醫務衛生署年報 Medical and Health Department Annual Report 1960-1961

QB B 40·

22501293436

HONG KONG

ANNUAL DEPARTMENTAL REPORT

BY THE

DIRECTOR OF MEDICAL

AND HEALTH SERVICES

FOR THE

FINANCIAL YEAR 1960-61

PRINTED AND PUBLISHED BY W, F. C. Jenner, Government PRINTER

AT THE GOVERNMENT PRESS, Java Road, Hong Kong

EXCHANGE RATES

When dollars are quoted in this Report, they are, unless otherwise stated, Hong Kong dollars. The official rate for conversion to pound sterling is HK$16=£1 (HK$1=1s. 3d.). The official rate for conversion to U.S. dollars is HK$5.714=US$1 (based on £1-US$2.80).

WELLCOME

ITE

Coll.

Cail

No.

CONTENTS

I. GENERAL REVIEW

Administration of the Medical & Health Services

Staff

Finance

Legislation

Professional Registers

Work of the Statutory Councils and Boards

II.

PUBLIC HEAlth

General Comments

Vital Statistics

III.

WORK OF THE HEALTH DIVISION

Hygiene and Sanitation

Urban Areas

Rural Areas

Epidemiology

Tuberculosis

Malaria Bureau

Social Hygiene Service

Port Health

District Midwifery Services

Maternal and Child Health

School Health

Industrial Health

Health Education

!!!

Paragraphs

1 - 20

22 - 30

31 - 34

36 - 37

38 - 55

57 - 61

63 - 65

66 - 69

70 - 91

92 - 138

139 - 151

152 165

166 - 171

172 176

177 - 183

184 186

187 - 190

191 193

IV.

THE WORK Oof the MediCAL DIVISION

Hospitals

Government Hospitals

Government-Assisted Hospitals

Out-patient Services

Specialist Services

Radiology

Dental Service

Ophthalmology

Paragraphs

194

195 196

197 - 227

ᅥ

228 - 239

240 - 245

246

247 - 252

253 - 258

259 - 260

Forensic Pathology

Government Chemist's Laboratory

Government Institute of Pathology

261 - 263

264 - 270

271 - 279

The Pharmaceutical Service

280 - 282

The Almoner Service

283 - 290

Physiotherapy

291 - 294

Orthopaedic and Prosthetic Appliances

295 - 296

Occupational Therapy

297 - 302

Medical Examination Board

303 - 306

Blood Banks

307 - 308

Hospital Maintenance and Supply

309 - 315

316 - 320

Auxiliary Medical Service.

TRAINING PROGRAMME

Doctors

Dentistry

Nurses

Midwives

Health Visitors

Radiographers

321 - 323

324 - 325

326 - 329

330 - 331

332

333

V. TRAINING PROGRAMME Contd.

VI.

VII.

Laboratory Technicians

Physiotherapy

Other Forms of Departmental Training Courses of Study

PLANNING UNIT AND BUILDING PROGRAMME

Planning Unit

Building Programme

MISCELLANEOUS

Conferences and Meetings

Visitors

Publications

Obituary

ACKNOWLEDGMENT

Paragraphs

334

335

336 337

338 - 340

341

342 - 346

347

348

349

350

351

352 - 353

VIII.

ACCOUNTS

Samaritan Fund

Nurses Rewards and Fines Fund

IX.

MAPS

X. APPENDICES

Digitized by the Internet Archive in 2019 with funding from Wellcome Library

https://archive.org/details/b31406087

I. GENERAL REVIEW

　On March 7th, 1961, the first census for thirty years was held in Hong Kong. It revealed a total population of 3,128,044, a figure which corresponds closely with the estimate of 2,981,000 for the mid-year population in 1960. Although a detailed breakdown of census returns is not available at the time of writing, preliminary results show the following distribution of the population:

Hong Kong Island

Kowloon and New Kowloon

New Territories

ILL

JOI

---

1,004,917 1,574,915 409,905

Boat population

IIL

LLL

138,307

　The population is a young one, approximately forty per cent being below the age of fifteen years and only five per cent being over the age of sixty; it is increasing at a rate of at least three per cent per annum.

　　2. The compression of this young and rapidly-expanding population into the 398 square miles of land which comprises Hong Kong, continues to make heavy and increasing demands upon water supplies, housing, communications and social services. In the case of the medical and health services, these demands have been further augmented by an increasing tendency to seek medical treatment by western methods. Although the greatest number of the population still have recourse first to traditional Chinese herbal methods of treatment for minor maladies, in the event of more serious illness they are turning more and more to public clinics and hospitals for aid.

3. The Medical and Health Department provides hospital and clinic facilities throughout both urban and rural areas. It also maintains maternal and child health, school health, port health and specialist services; it has the responsibility for measures to control epidemics and the endemic diseases of major public health importance. All these facilities have been subject to heavy and increasing pressure during the past few years and, although the year 1960-61 saw the first fruits of the planned building programme, there was little alleviation of the strain on most branches of the Department's activities.

　　4. This pressure on hospitals and clinics was particularly heavy, not only on those maintained by Government but also on those controlled

by voluntary and charitable bodies in receipt of financial assistance from Government. The situation can be gauged from Figure I which shows new and total attendances at Government out-patient clinics alone during the past five years.

FIGURE I

OUT-PATIENTS ATTENDANCES AT GOVERNMENT CLINICS

1956-60

6,000,000

New cases

5.000,00-0

Repeat attendance

4,000,000

3,000,000

2,000,000

1,000,000

1956

1957

1958

1959

1960

5. The shortage of low cost or free hospital beds has been the most serious single problem and has been aggravated by a number of factors. One of these, the increasing demand for western medicine, has already been mentioned. In addition, the rapid increase in population has resulted in a greatly augmented incidence of all forms of trauma and hospital admissions from this source have risen by fifty two per cent during the past four years. Moreover, the gradual ageing of a relatively young population has been reflected in the increasing number of patients suffering from malignant neoplasms and from cardiovascular and cerebrovascular disasters.

6. This burden has fallen most heavily upon the general medical and surgical beds of the Colony which are maintained in Government and Government subsidized hospitals especially upon those on the Kowloon peninsula where the most rapid industrial development has taken place during recent years. Although there has been some interim emergency provision of extra wards in existing hospitals and wide- spread use of camp beds in the wards the problem has had, perforce,

to be met mainly by a markedly increased rate of turnover of inpatients. This can be appreciated by a study of Figure 11, which shows the number of beds available in all hospitals and the numbers of patients admitted during the past five years.

4,000

FIGURE II

HOSPITAL BEDS

(Excluding Maternity Homes)

TOTAL HOSPITAL BEDS

GENERAL BĖDS

3,200

2,400

1,600

800

Governmakt

Government-Assisted

Private

90,000

70,000

50,000

30,000

10,000

TOTAL CASES ADMITTED

PILIH -turi+

GENERAL CASES ADMITTED

-----

IIILI----------

닭

7. In spite of these emergency measures, the pressure on general hospital beds is likely to continue, especially on the Kowloon peninsula, until the major projects of the Queen Elizabeth and the new Kwong Wah Hospitals, now under construction, are completed in 1963. On Hong Kong Island, an extension of 180 beds has been planned for the Queen Mary Hospital and building is expected to begin in 1962. Planning is now in progress for other major hospital projects designed to be complementary to the two main acute and specialist hospitals, the Queen Elizabeth and the Queen Mary. Paragraph 347 gives details of the immediate building programme in hand.

8. Despite the problems and anxieties arising from the shortage of general hospital beds, the year 1960-61 was an encouraging one in the field of hospital construction. In March 1961 the Castle Peak Hospital of 1,000 beds for mental patients was opened by His Excellency the Governor. This modern psychiatric hospital replaces the old, unsuit- able and extremely overcrowded Victoria Mental Hospital. It gives, în relation to the over-all needs, a more realistic ratio of beds for the increasing incidence of mental disease which can be expected in a rapidly-expanding industrial centre such as Hong Kong is to-day. The opening of this hospital has coincided with the introduction of the Mental Health Ordinance, 1960, which incorporates the liberal concepts of present-day management of psychiatric cases and their treatment.

9. Other major hospital developments were also completed. The construction of a new permanent wing, incorporating two surgical wards, a suite of four operating theatres and a new kitchen were completed at Kowloon Hospital. These additions will facilitate the conversion of this institution to a centre for the rehabilitation of trauma and orthopaedic cases and for tuberculosis cases in Kowloon when its present function as the main acute hospital for the mainland part of the Colony is assumed in 1963 by the Queen Elizabeth Hospital. The School of Nursing and the Sisters and Nurses Quarters for the Queen Elizabeth Hospital were opened in September, 1960 by His Excellency the Governor. By the end of the year the foundations of the Hospital itself had been completed and work on the superstructure will begin in June 1961.

10. Amongst the Government subsidized hospitals phase two of the rebuilding of the Kwong Wah Hospital in Kowloon was opened in March 1960 by the Hon. the Secretary for Chinese Affairs and the construction of phase three was well under way by the end of the year.

In the New Territories an extension to the Pok Oi Hospital at Yuen Long was opened by His Excellency the Governor in February 1961.

11. At South Lantau a small Government cottage hospital designed to serve the Shek Pik Reservoir construction workers and the villagers in that area was opened in June 1960.

