia fia. .it.nd I am learning rapidly, at least that

is "What the polite S8JOOans sa:y. It is after midnight.men thiS

last dance comes and then, after a refreshing shower, we hit the

sack for a few hours.

The following weeks follow Pllch the same pattern: Arrival

in a village, Kava cerelOOny, start of work which lasts until the

evening, interrupted by a one hourl¥ lunch-and-siasta break,

sleep_ In order to preserve the worki'l?; efficiency of our teams

we have expressed.ly asked the villagers to abstain from i'ia fias

for our teams during the week. But the end of the week, before

moving to the next district a big-style fiafia is alwa:ys held.

At this occasion our six field teams are assembled in the main

village of the district and we are in a posi tioD to return the

courtesies c£ singing and dancing. OUr group is very good and we

earn big appl ause wherever we IIR Ire our appearance. OUr program

is varied, a number of especia~ beautiful songs are selected

and our team members not only daree the Samoan siva, but also the

Tahitian papio, a fast,rbythmical dance, am even a hula is onour

repertoire now. Soretimes I feal like the director of a migrating

circus show . rather than the leader of a yaws team, but it woUld

be wrong to underestimate the importance of these things from the

standpoint of popularity. And popularity is what we need most to

get a one hurnred percent co-operatim from the Samoan villages.

The news of our coming is now spreading rapidJ.,y through Samoa and

the districts are now eagerly awaiting us. We bring SOIOO change

/ into their •••••

-46-

into their rather unifonn lives of fishing aoo copra and cocoa

growing. life are a walking infonnation can tre for the villages

coming from the capital of Apia, bringing the latest gossip. .AJli

if '!here is any countlY in the wrld where propagaooa am good

public relatiore are vital for a yaws campaign then it is Western

Sam:>a. lie have found that out during the first few weeks of our

work. We sonetimes refer to this campaign jokingl,y as the nSiva

C8.l1¥'aign" and laugh at ourselves. But everyore of us knows that

this is a serious business and that without the siva there would

be no successful yaws caJ!1)ai.gn. So our teams are do~ the:lJ:o

bes t in examining and treat.ing by dq and sivaing their way into

the hearts of 1he people by night.

* * *

- 47-

and §)now ~ ;." By DR. J. 81ERDRAGER ';:' s

After Greenland, New Guinea - area 347 ,J~50 square miles -

is the largest island in the world ..

A rugged limestone mountain range with peaks up to 16,000

feet high, a number of which are covered with perpetual snows,

runs lengthwise through the island, flanked tuextensive low-lying

plains.

Since New Guinea is on~ a few degreBs below the equator

its climate is typically tropical. Longitude lLl deg. consti-

tutes the dividing line between Netherlands New Guinea and the

Territory of New Guinea ani Papua, th e la tter being under AusiIm-

lian admi ni..stration.

New Guinea1s people are Melanesian. The irhabitants of the

central lOOuntain country are of smaller stature than those living

in the lo~lying country and along the coast. Huroreds of lan-

guages are spoken~ Communities from 500 to 50,000 people comprise

a "language area".

lIn territori as •••

In territories not yet UI¥ier Government contx:ol continuous

warfare is carried on ruoong the tribes, to which women ani

drGDalike fall victims, and cannibalism is frequent.

cldJr

New Guinea is first IlVilntioned in histor,y in the year lSIS.

In this year the Spaniard) Inigo Ortiz de Retes, was th:l first to

set foot 011 Papuan soil. In 1828 the Dutch settled in the western

part of the island. Mortality was so appallingJ¥ high in this

settlement that it had to be abandoned. About the year 1920 medi-

cal care fer the then extreme~ primitive population was begun.

Malaria, by far the most important disease in New Guinea,

is most prevalent in the low-lying plains and along the coast.

Aloong adult Papuans th e spleen index is nearly always above

60 per cent am, in children above 80 p3r cent. In fact, one au­

thor!. ty has stated that the Papuans, and especially their chiJ.,.

dl'arJ, represent a source of. malaria pa rasites unequaled in simi­

Jar areas of South East i~sia Md the Western Pacific.

It is impossible to estimate, e'/en approximatel3', to what

extent the energy of the papilla tion is advorse~ influenced by

the weakening effect of malaria attacks, nor do we have reliable

data on birth and mortali'lV" rates at our dispo~al.

It is a well known fact, however, that young PapuanchUdren

up to three years of age look unhealthy, are thin and anemic am that all medical officers report a high infant IOOrtality from

their various dis tricts.

It was supposed in the beginning that ft,nopeheles punctulatug,

which in New Guinea is the mosquito mainly responsible for trans-

/mitt~ the •••

- 49 -

m:i. tting the disease, could not be effectively combated by means

of DDT irrloor spraying as this species was not :in the habit of

remaining indoors after feeding.

Dr. Ph. van Thiel, Professor of Parasitology in the Univer­

si1;y of Leyden~ has proved~ however, by the use of "trap houses"

that the supposition is only partly true.

With the aid of 'WHO an:! UNICEF an eradication project was

started on a large scale, after it had been proved by a pilot

project that after 0 re spraying the plasmodium reservoir could tEl

reduced. by half. The reduction of primary infections :In ch:lldren

under one year of age was as high as 90%.

After malaria in importance comes Yaws.

The percentage of active yaws lies between 5 and lS, and

serological examination has proved that 90% of the population

suffer from the d:isease.

With the aid of 'WHO and UNICEF a nass yaws eradication cam­

paign has been started. The aim of the campaign is explained to

the people and they. coma for treatment in large numbers. Injec ..

tions are generally popular and treatment percentage arounts to

91%.

TUberculosis is found in all forms but pulJoonary tuberculo ...

sis is the 100 st important. This disease, as well as leprosy, has

only recently been introduced into New Guinea.

