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REPORT OF THE PRESIDENT



OF THE



BOARD OF HEALTH



OF THE



TERRITORY OF HAWAII



FOR THE



TWELVE MONTHS ENDING JUNE 30th, 1907




HONOLULU:

THE BULLETIN PUBLISHING CO., LTD.

1907



/*



::^



N.



1



i«ii:i*onT



OF THE



President of the Board of Health

FOR THE

TWELVE MONTHS, ENDING JINE 30TH, 1907



To THE Honorable GEORGE R. CARTER,
Governor of the Territory of Hawaii.

Sir: — I herewitli submit the report of the Board of Health

• for the period of twelve months ending Jnne 30th, .1907. I

., recapitulate to the extent necessary from the report submitted

C^ December 31st, 1906, that the present report may correspond

^ to the plan of annual reports conforming to Federal custom.

THE BOARD OF HEALTH COXSISTS OF THE FOLLOWII^G MEMBERS :

M. P. Robinson, Esq.

F. C. Smith, Esq. ■ -

J. T. Wavson, M. D.

W. D. Baldwin, M. D.

The Attorney General.

D. Kalauokalani, Sr. '

L. E. Pinkham.

The members retiring in the vear 1907, were A. Fernandez,
I#q. and Qr. James E. Judd, and by notification E. C. Peters,
Esq., Attorney General.



THE OFFICERS OF THE BOARD.



L. E. Pinkham, President.
C. Charlotik, Secretary.



RtePORT OF THE PRESIDENT.



THE CHIEF EXECUTIVE STAFF.



Dy. J. 8. B. Pratt, GeneraF Health Officer.

C. H. Tracy, Chief Sanitary Officer and Inspector of Ceme-
teries.

Dr. J. T. McDonald, Bacteriologist and Pathologist.

D. P. Lawrence, Registrar General.

E. G. Keen, Inspector of Buildings, Plumbing and House
Sewers.

R. A. Duncan, Food Commissioner and Analyst.
Dr. C. A. Peterson, Medical and Administrative Superin-
tendent of the Insane Asylum and Infirmary.

W. T. Monsarrat, V. S., Inspector of Meat and Animals.
H. Myhre, Inspector of Milk and Dairies.
L. K. Ka-ne, Morgue Attendant.

OFFICE EMPLOYEES.

W. K. Simerson, Chief Clerk.
Miss M. R. Weir, Stenographer.
Miss M. H. Lemon, Clerk.

SANITARY INSPECTORS HONOLULU.

J. F. Durao.

W. P. O'Brien.

L. K. C. Lane.

M. I. Silva.

J. A. Silva.

J. B. Gorman.

J. Vivichaves.

Beginning July 1st, the Inspectors were required to dress
in an appropriate and becoming uniform which it is believed
will do much toward improving the esprit and authority of the
force. ^ *

EXECUTIVE STA^F HILO^ HAWAII.

Dr. C. L. Stow, Chief Health Officer and Government Phy-
sician.



REPORT OF THE PRESIDENT. 5

D. S. Bowniaii, Sanitary Inspeetor and and Inspector of
liuildings, Plumbing, etc.

J. ( 'aceres, Assistant Inspector.

EXECUTIVE STAFF AT LEPER SETTLEMENT MOLOKAI.

J. D. McVeigh, Superintendent.

Dr. W. J. Goodhue, Physician and Surgeon.

Dr. li. T. Holhuann, Assistant Physician and Surgeon.

Cecil Kiilehua, Officer for Lepers, Honolulu.

FREE DISPENSAK Y H OXOL CLU.

Dr. A. X. Sinclair, Physician.
Dr. W. D. Baldwin, Physician.
F. R. Nugent, Dispensor.

IXSTTTl'TIONS UXDEK DIRECT COXTKOL OF THE BOARD OF HEALTU
OR SUPERVISED IN BEHAT/F OF THE TERRITORY.

Pree Dispensary, Honolulu.

Kalihi Receiving Station, Honolulu.

