PREFACE:
The information submitted in the following pages constitutes a preliminary report on the Medical Expedition to Easter Island. As it will be apparent to readers of this report the advances in technological sciences have made it possible for the first time to construct modern laboratory facilities and conduct detailed medical investigation in an isolated community. For this fact we are greatly indebted to the Department of National Defense in general and HMCS CAPE SCOTT and Commander C. Anthony Law in particular.

The communications constituted a very important part of our operation. When the Expedition was on Easter Island we were able to communicate constantly with the headquarters of the Easter Island Expedition Society in Montreal, thanks to the equipment provided generously by the Hallicrafter Company and Collins Radio of Canada. The contribution of the Montreal group during our absence has been considerable and I wish to thank Dr. H. Roche Robertson and Mr. Peter Laing, both Directors of the Society. Mrs. Gerd Hurum, Honorary Secretary-Treasurer has administered the Montreal office and Mr. Albert Tunis, Director of Information has performed very capably the extensive liaison duties required for the establishment of the Easter Island Biological Station. Dr.Deirdre Waldron-Edward, member of the Society has served as scientific liaison in Montreal for the Expedition.

The help I have received in the various aspects of this Expedition is too extensive to be acknowledged individually. I consider myself fortunate to have been able to work with the members of the Expedition and the crew of HMCS CAPE SCOTT.

This preliminary report was prepared at sea during the return voyage to Halifax. My secretaries Mrs. Isabel Griffiths and Mrs. Ana Maria Eccles are thanked sincerely for preparation of the manuscript, Lt-Cmdr. Channing Gillis, the Executive Officer of the ship, has made available all facilities and Lt-Cmdr. Alfred Shaw, has supervised the processing of this report. Leading Seaman Thomas Picco has capably carried out the printing of this document.

Stanley C. Skoryna,M.D., Ph.D.,
Director,
Medical Expedition to Easter Island.

INTRODUCTION:
The Medical Expedition to Easter Island returned to Canada on March 17, 1965. The Expedition, organized under the initial sponsorship of the World Health Organization, left Halifax aboard H.M.C.S. CAPE SCOTT on November 16, 1964. H.M.C.S. CAPE SCOTT, after an official tour of West Coast Latin-American countries, returned to Easter Island for the Expedition and the return voyage. This was the first time that the Royal Canadian Navy has participated in a medical scientific expedition including representatives of Canadian universities as well as scientific and educational institutions in other parts of the World.

OBJECTIVES OF THE EXPEDITION:

The objectives of the Expedition were two-fold and they can be summarized as follows:

1.- To study and develop methods for transportation and erection of self-sustaining medical research laboratories in isolated and underdeveloped areas of the world. This included portable pre-fabricated buildings, electrical generators, water desalinization stills and modern laboratory equipment such as X-rays, low temperature units for preservation of samples, centrifuges, as well as living accommodation for scientific and support personnel.
This aspect of the Expedition's program was assigned to H.M.C.S. CAPE SCOTT under Commander C. Anthony Law, by Canada's Department of National Defence.

2.- The medical objectives of the Expedition included the following points:

a) To carry out an integrated medical survey of the
total native population of Easter Island, in order to identify
and evaluate the relative role of environmental and hereditary
factors in an isolated population. This included investigation
of ecological, sociological, anthropological, genetical, micro¬
biological and epidemiological factors.

b) To study and develop methods of sampling procedures,
collection and transport of blood and other biological material.

c) To assist the population of Easter Island with
medical problems with which they are now faced and to which
they will be exposed after permanent contact with the mainland
has been established,

d) To establish an Easter Island Biological Station
for purposes of assistance in the health and welfare of the
population and to provide facilities for follow-up studies
after isolation of the island has been abolished.
This programme was carried out by a team of 38 members of the Expedition, including scientists, medical personnel and research assistants under the direction of Professor Stanley G. Skoryna of McGill University, Montreal,

OFFICERS - HMCS CAPE SCOTT

Cdr. C.A. Law -  Halifax, N.S.
LCdr. Channing D. Gillis -  Birch Cove, N.S.
LCdr. Robert Arthur Billard -  Dartmouth, N.S.
LCdr. Duff M. Pennie -  Dartmouth, N.S.
LCdr. Ernest E, Moore -  Dartmouth, N.S.
LCdr. Ross E. Thompson -  Halifax, N.S.
LCdr. Alfred E. Shaw -  Halifax, N.S.
Lt. Charles L. Westropp -  Halifax, N.S.
Surgeon 3g. Lt.
Gilbert Joseph Berube -  Quebec, P.Q.
Lt. Robert E. Manzer -  Springfield, N.S.
CMD. 0. James R. Barlow -  Halifax, N.S.

MEMBERS OF THE MEDICAL EXPEDITION TO EASTER ISLAND

 

REPORT OF H.M.C.S. CAPE SCOTT PARTICIPATION IN
MEDICAL EXPEDITION TO EASTER ISLAND
Commander C. Anthony Law DSC,CD,RCN:

The primary role of H.M.C.S. CAPE SCOTT upon reaching Easter Island was the setting up of the Expedition Camp together with all "essential" services. The time allocated for this was a period of six full working days and it was indeed completed in six days. On the whole, the project went smoothly and successfully. It provided a very interesting and different sort of challenge for a ship's company that is normally involved in the rather unexciting role of Fleet Maintenance.

Easter Island was first sighted, a dark shape on the horizon, at 3:00 A.M. Sunday, December 13, and at 7:00 A.M. CAPE SCOTT anchored in 24 fathoms of water at Cook Bay. We were immediately surrounded by a surprisingly well-dressed group of natives in outboard-powered boats who welcomed us and then started to barter their traditional wood carvings for soap and cigarettes. A 8:00 A.M., the Governor of Easter Island, Lieutenant-Commander Jorge PORTILLA, Chilean Navy, accompanied by Doctor Guido ANDRADE, the Chilean Naval Doctor and the Officer-in Charge of the air force contingent, Captain Sergio PINEIRO, Chilean Air Force, came on board. After a brief conference, the Captain went ashore with the Governor and leading members of the Medical Expedition to choose a campsite. The LCVP (Landing Craft Vehicles Personnel) with the advance beach party aboard followed the Governor's boat into Hanga Piko, the beachhead, and after a short survey, the navigator reported that there was ample water for one larger landing craft, the LCM (Landing Craft Medium) at all states of the tide.

The campsite finally chosen was at Hanga Roa, close to the native town but two miles from the beachhead at Hanga Piko. This distance would have oosed a major problem had the Governor not volunteered his agricultural tractors and native labour to transport the cargo. The heavy ground swell at the anchorage made handling of any cargo awkward and the launching of the LCM a very tricky proposition. Fortunately, all went well and the craft made its first run with the Expedition's red truck as cargo at 2:00 P.M. By the end of the first day, a truck, six collapsible trailers and a good deal of general cargo were landed: "Project METEI” had a good start.

"Day Two" was disappointing; the wind had shifted to the west in the early morning and slowly increased all day. By 1200 noon the discharge of all major equipment had become impossible as the swell, which makes operations difficult on a good day, was causing the ship to roll heavily, throwing the landing craft about. At 5:45 P.M. all operations for the day were cancelled and the ship brought to immediate notice for steam. Fortunately, the wind moderated soon after dark and the Commanding Officer was not forced to sortie; however, as a precaution, all boats remained overnight in Hanga Piko Cove.

The weather had improved by dawn of "Day Three", December 15, and everyone seemed determined to win back the losses of "Day Two". At the end of the day, 78% of the total cargo had been landed; this included 18 of the 24 trailers and all of the diesel generators and their associated equipment. Ashore, work too had been progressing well: nine trailers were erected on the campsite and the mechanical still and one generator neared readiness.

To go back a bit, the support required by the Medical Group was discussed at organizational meetings held in CAPE SCOTT in Halifax during September and October. As a result of these discussions, decisions were made regarding services and accommodation, the type of equipment required and where, when and how the supply and delivery would be effected.

These plans were followed with the boat of intentions but it was found necessary to manufacture many fittings and substitute suitable components during the passage from Halifax to Easter Island. Prefabrication of Solar Still units, storage tanks, sanitary facilities, power distribution, pumping and water distribution systems was also effected during the passage.