Tuberculosis is mainly found in urban centres and the popu­

lation of central New Guinea, which for the greater part is still

living in extrenely primitive corditions.

lIn close ••••

-50-

In close e»-operation with WHO, a 'beginning has 'been JlBde

1<11.. th the systematic survey of the population, after web ICO

vaccination will 1::e given in areas where this is [l!cessaI1'.

In 1953 the training of infant welfare nurses ;as begun.

Ten of these nurses are now ;oorking independen~ and 40

more are expected to be available during the present year. Be­

sides care of maternal welfare and child h;y'giene, they are also

tra;imd in midwifery. They are to be looked uron as the "pioneers

of health. in the remotest places, where infant mortali1:¥ is high.

New Guinea is a cOlUltry of contrasts. l;.longside communi­

ties lilich are among the most primitive in the world there are

others taki~ an active part in the process of cultural develop­

ment.

It is umoubtedl¥ a long way to a tavourable state of health

gener~, but it is not without prospects for the future. Tbere

is a great deal of interest in health education and by far the

'best educators are foum among the Papuans themselves.

***

.. 51-

b~ DR.. fUMIHIDE KOIKE & OR. HIROSHI YAMAMOTO

The stol)" dates back to

about fo~ years ago when Dr.

Kenji Takagi, then Professor in

the Orthopaedic Departnl3nt of To­

kyo Uni ve rsi ty Medical. Schoo~,

launched a campaign for establish-

ing a rehabilitation programme

fo r the crippled.

In thoeo days -rehabilita-

tion was quite a new concept, and

his proposals" which included the founding of a kim of social.

welfare system for the crippled, were regarded as the ideas of a

potentia.l:Q" dangerous political extremist.

His advocacy of the necessity to set up a hospital. which

would al.so be a school and a home for crippled children, a S11rVf!IY

of crippli~ co rxii tiona among the children of a municipal. primary

school, his public speeches before progressive professor-student

groups - all these activities, which he started:in 19lB, attracted

the attention of the sensitive police author:i.ties. He was kept

under close observation.

/Even the •••

Even the few ~athetic ani understanding persons in fi­

nancial and influential circles had to wait for some years before

they <lered to throw off their hesitation to help him ope~.

About this time the Tokyo area was vis ited by the great

earthquake of 1923. The heavy damages am casualties brought

about an unprecedented social chaos in the country, but this hap..

pened to arouse 8J1DIlg SOlIS intellllctual classes the idea of set-

ting up a social security system.

This trend resulted, to some extent, in helping Dr. Takagi

in furthering his campaign. Thus, in 1925, an association for

the aid of crippled children was organized by a group of finan­

cial, political and medical persone.HOwever, he had still a long

way to go.

In 19.34, he gave a special lecture on the importance of es-

tablish1ng his flhospital-school-and-hone" for crippled children

at the 9th joint session of the Japan Medical i.ssociation.

His address was accompanied by a film demonstration of a

number of therapeutic results, end he won over his audience mose

admiration was, however, still tempered with sone suspicion. 'This

one-hour speech, (also broadcast throughout the country) caused a

profound. sensation among professional as well as lay listeners.

Dr. Takagi kept on and eventually, with the Japan Medical

1.ssociation behind him, the present Japanese Society for Crippled

Children was formed. His long-cherished desires were partly sa­

tisfied when the Seishi R,yogo En (hospital school m d home for

crippled cbildren) was founded by 1he Association in Tokyo in

1937.

-53- /This institution •

•

..

This institution, covering a total floor space of 71,Jb6

square feet in spacious grounds of 1OOl'e than 16 acres, provided

fo r 10" in-patients all-roWld services of rehabilitation, includ­

ing surgical operation, orthopaedic treatment" physical and occu­

pational therapies, school education, vocational guidance train­

ing.

The institution, a Mecca for crippled children, drew visi­

tors from all parts of the country.

Through its actin ties the interest of the people in reha­

bilitation has grown with remarkable rapidity. UnfortunateJ,y,

however, the last war calli!, am the institution was almost com­

plete~ destroyed by a series of air raids in 1945. The mric,

however, was continued by utilizing the converted nurses' dormi­

tory, the only part remaining un1:urned.

hfter the end of the war, which brought about Uli'arallaled

changes in the social am ecommic situation of the country, so­

cial 'IOrk proved almost impossible so far as voluntary,individual.

support was concerned. As a result, the government had to assume

much larger responsibility than before for the welfare of the

people.

In consequence of thiS, new laws were proJlB.ll.gated one after

another: Child Welfare Law of 1947" Law for tJle Welfare of Dis­

abled Persons of 1949, Dai~ Life Security Law (Public i~stance)

of 1950, Social Welfare Service Law of 1951, and others.

/'the <hild •••

-~ ..

The Child Welfare Law was originally prepared for the pur­

pose of counteracting the pressing problaJIIS concerning children

such as those of foumlings, orphans and of juvenUe delinquents.

Some members of the draft:ing committee were hesitant to

adopt in the law the programme for the. physicalq handicapped

children on the ground that this ,las not so urgent a matter. How­

ever, public meoory of the splendid works of rehabilitation per­

fomed in the past finall¥ carr:i,ed the ~.

Thus services for the physically handicapped children have

for the first time been put into a governroont prograJlJ1\e to be run

on a nationaL-prefectural basis.

The programme now being carried out includes:

1. Clinic services for early casefinding and screening qy

135 health centres (aoong 783 health centres) and qy m­

bile clinics.

2. Short term, preventive treatment services, by the de­

signatod general hospitals - treatment given at the

earJ,y stages of disabilities aiming at the so-called 8:)­

condary prevention.