Leper Settlement, Molokai.

Kapiolani Girls' Home, Honolulu.

LTome for Xon-leprous Boys, Waiinea, Hawaii.

Insane Asylum and Infirmary. Honolulu.

Quarantine Hospital, Honolulu.

Quarantine Hospital, Hilo, Llawaii.

Malulani Hospital, Wailuku, Maui.

Queen's Hospital, Honolulu.

Leahi Home for Incurables, Honolulu.

Kapiolani Maternity Llome, Honolulu.

Associated Charities, Honolulu.

Hilo Hospital, Hilo, Hawaii.

Lihue Hospital, Lihue, Kauai.

Eleele Hospital, Eleele, Kauai.

Waimea Hospital, Waimea, Kauai.

DISTRICTS FOR CARE OF IXDIGEXT SICK AND VACCINATION, AND
EXAMINATION OF SCHOOLS AND SCHOOL CHILDREN BY GOV-
ERNMENT PHYSICIANS.

Island of Kauai, Five Districts.
Island of Oahu, Five Districts.



6 REPORT OF THE PRESIDENT.

Island of Molokai, One District.
Island of Mani, Five Districts.
Island of Hawaii, ^ine Districts.

PUBLIC SAFETY ;t',S\ EPIDEMIC DISEASE.

Once more to the Legislature, tlie Executive and the Citizens
of the Territory has occurred a striking warning as to the dan-
ger of leaving the Board of Health without funds with wdiich
to combat an epidemic of virulent contagious disease.

Had not the President of the Board personally assumed
unlawful responsibilities and obligations, trusting to private
financial support, the adequacy of vxdiich is undetermined at
this writing, July 15th, it would have been impossible to have
controlled the ejiidemic of plague which started on the 24th
day of March, 1907.

It is hoped this warning will not again go unheeded.

The Board of Health recomme-nded to the Legislature, Ses-
sion of 1905, the granting of an Emergency Appropriation of
$35,000.00.

The Board of Health recommended to the Legislature, Ses-
sion of 190Y, the granting of an Emergency Appropriation of
$100,000.00.

Each time the request Avas refused, unwisely, as the facts be-
low disclose.

CHARACTER OF EMERGEJNCY APPROPRIATIOT^S.

Thev are a 2;urantee that iniblie health officials need never
lose a moment in considering the means for combating virulent
disease, but can act instantly with the probability of promptly
limiting -or exterminating the particular disease threatening an
epidemic. Instant and thorough action insures small cost, as
may be realized by the comparison given in following para-
graphs :

An Emergency Appropriation does not imply the Treasurer
of the Territory must have ike sum on hand or prospectively
available within the period for there is no assurance it will be
needed or expended, but provides a way of using either money
in the Treasury or creating a temporary debt for a specific im-
perative public safety purpose.



REPORT OF THE PRESIDENT. • 7

All Eiiicraencv ApiMnpiiarion is simply a guarantee of public
lifaltli ami (Miutideiice and niav be liquidated promptly or de-
ferred as are oldiaations for public defence if unavoidable.

An Emero'ency Appropriation should be reasonably safe
ii'uarded by I'djuiriiii: the general appmval of the Governor for
expenditure.



1- I.XAXCIAL EXPP:XDITI'RES TX UK PLAGUE. TWEXTY-FOUK
:\IOXTIIS EXDIXG .TUXE 30th, Ift^V.

Cases. Deaths. Recoverier

1st Period l^ months S4t 31 3

2nd Period <1 months 41 29 12

Full Period 24 months. Total. . . 75 60 15



EXPEXDITURES.

Expense, ^NlecU-

cal. Quarantinp,

Buildings Apparatus General Transportation

Permanent. Permanent. Disinfection. Cremation, etr-.

1st Period $ $1,145.84 $1,753.09 $5,876.14

2nd Period 2,934.32 1,564.75 6,654.04



Cost of Plague 12,530.18



Cost of Precautions . $3,317.84 3,317.84



Total Cost $15,848.02



$1,145.84



$2,934.32 2,934.32



Cost of Permanent

Plant $4,180.16 4,180.16



Total cost of 75 cases of Plague $20,028.18



REPORT OF THE PRESIDENT.