At Easter Island, the selection of a suitable sits was made by noon of the day of arrival and the flow of equipment and supplies was well in hand by mid-afternoon. The off-loading was arranged to provide the construction teams with their equipment and pre-fabricated units as they were required.

The major items, i.e. pumps, generators, distilling units, storage tanks and trailers were given top priority.
A channel survey was carried out by ship's divers in the beach area adjacent to the campsite. The presence of reefs and the surf conditions made it impractical to use this area for any but the smallest boats, so the main landing area decided on was the Government wharf at Hanga Piko.

The location of trailers and services was staked out by the end of "Day One". The preparation of the site for the Solar Still and Salt Water storage tanks began early on "Day Two". Simultaneously the setting up of the salt water supply system was started. The suction basin was situated approximately 150 yards from the storage tanks with a lift of approximately 20 feet. The salt water requirement for the distilling units and sanitary services was estimated at 5,000 gallons per day. The fresh water production was estimated to be 500 gallons per day from the mechanical distilling unit and 200 gals per day from the 10 unit solar still.

Three 25KW Diesel driven generators were placed in position by tractors, uncrated, serviced and set up, tested and turned over to the Electrical Team, headed by Commissioned, Officer James Barlow CD RON, for hook-up to the power distribution system. The internal wiring of the trailer units was installed by the trailer manufacturers. These systems were completely checked out by the electricians, adjustments and repairs carried out as required. The complete power ring main was installed with special circuits to suit the requirements for laboratory equipment, galley and pumping systems.

As the trailer units were positioned they were assembled by a unit of the Construction company with assistance recruited from local labor - the Pascuenses - as the work progressed the local help became more useful and the production rate doubled by the fourth day. A fuel dump for 180 45 gallon drums of fuel was set up at the rear of the compound with a ready-use fuel system set up at the Diesel generator site.

The complete setting up of the Camp required six 12-hour days, plus one day for final testing of electrical circuits. An average of 28 Naval personnel were employed daily at the Campsite. "Day Four" was another good day and by 4:00 PM, all the trailers and large cargo had been discharged. The Chilean Naval supply ship, the PRESIDENTE PINTO, was undergoing emergency repairs in Chile and, the Chilean Government requested CAPE SCOTT to supply the island with essential foodstuffs that were in short supply, and transport 41 personnel, 70 tons of wool and 20 tons of general cargo to Valparaiso.

By "Day Five" all the cargo had been landed and the camp, now affectionately known as the "Rapa Nui Hilton", was nearing completion; all three generators were in operation and the solar and mechanical stills were almost completed. The only unfinished work to complete late on Friday. Loading of the wool commenced using Pascuenses boats but this proved a very slow business and to expedite this operation the landing craft were pressed into service. By nightfall, 75% of the wool and one jeep had been loaded.

Except for the electrical work, the camp was ready for use and at 10:00 A.M. on Friday, December 18, METEI moved into their new home. The last of the wool for the mainland was loaded during the afternoon and by 4:00 P.M. all work on the camp was completed.

At 9:00 on Saturday, December 19, all the Islanders (Pascuenses) gathered on the pier at Hanga Piko for the distribution of food. This was done on a sliding scale based on the number of people per family by Lieutenant-Commander Alfred Shaw the Supply Officer and his staff. This "feeding of the multitude" was witnessed by the Governor, the Roman Catholic missionary, Father Sebastian Englert, and his assistant, Father Ricardo, and the old Mayor and Elders and representatives of the Medical Expedition.

At 9:00 A.M. on Monday, December 21, CAPE SCOTT embarked 41 passengers and their baggage and landed two would-be stowaways who had hidden in the wool cargo. After final farewells to the Governor and a few tearful songs of farewell in Rapa Nui from our passengers' relatives in small boats alongside, the ship weighed anchor and proceeded at 12:00 noon to Valparaiso, Chile.
Christmas at sea is quite an unusual occurrence these days, but Christmas at sea with 25 Chilean and Polynesian (Pascuenses) children aboard was much more so. On Christmas Eve, a party was held for the children on the boat deck under a Christmas tree that had been brought from Halifax. Santa Claus (alias P1BN4 Neil CHAMBERS RCN), with many an exuberant "Ho-Ho" gave each child a small present from the ship's Company.

Upon arrival at Valparaiso, the CAPE SCOTT was directed to an anchorage in Valparaiso Bay and boarded by the Chilean authorities who took one of our passengers, Doctor Guido Andrade, Chilean Navy, into custody. He had been in political disagreement with the Governor of Easter Island. The ship weighed anchor at 5:00 P.M. to berth alongside in Valparaiso, marking the commencement of our Goodwill Tour to Valparaiso, Talcahuano, Antofagasta, Chile and Callao (Lima) Peru.
HMCS CAPE SCOTT sailed from Callao at 9:00 A.M. on February 2. While in Callao, it was hoped to receive "new" Canadian Flags so that all would be ready for the Proclamation Day ceremony on February 15. They failed to generate, however and the ship was forced to go into production. With the aid of the official description and a drawing taken from a Halifax newspaper cutting, the design team consisting of Mr. Charles FOWLER and the Commanding Officer went into action. For two days they laboured in vain but on the third day, the combined talents of architect and artist triumphed and CAPE SCOTT produced two hand-made flags patterns of the "ll-pointed Maple Leaf". The production team headed by the ship's sailmaker, LSRP2 D.W. EASTON, and assisted by L3SG2 T.C. LAFONTAINE, took over and soon had both Jack and Ensign ready for the big day. If flag collecting ever becomes as popular a hobby as stamp or coin collecting, surely as first issues with slight imperfections, the specimens would be very a valuable indeed.

The ship anchored of Cook Bay, Easter Island, at 9:00 A.M. on February 10 in the same position as on our previous visit. The wind had been blowing offshore for several days and the swell and surf conditions in the bay were ideal for loading cargo. Soon after the ship had arrived, the Governor of the Island, Lieutenant-Commander Senor Jorge PORTILLA, and Dr. Stanley SKORYNA, came on board. The Commanding Officer was informed that the Expedition had accomplished all that it had set out to do and that they were packed and ready to rejoin CAPE SCOTT. By 7:00 P.M. both LCVP's were in the water and soon the first LCVP was back alongside with a cargo of Expedition members and their baggage.

The Expedition had donated most of their equipment to the Chilean Government and the Islanders. The 24 large trailers that had filled the ship's Foundry and covered the upper deck during the outward voyage were to remain on the Island as a Hospital and permanent camp for future visiting scientific groups. The diesel generators, mechanical still and the vehicle were also left. As a result, the only cargo the ship had to load was personal baggage and crates containing medical specimens for follow-up research in Canada. The LCVP's proved quite adequate for this task; in fact, the entire loading operation was completed in 10 working hours.

By 11:00 A.M. on February 11, all the cargo was on board and all that remained to do was hand over the camp and equipment to the various authorities on the Island. On February 12, the last LCVP left the jetty at Hanga Piko at 5:00 P.M. and half the Island population seemed to have gathered to say a last farewell. It was with some regret that CAPE SCOTT weighed anchor at 7:00 P.M. and slipped into the night.

The weather on the passage to the Galapagos Islands had been miserable; it was a great relief when the morning of Proclamation Day Monday, 15 February, dawned bright and clear. Divisions and a short service were climaxed at noon by the raising of Canada's National Flag and the lowering of the White Ensign. This important ceremony was well covered by the press for as well as two Naval Photographers, representatives from the National Film Board, Canadian Broadcasting Corporation Television and LIFE and Time Magazines were aboard. It was the first opportunity that the ship's Company of the CAPE SCOTT had to see the new flag flying and many enthusiastic comments were heard.

CAPE SCOTT anchored at 6:30 A.M. Sunday February 21, at Bahia Academy, Santa Cruz Island (Galapagos Islands), the site of the Charles Darwin Biological Foundation, departing that same d transit of the Panama C March 1. Once clear of the canal, the ship headed for Cartagena, Colombia for a four-day informal visit designed to help reinforce Canadian-Colombian relations. This was a most successful project, and it included a visit to the Capital city of Bogota, where members of the Expedition participated in a symposium under the auspices of the Faculty of Medicine at the National University of Colombia. CAPE SCOTT departed Cartagena for Halifax on March 7, arriving Halifax March 17.