12. Forward planning has naturally taken account of out-patient, as well as of in-patient, needs and during the year a number of clinics were completed which fit into a programme designed to provide essential out-patient medical facilities sited in relation to population needs. Once again a grateful tribute is paid to the Royal Hong Kong Jockey Club, whose keen and practical interest in the provision of finance for welfare services in the Colony has resulted in the con- struction, amongst others, of a number of medical projects, three of which were completed during 1960.

13. A full list of projects completed and being planned is given in paragraph 347 of this report.

14. The considerable expansion in hand is only possible if the programme of staff training is geared to meet the demands of the future. In the medical field, the training of clinical specialists for major pro- jects now under construction is proceeding smoothly, but the recruit- ment of medical officers for general duties, especially in more remote areas and for certain other branches of the service, gives cause for concern. The holding of examinations in Hong Kong during the past three years by the Society of Apothecaries in London, with the approval of the General Medical Council of the United Kingdom, has resulted in 126 refugee doctors gaining a qualification registrable with the Medical Council of Hong Kong. The sympathetic and generous assis- tance given by the Society in dealing with this problem is gratefully acknowledged. For future needs the University of Hong Kong, now celebrating its Golden Jubilee, has plans in hand for an expansion of the Faculty of Medicine, which aim at an increasing output of doctors to a maximum of 80 each year by 1968.

15. Government facilities for the training of nurses have been doubled by the opening of the Queen Elizabeth School of Nursing and it is anticipated that the requirements for general nurses and midwives for the next five years can be met. A course of training. leading to the Registered Mental Nurse Certificate of the Hong Kong Nursing Board has been established at the Castle Peak Hospital.

६

　16. The training of other categories of staff is also carried out in the Colony where this is economic and practicable. Courses of depart- mental training are maintained and the curricula aim at preparing students for examinations held by recognized examining bodies in the Commonwealth. For example, during the year arrangements were made to hold the Intermediate Examination for the Institute of Medical Laboratory Technology in Hong Kong during 1961. Examinations are already being held for the Membership of the Society of Radiographers and the Health Visitors Certificate of the Royal Society of Health. Another advance in local training facilities was the inauguration of a Physiotherapy Training School under the direction of a qualified physiotherapy tutor. On the other hand, where the number of qualified personnel required makes it uneconomic to train in Hong Kong, scholarship are given by Government for training overseas. At present such scholarships are available for training in dentistry, and will be available soon for training in pharmacy. More detail is given in the section of this report dealing with the programme of training.

17. Certain other important aspects of the work of the year are worthy of mention in this general review. In the fields of environmental sanitation, food hygiene, food and drugs standards and public ameni- ties, control has been effected for the past 24 years under a series of disconnected Ordinances, the provisions of which have become in- applicable, in many instances, to present day conditions in Hong Kong. The revision and consolidation of these Ordinances has been under- taken by a Select Committee appointed by the Urban Council, with the continuous co-operation of the Medical and Health Department and in consultation with other Government Departments as and when necessary. The result has been the promulgation of the Public Health and Urban Services Ordinance, 1960, which is described in more detail later.

18. The legislation governing the practice of midwifery in Hong Kong has continued unchanged for the past fifty years. To ensure the maintenance of the highest standards in midwifery practice throughout the Colony, the Midwives Ordinance of 1910 was repealed during 1960 and re-enacted with modifications. These modifications include more adequate provisions for the registration of midwives, wider disciplinary powers for the Midwives Board, and improved control of the practice of the profession.

19. The problem of drug addiction in Hong Kong was described in a White Paper published in November 1959. The treatment and rehabi-

litation of drug addicts amongst convicted prisoners had already been placed on a sound basis by the establishment of Her Majesty's Prison at Tai Lam Chung. There remained, however, an unknown number of drug addicts who had not come into conflict with the law and who still retained sufficient strength of character to wish to terminate their craving. It was to assist such persons that the Drug Addicts (Treatment and Rehabilitation) Ordinance, 1960, was enacted, and a voluntary treatment centre of 120 beds has been opened within the Castle Peak Hospital. To this centre addicts are admitted who voluntarily seek treatment and who are willing to surrender their liberty for a period of six months.

20. In March 1961, the first of fourteen dosing plants commenced the fluoridation of Hong Kong's water supply. The fluoride ion con- centration to be maintained during the six winter months is 0.9 parts per million and during the six summer months 0.7 parts per million. This will bring the concentration in the public water supplies up to the optimum for the preservation of dental health and the prevention of caries in the child population.

ADMINISTRATION OF THE MEDICAL AND HEALTH SERVICES

21. Statutory responsibility for the administration of the services safeguarding the public health in Hong Kong lies jointly with the Director of Medical and Health Services, the Urban Council, the Director of Urban Services, the Commissioner of Labour and the District Commissioner, New Territories. Executive functions in con- nexion with curative medical services and a number of aspects of pre- ventive medicine throughout Hong Kong are the responsibility of the Medical and Health Department. The Urban Council is concerned with environmental sanitation in the urban areas of Hong Kong Island and Kowloon, through the Urban Services Department. The Director of Urban Services has executive functions as the Health Authority for certain of the townships in the New Territories and administers their environmental sanitary services. Medical Officers of Health are seconded in an advisory capacity to the Urban Services Department and the Labour Department has an Industrial Health section staffed by per- sonnel of the Medical and Health Department.

STAFF

　　　22. The Director of Medical and Health Services is the Head of the Department, the chief adviser to Government on medical and health

policy, and an official member of the Legislative Council. He is a member of a number of the Boards and Committees of voluntary organizations engaged in medical and health work whose activities. receive substantial support by way of Government subventions. He is also the Chairman of the Radiation Board and of the Statutory Boards dealing with the registration and disciplinary control of Medical Practi- tioners, Dentists, Pharmacists, Nurses and Midwives.

23. The Deputy Director of Medical and Health Services is the chief executive medical and health officer who co-ordinates the work of the Medical and Health Divisions, each of these divisions being in charge of an Assistant Director. The Deputy Director is also Vice- Chairman of the Urban Council and is the principal adviser to that body on health matters. The Principal Matron is the Chief Nursing Officer and administers the Nursing Division which provides nursing, midwifery. health visitor and health sister services.

24. The Health Division, which is the administrative responsibility of the Assistant Director, Health, is concerned with infectious disease control, personal health services, rural hygiene and certain ancillary services. The Medical Division is the responsibility of the Assistant Director, Medical, and is concerned with the provision of curative and specialist clinical services. Each Assistant Director is assisted by a Principal Medical and Health Officer at Headquarters, and each division is divided into units which are individually under the charge of a Specialist or of a Medical and Health Officer with special experience and training. The respective spheres of responsibility of the two Divi- sions are outlined in Appendix 2.

25. The Principal Medical and Health Officer (Planning) assisted by a Senior Hospital Secretary, is responsible for the co-ordination of all requests for accommodation and equipment for new Medical and Health Department institutions, for the processing of building plans and for the detail of the forward planning of expansion of the Department's activities. In addition, advice and assistance are given on request to voluntary and private organizations engaged in the planning and erection of medical institutions.

26. The Auxiliary Medical Service, which is a branch of the Civil Defence Service, is administered by the Medical Defence Staff Officer who is a member of the Medical and Health Department Headquarters staff. The Director of Medical and Health Services is the Unit Controller.

27. The routine administrative secretarial, establishment and clerical work of the Department is under the general direction of the Secretary

while the Principal Accountant and his staff deal with the financial and accounting duties. The work of the Board section is co-ordinated by the Boards Secretary.

28. The pharmaceutical and dispensing activities are the responsi bility of the Chief Pharmacist who also has inspectorial duties in con- nexion with the Dangerous Drugs and Pharmacy and Poisons Ordin- ances. The Government Chemist is responsible for the work of the Government Chemical Laboratory.

29. The Chief Hospital Secretary is responsible for the supply of equipment and the day-to-day lay administration of the hospital and clinic services. The hospitals and clinics are at present grouped into two large units to each of which is posted an Hospital Secretary. Assistant Hospital Secretaries are posted to the larger and more important institu- tions within these groups.

30. Appendix 1 shows the establishment at 31st March, 1961.

FINANCE

31. The actual expenditure of the Medical and Health Department for the financial year ended 31st March, 1961 was $56,573,091 to which should be added a further $21,910,889 disbursed in the form of sub- ventions. Capital expenditure on medical projects under the Public Works Non-Recurrent head totalled $12,369,272. These amounts rep- resent 10.75% of the Colony's total expenditure during the year. This does not include expenditure on environmental sanitation by the Urban Services Department.

32. A Statement of Expenditure for the five years from 1956-57 to 1960-61 is shown at Appendix 3.

　　　33. The total revenue collected from all sources by the Department totalled $3,311,019.

34. The largest subventions was made to the Tung Wah Group of Hospitals which received $11,317,366; in addition, a further capital grant of $4,317,732 was made towards the cost of continuing work on the redevelopment of the Kwong Wah Hospital. Other large subventions were $2,882,750 to the Grantham Hospital, $1,000,000 to the Hong Kong Anti-Tuberculosis Association and $575,000 to the Mission to Lepers, Hong Kong Auxiliary.

LEGISLATION

35. The following legislation dealing with medical and health matters was enacted during the year 1960-61. Mention is made of the purpose of the more important ordinances in the body of this report.

Ordinances:

(i) Medical Registration (Amendment) Ordinance, 1960.

(ii) Quarantine and Prevention of Disease (Amendment) Ordinance,

1960.

