醫務衛生署年報 Medical and Health Department Annual Report 1954-1955

17479

RBB 40n

HONG KONG

ANNUAL

DEPARTMENTAL

REPORTS

1954-55

RBB

PRICE: $6

THE ROYAL SOCIETY

for the Promotion OF HEALTH

LIBRARY

DIRECTOR OF MEDICAL

AND

HEALTH SERVICES

22501293365

HONG KONG

ANNUAL DEPARTMENTAL REPORT

BY THE

DIRECTOR OF MEDICAL

AND HEALTH SERVICES

FOR THE

FINANCIAL YEAR 1954-55

PRINTED AND PUBLISHED BY W. F. Č. JENNER, GOVERNMENT PRINTER.

AT THE GOVERNMENT PRESS,

Java Road. HONG KONG.

WELLCOME INSTITUTE

Coll.

Call

No.

Annky

寺

JHU

I. GENERAL

CONTENTS

Introduction Legislation

II. ORGANIZATION AND ESTABLISHMENT

Basic Organization

The Health Division

Liaison with

Department

Urban

H L

the

The Medical Division

Establishment

Expenditure

Paragraph Number

г. ...

г.

Services

10 - 11

13 - 14

Registered Medical & Dental Practi-

tioners etc.

III. VITAL STATISTICS

Births & Deaths

General

Births & Deaths Registered

•

Anomalies found in relation to Birth

Registration

The Population

Birth & Death Rates

Principal Causes of Death

IV. HEALTH DIVISION

Hygiene and Sanitation

General

New Territories

-TI

19 -

CONTENT S-Contd.

Paragraph Number

30 - 33

Communicable Diseases

Quarantinable

Notifications

Enteric Diseases

Rabies

Tuberculosis

Mortality

Medical Department Clinical Ser-

Treatment

vices

X-Ray Surveys

Service

Tuberculosis in the Government

Surveys for Private Firms

Survey of Prisoners

Survey of School Teachers

Prevention

T-

B.C.G. Vaccination

Social Work

Home Visitors

Leprosy

Rehabilitation

Social Hygiene

Analysis

44.

Syphilis in Pregnancy

Tests used and Investigations

Penicillin Resistance

Treatment

Follow-up of Anti-V.D. Section

Health Education

50 58

56 - 57

CONTENTS-Contd.

Paragraph Number

59 - 63

64 - 69

School Health Service

General

Health Education in Schools and

Colleges

Numbers Participating

Routine Work

New Clinics

Maternal & Child Health Services.

Midwifery Services

Ante-Natal Service

Post-Natal Service

Infant Welfare

- +

Special Investigations

Home Visiting

Malaria Control

Investigations on Larvicides

Port Health

General

Fumigation of Ships

Mosquito Control in Vessels

Industrial Hygiene-A new Venture Health Education Techniques

-- JLL

70 - 71

72 - 74

V. THE CURATIVE SERVICES

General Survey of Services

General Hospitals

Maternity Hospitals

т.

Infectious Diseases Hospitals

iii

CONTENTS Contd.

Paragraph Number

The Mental Hospital

The Social Hygiene Hospital

LJI

JLJ

■

Prison Hospitals and Medical Facilities

VI. THE OUT-PATIENT SERVICES

General

י...

г., г.

Medical Attention in Remote Areas Other Associated Medical Institutions

VII. THE INVESTIGATIVE SERVICES

General

The Pathological Institute

Vaccines Produced

Public Mortuaries

Work of the Police Surgeon

The Chemical Laboratory Radiological Service

VIII. SPECIAL AND ANCILLARY SERVICES

- 1

- -

88 - 89

588 a

92 - 94

95 - 97

- J L

98 - 99

Ophthalmic

General

. .

Preventive Treatment

Curative Procedures

Dental

General

LL LJ

100 - 103

100

101

102

103

104 - 109

New Dental Clinics Opened

Treatment and Attendances

104

105

L-

106

107

108

109

Assistance given to Voluntary

Organizations

Inspection Services

Dental Scholarships

CONTENTS Contd.

Pharmaceutical

General

Licensing

Physiotherapy

Medical Social Services

General

Financial Assistance

Paragraph Number

110 112

110

111 112

113

114 116

114

115

Workmen's Compensation Ordinance 116

Stores and Supplies

Equipment

Technical Improvements

Planning Committees

Building Programme

Staff Welfare

Auxiliary Medical Service

Blood Banks

General

י.

Plasma Drying

IX. TRAINING PERSONNEL

Liaison with University

Nursing Staff

- 7

LIL

117 119

117

118

119

120

LJI

121

122

123 124

123

124

125

126

Technical Staff

Health Visitors

General

г. +

Fellowships and Scholarships

Students Studying Privately

י .

Students sent to Hong Kong from

Abroad

127

128

129 - 133

129 131

132

133

CONTENTS-Contd.

X. INTERNATIONAL ORGANIZATIONS

Exchange Information

Assistance received,

XI. ACCOUNTS

Material

Technical

· +

XII. MAPS

Occupational Therapy Fund

Samaritan Fund

Nurses Rewards and Fines Fund

XIII. APPENDICES

Paragraph

Number

134

135

Introduction.

I. GENERAL

1. The year has been one of strenuous effort against increasing difficulties and it is gratifying to be able to report no deterioration in the general level of public health but rather a definite, if moderate, improvement.

　　　　　2. The demands on the services provided by the Depart- ment have steadily increased and all sub-departments, hospitals and clinics worked not only to full capacity but beyond what might have reasonably been considered full capacity. The volume of work done by all services and centres therefore shows a considerable increase over previous years. Normally during the cooler weather attendances at out-patient clinics tend to fall off, but this year during the cool season all out-patient clinics worked at what used to be considered peak hot season pressure and no sign of any slackening in attendance was apparent.

　　　　3. The year was marked by a phenomenally dry summer resulting in an acute water shortage which was reflected in the incidence of the "dirt" diseases, the diarrhoeas, enteric fevers and dysenteries. In spite of this the incidence of these diseases did not exceed or even reach the peak incidence of the previous year, which was also a dry hot year, when at one time the number of cases of enteric fever admitted daily threatened to swamp the hospital facilities completely. That this crisis has been avoided once more and the position slightly improved cannot be entirely disassociated from the vigorous propaganda and vaccination campaign carried out by the Department.

4. There were several major fires in squatter areas which necessitated the continued provision of emergency medical and sanitary measures during the year. The last of the emergency maternity hospitals however was closed in August, 1954, but one general out-patient clinic was still in operation at the end of the

year.

Legislation.

5. No new legislation was enacted but work continued on the revision of the Medical Registration and the Quarantine and Prevention of Diseases Ordinances and with the framing of the Radio-active Substances Bill. Action was also taken to effect a revision of the Colony's Lunacy Laws.

II. ORGANIZATION AND ESTABLISHMENT

The Department is divided for administrative purposes into two major divisions ie. the Health Division covering all services designed to promote health and prevent disease, and the Medical Division covering the curative and investigative services.

The Health Division is divided into sub-departments offering ten services grouped as follows:

Epidemiology and Port Health under the Chief Port Health

Officer,

Maternal & Child Health Services under a Medical Officer, School Health Service also under a Medical Officer,

The Malaria Bureau under the Malariologist,

The Tuberculosis Service under the Tuberculosis Specialist, The Social Hygiene Service under the Social Hygiene Specialist, Rural Health and Urban Health Services under the Health

Officers, and

Health Education shared by all sub-departments and supervised

and co-ordinated by the Senior Health Officer.

8. Responsibility for the Urban Health Service is shared with the Urban Services Department administered by the Urban Council, the Vice-Chairman of which is the Assistant Director of Health Services. The services affecting public health for which the Urban Services Department is responsible are the control of the sale and preparation for sale of all foodstuffs, the administration and supervision of the markets and slaughter houses, and the pasteurization and retail sale of milk. This Department is also responsible for domestic cleanliness, abate- ment of nuisance, scavenging and conservancy, the disposal of

the dead and administration and control of grave yards and crematoria. In addition the Inspectors on the staff of the Urban Services Department assist the Health Officers in the investi- gation of infectious diseases and the enforcement of the Quarantine and Prevention of Diseases Ordinance.

　　　　　9. The Medical Division includes the control of the various Government Hospitals and out-patient clinics situated throughout the Colony, the special and ancillary services, the mortuaries, and the pathological and chemical laboratories.

　　　　10. The official establishment staffing and operating the services briefly outlined above consists of:

Doctors

Nurses

Professional and Professional Assistants

Technical and Technical Assistants

244

795

183

2,205

Other Staff

　　　　11. A detailed table setting out this establishment will be found at Appendix 1.

Expenditure.

12. The Medical Department's actual expenditure for the financial year ending 31st March, 1955, was $25,105,400, but, to obtain a true figure of Government's expenditure on medical services, to this should be added a further $6,300,572 paid to volunary organizations in the Colony which provide hospital and public health services. These include the Anti-Tuberculosis Association $350,000, Mission to Lepers, Hong Kong Auxiliary, $850,000, and the Tung Wah Group of Hospitals which received the main subvention of $4,879,380. Combined expenditure on account of the Medical Department and medical subventions was approximately 8% of the Colony's total actual expenditure which represents a charge of approximately $11 per capita of popula- tion, accepting the official estimation of the population of the Colony at 2,277,000 persons.

جمیع

Registered Medical and Dental Practitioners, etc.

13. Medical and dental practitioners together with pharmacists, nurses and midwives are required by Ordinance to be registered before practising their professions in the Colony. The Director of Medical and Health Services is the ex-officio chairman of the Boards constituted under the respective Ordinances.

14. The numbers of persons registered under these Ordinances are as follows:-

Registered Medical Practitioners Registered Dentists

Registered Pharmacists

Registered Nurses

460

341

805

++ ++

867

Registered Midwives

The above figures do not include Service or Government personnel.

III. VITAL STATISTICS

15. The registration of births and deaths is compulsory under the Births and Deaths Registration Ordinance, the Director of Medical and Health Services being the Registrar of Births and Deaths. A central General Registry is situated in the centre of Victoria and several branch offices are dispersed throughout the Colony for the convenience of the public. In out- lying rural and island areas, the local Police Stations act as local Registries transmitting reports regularly to the Central Registry.

16. During the year 83,317 births were registered, the highest number on record. Deaths registered numbered 19,283. Deaths under 1 year of age recorded numbered 6,028 and the number of women who died as a direct result of complications. of pregnancy or delivery was 105. The number of birth certificates issued was 82,490 as compared with 78,406 in 1953.

　　　　　17. Provision is made in the Ordinance for the post re- gistration of births. An investigation made by the Supervisor of Midwives has indicated that some 3% of births are not registered within the first year of life. The majority of these are probably registered later under the provision mentioned above, but the statistical implication of this is that the number of births registered is not an accurate index of the actual number of children born during the year. A study of the sex ratio at birth as registered supports this, there being a marked dis- crepancy between the ratio of males to females born in the urban areas as compared with the number of males to females born in the rural areas where it would appear that an astonishingly high percentage of male children are born. The ratio in the urban areas bears a somewhat closer relationship to the male to female ratios at birth found elsewhere in the world, but it would still seem to indicate that Chinese mothers tend to give birth to male children rather more frequently than do mothers of other races, an observation subject to considerable doubt and more liable to some other explanation.

18. Another problem making it virtually impossible to produce reliable statistics for the Colony, is the fact that it has not been found possible to make a census of the population. Only a rough estimation of the total number is possible and this is accepted as 2,277,000. This figure probably errs heavily on the conservative side. Nothing is accurately known as regards the age, sex, or racial distribution of the population but the population is predominantly Chinese, and there would appear to be an unusual excess of young male adults judging by an analysis of the morbidity and mortality figures.

19. Accepting the figures reported at birth, a crude birth rate of 36.6 per thousand of population and a crude death rate of 8.5 per thousand of population is given; both somewhat higher than in 1953.

20. The infant mortality rate can be calculated with some- what greater accuracy. In spite of the greater number of deaths registered during the year of children under 1 year of age, which

is due to the larger number of births registered, the infant mortality rate has dropped from 73.6 per thousand live births in 1953 to 72.4 per thousand live births in 1954.

21. The neo-natal mortality, or the number of children dying in the first four weeks of life was 2,050 as compared with 1,948 in 1953 but, because of the increased number of births registered, the neo-natal mortality rate dropped from 25.8 per thousand live births in 1953 to 24.6 per thousand live births in 1954.

22. The following table sets out the figures in detail:

0-1 day 1-7 days

1-4 weeks

ווח....

4 weeks-3 months

3-6 months

Age Period

TABLE 1

1952

1953

1954

282

278

199

735

795

803

873

875

1,048

- JL LJLOJILJ

LIL

1,001

1,115

1.179

874

823

1,112

935

879

991

846

795

696

6-9 months

9-12 months

FILL J

Total under 1 year...

Infant Mortality rate

No. of deaths under 4 weeks

Neo-natal Mortality rate

5.546

5,560

6,028

77.1

73.6

72.4

1,890

1.948

26.3

25.8

2,050

24.0

23. It will be noted that the highest wastage of young life always occurs between the fourth and twelfth weeks of life and that there is an unusually heavy loss of life during the later months of infancy, contrary to experience elsewhere. It is gratifying to note that the rate of infant mortality has steadily fallen during the past years. 20 years ago the rate was around 300 per thousand live births.

24. It is an interesting feature of mortality in Hong Kong that the number of infant deaths is always approximately one third of the total deaths from all causes. In 1954 the deaths of infants under 1 year of age constituted 31.3% of the total deaths from all causes, being slightly higher than in 1953 when it was 30.4%.

25. There has been a slight rise in the maternal mortality rate from 0.97 per thousand live and still births in 1953 to 1.24 per thousand live and still births in 1954. The following table sets out the figures for 1953 and 1954 in detail:

TABLE 2

Year

Live Still Births Births

Total Live and

Pregnancy and Child bearing

Abortion

Maternal Mortality Rate

Rate

Still Births

No. of Death

per 1,000

No. of

Deaths

Rate

per 1,000 Deaths, 1,000

Rate

No. of

per

Births

Birthe

1953

------

75,544

1,158

76,702

74 0.96

0.01

75 0.97

1954

83,317

1,341 84,658

102 1.20

0.04

105 1.24

26. Deaths from toxaemias of pregnancy numbered 38, giving a death rate of 0.4 per thousand of all deliveries, a slight but insignificant increase on 1953. The following table shows deaths from toxaemias of pregnancy during the years 1953 and 1954.

TABLE 3

Year

Deaths from Total Births Toxaemias of (including

Pregnancy Still-births)

Death rate

per thousand

1953

76,702

0.3

1954

84,658

0.4

-------➖ ➖ ➖ ➖ ➖

27. Details of the principal causes of mortality are given in the following table. Most of the deaths from the diarrhoeas and the pneumonias occurred in infants.

TABLE 4

Number of Deaths

Causes of Death

1953

1954

Malignant neoplasms.

Gastro-enteritis and colitis

952

1,000

г. г гт

2,649

2,690

Pneumonia (all forms)

3,696

3,837

Premature birthe

876

921

Tuberculosis of respiratory system

IT‒‒➖ ➖ ➖ ➖➖

Tuberculosis (other forms)

1,974

965

2,052

824

IV. HEALTH DIVISION

Hygiene and Sanitation.

28. As stated in paragraph 8, the Urban Services Depart- ment is principally concerned with the maintenance of environmental hygiene. There has been little change in the general picture of gross overcrowding further complicated by the acute shortage of water in the urban areas where some 2,000,000 people are crowded into an area of some 10 to 12 square miles. Considerable progress has been made in clearing squatter areas, though assisted somewhat too vigorously by fire, and that problem is slowly coming under control. To ease the acute housing shortage, Government has authorized the formation of a Housing Authority with wide powers to build low rental houses and that body has initiated several major housing projects, the first of which is now in process of development. The Medical Department is represented on this body by the Assistant Director of Health Services.

