ON GUARD AGAINST DISEASE
Officials and Citizens Join Forces
ERNEST A. MOTT-SMITH
Secretary of the Territory of Hawaii
ONE of the greatest assets in
health matters which Hawaii
posseses is the constant and de
pendable interest of its residents in
matters of public health and sanita
tion. This interest exists among the
oriental as well as among the Cau
casian population. Its manifestations
run in many directions and have al
ways been enthusiastic and steady. It
has generally taken the form of hearty
co-operation with the territorial board
of health and federal service. It has
arisen to every emergency and has not
stopped when the emergency was over,
but continued during ordinary times,
when no imminent questions of public
health were at issue. Hawaii has firmly
established this reputation of civic In
terest at home and abroad by actual
work and not by mere talk or mere or
ganization.
In 1895 a cholera outbreak of no
mean proportion occurred in Honolulu.
The infection undoubtedly came from
the orient. The emergency was great. A
call was made for the citizens to organize |
a citizens' sanitary committee and corps
to assist the territorial board of health
,In stamping out the disease. The re
sponse to this call was remarkable.
The citizens immediately effected and
put into operation an organization un
der which the entire city was dis
tricted, policed and quarantined, a twice
daily inspection and census taken, all
cases of sickness promptly reported and
within a short time the disease was
stamped out.
In 1900 plague broke out in Honolulu.
The same process was gone through.
CLEANUP DAY
In 1911 cholera again broke out, and
within an incredibly short time was
eradicated, the mortality, with the ex
ception of two Portuguese, being con
fined to Hawaiians. This was followed
a few months later by a "cleanup day"
campaign which was organized, put into
operation and financed by the several
improvement clubs of Honolulu. Im
mediately thereafter the citizens organ
ized and conducted a mosquito elimina
tion campaign at a cost of $100,000,
which has so diminished mosquitoes In
Honolulu that they are now hardly
noticeable. In matters of health, clean
liness and sanitation the people of
Hawaii insist that not only shall public
officials, but also individuals, do their
share in the maintenance and continu
ance of health conditions. The city is
now on the eve of another cleanup day
campaign, and the indications are that
cleanup day will become an annual
affair.
* • *
Hawaii Can Combat
Easily All Disease
Hawaii, like other communities, has
•*fceen assailed from time to time by con
tagious diseases. With the exception of
the two smallpox epidemics which.oc
curred in 1852 and 1881, and a small
outbreak in 1910, the outbreaks of
cholera in 1895 and 1910 and that of
plague in 1900, there have been no
serious outbreaks of diseases of a con
tagious nature. Whatever cases have
occurred In the last 10 years have been
promptly and efficiently met by the
health officials and organizations above
named and without danger and with
very little inconvenience to the pub
lic. The recurrence of these is growing
less and less as time passes. There
are the usual occurrences of mumps,
whooping cough, measles and occasion
ally diphtheria and typhoid, such as
are found in any community, but they
are promptly met and usually occur
in modified forms. The general health
of the territory is good.
Hawaii is a healthy place in which to
live It has been aptly termed the
"Paradise of the Pacific." The place is
unique. It has many scenic attractions,
Interesting sports and customs. The
temperature is semitropical, never too
hot in the summer nor too cold in
winter.
The islands lie 2,000 miles away
from the nearest mainland coast in the
track of the northwest and the north
east trades which blow steadily from
March until November and intermit
tently during the other months. Hence
Hawaii with its sea isolation, sur
rounded on all sides by a vast expanse
of the Pacific ocean, with its salubrious
and healthy climate, is enabled to con
trol and combat the introduction of
diseases from without and to prevent
the spread of disease from within. Our
state boarders are the sea, our assets
perennial sunshine and healthful winds.
Hawaii Is not the endemic focus of
any disease. Every disease has been
introduced, principally from the orient.
Before the advent of other races dis
ease was practically unknown in these
islands. The native race waa composed
of healthy men, women and children.
The usual and destructive ills of mod
ern civilization were absent. Mosqui
toes were not to be found nor any of
the other Insects which play so impor
tant a part in the transmission of dis
eases. These were all introduced into
Hawaii from without. Hence it is im
portant that the precautions taken at
the ports of entry should be complete
and efficient and the outer defense be
strong.