(iii) Drug Addicts Treatment and Rehabilitation Ordinance, 1960. (iv) Mental Health Ordinance, 1960.

(v) Medical Registration (Amendment) (No. 2) Ordinance, 1960. (vi) Midwives Registration Ordinance, 1960.

(vii) Radiation (Amendment) Ordinance, 1960,

Rules and Regulations:

(a) Medical Practitioners (Registration and Disciplinary Procedure)

(Amendment) Regulations, 1960, (G.N.A. 34/60).

(b) Poisons List (Amendment) (No. 2) Regulations, 1960, (G.N.A.

42/60).

43/60).

(d) Dangerous Drugs (Amendment of Schedule) Order, 1960,

(G.N.A. 52/60).

(e) Poisons List (Amendment) (No. 3) Regulations, 1960, (G.N.A.

53/60).

(f) Poisons (Amendment) (No. 3) Regulations, 1960, (G.N.A.

54/60).

(g) Drug Addicts Treatment and Rehabilitation Regulations, 1960,

(G.N.A. 93/60).

(h) Poisons List (Amendment) (No. 4) Regulations, 1960, (G.N.A.

118/60).

(i) Poisons (Amendment) (No. 4) Regulations, 1960, (G.N.A.

119/60).

(1) Dangerous Drugs (Amendment) Regulations, 1960, (G.N.A.

136/60).

(k) Nursing and Maternity Homes Registration (Exemption) Order,

1960, (G.N.A. 138/60).

(0) Midwives (Registration and Disciplinary Procedure) Regula-

tions, 1960, (G.N.A. 143/60).

(m) Dangerous Drugs (Amendment) Regulations, 1961 (G.N.A.

12/61),

PROFESSIONAL REGISTERS

36. There are five statutory bodies dealing with the registration of medical practitioners, dentists, pharmacists, nurses and midwives. The Hong Kong Medical Council is responsible for the registration of medical practitioners and has responsibilities in connexion with dis- ciplinary proceedings and offences; it is not an examining body. The Dental Council, Pharmacy Board, Nursing Board and Midwives Board all maintain registers, regulate training, hold examinations leading to registration or enrolment and have disciplinary powers.

　　　37. At the 31st March, 1961, the numbers of persons on the statutory registers were as follows:

---

(Male)

Irr

- 11

952

397

1,789

104

- 1+

1,740

WORK OF THE STATUTORY COUNCILS AND BOARDS

Medical Council

　　　38. The Council met seven times during the year for the transaction of routine business; two notices to medical practitioners were issued for guidance on points of ethics. The Preliminary Investigation Com- mittee met twice to consider complaints of advertising and one of these complaints was referred to the Council for inquiry. The Council met once to hear this complaint and found the defendants 'not guilty'.

Dental Council

39. The Council met five times during the year for the transaction of routine business and once to hold an inquiry into a complaint concerning a conviction for 'covering an unregistered person to practise dentistry* referred by the Preliminary Investigation Committee. At the inquiry the defendant was found 'Guilty' and sentenced to have his name removed from the Register for three months.

40. Twenty two applications for registration were considered of which sixteen were accepted without examination. Of the remaining applications, one was rejected on the grounds that the curriculum of training was not of the standard required by the Council for entry to its examinations; five candidates were required to sit the Council's

examinations of whom one was accepted for registration after passing the examinations.

41. In addition, one application for restoration to the Register was approved.

Pharmacy Bourd

42. The Board met four times during the year, the main items of business being concerned with agricultural poisons and with a difficulty that arose over the use of scheduled poisons in traditional Chinese herbal medicines.

43. Twelve applications for registration were considered of which only one was accepted without examination. Of the remaining eleven applicants, two were accepted after examination and nine were required to undertake further practical training before sitting the Board's examinations.

Nursing Board

44. The qualification of Registered Nurse granted by the Board has been recognized by the Nursing Councils in the United Kingdom since 1939. Statutory preliminary and final examinations are held twice each year in the English and Chinese languages, under the general supervi- sion of the Board, which appoints examiners, conducts the examinations and approves the results.

45. The Board held four ordinary meetings and one special meeting during the year. In addition to routine business in connexion with examinations and registration the Board considered and approved the final drafts of the Nurses Registration Ordinance and Regulations. It is expected that the Ordinances and Regulations will become law in mid-1961.

46. For the examinations leading to registration as a General Nurse, 397 candidates were entered by the approved Training Schools for the Preliminary Examinations and 270 passed in all subjects; 194 candidates were accepted for the Final Examinations of whom 158 passed in all subjects.

47. The first Preliminary Examination in Mental Nursing was held in January and the four candidates who entered passed in all subjects.

48. There were 190 applicants for registration as general nurses and 178 were accepted. Of these, 154 were nurses who had qualified at the Hong Kong Training Schools recognized by the Board and their names were entered in the Register after passing the Board's Final

Examination. Twenty one nurses trained outside the Colony were accepted without examination and two after passing the Final Examina- tion; four applicants were required to sit the Final Examination; eight others were rejected on the grounds that their training was not of a standard equal to that set by the Board in the Colony; one application is still under consideration by the Board.

49. Four applications for re-inclusion in the Register were approved.

Midwives Board

50. This Board meets four times each year and conducts examina- tions in April, July, October and January. The course of training in midwifery lasts two years for pupil midwives entering the course direct but registered nurses are accepted for entry to the examination after one year's full-time training in midwifery.

　　　51. Owing to the social conditions existing in the Colony there is very little scope for domiciliary midwifery and the majority of confine- ments take place in hospitals and maternity homes. Therefore the qualification given by the Board is not fully recognized by the General Midwives Board of the United Kingdom for registration there. There is, however, a remission of three-quarters of the period of training in the United Kingdom granted to midwives registered in Hong Kong who may wish to sit the United Kingdom State Certified Midwives examinations.

52. One special meeting was held during the year at which the Board approved the final draft of the revised Midwives Registration Ordinance. This legislation was enacted in December 1960.

53. There were 142 candidates from approved Training Schools in the Colony accepted for the Board's examinations; of these 131 passed and were registered. There were three further applications for registra- tion; one was accepted without examination and two after passing the examinations.

54. In addition five applications for restoration to the Register were approved.

Radiation Board

　　　55. The Board, which was constituted by the Radiation Ordinance, No. 35 of 1957, met once to consider draft-regulations governing irradiat- ing apparatus, and a number of amendments to the principal Ordinance. These amendments, which were approved, concern certain technical definitions, give the Board some powers of exemption where it appears

expedient in the public interest, and they define the liability of the managements of companies. The regulations however were subjected to extensive amendments and a further draft is now in course of preparation.

II. PUBLIC HEALTH

GENERAL COMMENTS

56. Despite the density of population, the overcrowding and an annual movement of some 2,078,763 persons in and out of Hong Kong the general level of health has been well maintained and for the eighth year in succession no case of any of the quarantinable diseases was reported. Morbidity and mortality from diphtheria have declined appre- ciably as a result of an intensive and continuing inoculation campaign. The toll exacted by this disease and by the enteric fevers is still un- necessarily high and it is as yet too early to attach any significance to the lower incidences. A severe epidemic of measles occurred during the winter months and caused a number of deaths amongst the younger age groups of the large child population.

VITAL STATISTICS

57. The registration of all deaths and live births occurring in Hong Kong is compulsory under the Births and Deaths Registration Ordin- ance. Still births are not registrable but the numbers received by cemeteries for burial are recorded. Table 1 shows the annual returns for births and deaths during the past five-year period.

TABLE 1

BIRTHS AND DEATHS 1956-60

Extimated

Year

Mid-Year

Total Live Births

Crude Live Birch Rote (per 1,000

Stil Births Recorded

Total Deaths

Crude Death Rate

Population

(per 1,000

Population)

1956

LL-

2,440,000

96,746

39.7

988

19,295

7.9

1957

2,583,000

97,834

37.9

1,245

19,365

7.5

1958

1959

1960

2,748,000 106,624 38.8 2,857.000 104,597 36.6 2,981,000 110,667 37.1

1,297

20,554

7.5

1,393

20,250

7.1

1.680

19,146 6.4

58. Following the slight drop during 1959 in the total births recorded and the birth rate, there was a further upsurge during 1960 and the recorded natural increase of 91,521 was the highest in Hong Kong's history. The pilot census confirmed previous presumptions that the population is a young one, approximately forty per cent being below

the age of 15 years and only five per cent being aged 60 or over. This age structure is reflected by the low crude death rate, the continuing decline of which can be attributed largely to the concommitant fall in infant mortality; almost twenty five per cent of deaths at present occur in children under the age of one year.

　　　59. The mortality pattern continues to show the same trends observed during previous years, namely, decreasing mortality from the infectious and febrile diseases and increases in deaths from diseases of later life, particularly neoplasms and cerebro-vascular disorders. An analysis of mortality for the years 1956 to 1960 can be found in Appendix 4.

TABLE 2

INFANTILE AND MATERNAL MORTALITY 1956-60

Year

Infantile Mortality Rate (per 1.000 live births)

1956

60.9

1957

55.6

ILI

1958

54.3

1959

48.3

1960

41.5

Neo-natal Mortality Rate (per 1,000 live births)

24.2

23.8

23.4

21.3

20.9

Maternal Mortality Rate (per 1,000 total births)

0.90

1.06

0.85

0.73

0.49

60. Table 2 shows the recent trends in infantile and maternal mortality. There have been further reductions in infant deaths from bronchopneumonia and gastroenteritis and tuberculosis is now an al most insignificant factor in mortality amongst children under the age of one year. However, neonatal mortality is not declining at the same rate.