29. The environmental hygiene and sanitation of the New Territories is still the responsibility of the Medical Department, although plans are in hand to transfer much of the responsibility

for scavenging services in the major centres of population to the District Commissioner, New Territories. The year has been notable for a rapid development of industry and urbanization in certain areas. This development has produced many public health problems which have proved extremely difficult to control. The three main centres of population in the New Territories now comprise large size market and industrial towns with populations of fifty thousand or more, and the staff originally provided to supervise the hygiene and sanitation of these places when they were small rural townships is now experiencing great difficulty in maintaining adequate control.

Communicable Diseases.

30. Hong Kong again remained completely free of any case of the six quarantinable diseases, smallpox, cholera, plague, typhus, yellow fever and relapsing fever. In this connexion the following table is of interest:-

Disease

TABLE 5

Date of last case reported in Hong Kong

Remarks

Smallpox

Cholera.......

Plague

Yellow Fever

Typhus.....

Relapsing Fever

June, 1952

Imported case.

June, 1947

1924

June, 1950

No case has ever been

reported.

Scrub type occurs, no

epidemic type reported.

　　　　　31. There was a slight decrease in the total number of cases of communicable disease notified as compared with the notifications made in 1953 and there has also been a definite drop in the number of deaths from these diseases and in the case fatality rates, which indicates more efficient treatment. On the

other hand, poliomyelitis continued to show a tendency to in- crease, there being 49 cases with 9 deaths as compared with 22 cases and 3 deaths in 1953. Out of that total, 20 were Chinese and 29 non-Chinese including 24 Service personnel and their families. A feature of poliomyelitis in Hong Kong is that it affects foreign new comers much more than the local popula- tion. The Chinese cases, with few exceptions, were infants, while the majority of the non-Chinese infected were young adults recently arrived in the Colony. Some of the cases in non-Chinese proved rapidly fatal while others were of a non-paralytic type. The cases showed a scattered dis- tribution with no apparent relation to each other, which would seem to indicate that poliomyelitis is widespread in the Colony in a sub-clinical or unrecognized form. For that reason the use of active vaccination of the general population, in view of recent events, requires most careful consideration. Puerperal fever also slightly increased, there being 8 cases as against 2 in the previous year. There has also been an unusual prevalence of scarlet fever, normally a rare disease in Hong Kong. Possibly a new or more virulent strain of the organism has been introduced by new comers to the Colony. Apart from tuberculosis, which is reported on separately and in more detail, diphtheria and typhoid proved again to be the major problems of the year. Almost the same number of diphtheria cases were reported as in the previous year, despite energetic measures taken to combat this disease, but in view of the fact that the child population was vastly in- creased and that, prior to the anti-diphtheria campaign, the diphtheria incidence tended roughly to double in each successive year, these campaigns may be credited with at least slowing and checking the spread of the disease though, as yet, they have failed to bring it completely under control.

$2. Under the prevailing hygienic conditions and with the continued use of nightsoil as a surface manure, enteric diseases are inevitable. The reported cases show a slight decrease on the figures of the previous year, but there is little justification for complacency in this. Persons living under the existing conditions of fantastic overcrowding and further hampered by

the severe lack of water are incapable of maintaining the standard of cleanliness necessary to prevent this disease. In addition the majority of the population is far from being well versed in the precautions necessary to prevent this disease. Continuous efforts are being made to meet the problem both by instruction and by giving prophylactic vaccination. In this work a special mobile unit equipped with loud hailers and operat- ing as a travelling vaccination centre has proved by far the most effective weapon. This unit was donated by the Rotarians of Hong Kong. As in the case of diphtheria, the best that can be said is that these measures appear to have succeeded in somewhat reducing and slowing the spread of the disease.

　　　　　33. Rabies has been rather more prevalent this year amongst animals, 8 dogs and 1 pig having been found to have been infected. All cases were in the New Territories. Details of the notifications of infectious diseases and the mortality due to them are attached at Appendix 2.

Tuberculosis,

34. The incidence of tuberculosis as shown by notifications shows an increase which may be due to the greater use now being made of the available diagnostic facilities. Analysis of the notifications and consideration of the mortality in the different age groups indicates either an extremely unusual epidemiological picture or a high degree of unreliability in the statistics, and presents a problem which merits further study

35. The mortality rate from Tuberculosis shows a drop to 126.3 per hundred thousand of the population and tuberculosis now accounts for 14.9% of the total deaths. The downward trend which has been apparent since 1925 is likely to continue provided there are no further major population or social changes such as occurred in 1937 and 1950. At the same time there has been an absolute increase in the total deaths from respiratory tuberculosis, the rise being in the number of male deaths recorded. Deaths above the age of 10 years show a marked excess in males which reaches a peak in the 40-44 age group

The

where males account for 78% of the deaths in this group. unsatisfactory housing conditions are reflected in the high percentage (31.2%) of the tuberculosis deaths that occur in the group under the age of 5 years, three quarters of these being due to tuberculous meningitis.

36. The Medical Department operates two major clinics and several branch clinics at various outlying towns and villages. In addition to the normal daily clinics held at the main centres evening clinics are also now instituted at those centres for the benefit of employed persons unable to attend during normal working hours. For the third consecutive year there has been a 50% increase in the volume of work. Each of the main clinics now has its own X-ray department, capable of dealing with most of the examinations required and this year arrangements have been made whereby the Mobile X-ray Unit now calls once a month at the New Territories clinics. There has been a marked increase in the total number of Radiological examinations made. Comparative figures for 1953/54 are as shown in Table 6 below:

TABLE 6

1954

1953

Hong Kong (including

52.253

48.822

island branch clinics)

Large film or paper.

16,235

23,133

5" x 4"

10,597

Kowloon (including

35 m.m....

15,931

16,866

N.T. branch clinics)

Large film or paper.

19,460

19.978

5" X 4"

3,555

Nil

Treatment.

37. There are only 971 hospital beds available in the Colony for tuberculosis patients and there are at least 4,171 acutely ill active cases attending the clinics as out-patients who

are in urgent need of hospitalization. Even where home con- ditions are suitable, which is seldom the case, domiciliary care can only be minimal with the staff available, so that, though far from ideal, ambulatory treatment has to be the method adopted in the majority of cases. Although it is obviously undesirable to have seriously ill patients attending as out-patients at a clinic, the treatment given does at least help to reduce the risk of infection and the further spread of the disease to young children. Each course of treatment lasts 3 months and many patients require from 2 to 3 courses. Various combinations of drugs are given; Streptomycin, usually by bi-weekly injection, Sodium Para-amino Salicylic Acid, and Isonicotinic Acid Hydrazide, combined where necessary with collapse therapy, artificial pneumoperitoneum being the method most frequently employed.

X-ray Surveys.

38. X-ray surveys are done for three different categories, (a) Government employees, (b) private firms and institutions, and (c) detainees in H. M. prisons. All Government servants are X-rayed annually; the results of the last three surveys are set out in the following table:-

Total X-rayed

Year

Clinically examined

Incidence of active tuberculosis

TABLE 7

1952

1953

1954

19,611

24.915

26,255

2,640

2,746

3,282

0.98

0.72

1.02

39. The increase noted this year is, unfortunately, not confined to new recruits; the disease has also been found in personnel who have been repeatedly examined. This state of affairs can hardly be said to be satisfactory. The situation is being kept under review and special investigation is made where any unusually heavy incidence of new cases is detected in any

particular department. Unsatisfactory working conditions have been found to be the cause in some cases in the past, and corrected.

40. Surveys are carried out free for private firms and institutions on condition that they undertake to provide sick leave with pay on an agreed scale to persons requiring treat- ment. The number of such surveys done during 1954 was 35. A composite analysis of the findings are tabulated below com- paring the results with those of 1953:-

TABLE 8

Year

Total X-rayed....

Clinically examined...

Active tuberculosis....

Percentage with active tuberculosis

ITI

1954

1953

8,488

7,771

947

1,182

142

137

1.67

1.76

41. All prisoners are X-rayed and periodically checked by a Medical Officer. A high percentage of infection is usually detected. The figures for the current year are tabulated below:

TABLE 9

Total X-rayed

4.906

Requiring further examination

Tuberculosis-activity not specified

530

232

J----------------------

Admitted to hospital

-------+++------------------------

42. Special provision is made for the X-ray examination of all school teachers as it is realized that there is considerable danger that this disease may be spread amongst school children

by teachers suffering from active pulmonary tuberculosis. All teachers in Government schools are examined annually, being Government employees, but teachers in private schools are only examined when they seek registration either on appointment or on re-appointment to a new post.

Prevention.

43. Efforts at preventing the spread of tuberculosis are concentrated on public propaganda, education of patients, and B.C.G. vaccination. Public propaganda is, by agreement, the field of the Anti-Tuberculosis Association, education of patients is mainly done by the Medical Department staff of Tuberculosis Visitors in the home, and B.C.G. vaccination is done as a joint effort by all agencies concerned with the tuberculosis problem, including certain private practitioners.

44. B.C.G. vaccination started in April, 1952, with technical and material assistance from the United Nations International Children's Fund and the World Health Organization. This assistance comes to an end in April, 1955, after which the work will be carried on as a local responsibility. The scheme originally started with three mobile teams provided by Govern- ment and one static unit provided by the Anti-Tuberculosis Association. The mobile teams first concentrated on the vaccination of all school children and then turned their attention to the vaccination of younger children. These teams were broken up into smaller units, one of which was attached to the School Health Service to maintain the vaccination state among new entrants to schools and the remainder were stationed in Infant Welfare Clinics and other public places where children were to be found. The house-to-house campaign which was being carried out in conjunction with the house cleansing squads operated by the Urban Services Department had to be abandoned when house cleansing was discontinued.

45. The experiments conducted to ascertain which method of vaccinating new born infants would give the most satisfactory conversion rate with minimum complications indicated that the

multi-puncture method gave least trouble and that vaccine of 20 mgm. strength produced the most satisfactory conversion rate. There is however a great reluctance amongst mothers to permit their children to be vaccinated and less than one sixth of the children born in the hospitals are vaccinated.

Social Work.

46. All proved cases of pulmonary tuberculosis requiring investigation or treatment are interviewed by an Almoner. Particulars of the social and economic background of these patients are recorded and filed with the address thus providing a useful cross reference for the medical case cards filed by registration number. An alphabetical index would prove of little use in view of the difficulty generally experienced in standardizing the romanization of Chinese names. The Almoner has at her disposal a sum of $100,000 allocated from public funds for disbursement in accordance with an agreed scheme. Treat- ment allowances are available on an approved scale to patients whose prognosis is good and who give up work on the advice of the medical staff for the purpose of undergoing treatment. This applies particularly to teachers, who on detection are forbidden to teach and are therefore deprived of their means of earning a livelihood. These allowances are mainly used for the main- tenance of families of patients hospitalized, but in certain cases they are applicable also to patients undergoing ambulatory treatment. Additional nourishment may be provided from this fund also in the form of milk powder issued on the basis of 4 lb. per week to patients on treatment in the clinic.

47. Much of the home supervision of tuberculosis patients falls upon the Tuberculosis Visitors, 23 in number. These Visitors are local girls, locally trained and without any nursing background, and are attached to the Almoner's section and not, as is customary elsewhere, to the nursing side. Their day is normally divided between work in the clinics, assisting medical officers with clerical work, and, in the afternoons, in home visiting. At the first visit the Visitor instructs the patient on the simple methods of limiting spread of infection by isolation

as far as may be practicable, the proper disposal of sputum, and wise habits of rest and diet. At the same time the Visitor endeavours to ensure that all household contacts are examined and all younger children tuberculin tested and, if necessary, vaccinated by B.C.G. vaccination.

Leprosy.

48. The leprosarium on Hay Ling Chau Island (Isle of Happy Healing) is administered by the Mission to Lepers and is therefore a private Institution subsidized by the Hong Kong Government. It works in close collaboration with the Govern- ment leprosy clinics. The available accommodation in the leprosarium is still inadequate and admission is strictly limited. The majority of lepers are treated as out-patients at Govern- ment out-patient clinics. Fortunately it has been found possible with modern drugs to render the majority of cases of leprosy non-infectious by treating them on an ambulatory out-patient basis. This method has the added advantage of not removing the unfortunate sufferer from his normal environment and employment, a step which later is apt to raise problems of rehabilitation. During the year 3 clinics for treating lepers on an out-patient basis have been organized. The attendances are phenomenally high and during the year amounted to 11,526. The routine treatment is Dapsone (di-amino diphenyl sulphone) administered either by mouth or as a 20% suspension given by intramuscular injection weekly. There is a tendency in approximately 40% of cases for a therapeutic reaction, or exacerbation of signs which requires modification or cessation of treatment followed by gradual resumption. The clinical response shown by gain in weight and amelioration of skin manifestations is satisfactory, but bacteriological reversal is sometimes disappointingly slow.

Rehabilitation.

　　　　　49. A special committee has been set up by the Mission to Lepers, Hong Kong Auxiliary, to deal with the vexed problem of the rehabilitation of cured and non-infectious lepers. Two

senior members of the Medical Department sit on this committee by invitation and it is gratifying to report that it has achieved some success. It seems that it is slowly being recognized that this disease is curable by modern means and patients discharged and certified by recognized authorities as non-infectious are now being received back into the community and by their relatives. with less reluctance than formerly. It can at least be said that the age old prejudice against leprosy is lessening in certain quarters.

Social Hygiene.

50. The rapid development of the work is illustrated by the following table:-

TABLE 10

1950

1951

1932

1953

1954

MIT-----------➖ ➖

13,524

17,934

23,565

156,036

37,392

152.294 149,237 213,091 223,031

36,652

New Patients

Total Attendances

51. An analysis of the more important aspects of the work is attached at Appendix 3.

52. In co-operation with the Maternal and Child Health Services the blood of pregnant women is tested for the presence of unsuspected infection and in the 20,748 tests done during the year, 1,560 were found to be positive, giving an unsuspected infection rate amongst tested pregnant women of 8.5%. This service is available to private midwives also and during the year they submitted 5,697 samples for examination of which 319 were found to be positive, giving an infection rate of 6%. Amongst all women attending the ante-natal clinics, the average infection rate is over 6%.

　　　　53. The quantitative titration of the Venereal Disease Research Laboratory blood test is now extensively carried out and is of great service both for diagnostic purposes and post treatment surveillance. A special study of 1,000 such tests has been made and the results published as a special report. Studies were also made of the post treatment results in cases of neuro- syphilis treated by penicillin, which confirmed findings elsewhere. This work is continuing.

　　　　　54. Penicillin resistance was proved in one case of gonococcus, the first time a resistant strain of gonococcus has been identified in Hong Kong. Penicillin resistance in staphylo- cocci is however now very commonly found, 50% of swab cultures showing resistance.

Treatment.

　　　　　55. For the routine treatment of syphilis procaine penicillin with 2% aluminium monosterate (P.A.M.) is used. Ultra long- acting dipenicillin (Penadur) became available as a one-shot treatment in December, 1954, and has been used to a limited extent where follow-up can be adequate. This drug is of particular value in cases of syphilis with pregnancy who attend in the last few weeks of pregnancy. A clinical trial of aureomycin triple sulfas was made in the treatment of male gonorrhoea. One case of gonococcal ophthalmia in a male adult was treated in Queen Mary Hospital. This disease is now rarely seen in Hong Kong. Sulphonamides are regularly used for the treatment of chancroid and lymphogranuloma venereum.

Follow-up Work.

　　　　　56. From all sources 2,187 notifications were received. The Social Hygiene Visitors paid a total of 3,437 visits including 845 to defaulters.

57. In 1952 and 1953 the work of the anti-venereal disease section was restricted to the follow-up of prostitutes who defaulted from treatment. In 1954 a beginning was made in the follow-up of married women and male defaulters who had not responded to follow-up letters.

58. Considerable emphasis has been laid this year on Health Education activities. Special films have been made and shown to selected public audiences with considerable effect and the special value of ante-natal blood tests, penicillin treatment, and contact investigation were stressed. Close liaison is main- tained with the Moral Welfare Sub-Committee.

School Health Service.

59. In accordance with the terms of Government's agree- ment with the World Health Organization the latter body seconded a Public Health School Nurse Instructor in June 1954 to assist in and advise on the School Health Service. For training and demonstration purposes four schools were selected with a total enrolment of approximately 20,000 students, and good results have been achieved.

