THE AUTHOR Helen Robinson has worked as a Research Analyst / Inquiry Facilitator at the Waitangi Tribunal Unit since April 2009. Prior to her commission for this report, she wrote two non- commissioned reports as support work for researchers working on the Rohe Pōtae district inquiry. She has a PhD in history from the University of Auckland and has had several articles published in academic journals in New Zealand and overseas, the most recent being ‘Simple Nullity or Birth of Law and Order? The Treaty of Waitangi in Legal and Historiographical Discourse from 1877 to 1970’ in the December 2010 issue of the New Zealand Universities Law Review. ii CONTENTS THE AUTHOR ........................................................................................................................ II CONTENTS........................................................................................................................... III LIST OF MAPS .................................................................................................................................................... VII LIST OF FIGURES ............................................................................................................................................... VII LIST OF GRAPHS ...............................................................................................................................................VIII ABBREVIATIONS ............................................................................................................... XI INTRODUCTION.................................................................................................................... 1 0.1: HEALTH ISSUES IN TE ROHE PŌTAE STATEMENTS OF CLAIM ................................................................. 2 0.2: METHODOLOGY.................................................................................................................................... 4 0.3: THE STRUCTURE OF THIS REPORT.......................................................................................................... 7 CHAPTER 1: MĀORI HEALTH AND DEMOGRAPHICS IN THE ROHE PŌTAE INQUIRY DISTRICT, TO 1900 ........................................................................................... 11 1.1: POPULATION ....................................................................................................................................... 11 1.2: BIRTHS, DEATHS AND LIFE EXPECTANCY ............................................................................................. 16 1.3: DISEASE ............................................................................................................................................. 18 1.4: MENTAL HEALTH ................................................................................................................................ 24 1.5: CONCLUSIONS .................................................................................................................................... 25 CHAPTER 2: FACTORS CONTRIBUTING TO MĀORI ILL HEALTH IN THE NINETEENTH CENTURY .................................................................................................. 26 2.1: NUTRITION ......................................................................................................................................... 27 2.2: ALCOHOL ........................................................................................................................................... 33 2.3: TOBACCO ........................................................................................................................................... 38 2.4: HOUSING ............................................................................................................................................ 39 2.5: SANITATION ........................................................................................................................................ 42 2.6: WARFARE ........................................................................................................................................... 44 2.7: NATIVE LAND COURT AND LAND SALES ............................................................................................. 44 2.8: CONCLUSIONS .................................................................................................................................... 46 CHAPTER 3: PROVISION OF MEDICAL SERVICES TO ROHE PŌTAE MĀORI IN THE NINETEENTH CENTURY ................................................................................... 47 3.1: DOCTORS AND MEDICATION IN THE ROHE PŌTAE ............................................................................... 51 3.2: HOSPITALS ......................................................................................................................................... 58 iii 3.3: CONCLUSIONS .................................................................................................................................... 62 CHAPTER 4: MĀORI HEALTH AND DEMOGRAPHICS IN THE ROHE PŌTAE, 1900 TO 1938 ...................................................................................................................... 64 4.1: POPULATION ....................................................................................................................................... 64 4.2: MORTALITY AND BIRTH RATES ............................................................................................................ 67 4.3: COMPARATIVE DEMOGRAPHICS IN THE ROHE PŌTAE .......................................................................... 70 4.4: INFECTIOUS DISEASES ........................................................................................................................ 71 4.5: NON-INFECTIOUS DISEASES AND GENERAL HEALTH ............................................................................ 82 4.6: DENTAL HEALTH ................................................................................................................................. 84 4.7: MENTAL HEALTH ................................................................................................................................ 84 4.8: CONCLUSIONS .................................................................................................................................... 85 CHAPTER 5: FACTORS CONTRIBUTING TO MĀORI ILL HEALTH IN THE ROHE PŌTAE, 1900 TO 1938 .............................................................................................. 87 5.1: NUTRITION ......................................................................................................................................... 87 5.2: SANITATION ........................................................................................................................................ 92 5.3: HOUSING ............................................................................................................................................ 95 5.4: TOBACCO ......................................................................................................................................... 103 5.5: ALCOHOL ......................................................................................................................................... 105 5.6: POVERTY .......................................................................................................................................... 108 5.7: CONCLUSIONS .................................................................................................................................. 110 CHAPTER 6: PROVISION OF HEALTH SERVICES TO ROHE PŌTAE MĀORI, 1900 TO 1938 .................................................................................................................... 111 6.1: PUBLIC HEALTH AND THE DEPARTMENT OF HEALTH ......................................................................... 112 6.2: RESPONSES TO SPECIFIC DISEASES .................................................................................................... 118 6.3: MĀORI MEDICAL PROFESSIONALS ..................................................................................................... 126 6.4: DOCTORS .......................................................................................................................................... 128 6.5: NURSES ............................................................................................................................................ 133 6.6: DENTISTRY ....................................................................................................................................... 137 6.7: SCHOOLS AND HEALTHCARE ............................................................................................................. 139 6.8: MATERNAL HEALTHCARE ................................................................................................................. 141 6.9: HOSPITALS ....................................................................................................................................... 144 6.9.1: TOKANUI .......................................................................................................................................... 152 6.10: ISOLATION AND TRANSPORT ............................................................................................................. 152 6.11: CONCLUSIONS .................................................................................................................................