　　　61. An analysis of maternal mortality over the past four years is shown in Table 3. It will be seen that toxaemias and haemorrhages of pregnancy remain the principal fatal complications although marked reductions have occurred; ectopic gestations are becoming relatively more prominent as a cause of maternal death.

TABLE 3

ANALYSIS OF MATERNAL MORTALITY 1957-60

(per 1,000 total births)

Year

Sepsis (excluding

Toxaemias Haemorrhages Abortions

Septic Abortions)

Ectopic Pregnancies

Others

1957

020

.373

.334

.040

.060

.132

1959

.340

.226

.028

.066

.056

1960

.010

.179

.143

.045

.072

.045

III. WORK OF THE HEALTH DIVISION

HYGIENE AND SANITATION

62. The enactment of the Public Health and Urban Services Ordin- ance, 1960, was one of the major health advances of the past few years, for it revised, consolidated and co-ordinated a mass of disconnected legislation which had become unsuitable for the conditions prevailing in present-day Hong Kong. As a consequence certain administrative changes have been made, designed to centralize functions in connexion with the environmental health services in the urban areas and in the very rapidly growing townships in the New Territories.

Urban Areas

63. Responsibility for environmental sanitation in Hong Kong Island, Kowloon and New Kowloon continues to rest with the Urban Council. The Deputy Director of Medical and Health Services now serves as Vice-Chairman of the Urban Council and is the co-ordinating link between the two Departments for the control of communicable disease through improved environmental sanitation, food hygiene and vector control. Medical and Health Officers are seconded to the Urban Services Department from the Medical and Health Department and work under the direction of an Assistant Director of Medical and Health Services who is posted to the Urban Services Department as Assistant Director, Hygiene. He is responsible for the guidance of the Health Inspectorate in particular, and for advice to the Urban Services Department as a whole, in the day-to-day management of health problems.

64. Medical and Health Officers in the urban areas, in addition to their duties connected with the maintenance of satisfactory standards of environmental sanitation and food hygiene, are responsible for local co-ordination of all epidemiological measures to control the transmis- sion of infectious diseases. Exceptions are tuberculosis, venereal disease, leprosy and malaria which are the concern of specialized branches of the Medical and Health Department. Through the media of the routine house inspections and the regular visits to licensed food premises carried out by the Health Inspectorate, a great amount of health educa- tion is possible in connexion with immunization against diphtheria and with the control of intestinal infections. With the assistance of fully trained Health Visitors, the Health Officers maintain investigations

into the sources of known cases of diphtheria, tetanus neonatorum, poliomyelitis, typhoid and certain other intestinal diseases.

　　　65. These activities are closely co-ordinated with the activities of teams of inoculators from the Epidemiological Section of the Medical and Health Department which work under the immediate direction of area Health Officers and offer prophylactic immunization against small- pox, diphtheria and enteric fever. Such measures are described in detail elsewhere in this report.

Rural Areas

　　　66. The Public Health and Urban Services Ordinance provided for the gradual transfer from the District Commissioner, New Territories. to the Director of Urban Services of the various statutory powers and functions controlling environmental sanitation and food hygiene in the New Territories. By the end of the year the Director of Urban Services had assumed responsibility for all cleansing, amenity and allied services in the more developed townships of the area, while the District Com- missioner remained the licensing authority for all hawkers and premises where food is handled. The Principal Medical Officer of Health, New Territories, continues to advise the respective authorities on all health matters affecting the area and, in addition, co-ordinates all curative and personal health services provided by the Medical and Health Depart- ment in the New Territories.

　　　67. The responsibility for the extension of environmental health services to rural areas remains with the Medical and Health Depart- ment; the problem has been considered in detail with the aid of an Inter-Departmental Committee consisting of representatives of Depart ments interested in the improvement of village economy. The main emphasis is on health education stemming from the curative centres and designed to stimulate self-help through village schemes of environmental sanitation. Plans have been drawn up for a two-year pilot scheme. The principles behind the schemes have already been applied wherever possible by such means as insistence on the construction of aqua-privies in place of insanitary latrines. This type of latrine is becoming increas- ingly accepted as a sanitary installation which also provides a useful source of fertilizer for the traditional intensive cultivation of crops.

　　　68. The problem of malaria in the New Territories was surveyed in detail during the year and is described later in this report.

　　　69. Other questions which have given rise to environmental health problems during the year have been the increasing demand for cheap

meals in the New Territories townships, resulting in lowered standards in cooked-food stalls and the smaller restaurants; the need for better methods of control of theatrical performances in temporary matsheds; the control of sanitation standards in workmen's settlements around new development; and the prevention of illegal slaughter of animals for food.

EPIDEMIOLOGY

70. During the year 1960 there was a decrease in the number of cases of the more common notifiable diseases, the decrease being most marked for tuberculosis and diphtheria. Although this is encouraging, it is not yet possible to say it is an indication of success attending, at last, the intensive campaigns which have been waged against these diseases. Acute anterior poliomyelitis and malaria were the principal diseases showing an increase in the number of cases reported. Appen- dix 5 details the numbers of cases and deaths from notifiable infectious diseases recorded during the period 1956-60.

71. Free prophylactic vaccinations against smallpox, cholera, enteric fever and diphtheria continued to be available to members of the public at all Government Hospitals and Clinics, Port Health Inoculation Centres and District Health Offices. During the year, the main emphasis was laid on inoculation against diphtheria and no general anti-typhoid campaign was held during the summer months as had been the practice in previous years. The numbers of prophylactic immunization carried out during 1959 and 1960 are detailed in Appendix 6.

Amoebiasis

72. Although there was a marked rise in the number of cases of amoebiasis notified, mortality remained low and only nine deaths were registered. The extent of the problem presented by amoebiasis is diffi cult to assess as it occurs sporadically throughout the Colony in direct relation to extremely high population densities, further complicated by frequent changes of address.

Bacillary Dysentery

73. The incidence remained virtually unchanged with Sh. flexneri as the preponderant organism. The emerging resistance of many bacillary strains to antibiotics, notably to those of the sulphonamide group, gave rise to concern in the management of patients suffering from the dysen- teries.

74. Much intensive health education in the prevention of these infections is carried out by Health Officers amongst those connected with the handling, preparation and sale of food.

Cerebro-spinal Meningitis

75. This disease continued to occur sporadically throughout the Colony but, with its very low incidence, did not present a public health problem.

Chickenpox

76. During 1960 the incidence remained virtually unchanged, but there was a widespread outbreak during the first three months of 1961; however, few deaths resulted.

Diphtheria

77. The intensive inoculation campaign which commenced in the autumn of 1959 was continued throughout the year and resulted in a drop of 30.5% in the numbers of cases of diphtheria recorded as com- pared with 1959. However, the incidence still remains high and as yet there can be no complacency with regard to control.

　　　78. Diphtheria remained particularly prevalent in the densely- populated tenements and squatter areas of Kowloon and the clinical picture was mainly that of laryngeal involvement due to C. diphtheriae mitis; only in rare instances was an intermedius or a gravis strain isolated. Eighty per cent of cases occurred in children under the age of 10 years.

79. As previously mentioned, the intensive inoculation campaign was continued throughout the year, with particular emphasis on inocu- lation facilities being made available as close as possible to the home. To encourage the widest acceptance of this immunization, a plastic figurine symbolizing 'Health' was given initially to each child receiving two doses of P.T.A.P. at the prescribed intervals; the response to the figurine was unenthusiastic and in the middle of the year it was replaced as an incentive by sweets, which were naturally accorded a better reception by the children. House-to-house visits were conducted in Resettlement and other crowded areas, inoculators visited squatter areas both on hillsides and roof-tops, and the villages of the New Territories were served by mobile tearns or by inoculators working on the floating clinics. In the urban areas, the systematic coverage by inoculators of individual district health units in rotation, has resulted

in a marked decrease in diphtheria in those sections which have been completed. However, even in such areas, complete control of the disease has not yet been achieved owing to internal movements of population and to the apathy shown by certain sections of the community towards the immunization facilities offered.

Enteric Fever

80. During 1960, there was no marked increase in the incidence. during the summer months and the numbers of notifications received showed a fall of twenty three per cent compared to 1959. A close epidemiological study of typhoid fever is now being made and pre- liminary results indicate the possibility that water from polluted sources does not play such an important role in the dissemination of the disease as had been supposed previously.

81. Owing to the priority given to diphtheria immunization through- out the year, no intensive prophylactic drive against enteric fever was possible. However, facilities for inoculation remained freely available to the public and the annual campaign was maintained in schools, as the highest incidence recorded during the past few years has been con- sistently in the 10-14 age group.

Malaria

82. The number of cases of malaria notified increased markedly following a widespread survey undertaken in the New Territories; the survey is described later in this report. There were no deaths from malaria reported.

Measles

83. With over 100,000 births occurring each year, measles is wide- spread in the Colony. It is a disease of the cooler months, from November to March and, as elsewhere, recurs in two-year cycles. An epidemic, occurring in the winter and spring of 1960-61, was the most extensive recorded in recent years and caused a large number of deaths which were mainly due to intercurrent bronchopneumonia. Measles ranks second only to tuberculosis as a cause of death from infectious disease.

