Variations | Coral in the ears and other health issues in the Trust Territory

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TODAY we are concerned about lifestyle diseases in the CNMI and the rest of the Micronesian region, and some of us blame “modern living,” specifically “modern food”: processed meat, sugary treats and other “junk food” items. Many of us are likely to assume that 50 or so years ago, islanders were eating “healthy” food and were generally “healthier” compared with today’s generation.

Not exactly.

In his 1966 book, “A Reporter in Micronesia,” E.J. Kahn Jr. wrote about his experiences in the Trust Territory of the Pacific Islands which consisted of six districts: the Marianas (except Guam), the Marshalls, Palau, Ponape (Pohnpei), Truk (Chuuk) and Yap. The TT was administered by the U.S. which, some said, treated the islands with benign neglect. Kahn quoted a U.S. Navy admiral as saying in 1947, “For mercy’s sake, let [the islanders] alone in their happiness!”

Happiness, however, is relative, and in the mid-1960s, Kahn learned that many islanders were deeply unsatisfied with their living conditions, especially considering that they were supposed to be the wards of the world’s most powerful and richest nation.

He said an American doctor in Ponape, for example, “had a good many reservations about the state of medical affairs in the Trust Territory.” The doctor had “delivered his baby at his home, because his wife, after taking a look at the shabby delivery room at the hospital where he worked, had burst into tears.” On the atoll of Kapingamarangi, Ponape District, the doctor had to examine “a few old women of massive obesity.” Kahn said the doctor was concerned about the natives’ diet: pandanus, breadfruit, coconut and taro. He had also noticed “a disturbing number of dental cavities, and a high incidence of anemia.” The doctor told Kahn: “I’ve never seen so many umbilical hernias in my life.” And a lot of the children had a lot of coral in their ears. “ ‘Good Lord!’ he exclaimed, squinting into one captive infant ear. ‘A whole reef in his head!’ ”

At the end of the day, Kahn said, the doctor had completed 107 physicals. Of the 77 pre-school children he had examined, he found 28 umbilical hernias, 28 cases of rotted teeth, 18 of pyodermia (impetigo, skin ulcers and the like), four of fungus, two of bronchitis, one of heart disease and one of aggravated diarrhea. In addition, six children had otitis media or ear infection and 15 others had coral in their ears.

The doctor wanted to obtain data on the physical make-up of the islanders, but it had “quickly become apparent that it would be impossible to ascertain the exact avoirdupois of two-thirds of all…women beyond the age of eighteen because [the doctor’s] bathroom scale could not register any weight over two hundred and fifty pounds.” The doctor likewise concluded that the atoll had a high incidence of perinatal deaths. He said there was also a need for an X-ray machine so that the islanders could be checked for tuberculosis.

Later, Kahn was told by an Australian who resided in the TT that Kapingamarangi had “by far the healthiest inhabitants of any part of the entire Ponape district.” When Kahn replied that an American doctor was worried at the state of Kapingamarangan health, the Australian said, “Really? Well, if Kapingamarangi worries him, he’d better not go to Pingelap [another Ponapean atoll]. He’d drop dead of fright.”

In his 1965 inaugural address, President LBJ declared that there was “no room for second-class health services.” Kahn said whether the president “had the Trust Territory specifically in mind is debatable, but in [the TT] his words have been much repeated, and the consensus there is that what he preached has not yet been practiced.”

In the TT, Kahn said, “nearly everybody has intestinal parasites” and there were no facilities for mental health patients. “In theory,” he added, “each of the six [TT] districts has an American physician assigned to it full-time. It is not easy to get doctors to go there, though; the job of director of medical services for the whole area was vacant for eleven months not long ago before anybody could be prevailed on to take it, and the man who finally did quit after a year, following an almost non-stop vendetta with the administration.”

And there was the natives’ lack of resistance to epidemics. When they occurred, Kahn said, “the Americans in charge still sometimes use old-fashioned means of coping with them. A field-trip ship called at Satawal, in the Yap District, in the winter of 1966 and found a few natives with whooping cough. They were taken away, put ashore on an uninhabited island of the nearby Woleai atoll, and told to stay there at least two weeks, after which, if all went well, somebody would come fetch them.”

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