REFORT OF MEDICAL EXPEDITION TO EASTER ISLAND Professor Stanley G. Skoryna, Director

CONSIDERATIONS

At the time of departure of the Medical Expedition from Halifax on November 16, 1964, the question was asked how far the main objective of the Expedition - to conduct an integrated study of the whole population- could be completed within the time limit of the stay on the island. I pointed out, at that time, that all Expeditions of this type involve a risk element. As our expedition had as its task the identification and evaluation of the relative role of environmental and hereditary factors in an isolated copulation, a great deal of our work would depend upon the co-operation of the people on Easter Island; we were counting on the well-known friendliness of the Islanders. But we had also designed a number of environmental research projects which could be carried out independently.

I am happy to report, on our return that our work was a complete success, and we have overcome real or presumed obstacles. The integrated survey was carried out to its full extent and all 949 native inhabitants of the Island have been included in our survey. In addition, all specific research projects, such as veterinary survey, ecology and soil bacteriology, have been completed as well.

The success of the Expedition should be examined in the light of several factors which may be of importance in future undertakings of this type. First of all, we had excellent laboratory facilities for field work. The camp consisted of 24 palletized trailer units, transported to the Island by H.M.C.S. CAPE SCOTT, under Commander Law, and constructed on the chosen site by the crew of the ship in a six-day period. The preceding report deals with some of the difficulties involved in landing all the "portable laboratories" on Easter Island in a constant Pacific Ocean swell. I cannot give enough praise to the officers and crew of the ship for completing this task efficiently, without serious injury to the personnel involved and without any damage to the materials transported.

We were thus provided with modern laboratory facilities for medical field work in an isolated area, something that had not been done before, I shall mention here items such as low-temperature equipment for the preservation of viruses; lyophilyzation apparatus which is capable of producing freeze-dried specimens of serum; and bacterial culture media for inoculation and studies on the spot. These facilities enabled us to carry out some of the studies immediately while other biological material was prepared and preserved for later investigation in Canada. All in all, approximately 17,000 samples and medical records and X-rays have been collected, an indeed remarkable quantity.

The areas of study which are outlined in this report be the participating investigators, include medical examination, child development study, radiography, dental survey, anthro-pormetric measurements, hematology bacteriology, virology, parasitology, epidemiology, work physiology, sociology, veterinary survey, biology and ecology.

In connection with these studies, it must be appreciated that a large part of the biological material awaits further detailed study, computer analysis and statistical evaluation. The medical and biological sciences have kept pace with technological Developments and great progress has been made in what is considered research detail . The blood group distribution study, as you will see, has been done on Easter Island; however, the study of literally hundreds of genetic traits will be carried out on serum and red cell samples. The Expedition was indeed fortunate to be able to complete what could be called a data-gathering operation and to bring back the samples in goo] order for such detailed studies.

This brings us to the fulfillment of the other objectives of the Expedition, namely, to study methods of sampling procedures, transportation of biological material, and training of research personnel in medical survey work. I can assure you that all members of the Expedition have gathered valuable experience which will be important in other undertakings of this type. In this connection, let me add another word of thanks: to those Universities and
institutions which granted leaves-of-absence, thus permitting the expedition to acquire sincere and interested medical and research personnel. Needless to say, the most vital contribution has been the assignment of H.M.C.S. CAPE SCOTT and for this, we are indebted to the Government and people of Canada.

Some of the preliminary findings available at present are of great interest and indicate that further analysis of the data collected may constitute a significant contribution to the medical sciences. The following points may be of interest:

1. Sixty-seven percent of the Easter Islanders are of the
same blood group) A, while thirty-one percent have
blood grouo 0; only one percent are of groups B and
AB. This indicates a relatively high degree of con-
sanguinity, and I hope that our studies on the salivary
secretor status relationship will lead to valid
conclusions concerning the genetic transfer of these
characteristics.

2. The bacterial throat cultures of Easter Islanders
exhibit a striking similarity. This indicates interest-
ing avenues for investigation of antigenic properties
and also raises some practical implications with
regard to the introduction of new strains when contact
with the mainland is increased,

3. Analysis of unpasteurized cow milk samples revealed a sixty percent incidence of presence of staphylococci. This brings up an interesting point of transfer of bacterial infections with ingested products and its possible role in gastrointestinal disorders in children on Easter Island.

Finally, I wish to return to the point at which I started: the people of Rapa Nui. I can assure you that none of the members of the Expedition had ever met more friendly, honest and intelligent individuals. We had many local volunteers who worked with us in the Expedition camp, and who learned complicated techniques very quickly. We made many friends, one could say without exaggeration that the whole population became our friends. The simple society of Easter Island is undergoing a change at the present time and our presence on the Island has probably coincided with the last year of relative isolation.

All of us have a desire to return to this beautiful and historic Island. If any of you ever have an opportunity to visit Easter Island, you will see that the Expedition has left a lasting impression on the Islanders and that the good-will towards Canada is probably more marked than towards any other country.

1. MEDICAL EXAMINATION :
A complete medical examination was carried out by a team of physicians under the direction of Surgeon Captain Richard K. Roberts. This team included Dr. Helen Reid, Dr. Maureen Roberts, Dr. Peter Beighton, Dr. Garry Brody, Dr. Denys Montandon and Dr. David Murphy. The examinations were carried out simultaneously by four physicians and were preceded by taking case histories and physical measurements.

The data are contained in nearly one thousand detailed records which will be analyzed by computer methods. The analysis of this material will permit evaluation of such items as blood pressure distribution, body build and deformities.

The patient's build, skin colour, hair colour and hair texture were noted. Any abnormality was recorded. The extremities were examined for any genetic markers such as polydactylity, syndactylity, single palmar creases, hair on phalanges etc., and for ordinary abnormalities. The skeletal system was assessed by tests of mobility and muscle strength. The eyes were recorded as to colour and shape, the fundi were examined on all those old enough to cooperate. The eye movements and pupillary reactions were noted and the cornea, lens and conjunctiva examined carefully for evidence of degenerative disease. The ears were examined for deformity of the auricles and hairiness.

The population of Easter Island seems to be basically healthy and is certainly astonishingly clean when the lack of fresh water is considered.

The children and young males are nearly all lean and muscular (ectomorohic mesomorphs) and very few obese children were seen. Some of the older women were obese - occasionally very obese. Few skeletal deformities were seen.

The adults were quick to age. At the age of 40 to 45 most showed an arcos senilis of the cornea, marked injection of the solera with often pterygium, occasionally early cataract. The majority of this age group showed a chest expansion disproportionately small when compared with their general muscular development. Many showed early degenerative arthritis of the spine on X-Ray and marked calcification of the costal cartilages. The E.C.G.s revealed no case of unequivocal coronary disease. One lady of 76 had a grossly abnormal ECG attributed to probable arteiosclerotic heart disease. Two others were suspicious. There was one case of severe hypertensive heart disease with left ventricular strain in a lady of 52.

Tuberculosis: Several persons were under surveillance or active treatment for tuberculosis of the lungs when we arrived on the Island. This was on an ambulatory basis and none were confined to hospital. They were all included in our survey and in no case was an extensive or progressive lesion found.

An otoscopic examination of the canal and drum was made and the hearing roughly assessed by a watch. The nose was carefully examined with particular reference to leprosy. The lips were screened for evidence of deficiency disease. The tongue was examined for ability to fold as well as abnormality. The pharynx was examined; the neck-for thyroid enlargement, glandular swellings and any congenital deformity such as webbing. The examination of chest and heart followed a normal pattern and an electrocardiogram was performed on nearly all persons over 50 years as well as on a few other persons with a suspicion of heart disease. The abdomen was examined with particular reference to disorders of the liver and spleen. A brief neurological examination completed the examination.

The types of laboratory specimens varied from time to time, but from the majority of subjects the following were obtained:

A hair clipping Two nose swabs
Two throat swabs Two rectal swabs
Collection of saliva Collection of urine Collection of stool
- For fungi
- One for ordinary bacteriological examination - one for the leprosy bacillus.
- One for bacteriology -one for virology.
- One for bacteriology-one for virology.
- For group specific substances.
- For simple albumin and bacteriology.
- For parasites and bacteriology.