HOW PAID.



Honolulu Ship-
Grovern- pers' Wharf
merit. Committee. Private.

1st Period $6,412.26 $1,789.46 $ 573.35

2n(l Period 1,834.94 9,318.17



$ 573.35







$11,107.63


$11,107.63




Total Private


. .$11,680.98






.$8,247.20




8,247.20
$20,028.18




Total Gov't...




$20,028.18



General disinfeetion was a precautionary measure and cover-
ed the following work :

Buildings disinfected 1,934

Stores disinfected 1,363

Rooms disinfected 14,511

Outhouses disinfected 2,223

In the years 1899 and 1900, 71 cases of plague including
61 deaths and 10 recoveries is said to have cost the Territory
of Hawaii between $3,000,000.00 and $4,000,000.00.

.This comparison simply illustrates the differences between
keeping cool and working quietly and instantly, and on tlu-
other had, getting excited and exciting the community, how-
ever, the circumstances and inexperience were extenuating in
1899-1900.

These remarks are made to endeavor to impress upon the
authorities. and citizens the extreme danger, improvidence and
injustice of forcing the Board of Health or its Chief Executive
to rely on private resources to protect public health in attacks
of virulent epidemic diseases. It is plain trifling with public
welfare.

SUPERINTETSTDENCE.

The President of the Board of Health will not review his
personal work. It must speak for itself to his credit or dis-



REPORT OF THE PRESIDENT. b

credit, lie regards matters of health as above politics, has
ahvays ordered and so far as possible enforced the rule that
politics should occupy no time paid for by the department.
Employees are not inter f erred with in the exercise of their
rights and choice as citizens.

The Secretary and Registrar General — The duties performed
by these gentlemen are not indicated by their titles. They are
our main reliance in visitations of epidemic, virulent and con-
tagious disease. They handle all such sick as well as all others
needing our ambulance service. They are called upon at all
rimes, recently for instance seven times at night in one week.

Xt the same time they work moie than regular hours. They
are experts at quarantine and disinfection work and invariably
take charge of all such work. They are exposed to all the dan-
gers of infection.

The Office Clerhs and Stenograplier have had long experi-
ence, are expert and faithful, always ready to give overtime
when necessary.

SAIS^ITATIOK".

The General Health Officer — This is a new office and will
enable the Board to extend its work in directions greatly needed.

The Chief Sanitary Officer has rendered excellent service.

The Inspector of Buildings and Plumbing, Etc., has taken
a lively interest in raising the standards of both items and
furthered all work related to that of his department.
Sanitary Inspector, Etc., Hilo — This gentleman has accom-
plished a great deal for his city and now the leading men wish
to see him extend his work into Puna and Hamakua where
there is much need.

Assistant Sanitary Inspector, Hilo — For twenty-three months
the Hilo Shippers' Wharf Committee have met this expense.
The Legislature established this office and has provided a salary.

Sanitary In.spectors — Their number has been reduced from
eight to seven. Their salaries have been raised and they have
been placed in uniform, a measure that will aid them in exer-
cising authority. These gentlemen have worked faithfully
often exposing themselves to contagious disease.



10 REPORT OF THE PRESIDENT.

FOOD COMMISSIONER'S DEPARTMENT.

The Food Coinmissioner and Analyst has had much impor-
tant work during the period and will have much to do with en-
forcing the new Pure Food Law, as he has been commissioned
by the Federal Authorities.

Meat and Animal Inspector — This officer has had milk and
poi inspection under his charge. He cannot attend to these
duties, hence they have been transferred,

Inspector of Dairies wnd MUh — Tw^o years ago I showed the
need of such an inspector and the need has been emphasized by
the incident last September of many being suddenly taken
violently sick from impure milk. I regret to say the the pro-
vision for this position made by the Legislature is inadequate
and not equitable.

