on ™ SOit ne tree Ue RE NE Reeree TS ck Lk ee Perea U.S. ARMED FORCES MEDICAL JOURNAL By the time the health survey was launched, however, health conditions were much improved. The islanders had received medical care on an emergencybasis immediarely following American occupation in 1945, until July 1947 whenthe territory passed from military of the Navy for the Trust Territory of the Pacific Islands, outlining a health program forthe trust territory, was adopted for the purpose of controlling preventable disease and rendering medical and dental care. By 1 August 1948, the date the health survey started, this program was in full operation and rapid strides had been made in the control of preventable disease. Measures to correct sanitary practices of the islanders were being enforced: treatments, inoculations, and vaccinations had been administered; and the food supply had been improved to the extent that. malnutrition no longer existed except ina few areas. Diseases that were previously the most serious threats had been brought under control. In manyrespects the health survey served asa means of evaluating the health program. A marked reduction in the prevalence of intestinal parasites was accomplishecl in the interval prior to the health survey. It is believed that at the time of the American occupation nearly 100 percent of the indigenous population was infested with hookworm. Ascaris and Trichuris were also extremely prevalent. Asa result of a mass deworming program, the controlof flies, and education regarding health habits, sanitation and particularly the use of sanitary latrines, the prevalence of intestinal parasites had been noticeably reduced throughout the trust territory. Yaws is another disease that was brought under control witheffective treatment. The large numberof inhabitants exhibiting multiple scars and the high proportion of positive Kahn tests bear testimony to the widespread prevalence of yaws. Very few primary lesions were noted during this survey, however, as these had been virtually eradicated by extensive treatment with penicillin adiministered by Navy medical offivers on field trips prior to the survey. The findings of the health survey revealed, however. that certain sanitation problems still remained. Most islands had community latrines that. in general, were clean and in good repair. It was evident, however, that use of the beaches was still 1 common practice throughout the islands. In many phices, leaves and coconut Aber used in lieu of toilet paper were thrown about promiscuously. Maloelap Atoll was the only place where no latrines were available but many islands had clean and well-constructed latrines that were seldom used. Even on Saipan Island, where virtually every household had its own 1206 5013258 . VOLUME 10, NO. 10 n government to civil administration, In 1947 the health service policy