OUTPOSTS AGAINST DISEASE
The outer defense against the intro
duction of diseases consists of the
United States pubHc health and marine
service and its station in Hawaii, the
federal immigration service and the
territorial board of health. The func
tions of the public health and marine
hospital service are well known. That
service has absolute quarantine pow
ers against cholera, yellow fever,
sSftllpox. typhus fever, leprosy and
plague. The efficiency of the service is
beyond question. The federal Immi
gration service has authority to re
ject and deport immigrants afflicted
with other disease. The territorial
government has control of internal
health matters and concurrent jurisdic
tion with the federal government over
vessels and passengers entering the
harbors' of the territory. Its quaran
tine powers extend and apply to the
whole category of infectious and con
tagious diseases. These three services
work together in hearty co-operation
and form an effective barrier against
the introduction of diseases from with
out. * In addition thereto the territorial
board of agriculture has among Its'
other functions, quarantine powers
over tuberculosis in cattle and rabies
in dogs. The activity of the territor
ial board of health in internal health
matters includes among other things
a complete system of inspection and
sanitation in which each house is
mapped and the owners and occupants
recorded.
Fumigation and disinfection work is
carried on; a system of vital statistics
and the maintenance of 24 physicians
under government pay In the various
districts of the territory, whose duties
are not only to report births, deaths
and marriages and issue birth certifi
cates and burial permits, but immedi
ately to report all cases of sickness of
a contagious or anjnfectious nature as
well as to take care of and treat indi
gent persons for sickness of any kind
and to pass upon the location of dai
ries, markets, slaughter houses, laun
dries and the like; the maintenance of
an insane asylum, a mosquito cam
paign and an efficient system for the
quarantining.care and treatment of all
diseases of a contagious or Infectious
nature.
No person coming to the Hawaian
islands need fear contracting any unus
ual disease or any disease for that
matter. Very few communities look
after their general health conditions
more consistently than this community
does. The purpose of Its health de
partment, with Its elaborate organiza
tions, its liberal appropriations, its
system of care and treatment of Indi
gent sick, its facilities, among oth
ers, for quarantine, disinfection
and fumigation is to make these
islands a "Paradise of Health" as well
as the "Paradise of the Pacific." There
is no reason why this can not be done
with the facilities at the disposal of
the federal, territorial and county
services and .with the advantage of a
fresh, brisk and healthful climate and
sea isolation. The territory has already
gone a long way toward this consum
mation.
* * *
Statistics Prove
Rumors False
" 'Leprosy in the Hawaiian islands.
It is increasing at an alarming 'rate
among the white population. One
Hawaiian in 34 is a leper. Lepers may
be'seen in the streets of Honolulu
almost every day. The law governing
segregation of lepers is feeble, concili
atory and inefficient and does not pro
tect public health. The whole subject
is governed by politics,' " quoted Ernest
Mott-Smith, secretary of the territory
of Hawaii, to the interviewer. "These
and like statements are the head lines
and body material occasionally met
with in daily papers," he continued.
"Then again writers of fiction have
touched on this disease.
"For dramatic effect the subject is
easy. To depict it needs no Imagina
tion; the bare mention of the affliction
is alone sufficient. It is, and has been,
pictured as the highest form of martyr
dom—a horrible living death. Worse
still It is now so considered and has
been for centuries. Some even regard
it as an adequate and fitting method
of personal expiation, while others
hale it as an opportunity of dying in
a blaze of glory. These statements
are not unfounded. Applications have
been received in Hawaii from soldiers,
nurses, doctors, divines, clerks, in fact
from people in all walks of life in the
United States and elsewhere begging
the territorial officials that they be
allowed to go to the leper settlement
on the island of Molokal that they may
there suffer and die.
"To those who are-rfamillar with lep
rosy this sentiment is all rot. It is in
maudlin contrast with the high pur
pose and devotion of the Catholic
brothers and sisters and of the officials
and others who are ministering to the
afflicted at the leper settlement on Mo
lokal. These people are not afraid of
leprosy. Nor do they seek to get it; nor
do they hope nor contemplate dying
of it.
LITTLE DANGER OF CONTAGION
"The fact is, leprosy is one of the
least, if not the least, communicable
of diseases. It can not be communi
cated by direct innoculation. It is not
hereditary. Eminent medical authori
ties have held that the disease Is not
even contagious. No qualified authority
goes further than to claim that it is
more than very mildly contagious or
communicable, and then only under
very special conditions, or Because of
the peculiar receptability of the host
through anemic or diseased conditions,
accompanied by filth, poor and re
stricted diet, poor ventilation, poor
sanitary conditions and the like. Lep
rosy is seldom If ever communicated
by direct contact, though such contact
may be daily and intimate, as will be
shown below by statistics concerning
Kokuas at the leper settlement on Mo
lokal.
"A person of clean habits and diet
need have but little fear of contract
ing leprosy.
"Hence while there are several means
by which leprosy is known to be com
municated, means by which it has been
■-M l «v « m.V' ■ » y™^TaTN af'l A H* aM / tj'i X ij^ T\ A A g t /""M i ,4
popularly thought to be communicable.