QUARxiNTINE SERVICE.

The Bacteriologist and Pathologist has done much service.
The office is indispensable and the occupant is highly skilled
and appreciated. During the recent epidemic of plague the
demands on his time and skill were very exacting and were ably*
rendered.

Chief Health Officer and Government Physician^ IlHo —
With direct steamer connection with Mexico this official should
be classified under Quarantine Service and given special charge
of watching for infection from that source.

Morgue Attendant is an Hawaiian young man Avhom we pro-
moted and appreciate.

INSTITITTIOXS DIRECTLY AND INDIRECTLY UNDER CONTROL OF
THE BOARD OF HEALTH.

Free Dispensary — Ilonohdu.

This is an indispensable instii;ution for the treatment of the
indigent sick and children, ft is largely patronized as the
statistics later noted show. The physicians and dispenser are
greatly interested in their work and deserve public appreciation
as well as official praise.



REPORT OF THE PRESIDENT. IJ.



Kalilii Receiviricj Station- — Honolulu.

The place of detention has been greatly improved by new
bnildings, and the rebuilding of others. Plans have already
been drawn for fnrther additions and improvements for which
$8,000.00 was appropriated. The place will have first class
facilities for temporary or extended treatment of those there
detained. The private rooms are quite daintily furnished and
are scrupulously kept. Certainly every effort is made to have
^the station attractive and homelike, and to appear like a sani-
tarium, rather than a place of detention. For the care of
children and young women a matron is in constant attendance.
When complete there Avill be accommodations for thirty-four
patients, three attendants, the Board's Officer, and the Keeper's
family.

LEPER SETTEEMEXT MOLOKAI.

There has been a great improvement at the Settlement during
the past year and during the period just closing. It is hoped
an equal amount will be accomplished during the coming period.
The present administration had hoped to so plan the work that
by the close of the 1907-1909 period the Settlement would have
become a finished village in fact superior in its utilities to any
village of a like number of inhabitants.

It'is with profound regret I record the fact the Legislature
at its recent session failed to grant the appropriation so ur-
geutly placed before them for the proposed General Hospital
for treatment of other diseases than leprosy, the need for which
is so apparent.

With this established nothing further in the care of sickness
would be wanting.

The improvements completed comprise the following:

Bisliop Home for Girls.

j^ew dormitory accommodating twenty persons.
Xew bath house for medicated baths.
Xew dispensary.



12 REPORT OF THE PRESIDENT.

Xeir Cvenrird Disfjensary.

Contains operating, laboratory, and drug rooms.'
Equipment eqnal to the highest class operating rooms in any
hospital.

Fitting old dispensary for photographic and store rooms.

New Visitors' House.

Contains two segregated wards accommodating six men and
six women. Supplied with cooking facilities and all conveni-
ences, except sheets, pillow cases and blankets.

Relatives are permitted to remain from one steamer day
to the next steamer day and may see and converse with friends
separated only by very large plate glass windows or the double
fence corral.

yeir Poi Factory.

Is now complete and will obviate the necessity of the in-
mates ponnding either taro or paiai for poi. It is very satis-
factory to the residents.

Xeir Steam Lawndry.

The machinerv is of the very best class, and the laundry will
be a great relief to the inmates as it is of sufficient capacity
to do all the Settlement laundrying and coarse ironing. The
method of disinfecting renders the operation beyond criticism.

Xeir Physicimis House.

This has been erected for the Assistant Physician, and that
.)f the Physician in charge has been enlarged.



ev) manies



These were imperatively needed and are complete and well
built.



REPORT OF THE PRESIDENT. 13

New Cottages.

Some twelve .new cottag-es have been built, and have been
constructed of higher class material and finish than has here-
tofore been customary. The three more recent ones have been
built with some architectural pretension. The policy of giving
attractive variations in style and decoration will be continued
in all buildings that the Settlement may more and more present
a pleasing appearance to the eye.

New Warehouses.

These have been provided by moving back in line with the
store and street the buildings at the landing and rebuilding
them.