60. In September, 1954, the World Health Organization Regional Adviser on Health Education visited the Colony and as a result of his visit a special co-ordinating team on Health Education was formed, consisting of W.H.O. Maternity and Child Health personnel and their local counterparts, and members of both the Education and Medical Departments, to study methods of health education and to experiment and implement suggestions. An Education Officer has been assigned for work in relation to Health Education in schools and as a liaison officer to the School Health Service. New films and film strips have been added to the Education Department Library and all schools with suitable equipment may have them on loan. Health Education is part of the compulsory course for first year students of the Northcote Teacher's Training College, and the majority of the lectures are given by the staff of the School

Health Service The course at Northcote Training College is attended also by undergraduates of the Department of Educa- tion, Hong Kong University. During the year these Health Education courses were completely revised and now the same basic course is used for all students, one course being given in English and the other in Cantonese. A second year course on Health Education for students of Northcote Training College is under consideration.

61. The number of participants in the service rose from 46,051 to 52,329 and this figure is expected to increase as a result of new schools which are being opened in the Colony.

　　　　　62. During the year 63,060 medical inspections were carried out, 20,490 on new entrants to the service and 42,570 re-examinations. Only 28.72% of the students were found without apparent defects and 53.06% were listed for observation or re-inspection. The remaining 18.22% were noted for treat- ment. The nutritional state of the new entrants and the pupils re-examined showed a lower standard and the following table shows the percentage of those classified as slightly below normal and poor for the last three years:

TABLE

1954

1953

1952

New entrants

Re-examination

31.77%

| 15.94%

17.64%

20.55%

17.23%

21.61%

63. It has been agreed in principle that where necessary and practicable, new Government schools should be planned to include a special school clinic. These clinics will not be for the sole use of the school to which they are attached but will be to meet the requirements of all schools in the area. The first of these new clinics was opened towards the end of the year.

Maternal and Child Health Services.

64. The Government Midwifery Service, operating from nineteen centres, attended 9,087 women, delivering 8,895 successfully and 121 of still births. It was necessary to refer 140 of the cases to hospitals to deal with complications of pregnancy and child birth. Approximately 11% of all births registered have therefore been attended by the 35 midwives comprising the Government Midwifery Service.

The average

number of cases handled by a midwife during the year was 259, but one midwife actually delivered as many as 559 cases or rather more than one birth every sixteen hours, a truly remark- able record of service. A case load of over 100 cases per annum is regarded as putting an excessive strain on a midwife elsewhere, militating against adequate attention. Many of these cases were delivered in their own homes, particularly in resettlement areas. The 213 midwives in active private practice delivered 30,195 cases, 29,903 being delivered of living children and 292 of still births.

65. In addition to the normal duties of attending actual births all midwives, private and Government, are expected to give ante-natal supervision during pregnancy to their clients. It is hardly surprising, if a little disappointing, to find that only 66.17% of women delivered by Government midwives and 83.07% of cases attending private midwives were able to receive this attention. The average number of pre-natal examinations given to pregnant women attending all centres was a little over two per pregnancy, but in actual practice the vast majority of pregnant women tended to come only once late in pregnancy when, as often as not, it was already too late to deal adequately with any abnormality present. According to present experience it would seem that at least 8% of all pregnant women are suffering from some grave defect or complication of pregnancy endangering either their own life or that of their unborn child or making for a difficult and dangerous birth, a very large percentage of which could be avoided or ameliorated by earlier attendance and, as has already been pointed out, at least 6% are found to be suffering from unsuspected syphilis which

disease very seriously threatens the life and health of the child. To date it has been found practicable to organize ante-natal sessions at 17 of the 19 Government centres.

66. Post natal care was started on an organized basis in 1953 and this service has been steadily expanded during the year under review. Comparatively few women as yet avail themselves of this service, the average attendance at sessions being only about 9, but that a need exists is revealed by the fact that 16% of women examined are found to be in need of corrective treatment.

67. The care of children during the first 2 years of life is now the most gratifying and highly organized of the Maternal and Child Health Services. During 1954, 16,649 children came under the care of this service, on an average each child attend- ing 12.46 times in the year, that is to say, the majority of children were brought regularly and seen at least once a month. This would seem to indicate that the services rendered are increasingly appreciated and the regular attendance makes it possible to do much systematic health education amongst mothers, an opportunity that is fully exploited by the staff. It is interesting to note that of the children brought to the 3 main urban centres, only 2.21% were found to have any defect whereas amongst those attending the rural centres 4.13% show some defect needing correction. This does not indicate that rural children are twice as liable to malady or malformation as urban children; but rather that urban mothers more fully appreciate that infant health centres are intended to guide and supervise the normal growth and development of healthy children whilst rural mothers incline to regard these centres as places to which to bring their children when sick. Children found to be in need of more than the simplest medical care or advice are of course referred to the appropriate treatment centres.

　　　　　68. Much of the health education is done by the nurses during visits to the homes of the mothers. This aspect of the work, home visiting and investigation of the background living

conditions of each child, has been increasingly developed and during 1954 22,750 such visits were made. The visiting nurse advises the mother on the spot in her own home on the most practicable steps to take in her particular situation to safeguard the health, not only of her baby but of the whole family, checks on such matters as vaccinations and anti-diphtheria immuniza- tion, and notes any special risk or hardship for special attention.

69. Two special investigations carried out by the staff of the Maternal and Child Health Service are worthy of mention. A careful check on the number of births attended and of children attending the health centres revealed the fact that some 3% of births had not been registered within the first 12 months of life. The second investigation was an exhaustive study of the weight and growth of 2,000 infants which revealed that the growth rate of properly supervised Chinese children prior to weaning closely parallels the average growth rate of all children, but that after weaning, when they receive normal Chinese diet, there is a marked tendency for growth to slow up. Taken into consideration with other investigations made, parti- cularly the prevalence of cirrhosis of the liver amongst adult Chinese, and various spot checks on the composition of average diets, this observation lends confirmation to the impression that the average poorer class Chinese diet is gravely deficient in protein-a deficiency which is probably also reflected in the serious tuberculosis incidence.

Malaria Control.

70. Malaria is not a serious problem in Hong Kong, there being only 475 cases recorded during the year under review with 16 deaths, and the spleen index rate amongst children in the New Territories, the most highly malarial area of the Colony, is only 4% (rates of 5-10% being regarded as "ideal targets" by the World Health Organization in malarious areas brought under control by residual spraying). But it must not be overlooked that this has only been achieved by constant and careful larvicidal control. Hong Kong was and still is poten- tially a dangerously malarious area. Vector mosquitoes abound

on the borders of the controlled areas and, given a favourable opportunity, can increase rapidly at any time. This constant threat of malaria to the Colony is not generally realized.

　　　　　71. During the year experiments were carried out with new insecticides which were submitted for testing by various Companies. Under local conditions water-miscible Gammexane has been found to be the most efficient larvicide.

Port Health.

　　　　　72. The Port Health Administration is responsible for the prevention of the importation into the Colony by sea, land, and air of the six quarantinable diseases and of leprosy. The work is governed by local ordinances, the Quarantine and Prevention of Diseases Ordinance (at present under revision) the Merchant Shipping Ordinance, the Vaccination Ordinance, and the Asiatic Emigration Ordinance. Passengers and crews of incoming vessels are inspected at the two Quarantine Anchorages at Kowloon Bay and at Stonecutters Island; arrivals by air are inspected at the Kai Tak Airport and persons entering by the land frontier are checked at Lo Wu Station. The work is carried out expeditiously and with the minimum interference with traffic or inconvenience to passengers and crews. During the year 4,715 ships carrying 57,251 passengers and 230,083 crew were inspected on arrival as against 3,734 ships and 57,106 passengers and 200,701 crew in 1953. The routine spraying of all aircraft with insecticide before arrival is insisted upon. Arrivals by air increased from 15,372 in 1953 to 18,423 in 1954. A total of 189,957 persons entered the Colony by the land frontier compared with 301,670 and 163,695 in the previous two years. Of these 46,871 were vaccinated against smallpox.

Fumigation of Ships.

73. An important feature of port health work is the destruction of rats on ships by fumigation as an international measure against the spread of bubonic plague. During the year

40 ships were fumigated with sulphur dioxide, 19 with cyanide and 148 were granted exemptions subject to proof of freedom from rats. The fumigation staff also fumigated or disinsected bales of gunny, feathers, etc., before export on request by business firms.

Mosquito Control in Vessels.

74. Mosquito breeding on small craft in the waters of the Colony has been reduced to negligible proportions and Aedes aegypti, which was the predominant species found breeding on junks in 1953, has practically been eliminated. This has been brought about chiefly as a result of measures taken by junk masters themselves on the advice given by the Port Health Inspectors during the regular inspection of junks throughout the year. Out of 11,350 junks inspected mosquito larvae were found on only 26, i.e. 0.23% of vessels inspected as against 2.32% in the previous year. The species identified were Culex fatigans on 14 junks, Aedes albopictus on 5, Aedes aegypti on 4, Aedes aegypti and Culex fatigans on 1 and Aedes albopictus and Culex fatigans on 2.

Industrial Hygiene.

75. Towards the end of the year a start was made towards organizing a Factory Health Service by seconding a Medical Officer specifically trained in industrial hygiene to the Labour Department. Draft proposals were prepared and approved for establishing a special service to cover this aspect of public health and exercise a more satisfactory supervision of the health of industrial workers as well as to extend the present supervision of working conditions exercised by the Commissioner of Labour.

Health Education Techniques.

76. Much time and effort has been expended in trying to instruct the general public by various means on both general and specific health problems. Special films have been made, posters

and pamphlets printed, talks and demonstrations arranged, discussion groups organized, radio plays produced and special broadcasts given during the year. In an attempt to assess the relative merits of the various techniques and approaches, an investigation was made by the Health Officers in connexion with the anti-diphtheria campaign, during which all methods of propaganda were used, to ascertain from parents what had persuaded them to bring their children for immunization. The results of this investigation were somewhat inconclusive in some respects but showed definitely that the method which produced most and immediate results was the use of the loud hailers of a public address system mounted on the mobile inoculation vehicle donated by the Rotary Club. At the other extreme posters were very clearly demonstrated to be quite the most unecon- omical and least productive form of propaganda. Direct advice from friends and doctors rated fairly high and interestingly enough quite a surprising number of persons gave their reason for coming for immunization as "seeing the queue." The responses ascribed to seeing cinema trailers, reading press articles or hearing broadcast talks were disappointing. It would seem that direct conversation or discussions amongst individuals or small groups is the most effective health educa- tional technique.

V. CURATIVE SERVICES

　　　　　77. There are in the Colony 27 hospitals of all kinds ranging in size from small twelve bed units to a large general hospital of 589 beds. Government owns and operates 11 of these and provides substantial financial assistance to 7 others orperated by voluntary organizations. The remaining 9 are entirely independent and receive no financial assistance from Government. The 11 Government hospitals provide 1,856 beds, the assisted hospitals 2,111 beds, and the private hospitals 994, a grand total of 4,961 hospital beds for all purposes or a little more than two beds per thousand of population, assuming that the population has not been under estimated. According to certain British authorities quoted in standard text books on the

subject, a community should provide per thousand of population 6 beds for general purposes, 1.5 beds exclusively for tuberculosis patients, I for the isolation of infectious diseases, and up to 6 beds for the accommodation of mental diseases and mental deficiency cases, a total of 14.5 hospital beds for all purposes or 7 times the total facilities available in Hong Kong. Details of the categories of beds available in the hospitals and of in-patients treated during the year are shown in Appendix 4. Details of work done in Government hospitals and in the assisted hospitals, classified according to the International Standard Classification (International List of 150 causes) are given in Appendix 5. The 11 Government hospitals comprise 2 major general hospitals and 1 minor rural hospital on lease from the St. John Ambulance Brigade and used largely for minimal cases of tuberculosis, 2 maternity hospitals, 2 infectious diseases hospitals, 1 hospital for venereal diseases in women, 1 hospital for mental diseases and 2 prison hospitals. The major hospital for tuberculosis. the Ruttonjee Sanatorium, is operated by the Hong Kong Anti- Tuberculosis Association assisted financially by Government, and the Maxwell Memorial Hospital for lepers on Hay Ling Chau is administered by the Mission to Lepers again with financial assistance from Government. In addition to the major hospitals Government also operates 2 major out-patient polyclinics on the Island and I in Kowloon, 2 major chest clinics, 10 public dis- pensaries in the urban area and 12 rural health centres which do both curative and preventive work, and 2 mobile dispensaries, as well as certain emergency and special clinics. At most of the rural centres a limited number of beds are provided for maternity cases and, in addition to general out-patient services, visiting specialists offer dental, ophthalmic and other services.

The General Hospitals.

78. There are three Government general hospitals, 1 on the Island, the Queen Mary Hospital, 1 in Kowloon, the Kowloon Hospital, and 1 on Cheung Chau, owned by the St. John Ambulance Brigade but operated on a lease by Government. The Queen Mary Hospital is the largest in the Colony and is the

main centre for the clinical training of medical students of the University of Hong Kong and is also the main school of nursing in the Colony. The senior staff is supplied about equally by Government and by the Medical Faculty of the University. The Hospital does not offer any true out-patient service but it handles most of the serious accidents and acute cases that occur on the Island and all cases coming under police attention. It has been found necessary to extend the existing hospital by adding a new casualty wing and work on this project has just commenced. Kowloon Hospital is old and much smaller, and quite inadequate for the needs of the population its 233 beds serve. It has to deal with the whole of the urban area, which alone has probably a population of about a million people, and also the more serious cases from the New Territories. The main Kowloon out-patient service is operated in this hospital also and although there has been some lessening of pressure due to the opening of out-patient clinics elsewhere, this department continues to be extremely hard pressed. Kowloon Hospital also functions as a school of nursing. The increase in the work is perhaps most vividly illustrated by the following table which gives not the actual figures but the percentage of increase yearly since 1947 using the figures for that year as a base. It must be remembered that the facilities were already overloaded in 1947.

TABLE 12

1947

1948 1949 1950 1951

1952 1953 1954

General In-patients

100

104

113

130

144

163

162

183

Maternity Cases.........

100.

115

168 198

177

192

O.P.D. Attendances ....

Operations

100

145

366

412 385

322

100

128 142 165 218

245 261 278

It is to replace this institution that a new 1275 bed hospital is being planned. The St. John Hospital on Cheung Chau is a small rural hospital of 102 beds, 42 of which are reserved for

milder cases of tuberculosis. It serves not only the small island of Cheung Chau but the neighbouring islands also. The staff is small and the services offered are limited, any major surgical or emergency case being transferred to Queen Mary Hospital by ambulance launch. It has been suggested that a helicopter ambulance would be more expeditious. The work done has considerably increased as can be seen from the following figures:

1958

1954

1951

1952

Out-patients (new cases) In-patients admitted

➖➖ ➖ ➖

13,945

1,593 1,683 1,589 1,719 8,180 11,855 12,020 12,420

16,830 22,299 30,078

Vaccinations/Inoculations

Maternity Hospitals.

79. As has been stated previously in this Report, a great deal of maternity work is done by the Government Midwifery Service and by private midwives. Still more is done by certain non Government institutions with or without financial assistance from Government, most notably perhaps at Kwong Wah Hospital and at the Alice Ho Miu Ling Nethersole Hospital. The main Government maternity hospital is the Tsan Yuk Hospital, an institution of 85 beds housed in old and thoroughly unsuitable premises which has served the Colony well for many years. This hospital, which is very shortly to be replaced by a modern 200 bed maternity hospital, is the main training centre in the Colony for medical students and midwives and the Professor of Obstetrics and Gynaecology of the University of Hong Kong is responsible for supervising the clinical work. The volume of work done is stupendous. No fewer than 7,164 patients were admitted to the 85 beds during the year and the total number of deliveries was 6,606, that is to say some 7.9% of all births registered in the Colony during the year took place in this one comparatively small hospital. There were 7 maternal deaths in this large number of deliveries, many of them being of an emergency nature or complicated in some way, giving a maternal mortality rate of 1.06 per thousand deliveries. It is worthy of note that among the 6,433 deliveries

The new Tran Yak Maternity Hospital of 200 beds.