3. Provision 0 f prosthetic appliances.

4. Planning ani budgetary support for construction ani ope­

ration of the "hospital-schoo1-ani-homesR for crippled

children.

The nhospitaJ.,.school-and-holOOlI is a community centre fbr the

rEhabilitation of crippled children, and there are now 17 such

institutions established throughout the countxy.

...

J

AnDng these, the Seishi R¥ogo En in Tokyo" mentioned above,

has been under reconstruction since 1950 by 1m Ministry of Health

and Welfare which plans to make it eventuall,y a complete demon­

stration centre for the country.

WHO am UNICEF came to the help of the Japanese Government

in this connection in 1952.

Under this project six WHO fellows were sent abram to stu­

qy and observe general rehabilitation practice, physical therapy,

occupational therapy, orthop"tedic nursing, medical social work and

speech therapy for the cerebral palsied children, respectively.

Two WHO consultants on general rehabilitation and on occu.­

pational therapy came and stayed in Japan for a month each and

have done splerxiid work.

UNICEF also contributed equiproont ard literature on rehabi ...

litation to the value of $17,000.

This project worked excellently in many ways a.rxi one of the

results was that the Seishi Ryogo En has reen provided with im­

proved facilities as a demmstration centre for tra1 ni ng the wor­

kers who are badly needed in each branch of rehabilitation.

'1he "IOOther-child class" of the Seishi R¥ogo En in Tokyo

deserves special mention.

This section, constituting 30 'OOds of the total 2OD-'OOd ca ..

paci ty , has been carried on for these three years mainly for the

cerebral palsied.

To this section of the hospital both mother and child are

admitted together for about two months, during which period the

/mother learns •••

mother learns how to take care~ both pbysica.lJ¥ and psycholog1-

callor ~ of her palsied child at hOm3 ani the child comes to res­

pond to his therapeutic training and is encouraged in overcoming

his handicaps.

ntis class is open fur the cases of cerebral palsy in ear~

chiJdhood who are inseparable from the parents. It is also in

sorna part open to severe cases of cerebral palsy for training in

selt-help activities. 'Ibis " rnother-child class" is performing

excellent work am is welcom3d by the parents •

•• long with the government progrrurme the Japanese Society

for Crippled ChildrenJ Inc. - activo member of the International

Society for the Welfare of Cripples - has been carrying on a wide

var:ie tvr of voluntary services centering around public aoo. parent

education.

Prejudices that were held against physical hamicaps in the

past are now eradicated and people find interest and pleasure in

helping crippled children. lie are~ however, still faced tv great

shortage in facilities and staff to meet the total needs of the

colTllllWlity.

We koow that the establishmsnt of rehabilitation services

is urgent~ needed and is being planned in other parts of the

Orient. We hope the plans and efforts which are bejng made in

those countries will bear rich fruit in the near future.

***

J

•

"'.

Tke WOR1(~ <::'1[-'--; •• '-

~'i-, ~'H~~A--N' ':..,. - t"I"~

1\ \ \' \-:-'- .. c-'.~,' .. I, ,

"" ' ,\':' ,

'tke MAT~RNAL and CHILD fAM in Vt~TNAM

- . - . -

Our work in Vietmm started at the beginni~ of 1955, but we

can sq that up to the tine this story was writteA all we have d~

is to prepare for the job that is to be dare.

First we went to a town in the mountains of Vietnam called

Dalat. The population of th:iB town is Vietmmese and French. It

is surrruncled by villages where the primitive Montagnards live.

Da1a.t has a civil hospital of several pavilions with approXimate-

ly 200 beds. One pavilion is qu ite new. Unfortum te ~, t1J:l hos-

pital is built on top of a hill and the water supply, due to lack

of pressure, :iB very poor. That is being correctEJd now with aid

from the United States Operations Mission and very soon a pl,mp

installation will take care of regular water supply.

The Montagnards, who are ala 0 called Iilis, speak several

dialects and keep apart from the Vietmmese population and have

their own pavilion at t1J:l hospital. ViSi ting families are seen

/making their ••••

-58-

making their own fires in the hospitaJ. grounds and cooking their

own mealBthe re. They are a shy, friendly people rut cleanliness

is not om of their virtues. They are dressed rathilr spari~ly

w.:I.th a hand-woven mtive oJ.oth wrapped around them. The mothers

carry their small children durin g their long weJXierings in a

sling on their backs. They have no schools in their villages, no

IEdical care and wanier long distances to reach a. hospi1iaJ. or a

market place. '\ihen the soil ara:url their village is exhausted,

they abandon itarxi move to another place where they build a new

village of hu ts •

The Vietnamese POp1.]a tion of Dalat is quite different. It

is intelligent and they cultivate beautiful vegetable and fruit

gardens. They also have several French and Vietnamese schools.

Their cleanliness, however, leaves much to be desired and the in­

fant mortali tu is high becauso of intestinal infections J pneUIDo­

nia, skin and eye diseases. Preventive medicine is practically

unkmwn, with the exception of a small minority of well-to-do wo­

men who go to the hasp ital for prenatal care. An attenpt of the

Social Service of the town to establish child clinics has failed

in the intensive campaign to educate the women as mothers failed

to visit it vdth their children. So we decided to start consul­

tations for sick Children at the hospital, aside from those we

had for adults. ile did that with the aid, equipment ani medical

supplies from the United Nations Children\s FUni, while the Uni-

/tod States ••••••••

- 59-

..

, I

"

•

."

ted States Operations Mission gave the furniture aOO the printed

material. The clinics are visited by Vietnamese children from

Dalat itself' and Montagnard children from the surroundill?; ville.­

ges. Sometimes half of a Montagnard village arrives at tw same

time. As soon as we have a secord maternal ani child health nurse

for thG team and have received from UNICEF the equipment for a

prenatal consultation room in the Maternity waro,Vte hope to ex­

pand these consultations. Later we are going to start again the

well-baby and prenatal clinics.