Poliomyelitis

84. A small seasonal rise during the summer months accounted for the increased incidence of cases of poliomyelitis recorded during 1960,

but the case fatality rate fell to 15.5 per cent compared with 23.2 per cent in 1959. The attack rate was 4.96 per 100,000 of population.

85. A polio-virus laboratory was established early in the year by the Government Institute of Pathology in co-operation with the Department of Pathology in the University of Hong Kong. Two surveys were under- taken to determine the prevalence of poliomyelitis in the Colony. The first survey was designed to provide information on the prevalence of excretors of the virus; faecal specimens from healthy children under the age of 5 years were collected in a number of clinics and child health centres and despatched to the laboratory for culture. Table 4 presents the findings.

TABLE 4

TYPES OF POLIOVIRUS FOUND AND EXCRETOR RATE

No. of specimens

examined

438

Poliovirus positive

Type I Type 2

Type 3 1

Total positive 9

Excretor rate

per 1,000

20.5

86. The second survey was a serological survey designed to assess again, after 3 years, the immunological status of the Chinese population of Hong Kong. Samples of blood were collected at various hospitals, clinics and maternal and child centres throughout the urban areas of the Colony, mainly from healthy children between the ages of 7 months and 9 years; none of the persons from whom the samples were collected had received immunization against poliomyelitis. The prevalence of poliomyelitis antibodies in the samples was then determined and the results are detailed in Table 5.

TABLE 5

DISTRIBUTION OF POLIOMYELITIS ANTIBODIES IN DIFFERENT AGE-GROUPS

No.

No. with

Age-group

마

sera

Type Type Type

antibody

Number with antibodies to poliovirus types one type

Two types Total Type Type Type Total 142 143 243

three

types

7-12 months

146

83(56.9) 42

57(39.0) 2

40 2.7)

20 1.4)

13-24 months

151

44(29.2) 34 17

58(38.4) 21

37(24.5)

25-36 months

179

18(10.1) 20

57(31.8) 25

17 19

37-48 months

138

70 5.1)

49-60 months

112

J-

L(0.9)

5-9 years

145

IC 0.7)

15(10.9) 25

11( 9.8) 12

X 2.0)

61034.1) 45(32.6) 71051.4)

120 7.9)

43(24.0)

9 31(27.7) 69(61.6) 9 28(19.3) 113077,9)

Figures in parentheses denote percentage of total sera examined in each age-group,

　　　87. From the results of the two surveys it is apparent that there is wide circulation of the three types of poliomyelitis virus amongst the child population, that by the age of 5 years over 99% of children have

been exposed to at least one type, and that more than half have, by the same age, developed immunity to all three types.

Tuberculosis

88. Tuberculosis remains the major public health problem of Hong Kong and although there are indications that control measures are beginning to exert an effect, particularly in regard to the disease in childhood, much remains to be done. The problem is considered in detail elsewhere in this report.

Other Notifiable Infectious Diseases

89. Influenza, which has been notifiable on a voluntary basis since 1957, did not present a problem during 1960. There were few notifica- tions of scarlet fever and whooping cough, and only one case of puer- peral fever was recorded. Reports of ophthalmia neonatorum remained almost unchanged in numbers as compared to the previous year.

Other Communicable diseases which are not notifiable

Tetanus

90. Of 165 cases of tetanus admitted to hospital, 61 occurred in new born children. Most of these cases of tetanus neonatorum, which carry an average fatality rate of sixty four per cent, occur in the children of mothers who, having previously borne a number of infants delivered in institutions, have decided for one reason or another to have the next baby at home. In such cases, assistance by an untrained person, the use of unsterile material and instruments and the common practice of applying ground ginger root to the umbilicus as a styptic, all combine to give a grave risk of tetanus neonatorum.

Food Poisoning

➡

91. Three hundred and fifty six cases of food poisoning were recorded. Of these, forty six were due to coagulase positive staphy lococci, many of which had developed a resistance to a wide range of antibiotics.

TUBERCULOSIS

92. Tuberculosis continues to present the major public health prob- lem in Hong Kong and there still remains a large volume of un- diagnosed cases in the community. An investigation into the individual deaths notified suggests that less than half of such cases have been recognized prior to death. Furthermore, morbidity, as measured by the

　　number of cases reported annually, has varied very little amongst the adult age-groups during recent years.

　　　93. It is in the prevention of tuberculosis amongst children and in the reduction of mortality at all ages that the control programme has achieved the main successes. Table 6 details the progress over the past five years.

TABLE 6

TUBERCULOSIS IN HONG KONG 1956-60

Year

1956 ..

1957 ..

1958.

1959 .. 1960..

TUBERCULOSIS

Estimated

Percentage of

Death rate

population

Percentage of

tuberculosis deaths

per 100,000

total deaths

below 5 years

2,440,000

107.0

13.6

25.0

2,583,000

103.6

13.9

21.2

་་

2,748,000

83.8

11.2

19.6

2,857,000

76.2

10.7

19.2

2,981,000

69.9

10,8

10.5

　　　94. It will be noted that there has been a steady fall in the death rate although the proportion of the total deaths from all causes resulting from tuberculosis has declined only slowly. However, the mortality amongst children under the age of five years has been falling rapidly during recent years.

　　　95. Parallel to the fall in child mortality from tuberculosis, there has been a marked reduction in the morbidity, as measured by the num- ber of notifications received in spite of the increasing numbers at risk. There is little doubt that there have been improvements in general child health during recent years due to better economic and social conditions; should these have played a great part in the reduction of child tuber- culosis, it would be expected that there would have been some reflection of them in a reduced incidence in adults and this has not happened. A further possibility is a reduced reservoir of infection; this also is not the case. In the year 1952, the percentage of reactors to tuberculin in the age-group 0-6 years was thirty four. In 1960, all children in this age- group attending Maternal and Child Health centres, who gave a definite. history of not having received B.C.G. vaccination, were tuberculin-tested and the percentage showing a positive reaction was thirty eight. It is therefore reasonable to assume that the B.C.G. vaccination of new-born babies, along with chemo-prophylaxis, using I.N.A.H., in the limited group with tuberculin sensitivity naturally acquired under the age of three years, have been the major factors in effecting this reduction.

1956...

1957

1958

1959

1960.

TABLE 7

TUBERCULOSIS NOTIFICATIONS IN CHILDREN

Under Five Years

All Forms

1.459

1,441

1.137

975 660

Under One Year

T.B. Meningitis

All Forms

T.B. Meningitis

454

275

126

448

270

114

309

224

105

276

190

181

Agencies Engaged in Tuberculosis Control

96. Government policy is to encourage and assist voluntary agencies to participate in medical, social and welfare schemes which can be integrated into the programme of tuberculosis control. Because of the magnitude of the problem most cases of active disease are treated by ambulatory chemotherapy, the greatest number being under treatment at the Government Chest Clinics. Hospital treatment on the other hand is provided largely by the Hong Kong Anti-Tuberculosis Association, the Tung Wah Group of Hospitals, the Junk Bay Medical Relief Council and the Society for the Relief of Disabled Children. All these organiza- tions receive recurrent grants-in-aid from Government; certain other hospitals also maintain a limited number of beds for tuberculosis patients. There is a close liaison between the voluntary agencies and the Government Tuberculosis Service.

97. The control programme is based on the following measures:

(i) Ambulatory chemotherapy in known cases.

(ii) Prophylactic chemotherapy of young contacts.

(iii) B.C.G. vaccination of new-born children and of older tuber-

culin negative reactors.

(iv) Hospital treatment of selected cases that will respond to

medical or surgical in-patient treatment.

(v) Limited case-finding through X-ray surveys, subject to sick

leave and re-employment guarantees,

(vi) An annual X-ray survey of all Government employees.

GOVERNMENT TUBERCULOSIS SERVICE FACILITIES

Ambulatory Chemotherapy

98. Ambulatory chemotherapy is now the standard form of treat- ment used in the Government Chest Clinics. The routine regimen is streptomycin daily by injection together with the combined P.A.S. and I.N.A.H. tablets until the tuberculous lesion is apparently stable; the streptomycin is then discontinued. Thereafter, the combined P.A.S. and

I.N.A.H. tablets are administered for a minimum period of two years. All treatment at the chest clinics is free of charge,

　　　99. The principal problem arising out of this form of treatment is the failure of patients to follow completely the course advised. Attendance registers show that exact regularity of attendance for injec- tions is infrequent and the testing of urine samples indicates that a proportion of patients, which may be as high as twenty five per cent in certain areas, fail to take the combined P.A.S. and I.N.A.H. tablets. In addition, approximately twenty per cent of cases failed to continue treatment despite home visits and other follow-up methods. There are indications that one major reason for the latter is an influx of cases from outside Hong Kong who return home before treatment is completed.

　　　100. The Jockey Club Clinic, Sai Ying Pun, opened during the year, contains a major chest clinic, bringing to four the number of full- time centres of ambulatory treatment; two are in Hong Kong and two in Kowloon. In addition, there are eleven part-time out-patient clinics and ten injection centres, while the staff of certain general clinics in the New Territories maintain an injection service for patients referred by the Tuberculosis Service. In all full-time centres, evening sessions are held and these are proving increasingly popular.