וי

THE VIOLET PEEL HEALTHCENTRI

The older type of General Out-patient Clinic combining several curative services.

　　of booked cases, all of whom received ante-natal supervision, the mortality rate was only 0.77 per thousand. The 155 deliveries of non booked cases were all emergencies and it is not surprising that the mortality amongst them was somewhat higher, but even so it was gratifyingly low. There were no deaths from puerperal sepsis, 3 of the 7 deaths were due to toxaemia of pregnancy, 2 to hemorrhage, and 2 to associated diseases. There were 24 cases of eclampsia but only 1 death, giving a case fatality rate of 4.2%, the lowest figure on record in this institution. The other Government Maternity Hospital is the Eastern Maternity Hospital which originated many years. ago as a private enterprise of the local Kai Fong. Since the war it has become a Government Hospital. It is a small 24 bed hospital also extremely badly housed in unsuitable premises by modern standards but again the quality of work done is most satisfactory. During the year 2,662 patients were admitted with 2,478 deliveries and only 2 fatalities, giving a maternal mortality rate of 0.8 per thousand which is comparable with the best rate at the much better equipped Tsan Yuk Hospital. A valuable addition to the maternity service of the Colony was made during the year when the new Obstetrical and Gynaecolo- gical wing of the Alice Ho Miu Ling Nethersole Hospital was opened by His Excellency the Governor. This hospital, operated by the London Mission Society and assisted financially by Government, has long been famous in the Colony particularly for the excellence of its maternity services and the outstanding quality of training given to nurses and midwives therein. It also provides surgical and medical services and has a busy out-patient department. The new wing accommodates 110 beds of which 70 are for maternity and 40 for gynaecological cases.

Infectious Disease Hospitals.

　　　　80. The Government maintains 2 hospitals for the treat- ment of infectious diseases, mainly diphtheria, typhoid, and the dysenteries, one on either side of the harbour. Neither hospital can be said to be entirely suitable for the purpose as they were not designed to fill this particular need. The Sai Ying Pun Infectious Disease Hospital is housed in very old and dilapidated

buildings situated in one of the most congested areas in the city. It is a hospital of a nominal bed strength of 88 beds but rarely are there less than 100 patients in it at any one time and very frequently considerably more. There is a staff of ten doctors but these officers are also responsible for certain duties in the adjacent Sai Ying Pun Out-patient Clinic. A disturbing discovery made in this hospital during the year was that a local strain of Shigella has developed resistance to chloramphenicol making the successful treatment of certain cases of bacillary dysentery rather more difficult. Fortunately certain anti-biotics proved efficacious. Lai Chi Kok Hospital is not strictly speaking a hospital for infectious diseases alone. It is a large institution of the pavilion type with 484 beds, housed in adapted premises, and only part of it is used as an infectious disease hospital, 208 beds being set aside for cases of tuberculosis and 108 being used as a relief hospital for con- valescent and chronic cases from the two general hospitals. Many of these long term chronic cases are orthopaedic cases in children and this year one general ward of 26 beds was specifically set aside for this type of patient. The Red Cross Society interested itself in these children and has provided a teacher and teaching equipment for this ward. Occupational therapy has been introduced but so far little enthusiasm has been aroused for making articles for which no monetary reward is to be expected. In the infectious disease section of the hospital 1,159 cases were treated during the year which is 325 less than in the previous year.

Mental Hospital.

　81. The present hospital for mental diseases is completely inadequate, antiquated, and thoroughly unsatisfactory. It is hoped to replace this institution shortly with a modern well designed hospital. Overcrowding, always a serious problem, was worse than ever during 1954. There were 1,023 admissions as compared with 825 in 1953. The hospital is designed to accommodate 140 patients but during the year there were never less than 300 housed in it at any one time and at the end of the year there were 363. A high standard of modern treatment

is maintained nevertheless and the hospital is the University training centre for the study of nervous disorders. The quality of work done has received favourable commendation from visiting prominent psychiatrists. During the year no less than 635 patients were discharged home with all symptoms fully remitted and 181 were discharged greatly improved and fit to resume normal life. The average length of stay was 44.75 days. There were 55 deaths, 30 of them due to syphilis. There were 468 new cases treated as out-patients and 1,188 old cases continued out-patient treatment. The new drug "Chlorproma- zine" was used for the control of disturbed patients and found to be of great value. Trials are being made at present of the new Rauwolfia alkaloids for the same purpose.

　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　An occupa- tional therapist with experience in mental hospitals has recently joined the staff and this form of therapy is being further developed.

Social Hygiene Hospital.

　　　　　82. This small hospital provides 20 beds and 8 cots for the treatment of venereal diseases in women and infants. The premises are old and not satisfactory but recent renovations. and re-decoration have considerably improved conditions. Because of these major repairs and alterations, which were completed towards the end of the year, only half of the hospital was able to function at any one time during 1954, and con- sequently there was a sharp reduction in the volume of work done. Only 588 patients were admitted. Because of the convenience, safety, and efficacy of the modern out-patient treatment with antibiotics, it is less frequently necessary to hospitalize cases of gonorrhoea although this disease has much graver sequelae and complications in women than in men. An out-patient service is also operated in this hospital for female patients.

Prison Hospitals and Medical Facilities.

　　　　　83. There are 2 small hospitals in each of the two main prisons but not in the remand prison or in any of the institu- tions for youthful offenders. In these latter institutions there

is a sick bay and a doctor visits regularly and conducts out- patient clinics and sick parades. Specialist services are available in the same manner. The Queen Mary Hospital is equipped with a special detention ward to which prisoners requiring more serious medical or surgical treatment can be admitted. A clinical laboratory was established in conjunction with the clinic at Victoria Remand Prison during 1954 to handle the simpler types of investigations and 224 such investigations were made. The officers of the Dental service make periodic visits. All prison inmates are regularly X-rayed and blood tested for evidence of venereal disease, as already reported. The prison medical officers supervise the general hygienic condi- tions of the prison and cook houses, etc. During the year the bed strength of the Stanley Prison Hospital was increased to 70, and 592 prisoners were admitted for treatment. The average stay in hospital was 27 days. The number of more serious cases transferred to other hospitals was 24, 11 of these to the Queen Mary Hospital and 13 to the Mental Hospital. Only 6 deaths occurred in prison, 2 of them being suicides. There were in addition 5 judicial executions and 1 prisoner died in Queen Mary Hospital to which he had been transferred with a serious surgical condition. Drug addiction amongst prisoners is always a major problem and 2,086 addicts were treated during the year. Tuberculosis is also always very prevalent; 232 new cases were detected while the average number of tuberculosis cases in prison at any one time was 106. Fewer prisoners were found to be suffering from venereal diseases this year, there being only 2,749 cases compared with 3,757 in the previous year. The Dental Surgeons treated 369 prisoners at their fornightly visits. Only 19,943 prisoners attended sick parades during the year as compared with 35,266 in the previous year, the average parade being only 65 and mainly for very minor injuries or ailments. As the total number of prisoners committed to Stanley Prison during 1954 was 5,174 and the daily average population 2,099, these figures do not indicate any unusual morbidity. The hospital at Lai Chi Kok Female Prison is little more than a sick bay. It has only one 12 bed ward and a single bed maternity room with an examination room used also as a dispensary and out-patient

clinic. During the year 185 cases were admitted to this small hospital, 6 of whom were maternity cases for delivery, 34 were suffering from pulmonary tuberculosis, and 37 were drug addicts. In addition to the medical services mentioned above for prisoners the Medical Department also holds special clinics for prison staff and their dependants.

VI. THE OUT-PATIENT SERVICES

　　　　　84. The work done in the various out-patient clinics during the year borders on the fantastic. At the main clinics doctors work in shifts from 9. a.m. to midnight continuously and on the average each doctor sees one patient every 2 to 3 minutes. Patients are expected to pay $1 per visit, a step introduced some years ago with a view to deterring irresponsible visits for trivial causes; but the volume of work continues to increase yearly. The main out-patient centres are at Sai Ying Pun and Violet Peel Health Centres on the Island and at Kowloon Hospital on the mainland. The opening of the new Police Medical Post in Kowloon, the Maurine Grantham Health Centre in the New Territories, and other subsidiary small clinics has somewhat relieved the pressure on the Kowloon Hospital out- patient department but nevertheless 499,403 attendances were recorded at the latter institution. Pressure of work at the Sai Ying Pun out-patient department is equally heavy. Thanks once more to the continuing generosity of the Jockey Club it is hoped shortly to erect a multi-storied building to accommodate the work now being done at this clinic. The Sai Ying Pun clinic serves as a field training centre for medical students studying at the University of Hong Kong. Conditions at the Violet Peel Health Centre are little better although this building was built comparatively recently and began to function just before the out-break of the Pacific War. The pressure of work completely swamps the available space and facilities and it has been found necessary to extend the waiting space by erecting shelters outside the building to protect the queues. At the Violet Peel Health Centre alone over 196,000 patients attended the regular day clinics and over 90,000 the late evening clinics.

There were 185,718 new cases. Out-patient attention is also available at the 10 public dispensaries in this city and at 12 rural health centres scattered over the New Territories. In addition other smaller clinics are held in premises of certain other Government departments. A special clinic is held for English speaking Government servants in the new Secretariat building where the Families Visiting Doctor sees English- speaking patients by appointment. Similar facilities are afforded at Kowloon Hospital. A small clinic for the benefit of the staff of the Marine Department is served by the Port Health Officers; a clinic is held in the Kowloon Terminus Station for the benefit of railway employees; and 2 clinics, one in Hong Kong and another in Kowloon, are operated for members of the Police Force and their dependants. Still another is being developed at Kai Tak Air Terminus for the benefit of air crews and airport personnel. A very busy clinic functions at the Portland Street Society for the Protection of Children Centre, and during the year temporary clinics were operating in association with the work of the Social Welfare Department for fire victims and at certain relief camps. These smaller clinics serve to disperse the overwhelming load on the main centres to some extent but the present pressure of work cannot be sustained indefinitely. Although the health of the Medical staff has shown no particularly marked deterioration as yet, the matter is causing grave concern. Details of the attendances at various centres will be found in Appendices 6, 7, 8 and 9.

Medical Attention in Remote Areas.

85. The Medical Department operates two small vehicles equipped as travelling dispensaries to augment the out-patient work of the rural health centres in the more remote villages and areas of the New Territories which are accessible to road transport. Unfortunately there are still some settlements in the New Territories which are not easily accessible to road transport and at Sai Kung, one of the more remote villages, a new health centre is being built. Considerable help is given in rural areas and in the outlying islands by the St. John

Ambulance Brigade which sends small parties called "Penetra- tion Squads" periodically to visit such places. These squads give medical, dental, and nursing care and minor surgical treatment and also play a considerable part in the work of protecting the population in these areas by prophylactic injections and hygienic advice.

Other Associated Medical Institutions.

　　　　　86. The 7 voluntary institutions most closely associated with the Government service and in receipt of Government subsidies are the Ruttonjee Sanatorium, the Tung Wah Group of three hospitals, the Alice Ho Miu Ling Nethersole Hospital, the Hay Ling Chau Leprosarium and the Pok Of Hospital. The Ruttonjee Sanatorium is operated by the Anti-Tuberculosis Association of Hong Kong and provides 230 beds, including 38 cots for children, for the treatment of tuberculosis. Admission to this hospital is generally made through the Government chest clinics and close liaison is maintained between this Association and Government's Anti-Tuberculosis Service. Plans are at present in hand for the Association to build a tuberculosis convalescent home and another sanatorium. The Tung Wah Hospitals are operated by a long established Board of prominent and civic minded Chinese gentlemen who not only administer 3 large and very busy general hospitals, which are also training schools for nurses and midwives, but also schools and other charities. They accommodate a percentage of the long term chronic sick and thus allow the Government hospitals to deal with the more acute cases. The Medical Superintendents of the 3 Tung Wah Hospitals are Government Medical Officers specially seconded for the purpose but the rest of the staff is engaged and paid by the Board of Directors. Several prominent specialists in private practice give their services as honorary consultants. A small convalescent hospital for tuberculosis patients is maintained by the Tung Wah Board of Directors at Sandy Bay in temporary wooden structures.

structures. Mention has already been made of the work of the Alice Ho Miu Ling Nethersole Hospital and the Leprosarium, The Pok Of Hospital is a small rural hospital of 36 beds situated at Un Long built

some time ago and supported by voluntary effort. It is ad- ministered by a Board of Directors and 2 Government Medical Officers are seconded to work in it. The general pattern of administration closely follows the pattern of the Tung Wah Group of Hospitals.

VII. THE INVESTIGATIVE SERVICES

87. Under this category come the Pathological Institute, the Public Mortuaries, the Chemical Laboratory and the Radio- logical Department.

Pathological Institute.

88. Routine laboratory investigation of diseases and bacteriological examinations of food and water are made at the Pathological Institute and its subsidiary laboratories. This institute also produces the majority of the vaccines used locally. The Pathological Institute comprises a main building on the Island and a subsidiary institute situated at the Kowloon Hospital on the mainland. In addition there are 2 small clinical laboratories, one at the Queen Mary Hospital and one opened during the year at the Lai Chi Kok Hospital. The Institute's responsibilities also include the 2 public mortuaries and super- vision of the Blood Bank.

89. Specimens received for examination in 1954 numbered 256,593-an increase of 16,650 over the previous year's figures. Since the war the annual increase has been fairly steady and the present figures are more than treble those for 1946. Serological tests for syphilis alone numbered 104,058. Sputum specimens totalled 34,947 and bacteriological examination in connexion with the diagnosis and treatment of tuberculosis expanded to such an extent that this work has now become a separate branch which should have its own premises and staff.

90. The vaccines produced in 1954 were:

Anti-smallpox vaccine

cholera

typhoid-paratyphoid vaccine (Adult)

rabic vaccine (2%)

לל

(4%)

rinderpest vaccine.

Diluted tuberculin

38,066 ml.

156,900

150,700

(Children)

----

220,000

25,600

J+

14,760

77,900

32,300

Grand total

716,226 ml.

Public Mortuaries.

　　　　　91. There are 2 public mortuaries, one in Hong Kong and one in Kowloon. Although both are old buildings, and the Kowloon mortuary in particular is unfortunately sited, they continue to serve their purpose reasonably well. Both are now air-conditioned and equipped with refrigeration units for the keeping of bodies pending investigation. Specimens of scientific interest were sent to the University of Hong Kong for teaching purposes. A statistical summary of the work done is attached at Appendix 10.

Work of the Police Surgeon.

　　　　　92. To assist the police in investigating the medical aspects of suspected crimes 2 medical officers with special experience in forensic medicine are seconded to the Police Department. They are assisted by a chemist and certain specially trained police personnel. The work falls into 3 categories:

(a) Forensic (b) Laboratory

The forensic work covers--

(a) The examination of victims and suspects connected

with violent and unnatural crimes;

(b) Calls to assist at scenes of crimes especially in

murders and sudden deaths;

(d) Medico-legal post mortems covering both Hong

Kong and Kowloon;

(e) Raids on unregistered medical practitioners, un- registered dentists, sellers of poisons, and manu- facturers of dangerous drugs.

93. The laboratory work deals mainly with examinations of blood and seminal stains, hairs and fibres, weapons and articles connected with crimes. In addition the laboratory staff blood-group all police recruits before they pass out of the Police Training School.

94. Short lectures and demonstrations of an hour's dura- tion are given from time to time to police officers at the laboratory showing medico-legal aspects of certain crimes. Lectures are also given once weekly to the medical students at the University.

The Chemical Laboratory.

95. The Government Chemical Laboratory carries out analytical and consulting work for Government departments, the Services, and the commercial community. Government work is done free, but for other work fees are charged accord- ing to a prescribed tariff. This tariff has been revised and its scope widened during the year.