After having spent three months in Dalat, we reillrnad to

Saigon to assist in the openill?; of tle Children'S Hospital there.

This hospital has beoo built by the Government and has room for

100 children. In time it will have room for 250 children. It is

the first children's hospital built in Vietnam.

Saigon is a city of more than two million inhabitants, di­

vided in two parts, of which the Chinese part is called Cholon.

TherG are SGveraJ. other hospitals with children1s departments, but

all are too anaU fir this enormous population. The Uniwd Na­

tions Children's Funi (UNICEF) and tre United States Operations

Miasion (USOM) are furnishir.g the medical equipment of the hospi­

tal, while the Govermnent is taking care of tre non-medical equip­

ment. 1l. postgraduate course for nurses who have already a state

diploma, will be opered in the hospital with the assistance of

the maternal and chili health tGBm ani the medical students of

the university of Saigon Will get t.heir paediatriC training there.

**** -60-

'.

"

..

o q~ fiJI tilAHOf

ROBERTO Rt'NDUElES

, , I ' \ \ I • 1

When I arrived in Fiji, I discovered that the pilot stage of

the yaws control campaign had ended and that 1he s:ix assistant

medical practiticners who had been t :-ained 1:¥ Dr. FriecirichC.

T1'08S, the WHO Medical Adviser to the Government's Yaws Control

Programme, were now heading their own Yaws Teams ani in-charge of

the caJJtlB.igns in the various islands of the Group. Three tealllS

were in Savu-SavuJ second largest of the islands, one was in Ta­

veuni; another one was in Lakemba and the last one was :in the

island. of Kandavu, ~ich is some sixty miles south of the min

island of Viti Levu.

I had a meeting with Dr. Friedrich C. T1'Oss, woo was gottiag

ready to leave for Western Samoa, where he was to help the Govern-

ment begin its own Yaws Canpaign and Dr. L. I. Verrier, Medical

Off:icer of 'the Fijian Government in-charge of the Yaws Programme.

They decided that I should go to the Island of Kandavu and see

how the yaws team there was operating under the direction or the

/assistant. medical •••

- 61-

assistant medical practitioner, Tayione Sikivou. Dr. Verrier, a

most energetic and most enthusiastic nan mo is an expert on

health statistics, took care of making arrangements for the trip.

One Sunday evening, I was driven in a UNICEF landrover to the me­

dical vessel, the 7O-foot ketch VUN~ which was moored to a

pier in Suva harbour waiti~ to take lie on the t ~ to Kandavu

Island. "Vuniwai" is the Fijian word for 'physician' am the mi­

nute I boarded the ship I felt that I ms in good hands, especial­

~ when Captain Filipe shook hands with me am guided ma to his

cabin. Seru, a Fijian IOOmber of Dr. Verrier's staff in Suva, was

also on board to act as ~ interpreter an:!. guide.

It was almost II o'clock in the evening when we left Suva

Harbour am the WNIWAI began to be pounded by heavy winds. Seru,

who is a native of Viti Levu am had never left the island, be­

came very seasick and had to be helped to his cabin. 'Ihe winds

continued throughout the njght am poor Seru was very sick.

When I got up early the next morning the sea was calm am

as the S'tlll rose in the sq there was every sign that it would be

a beautiful day. In the distance _ could see Kandavu Island

looking very green. It was about 8r3O in the IIIOrning when t,he

VUNIWAI sloWly slipped into the waters of Namalata Bay, where the

village of Vunisea is located. Assistant Medical Pr~ctitionGrs

Taione Sikivou, in-charge of the Yaws Team in Kamavu, and Mesui­

lare V. Mataitoga, in-marge of tile Vunisaa Hospital, came aboard

to greet me. They infol'JlEd lIB that the Yaws team wouJl:i be leav­

ing soon for tile village of Naniara mere I wouJl:i have an opportu­

nity to see it in action.

- 62 -/Kandavu is ••

.f

~ I

Kandavu is thirty-six miles long and varies in width from

eight miles to a few hundred yards. Thus at Vunisea, Namalata

Bay and Galoa Harbour are separated only by a sarxiy isthmus s tand­

ing a few feet above sea level. The mountain ranges are high

for so narrow an island, several peaks being tWo thousam feet or

more in height, and many others exceeding a thousand feet.

TIlere are no roads in this island... just trails and travel

is by foot. Commur~cation from village to village is b.Y boat.

We visited the Vunisea Hospital where Vie met the staU. Joanna,

the Fijian nUrse attached to the Yaws Team, and Anawaita" another

Fijian nurse, who had been lent by the hospital, had everything

ready for the day's trip to Namara. At the Hospital I also met

the Mosquito Inspector \>mo decided to accompany us to Namara.

Through a narrow trail we descended to Galoa Harbour where a mo­

tor lrunch was waiting for us.

The trip from Galea Harbour to the little bay leading to

the village of Namara took atout one and one-half hours. As our

launch approached the mainland could hear the sound of a sball

trumpet - which reported our imminent arrival.

'lhese trumpets are used in Kandavu to announce the arrival of vi­

sitors. In former times these trumpets ,-,ere used by turtle fish­

ers to announce to those ami ting them on land the degree of suc­

cess with which they had met during the expedition.

A member of the village lOOt us to announce that a prize

consisting 0 f a tale of p andamus the fibra used for making mats,

was awaiting the first of the party to arrive in the village.

/Seru and •••

- 63 -

Seru and the Mosquito Inspector raced for this prize am Seru won.

He was vo17 plaased as his wife knew how to make mte and had

asked him to get some of the fibre.