No cases of open (infectious) tuberculosis was found by us but our X-Ray survey revealed five new cases in which a suspicion of pulmonary tuberculosis was raised. These suspicious cases are being checked by Dr. Peter Beighton who remained on the Island. One case of tuberculosis glands of the neck was found.

Leprosy. Twenty eight persons were on the Island register of lepers when we arrived. Of these, six were confined to the Sanatorium though only one could be regarded as contagious. The others were there because of mutilations which precluded their working or looking after themselves outside. Our survey resulted in a firm diagnosis of one new case of leprosy and a suspicion in two other cases. The suspected cases were very carefully checked by Dr. Beighton who had previous experience of treatment of leprosy and he also made a complete survey of the registered lepers. Those that needed treatment were all receiving adequate chemotherapy. Care of Islanders: When we arrived on the Island, the Naval medical officer who had been looking after the Islanders had to leave in the CAPE SCOTT for Chile. No relief had been sent for him and we were requested to look after the health of the Islanders until a new Chilean doctor arrived. We arranged that the nursing staff of the Hospital would screen the patients and would refer to us the more serious cases. Then one of the M.D.s accompanied by an interpreter would visit the Hospital each day to see these patients.

In addition all emergencies were attended. Several babies were born while we were there - largely without difficulty though one lady had a rather severe bleeding which required transfusions which we obtained from members of the Expedition. The fact that we were caring for the Islanders made it easier for us to study their day to day illnesses and made the hospital records readily available to us.

Health of Members of the Expedition: Because of our isolation on the Island we thought it wide to go there prepared for al-most all medical and surgical emergencies. A very complete surgical kit was borrowed from the Canadian Forces Medical Service but fortunately, apart from minor cuts, was never used. A wide variety of drugs was taken - these being provided through the courtesy of our good friends in the drug industry both of Canada and the U.S.A. We must express our sincere thanks to the firms donating these drugs as they proved most useful not only in the active treatment of the Islanders but also in the treatment of the illnesses of members of the Expedition. Fortunately, we as a group remained very well though we had our share of diseases such as diarrhea which invariably affect persons visiting hot countries. Some of us suffered from the "KOKONGO" - the infectious disease which is regularly brought to the Island from Latin America.

2. GROWTH AND DEVELOPMENT STUDIES OF EASTER ISLAND CHILDREN:
This study was undertaken by Dr. Helen Reid in cooperation with the radiographer-in charge Mr. Archibald Wilkinson.

One of the main purposes of the expedition was to establish a base line, an assessment of the population and its environment, now in order that future evaluations of the status of Easter Island society would be meaningful. To study the rate of growth and development of the children of the Island, X-ray pictures of the hands and wrists of all individuals between two and eighteen years were made, some five hundred and eight plates.

By examining one of these plates the "bone age" of the child can be determined. This figure can be compared with his chronological age in order to give a quantitative statement of his stage of development.

While this comparison will permit a statement of the rate of childhood development on the Island it is felt that some comparison of these data with those of a similar group of Canadian children will make the assessment more valuable. For this reason the series will be compared quantitatively with plates from five hundred children in Montreal and Toronto who are of similar age. It is felt that the results will permit a valid opinion when considered along with measurements of head size, chest size, standing height, and age of onset of puberty.

In the course of the X-ray examination it was noted that the fingers seemed especially long. An historical account of the Island refers to the increased length of the fingers, and many of the native carvings represent this feature. Measurements under standard conditions of the length of the metacarpals (the bones of the palm) and phalanges (the bones of the fingers) will be made. A comparison will also be made with the plates of Canadian children to define in which bones any differences occur.

3. ODONTOLOGY
This survey was conducted by Major Alexander G. Taylor, R.C.D.C., and included the following:

1. Examination and charting during which records were made to include: cavities, missing teeth,fillings present, condition of intraoral softtissues, abnormalities, condition of dentures if present and extent of oral hygiene.

2. Impressions from which study models were made.

3. Skull and intraoral x-rays.

4. Facial photographs.

5. Laboratory analysis of saliva samples.

During the dental survey 239 adult subjects of 18
years and older were examined; generally their dental condition is very poor and is attributed to two factors:

1) very poor oral hygiene and

2) insufficient dental treatment.

A questionnaire which was completed on 100 subjects of all ages verified these observations.

This material will be used, along with results from other departments, to complete the overall physical picture of this group of people. The samples gathered on the island will be analyzed in Canada. These analyses will include a detailed cephalometric study of the skull x-ray and study models.

4. PHYSICAL ANTHROPOLOGICAL; RESEARCH:

This study was conducted by Dr. Robert J. Meier. The main objective of this research was to obtain a basic description of the physical characteristics of the adult human population. This description provides the necessary data for establishing the range of variation in a number of morphological features and records the presence and appearance or absence of certain additional traits. It is hoped that this type of information will aid the medical survey by outlining the physical type of the normal individual and, hence, delineate more clearly any deviations from normality.

A second purpose of the study is to assess the degree of biological relationship of the Island population with other peoples in Oceania, in general, and in Polynesia in particular. In making the comparisons, information from both the living inhabitants and skeletal evidence of past populations will be utilized. In addition to studying similarities in physical types, this kind of investigation seeks to discover how the people on Easter Island came to look the way they do, as portrayed in the descriptive analysis. That is, an attempt will be made to evaluate the influence of various agencies of evolution such as, racial admixture and natural selection, have had in producing the existing phenotype or outward appearance of the Island population.

Data were collected from slightly over 300 males and females all of whom were 18 years old or more. Selection of individuals was determined by the daily medical examination appointments for family units from which all of the adult members were drawn.

Individuals were measured on the day of their medical examination. Measurement took place in a laboratory where the same individuals were given dental examinations. About eight to twelve persons were measured each day.

After each person was asked to enter and sit down, a brief family history was taken. The measurements were then made with the necessary instructions given in Spanish. Finger and palmar prints were taken after observations of various physical traits. Amount of time for each individual was between 20 and 30 minutes.
The collected data included:

A) Anthropometry - The quantitative data consist of about 30 linear and circumferential measurements made on each person. Examples of these are: stature, head dimensions, facial diameters, upper-arm circumference and skinfold thickness. The measurements were taken according to standardized anthropometric techniques. The instruments employed were spreading and sliding calipers, anthropometers, skinfold calipers and steel measuring tapes,

B) Observations - Visual observation was made on a
number of physical traits. These non-metrical data include
the appearance of facial features such as mylecoloury nose-shape and hair distribution. In addition, head hair samples were collected for later laboratory analysis.

C) Dermatoglyphics - Duplicate sets of finger and
plamar prints were collected from all of the individuals
by means of the Faurot Inkless Method.,

D) Cranial Series - With the kind permission of
Father Sebastian Englert, a series of thirteen skulls (three
with mandibles) were measured in the local museum. This
aeries is from various ahas (burial places) located around
the island coastline.

In general, the adult population appears to be mostly uniform with respect to many physical characteristics. For example, long-headedness is highly prevalent. Furthermore, hair colour is most often black and eye colour medium brown. There are persons with mixed red and black head hair and a few individuals with sandy-red or blonde hair. There are also some adults with blue eyes or brown eyes mixed with bluish pigmentation. There is not a high frequency of the epicanthia folds. Nose shape is moderately flaring and lip size is often rather thin with no lip eversion present.

The chest x-rays and other films will be studied in detail by Dr. Robert G. Fraser, Radiologist-in-Chief at the Royal Victoria Hospital in Montreal. Skull measurements will be made from the x-ray films taken on the Island.

6. HEMATOLOGY AND PATHOLOGY:

Laboratory studies were carried in several disciplines under the direction of Dr. Eivind Myhre, with technical assistance of CPO Fred Joyce and Sgt. Arnaldo San Martin. The blood samples collected were processed in the Laboratories, Blood samples were taken from all patients. Venous blood was drawn from patients aged 7 years and over; in most cases 40 cc were drawn. In patients under 7 years of age, only finger prick-blood was obtained. Blood smears were prepared from every patient, one for differential white blood cell count and one for morphological study. Blood smears were also prepared from all children for special studies on anemia. Hemoglobin determination was made in 38 patients by random sampling. These were found slightly below normal.