Oil Warehouse.

A new building of corrugated iron has been built at a proper
distance from the village.

The Brothers' Home.

This has been put into first class order, repainted, etc., and
surrounded by tropical trees and plants appears very homelike
and inviting.

New Ambulance,

This vehicle is in quite constant use and its utility such it is
unfortunate it \vas not long since provided. By it patients
are now brought from their homes to the dispensary for special
treatment and operations.

Landing.

This has been improved by the construction of walls and
filling and grading and laying of a steel rail track to the ware-
houses, etc.



14 REPORT OF THE PRESIDENT.

^¥ater Supply.

Pipe has been purchased that Avill, when laid, give an ample
water supply for all purposes.

These improvements have largely come from savings made
by the most careful administration of funds allowed the Board
of Health for Settlement use.

IMPEOVEMENTS PROJECTED FOE PERIOD 1907-1909.

The Legislature, Session 190Y, made no grant of money for
use for improvements in the Settlement for the above pferiod,
except for installing the enlarged water supply, nevertheless
we expect to execute the following projects:

The Nursery and Nurses Cottage.

To accommodate 24 babies and children to be taken from
their parents as soon after birth as possible, thereby reducing
to the minimum the danger of infection. We have the lumber
on hand.

The Contagious Ward.

To accommodate special cases such as pulmonary tubercu-
losis. Each patient is isolated as is the nurses room. We have
the Ixnuber on hand.

B 1(^1 (ling for flie Insane.

This is an imperative necessity as we have several mildly in-
sane lepcTS. This buildinix and compound will be superior to
ordinary accommodation for the insane.

Treatment Bath House.

While the Homes are provided with facilities for medicated
baths those dwelling at home are ill provided. The bath house
will be of smooth concrete well drained and have sixteen porce-
lain bath tubs, now on hand. There will be suitable lounging



REPORT OF THE PRESIDENT. ]5

rooms where pMticiits may rest nfter their baths and resume
jiormal temjierature, thereby avoiding exposure and chill>.
The sexes are sejOTea'ated.

Baji 1 u'li- If'inic.

There sliould 1)e added a new domitory building. We can
only lio]^e we may be able to provide this addition.

Wood Sair and Sph'ffiur/ Yard.

This is an imperative necessity and will be provided. The
crippled hands of the lepers should be relieved of this work.

The Pali Trail

This is being Avidened to six feet so the dangers of this mode
of exit will soon be of the past.

Pavilion at the Landing.

This will be an attractive building usually open except on
the windward side, and so arranged by closing the shutters
as to be made into an assembly hall 2-*^ by 80 feet. Most of
the lumber is in hand.

Improved ^Vater Su j)[ihi and Fire Protection.

The Legislature voted $12,000.00 for the installation of the
pipe on hand, and placing hydrants which are much needed.
The enthusiasm of many of the inmates is such we will find
no difficulty in organizing hose companies.

Sewerage System — Baldirin Home for Boys.

This is the gift of the Honorable H. P. Baldwin and will
be installed during the coming period.



16 REPORT OF THE PRESIDENT.

FUTURE NEEDS TO COMPLETE THE SETTLEMENT.

General Hospital.

It will be a stain on the next Legislature should it neglect
to provide for this.

Ice Plant.

Its need and economies are too obvious to need discussion.

Electric Light.

It is believed the head of the new water supply will be so
great as to be capable of furnishing power sufficient to light
the whole Settlement, so that the expense for light will be far
less than the present cost of coal oil.

Breakwuter.

With an expenditure of $5,000.00 the landing could be made
comparatively safe in all stages with few exceptions.

With these improvements completed the Settlement would
be a model village. Maintenance and the renewal of old build-
ings may be summed up as practically the entire future needs
of the Settlement as it is to be hoped there will be no increase
in the number of inmates at the Settlement.

MEDICAL TREATMENT OF LEPERS.

