, v B (Health and San) 30 Sep t 1947 Yap Dis t . 4 ( Pr- ev ent ,) (a ) Field t rip t o Ul ithi Ato l l , Fa is,I f alik, Sor ol , and Ngulu. (1 ) Nine days (7-20-47 t o 7- 30-47 ) were spen t maki ng a f ield tri p to the i s lands of Ulithi At oll, Fais, I f alik, and Sorol . The Me di cal Of f i cer du t i e s c ons i s t ed of the usua l r ou ti ne. Upon meet i ng the ch i efs, a sh or t publ ic h ealth l ec tur e was gi ven . Empha sis was pl aced on the i mpor t anc e of good fecal and waste disposal , and the r el ati onship of ·this prac tic e to r a t s and f lies . The cus tom of dispos ing was tes into the s ea was endorsed as the saf est and eas i e s t by r eason tha t the se isl ands are s mall; the currents ar e swift and access i ble ; and that th e pe ople live c l ose t o the shor e . The Chief s wer e encouraged t o construc t the natl. ve over-wat er heads further out i n t h e wat er s o they would be over wa ter at al l t i mes ~her than at hi gh tide onl y . ( 2 ) An adequat e new suppl y of firs t aid supy l i es wer e l e f t at each i sland wi th i ns truc t i ons. A dr um of 5%D.D . T. i n Kerosene and Red Squi l l were al s o l e f t on each island excep t Sorol . The chi ef s appear ed thankful f or these provisions and there wer e indications that tbey were us ed pr eviously an d we ~ e ef f ec tive. Sorol on l y has a popul ation of t en people and al l are c l os e l y r elat e d. I t would appe ar tha t they could give us some advic e on ho w t o keep healthy . The ch ief although ab out 60 y ears of age i s a f ine physical specimen . He has t wo sons Who wei gh appr oxima t ely 225 I bs . ~ piece. One of thes e 80ns has a 15 year ol d daughter who we i gh s abou t 1 65 Lba , end a 10 ye ar Ot;),) old son vmo weigh s about 140 Ibs. B (Hea l th and San ) 30 Sept 1947 Yap Df s t , 4 (Prevent. )- 2 All accessible peopl e a ppeared at s i c k ca l l . Eac h pe r s on ' s compla i nt and treat ment was r ecorde d on his or her r espective card; Al l chl 1cren manl fes t ine ques t l o n a~ le s igns or s ymp tomB of h elml n e thl a sls received t r ea t ment nl t h cry stolds and ~ag­ n esium sulfate i n t hre e h ours . Per sons n ever bef or e v acc i nated for pox by an Amer i can Do~ tor wer e vacci nated . ( 4 ) The h eal th o f t h e people i n gen er a l ap?ear ed good . One l a dy , ap prox i matel y 55 y ear s of a ge on t h e island o r Ullthl 1:og -I.:og , wa s sus pee t e d of havi ng me nl ngi t is . '!he na tiva s se t a kerosene r eef er into operation and 2, 000, 000 uni ts of pen i c i l l i n were l ef t with the newl y re turned Health Aide f or trea t men t . The history of t he c ase was a bi t obs cure an d i t Is possible she vms a victim o f apoplexy . A qut t e common comp l aint on the is­ l a nds was occasiona l ge n~ ra 1 1z e d abdominal cramps . Consider ing the po s s ibi l i t y of chroni c dy sentery a consider ab le number of s pecific trea tment s wer e prescribed . The po s s ibi l ity o f he l~~n ­ t hiasis being t h e e t iology ttU s t be considered . I f the inci dence of this comp lai nt has not subsided by t he next vi s i t , i t may be pr oper to a dm i ni s ter cr y s toids to the adul t s also . Sever al cases of b i l a t er al catarac t wer e diagno s ed . Medi aa l pr actitioners should be t aught the operati onfbr t he conditi on. A cachetic mal e of I f a1ik , age approximately 35, havi ng an abdomi na l fistula in R . L.Q . refused t o c orne to Yap for fur ther trea t men t . The woman on U1 i t h i (Fo ssere ) having a l arge l esion on her l ef t br ea s t died . The eti o logy, appaaent l y being car ci no ma. B (Hea lth and San ) 30 Sept 1947 Yap Dt e t , 4 (Prevent. )-3 (5 ) The s a me pr oc edure WB.a f ollowed when l and i ng on Ngu l u Isla nd . The Sanl tary eand! tion of t h e isl a n d i n ge n er a l a p pe a rs g ood . There wa s no ev i dence of not di s po s ing f ec es an ywh e~ o ther than i n to the s ea. Althou gh there appeared to b e an e xc ess o f :fl ies, i t is pr omi sing t o not e that t h e ch i ef i nquir ed abou t br i ngi ng D.D. T. which wa s l eft. The Ngul u Hea l t h Aid wa s r e t u:zre d after compl et l ng 6 mon th s in t he Ya o Na t i ve di spens ary . I n a dd! t i on t o first a i d supp l ies , h e was gi v en a f e w o t h er drugs which he pr oved hirrs el f qual ified to use . The i n cidenc e of n o och er- di s eas e wa s no t e d , A few cas e s presc n :te d s i gns a nd s yrr.p toms whi ch s i mul ated pos sib l e t ub er c u l o s i s . 'lh ey we r-e not brought b ack because () f thc inadequa te hospitaliza t ion facilities on Ya p . Ch i ldren wer-e d e wormed wi th c rys t oi d s and magnesi um s ulf a t e i n :3 hours . .lher e we r e no c a s e s of obvi ous dysentery . The i r pr emi s e s wer e c l ean . lher e wa s , a n appa ren t s l i gh t decr ea se i n the i nd1d on c e of Yaws s i nce l a s t visi t , (b ) Medi cal Fi el d 'Iri p t o Satelli t e I sl ands • ( s . ~ 6c1. ("r~ J . b< 1= ) . 1 . Introduc tion . (". <.1 . J ) . (a) Thi s i s t he second t i me tha t t he I sla n d s i n the We s t er n Carol ines have b e en v :Lsit ed b y the Yap CAU . TIle s t a t i on s h ip l e f t YaP on 28 Au gus t a nd a fter v i s i t ing Sor o l , ~o l e ai , a n d Ifa l i k , r e turned on th e 4 t h of Septemb er enrout e t o Gu am f or r e p airs . On 1 1 September the r e lief station ship l e f t Yap t o c omp l e t e the f ield trlp a n d r e t urn ed on 20 September . B (Health and San ) 30 Sept 1947 Yap Dt s t., 4 (Prev ent . )-4 (b) The purpose of t h i s trip wa s to check the Islands for i mprovement of s anl t a~J condi tions; i f po s sible , t reat the d i sea ses enc ountered , determine the ben ef ! ts ob tain ed from prev i ou s treatment s , d istribute f i rst a i d and sanit a t i on sup plies, a n d to con t i nue v ital statistic r ec ords .