[5] MEDICAL WORK IN MELANESIA
The need. It is imperative, clamant, appalling. Most
diseases of a cosmopolitan nature are to be found in the islands
together with such tropical diseases as ankylostomiasis (hookworm),
beriberi, epidemic jaundice, filariasis (elephantiasis), yaws,
leprosy, dysentery and malaria.
Disease is caused, encouraged, and developed by the supposed
malign influence of evil spirits and the inertia due frequently
to the fatalism that is the consequent accompaniment of much
sickness.
By the absence of sanitation--almost everywhere.
The bad ventilation of the sleeping-houses.
The custom of numbers of people crowding as visitors about
a patient.
The unwashed.
Malnutrition.
Numbers of the people are normally very much below par. In
fact their reputed laziness is often the result of disease.
Men and women are disabled by the deformities caused by disease,
often contracted while in childhood. Mentality is lowered and
the race in general lives under a very heavy handicap. Far too
many babies die. Strong men and women die, as it is said "before
their time". Much of this--most of it--is preventable.
The understanding of the Christian Faith is the only means
by which heathen beliefs will be cancelled out. Better sanitary
arrangements would end hookworm trouble and do much to eradicate
dysentery. The matter of ventilation is tied up with the destruction
of the mosquito--or the use of nets. The native shuts his house
[5/6] up tight at night and keeps a smoky fire going for the
purpose of stifling the mosquito, the bites of which are a nuisance.
He rarely connects the bites with the malaria that follows. A
good deal can be done by natives to destroy mosquitoes. In any
case mosquito-nets are available to most coastal natives and
there is no longer the need to sleep in a smoky atmosphere. Continued
emphasis on the danger of infection has made a difference to
the number visiting at one time. In some villages the chiefs
impose a strict control.
Still there is the need of telling the Gospel story of the
Christ to whom the devils were subject. There is repair or ambulance
work waiting. There is the long slow business of instructing
Melanesians in hygienic ways of living.
The difficulties of the task. People do not live in
masses in large villages or towns, but are scattered over large
areas in groups of anything from twenty to two hundred people.
There are no roads as we know roads and the tracks that serve
almost invariably pass through rivers, rushing streams sometimes
and shallow and slow running at others. The islands are separated
from each other by miles of sea, from fifteen to upwards of sixty.
Boats or canoes are not always available or weather good.
Prejudice. Certain natives claim to know means of curing
some of the ills of their fellows. They are generally very unwilling
to tell a white person what means they use, even when offered
money to do so. The native generally prefers to go to a native
and pay for treatment rather than to a white man and be treated
for nothing.
This is really not so strange when one remembers the number
of people at home who "Don't believe in doctors", and
won't go to them till too late. It is just that which happens
in Melanesia over and over again. The native treats the native
until it is too late, and a patient [6/7] dies, who if he had
been seen by the missionary in the early stages of his trouble
would have lived.
The problem here then is:
To get the missionary doctor or nurse and the patient together,
and
To break down prejudice by familiarizing the native with the
white workers (or coloured) and their methods.
The first qualified Melanesian nurse
An Assistant Medical Practitioner
"There is no question of the need"
"Full scope for the ministry of healing"
What has been attempted? The Mission has always tried
to have, at least, one doctor on the staff. In 1888 Dr. Welchman
came and worked on Ysabel till he died in 1908. Between 1910
and 1949 there have been, in succession, six doctors, Marshall,
Maybury, MacPherson, James, Thomson and Hemming. The Welchman
Memorial Hospital was put up on Guadalcanar by Marshall. With
money given for the purpose Maybury built a hospital of the Epiphany
on Malaita (Fauabu). The later doctors have all worked at this
Hospital. The Godden Memorial Hospital in the New Hebrides (Lolowai)
has never had a full-time European doctor, but has always been
in full operation. From time to time white Sisters have been
alone. Latterly an Assistant Medical Practitioner (Melanesian)
has been attached.
The Hospital of the Epiphany has beds for sixty patients.
It is usually full to overflowing. It has a fully equipped operating
theatre, doctor's and nurses' quarters.
These Hospitals serve a certain area in their immediate neighbourhood
with ease and convenience to all concerned. Patents from a distance
come either by canoe, mission launch, or Southern Cross.
Obviously they must wait the occasion when a launch or the
ship is available. This is a great drawback in serious illness.
The doctor, who cannot be away from his base for long, takes
short trips through the villages doing what is possible as he
goes. A launch [7/8] was set apart for the doctor's use and it
was possible for him then to go farther afield and also to carry
a certain number of patients back to the Hospital, with him.
The work of these Hospitals and their staffs is too great
to measure. The devotion of the workers has always been beyond
praise; but it is clear that two Hospitals situated as these,
only touch a small part of the problem.
Itinerating missionaries. In the normal course of his
work the white priest, unless settled at a school or college
travels constantly within his district. Most men have had some
training in medical and surgical matters before going out. Drugs
and dressings are always carried and there is usually a lot of
work to be done. This is a very valuable effort. The people know
the missionary and he knows them. He can probably talk their
own language and that gives them some confidence. There are many
small troubles which, if untreated, would result in severe illness
and death. A particular medicine used at the right time cures
rapidly. Pain is relived, "sore-legs" cleaned and bandaged.