~e team was welconed by the Turaga-ni-Koro (head of the

village) and the lOOn of the village in an impressive ceremqf

during which I was presented with a Tambua. (a whale's tooth) am

offered Yanggona (the drink made out of the Yanggona root which

is the symbol of friendship and hospitality).* Since the team had

to begin its work the Turaga-nL-Koro agreed to po~tpone a make (a

gesture dance qy the w::>men of the village) until after the yaws

programme operations had been finished f or the day. I thanked

the Turaga-ni-Koro in the name of tolHO for the Tambua. and "We than

proceeded to the school where Taione expla med the purpose am

aims of the campaign. The children listened most attenti~.

Joanna and Anawaite turned the schoolroom into a sort of

hospital. dispensary. A table was placed outside which Taione

Sikivou and Mesuilame V. Mataitoga used as a desk to fill out the

marw cards describing the cases which they were to examine during

/the course •••

*The Yanggona ceremony is carried out as followsl (1) 'Ille root of the plant (from which the drink is prepared) is first presented to the honoured person; (2) the tradi­tional. yanggona bowl (carved from a solid piece of wood) is brought forward. The shredded Yanggona root is put in the bowl; (3) water for use in th6 preparation of the drink in a hollowed polished coconut shell is brought am p1::tced on top of fresh leaves; (4) the prepared root is "kneaded" in the water which eventually takes on a milky appearance; (5) with the greatest ceremorv a halved coconut shell is d;i.pped into the bowl arxl hal.f filled with the liquid) (6) the h0-noured guest accepts the bowl from the bearer. . The drink­ing of the Yanggona is followed by solem hand clapping by all p:-esttlt at the ceremorw.

the course of the day. The smiling children lined up at the right

and the examination began. As Taione ani Mesuilame examined them,

they were haDded a slip of paper which they took :inside the school

and were given a penicillin injection. '!here was no crying, no

protests - they all took their medicine like little soldiers. By

4.30 all the children of the village had been examined and treat­

ed. Taione reported that thirty-five percent of them had active

cases of yaws. In a few weeks after receiving treatment all these

children would be free from yaws.

That is wny for me it was such a happy occasion to go into

the village meeting house ani watch the W)nen of the village per­

fonn a m.elo3 (gesture dame an:i singing). Somehow these people -had heard all about the magic qualities of penicillin am thoy

l4. shed to express their appreciation. 'llle Turaga-ni-Koro again

e:xpressed the appreciation for the viJ.lage. Through Seru, 11\1 in­

terpreter, I explained to them !IV own purpose in visiting the vil­

lage, which was to be able to tell the sto.ty of mat the Govern-

mant, WO and UNICEF wore doirg in connection with the campaign,

so that cont:inued support could be given to the work that was

being carried out. It was the first ti.1le that Namara had heard

arwthing about public information.

After the meke I.as given a simple supper of b:liled chic--ken and broth am then I accepted the Methodist minister1s invi­

tation to attend the services that evening. More than 8u per cent

of Fijians are Kethodists. They love to sing and it mq be that

for that reason they have found a greater expression in Methodism

/than 1t1 •••

- 65-

than in other religions. Again the Minister expressed the apoo

preciation of the people and prayed for the success of the Yaws

Team.

'!hat evening the Team was invited to a "Vakamalolo" (Fij:ial

sittjng down dance). I did not attend but I was told that the

celebration lasted until about three o'clock in the IOOrnil'Ig.

Seru, who represented me in the cerenxmy told me he had drunk

Yanggona all night lo~ and felt quite Sick the next day,

In spite of the "Vakamalolo" the Yaws Team was already in

action a little after seven o'clock in the morning, when exam:i.Jla,oo

tion and treat.nent of the adult population am the babies were

started. By eleven o'clock the job had been done and we were

ready to depart. OUt of a population of 117 persons, 106 had been

trea ted, Eleven persons were absent visi ting other tillages,

'!hey would be asked to go to Vunisea Hospital to be treated later.

Twenty-one per cent of the adults had been found to have infec-

tious yaws.

Again 1:efore the Team left, we were 0 ffered IOOre Yanggona

and as we went down the hill towards the beach, the young girls

of the village accompanied us. '!he rotor lauooh did not arr1 va

in time rut since I had to make a connection wi 1h the WNIWAI,

Taiona Sikivou, Seru and I took an outr~ger ani met the Jaundl

halfway. The rest of the team, it was decided, would wait for

the launch to pick them up with the equipl1J3nt. As our outrigger

departed the girls of the village began to sing "Isa Lei" the

bautiful F:i.jian farewell song.

/We met •••

-66 ..

, I

, I

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.. '~ .

...

We IlEt the launch half'wq to Galoa Harbour and we got on it.

We were soon at our destination, and after saying goodbye to tile

Hospital Sta£:t:" I left to meet the WNMI again. I said goodbye

to Taione Sikivou am as I boarded the WNIWAI again, I thought

that the Fijian Government had every reason to be proud of its

OPERATION Y.AJi3 ERADICATION. Soon all the smaller islands would

have been covered ani then the six teaIIB would converge in the

big islaM of Viti Levu for tile final operation. Atter that it

was hoped that there would be a beginrWlg of a yawsless era in

the Fiji Islands.

***

•

L

SOMETHING ABOUT 'lEE AUTIDRi· OF 'lHESE SToom

Sir ANTHONY FOSTER ABELL, K.C.M.G., is tre Goveroor of Sar-

awake

Dr. LAWREf£E O. ROBERl'S is the Vfil) Regional Adviser on Tub­

erculosis for the ~stern Pacific Region.

PilPTOR S. ECHI\.VRl is the WHO Public Health Engineer in the

Malaria Control Project in Taiwan (China).

MARGARET CHALMERS is a WHO Senior Nurs e Educator in Singa-

pore.