　　　101. For the second successive year there was a fall in the number of persons presenting themselves for the first time at the chest clinics. Although the total number of cases of tuberculosis under active treat- ment continues to increase, the indications are that patients are presen- ting themselves earlier in the course of disease and that fewer advanced cases are being seen. Nevertheless, pressure on the clinics remains sub- stantially unchanged and the volume of work undertaken which is detailed in Table 8, continues to increase.

TABLE 3

GOVERNMENT CHEST CLINICS 1956-60

First attendances

1956 1957 34,607 35,126 39,454

1958

1959

1960

39,008

35,991

　　　Cases of tuberculosis discovered Total attendances for treatment Under treatment from previous year Started treatment during the year Completed treatment

10,733 401,568

11,428 12.270 539,282

14.406

12.937

*803.326

1,655,100

2,001.960

1.703

5.887

9.132

13,733

16,062

7,861 7,964

11,546

11,357

12,617

1,037

1,213

1,048

2,064

3,724

Failed to attend

2,022

2,868

3,048

5,391

4,975

Admitted to Hospital from Chest

Clinics

1,029

1,078

1.511

1,587

1,592

Still on treatment at end of year..

5,887 9.132

13,733

16,062

16,433

➡ Streptomycin course extended by daily injections.

Chemoprophylaxis

102. A large proportion of the deaths from tuberculosis in child. hood are caused by acute post-primary disease; this is especially true in the case of tuberculous meningitis. Efficient B.C.G. vaccination offers good protection against the disease at such time of life, but in those children without such protection and who acquire a natural and hence, virulent, infection the possibility of progressive development of the disease is ever present. To such cases, discovered by Mantoux testing of home contacts and attenders at Child Health Clinics under the age of three who have not received B.C.G., I.N.A.H, is administered for a period of one year.

103. This is a measure which is applicable to a small number of children and during the year only 180 were given this treatment. It is expected that the number will be further reduced as the popularity of infant B.C.G. vaccination increases.

B.C.G. Vaccination

104. The B.C.G. vaccination campaign is now incorporated into the general organization of the Tuberculosis Service, with the assistance of certain other branches of the Medical and Health Department such as the School Health and Maternal and Child Health Services. The central B.C.G. office is mainly a supply organization but it is responsible for the examination and vaccination of contacts, surveys of children. in certain groups and for the operation of the campaign to offer vaccina- tion to all new-born children. It is in the last-mentioned sphere of activity that the most spectacular results have been achieved and, due to the central organization of the campaign plus the increasing co- operation of voluntary and private hospitals and doctors and midwives in private practice, the percentage of new-born infants who receive such protection rose during 1960 to the satisfactory figure of 71.5 per cent. The progress during the past five years is shown in Table 9.

TABLE 9

B.C.G. VACCINATION OF NEW-BORN BABIES 1956-60

(within 48 hours of birth)

Year

1956

1957

- L -

JIL

1958

1959

ILL

1960

Percentage Vaccinated

24.21

35.93

46.86

...

59.53

...

71.54

105. By the end of the year, almost all infants delivered in Govern- ment or Government-assisted institutions were receiving this protection. It is now in the field of private midwifery practice that further advances must be made and a refresher course was organized accordingly, for all private midwives, in the technique and value of B.C.G. vaccination. Attendance and interest were most encouraging and there is already an increase in the number of B.C.G. vaccinations performed by these members of the profession. For new-born babies the vaccine is adminis- tered by the multi-puncture method.

106. Vaccination of other groups of children is carried out by the classical intradermal method and is administered to all tuberculin- negative contacts of known cases of tuberculosis. It is also performed on tuberculin-negative children attending School Health and Maternal and Child Health Clinics and at the B.C.G. clinic operated by the Hong Kong Anti-Tuberculosis Association.

107. Reference has already been made to the findings from Maternal and Child Health centres which suggest that exposure to infection amongst the young age groups remains virtually unchanged from that existing eight years ago. Further, home conditions and the number of active cases of tuberculosis amongst adults have not changed materially. It would appear, therefore, that the improvements recorded in morbidity and mortality from tuberculosis amongst young children of five years and under can be attributed to the extent of the B.C.G. vaccination campaign, particularly in the new-born. The prophylactic regime of I.N.A.H. for child contacts is administered to so few that it cannot have had any significant impact on the total situation in the 0-5 age group.

Chest Surgical Clinics

108. Chest surgical clinics are held at regular intervals in the Wan Chai Chest Clinic by both the Government Thoracic Specialist and by the Chest Surgeon attached to the Grantham Hospital, while cases are also referred to the Ruttonjee Sanatorium for surgical treatment there. The waiting list was considerably reduced during the year, but there still remains a number of more complicated cases requiring pneumon- ectomy who are harbouring resistant organisms as a result of an un- satisfactory response to ambulatory chemotherapy.

Orthopaedic Clinics

　　　109. Regular sessions for patients suffering from bone and joint tuberculosis are held in a number of Chest Clinics under the combined

direction of the University Consultant Orthopaedic Surgeon and the Government Orthopaedic Specialist. Medical, clerical, nursing and social assistance is provided by Government and all necessary out-patient treatment is carried out in the various Government clinics. The radio- logical investigations are undertaken by the Hong Kong Anti-Tuber- culosis Association or by the Government Radiological Service, depend- ing on which of these facilities is most easily available. Hospital treatment is provided in the surgical wards of the Queen Mary and Kowloon Hospitals, at the Grantham Hospital, at the Sandy Bay Convalescent Home and at the Ruttonjee Sanatorium.

110. The number of new cases presenting at these orthopaedic clinics continues to decline and the new cases are of comparatively recent origin. It is believed that the greatest number of chronic cases has now been treated and that the falling attendance at the clinics is an indication of the effect of B.C.G. vaccination in infancy upon the incidence of tubercular bone disease in the youngest age groups.

Radiology

111. All radiological work in connexion with the Government Tuberculosis Service is carried out by the staff of the Radiological Branch of the Department, under the direction of the Senior Radio- logical Specialist. Static X-Ray units are installed in the major clinics and subsidiary centres are served, as far as possible, by two mobile units. The increase in the radiological work undertaken can be seen from Table 10.

TABLE 10

TUBERCULOSIS RADIOLOGICAL WORK 1959-60

Total exposures

Large films or papers

1959

1960

194,181

234,181

128.894

146,784

Bacteriological Examinations

112. All bacteriological work for the Government Tuberculosis Service is carried out by the staff of the Government Institute of Pathology under the direction of the Government Pathologist. A con- stant watch is kept for atypical acid-fast organisms resembling the tuber- culosis bacillus, but the number found and identified have been very few and do not pose a clinical problem.

Hospital Treatment

113. The detailed distribution of beds for tuberculosis in the civil hospitals throughout the Colony is shown in Appendix 10; this repre- sents the average number of beds available during the year for the treatment of tuberculosis. For convenience, a summary of the distribu- tion is given in Table 11.

TABLE 11

TUBERCULOSIS BEDS IN HONG KONG 1960

Government Hospitals

Hong Kong Anti-Tuberculosis Association

---

FIL

Tung Wah Group of Hospitals

---

Haven of Hope Sanatorium

Other Government-Assisted Hospitals

Private Hospitals

111

Total

rr-

216

870*

326

---

210

г. т

241

1.889

* Includes Grantham Hospital, Ruttonjee Sanatorium & the Freni Memorial Home.

114. In addition to the beds available to the Tuberculosis Service in the Government Hospitals, there are 444 beds in the Grantham Hospital and 336 beds in the Ruttonjee Sanatorium, which includes the Freni Memorial Convalescent Home. Admission is governed by the need for using the beds to the greatest advantage and they are occupied mainly by patients whose recovery can be hastened by medical, surgical or orthopaedic treatment or who require emergency admission for com- plications arising during ambulatory chemotherapy. Segregation of open cases on a large scale is not yet possible, but this aspect of control is being studied by voluntary organizations and it is probable that long- term isolation facilities for an increasing number of infectious and chronic cases may become available in the near future.

Radiological Surveys

　　115. No general population surveys have, as yet, been possible. However, during 1960 small pilot surveys were carried out in Resettle- ment areas with the object of learning case-finding techniques; results were disappointing as co-operation by the public was very poor. Although facilities are available now to launch these surveys on an increasing scale further investigations will have to be made into methods suitable to local conditions which will enlist public interest and co- operation.

116. Case finding X-Ray surveys continue to be made on request by industrial and commercial firms who agree to certain sick leave and re-employment guarantees for employees with active disease. The number of firms taking advantage of these facilities continued to in- crease. The annual survey of all Government servants and the examina- tion of all prisoners, except those serving very short sentences, continued as in previous years. Results of such surveys are detailed in Table 12.

TABLE 12

RADIOLOGICAL SURVEYS 1960

Total examined

Re-examined clinically

Active Tuberculosis

Percentage with active tuberculosis

Governmen!

Private

Prisoners

Servants

concerns

42,482

17,311

9,481

4,822

1,267

3,105

372

217

985

0.88%

1.25%%

10.4%

117. A further survey was made of all school children showing a reaction of more than 15 mms. to the standard Mantoux test. A total of 822 such children were X-rayed and subsequently examined clinically. The number of cases showing active tuberculosis was less than had been expected, only twelve such cases, or 1.4% of the total, being found.

118. Teachers in Government schools are X-rayed annually in the course of the Government surveys. In all other registered schools, teachers are required to register with the Education Department and before being passed fit to teach they have to undergo a chest X-ray, not necessarily by the Government Radiological Service. Only those teachers with positive X-ray findings are referred to the Government Chest Clinics and the numbers so referred are detailed in Table 13.