96. During the year the laboratory moved into new and much improved accommodation.

　　　　　97. The volume of work dealt with has shown a marked increase over that of last year 27,675 samples being dealt with as against 24,907, and the following table shows very briefly the distribution of this work:

TABLE 13

1953

1954

Public Health..

12,281

14,551

Chemico-Legal..

800

939

Commercial

1.747

966

Revenue Control, Narcotics, Strategic

Materials

9,928

10,518

Miscellaneous Government Work.........

250

701

24,907

27,675

The Radiological Department.

98. The work of this department is mainly diagnostic but therapeutic treatment is also carried out. Under the adminis- tration of the Radiological Specialist are also grouped the physiotherapy and occupational therapy units. The diagnostic work is done in Queen Mary Hospital and Kowloon Hospital, the chest clinics, and by mobile X-ray units. Radiotherapy is confined to the Queen Mary Hospital only.

99. The following forms of radiotherapy are given:-

(a) superficial X-ray

(b) contact X-ray

(d) telecobalt

The diagnostic work of the department has steadily increased as is illustrated by the following table:-

TABLE 14

1952

1953

1954

Total number of examinations... 141,694 195,673

233,563

Of these 233,563 examinations, 207,043 were chest examina- tions, mainly for tuberculosis. The total number of treatments given was 5,165.

VIII. SPECIAL ANCILLARY SERVICES

Ophthalmic Service.

100. The main opthalmic centre in Hong Kong was establi- shed in Violet Peel Polyclinic, Wanchai, at the beginning of the year. The main centre in Kowloon is located at Kowloon Hospital. From these 2 centres staff are sent out to various out-patient clinics to operate special ophthalmic clinics once or twice a week. Such special sessions are now being held at 10 out-stations. During 1954 there were 50,378 attendances at the various eye clinics, of which 25,518 were new cases. The pressure on the clinics of cases suffering from actual eye diseases has been so heavy that it has been impossible to under- take simple correction of vision tests for the general public to any great extent, but in cases where correction of vision is needed as part of treatment of an eye disease, free or cheap spectacles have been provided.

Preventive Treatment.

101. Penicillin is now used as a routine prophylactic measure at birth in all Government maternity centres in place of the former silver nitrate treatment. This has been found

　　　to produce less irritation and to be as satisfactory in preventing eye diseases amongst the new born. Persons sustaining eye injuries in industry are now attending much more promptly for treatment and the number of eyes lost from neglect or delay in seeking treatment in such cases is diminishing in a most gratifying manner. Shark's liver oil, prepared locally, is used as a supplementary diet to provide vitamin A in cases suffering from eye conditions associated with malnutrition.

Notes on Curative Procedures.

102. Trachoma is now treated as recommended by the World Health Organization with tetracyclines. It is, however, not a grave problem in Hong Kong and a recent survey of all patients attending the eye clinics revealed that only 15% suffered from this disease.

　　　　　103. Dimox and Di-fluoro Phosphene have been used with excellent results in the treatment of glaucoma. The use of cortisone in addition to systemic treatment given at the social hygiene clinics has been most successful during the current year in preventing cases of blindness from interstitial keratitis, not one case having developed. The out-patient operation theatres have been fully used all year for the surgical correc- tions of eye defects, greatly relieving the load on the hospitals.

Dental Service.

104. At the close of the period under review there were 8 dental clinics in operation; 4 in the General Dental Service, 3 in the School Dental Service, and 1 operating jointly for the General and School Dental Services.

105. Two new dental clinics were opened during the year. The new Wanchai Clinic in Kennedy Road, which was officially opened on 1st April, 1954, includes in its second floor the Dental Headquarters (Dental Specialist's office, stores and laboratory) a Government Servants' Dental Centre (4 surgeries

with ancillary offices), and a School Dental Centre (4 surgeries with ancillary offices). One School Dental Clinic was moved from temporary quarters to permanent accommodation attached to a new Primary School on 1st October.

106. In the General Dental Service, treatment was provided for Government Servants and their families, in-patients of Government hospitals, prisoners, and general public poor per- sons in urban and rural areas. Treatment visits totalled 10,899 Government Servants, 8,523 families, and 15,819 general public, making a grand total of 35,241 visits. In this service 24,420 teeth were extracted, 7,311 teeth were filled or crowned, and 791 prosthetic appliances were fitted. Pupils and teachers in private and grant schools who joined the School Health Service were dentally examined every six months. 23,468 examinations were carried out and 16,287 were found to require treatment, a percentage of 69.4. 3,644 permanent and 27,759 deciduous teeth were extracted, and 4,077 permanent and 552 deciduous teeth were filled or crowned.

107. Several dental clinics were operated by welfare organizations either for their members or for the poor in their respective districts. In the latter category were included the evening clinics operated by the Hong Kong Dental Society at the Hong Kong Family Welfare Society's Centres in Hong Kong and Kowloon, and the St. John Ambulance Brigade Penetration Party which visits remote areas in the New Territories where dentists give their services free of charge for the treatment of poor persons.

108. Two dental inspectors were employed on duties in connexion with the control and supervision of dental practice in the Colony. They regularly inspected premises used and proposed to be used by dentists, a large majority of whom possess no dental qualifications of any sort. They were also vigilent in investigating and reporting instances of illegal dental practice by unregistered persons. In this category 9 persons were convicted under the Dentists Registration Ordin- ance during the year.

109. In 1954 Government announced a dental scholarship scheme, and 6 such scholarships were awarded to Hong Kong students in October. Concern has been felt in that, lacking a dental school in Hong Kong, the number of dental surgeons to care for the population is likely to be seriously deficient during the next ten or twenty years. The dental scholarship scheme has been devised to ensure that a sufficient number of well qualified dental surgeons will come to Hong Kong and practise in government service or privately. To this end an obligation is laid on them to return to Hong Kong after qualification for at least three years. The first year's study is spent in the Science Faculty of Hong Kong University, and the student then goes to Singapore to study for four years in the Dental School of the University of Malaya, after which he qualifies as Bachelor of Dental Surgery. Five scholarship students who had already passed their first year examinations in Hong Kong University proceeded directly to Singapore, and one student took up his first year studies in Hong Kong. It is anticipated that 9 dental scholarships will be awarded each year to suitable male or female students who have qualified to enter the Hong Kong University.

Pharmaceutical.

110. This sub-department has its administrative head- quarters at the Central Medical Store, located in the same compound as the Government Stores Department. Its most important function is to maintain an adequate flow of drugs, dressings and instruments to the various institutions of the department. To do this, its activities cover a very wide range. Very large quantities of bulk preparations are made on both sides of the harbour. These include injections, transfusion fluids, concentrated mixtures, ointments, etc. Large quantities of special surgical instruments and equipment are purchased by the sub-department through the Crown Agents for Overseas Governments and Administration. All standard lines of phar-

maceuticals, routine instruments, and dressings are purchased locally through Controller of Stores. During the year supplies were issued to 215 institutions.

111. Another very important aspect of the Chief Phar- macist's duties is the issue of licences to premises registered under the Pharmacy and Poisons Ordinance and the routine inspection of their records. In addition, similar duties are involved in the supervision of dealings in anti-biotics and dangerous drugs. A careful examination is made at the end of each month of all movements of dangerous drugs within the Colony. Licences (official authorizations to import) are issued for each individual importation of dangerous drugs, and the numerous quarterly and annual returns to the Permanent Central Opium Board are prepared by the Chief Pharmacist.

112. Following are comparative figures for 1953 and 1954 of issues of licences to deal in poisons and anti-biotics and the number of inspections made:

1953 1954

Wholesale Dealers Licences

Listed Sellers Licences

Licences issued to Authorized Premises

(Pharmacies)

Anti-biotic Permits

Restricted Anti-biotic Permits

Premises inspected

475 429

229

238

207

194

157

1,078 1,092

The drop in the number of Anti-biotic Permits issued can only be construed as an indication of trade conditions in anti-biotics.

Physiotherapy.

113. The headquarters of this sub-department was moved to a new clinic which was opened on the 1st April, 1954. This new clinic, which is conveniently situated on the ground floor

of the building, contains 6 treatment units, an occupational therapy room, and a hydrotherapy room which accommodates one large and two smaller tanks supplied by the United Nations International Children's Fund. There is also a working area where the wax baths are given and other treatments prepared and a large re-education room with fitted wall bars and numerous aids for patients of all ages who are just beginning to regain the use of their limbs. The treatments at this new clinic alone totalled 26,852 by the end of the year.

Medical Social Services.

　　　　114. The increased turnover of patients in all the hospitals brought more work for the almoners as each patient is inter- viewed at least once. At the Mental Hospital there has been a noticeable increase in the work of tracing the home connexions of the "unknown" and "neglected" cases. Considerable time and effort is needed to discover their true identity and social resources, but in most of these cases relatives have been traced and patients returned to their homes. Special attention has been given to patients suffering from nasopharyngeal carcinoma who often make long journeys several times weekly for radio- therapy at Queen Mary Hospital. Many are found to be too poorly nourished to take the treatment and these patients are given extra food and their travelling expenses are paid. Some attempt has also been made to help with the social problems of lepers, both those attending the out-patient clinics and those fit for discharge from Hay Ling Chau Leprosarium. Experience has shown that the problems of this group of people are not easily resolved and it is unlikely that any really useful contribu- tion can be made until an almoner is appointed solely for this work.

　　　　115. Expenditure on surgical appliances for patients too poor to meet the cost themselves amounted to $3,422. Grants were made from the Samaritan Fund for temporary maintenance of patients or their dependants, for fares for patients to attend

hospitals or clinics, or for their relatives to visit them in hospital, and for various forms of help in re-establishment after discharge, the total expenditure being $4,578.

Workmen's Compensation Ordinance.

116. The Workmen's Compensation Ordinance gives welcome relief to many injured workmen and their families and is helpful to the almoners in that it makes compulsory much that was previously only achieved by prolonged negotiation and it ensures aid from the less conscientious employer. Nevertheless it intro- duces methods and principles which are strange to many injured workmen and a great deal of time has to be spent by the almoners in clearing the mind of the patient, whose recovery is apt to be retarded if he feels that adequate compensation for his injury is being overlooked.

Stores and Supplies.

117. In general there has been no serious hold up in the supply of equipment. Money has been saved by making as many items of surgical furniture as are possible either in the Department's own workshop or in the workshops at Government Stores. New high pressure sterilizers of an improved modern rectangular type have been installed in the Queen Mary Hospital. The old ones, which had seen service for many years and were considered unfit for further use, were removed and from them it was possible to build one high pressure sterilizer to be used at the new Tsan Yuk Hospital.

Technical Improvements.

118. Air conditioning was introduced into the out-patients Department, Dental Centre, Casualty Operating Theatre and the second major operation theatres at Kowloon Hospital. The Operating Theatre and X-ray Department at Lai Chi Kok Hospital were also air conditioned. At Lai Chi Kok Hospital also a large new incinerator was installed and the kitchen was fitted with an auxiliary cold room for food storage.

Planning Committees.

　　　　　119. Two new planning committees were organized during the year:

(a) A special Sub-Committee to consider the prepara- tion of comprehensive lists of furnishings, fixtures and equipment for the new Kowloon Hospital in order to ascertain what articles could be manu- factured locally.

(b) A Departmental Planning Committee to advise on

new establishments.

Building Programme.

120. At the beginning of the year a new clinic was opened in Wanchai which provides chest, dental, and physiotherapy services. It replaces older and less satisfactory facilities provided in other premises now adapted for other purposes and is therefore not so much a new development as an improvement on existing services, but it has resulted nevertheless in a large increase in the volume of work being handled. A little later in the year the Maurine Grantham Health Centre at Tsun Wan was opened by Lady Grantham. This centre was built with funds. raised by a group of benevolent residents of the Colony. It is a typical rural health centre offering curative and preventive services, the upper storey being a small but well equipped maternity hospital. Work has already started on enlarging this health centre to meet the heavy demands made upon it during the few months in which it has been operating. Also during the year work was completed on the new 200 bed Tsan Yuk Maternity Hospital which will shortly replace the existing over- crowded and antiquated hospital. Much progress has also been made in the detailed planning of new institutions, including a 1,275 bed general hospital for Kowloon, a hospital for mental diseases, and a multi-storied polyclinic, as well as certain smaller health centres and clinics in the New Territories and resettle- ment areas.

Staff Welfare.

121. Preliminary steps have been taken for the commence- ment of a Sports and Recreation Club for the staff as a whole. An application is being made to Government for a site for a sports ground and clubhouse. This club will, it is anticipated, serve further to improve morale and fellowship amongst the staff.

Auxiliary Medical Service.

122. The Auxiliary Medical Service was established in 1950 by regulations made under the Essential Services Corps Ordinance. It is a unit within the Essential Service Corps and its unit controller is the Director of Medical and Health Services. The purpose of the Service is to supplement medical services in times of emergency; substantial progress was made towards this objective during the year. With the co-operation of the St. John Ambulance Brigade the casualty collecting service has been built up to a reasonable standard of efficiency and the scope of the service has been expanded. Field training exercises were carried out continuously. Training of auxiliary dressers to work in hospitals has continued and the point has been reached where almost all the personnel needed for the scheme have received at least one course of ward training.

Blood Banks.

123. The blood banks at Queen Mary and Kowloon Hospitals work in close co-operation with the Hong Kong Branch of the British Red Cross Society, the latter being responsible for the collection of more than 80% of all blood used in Hong Kong and Kowloon, while the banks act as storage and distribution centres. Blood is supplied without charge to all hospitals and doctors throughout the Colony when required in emergency. Each bank is staffed by one nursing sister and one male attendant.

　　　　124. A plasma drying unit consisting of a vertical spin freezer and a centrifugal vacuum machine was installed at Queen Mary Hospital Blood Bank in the early part of September, but so far there has been little surplus blood for plasma produc- tion. Nevertheless, sufficient has been available to enable experiments to be conducted and as a result it has been found necessary to order additional minor equipment.

IX. TRAINING OF PERSONNEL

Liaison with University.

　　　　125. As has been mentioned frequently throughout this report the Medical Department co-operates closely with the Faculty of Medicine of the University of Hong Kong in the training of medical students. Many members of the Govern- ment staff act as part-time lecturers and during the year the Director of Medical and Health Services acted as Professor of Social Medicine. Students of medicine and the social sciences attend various Government institutions for clinical instruction and field observation. After qualification medical graduates are required to do one year post graduate work under supervision as house officers before qualifying for registration and these young doctors are largely employed in the various Government hospitals for this experience.

Nursing Staff.

　　　　126. An important part of the work of the Medical Depart- ment is the training of nurses (male and female) and midwives. Recruitment of student nurses and dressers continued to be satisfactory but in the early part of the year 9 student nurses and 1 dresser failed to pass the Preliminary Training School Examinations and 4 student nurses and 2 student dressers found they had chosen the wrong profession and resigned. Twenty- seven nurses and 2 dressers passed the Final Nursing Board Examination and 24 students qualified as Midwives.

Technical Staff.

127. In addition to training nurses, the Medical Department also trains technical assistants in pharmacy, radiography, laboratory techniques, physiotherapy, and in medico-social ser- vice. The following table lists the work done in this field during 1954:-

TABLE 15

Appoint-

Dent

Resigna- tion

Strength

31.3.55

Probationer Assistant Physiotherapist

Radiographic Assistant

Dispenser

Laboratory Assistant

Assistant Almoner

וזזוז

Nurse

131

Dresser

Pupil Midwife

Health Visitors.

128. A new venture in the training of personnel this year has been the institution of an official course of training for the Health Visitor's Certificate under the auspices of the Royal Sanitary Institute. Ten students commenced the course in October, 1954.

Fellowships and Scholarships.

129. In addition to local training, Government provides financial assistance to certain selected personnel to take special courses of study abroad. This is augmented by Sino-British Fellowship Trusts Funds administered by the British Council.

　　During 1954 11 students of various grades were assisted by Government and 4 received financial assistance from Sino-British Fellowship Trust Funds.