Dr. J. LLEWELLYN SAUNDERS was a WHO Dental Health Consult­

ant aSSigned to the Philippines.

JOHN WATERER is a \1HO Nurse Educator attached to the lilrsing

Pro ject in PenaIlg, Federation of lJalaya.

Dr. JIlJ\ MANN was a WHO Trachoma Consultant in Taiwan

(China) •

Dr. FRIEDRICH C. TROSS, whose two stories on the Yaws Cont.

rol Campaign in Fiji appeared in the first volume of this series,

now tells of the Yaws Control Campaign in Western Samoa. Dr.

Tross is the ioo Medical Officer attached to t he Yaws Control

Pro ject currently being carried out in the Bri Ush Solomon Islaals

Protectorate.

Dr.J. BIERDRA.GER is the Director of Public Health Service,

HolJanUa, New Guinea. He was chairman of the Seventh Regional

Committee Meeting of 1jffi() for the "Iiestern Pacific held in Manila.

Dr. FUMIHIDE KOIKE is. a Crippled Children's Officer, Child­

ren's Bureau, Ministry of Health am lielf'are, Japan am

Dr. HJROOHI YAMAMOTO is the Medical Director and Surgeon­

in-Chief of the Seishi Ryogo En (Hospital School & Home for

Crippled Children) Tokyo, am a former YHO Fellow.

Dr. J. A. STROINK is the \ffiO Medical Officer for the Mat­

ernal and Child Health Demonstration Project in Vietnam.

ROBERTO RENDUELES is the Public Information Officer far

the w~ Regional Office for the western PacifiC.

*** -M-

• I ~

Stories of the

WORLD HEALTH ORGANIZATI(]

1957 EDITIO;,; - Vol. III

.' .. •• rQ

•• _ 0::> <t. _

',. G o <:;) ..

!\ I '. a. 'V ••

n' )

o· ..

IN THE WESTERN PACIFIC I I

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•

STORIES OF 77IE

WORLD HEALTH ORGANIZATION

IN THE

WESTERN PACIFIC

1 9 5 7

Published by the

PUBLIC INFORMATION OFFICE WESTERN PACIFIC REGIONAL OFFICE

WORLD HEALTH ORGANIZATION MANILA

1957 • Vol. III

t

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FOREWORD

The yearly publication of STORIES OF THE WORLD HFALTH ORGANIZA­

TION IN THE WESTERN PACIFIC has now become a tradition in the Re-

gional Office. The first two volumes have been well received and

have become a source of material for writers. The stories as a

whole give an impact of our work in the Region which could not be

possible by the mere reading of off1cial reports.

This year, the stories again tell in human terms of the work

that is being done in this part of the world by the various govern-

ments with the direct or indirect help of the World Health Organi-

zation. Because the World Health Organization will celebrate its

Tenth Anniversary in 1958, we include also a story by Ruth Ingram

who started ber career with WHO in 1947, in which she describes her

pioneering work as nurse educator in China during some very cri-

tical years . and her work wi th the United States Government in the

Trust Territory of the Pacific.

Again, 'With these stories also go my greetings to you and best

wishes for the coming year ___ during which will be celebrated the

World Health Organization's tenth birthday.

/~c--r.'lC I. C. Fang, M.D. Regional Directo .

December 1957

-i-

TAB L E o F CONTENTS

FOREWORD Ilr. I. C. FB.Il.g • _. • • • • • • • • • • • • • • • • • • • •• i

~

* TREE OF LIFE Dr. W. G1ytl Evans • • · · • • • · • · · • • • • • • 1

* TIlE KAPAUKOS OF TIGI LAKE Dr. Donald R. Huggins • · · • · • • • · · • • • 9

* TIlE STORY OF ELICIA HECHANOVA Dr. Sofia Bona • • • • • • · • · • • · • • · • · · 17

* OF .HEALTH AND ELEPHANTS Dr. R. Pierron • • • • • • • • • • · · • • • • • • 24

* ON THE ISLAND OF THE WINDS Dr. Alan H. Penington • · • • • • • · · • · • • • • 31

* TIlE STARLINGS - FOUR YEARS lATER Roberto Rendue1es • · · • • • • · · • • • · • • • · 37

* THE HERB-DOG"l'OR' s GRANDCHILD Taione Sikivu • • • · • • • · • • · · • • · • • • • ~

* A HIIDT OF CANDELARIA Jose C. Abcede • • • · • • • · · • · • • • • • • · 46

* "MISSION COMPLEI'ED" IN SMALL MAIAITA Dr. Friedrich C. Tross • • • · • • · · · • • • • • 54

* TEN YEARS OF NURSING EOOCATION IN CHINA, BtrnMA & MICRONESIA

Ruth Ingram • . • • • • • • • • · · • · • • • · • • fIJ •

BOMErHING AOOtJr TIlE AUl'HORS OF THESE STORIES • • • • • • • • •• r(~

-1i-

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TREE ~ lite by

dr. w. glyn evans

"Hope def'erred

lIl8keth the heart sick but

when the desire cometh it

is a tree of life. " It

'WaS indeed a tree of'

life that after many

hea.rt.sick f'rustrat:f.ons

and disappointments we

dropped into Dareo in

the Kelabi t country of' Sa.rawak by pa.re.cb.ute on 30th January 1957. A parachute supply drop like this needs to be organized well in

advance and the initial. moves in the planning of this one were about

six mOQths previously when it 'WaS decided that the OIllY way in which

malaria control couJ.d be taken . GO this territory would be with the

assistance of' an airdrop. The date decided for the drop 'WaS January

24th. I cannot nov say exactly why this date was fixed, I think it

'Was purely arbi tra.ry. We had to say some date and January 24th

seemed as good as any other. It would take the ground party about

three weeks to reach the drop!"·ing zone from their Hea.dqu.a.rters and 1 t

may have been in our minds to let them get over Christmas and the New Year before starting out. Anyway, -whatever the reason January 24th

-1-

'WaS fixed.