It remains to be ascertained how it act
ually Is communicated. The Incubation
period of most communicable diseases
Is known, as also the means of com
municability and degrees of virulence
These facts are unknown In leprosy.
"But few months have elapsed since
the bacillus of leprosy has been suc
cessfully grown artificially, this having
been first accomplished by M. T. Clegg,
who Is now developing his discovery in
the federal laboratory near Honolulu.
The incubation period and transmlssi
bllity of the disease are now receiving
close attention and some light may be
thrown upon these important points so
that In the near future a cure for the
disease may be discovered. The dis
ease Is not incurable. There have been
natural cures and some apparent cures.
The uifnculty is that the universal
specific Is as yet unknown.
DOES NOT SPREAD AT MOLOKAI
"The facts aho%'e stated are not based
on theory. They have been learned
from actual experience in Hawaii and
do not differ from facts learned from
experience in other countries where
leprosy has been or is present," con
tinued the territorial secretary. "There
is # good deal of leprosy in other parts
of the United States today.
"In regard to hereditary and contact
the following statistics are Instructive:
"Since 1003 there have been 156 chil
dren born at the leper settlement on
Molokal of whom but one, who was not
removed at birth from the leprous
mother, became a leper. It has been
ascertained that if a child Is removed
at birth from the mother and from con
tact with other lepers it will not be
come leprous. During the last 46 years
there have been 234 Kokuas at the set
tlement of whom 156 have been there
more than five years, 97 more than 10
years, 67 more than 15 years, 43 more
than 20 years, 21 more than 25 years.
These Kokuas are the helpers and per
sonal nurses of helpless lepers in most
cases the husband or wife of the leper.
Hence the contact between them is
daily and intimate. Of these 234 Ko
kuas over a period of 46 years only
four have acquired leprosy at the set
tlement. Not one of the officials, doc
tors or nurses connected with the set
tlement on Molokal since its establish
ment In 1866 has acquired leprosy.
Father Damien contracted leprosy, but
that was an extraordinary exception
to the experiences of others.
"It is a fair question: Is there any
truth in the reports in newspapers
and periodicals which are contrary to
the records of the settlement?
LEPROSY ON DECREASE
"Leprosy Is not on the Increase in
Hawaii. It Is on the decrease," de
clared the official. "Moreover, there is
a material diminution in Its virulency.
From a statistical standpoint it may be.
said that one Hawaiian in 70 is a leper.
But to convey the Impression thereby
that one Hawaiian in every 70 met with
in the streets or at large in the country
is a leper is a crime against truth.
The figures mean no more than this,
that the Hawaiian and part Hawaiian
population in the territory is estimated
at 38,000, of which 550 are lepers, seg
regated over a number of years, who
are now confined at the leper settle
ment on the island of Molokal. The
lepers are not allowed to remain at
large In the community.
"In regard to lepers wandering at
large, an inquiry on this point was
made a short time since of every prac
ticing physician in the territory, with
the consequential effect that there were
no lepers seen at large who were not
then or shortly afterward apprehended
by the territorial board of health. The
value of this testimony arises from the
fact that all physicians are required by
law, under penalty of a fine and for
feiture of license, Immediately to re
port all new cases to the health author
ities. All sheriffs, deputy sheriffs, po
lice officers and school teachers, as well
as other officials, are also required to
do the same. Moreover the territory
maintains 24 physicians under pay
upon whom is laid this duty of discov
ering cases of leprosy. These and many
other means and precautions are em
ployed to remove the afflicted from the
community. The segregation law is
backed by a warrant of arrest and for
cible removal If necessary. A case oc
curring among the thousands of tour
ists and the more thousands of soldiers
who have come to Hawaii is yet to be
heard of.
"Among the 6,000 people made home
less by the great Chinatown fire of
1900, which occurred during the plague
outbreak of that year and destroyed
moi*a than 30 acres of congested and
crowded quarters, In which were housed
people of all nationalities, but three
lepers were found, and the existence of
these had already been known to the
health authorities. These 6,000 people
were individually bathed and given a
careful inspection and examination by
physicians before being placed in the
quarters temporarily erected for them.
The chance that there are more lepers
among them is very remote. The de
plorable house and living conditions of
that day have not been allowed to re
cur.
"Leprosy is confined almost wholly to
Hawaiians. There are a few cases
among Portuguese, Japanese and Chi
nese. Among American, British and
German there has been but one case
since 1910, and but very few cases be
fore that date. Almost without excep
tion, every case hae been the result of
extraordinary contact with or exposure
to the disease."
Alexander &Baldwin, ud.
OFFICES:
Stangenwald Building, Honolulu, T. H.
