HEALTH PROBLEMS IN COUNTRY DISTRICTS. 4OI 



at the other ends of the earth. How is she to face her coming 

 trial ? What wonder is it if she shrinks back with fear and insists 

 upon a return to town, with its possibilities of skilled help and 

 aseptic nursing. The newspapers are full of schemes for closer 

 settlement, for putting returned soldiers on to the land, for 

 encouraging miners' phthisis victims to go on to the land, but I 

 maintain that the first step to be done is to make provision for the 

 care of maternity cases, so that the women from overseas who 

 are willing to go with their husbands, will know that when they 

 do their duty to the State by bringing forth children they will 

 have some reasonable care and attention. 



Although I am emphasising the case of the newer settlers, 

 1 do not in the least wish to ignore the claim.s of the older settlers 

 — the Boer farmers. We are told that there is unrest in the back 

 veld — there is a cry for a Republic, for the old flag. The truth 

 is that there is a justifiable feeling of unrest and dissatisfaction, 

 but the majority of the people do not realise what is the matter. 

 Mischief-makers try to make political capital out of it, but what is 

 really needed is a sympathetic imagination that will put into plain 

 language the inarticulate cry of the people. 



In regard to sickness or accident in the home, let me 

 emphasise the fact that the onset is unexpected and cannot be 

 foreseen. If help is to be of value, it should be given promptly. 

 If the initial dose of castor oil or the like is not curative, then 

 skilled medical treatment should be available. In all cases of the 

 non-indigent, no assistance is given to secure this help in the 

 country. In the regulations for district surgeons this definition is 

 found. Indigent person is one '' certified by a magistrate to be 

 in a state of absolute poverty and physically incapable of earning 

 a livelihood." Let it be granted that such indigent persons are 

 well looked after by the magistrate and the district surgeon, but 

 the question arises, what happens to the others? It may also be 

 taken for granted that there are in the country certain farmers 

 who are in a financial position to pay properly for any medical 

 attention they require. Having excluded the highest and the 

 lowest ranks, there remains the large middle class of all grades 

 and capacities. There is many a man who can keep his house- 

 hold going — it may be in a very humble way, but at least clothed 

 and fed — who is quite unable to pay a reasonable fee to a doctor. 

 The Kaffirs and the coloured people are not included in the defi- 

 nition of "indigent" ; most of them are not in a state of absolute 

 poverty, and physically incapable of earning a livelihood, yet how 

 n:any are in a position to pay mileage to bring a doctor out to 

 their hut in case of serious illness ? 



In order to get definite statistics I applied to the Registrar- 

 General, Pretoria, for information, and received a letter in reply 

 from Mr. C. W. Cousins, Director of Census, informing me that 

 the first issue of " The Official Year-Book of the Union " was 

 in the press, and at the time of writing it is apparently not yet 

 released for distribution. I have found figures relating to the 