　　　　130. The following table sets out the nature of the appoint- ment of the officers sent abroad for special study and the subjects studied with the assistance described above:-

Appointment

TBBLE 16

Subjects Studied

Radiological Specialist

Medical Officer

Assistant Dental Surgeon

Almoner

Radiographic Assistant

Laboratory Assistant

Nurse

Senior Dresser

Medical Radiotherapy

Anaesthesia

Forensic Medicine

Post-graduate course in oral Surgery

Almoner's training

Therapeutic Radiography

Medical Laboratory Technology

Mental Nursing

Dresser

Dreaser

Mental Nursing

　　　　131. The World Health Organization also assists Government in this special post-graduate work and during the year under review 2 Medical Officers were sent abroad under W.H.O. Fellow- ship funds, 1 to study for the Diploma in Public Health and 1 Malaria Control, and 2 nursing sisters to study Paediatrics.

Students studying overseas at their own expense.

132. In addition certain personnel elected to take special study abroad at their own expense and were granted special leave of absence for this purpose. They are expected to join the Government service on their return.

Students sent to Hong Kong from abroad for special study.

133. The training facilities of Hong Kong are now recognized by other bodies outside the Colony and certain students financed by W.H.Q. have paid brief visits for instruction. Four nurses who had been studying in New Zealand were sent to Hong Kong to complete their experience before returning to their posts, a Japanese doctor studying Port Health Administration was sent by W.H.O. to Hong Kong and 2 French professors interested in medical education paid a visit to the Colony to study Hong Kong methods.

X. INTERNATIONAL ORGANIZATIONS

Exchange of Information.

134. Close liaison is maintained with the World Health Organization in the exchange of epidemiological information.

Assistance received, Technical and Material.

135. As already mentioned W.H.O. provided 4 Fellowships to assist post-graduate study. In addition that Organization has continued to support a team of Advisors on Maternal and Child Health and School Health Services who are working with the Medical Department in strengthening these services in the Colony. The United Nations International Children's Fund continued to give considerable material assistance.

K. C. YEO,

Director of Medical & Health Services.

OCCUPATIONAL THERAPY FUND

Statement of Receipts and Payments for the year ending 31st March, 1955.

RECEIPTS

Description

To Balance brought forward

To Refund of honorarium from Miss Chan Kwai Yue.......

To Sale of rattan articles and materials

Amount

PAYMENTS

Description

Aniount

2,400.01

By Travelling expenses for voluntary workers...

296.10

200.00

By Purchase of material..

466.27

6,680.20❘ By Honoraria to voluntary workers.

LIL

4,190.00

By Balance carried forward

4,327.84

9.280.21

9,280,21

The above account has been examined in accordance with the Conditions set out in the Schedule to to the Resolution approving the Establishment of the Occupational Therapy Fund. I have obtained all the information and explanations that I have required, and I certify, as a result of this audit, that in my opinion the account is corret.

Sgd. W. H. WILLIAMS Acting Director of Audit.

Certified Correct.

Sgd. K. W. FORROW

p. Director of Medical and Health Services. 18th June, 1955.

Sgd. B. I. BICKFORD

Secretary. Occupational Therapy Committee. 18th June, 1955.

30th June, 1955.

SAMARITAN FUND

Statement of Receipts and Payments for the year ending 31st March, 1955.

RECEIPTS

PAYMENTS

Description

Amount

Description

Amount

To Balance brought forward

8,043.90

To Donations..

17,362.50

To W. & O. Pensions (Mrs. Li Shuk Hing widow of late Mr. Chan Nai Teo, now an inmate in mental Hospital).

640.97

By Providing maintenance and capital grants, clothing, food, travelling expenses and etc., to patients

By Balance of pensions and other monies held on behalf of various pa- tients...

LILLILLII

5,640.54

$ 3,379.42

By Balance carried forward.... $ 17.027.41

20.406.83

26,047.37

The above account has been examined in accordance with the Conditions set out in the Schedule to the Resolution approving the Establishment of the Samaritan Fund. I have obtained all the information and explanations that I have required, and I certify, as a result of this audit, that in my opinion the account is correct.

30th June, 1955.

Sgd. W. H. WILLIAMS Acting Director of Audit.

Certified correct.

Sgd. K. W. FORROW

p. Director of Medical & Health Services. 18th June, 1955.

Sgd. M. E. M. BENHAM Principal Almoner, Medical Department. 18th June, 1955.

NURSES REWARDS AND FINES FUND

Statement of Receipts and Payments for the year ending 31st March, 1955.

RECEIPTS

Description

To Balance brought forward

To Forfeiture of deposits from Misses Edith Fung, Gertie Silva, Roseannia

Amount

1,943.82

Yuen, Diana Cheung. Mary Ho.

Laura Shum, Dorothy Mao, Lui Suk and Josephine Shain

1,800.00

3.743.82

PAYMENTS

Description

Amount

--JILJILLJL-I

615.00

By Purchase of prizes for Nurses and Dressers, and cost of frames, pho- tographs etc,

By Provision of tea for 430 persons on the occasion of presentation of cer tificates and prizes to Nurses and Dressers

By Balance carried forward

1,075.00

2,053.82

3,743.82

The above account has been examined in accordance with the Conditions set out in the Schedule to the to the Resolution approving the Establishment of the Nurses Rewards and Fines Fund. I have obtained all the information and explanations that I have required, and I certify, as a result of this audit, that in my opinion the account is correct.

Sgd. W. H. WILLIAMS Acting Director of Audit.

30th June, 1955.

Certified correct.

Sgd. K. W. FORROW

p. Director of Medical & Health Services. 18th June, 1955.

Sgd. H. C. FISHER

Ag. Principal Matron, Medical Department, 18th June, 1955.

COLONY OF HONG KONG

MEDICAL FACILITIES

MAP 1954

CASTLE

PEAK

BAY

CHINESE

TER TORY

HOSP.

UN LONG DISPENSARY

KAM

TIN

TA KULING

LOK MA CHAU

SHEUNG

SHUI

DISPENSARY

FAN LING

TAI PO

DISPENSARY

SHA TAU KOK DISPENSARY

SAN HUI DISPENSARY

NEW TERRITORIES

MAURINE GRANTHAM BEALTH CENTRE

SHATIN.

SAI

DISPENSAR

MATERNITY HOME,

SILVER MINĖ BAY. DISPENSARY

TAI O DISPENSARY

LANTA

HAY LING CHAU

LEPER SETTLEMENT

CHEUNG

CHEUNG CHAU

JOHN HOSPITAL

HONG

KONG

(See Japarate Map)

SWELTER

CHLANEL

HONG

KONG

ISLAND MEDICAL

FACILITIES

LING YUET SIN INFANTS' HOSPITAL

TSAN YUK HOSPITAL

MENTAL HOSPITAL

TAI WO HOSPITAL

SAI YING PUN HOSPITAL & OUT-PATIENT DEPT.

TUNG WAR HOSPITAL

ALICE HO MIŲ LINE HETHERSOLE HOSP.

PORT HEALTH INOCULATION CENTRE

CENTRAL PUBLIC DISPENSARY

TO POLICE MEDICAL POST

+25

HONG}KONG

H.K. FAMILIES CLINIC

STATUE SQUARE INOCULATION CENTRE

H. K. CENTRAL HOSPITAL

MILITARY HOSPITAL

ST. FRANCIS HOSPITAL

VIOLET PEEL POLYCLINIC

EASTERN DISPENSARY & MATERNITY HOSPITAL

AUTTONJEE SANATORIUM

MATILDA HOSPITAL

WANCHAL S.H. HOSPITAL

QUEEN MARY HOSPITAL

HARCOURT HEALTH CENTRE

ABERDEEN PUBLIC DISPENSARY

ST. PAUL'S HOSPITAL

SHAUKIWAN PUBLIC DISPENSARY

ST. JOHN AMBULANCE BRIGADE CENTRE

TUNG WAH EASTERN HOSPITAL

30 STANLEY DISPENSARY & MATERNITY HOME STANLEY PRISON HOSPITAL

H. K. SANATORIUM & HOSPITAL

NAVAL HOSPITAL

NORTH POINT MATERNAL & CHILD HEALTH CENTRE CHAI WAN MATERNAL & CHILD HEALTH CENTRE WAN CHAI CLINIC

SHAM SHUI PO PUBLIC DISPENSARY

ST. TERESA'S HOSPITAL

LAI CHI KOK HOSPITAL

FEMALE PRISON HOSPITAL

PRECIOUS BLOOD HOSPITAL

MONGKOK CLINIC

MILITARY HOSPITAL

LI KEE MEMORIAL DISPENSARY

KOWLOON HOSPITAL & OUT-PATIENT DEPARTMENT

KOWLOON CHEST

CLINIC

KWONG WAH HOSPITAL

YAUMATI PUBLIC DISPENSARY

HUNG HOM PUBLIC DISPENSARY

TSIM SHA TSUI HEALTH CENTRE

ASHLEY ROAD SOCIAL HYGIENE CLINIC KOWLOON POLICE MEDICAL POST KOWLOON-CANTON RAILWAY STAFF CLINIC NGAU TAU KOK MATERNAL & CHILD HEALTH

CENTRE.

क्र

KOWLOON

PENINSULA MEDICAL FACILITIES

KOWLOON BAY

APPENDIX 1

Establishment of the Medical Department as at 31.3.55

Director of Medical and Health Services

Deputy Director of Medical and Health Services Assistant Director of Medical Services

Assistant Director of Health Services Senior Medical Officer

Senior Health Officer

Secretary

Senior Specialist (Medical)

Senior Specialist (Malariologist) Government Pathologist

Surgical Specialist

Tuberculosis Specialist

Radiological Specialist

Chief Port Health Officer

Dental Specialist

Social Hygiene Specialist

Ophthalmic Specialist

LL J

Psychiatrie Specialist

Gynaecological and Obstetrical Specialist

---

Pathologists

Radiologists

Chemists and Assistant Chemists

------

Anaesthetic Specialist

Medical Officers. Assistant Medical Officers, Women Medical Officers,

　Assistant Women Medical Officers & House Officers Dental Surgeons and Assistant Dental Surgeons

Government Chemist

Principal Matron

221

- JL-J

Nursing Staff

795

Principal Almoner

Almoners and Assistant Almoners

1 20

Executive Officers

Clerical Staff

197

Chief Pharmacist, Pharmacists, Dispensers, & Dispensary Super-

visors

Superintendent Radiographer, Radiographers, and Radiographie

Assistants

Superintendent Physiotherapist, Physiotherapists, and Assistant

Physiotherapists

Physicist

Occupational Therapists

וזוום

Laboratory Assistants

Chief Laboratory Technician, Laboratory Technician, and

Chief Hospital Secretary and Hospital Secretaries

Health Inspectors and Malaria Inspectors

Dietitians

Public Vaccinators

Other staff

יי

IL-LI

TOTAL

2,000

3,514

Amoebiasis

Cerebro-Spinal Meningitis

Chickenpox

Cholera

Diphtheria

Dysentery (Bacillary and clinical).

Enteric Fever

Malaria

Measles

Plague

Poliomyelitis

Puerperal Fever

Rabies - Human

Animal

Relapsing Fever Scarlet Fever

Small-pox...

Tuberculosis

Typhus Fever

Whooping Cough Yellow Fever

+++

Appendix 2

Notifications and Deaths

1953-54.

Total No. of Notifications

Total No. of Deaths at all ages

1953

1954

1953

1954

285

236

298

233

1116

1104

133

116

662

535

1434

1099

128

780

475

661

597

126

WINN

11900

12508

2939

2876

131

130

Appendix 3

Composite Table to Show Incidence of Venereal Disease in Hong Kong

and work done by Social Hygiene Department

1951

1952

1953

1954

New Cases....

17,934

23,565

Total Attendances

152,294

149,237

37,392 213,091

36,652 223,031

Addmissions to Hospital..

1,063

1,106

741

508

Total Syphilis

3,215

3,216

6,969

6,825

(except Congenital)

-----

Congenital Syphilis

Gonorrhoea

Chancroid

Primary Syphilis Secondary Syphilis Early Latent Syphilis Late Latent Syphilis Congenital Syphilis (under 1 year)

(over 1 year)

Lymphogranuloma Venereum...

Non Venereal Disease

Statistics for the Period 1st April, 1954 to 31st December, 1954

Leprosy Out-Patient Service

562

672

634

393

301

180

132

1,101

882

2,298

2,209

1,038

1,275

3,727

3,983

164

6.903

8,546

11,625

2,347

2,400

2,507

10,705 2.365

197 2,420

111

208

286

6,596

13,616

14,526

New Cases of Leprosy..

Lepromatous Tuberculoid

Total Number of Clinica

Total Attendances......

Number of Cases transferred for Admission

149

171

492

----------

94 11526

Patient

Type of Defaultera

No. of visits made

Cases❘ seen,

ignored returned

advice given

Patient

out,

message left.

Not

Moved known

away

¦ address

No such address

Others

Prostitutes

637 82

140

184

107

14%

8.1%

1.7%

22% 18.8% 9.5%

Male..............

173

9.2%

10,4%

Married women

(Kowloon only)

14.5%

16.7% 27.7% 20.2%

Died

----

8.2%

14.3% 14.3% 11.4% 31.4% | 16.4%

Died

APPENDIX 4

In-patients admitted into Government, Government Assisted and Private Hospitals, 1954, including cases remaining in

hospital from the previous year.

NAME

Government Hospitals:

　　　Queen Mary... Kowloon

--------

Sai Ying Pun

Toan Yuk...

Mental

Stanley Prison

Eastern Maternity

banchai Sorial Hygiene

Lai Chi Kok

St. John

➖➖➖ ➖➖➖➖➖➖➖➖➖-----------------➖➖➖➖

Lai Chi Kok Female Prison

TOTAL........

Government Assisted Hospitals:

Tung Wab Group

Alice Ho Miu Ling Netherole Ruttonjee Sanatorium

Pok O

Hay Ling Chau Leprosarium

Beds

¡ General

Carer

In- Tuber- fectious culosis

Caser | Caree

Mater- nity Caves |

! Mental

Cagea

Total

589

8,521

115

690

2,308

11,637

233

6,369

112

114

2,829

9.438

440

1,228

1,714

767

7,256 1

8,023

140

1,332

1.892

431

102

642

2,59

2,683

613

404

133

1,159

673

1,965

102

1,258

122

379

1.789

135

189

1,856

18.759 2,737

1.784

15,369 1,376

40,025

- PILL

1,255 240

23.471

268

3,279

23,604 !

50,622

3.638

126

138

1,841

11---I

5,743

230

676

36 1,179

741

1,920

350

TOTAL...

2,111

28,288

744

4,093

26,186

59,311

Private Hospitals:

Tai Wo.......

40 1,091

1,174

St. Paul

172

987

252

885

580

2,704

Ling Yuet Sin Infant."

125

265

172

444

Precious Blood

2.083

192

195

163

2,633

Hong Kong Staktorium

239

4,400

143

380

1,352

6,324

St. Francis

1,075

1,120

St. Teresa'.

1.475

100

264

1,910

Hong Kong Control

103

2,195

101

228

153

2,677

Matilda and War Memorial.

1,013

1,112

TOTAL.......

994

14,584

804

1,847

2,814 !

49 | 20,098

GRAND TOTAL : .....

4,961

61.631 4,285

7.724

44,369 | 1,425

119,434

Inter-

mediate

APPENDIX 5

In-patients treated in Government and Government Assisted Hospitals, 1954.

Classified according to International Standard Classification Intermediate List of 150 Causes.

Detailed

List

Cause Groups

List

| Number.

Number

Deaths 1954

Whole Colony

Cases

Treated 1954

Deaths 1954

Govern.

mtot

Govern-

ment

Awisted

Govern.

Pent

Hospitals

Govern-

ment

Assisted

Hospitals

! Female Male

Sex Un

| known

Total

A 1

001-008

A 2

010

008 ¡Tuberculosis of respiratory system 1,388 Tuberculosis of meninges and

3,196

1,296 1,328

724

2,052

central nervous system.

153

648

449

308

271

579

A 3

011

¡Tuberculosis of intestines, peri-

toneum and mesenterie glands.

421

012-013

Tuberculosis of bones and joints...

151

105

A 5

014019

Tuberculosis, all other forms

102

108

A 6

020

Congenital syphilis.