Mehlhorn Building, Seattle, Wash. 82 Wall Street, New York, N. V,
Alaska Commercial Building, San Francisco, Cal.
t , —-—^—_____
OFFICERS AND DIRECTORS
J. P. COOKE President and Director.
W. M. ALEXANDER First Vice-President and Director.
J. R. GALT Second Vice-President and Director.
W. 0. SMITH Third Vice-President and Director.
J. WATERHOUSE Treasurer and Director.
E. E. PAXTON Secretary and Director.
GEO. N. WILCOX Director!
W. R. CASTLE Director.
S. A. BALDWIN.. ~ Director.
• j
Sugar Factors,
Commission Merchants
and Insurance Agents
AGENTS FOR
Hawaiian Commercial and Sugar Company. Kahului Railroad Company.
Haiku Sugar Company. Kauai Railway Company.
Paia Plantation. Honolua Ranch.
Maui Agriculture Company. Springfield Fire and Marine Insurance Co.
Hawaiian Sugar Company. American Central Insurance Company.
Mcßryde Sugar Company, Ltd. New Zealand Insurance Company.
Kahuku Plantation Company. General A.F.&L. Assurance Corporation, Ltd.
Haiku Fruit and Packing Company, Ltd. German Alliance Insurance Association.
Kauai Fruit and Land Company, Ltd. Switzerland Marine Insurance Company, Ltd
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C. Brewer & Company, limited
Established 1826
PLANTATION 40—KCmmt ShiDDIIIIL INSURANCE] AGENCIES!
Hawaiian Agriculture Compaay, Kan. mT 2** — '- ¥ ___._„ «_ „ # ¥ i»-«.«^i
PepeekeoS««« Company. Hllo. IsUIIIIIIi>MUII dllU Caledonian In.ura.ee Company ot Edinburgh.
«»«r m„i ~ .... Scottlah Union * National Inaurance of Edinburgh.
Co«mmlal Uoion A».m« nM Co. ot London.
kE Kll.uea, Kaai. UCnerai MerCnanlS AneH«. and Foreign inauranee Co.
Hllo Sugar Company, Walnuku, Hllo, Hawaii.
Paauhau Sugar Plantation Company, Hamakua, HawaU _ _ ______ AGENTS
Hakalau Plantation Company, Hllo, Hawaii. FORT STREET
Hutchlnaon Sugar Plantation Company, Kan, Hawaii. *\/«»A wittuui,
Walmaaalo Sugar Company, Walmanalo, Oahu. TTriWrtT TTT TT 1> TX Taomaa Pineapple Company.
Honolulu Plantation Company, Alea, Oahu. Win VJjUJLiU, A. XI. Baldwin Locomotive Work* of Phlldelphla.
C. BREWER & COMPANY, Limited,
An Hawaiian corporation, was founded as early as 1826, and 1* tne Islands, the largest quantity controlled by any one concern
said to be the oldest American Mercantile organization west among the several agency houses of Honolulu.
of the Rockies. Among the earlier names Identified with the House of
The business, first begun by Captain Charles Brewer and fl^7. <F nl t itX^ G J ne^t t }u ned P , e Vl r Bushman Jones its rirst presi-
James M. Hunnewell oarlv traders in th« Parlflr from K«v %L Dt \ Cna / 1 ?? R - Bisno P. of the Bank of California; the late
t«t.nf . fu „l A JT ii ZT Charles M. Cooke, Henry A. P. Carter, at one time Hawaiian
England, carried on business through the whaling period as minister to Washington
general merchandisers and agents of the whaling fleet. Final- _. "
ly, with the wane of the whaling business, became interested tt-,,,??^-^! 6111 B ?f rd * °t, directors are the following: E.
in the sugar business and has steadily expanded as a factor Cl"enc? IS rL %oSke S /"r cdtVw
of the sugar development of Hawaii since 1876, the year that g 0 a £ c alorge R Carier&nd R T Ckfoke Gartley.
the sugar industry received its initial impetus through the v BB ™" LWierwna «• *•
Hawaiian Reciprocity Treaty with the United States, in 1883 The business of the concern is confined to agency lines,
the firm became incorporated with a capital of $500,000—while # representing very substantial plantation artd steamship hold
today Its capital is $2,200,000, with a reserve and surplus ad- lngs, insurance representations and incidental connections. This
ditional of $3,000,000. house is the general agent of the Oceanic Steamship Company,
On January 1. 1910. C. Brewer A Company, Limited, took cSis* betWeCn B * n Franclsco ' Honolulu and the Australian
over the business of William G. Irwin & Co., Limited, which
substantially added to its greatness as a mercantile organlza-* The Saa Franciaco correapondenta of this firm are: Messrs.
tion. For the year 1911 the house represented the production Welch * Co. of 244 California Street, and J. D. Spreckela Broa.
of 132,000 tons of sugars about of the product of Co. of 106 Davie Street.
3