The public have little idea of the amount of working being
done in this respect. T refer them to the reports of Drs. Good-
hue and ITollmann. Other physicians, to the number of four,
have been at work and the coming year will see greater facili-
ties and greater efforts than ever, and our efforts will be to
secure the best skill available.

UNITED STATES LEPROSARIUM.

Owing to delays incident to all undertakings of a great gov^
ernment obstacles have intervened, but undoubtedly the work
Avill soon be begun.



REPORT OF THE PRESIDENT. 17

MISREPRESENTATION ABROAD OF THE CHARACTER OF THE
LEPER SETTLEMENT MOLOKAI.

The President of the Board of Health has most determin-
ably set his authority and influence against the sentimental and.
sensational dark shadows thrown like a pall over the Settle-
ment. The main object of his incumbency has been to dispel
every shadow possible, to make a cheerful appearing village,
with as happy inhabitants, as well cared for, as wholesomely
employed, as rationally entertained as possible in any com-
munity of persons not in perfect health.

I believe this to be the object of the Superintendent, Physi-
'cians, the Bishop, Priests, Ministers, Sisters, Brothers and all
in authority, and my efforts have been feeble compared with
theirs.

Any care of the sick has its trials, but I doubt if any of those
I have named would care to have the word "sacrifice" attached
to their deeds of devotion. 'No infection has ever passed to
those exercising prudence or right living. Visits of friends to
Sisters, Brothers, Priests or officials are not denied where the
rules of segregation are strictly observed, nor are "clean" in-
mates prohibited from leaving the Settlement on business,
vacations or visits. The reward they secure is the approval
of their own hearts and duty, a reward scarcely appreciated in
this material age.

I doubt the sincerity of those who herald their intentions of
"sacrifice," and such people have no welcome from those in
authority over the Settlement.

In order that the world might he appraised of the facts as
they exist the President of the Board of Health invited that
distinguished writer, Jack London, and his wife to visit the
Settlement for a few days, including the celebration of the
Fourth of July, and I trust his promised account of their ex-
perience may be placed before the reading public.

I, possibly more than anyone, appreciate those who devote
their lives to work in the Settlement and the wealth of their
lives is deposited in hundreds of human hearts, a treasure
"moths cannot corrupt nor thieves break through and steal."



18 REPORT OF THE PRESIDENT.

KAPIOLANI girls' HOME HONOLULU.

This institution continues, under the Sisters of St. Francis,
its remarkable record of efficiency and economy.- The 48 girls
within its kindly shelter have a home with all the attributes
the word indicates. The Legislature dealt very generously
with this Home so that many things near to the hearts of the
Sisters can be provided.

HOME FOE NON-LEPKOUS BOYS^ CHILDREN OF LEPERS^^ — WAIMEA^

HAWAII.

After many years of discussion this Home is now within
reach as the Legislature voted an adequate appropriation of
$15,000.00 for its establishment.

The appropriation, for the period lOOS-lOOY, of $6,000.00
was so inadequate building operations could not be begun. It
is hoped to locate this institution at Waimea, Hawaii.

OAHU INSANE ASYLUM AND INFIRMARY HONOLULU.

The patients in care of this institution numbered on July
1st, 1905 — 16Y, on December 31st, 1906 — 196 and on June
30th, 1907—217.

Although the attention of the Legislature Avas brought to
the need of more attendants, it chose to increase the pay of the
number employed, providing for no increase.

The Legislature increased the Maintenance Appropriation
from $40,000.00 to $45,000.00 under the title ''Insane Asy-
lum AND Infirmary^' in response to the representations of
the President of the Board relative to the necessity of a place
of detention and care of those whose cases properly require ob-
servation before a charge of insanity should be lodged against
them. Many of these cases are the result of indulgence in
liquor and drugs and in a short time their normal mental bal-
ance becomes restored.

We have already taken steps'lo erect a building that will
shelter fort}^ patients and so relieve the buildings at the en-
trance of the grounds ; they can be turned into the Infirmary
and accommodate some twenty patients.



REPORT OK THE PRESIDENT. 19



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