Address By The Chairman
New zealand's Responsibility for Medical Research in the South-West Pacific
At The Royal Society's Empire Scientific Conference held in England during June and July, 1946, consideration was given to the strategy of research within the British Commonwealth. In the discussions on the research problems of the Colonial Empire with its 60,000,000 of people the official representatives of the Colonial Office appealed to the dominions for assistance in the initiation and carrying out of research within those parts of the Colonial Empire adjacent to them. It was pointed out that as universities were the self-renewing centres of scientific research, research inevitably languished in countries where there were no universities. As there are no universities as yet in the West Indies, in Central Africa, or in the South-west Pacific, and only an emergent one in East Africa, it was evident that the colonies must for many years look to the universities of the Commonweatlh for assistance in research problems.
In an official address, Dr. Simonsen, F.R.S., representing the Colonial Office, referred to the fruitful regional collaboration which had been established between Fiji and New Zealand in regard to both Health and Agriculture, and he assured the conference that the Colonial Office would welcome much closer collaboration. This invitation was subsequently endorsed by Sir Edward Mellanby, Secretary to the Medical Research Council in the United Kingdom. Sir Edward informed the conference that a Colonial Medical Research Council had been recently appointed jointly by the Colonial Office and the Medical Research Council of the United Kingdom to advise both bodies regarding the promotion of research in colonial territories.
It is appropriate that the research responsibilities of New Zealand in the South-west Pacific area should be raised at this conference, for it was at the Pan-Pacific Science Conference held in Melbourne and Sydney in 1923 that the problems of the Pacific first received serious consideration. It was the Section of Hygiene of this conference whose resolutions led later to the establishment of the first International Pacific Health Conference, which met in Australia in 1926.
The British Commonwealth has great responsibilities in the South-west Pacific area. The Pacific Ocean, with its bordering seas, constitutes about one-half of all the oceans and one-third of the earth, and this fraction known as the South-west Pacific is of a vast area. It extends from the 141st Meridian West to 131st Meridian East and from the Equator to Latitude 30 S. The South-west Pacific can be again divided by Meridian 178° W., which passes through Fiji, into a sphere of Australian and one of New Zealand influence. Fiji is
at the junction of Melanesia and Polynesia, but for geographical and cultural reasons it can be regarded as falling within the New Zealand Region. This sub-division of the area covers approximately five million square miles of ocean and includes Fiji, Tonga, Samoa, the Cook Islands, Niue, and Tokelau.
New Zealand extended her political responsibilities in this area when, in 1901, she annexed the Cook Islands and Niue; in 1918 she received a mandate from the League of Nations for the administration of Western Samoa, and in 1925 accepted from the United Kingdom the administration of the Tokelau Islands.
It was in Samoa that Dr. Ritchie, now Acting Director-General of Health, did such excellent work in the control of yaws and hookworm. Here, also, the London School of Hygiene and Tropical Medicine sent two research expeditions to study filaria and hookworm.
New Zealand has also established close relations in such matters as health and agriculture with Fiji. All cases of leprosy occurring in New Zealand herself or in her island dependencies or mandated territories are sent to the Makogai Leper Hospital in Fiji, which has become an international centre for the treatment of the leprosy of the South-west Pacific area. Ten different administrations in the area are now sending students to the Central Medical School at Suva to undergo a four years' course to qualify as native medical practitioners. This admirable institution was opened in 1929, and the Rockefeller Foundation deserve much credit for the active part which they took in establishing the school. All the European nurses in Fiji are drawn from New Zealand, as are some of the medical practitioners.
With these affiliations it was a natural development for New Zealand to enter in 1946 into an agreement with the United Kingdom to form a South Pacific Health Service to serve Fiji, the West Pacific High Commission, Tonga, and the New Zealand dependencies and mandated territory. The population in the area is about 250,000 and it is proposed to have uniform quarantine regulations, to exchange epidemiological information, to interchange medical personnel, to train to uniform standards native nurses, dentists, sanitary inspectors, and nursing orderlies. No health service is complete without a research programme, and the New Zealand Medical Research Council and the Otago Medical School are anxious to give practical assistance within the area covered by the Service.
Meantime, the World Health Organisation was formed, with regional committees, and in February of this year an international conference was held at Canberra to consider the best means of promoting the development of the inhabitants of the South Pacific. Representatives from the United Kingdom, Australia, New Zealand, the United States, and France attended the conference. The conference decided to establish a South Pacific Regional Commission to act as a consultative and advisory body to the participating governments in matters affecting the economic and social development of the non-self-governing territories within the scope of the Commission and the welfare and advancement of their peoples. To this end it was decided to establish a Research Council to serve as a standing advisory body ancillary to the Commission. The functions of the Research Council are a follows:—
To maintain a continuous survey of research needs in the territories within the scope of the Commission and to make recommendations to the Commission on research to be undertaken.