Total white blood cell count and hacmatocrit determination were made in all patients over 7 years of age.

Blood grouping (ABO System and Rh) was carried out in all patients using the method of Eldon card system, which allows immediate identification of blood group and Rh factors. The results show that 66.89 percent of Easter Island population was blood group A. Group 0 was found in 31.33 percent of the individuals, while groups 3 and AB were found only in approximately 1 percent of cases each.

The zygomatic arches are quite prominent especially in older males. However, the maxillae are not particularly large and protruding. Facial length tends to be long and somewhat tapering to a narrow mandible.

Partial baldness and receding hair-lines are common as is graying in older individuals. Hair form is mostly straight with a smaller proportion of wavy and curly hair. Moustaches are rather common in the males but the amount of hair on the lower cheek and chin is not often great.

Stature is rather variable with some individuals quite tall and either linear or heavy-set in body build.

Fingerprint patterns appear to contain a large proportion of whorls. In addition, the frequency of horizontal single diatal palmar crease seems to be quite high.

These data will be analyzed by computer methods and it is hoped that a clear picture of the racial ancestry of present day Easter Islanders can be obtained.

5. RADIOGRAPHY:

The radiological phase of the medical examining team was headed by Mr. George Archibald Wilkinson.
During the period of operation, which included two days for recall examinations, the following examinations were performed: figures are
subject to minor revision):

Average examinations per day 1933 ÷ 33 = 58.6
Average patients per day 920 ÷ 33 = app. 28
Due to the exposure time limitations of the radio-graphio equipment, children under age two were not radiographed routinely. A total of 840 persons were examined for the first time with 80 persons returning for recheck examinations.

The above examinations required the exposure and processing of the following films:
10 x 17 = 1,300 app.
10 x 12 = 1,500 app.
Dental  =   650 app.
Total   = 3,450 app.
Average films processed daily - 105 app.

The radiographic equipment and the film and processing chemicals performed admirably under what may be described as less than optimum conditions. Most of the radio-graphic equipment was left in the Easter Island Biological Station in the charge of Sgt. Castro of the Chilean Navy Hospital, who was given instruction in its use prior to the departure of the Expedition from the Island.

Genealogical data on families of purely Rapa Nui extraction were obtained by Dr. Eivind, Myhre.
The major part of the blood specimens obtained was preserved for further studies in Canada. Dr, Armand Boudreault with the assistance of Dr. Denys Montandon, Sr. Arnoldo San Martin and CPO Fred Joyce have participated in the various procedures involved. The serum was divided into portions for various investigators and preserved by freezing. Part of the serum was placed in a Freezer Dryer (Model 10 MR 80). The temperature was controlled directly in the vials by an electronic thermometer. During the first 5 hours the samples were frozen to a temperature of 40°C below zero. Then, the samples were dried under vacuum and sealed at 25°C Specimens were preserved also for the World Health Organization reference file.

7. BACTERIOLOGY AND VIROLOGY.
This programme was carried out under the direction of Dr. Georges Nogrady (bacteriology) and Dr. Armand Boudreault (virology) with technical assistance of Miss Carlotta L. Hacker, Miss Margarita Tepano and 5 other Pasquence laboratory aid, who carried out media inoculations preparation of, tubes and other procedures.
The bacteriological programme included human, animal, soil and water bacteriology. A total of 56OO samples was prepared including hair, nasal, throat and rectal swabs, sputum, saliva, lesion samplings and serum. Large numbers of positive cultures were obtained when hair and skin scales were studied for fungi and yeasts. Although this indicates a high degree of infestation of the population by these micro-organisms, further studies are necessary to establish the presence of pathogenic fungi or yeasts.

Cultures obtained from nasal swabs showed a frequent presence of Staohylococci. Further studies will be carried out to determine the percentage of pathogenic (coagulase positive) and antibiotic resistant strains as well as their phage type.

Throat swabs cultures indicated the dominating presence of viridans type Streptococci. A striking similarity of cultures obtained from all the individuals was observed, which indicates a uniformity of throat flora. Further breakdown such as antigenic analysis and relationship to animal origin will be carried out at the University de Montreal. However the fact that the cultures exhibit such a close similarity suggests that Easter Islanders have identical strains and while there is little possibility of cross infection, introduction of new strains from the mainland may have serious consequences.

SOIL BACTERIOLOGY:
A systematic study of soil bacteriology was carried out by Dr. Georges Nogrady, with collection of samples both from surface and from the caves. The area of Easter Island (64 square miles) was divided according to a grid,
where each area represented one square mile. As a starting point the Hanga-Roa geodesic point was selected and fitted exactly to the center of the first allotted area. All areas were numbered by Arabic numerals (1-67) and at the chart side, capital letters (A,B,C,D,E,F,G,H,K) as well as Roman numbers I - XIV) were also used to specify, areas. For practical reasons (share extending the 64 areas coverage; the islet - Motu-Nui- . close to the main Island) new areas were added and finally 67 areas were established, covering: the Easter Island area and Motu Nui. The chart placed at our disposal by the Governor of the Island Capitan de Fragata Jorge Portilla was photographed covering 6 areas on each Polaroid print. This easily transportable detailed map proved an important aid in identification and position of field areas.

Sampling was generally carried out in the center of each area. The site was approached by jeep, horse or by foot in case of terrain difficulties. The location was established by means of a position finder, using two geographic points. Sampling was done by scraping the soil with the rim of a sterile 50 ml tube, supplied with metal spoon. Samples were sealed and preserved at room temperature, protected from light.

The surface samples will be studied for anaerobic bacteria with the following objectives:

l) to establish the relationship between the anaerobic soil contamination and herding

2) to provide explanation for infrequency of anaerobic
infections (gas gangrene, tetanus) on Easter Island In spite of presence of large number of animals which provide a source of continuous soil contamination through the excrements and 3) to obtain data on bacterial agents of mixed gas gangrene infection flora for development of antisera for use in case of injury.

The cave samples will be studied for antibiotic pro¬ducing bacteria and fungi.

6. WATER BACTERIOLOGY:
Dr. Georges Nogrady has carried cut in cooperation with the epidemiologist Dr. Elliot Alpert, a programme of water sampling from house tanks, wells, crator lakes and from the-sea. The tank water (collected rain water) is used for drinking purposes. The wells are scattered on the shores of the Island and are used mainly as a source for animals. The crater lakes water is used by animals and occasionally by humans. Shore sea water samples were taken to study contamination caused by humans and animals. Although the dilution factor is considerable; the direct garbage disposal to the sea suggests an interesting point for investigation.

Sampling areas were selected using a grid system similar to that of used for soil sampling. In the Hanga Roa village the sampling silo was established by number of the house, assigned by the Expedition during the census taking. Samples were collected in sterile plastic 50 ml bottles.

A special device was used to lower oven sampling bottles into the wells, if difficulties were encountered in reaching the water surface area. The water samples were transported immediately to the laboratory where they were immediately refrigerated at 5°C. For total bacterial count T.S.A. medium plates were poured in parallel runs; T.T.C. was added to facilitate colony counting.

The Endo media were inoculated establishing the Esche-rischia coli count and incubated at 37° for 24 hours. The M. Enterococcus Agar plate was used to detect Streptococcus faecalis.

The samples were preserved for further studies in Montreal. The preliminary results indicate bacterial contamination with Staphilococci in sea water samples in areas where human habitation was close to the shore. This means a considerable degree of contamination if the dilution factor is taken into consideration.

 
7. VIROLOGICAL STUDIES:
A programme of virological sample collection and tissue culture was carried out by Dr. Armand Boudreault. Falcon plastic tubes, containing throat and rectal swabs were collected from all patients by the four examining teams. The tubes were then labelled and frozen in a Revco deep freezer at -94 0. Pyrex test tubes containing Hela cells culture were also inoculated with some of these samples and incubated for 15 days at 37°C before they were frozen.

HeLa and KB lines were used in the experimental work. More then 2000 test tubes containing HeLa or KB cells were inoculated and incubated with 459 swab samples. These tubes were observed under microscope for a period of time varying from 7 to 18 days. All the samples frozen will be inoculated in Montreal on 3 different cell lines incubated at 33°C and 37° C.