N J

165

A 7

021

Early Syphilis..

Art

56 1

A 8

024

Tabes dorsalis.

A 9

025

General paralysis of insane

110

A 10

022, 023

'All other syphilis

147

NKA

30.

026 - 029

A 11

030 - 035

A 12

040

Typhoid fever.....

A 13

041 - 042

Gonococcal infections.

Paratyphoid fever and other

130

581

277

51 32

1 Salmonella infections

-------------

A 14

043

Cholera.

++HL

A 15

044

Brucellosis (undulant fever).

A 16 (0)

045

Bacillary dysentery

268

(b)

046

Amoebiasis

117

Other unspecified forms of

dysentery

A 17

050

Scarlet fever

Carried forcard.

3,358

4,559

206 1,912

1,934. 1,172

3,106

APPENDIX 5-Continued

Inter-

Detailed

Cases

Treated 1954

Deaths 1954

mediate

List

Number

List

Number

Cause Groups

Govern-

went

Hospitals

Govern-

ment

Assisted

Hospitals

Govern.

Govern-

Deaths 1954

Whole Colony

FEAT

Hospitals

ment

Assisted

Hospitals

Molo Female

Sex Uo-

known

Total

- -

Brought forward.

-H+-

יזיזיז

3,358 4,559

206

1,912

1,934; 1,172

3,106

A 18

051

Streptococcal sore throat........

A 19

052

Erysipelas

A 20

053

'Septicaemia and pyaemia.

A 21

055

Diphtheria

++LLJ

1,050

48 68

116

A 22

056

Whooping cough

A 23

057

Meningococcal infections

A 24

058

!Plague

------ ---

A 25

060

Leprosy

A 26

061

Tetanus

A 27

062

Anthrax

A 28

080

Acute poliomyelitis

➖ ➖ ➖ ➖ J

A 29

082

A 30

Acute infectious encephalitis

081, 083 Late effects of acute poliomyelitis

and acute infectious encephalitis

--- LI

]

[ས།མཚ༷།ཕས་

A 31

084

Smallpox

1 |

A 32

085

Measles....

285

A 33

091

Yellow fever

A 34

092

Infectious hepatitis

126

A 35

094

Rabies

A 35 (0)

100

Louse borne epidemic typhus

(b)

101

(0);

104

(d);

105

(e)

102, 103

A 37 (u)

110

106 - 108

Flea-borne epidemic typbus

(murine)

Tick-borne epidemic typhus. Mite-borne typhus

Other and unspecified typhus

Vivax malaria (henign tertian)

Carried forward...........

---

5,010

4,667 43B

1,927

2,107 1,340

3,447

Inter-

mediate

List

Number

APPENDIX 5-Continued

Cases

Treated 1954

Deaths 1954

Detailed

List

Number

Cause Groups

Govern-

Dent

Hospitals

ment

Assisted

Hospital

Govern-

mcat

Hospitale

Govern

Bent

Assisted

Hospitals

Deaths 1954

Whole Colony

Male Feniale

Sex Un-

known

Total

A 37 (b)

111

(c)

112

Brought foricard..

Malariae malaria (quartan)

Falciparum malaria (Malignant

5,010 4,667

438 1,927

2,107 1,340

3,447

| tertian)...

(d) 115

Blackwater fever

JILL JL.

A 38 (0)

(e) 113, 114 116, 117

123.0

Other and unspecified forms of

malaria........

156

Schistosomiasis vesical (S. haema-

tobium)

(b), 123.1

Schistosomiasis intestinal (5.

Mansoni)

(c), 123.2

(d), 123.3

Schistosomiasis pulmonary (S. Japonicum)

Other and unspecified schis- tosomiasis

Hydatid disease

A 39

125

A 40 (0)

127

Onchocerciasis.

ז..

(b)

127

Lojasis

(0)

127

Filariasis (bancrofti)

(d)

127

Other filariasis

A 41

129

Ankylostomiasis

...

A 42 (0).

126

(b)

130.0

(d) 124, 128

Tapeworm (infestation) and other

cestode infestations

Ascariasia.......................

Guinea Worm (dracunculosis)

Other diseases due to helminths....

138

A 43 (0)|

'130.1, 130.2

037

Lymphogranuloma venereum

------

Carried forward.

5,218

5,230

439

1,932

2,115 1,348

3,463

Inter-

mediate

List

Number

Detailed

APPENDIX 5-Continued

Canes

Treated 1954

Deathe 1954

List

Number

Cause Groups

Govern

Govern-

ment

Govern-

Hospitals

A 43 (b)

038

(c)

039

(4)

049

intoxication

071

072

Brought forward..

Granuloma inguinale, venereal..... Other and unspecified venereal diseases

Food poisoning infection and

Relapsing fever

Leptospirosis icterohaemorrhagica

(Weil's disease)

Asiated

Hospitals

5,218 5,230

Hospitals

Govern-

ment

Assisted

Hospitali 439 1,932 2,115, 1,348

Deaths 1954

Whole Colony

Sex Uo

Male Female

Total

known

3,463

| |

---- ➖ ➖ ➖ ➖

IL -

الرحام

073

Yaws

ILJ

(h) 087

Chickenpox

(i) 090

Dengue....

- г гт г

(j) 095

Trachoma

г.

(k): 096.7

Sanddy fever

(1) 120

{m}

121 (a)

(b)

Leishmaniasis

Trypanosomiasis gambiensis. Trypanosomiasis rhodesiensis

(c)

Other and unspecified

trypanosomiasis

(n)

131

Dermatophytosis

074,086,088,1

089,093,

(0) 135

Scabies

(p) 036,054,059, All other diseases classified as

063,064,070, infective and parasitic

-----

112

096.1,096.6.

096.8,096.9.

122,132-134,

136-138

Carried forward.

5,413 5,245

440

1,933 2,117 1,348

3,465

APPENDIX 5-Continued

Inter-

mediate

List

Number

Cases

Treated 1954

Deaths 1954

Detailed

List

Number

Cause Groups

Govern.

! m+cot

'Hospitale

Govern-

ment

Assisted

Hospitals

Govern-

ment

Hospitals

Govern

Jucat

Assisted

Hospitals

Deaths 1954

Whole Colony

Male Female

Sex Vo-

kuown

Total

A 44

A 45

A 46

A 47

150

151

Brought forward.

140 - 148 'Malignant neoplasm of buccal cavity and pharynx

Malignant neoplasm of aesophagus Malignant neoplasm of stomach

152.153 Malignant neoplasm of intestine,

except rectum

...

5,413 5,245

440 1,933

2,117 1,348

3,465

200

92 47

139

204

79,

145

A 48

154

Malignant neoplasm of rectum

26;

A 49

A 50

161

Malignant neoplasm of larynx

162,163

Malignant neoplasm of trachea,

and of bronchus and lung not specified as secondary

A 51

A 52

A 53

170

171

uteri

172 174 Malignant neoplasm of other and

Malignant neoplasm of breast

117

Malignant neoplasm of cervix

184

223

unspecified parts of uterus ......

A 54

177

Malignant neoplasm of prostate

A 55

A 56

190 191

Malignant neoplasm of skin...

---

196, 197

Malignant neoplasm of bone and connective tissue

A 57

155 160

Malignant neoplasm of all other

164, 165,

and unspecified sites

185

219

138

186 105

291

175, 176,

178 - 181,

192. 195

A 58

198 199

204

Leukaemia and aleukaemin

---ILLIL

Carried forward..

6,284

6,523

561

2,409

2,636, 1,852

| 4,488

APPENDIX 5-Continued

Inter-

mediate

List

Number

Detailed

Cases

Deaths 1954

Treated 1954

List

Number

Cause Groups

Govero-

Govern-

meat

Hospitals

meat

Assisted

Hospitals

Govern-

menl

Hospitals

Govern-

ment

Assisted

Hospitals

Deaths 1954

Whole Colony

Male Female

Sex UD-

known

Total

Brought forward...

6,284 6,523

581

2,409 2,636 1,852

4,488

A 59

200 - 203

205

Lymphosarcoma and other

neoplasms of lymphatic and

haematopoietic system

A 60

- 210 239

Benign neoplasms and neoplasms

of unspecified nature.

675

276

A 61

250, 251

Nontoxic goiter

A 62

252

Tyrotoxicosis with or without goiter

173

A 63

260

Diabetes mellitus

A 64 (a)

280

Beriberi

140

(b)

281

Pellagra

282

Scurvy

ន៍ដដទ | |

LILLI

(d) 283 - 286 Other deficiency states

A 65 (a)

290

291

Pernicious and other hyperchromic F auaemias

Iron deficiency anaemias

(*); 292. 293 Other specified and unspecified

265

(hypochromic)

anaemias

A 66 (0)

241

(b)

240

Aathina

223

+++ ...

330

All other allergic disorders,

242 - 245

253, 254

270-277

287 - 289

294. 299

endocrine, metabolic and blood diseases.

236

12 16

Carried forward..

7,737

7,924

614

2,509 2,780 1.955

4,735

APPENDIX 5-Continued

Inter-

mediate

List

Number

Cases

Treated 1954

Deaths 1954

Detailed

List

Number

Cause Groups

Govern.

mtnt

Hospitals

Govern-

ment

Ansisted

Hospitals

Govero-

Govern-

Deaths 1954

Whole Colony

10300

Hospital

ment

Assisted

Hospitals

Male Female

Sex UG-

known

Total

Brought forward....

7,737 7,924

614

2,509

2.780 1,955

A 67

A 68

300 - 309

Psychoses.

926

17.

4,735

310 - 324

Psychoneuroses and disorders of

326

personality

237

A 69

325

Mental deficiency

A 70

330 - 334

Vascular lesions affecting central

nervous system

161

471

120

295

338

234

572

A 71

340

A 72

345

Nonmeningococcal meningitis Multiple sclerosis

A 73

353

Epilepsy

ILI - ➖➖ ➖ ➖

--- - - - - - -

A 74

370 - 379

Inflammatory diseases of eye

A 75

385

Cataract

146

113

A 76

387

Glanroma.

יי

A 77 (a)

390

Otitis externa

т-г гт - от

(b)

391 - 393

Otitis media and mastoiditis

(c)

394

A 78 (4)

380 384

Other inflammatory diseases of ear All other disease and Conditions

386, 388.

389

of eye

Carried forward..... 9,505

8,723

765 2,819 3,139 2,210

5.349

* Among these.

I died of Al-Tuberculosis of respiratory system.

3 died of A64(a)-Beriberi.

I died of A65(b)-Iron deficiency anaemias (hypochromic).

3 died of A70-Vascular lesions affecting central nervous system.

† died of Al6(e)-Other unspecified forms of dysentery.

3 died of A78(6)-All other diseases of the nervous system & sense orgāns.

1 died of A81-Arteriosclerotic & egenerative heart disease.

1 died of A82-Other diseases of beart.

1 died of A91-Primary atypical, other & unspecified pneumonia.

I died of A104(c)-Chronic enteritis and ulcerative colitis.

1 died of A109-Chronic, other and unspecified nephritis.

1 died of ANI50-All other and unspecified effects of external causes

Among thest. I died of A70-Vascular lesions affecting central nervous system.

Inter-

mediate

List

Number

APPENDIX 5-Continued

Cases

Treated 1954

Deaths 1954

Detailed

List

Number

Cause Groups

Gavera-

Govern

Govern.

Deaths 1954

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

Assisted

Hospitals

Male Female

Sex Un-

known

Total

Brought forward...

9,605 8,723

765

2,819

3,139, 2,210

5,349

(b) 341 - 344 'All other diseases of the nervous

system and sense organs

145

102

311

350 - 352

354 - 357

360 - 369

395 - 398

A 79

400 - 402

Rheumatic fever.

A 80

410 416

Chronic rheumatic heart disease.

LIPH

161

492

179

153

162

315

A 81

420-422

Arteriosclerotic and egenerative

heart disease

----

431

131

319

254

573

A 82

430 - 434

Other diseases of heart...

114

449

106

A 83

440 - 443

Hypertension with heart diseases..

133

206

A 84

444 - 447

Hypertension without mention

of heart

450 - 456

Diseases of arteries

18 2*

95 63

158

114

460 - 468

Other diseases of circulatory

system

224

553

A 87

470 - 475

(Acute upper respiratory infections

465

306

A 88

480-483

Influenza

241

A 89

490

Lobar Poeumonia

121

757

141

351 172

523

A 90

491

Bronchopneumonia.

386

3,832

175

1,804

1,637, 1,630

3,267

A 91

492, 493

Primary atypical, other and

unspecified pneumonia

495

10'

A 92

500

Acute bronchitis.

199

192

132

118

250

A 93

501, 502

A 94

510

Bronchitis, chronic and unqualified Hypertrophy of tonsils and

433

139

A 95

adenoids

518, 521 Empyema and abscese of lung

-------T--------------+ +

331

---

Carried forward.

12,265

17,425

1,095

5.222

6,153 4,877

11,030

APPENDIX 5-Continued

Inter-

mediate

Detailed

Cases

Treated 1954

Deaths 1954

List

Number

Cause Groups

Govern-

Govero-

ment

Govern.

Number

meat

Hospitals Hospitals

Gent Assisted Hospitals

Covera

ment

Assisted

Hospitals

Deaths 1954

Whole Colony

Male Female

Sex Uq

known

Tota!

Brought forward...

12,265

17,425

1,095 5,222

6,153 4,877

11.030

A 96

519

Pleurisy

119

A 97 (a)

523

Pneumoconiosis

(5)

511-517

All other respiratory diseases

326

157

102

520 - 522

524 - 527

A 98 (a)

(b)

530

Dental Caries

531 535

All other diseases of teeth and

supporting structures.

124

A 99

A 100

A 101

540

Ulcer of Stomach

219

568

119

541

Ulcer of duodenum ...

JILLI

353

543

Gastritis and duodenitis

398

A 102

550 - 553

Appendicitis

674

---------

388

A 103

560, 561. Intestinal obstruction and hernia.

463

210

570

A 104(a)

571.0

Gastro-enteritis and colitis.

between 4 weeks and 2 years...

347

920

1,215

1,092 1,131

2,223

(b)

571,1

Gastro-enteritis and colitis, ages

2 years and over

250

2,545

411

243

187

430

(c)

572

Chronic enteritis and ulcerative

colitis

118

A 105

581

Cirrhosis of liver

121

267

105

154

207

A 106

A 107

584 - 585 Cholelithiasis and cholecystitis. 536 - 539 Other diseases of digestive system 542, 544

150

25 11

584

677

147

545

| 573 - 580

582 - 583

586, 587

Carried forward.

15,909

23,977 1,357

7,154

8,061 6,456

,14,517

APPENDIX 5-Continued

Inter-

mediate

Detailed

Cases

Treated 1954

Deaths 1954

List

Number

List

Number

Cause Groups

Govern-

Gavern-

ment

Govern-

meat

Deaths 1954

Whole Colony

DEAL Assisted Hospitals Hospitals

ment

Hospitals

Assisted

El-ospitals

Mule Female

Sex Un-

known

Total

Brought forward.

15,989

23,977 1,357

7,154

8,061 6,456

14.517

A 108

590

A 109

Acute nephritis

591 - 594 Chronic, other and unspecified

118

!nephritis

115

637

22 !

130

173

143

316

A 110

600

Infections of kidney

A 111

602, 604

'Calculi of urinary system.

172

A 112

A 113

610

620, 621

Hyperplasia of prostate

NIN

A 114

(0)

(b)

613

634

(c)

601, 603

All other diseases of the

| 605 - 609

Diseases of breast

Hydrocele

Disorders of menstruation

genito-urinary system

123

780

1,232

2 5

611, 612 |

614-617 |

622 - 633

635 - 637

A 115

| 640-641, Sepsis of pregnancy, child-birth 681, 682, and the puerperium

ليا

ร

684

A 116

642, 652 Toxaemias of pregnancy and the

685, 686

puerperium

514

156

A 117

643, 644

Haemorrhage of pregnancy and

670 - 672

childbirth..

294

242

A 118

650

Abortion without mention of

sepsis of toxaemia ....