To arrange, with the assistance of the Secretary-General, for the carrying out of the research studies approved by the Commission, using existing institutions where appropriate and feasible.
To co-ordinate the research activities of other bodies working within the field of the Commission's activities and, where possible, to avail itself of the assistance of such bodies.
To appoint technical standing research committees to consider problems in particular fields of research.
To appoint, with the approval of the Commission, ad hoc research committees to deal with special problems.
To make to each session of the Commission a report of its activities.
The South Pacific Commission were recommended to give early consideration to the carrying out of research in Agriculture, Economics, Educational and Social Development, Fisheries, Forestry and Medicine. The scope of the activities envisaged in Medical Research will be seen from the following list:—
A survey of improved methods of nutrition and an investigation of the relationship between nutrition and dental defects.
An investigation to improve methods of village hygiene including housing.
General surveys of disease and disease-carriers, with particular research into:—
the respiratory diseases (including pulmonary and surgical tuberculosis);
malaria prevention, and the dysenteries and other bowel infections;
yaws and its relationship to syphilis;
hookworm and other intestinal parasites;
diseases of the skin.
A study of infant and maternal welfare.
A study of the human body's response to changes of climate and environment with a view to the improvement of diet and general living conditions.
A study of quarantine procedures, including the existing international regulations, in order to meet the particular needs of the territories.
The collection and dissemination of epidemiological information.
The temporary headquarters for the Commission is to be in Sydney, and New Zealand has agreed to pay 15 per cent, of the initial vote of £50,000 for the working expenses involved in setting up the Commission. New Zealand has also agreed to appoint two commissioners
to the commission. It is obvious that if this Commission is to carry out effective work, New Zealand must be providing men with the necessary ideas, ability and energy to put motive force into the organisation.
It will be apparent that there is now no lack of goodwill and no lack of administrative machinery to prevent New Zealand's full, participation in the manifold research problems of this area of the South-west Pacific.
Close to the western boundary of the area is Longitude 170° E, the malaria base line. To the west of the line malaria constitutes a major public-health problem. To the east there is no malaria. Polynesia as a whole is malaria free. For some reason still unknown, this meridian marks the limit of the spread of the Anopheles. This line also separates the nocturnal and periodic form of Filaria found to the west from the non-nocturnal form found to the east. Tropical phagadenic ulcers are common to the west of Longitude 170° E., but do not occur east of it. The reasons for these findings remain obscure. Yaws, leprosy, and tuberculosis are as common to the east as to the west of this remarkable meridian. Hookworm is widely prevalent, indicating that faecal pollution of soil is still widespread. Skin diseases are extremely common. Infectious hepatitis has appeared in many of the islands and calls for investigation. The area presents a fruitful field for the study of endemic goitre, dental caries and other nutritional problems. Anaemia, diabetes and epidemic dropsy are common in the Indian women of Fiji.
Here is a field of practical endeavour for New Zealand science.
Sir Theodore Rigg agreed with Sir Charles on the responsibility of New Zealand in regard to research in the South-west Pacific. The Dominions must play their full part in regard to research in order to aid in the rapid development of the people of the Colonial Empire, taking some of the burden of this from Great Britain. There were particular responsibilities in Samoa and the Cook Islands, and much more should be done in the islands close to our shores.
Dr. Maclean pointed out that a beginning had already been made in regard to investigating health problems in the South-west Pacific by the recent visit to Samoa of Dr. Claude Taylor, Director of the Division of Tuberculosis, of the Health Department, who was sent to survey the position as regards Tuberculosis. He agreed on the great need for research and with its very large scope.
Professor Richardson asked for the speaker's views on the set-up of such research establishments as were envisaged. Sir Charles outlined the British organisation for research in the Colonial territories, with bases established at the Schools of Tropical Hygiene at London and Liverpool, and field stations established in various outlying positions in the territories concerned. Australia had a similar set-up, with its base at Sydney and field stations in New Guinea. In regard to New Zealand, he considered a similar arrangement would be the most satisfactory with a base established at the Otago Medical School, from which the research would be directed, and with field stations established in outlying locations such as Apia.
The following resolution was proposed, seconded and passed unanimously: “This meeting of the Medical Science Section of the Congress of the Royal Society feels that the need for research into health problems (medical, nutritional and other types) in the South-west Pacific is very great, and that their solution is urgent. It urges that the Government be approached to give all necessary assistance to ensure that New Zealand takes its full share with other nations in establishing research organisations to deal with these problems.”