TABLE 13

TUBERCULOSIS IN SCHOOL TEACHERS 1956-60

1956

1957

1958

1959

1960

Referred to Chest Clinics owing to suspicious X-ray findings Unfit to teach on account of

pulmonary tuberculosis

455

318

249

179

338

Percentage of referred cases

found unfit

10.7% 16.6%

9.2%

17.9%

8.3%

　119. Those found to be unfit are offered priority of admission to hospital, but there is no compulsion and it is suspected that, in addition, a number of teachers with active disease may be teaching in unregistered schools.

Medical Social Work

　　120. This is carried out by Almoners assisted by a staff of Tuber- culosis Workers. This work is of paramount importance in view of the local living and economic conditions, the absence of comprehensive social insurance and the emphasis on ambulatory chemotherapy.

121. The roles of the Tuberculosis Almoners and of the Tuberculosis Workers are complimentary. The Almoners interview all new patients in whom tuberculosis has been diagnosed to assess social and economic circumstances and they maintain a constant check on the regularity of individual attendances for ambulatory treatment. Waiting lists of patients recommended for admission to hospital, according to the category of treatment required, are kept by the Almoners who also assist in the settlement of all foreseeable social problems prior to admission. There- after they pay regular visits to patients in hospital. On discharge from hospital all patients are given a small supply of drugs to continue treatment until arrangements have been made for further care at the Chest Clinic most convenient to the patient.

　　122. The Tuberculosis Workers assist in the reception of patients and the maintenance of records in clinics. They maintain under the supervision of the Almoners the distribution of drugs prescribed for oral administration. A district is allotted to each Tuberculosis Worker and in it she is responsible for home visiting, health education and the organization of contact examinations. Recruited specifically for field work in connexion with the social aspects of tuberculosis in Hong Kong, the Tuberculosis Workers have no nursing training, but receive an in- service course of training lasting from six to twelve months.

　　123. The Almoners have available a sum of money from Govern- ment funds for the assistance of tuberculosis patients and their families. This is used to provide financial assistance to the families of those patients whose admission to hospital has caused great economic hard- ship, to give food supplements in the form of milk powder where required and to alleviate the burden caused in certain instances by such items as travelling expenses, domestic help, or orthopaedic appliances.

Tuberculosis Contacts

　　124. Efforts are made in the course of home visiting to have every close family contact of known cases of tuberculosis examined. The results of this work are detailed in Table 14 and it will be seen that,

while the number of examinations have increased, the significance of the contact as a case-finding source would appear to be decreasing.

TABLE 14

CONTACT EXAMINATIONS 1959-60

Under 8 years of age

Tuberculin Tests

Negative

Positive

Active

Clinical findings of

Inactive

Contacts showing

Positive Mantoux

Suspicious

Free of T.B.

Percentage of Contacts found to have active

tuberculosis

Over 8 years of age

Results of Clinical

examination

following

'Contact' X-rays

Active Inactive

Suspicious

Free of T.B.

1959

1960

996

907

1.928

2.392

...

110

101

324

473

1,429

1,749

3.72%

2.09%

336

318

159

387

658

1,043

6,856

8,766

4.19%

3.02%

10.933

13,813

Percentage of Contacts found to have active

tuberculosis

Grand total of Contacts examined

The Hong Kong Anti-Tuberculosis Association

125. The major part of the work of the Hong Kong Anti-Tuber- culosis Association lies in the provision of hospital facilities for the treatment of tuberculosis. To this end the Association maintains three institutions-the Grantham Hospital, the Ruttonjee Sanatorium and the Freni Memorial Convalescent Home. The affairs of the Association are managed by a Board of Directors which appoints two Management Boards, one for the Grantham Hospital and one for the Ruttonjee Sanatorium and Freni Memorial Home. In addition, the Association maintains a B.C.G. Clinic, a Tuberculosis Insurance Scheme and a Health Education Service.

126. The Association's work receives considerable voluntary support and this is augmented by a Government subvention in respect of the Ruttonjee Sanatorium and Freni Memorial Home, the B.C.G. Clinic and the Health Education service. The insurance scheme is, of course, self-supporting.

Ruttonjee Sanatorium and Freni Memorial Convalescent Home

127. Containing 340 beds and operated as a single unit, these two institutions are financed by funds from the parent Association, by Government subvention and by the maintenance of a number of spon- sored beds.

128. Medical and senior nursing staff are provided by the Sisters of the St. Columban Roman Catholic Mission; staff of the Medical Faculty of Hong Kong University act in a consultant capacity. Admission is through the sponsoring agencies, the University Clinical Units and the Government Tuberculosis Service. Full medical and surgical treatment is available free of charge, and a follow-up clinic is maintained by the Sanatorium for all discharged patients. All necessary social work is provided by the Almoners of the Government Tuberculosis Service.

129. The work of these two institutions during 1960 as compared to 1959 is outlined in Table 15.

TABLE 15

RUTTONJEE SANATORIUM AND FRENI MEMORIAL CONVALESCENT HOME 1959-60

Adults admitted through Government Clinics Children (Pulmonary) from Government Clinics Children (Orthopaedic) from Government Clinics Other admissions and re-admissions

LLL

...

Total admissions

1959

1960

279

350

277

252

662

693

Grantham Hospital

130. This modern hospital, maintained by the Association through a Board of Management, contains 532 beds. Of these, 444 are maintained by a Government grant based on a daily maintenance charge and patients are admitted to these beds through the Government Tuber- culosis Service for treatment free. For the remainder of the beds, maintenance fees are charged but all fees are calculated on a non-profit- making basis.

131. Clinical supervision of the 444 subsidized beds is divided between the medical staff of the Hospital and of the Government Specialist units dealing with the medical and surgical aspects. The work done during 1960 is outlined in Table 16.

TABLE 16

SUBSIDIZED ADMISSIONS TO GRANTHAM HOSPITAL 1960

Admissions

Grantham Hospital Pulmonary Unit

Government Pulmonary Unit

Government Orthopaedic Unit

Total

LL J

Beds

240

277

128

214

100

444

591

132. Subsidized patients, on discharge, attend the Government Chest Clinics for further treatment but full follow-up facilities are available in such clinics to the medical staff of the Hospital. Medical social work for all subsidized patients is carried out by the Almoners of the Government Tuberculosis Service.

The Tung Wah Group of Hospitals

133. This Group of Chinese Charitable Hospitals maintains 326 beds for the treatment of tuberculosis patients. In addition, approximately one-third of all births in the Colony occur in the maternity wards of these hospitals, and hence they play a most important part in the B.C.G. vaccination campaign amongst the new-born. During 1960, 86.1% of all babies born in the three hospitals received such protection.

The Haven of Hope Sanatorium

134. This hospital, situated in the New Territories, is governed by the Junk Bay Medical Relief Council, and is supported mainly by a group of Protestant Missions. Government gives an annual subvention for the maintenance of 60 beds. An out-patient service for tuberculosis patients is maintained by the Sanatorium in the adjacent Rennie's Mill settlement and during the year a tuberculosis survey of the inhabitants of that area was conducted.

Sandy Bay Convalescent Home

135. This institution is maintained by the Society for the Relief of Disabled Children and is staffed in part by the Hong Kong Branch of the British Red Cross Society. It provides convalescent care for children suffering from orthopaedic conditions, many of which are due to tuberculosis.

136. During World Refugee Year, the work of this institution aroused great interest in many countries and a number of donations have been received both of equipment and of money from most parts of the globe. Plans are now in hand to build a new wing containing another 50 beds.

Rehabilitation Projects

137. Although the need for rehabilitation of tuberculosis patients has been considerably modified in Hong Kong by the wide use of ambulatory chemotherapy, there is still a steady flow of cases which require some assistance, both physical and mental, in their adjustment to the circum- stances arising as a result of the infection. A large amount of this work

　is carried out as part of the normal routine of the Almoners' section with a special emphasis on re-employment. It is encouraging to note that the situation with regard to re-employment has somewhat improved in comparison with previous years.

138. During the year, the Lutheran World Service started a Tuber- culosis Rehabilitation Project and is working closely with all agencies. involved in the treatment of tuberculosis, including the Government Tuberculosis Service. As yet, the numbers assisted have been small but results are promising and it is expected that the scope of the scheme will expand significantly during the next few years.

MALARIA BUREAU

139. The Malaria Bureau, under the direction of the Government Malariologist, is responsible for all malaria control operations through- out Hong Kong and, in certain instances, it also undertakes the control of breeding of culicine mosquitoes. Lectures are given on malaria and allied subjects to various groups of health personnel under training and expert advice is offered to the Armed Services, to the Pest Control Unit of the Urban Services Department, to Hei Ling Chau Leprosarium and to Her Majesty's Prisons in the New Territories.

Control Operations

140. The important malaria vectors are A. minimus and A. jey- poriensis var. candidiensis, while A. maculatus and A. hyrcanus have also been proved to be potential carriers.

141. The great majority of the population of Hong Kong are pro- tected from the risk of malaria infection, for the whole of the urban area comprising Hong Kong Island, Kowloon and New Kowloon is covered by anti-larval measures. These measures consist of rough train- ing of streams, ditching and larviciding; the latter is effected by the use of anti-malarial oil except on agricultural lands where Gammexane dispersible powder is used instead. In addition, certain relatively small centres of population in the New Territories, such as Rennie's Mill Camp, the township on Cheung Chau Island and the island of Hei Ling Chau are also protected zones.

