the dangers of the pest, was crestfallen when, after his most enthus
astic lecture, a member of the audience commented: “That mayaj
be true, Doctor, but we don’t have flies that large.”
Medical personnel assigned to field trips always spent part of thei
time ashore giving instruction in preventive medicine and sanitation
Doctors became increasingly aware during these visits of the need fo:
a local solution to the problem of medical attention because most o
the patients were reluctant to leave their homeislands for treatment
at the civil administration dispensaries. The report of the administra.
tive-medical field trip to the Mortlocks in 1951, when thorough in.
vestigation of conditions in an outlying area was possible, notes:
I
{
... only through the medium of education can the health of thee
islands be materially improved. Public health, its teaching and its methods,
must precede the steps of curative medicine. There ts little value in treating
a disease in one or two individuals when the population as a whole has
no conception of its communicability or control. The natives are eager to
learn and should be taught. This can be done throughthe school system provided the instructors themselves have a frm and truthful understanding of
diseases. Fleeting visits by medical officers or assistants can not accomplish
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this end.
Fundamentals of sanitation and public health must be stressed
in the schools and in the daily lives of the islanders.
The problem of enteric parasitism is a glaring example of the need ior
mass education. On all the islands it is believed that 50°%4 or more of the
younger age groups harbor Ascaris Lumbrecoides. Though no survey was
conducted several scattered atoll] examinations revealed Hookworm ova as
well. Most of the islands have an adequate number of benjos. However,
as has been witnessed, the natives do not use the benjos even though theyare
convenient. They do not understand our insistence that benjos be constructed and used.
Teaching must start at the most primitive level and
follow through until the problem is understood and then the cure of the
most common diseases will come from the people themselves.°°
The impossibility of assigning a sufficient numberof nonindigenous
medical personnel to conduct an education program definitelyretarded
the progress of the entire health program. Theonly solution fay in
intensive, reiterative training of health aides and teachers who, when
they returned to their home islands, could assume responsibilityfor
teaching the principles of health education. The lack of knowledge
of preventive medicine and of appreciation of American health and
sanitation standards, together with the understandable slowness 0!
*Encl (3) to Technical Reports on cldministrative-Medical Field Team Trip to Mortlect
fslands, pp. 15-16.
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