Serum samples from every patient older than 7 years, 40 ml of blood were drawn. The blood was kept one hour at room temperature and two hours at 4 C. Then the serum was separated from the clot by centrifugation and dispensed to various investigators. On each frozen serum sample, a serological study will be carried out. In the laboratories of the Institut de Microbiologie de Montreal the following antibody titers will be studied:

l) Influenza A,B,C,;

2) Para influenza type 1-2-3-4-;

3) Adenoviruses;

4) Coxakie viruses A-B;

5) Polio viruses type 1-2-3;

6) Mumps;

7) Measles;

8) Rubeola;

9) Rhino-viruses;

10) Vaccinia.

At the Dalhousie University Dr. Van Royen will study the hepatitis viruses. The Tropical Disease Centre in Panama has undertaken to study the RBOR viruses.

In addition to the population, the swab and serum samples were collected from examining rooms, the Hospital members of the Expedition, the crew of CAPE SCOTT and the Chilean Marines which landed on the Island which might be of significance for isolation of KOKONGO virus.

All these samples will be studied at the Institute de Micro-biologie de Montreal and other specialized Laboratories in Canada.

8. PARASITOLOGICAL SURVEY:
The survey of parasitic disease among the human population of Easter Island was undertaken by Dr. Harold C. Gibbs. Four methods were employed in this survey:
1. Blood smears. Thick and thin smears of blood from patients were made at time of bleeding during examination.

These were air dried and: stored in slide boxes for
further examination.

2. Fecal samples. Fecal samples were collected from the
population by issuing them with plastic cups and paddles.
When the containers were returned fecal smears were made

in P.V.A. on glass slides for later examination. In
addition pea-sized portions of feces were collected in
20 ml of 10% formalin for later examination.

3. Anal smears. Anal smears were made on children under
the age of 11 years using Scotch tape. These were
examined on the spot for the presence of pinworm eggs.

4. Arthropods. A survey of several houses was made at night for evidence of the presence of arthropods of medical importance such as bedbugs and mosquitoes. In addition trips were made to the two main crater lakes and
examination of cistern water was carried out for the
presence of mosquito larvae and adults.

A total of 400 blood smears and 207 fecal smears and samples have been collected. These are being taken to Macdonald College where they will be examined.
Examination of a total of 322 anal smears revealed an infection rate of 22.5% pinworm infection. In addition evidence of infection with whipworm was also seen.
No bedbugs were found but the houses appeared to be plentifully supplied with fleas which on preliminary examination resemble Ctenocephalus sp. Very few mosquitoes were obtained. Preliminary examination indicates that there are possibly two species of culicines. No anophilines were seen so this probably rules out the presence of malaria. Culicine type were recovered from reservoirs.

9. EPIDEMIOLOGY.
The epidemiologists, Dr. Elliot Alpert and Dr. John L. Cutler, both from the United States Public Health Service, carried out several projects during the expedition. Their efforts were concentrated on collecting data, with the analyses to be performed upon return to the United States. At present, therefore, it is possible only to describe several of the major projects and to give some overall impressions that subsequently may be altered upon careful scrutiny of the data.

The initial effort was to make a census of the Island and to locate each family on a map. Final tabulation of the census has been made and there are 949 Pascuenses and 140 Chileans living on Easter Island, as had been known, there is often an epidemic of upper respiratory illness which the natives term KOKONGO, following the arrival of a ship. A typical epidemic occurred in January shortly after the arrival of two ships from Chile, within a short period. This epidemic was investigated both at the hospital and by doing a household survey. It is hoped that analysis of samples collected from the patients during the epidemic will indicate the responsible agent, presumably some virus.

Very complete vital statistics have been kept on the Island since 1915; the mortality and birth records were abstracted so as to provide a summary of any changes that may have occurred over the years and also to indicate when major epidemics occurred.

A sample of the island’s families was interviewed concerning dietary habits. The initial impression is that the Islanders are well fed and that their nutritional status is good.

There is a considerable amount of asthma present on the Island; information on the persons with asthma as well as on environmental conditions such as the weather, was collected. It is hoped that a study of these data may enhance our knowledge about asthma.

Tuberculosis, as pointed out by the departing Chilean physician, is fairly prevalent on the Island. Data was collected from hospital records and previous chest X-ray
surveys and will be correlated with the Expedition's medical and X-ray surveys.

Soil samples were collected for biological, chemical and physical analysis for histoplasma. Serum was collected for several biochemical determinations which will be correlated with other Expedition data, in order to study some of the metabolic diseases.

The help and cooperation of the Chilean authorities on the Island for making all its official vital statistics and hospital records available is greatly appreciated. This assistance materially contributed to the success of this Expedition.

10. WORK PHYSIOLOGY:
A study of work physiology was carried out by Drs. Bjorn T. Ekblom and Einer Gjessing with technical assistance of James Nielsen. The purpose of this survey was;

l) to obtain data on the physical fitness of the population of Easter Island - all ages and both sex-groups, selected by random sampling.

2) To relate these data to other parameters studied such as genetics, sociology, pathological conditions etc.

3) To measure the habitual physical work.

The following methods have been used:
1) Physical fitness is defined as the maximal capacity to
consume oxygen. To be able to obtain maximal oxygen uptake, it is necessary to work with large muscle groups. We used mainly a bicycle ergo meter - model von Dobeln - and if this procedure was not possible we carried out measurements during brisk walking or running. During maximal exercise the expired air was collected in rubber Douglas bags; the volume measured and two small samples were taken for analysis in the Expedition labo-
ratory with respect to the content of oxygen and carbon dioxide.
2) The habitual physical work, defined as the total energy
requirement during a normal working day, was measured by Registering the heart rate during the whole day and through direct measurement of the energy requirement of certain work periods.

The pulse rate was measured through a pulse sender on the patient's chest and registered by a standard radio-transistor.

To care for; the 5 male patients were selected from the two main occupational groups of the population; workers at the Sheep farm at Mataveri, and from the non-employed group.

These data will be subjected to computer study and detailed statistical analysis. Our impression from this study is that the habitual physical level both in the female and the male is lower when compared with the Scandinavian populations. Data from the North American continent is not available.

11, SOCIOLOGICAL STUDY:
A Sociological survey of the Island population was carried out by Mrs. Cleopatra Montandon. The object of the research was twofold:

a) To test certain hypotheses deduced from a study of the existing bibliography on Easter Island,

b) To collect observations and information for a more general approach to the Easter Island society and its acculturation problems.

For object (a) a questionnaire was used, the definitive form of which was elaborated after it had been tested on a random sample. For object (b) all observations during the visiting of the households and all additional in-formation volunteered during the interviews were collected and classified under particular subjects. In the same way, all data supplied by a group of reliable informants and by:

3) Certain measurements were also made to determine the shape and size of the body: body mass and body weight.
1. - Two hundred and ninety seven work experiments were carried out on 205 patients - 2176 patients’ gas analyses were made. We got a very good response from the male part of the "random sample", while we had some difficulties and problems with the female participation especially in the age group of 20-40 years. In these age groups there were many patients who were in different degrees of pregnancy or suffered from some sickness which did not classify them as a normal representative of the population.

Although the population seems to be very strong and in good muscular condition, we have the impression that the physical fitness of the population is lower than that of equivalent populations. This is certainly connected with the question, "Which factors determine the physical fitness and status of man?" Data from this expedition will be most useful in answering this question. Two main factors are genetical factors and degree of training; other factors which probably influence the second main factor include climate, nutrition and psychological state.

2. - A total of 8 patients were examined regarding the habitual physical work using the telemetric system. Each patient was followed continuously for approximately 9 hours. The 3 female patients were all housewives - with many children different records existing on the island were also collected. One hundred and fort}/ households, which amounts to about 80% of the total number, were visited during the stay on the island. The answers to the questionnaire will help - after they are statistically evaluated - in testing the following hypotheses:

1) whether native cure of illness is still practiced in some
way;

2) whether native concepts of the cause of disease are related
to beliefs in evil spirits or other supernatural causes;

3) the main cause for the strong emigration desire;

4) whether western values have had a strong enough impact on
Easter Island society so as to change their cooperation
principles to more competitive ones and alter their property
and prestige concepts;

5) whether the rapid population growth has changed the
community organization (social control system, intercommunity
relations, education principles, etc.)