Correspondence 'WaS started 'With the Royal Air..2oroe in Singapat' e

and they confirmed that the 24th and the succeeding few days w::>uld be

reserved for us. At the same time we started to make lists of the

vari::>us things that we wanted to be dropped and began to collect the

necessary materials and to arrange for their special packing. We

thought that YIh1le the airc;rai't 'Was available we should take advan­

tage of it and have another airdrop to another party in a different

part of Sarawak, but this second drop was later cancelled as it was

not absolutely essential like the one at Dareo was.

On January 6th the ground party of 30 men under the leadership

of Mr. Franct0is Lachance, World Health Organization Entomologist

with the Sarawak Anti-Malaria Project left their Head.q'Ja.rters at Me.­

rudi and proceeded u;pri ver towards the dropping Z-:lne 1 and then we

lost touch with them until more than three weeks later when we saw

them fram the air like a lot of little ants running about on the

ground. The Journey from their Headqu.a.rters at Ma.rudi to Dareo would

ordinarily be, first, by river f::>r ab-:lut a week to a place called Lio

Matu in the head waters of the river Ilaram and then by trek through

the jUJ:lgle for about another week.

As the date of the drop approached we began to get very worried

about the weather. January is a wet time of the year in Sarawak, but

the third week of January -was the nastiest ever remembered, and it

looked as though the flight was g::>ing b be very difficult. Then on

the eve of the drop, that is on January 23rd, a long telegram came

from the Royal Air Force saying that on account of exceptionally bad

weather conditions and weather forecasts indicating no improvement in

the near future it was prop::>sed to postp::>ne indefin:Ltely. Unf::>rtun-

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L

ately, no arrangements had been made ..n. th the ground party for such

an eventua.lity. We bad supposed that far reasons of weather or dif­

ficul.ties :;,1' navigation we might perhaps n:;,t have been able to find

them on the first day and they were instructed if we fa.1led to ar­

rive :;,n the 24th to look out for us :;,n the 25th, but the possibility

:;,1' an ind.ei'ini te postponement had. never occurred to us. I therefore

replied to the R,.A.F. telegra.m saying that we were out of commxm.:J.~

tion With the ground party and that every attempt shoul.d be made to

ca.n'y out the drop as planned. They agreed in reply to this to make

an attempt the following morning.

"Hope deferred ma.keth the heart sick" and it was with sensD.ti~

amounting almost to physical nausea that we watched the weather for

the next 24 hom-s, but unfortunately it did not improve at all. The

aircraft was due here at 9 a.m. and I 'WaS out at the airport to meet

it, but it was ra.1ning and the cloud rea.ched down to the ground, in

technical tems I believe the expression is "Ceiling nil. II The plslE

arr! ved; we could hear it overhead and we talked to the pilot :;,n"t:.re

radio telephone, but it was quite impossible for him to land. He

said he w~d carry on toO Iaruan and wa1 t there in the hop:! of scme

improvement in the wea~r.

We promised to send him ha.l1'-hourly weather reports but our

heart-sickness c::Jntinued all day and trere was no improvement. 'lhe

following morning there still being no hop:! of iInprovement the air­

craft was instructed by its Head~ters to return to base in Singa­

pore, but there was still one II ttle gleam of hope and the pilot of

the aircraft was t:;,ld that in case of unexpected improvement he

could at his own discretion land at Kuch:l.ng ::In the way. The SWl

nearly shone that day and we built this tiny gleam :;,1' l!I.ope into a

-3-

great haven of hOJe and began to get very optimis tic. HOYlever, our

optimism was dashed to the ground once more when we got a message that

the aircraft after taking off from Labuan met worse weather than ever

and was obliged to put back there, the whole project now being final-

ly abandoned.

My thoughts were with Lachance, out of communication with us and

listening and looking day after day for help that did not come. Ra-

dio Sarawa.k now came to our rescue and agreed to brodcast twice a

day for many days in succession the follcwing message, in the hope

that somebody in contact with the party would have a radio set, hear

the message and pass it on:-

"HERE IS A SPECIAL MESSAGE FROM DR. GLYN EVANS, DIRECTOR OF MEDI~ SERVICES, TO.MR. LACHANCE, LFADER OF THE ANTI­MALARIAL PARTY AT BARJOC) ON THE J:CE:LABIT PLATEAU. THE ROYAL AIR FORCE HAVE AGREED TO TRY AGAIN TO MAKE THE AIR DROP ON WEDNESDAY JANUARY 30TH. PLEASE LOOK OUT FOR THE AEROPlANE ON WEDNESDAY JANUARY 30TH."

I telegraphed the Royal Air Far ce in Pingapore telling them ..mat

I rnd done and why, and beseeching them to make an attempt on the

30th and Whatever the weather, and to this they agreed, so once more

hop: was raised and how anxiously the weather was watched for the next

five days!

Since the earliest possible start in the morning was essential

to make the most of any fine spell that might occur, the aircraft

would come to Kuching from Singapore the day before and we were told

that it would leave Singapore about 9 a.m., but !!lot 9.:;0 on the 29th

came a telegram. saying that owing to engine trouble the flight was

1ndefini tely delayed. Hopes dashed once more and we waited anxiously

all day for further news which came at last in the afternoon and was

rapidly followed by the safe arrival of the aircraft itself, a Valet-

ta, in comma.n.d. of Fly.l.ng Officer Tony Spry, with Flying Officer Brian -4_

A

...

Lippett as navigator, Sgt. Peter Bates as radio operator and a crew

of seven British soldiers as despatchers in charge of Sgt. Dalton

R.A.S.C.

