HEALTH SURVEY IN PACIFIC U. 5. ARMED FORCES MEDICAL JOURNAL oy VICINITY MAP OF TRUST TERRITORY OF THE PACIFIC ISLANDS NORTHERN MARIANAS, CAROLINE, AND MARSHALL ISLANDS } HAWAIIAN ISLANDS a2 e 2 * those islands surveyed by the U.S.S. WAddbey during the period from August 1948 through June 1950. administrative districts, those of % Islands, are represented. All of & northern Mariana Islands (except Three of the trust territory civil Palau, Saipan, and the Marshall the western Caroline Islands, the Alamagan and Agrihan Islands). * and the eastern islands of the Marshall Islands group are included. Subsequent to June 1950 the U.S.S. Whidbey also surveyed the Truk # and Ponapedistricts. However, data for these districts corresponding to those for the three districts mentioned before are relatively incomplete. As a consequence, it is impossible to present a comprehensive description of the health status of the populationin the trust _ territory as a whole. The fragmentary data available for Truk and _ Ponape, while not included inthis article, are contained in a detailed study in the Bishop Museum, Honolulu, Hawaii, and the Bureau of Medicine and Surgery, Department of the Navy. ae , om POPULATION CHARACTERISTICS a, ae ee The total native population of the trust territory was placed at ap- spree AUSTRAL A Figure 1. The Trust Territory of the Pacific Islands. Motivated by these considerations, the Navy undertook a health survey of the trust territory to determine the public-health problems of the indigenous population. The U.S.8. Whidbey, converted especially for this survey, was a twin-screwdiesel-driven 177-foot. vessel displacing 935 tons. The Whidbey was equipped with a photofluorographic unit and facilities for complete physical and dental examinations. The survey was begun in the Marshall Islands area on 1 August 1948. Fourofficers and 21 enlisted men made up the ship’s company. The surveystaff was comprised of the following person- nel: 2 Medical Corps officers, 1 Dental Corps and 1 Medical Service Corps officer, and 9 hospital corpsmen serving in laboratory, x-ray, dental, epidemiologic, andclerical activities. 1200 VOLUME 10, NO. 10 ao Pad oem ost Traveling from island to island the survey group examined every : native present and investigated and evaluated the food, water, sewage, and garbage facilities, as well as the general living conditions and - native habits and customs that had a bearing on the subject of health ; and sanitation. Among otherthings the survey included a physical , examination, photofluorographic examinationof the chest, Kahn test, : tuberculin skin test, and stool examination. This report concerns HAneh, SRESRARs, LAR oF => One of the main difficulties encountered in developing a publichealth program forthe trust territory was the lack of reliable information concerning health and sanitation conditions. The most reliable reports came from the naval dispensaries where natives living in the immediate vicinity were given medical care and treatment. There was definite indication from these reports that certain diseases were affecting the health of the islanders and that sanitation in general was on a very lowlevel. Without a comprehensive survey, however, a correct appraisal of disease prevalence, morbidity, and sanitation problems could not be made. a a as proximately 54,300 in 1950. About 28,600 of these were in the three districts of Palau, Saipan, and the Marshall Islands. The population figures presented in the accompanying tables, totaling 22,146 for these three districts, are based upon the numberof identification cards distributed during the survey. One card was distributed to each inhabitant present on the island at the time of the visit of the U.S.S. WAidbey. Although it was intended that every inhabitant be included, the Jength of time involved in making a survey of this nature, coupled with the fact that there was a great deal of interisland visiting, resulted in some individuals being examined at places away from their home island and others not receiving any examination at all. The area of the island, the scattering of the population, the terrain, and the amount of control exercised over their people by the local chiefs or administrative heads were all factors affecting the extent to which the population was broughtinto the survey. Density. Population density varied fromisland to island. Out of 39 islands or atolls, 5 had a population of less than 100, 24 had a 1201