The information recorded during the post-questionnaire conversations with the Easter Islanders as well as the interviews with the key informants (mayor, representatives, governor, priest, etc) were found to be extremely valuable.

It is difficult to discuss the results of this study since the information and data collected have to be statistically evaluated. The general impression is that the native cure of illness has been replaced by acceptance of medical care; the traditional cure still widely practiced is the use of certain plants. The concepts of the cause of disease still contain superstitious elements.

As regard the desire for leaving the island, it is extremely high, due mainly to the lack of occupational mobility and the desire for knowledge about the world.

Easter Island society is undergoing a great change. One of its big problems is that the desire to learn is blocked by the knowledge that part of their aspirations will be impossible to reach. It will be interesting to follow the changes which will occur after a rapid integration of Easter Island into western civilization has taken place. It is hoped that this study will establish a baseline for further investigation of the native concepts of disease on Easter Island.

12. VETERINARY SURVEY:

A survey of veterinary conditions on Easter Island was conducted by Dr. David A. Murphy and Dr. Harold G. Glbbs. The objective of this survey was to determine the health status of the animals and the presence of common zoonotic diseases in the animal copulation.

In all, 201 cows were tested for tuberculosis and fecal material was taken by random sampling for later parasite examination. One hundred fifty six blood samples from sheep were taken. Intestinal tract contents from 15 randomly selected animals were collected and preserved for later examination.

Other animal species studied on a limited basis included chickens, rats and horses.

An interesting bacteriological observation was made by Dr. Georges Nogrady on milk samples from 15 cows, drawn under sterile conditions. A high number of positive Staphylo-coccus cultures (60%) was found. This suggests the importance of further studies concerning the role of Staphylococci in enteric infections particularly among children.

Further knowledge of the general health of the animal population was obtained by numerous trips to the main sheep farm Vaitea, the Governor's farm Mataveri, and observations of the livestock in the community pasture. Approximately 400 cows, 1,000 sheep and 500 horses were seen at close quarters by this method.
The general health of the animal population was considered fair. There was little evidence at this time of the presence of acute infectious disease. This impression might have been different had we examined the animal population during the rainy season. We have been informed by the ranch manager that pneumonia is a very common problem during this season.

As might be expected under the existing climatic conditions chronic diseases such as internal parasitism was prevalent.
 
13.-BIOLOGICAL AND ECOLOGICAL SURVEY:

This study was undertaken by Dr. Ian S. Efford and Jack A. Mathias of the University of British Columbia.
To a biologist Easter Island is important for three closely related reasons, all of which originate in the island's extreme isolation in the Southern Pacific.

(l) The island has an extremely simple plant and animal community.

(2) This simplicity provides opportunities for the invasion of other plants and animals which might became pests.

(3) The isolation poses the question where did the fauna and flora come from and particularly, where did the marine fauna and flora originate.

During the present investigation, 5 projects were undertaken. The three main ones were completed in detail. These were:

A. A study of the species composition and biomass of the
grasses and soil invertebrates in four study areas on the
island.

B. A study of the introduced plants and animals on the Island,
their country of origin and their relative importance
compared to the native species.

C. As complete a collection of fish as possible from the in-
tertidal regions and from the deep water around the Island.

Two other projects were completed in part;

D. A study of the volcanic lakes.

E. A study of the intertidal fauna and flora.

I) Specios Composition and Biomass:
Research groups at a number of universities are studying the laws governing the relationship between the rate of energy transferred through a biological community of plants and animals and the species composition of that community. Energy transfer is the passage of energy from the sun to the plants and from the plants through the herbivores to the carnivores. Species composition is the relative number of individuals of each species in proportion to the total number of individuals present. Biomass is the total amount of living-material (or standing crop) of any species usually expressed as weight per unit area. For example we might express the biomass of a particular plant species as 200 grams per square meter. Studies of this type are made under extreme conditions i.e. the Arctic tundra where there are few species and low rates of energy transfer and the tropical jungle where one finds countless species of plants and animals and high rates of energy transfer.

Easter Island is an anomaly because although in the tropics, and under conditions where a high rate of energy transfer would be expected, its isolation produces a very simple community similar to that found in the Arctic tundra.

As all aspects of energy transfer could not be studied in a short time, species composition was selected for particular study whilst we were on the island. Four study areas wereselected:

(A) near the village (Hanga, Roa);

(B) near the centre of the island (Vaitea);

(C) on the headland at the extreme east of the island (Poike);

(D) on an off-shore islet (Motu Nui).

It was necessary to choose four study areas because one area alone would not give a true indication of species composition. This is because the number of introduced plant and animal species tends to be greater near the habitations of man since man is an important factor in the introduction of new species. Thus the number of introduced species (and the index of species composition) might be expected to be higher near the village than on the uninhabited islet of Motu Nui. The center of Easter Island (3) and the rather inaccessible Poike Peninsula (C) are intermediate between the village and Motu Nui with respect to human habitation.

In each locality an area of flat grassland 50 m x 50 m was selected and placed at random within this area were 30 half metre plots. All plants within each plot were collected and dried for subsequent determination of dry weight (species biomass) and species composition. 3eside each plot a sample of the soil was taken with a core.

 This sample was preserved and returned to Canada where the soil animals will be extracted and species composition examined. In all, 120 grassland plots were sampled and 120 core samples were taken.
In addition, within the village, four small areas were selected under Eucalyptus, Banana, Miro Tahiti and Sweet Potato and 20 regularly spaced soil core samples were taken from each area. These data will be compared to similar data taken from the grassland and soil sampling areas. It is possible that the species composition of soil invertebrates will be different for different crop areas.

In order to examine the food chains in the grassland sampling areas, large collections were made of the lizards, passerine birds and hawks. This material has been preserved for subsequent stomach analysis.

The results of this work on species composition will be compared with data published from similar areas at the University of Michigan and is part of an analysis of the relations between energy transfer and species composition being made at the University of British Columbia by Dr. Efford.

II) Introduced Species:
Most of the devastation of farmland, crops and forests by pests has not resulted from outbreaks of native animals or plants but from those introduced from other areas of the world. If an introduced organism finds conditions ideal in its new home a great increase in its numbers is likely to occur. Usually when a species is introduced to a new area its predators and parasites are left behind and are not present to restrict the population explosion. This is particularly true if the introduction is into a simple community such as a crop or a conifer forest where the number of species present is low and therefore the probability is low of new predators or parasites restricting the growth of the introduced species. Easter Island with its very simple plant and animal community is thus an area where outbreaks of introduced animals and plants night be expected. For this reason it is necessary to have a detailed knowledge of the animals present and their possible food plants before any outbreak occurs so that there would be no delay in deciding which control methods to use if such a pest outbreak DID occur.

To examine this problem and to document the countries of origin of the introduced plants and animals already present on the island, a detailed collection of all the terrestrial animals, particularly insects, and plants were made and preserved for subsequent identification in Canada.

At the present time we can say we have expanded and probably doubled the number of known species of plants and animals on the island and that the majority of these species are rather cosmopolitan species introduced in recent years. For example, of the 53 species of plants eaten as leaves, roots or fruits probably 40-45 have been introduced by man since 1800; similarly of the seven species of terrestrial birds found only one was present before 1800 - the chicken; most species of insects have been introduced but in these cases the introductions were chance occurrences and not intentional introductions by man.

The island is thus passing from a very simple grassland community found in 1722 by Roggeveen to a much more complex community consisting mainly of cosmopolitan species of plants and animals many of which, like the rat, the flea, the English sparrow and the pigeon etc, are commensals of man.

III) Marine Zoogeography:

The marine fauna provides an interesting zoogeo-graphical problem because certain barriers prevent the migration of marine animals and plants to the rocky shores of the island from other shores. The main barrier in all directions is open sea, 2500 miles from the coast of South America to the east; 1000 miles from the nearest Pacific Island to the west; open water to the north and the ice of Antarctica to the south. Distance is not, however, the only barrier to the migration of marine organisms to Easter Island. The cold Humboldt Current passes up the coast of South America and part swings west into the Central Pacific just south of the Galapagos Islands. In the calm eddy area formed by this current is situated Easter Island. It is not in the main stream of the current and is therefore not ideally situated to receive new species from the South American coast. Furthermore any that did arrive would probably have originated in the cold water of the southern coast of Chile and would be unable to survive in the warm tropical waters of the island. Migration of tropical species from the other direction, from the islands to the west, is hampered by the general flow of water from East to West in this area. Thus the marine organisms present on Easter Island must have had considerable difficulty in crossing. The directions from which the animals came can be decided from the data collected.