Loading of the aircraft with our "tree of life" proceeded im­

mediately and it was with a very light heart that I watched ove ~ the

proceedings. Everything seemed good and the incllE ion in the load

of about 150 ·lbs. weight of school books seemed to be good omen of

the highest order. Here were we arranging to provide not only :for

the bodies but also for the minds of the Kelabi t people. The job

was soon conc.luded and it was arranged to fill up with petrol the

following morning, and so we all repaired in joyful spirit to the

hotel where the air crew were going to stay the night.

Several times in the night I looked anxiously out of the window

and several times stars were visible. So it was with great hopes I

went out to the airport and got there about quarter to seven ready

for a take off at 7 a.m. The air crew had been there since 6.15

but •••• heartbreak aga.in~ The only slip in the whole of the arrange­

ment was one for which I must take the blame. We had neglected to

pass on the proper IIISssage to the Oil Company and to the Control Tow­

er, so that nobody was there and we were delayed. Anxious telephon­

ing followed and in about half an hour the two key men arrived, but

in the meantime, the weatber was deteriorating and our joyful hopes

of the evening before were going down the drain •

While we watched rather fearfUlly with Olle eye on the 'Weather

and one on the petrol pumps, Sgt. Dalton who was not going to :fly

with us cheered me up with long stories about the bad luck that this

particular air command had had recently! Many aircrai't had been loot

for reasons which were nevor ascertained. Only a few weeks ago, two

-5-

civilians wo acc~panied such a.fllght as this were l:dlled and there

'TI8e.theinteresting story of Driver Lee wo was the sole survivor of

a crash. Driver Lee, Sgt. DeJ.ton told me, was not hurt at all. Of

course, he 'Was very badly burnt and broke a leg and wen eventuaJJ.y

he managed to return out of the jUDgle he was in a terrible state but

all the others were l:dlled. Cer"tainly, Sgt. Dalton took my mind off

the weather but I don't think he cheered me upl

At la.st we took off at 8 a.m. Visibility was very iD.d1fferent

but it d:1d not matter very much at first as were fJ.Jtn.g on a pre-

determined c~pass course but Wen we got near our destination it be-

came necessary to see 'Where 'We 'Were and the sight that met our eyes

over the Kel'abi t country was a very melancholy one, nothing but thick

cotton wool clouds. Captain Sprv was not to be put off by this and

found a way in, but no'W 'We were faced 'With another difficulty. Our

first drop was to be a small parcel of med:1cine at a pla.ce called

Long Tebangan and I suddenly realized that, of course, Long Tebangan

would not be marked as they were not expecting us that day and nobody

on board the aircraft could identify it. Navigating to it !'rom an

identifiable spot was n::Jt possible because we could not fly by dead

reckoning in a straight line, having to dodge up and down the valleys

in and out of clouds. We saw a village that we thought might be it,

but quickly realized that there was no 'Way of knowing Wether or not

we were right, so a quick decision was taken to make the drop and

hope for the best. I decided afterwards that it was not the right

villa.ge and so my apol.ogies go to wng Tebangan but even greater ape-

logies go to the villa.gers of the wrong pla.ce whoril we saw rushing out

to collect the gift !'rom heaven; they found it to consist of a small

supply of med:1cine and a large supply of stones and earth taken !'rom

-6-

A ....

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the airport at Kuching for ballast!!!

After a few turns we soon realized that we were lost but nothing

deterred, the pilot quartered the area and after' about half an hour

we sighted our UDIDistakable objective, Dareo. Lachance had obvious~

received my message. The white cross was out' on'tb.e"fi;eld and a

smoke fire was burning. We circled round for a while st~ the

clouds and ensuring as far as possible our escape 'When our mission

was complete. The pilot pes ted one of his men to keep an eye on a

certain gap in the clouds and then as quickl.y as possible at some

loss of acouracy 'We dropped in six circuits our six loads. All fell

safely and we saw that they were all recovered. The last load of all

contained the VEil. ua.ble beer for the grotmd party and I noticed with

the greatest pleasure tha.t it dropped right on the very centre of the

mark!

We circled a few times more to gain height and sped a.way rapidly

out of the gap in the clouds Wich had f'ort'Im.B.tely remained open for

us. There 'Wa.S one more drop to make and that 'Wa.S a load of about 300

lbe. of medicine at Lio Matu, but petrol was rmming short and we

could not see our way, so I wrote on a piece of paper and handed it

to the pilot "It t s not life or death, let t s go home!" I but Capta.in

Spry of the R.A.F. would have none of' that and we f'lew up and down

backwards and f'orwards 'UIlt11 at last we f'o'UIld L10 Matu 'Which was not

expecting us since they had not received a message. However, we ce.ma

down, dropped the load saf'ely and then :f'u.lJ. speed ahead on a compass

course f'or the nearest refuelling place 1 La.bua.n, 'Where we got filled

up with petrol and returned safe~ by 4 0 I clock in the evening to Ku­

ching.

While flying around the Kela.bi t CO'UIltry, one could not help being

-7-

impressed by 'What a wonderful country it is, very reminiscent of the

Cameron Highlands in Malaya, fertile valleys and quite considerable

plains at heights of a,b:> ut 4 000 feet. It struck me that here was a

wonderful new country for Domeo. Perhaps we shouJ.d call it Harris­

son I s High] ands and lJEll'haps it wiU a.t some future date S\lilPly us

wi til. fresh vegetables and wi til. holidays. The on.ly things -wrong with

it are poor communications with the rest of the country and disease.

The poor communications can easily be overcome in this second half of

the 20th century and the tree of life that we dropped there on 30th

January 1957 will be the beginning of our conquest of disease. I

like to think that the school books we dropped were almost as import­

ant a.s the medicine s •

* * * , '

I'