A Yankee doctor in paradise

by S. M. Lambert

My ruling ambition, all the time I was down there, was to tighten up the loose and scattered medical authority on all the island groups. The only hope was to centralize power, or nothing would ever get done. We had centralized it in the Mokogai leper colony, an unqualified success. We had centralized it more and more in the Medical School, where the same professional education was being given to natives from the four comers of Oceania. Suva had grown to be the South Pacific’s medical center, and the one logical thing was to vest the whole public health authority in Fiji’s Chief Medical Officer.

That seemed simple, for the Colonial Governors were behind us. Then politics came in through the door and common sense flew out of the window. My plan was to put Fiji’s medical chief at the head of this wide service as Central Medical Authority with additional pay of £300—little enough, especially when you take into consideration his increased duties, which would involve personal visits of inspection to all the island groups. The Foundation agreed to pay fifty per cent of this sum for a period of four years.

All set to go. But were we? Dr. Montague’s honor chided him to a decision that he would accept no money that was not paid to him by the Empire that he served. Sir Eyre Hutson, then Governor, agreed that the High Commission Group would pay it all; but Montague objected that he did not deserve the extra stipend, as I would be doing practically all the work. We were stuck on that point. The annual pay of £300, added to Montague’s salary of £1,100, would have been an inducement sufficient to attract an excellent man. But to ask anything like a first-class physician to devote all his time and energy to the Unified Service for £1,000 a year was simply out of the question.

When Montague retired, I raised the question again, and struck an obstacle no larger than a gallstone, and quite as tormenting. It was the little bureaucratic mind of Fiji’s Colonial Secretary, who sat around all day worrying for fear that somebody in the Government would be making a halfpenny more than he did. You know the type. There’s one—at least—in every American county courthouse. Mr. Colonial Secretary sat brooding, “Ha! If that rule goes through, the C.M.O. will be topping my salary!”

Well, it didn’t go through. During my London visit in 1936, I discussed the deadlock with Sir Thomas Stanton. He said, “It’s a splendid idea, and it would take hardly any new machinery to put it over. It has my hearty approval.” But Fiji’s Colonial Secretary belonged to another branch of the service, over which Stanton had no power. Suva’s petty politician held a strategic corner where he could pop a pinch of sand into the wheel. Unfortunately all my suggestions have been pigeonholed.

In 1927 the Unified Medical Service had been voted in—on a small scale. It was devised to control the High Commission groups only; five in all. New Zealand, who had endorsed the idea from the first, was clamoring to come in. But our Colonial Secretary couldn’t see it that way. Somebody would be getting too much power, with the run of all those islands. Therefore New Zealand was out.... All so like a chapter from the history of New York’s Republican Party—or Democratic.

In spite of this I found myself appointed to the sonorous position of Deputy Central Medical Authority, under the Chief Medical Officer as Central Medical Authority, who controlled the health work of the five groups. As he had never visited all these groups, and I had, I was kept quite busy as his adviser. In 1934 the Medical Authority went into fuller effect, so that the Chief could make the rounds and study conditions at first hand. The other day Dr. McGusty, now Chief Medical Officer, wrote me that these visits had become a part of his routine.

Here is something from my files. It is headlined “Memorandum for Dr. McGusty.”

Based on personal experience with administrations in the South Seas since 1916, I regret to record that nowhere in the world have I found so large a percentage of doctors who discredited the medical profession and the various governments that employed them. Poor organization is another important factor.... I have been greatly interested in the efforts of (Governor) Sir Murchison Fletcher to bring about more effective aid. The plan to amalgamate the medical services of Tonga, Gilbert and Ellices, Samoa and other groups with Fiji is an important step to make the service more attractive and draw to it the type of man and woman who may be counted upon to bring about a vast improvement....

This document, in its original, was signed, “Victor G. Heiser.” When last heard of, however, the local Colonial Secretary was still pouring sand into the dynamo.