It was impossible to collect every animal and plant present in the intertidal so we concentrated almost exclusively on one group - the fish. Fish collecting methods included the extensive use of poison, spear fishing by ourselves and with our native assistants and trading with fishermen for deep-water fish. These methods resulted in a very extensive collection of fish (2500 specimens) from all sides of the island. These will be studied by ichthyologists and both identified and recorded as to their probable origin in South America or the Pacific Islands. It seems probable that the data will show that almost all the species migrated along the chain of Pacific Islands to Easter Island and few if any came from South America.
Other less extensive collections were made of marine invertebrates and seaweeds for the same purpose. Two other collections are being returned to Canada, for study:

 
IV) A collection of the marine mollusk CONUS:
The stomach contents of this species will be compared to similar data obtained by Dr. Alan Kohn of the University of Washington from the same and other species of this genus living
on other Pacific Islands. It is expected that in a simpler community the species will show a wider variety of prey organisms.

V) Collections from the Crater lake at Rano Raraku:
Preliminary collections were made of the phytoplankton,
zooplankton and organisms living in the mud bottom. These samples will be studied as little or nothing is known about the biology of the crater lakes on Easter Island.

CONCLUSIONS:

All field work was successfully completed. It is expected that analysis of the data will take one year. At the present time we are confident that we have obtained excellent extensive collections of the fish, insects and plants and considerably increased the number of species previously known from the island. It is hoped that after publication a short return visit to the island can be made. This visit would consist of a group of biologists doing specific jobs designed to fill in gaps in this present study that will become obvious during the period of analysis.

The following samples are being returned to Canada for analysis:
1. 200 soil samples for the study of invertebrates.
    A. 120 from the 4 grassland research areas.
    B. 80 from the 4 tree and crop areas in the village.

2. Plants collected from the 4 grassland research plots - for
analysis of species composition and biomass of the grassland.

3. A general plant collection of over 250 species for the
purpose of taxonomy. Those were collected in all parts
of Easter Island and the nearby island of Motu Nui.

4. An insect and terrestrial invertebrate collection. Close to
150 insects wore mounted and many others were preserved in
alcohol.

5. A collection of terrestrial birds, sea birds and lizards.
This includes approximately 40 birds and 30 lizards.

6. An extensive collection of fish (2500 specimens).

7. A collection of marine algae,

8. A preliminary collection of intertidal invertebrates.

9. A collection of mollusks of the genus Conus.

10. A collection of zooplankton, phytoplankton, mud-dwelling
organisms and core samples from one of the crater lakes.

PHYSICAL PLANT:

The physical plant of the Expedition was under the direction of Air-Vice Marshal John A. Eastin. The physical planning embraced twenty four categories to make the Expedition completely self-sufficient. These ranged through such vital requirements as food, tools, laboratory and housing facilities, water, power supply and fuel as well as communications.

The physical plant provided the Expedition with the most modern in scientific and medical equipment to carry out the investigation. This was the first time that such comprehensive medical laboratory facilities have been transplanted into a primitive environment. The areas of study of the population has included all important disciplines of medicine such as virology and bacteriology, hematology, immunology, genetics, metabolism and general epidemiology, as well as investigation of environmental factors such as soil biology, nutrition, and sociology. To carry out this work, the Expedition laboratories were equipped with such modern apparatus as a lyophilizing machine which dry freezes secretion ana serum specimens and Revco low-temperature equipment capable of maintaining virus samples at -87 degrees for transportation to home laboratories in Canada. Du Pont of Canada donated a complete set of films for X-rays. Most of the food for the Expedition was donated by Canadian suppliers and surplus food was distributed to Islanders.

While most of the food was in dehydrated and canned form, the advice of a nutrition expert, Mr. W. Esalinger of C-A Sales Ltd., ensured a proper dietary selection. The problem of shelter for the Expedition was solved by the 24 palletized trailer unite manufactured by Alberta Trailer Company of Calgary. These units were transported in a collapsed state and were erected within hours at the site. In support of the objective of establishing a permanent biological station on Easter Island, several trailers have been purchased by the Canadian Medical Association; Kerch Sharpe and Dohme; Mead Johnson Company; and the Aluminum Company of Canada.
The trailers were arranged to form an enclosed compound according to a plan devised by Professor Norbert Schoenauer and students of the McGill School of Architecture. In addition to the examining and laboratory units, the camp also accommodated a Picker X-Ray apparatus, and two radio transceivers, Wajax water pumps and an electrical distillation unit.

In addition to conducting its medical scientific work the Expedition has provided the Islanders with a number of useful items which will assist in the development of the community. A four wheel drive truck, made available to the Expedition by General Motors of Canada was used continuously for transport of families living at great distances from the camp site as well as for transportation of patients to the hospital. At least one life was saved when an Islander had to be rushed to the Hospital for transfusions. The truck has been donated to the Easter Islanders by General Motors Company for continued use as an ambulance and for benevolent community purposes such as attendance on the sick by Father Sebastian. The X-ray unit, an important diagnostic tool for the expedition, was donated by the Picker Company and forms vital part of the new Island hospital. The Royal Victoria Hospital, Montreal, permitted the expedition to leave some valuable items of surplus hospital equipment which formed part of the scientific facilities of the physical plant. Canada Pumps Limited of Montreal, donated two water pumps which wore installed as part of the distillation unit and which are now a part of the Biological Station.

In addition, through the generosity of a number of Canadian and foreign firms, the Expedition was able to distribute a number of valuable commodities among the islanders. Various types of fertilizer, provided by Canadian Industries Limited, proved of great value in the agriculture of the Island. Insecticides and fire extinguishers, donated by Record Chemical Company, also proved popular and valuable. Five thousand cakes of soap were distributed through the co-operation of "Jabonerias Lavador C.por A., Santo Domingo, Dominican Republic.

ORGANIZATION OF THE EXPEDITION:

The Expedition was organized with the aid of an initial grant of the World Health Organization, which is interested in the development of methods for medical field studies. The Medical Research Council of Canada contributed a $10,000 grant for medical equipment and supplies, and the McConnell Foundation of Montreal a further sum of $10,000 for the general expenses of the Expedition. Major pieces of laboratory equipment were obtained on free loan from manufacturers. The Department of National Defence has co-operated in a most laudable way by making available the Royal Canadian Navy's supply ship H.M.C.S. CAPE SCOTT, for transport of the Expedition and construction of the camp on Easter Island. This active participation is a landmark in the direct co-operation of the Armed Forces with medical research for the improvement of health standards of people throughout the world. In addition to the accumulation of significant medical data, the Expedition provided valuable information for similar undertakings both in Canada and elsewhere.

A great number of Canadian and U.S. firms as well as individual donors have provided the Expedition with all necessary supplies and equipment which amounts to well over $100,000. The supplies of the Expedition have been divided into 24 categories including the following: 1. Food, 2. Messing equipment, 3. Tools, 4. Shelter, 5. Furnishings 6. Office equipment, 7. Medical equipment, 8. Non-medical scientific equipment, 8\ Sampling supplies, 10. Recordsi 11, Medical treatment supplies, 12. Sanitation, 13- Clothing 14 Electricity, 15. Water, 16. Fuel, 17. Transport, 18. Communications, 19. Photography, 20. Gifts, 21. Recreation, 22. Personal items, 23. Packaging equipment, 24. Items used on voyage on H.M.C.S. CAPE SCOTT.

The Expedition has issued a limited edition of a commemorative seal which is still available from the Expedition headquarters for the sum of $1.- This seal, together with a Chilean postage stamp have been placed on a special postcard, bearing a map of Easter Island and a diagram of the Expedition camp. All cards have been properly cancelled on Easter Island. Those who wish to obtain this unique commemorative card should mail this sum (plus postage) together with a self-addressed envelope. The mailing address is as follows:

Medical Expedition to Easter Island

Donner Building for Medical Research

3640 University Street, Montreal, P.Q.

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