402

1,615

A 119

651

Abortion with sepsis

Carried forward.

FILLILIL

18,579 28,271

1,405

7,351 8,282 6.703

14,985

APPENDIX

Inter-

mediate

List

Detailed

5-Continued

Cases

Treated 1954

Deaths 1954

List

Cause Groups

Govern-

Govern.

Number Number

Govern-

ment

Govern-

ment

Deaths 1954

Whole Colony

ment Assisted

Hospitala

Hospitals

meat

Assisted

Hospital

Male Female

Sex Uo.

known

Total

Brought forward.

A 120(a) 645-649 Other complications of pregnancy,

673 - 680

683

18,579 28,271

1,405 7,351

8.282 6,703

14.985

childbirth and the puerperium

---

3,433 2,007

- L

| 687-689

(5) 660

Delivery without complication

11,372 24,206

A 121

690 698

Infections of skin and

subcutaneous tissue

412

508

A 122

A 123

720 - 725

On m

726, 727

Arthritis and spondylitis Muscular rheumatism and

248

rheumatism, unspecified

A 124

730

Osteomyelitis and periostitis

A 125

737

Ankylosis and acquired

745 - 749

musculoskeletal deformities

A 126(a).

715

Chronic ulcer of skin (including

tropical ulcer).

202

(b)

700 - 714

716

All other diseases of skin....

323

228

| 55

(c), 731-736

All other diseases of

738-744

musculoskeletal system

128

A 127

A 128

751

Spina bifida and meningocele Congenital malformations of circulatory system

17.

A 129

750, 752 All other congenital malformations

152

753

755 - 759

A 130

A 131

760, 761

162

Birth injuries

16.

Postnatal asphyxia and atelectasis

174

70:

162

Carried forward...

34,844 56,070

1,486

7,481

8,443 6,864

15,307

APPENDIX

Inter-

mediate

List

Number

5-Continued

Cases

Treated 1954

Deaths 1954

Detailed

List

Number

Cause Groupe

! Govern.

ment

Hospitals

Gavern.

ment

Assisted

Hospitals

Govern-

Covern-

140

Deaths 1954

Whole Colony

10000

Hospitals

Anointed

Hospitals

Male Female

Sex Un-

known

Total

Brought forward.

34,844

56,070 1,486

7,481

8,4.3 6,864

15,307

A 132(a)

764

Diarrhoea of newborn

(under 4 weeks)

196:

160

103 85

188

(b). 765

Ophthamia neonatorum.

...

A 133

770

A 134

(e) 763,766-768 Other infections of newborn

769,771,772 AB other defined diseases of early

247

159

108

267

Haemolytic disease of newborn

I LI

infancy

199

101

188

-----------------

A 135 773-776

Ill-defined diseases peculiar to

early infancy

468

565

121

493

502

419

921

A 136

794

Senility without mention of

Psychosis

295

142

105

191

296

A 137(a)

788.8

Pyrexia of unknown origin

301

رقام

793

Observation, without need for

further medical care

238

835

(+) 780 - 787

All other ill-defined causes of

788.1-788.7

morbidity.

239

144

597 556

1,159

788.9

789 - 792

795

Total.

36,139 58,821 1,702

8,504 10,035 8,345

6 18,386

APPENDIX 5-Continued

Inter-

mediate

Detailed

Cases

Treated 1954

Deaths 1954

List

Number

List

Number

Cause Groups

: Govern

Meat

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

meat

Hospitals

Govern-

ment

Assisted

Hospitala

Deaths 1954

Whole Colony

Mule Female

Sex Un-

known

Total

Brought forward.

36,139

58,821

1,702

8,504 10,035 8,345

6 18,386

AE 138

AE 139

E810 - E835 Motor Vehicle Accidents E800 - E802 Other transport accidents. E840 - E866

869

67 36

103

256

| |

AE 140

E870 - E895 Accidental poisoning

144

AE 141 E900 - E904 Accidental falls

ILL LILLIL

938

AE 142 E912

1 છે ન

115

ન્ય

AE 143 E916

Accident caused by fire and

123

Accident caused by Machinery

explosion of combustible material

AE 144 E917, E918 Accident caused by hot substance,:

AE 145 E919

AE 146 E929

AE 147

(a)!E920

(6)|E923

corrosive liquid, steam and

radiation

Accident Caused by firearms Accidental drowning and

submersion

Foreign body entering eye and adnexa

Foreign body entering other

orifice

гг.

Accidents caused by bites and stings of venomous animals and insects

174

78.

117

121

Carried forward.

38,925

58,911 1,092

8,506 10,344 8,515

6 18,865

APPENDIX 5 Continued

Inter

mediate

List

Number

Detailed

Cases

Treated 1954

Deaths 1954

Liet

Number

Cause Groups

Cavern.

mocat

Hospitals

Govern.

Deat

Assisted

Hospitals

Gover-

Govern-

ment

Deaths 1954

Whole Colony

Hospitals

Ment

Assisted

Hospitals

Male

Female

Sex Un.

knowa

Total

}

Brought forward.

38,925

58,911: 1,892

8,506 10,344 8,515

6 18,865

(d) E928

Other accidents caused by animals

(e) E910, E911, All other accidental causes

433

59 14

E913-E915,

E921-E922.

E924- E926,|

·E930 - E965|

AE 148 E970 E979|Suicide and self-inflicted injury AE 149

378

183

119

302

E980 E985 Homicide and injury purposely

AE 150 E990 - E999¡Injury resulting from operations

inflicted by other persons

(not in war)

280

4.3

of war

GRAND TOTAL

40,025

58,961 1,996 8,506 10,617 8,660

6 19,283

APPENDIX

Inter-

mediate

List

Number

5-Continued

Cases

Treated 1954

Detailed

List

Number

Cause Groups

Gover-

ment

Iospitals

Govern

went

Assisted

Hospitals

Deaths 1954

Govern-

Deaths 1954

Govern

Whole Colony

mcot

Hospituls

cornt

Assisted

Hospitals

Mule Female

Sex Un-

known

Total

AN 138 N800 N804 Fracture of skull

373

AN 139

AN 140

AN 141

AN 142

N805 N809 Fracture of spine and trunk N810 N829 Fracture of limbs

217

---

746

--------

N830-N839 Dislocation without fracture N840 - N848 Sprains and strains of joints and adjacent muscle

155

AN 143

AN 144

N850 - N856 Head injury (excluding fracture). N860 N869 Internal injury of ebest, abdomen and pelvis

666

128

119

AN 145

AN 146 AN 147 N930 N936 Effects of foreign body entering

N870- N908 Laceration and open wounds N910 - N929 Superficial injury, contusion and crushing with intact skin surface

472

198

through orifice

AN 148

N940

N949 Burns

319

AN 149

N960 - N979 Effects of poisons

454

JILL

AN 150

N950 - N959 All other and unspecified effects

N980 - N999 of external causes

192

117

309

TOTAL...

3,886

140

294

582 315

897

APPENDIX 6

Attendances at Public Dispensaries 1954

Out-Patients

Deliveries

Public

Children

Adults

¡Vaccina- Inocula-

Dispensaries

New

Cases

Total Atten- dances

New Cases

Atten- dances

Total In-pat- Dom- tione tions

ients iciliary

Central

Eastern

22,463 35.667 10,257 21,575

4,294. 8.268

16,591 20,636. 10,877

20,125

12,417

1,595

Shaukiwan

32,660 40,522 15.345

27.682

5831

6.180

4.733

Aberdeen

10,340 11.915 5,743 9,321

485:

2,770

2,549

Shamshuipo...

41,747 102,862

559

13.491

Yaumati Hung Hom

11,731 16,915

9,111 21,498

257

7.218

7.266

16,180 17.234

---------

Stanley

1,947

Li Kee Memorial...

$1,299

Mongkok

36.959

10,203 2,389 2,699 45.723 21.124 32,154 43.351 24.264 33,929

12,656

3.688

4,573

6,217

283

1.497

1,154

1,156

15,066

19,308

Total 190,170 234,352 151,370 288,019

283 3,046

666,21

49.446

APPENDIX 7

Out-patients - 1954

Total Attendances at Government and Government Assisted Hospitals, Clinies and Dispensaries.

General Chil.

Kowloon...........

INSTITUTIONS

Hospitals:

Queen Mary

Tean Yuk

St. John....

Stapley Prison

Dres-

sings

Out-

patients

druc'

Auto- Port- Gynaeco Social

Clinics

Natal Natal

logical Bygiene

Eye

Ear,

Nose &

Throat

Tuber-

culosis

Mental

Total

7,873

11,013.

3,036

306

4,751

255,921

198,830 3,534

15,954

227

2.796

217

16,651

284

202

£7,749

5,590

499,403

15,425

18.719

24,329

875

53.348

Lô 765

19,631, 16,009

344

167

2.108

49,034

0,485

24,987

3,310

1,723

39,505

L. C. K. Female Prison......

5,701

Mental

| |

5,701

1,656

Clinica and Dispensaries

Sai Ying Pun

43,303

109,565 78,099

4,506

111

4,314,

(a) 2,836

(6) 9,647-

1,961

25-1,542

Violet Peel...

109,839'

93,410, 73,692

7,855

*1.382

2,453

387,249

* 1, 182

Wanchai Chest Clinic.

Kowloon Chest Clinie.

115,758

102,666

115,758

102,666

Social Hygiene

223,031

10 Public Dispensaries..

81,597

167,082 234,352

10,616

7,758

129

480

351

522,371

14 New Territories Dispa...

63,669

137,380 2,531

8,600

5,453

6,918

666

4,947

230, 164

Familie. Clinic

7.7971

7.797

Police Medical Post.......rr

3,068

8,000 10,531

289

183

596

959

23,743

Kow. Police Med. Post

1,373

8,053 18,906

327

934

1,472

1,468

238

32,859

Victoria Remand Prisoù..

1,307

23,459

601

470

714

248

26.847

Port Health

1,573

K. C. R. Clinic

160

1,196

939

2,295

Health Centres :

Western

LIILI

LIL

2,081

401

2,182

Kowloon....

3,560

449

4,018

Harcourt

---------

456

2,850

Total of Government

Institutiona

---------------

602,785

30,468

837,737, 451,312

75,954 2,833 167,138 90,336 14,238

2,432

26.943 6,528 7.914

49.738.

GRAND TOTAL......

Tung Web Group of Hospe. Alice Ho Miu Ling

Nethersole Hospital.. Buttonjee Sanatorium.. Pok Of Hospital......

635,685 1,080,556) 548,176 100.409 5,950 35,600 232,545 82,818 14,603 247,434 (6) Patients seen in Hongkong University Eye Clinics. Government Servants & dependants seen by Government Ophthalmologist.

91,103 332,545 50,081 4,130 32,737

14,600

227,206.

14,710

1,656 2,517,815

35.3,757

2,303

1,095) 10,367

2,022,

55,279

5,518.

5.518

53,063

1,656' 2,985,432

Tano Yuk

St. John.

Stanley Prison

Mental

L. C. K. Female Prison.....'

Clinics and Dispensaries t

Sai Ying Pun

Violet Peel.

Wanchai Chest Clinic

Kowloon Chest Clinic.

JILLI

-------J➖➖➖LIJ

APPENDIX 8 Out-patients-1954

New Cases at Government and Government Assisted Hospitals, Clinics and Dispensaries.

INSTITUTIONS

Hospitals:

Queen Mary Kowloon...

וזו--

General Chu-

Ear,

Dres-

sings

drea**

Out- Patients Clinics

Ante- Post- Natal Natul

Gynaeco Social logical Hygiene

Eye

Nose &

Throat

Tuber-

culori

· Mental

Total

7,873

255,921

4,810, 4,483) 12,060,

9,683

427

166,600

3,534

2,973

227

262

1,316

217

284

202

16.948

8,611

3,139

441,321

4,820

7.456

430

17,516

12,044

193

1,200

30,078

3,709,

14,374

5,701:

| | |│

1,038

#22

19,943

468

5,701

468

5,642

73,175 59,788

1,513

110

1,933

(a) 1,5-69.

565

(6) 2,485)

65,533

63,595' 51,785

.025)

780

4532

146,780

185,718

• 422

18,881.

18,881

17,065

Social Hygiene

-----------

36,652

10 Public Dispensaries

35,275 106.434' 190,170

5,500

3,616

109

103

341,540

14 New Territories Dispa...

15,282' 85,560 1.085

3,669

948

3,371

646

790.

IL1,351

Families Clinic

309

308

Police Medical Post.

1,596

6,048

7,383

241

118:

3.99

604

16.458

Kow. Police Med. Post

617

5.937;

13,056

295

394

5:04

142

137

21,717

Victoria Remand Prison...

5G1

6,328

225

196

317

1:1

7,738

Port Health

----------

1,231

K. C. R. Clinic

129.

1,078

2,106

Health Centres:

699

Western

Kowloon...............................................................

Harcourt

Total of Government

Institutions

Tung Wab Group of Hoops.

307

342

649

576

166

742

560

331

891

--------➖➖➖➖ ➖➖➖

401,431

12.175.

Alice Ho Miu Ling

Nethersole Hospital

--- ri

Po Oi Hospital.

GRAND TOTAL...... 413,606-678,629. 385,679 39,933 (4) Patients seen in Government Eye Clinico.

• Government Servants and dependants seen by Government Ophthalmologist.

55,812 344,564 23,710 82.104. 39,720 12,821 6.219 1.395 2,394 1,095 32,194 1,008

1,613

7.729- 38,931 23,116 6,480 .548 13,012

38,070

2,603

468

1,444,224

164,983

5,012,

16,115

718

33,920

3,426

15,289

38,931

36,128 6.480 40,673

468

1,659,242

(5) Patients seen in Hongkong University Eye Clinics.

APPENDIX 9

Attendances at Medical Centres - New Territories

Out-patients

1954

Deliveries

Dispensaries

New Cases

Total Attendances

In-patients

Domiciliary

Tai Po

Ho Tung Shataukok.

Un Long San Hui

Sai Kung Shatin Tai 0

Silver Mine Bay Ping Chau

28.205

49,445

938

1.370

3,547

482

3,001

6,052

203

20.156

40.329

1,099

2,448

5,582

378

5,643

10,168

202

3,300

7,362

230

12,646

45.203

361

2.158

5,896

2,766

3,950

Travelling (East).

9,182

12,609

Travelling (West)

Maurine Grantham H. C. Tai Lan Chung

3.774

9,175

་

14,230

25,004

659

2,472

5,762

Total.........

111,351

230,164

4,613

249

APPENDIX 10

A Summary of the work done at the Hong Kong and Kowloon Public Mortuaries, 1954

Total No. of Post-mortem Examinations performed during the year

4,147

No. of male bodies examined

2,444

No. of female bodies examined

1.696

Sex unknown owing to decomposition

No. of claimed bodies sent from hospital, etc.

No. of unclaimed bodies, mostly abandoned

No. of bodies cremated

No. of Chinese bodies examined

No. of Non-Chinese bodies examined

No. of Medico-Legal Cases

1,182

2,965

683

4,133

579

Male Female Total

No. of bodies under 2 years of age

1,055

956 2,011

No. of bodies over 2 years of age

1,389

740 2,129

No. of bodies received from the following sources:

{Hong Kong)

Victoria District

Shaukiwan District

----

г. ++

Infant Hospitals

Other Hospitals

Marine Police

473

133

164

836

(Kowloon and New Territories)

Police

Station

Water

T. Land

103

гот. - 1 гти

447

זי

373

...

г.тг.

Yaumati

Mongkok

Shamshuipo

Kowloon City

Hung Hom

Tsun Wan

Castle Peak

Pingshan

Lok Ma Chau

Pat Heung

Sheungshui

Takuling

Shataukok

Tai Po

Shatin

Sai Kung

Tai O

Cheung Chau,,

H. O. (K)

Li Kee Memorial Disp.

Hospitals, etc.

ITITII

-1

- L

1,943

3,311

No. of rats caught and brought to mortuaries

г.

238,484

No. of rats examined

238,484

No. of rats' spleen smears taken for examination

No. of rats infected with plague

16,463

Nil.