This appears difficult when as sometimes happens, the patient
says he has a "sore leg along throat", the pidgin-English
way of saying he has a sore throat! Eye troubles are very frequent
and a bottle of healing lotion left behind will often relieve
and cure. The teacher probably asks for a few things; some cough-medicine,
quinine, iodine, and a few dressings, and he is given what can
be spared. It will probably be some weeks before the missionary
is in the villages again. People get ill between the visits of
the missionary, accidents occur and recovery takes time. The
missionary is continually on the move and no one knows exactly
where to find him. Village people have no special liking for
caring for, and nursing, sick folk. The native doctor is on hand
with his magic and he is called in. Patients suffer and die.
For many years this was the only way in which attention could
be paid to the sick.
[9] Dispensaries or District Hospitals. At settled
stations such as the Schools there was usually a small Hospital
for the sick of the station. A trained nurse lived at each of
the Schools. Gradually the natives of the neighbouring villages
began to attend as "out-patients", accidents were brought
in and the prejudice against the white people's medicine was
broken down. It became possible to receive villagers as in-patients
and visits by relatives were encouraged. The patient in coming
to a station in the neighbourhood did not suffer great inconvenience
and difficulty as would be met in a long journey by sea.
A number of selected schoolboys were trained in these school
hospitals. Some of these have since become fully trained and
are Assistant Medical Practitioners.
Latterly, with the growth of women's work, and the acceptance
of these workers by the natives, a number of out-stations have
been established and staffed by qualified white nurses. These
are at Kerepei, Siota, Ysabel, Lamalaña, Pamua, and in
a smaller way, at Buñana and Torgil.
Assistant Medical Practitioners. A venture was made
at one of the Schools and boys were trained to work as orderlies
in the School Hospital. A step forward was taken when some of
these boys became employed as orderlies in the Hospital at Fauabu.
Their work was excellent. A selected few were trained by the
doctor and upon their return to their homes they built small
dispensaries and became very effective workers among their own
people at home. This was the first medical work done independently
by Solomon Island natives.
Then a Medical School was established in Fiji by the Government
of the South-West Pacific. Mission school boys entered this school
and several of them, qualified, are back in their homes, or in
districts elsewhere working as Assistant Medical Practitioners.
Some [9/10] are in the employ of the Mission and others are used
by the Government.
Native women nurses. Because of the prejudice against
teaching women and employing them in positions of responsibility
it was not possible to train women nurses. During the war, ninety
years after the beginning of the Mission's work, the training
began and it has gone on without interruption. It is hoped that
in time there will be no one in Melanesia who is out of reach
of skilled medical help, as trained nurses will be available
in every populated place, and, not too far away, there will be,
at least, an A.M.P.
Definite instruction in the Schools about disease, its
causes and prevention
The supposed influence of evil spirits and the effects of
"magic" are covered naturally in the usual course of
religious instruction.
Scholars are taught the relationships of dirt to disease and
that no Christian can be indifferent about sickness--their own
or others. More, that it is a definite duty to seek health for
themselves and for others, and to use every known means of retaining
or recovering it. Also that it is a disgrace--nay a crime--to
do anything that may favour the spread of illness.
The results of this teaching have been so good that the hearts
of the teachers leap high with hope for the future. This is a
slow but very certain line of progress towards a healthy community.
Note.--No. 6 of this series particularly deals with
Leprosy, and No. 8 with Mothercraft and Infant Welfare.
Why should everyone help the medical missionary work?
Jesus said, "Preach the Gospel . . . Heal the sick."
The Gospel is the promise of the life that now is as well
as that which is to come.
[11] Because medical work is a guarantee of the truth of the
Gospel which can be understood by the simplest minded person.
A heathen boy was very seriously wounded by a companion who was
"mad". It would be more accurate to say that he was
"possessed." The other heathen present could do
nothing to help.
They would do nothing as they were afraid of interfering
with the intentions of the evil spirit who had brought the attack
about. His attentions might be diverted to them! The wounded
boy was, after a long struggle, nursed back to health in the
house of the missionary. Daily the heathen expected to see one
of the white people fall ill or meet with an accident. They were
not at all sure that the house wouldn't fall down upon them!
The immediate result of the boy's recovery was the breakdown
of a barrier of prejudice and suspicion. The men asked for a
Christina teacher, saying, "We are sure now that there is
truth in what you say". Later on, eight men were baptized,
one of whom ultimately became a teacher himself.
"Freely have ye received, freely give."
The position to-day:--
The Solomons
Hospital of the Epiphany, Malaita, sixty beds.
Nursing Stations, Ugi, Gela, Ysabel, Buñana.
Mothercraft School, San Cristoval.
Leper Colony, Malaita
The New Hebrides
Godden Memorial Hospital, Aoba, sixty beds.
Nursing Station, Raga.
[12] Government financial assistance is:--
The Solomons--£200 per annum towards expenses
of a white doctor. £50 per annum for each white nurse.
A grant of drugs in kind.
The New Hebrides. The British Administration gives
£350 per annum for general medical work and a grant for
drugs. It also pays half of the salary of an Assistant Medical
Practitioner.
