Imported Diseases

The European explorers and missionaries who first contacted the indigenes brought with them diseases common in their own homelands or in the ports they had been visiting. However, in the small isolated communities common throughout this region, most diseases could not be maintained indefinitely and needed to be reintroduced through outside contact after a new pool of susceptibles had developed. Such reintroductions were accomplished by interisland voyaging, trade among different tribal groups, explorers, merchants, whalers, missionaries, soldiers, "blackbirders," Asian laborers on plantations and in mines, and soldiers from afar. Lacking the immunity that develops after centuries of coexisting with pathogens, Pacific populations provided a "virgin soil" for these epidemics from the rest of the world or even-in the case of malaria in the Papua New Guinea highlands - from circumscribed areas of en-demicity within the region.

Because it involved translocating large numbers of people around the Pacific and concentrating them in crowded unhygienic quarters, the labor trade had a particularly devastating effect on health (Saunders 1876; Schlomowitz 1987). Laborers not properly screened or in a preclinical phase of a disease when recruited could infect the entire ship during the journey. If the pathogen survived in new susceptibles until the ship landed, the disease rapidly spread throughout the labor camp. Moreover, in addition to introducing infections, the new recruits were particularly susceptible to any diseases present in the camps. Excessively heavy work, poor shelter, lack of sanitation, poor diet, impure water, and lack of health care meant that many did not survive the first year.

Along with internecine warfare and the usual natural disasters that led to famine and water shortages, diseases in this region caused extensive loss of life before preventive or curative methods were successful. Endemic diseases regulated fertility and mortality over time; epidemics of new diseases often caused severe depopulation in all age groups when first introduced. The latter were devastating not just because of their initial toll but also because the loss of mature adults reduced the group's ability to provide food, shelter, and nursing care for itself or to reproduce itself. Pneumonia, diarrheal diseases, and-if present - malaria are still major causes of severe morbidity and mortality for infants and toddlers in the region (Prior 1968; Moodie 1973; Marshall and Marshall 1980; Townsend 1985).

However, as in other regions of the world, infectious diseases have not constituted all of the health problems in Oceania and Australia. Nutritional deficits or excesses, either alone or in concert with infectious agents or predisposing genotypes, have caused a number of important diseases, as have environmental toxins. Hemorrhage, obstructed labor, and sepsis in childbirth have had fatal consequences in the many areas where specialized care is relatively inaccessible (Marshall and Lakin 1984). The same has been true for any trauma leading to hemorrhage or sepsis. In addition, since the post-World War II years, the chronic life-style diseases (obesity, diabetes, cardiovascular disorders, cancers, substance abuse) have become common throughout most of the Pacific.

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