142. Results of the malaria control work in the urban areas continue to be most satisfactory and the incidence of natural malaria transmission has been reduced virtually to zero. However, vector mosquitoes abound just outside the boundaries of the protected areas and hence there is no room for complacency or relaxation of control measures.

143. In the rural areas there is no overall vector control programme except in the limited areas previously mentioned. The scattered popula- tion, the widespread wet cultivation and the unprotected contiguous borders render unfeasible the adoption in these areas of either anti- larval or anti-adult measures. Therefore, paludrine prophylaxis continues as the main line of defence against malaria for disciplined groups stationed in the New Territories.

144. The cost of the control measures during the year under review was thirty eight cents per head of population living in the protected

areas.

Incidence of Malaria

145. Malaria is a notifiable disease, and the returns for the past five years are set out in Table 17.

Year

1956

ггг

1957

1958

1959

1960

TABLE 17

MALARIA 1956-60

Cases Notified

Deaths

496

гг.

...

447

659

442

833

146. The marked increase in notifications during 1960 is due to a survey designed to give an accurate picture of the prevalence and dis- tribution of malaria in the New Territories.

　147. The survey, which was carried out in conjunction with the Principal Medical Officer of Health, New Territories, and the Govern- ment Institute of Pathology, was designed to take a blood smear from every child under 10 years of age with pyrexia attending at a clinic in the New Territories and to subsequently examine such smears for the presence of malaria parasites. At times it was impossible to complete the investigation on every child attending the travelling and floating clinics, but the number so omitted was small; there was no selection of cases. At the same time, all notified cases of malaria were analysed and grouped into areas comparable with those in which the blood smears had been taken. The results are detailed in Table 18.

TABLE 18

MALARIA IN NEW TERRITORIES 1960

Positives as

District

Malaria

Pastrive

%% of toral

Incidence

Population

blood

Percentage

N.T. cases

per 1,000

of total

1960

SMCAT

Rate per 1,000 population

smears

Tai Po

Yuen Long.

Tsuen Wan .

147,307

1.7

0.09

0.5

0.05

104.632

0.3

0.02

89.905

1.0

0.09

0.1

0.02

Sai Kung

14,427

383

262

Sai Kung Boats

5,376

110

14.5

20.5

South Lantau

7.696

210

27.5

8.2

Islands

40.336

5.0

0.7

2.8

0.85

Total ..

409,679 765

100

369

148. The experience of previous years is repeated in that the large majority of cases came from the area surrounding the small town of Sai Kung on the east coast. However, South Lantau has now appeared as an important endemic focus and, although the increase in the number of cases reported in that area can be attributed to the posting of a full- time medical officer to the waterworks project and to the presence of a large number of workers who have not developed tolerance to the symptoms of malaria, there is still a relatively high incidence in the villagers of the district, as shown by the smear survey.

　　　149. It will be seen that in every district surveyed there is close agreement between the incidence of malaria and its latent frequency in children, suggesting that reporting of cases may be more complete than might have been supposed. Nearly all cases occur in the littoral rather than in inland districts; the possibility that the vector is carried by boats must obviously be taken into account but is not supported by the evidence available, particularly when the absence of cases of malaria in other islands is considered. Further investigations are in progress but, meantime, treatment is given whenever possible to all cases with a positive blood smear.

　　　150. Of the few cases of malaria reported from the areas of the Colony covered by control operations, none could be traced to an infection contracted locally and in all cases except two there was strong presumptive evidence that the infection had in fact been contracted outside the protected zones. Of the parasites identified, 95% were P. vivax, 4.5%, P. falciparum and 0.5%, P. malariae.

Laboratory

151. The Bureau laboratory continued to carry out the routine identification and dissection of mosquitoes and field tests were conducted into the efficacy of various insecticides and the susceptibility of anophelines to them. Information on tests of insecticide resistance in adult mosquitoes was forwarded to the World Health Organization.

SOCIAL HYGIENE SERVICE

152. The Social Hygiene Service provides free facilities for the diagnosis and treatment of venereal disease and leprosy in thirteen centres in the urban districts and in five part-time centres in the New Territories. It operates the Wan Chai Hospital for female patients suffering from skin disease, and maintains a number of dermatological sessions in various clinics.

Venereal Diseases

153. The most disturbing feature of 1960 was a marked rise in the number of cases of primary and secondary syphilis presenting; this was due, in part, to the inability of four cases of the disease in its primary stage to identify their contacts. However, the number of cases presenting with syphilis in its later stages showed a further decline and no case of congenital syphilis was seen in a new-born infant for the first year on record.

154. The incidence of gonorrhoea and of lymphogranuloma venereum continued to decline, as did that of non-gonococcal urethritis, but chancroid showed an increase of one hundred and sixty nine per cent as compared to 1959. The annual incidences and trends in these diseases are shown in Appendix 7.

155. Penincillin remains the treatment of choice for both gonorrhoea and syphilis, but the slightest sign of intolerance to the drug is followed by a change in therapy; in the case of syphilis, chloramphenicol is used as the alternative and in the case of gonorrhoea either chloramphenicol or streptomycin is exbibited. No death from anaphylactic shock was recorded.

156. Since 1959, the extent of venereal disease in prostitutes has been under investigation, and the results, detailed in Table 19 are of interest.

TABLE 19

VENEREAL DISEASE IN PROSTITUTES

Year

1959 1960

LLI

LLL

---

Syphilis

No. of first attendances

692 (63.8) 613 (64.4)

No V.D. found Gonorrhoea Early

Latent 235 (21.6) 63 (5.8) 124 (13.0) 69 (7.2)

Late Latent

96 (8.8)

146 (15.4)

1,086 952

Remarks: Figures in brackets represent percentage of number of first

attendances.

　　　157. Many patients suffering from venereal disease do not appreciate the importance of prolonged treatment or of regular assessment after treatment has been completed. In each case where recommended attend- ance at a Social Hygiene Clinic is not observed, the patient is contact- ed by letter and reminded of the necessity for further clinical examina- tion or treatment. If there is no response to such letters, visits are paid to the patients' homes by Social Hygiene Visitors, who also carry out epidemiological investigations into each new case of venereal disease reported.

Leprosy

158. Thirteen clinical sessions are held weekly in eight centres solely for leprosy patients, while two other sessions each week are held in conjunction with other social hygiene clinics; in addition, one session is devoted to the care of leprosy patients suffering from trophic ulcers. During the year, infectious cases numbering 124 were admitted to the Hei Ling Chau Leprosarium which is maintained by the Hong Kong Auxiliary of the Mission to Lepers; a very close liaison with this in- stitution, which is referred to in paras. 235-238 of this report, is maintained by the Social Hygiene Service.

159. For routine out-patient treatment at the Leprosy Clinics, dapsone remains the drug of choice and is administered orally or in- tramuscularly; if there is intolerance to dapsone, diphenyl thiourea is exhibited instead. In selected cases bi-weekly inunctions of ditophal are used, combined with routine systemic therapy, but results have not been promising and, in addition, there have been instances where a contact dermatitis has resulted.

　　　160. Surgical rehabilitation of patients suffering from deformities and disfigurements is carried out at the Maxwell Memorial Hospital at the Hei Ling Chau Leprosarium; it is also provided in certain Govern-

ment hospitals where a limited number of beds is available for this

purpose.

161. In the epidemiological field, it is a routine for the home of each new patient to be visited by a Social Hygiene Visitor within a month of the diagnosis being made; personal advice is given, contacts are requested to attend for examination and it is urged that child contacts receive B.C.G. vaccination. After the initial examination, con- tacts are advised to return for re-examination at least once a year; those who do not return are re-visited as are patients defaulting from treatment. Unfortunately, the insidious nature of the disease is such that many persons are unwilling to attend early, as they neither see nor feel any indication of illness.

162. The work done by the Leprosy Out-Patient Service during recent years is detailed in Table 20.

TABLE 20

LEPROSY OUT-PATIENT SERVICES 1956-60

1956

1957

1958

1959

1960

New Attendances at Clinics

751

981

976

767

705

Total Clinic Attendances

Lepromatous cases seen

25,789

31,204

36,338

31,986

26,329

160

173

160

111

Intermediate cases seen

Tuberculoid cases seen

262

214

183

126

Total cases of leprosy seen

423

436

379

297

239

Dermatology Service

163. Patients with skin diseases may attend any of the Social Hygiene clinics and, in addition, there are nine consulting sessions each week, five on Hong Kong Island and four in Kowloon, solely for patients with skin complaints referred for an expert opinion. Female patients requiring hospital treatment are admitted to the Wan Chai Hospital, while beds are available for males at the Lai Chi Kok Hospital.

164. Appendix 8 shows the classification and relative frequency of dermatological cases seen. It will be observed that contact dermatitis, boils, impetigo and eczema continue to be the predominant diseases encountered. All cases of industrial dermatitis were notified to the Industrial Health Officer, as were cases of other dermatological con- ditions suspected of being due to an industrial hazard.

　　　165. There is an Almoner attached to the Leprosy section of the Social Hygiene Service but the major part of the contact follow-up and home visiting for the Social Hygiene Service as a whole is carried out by the Social Hygiene Visitors. These visitors are analogous to the Tuberculosis Workers and on appointment are given a short course of in-service training in their duties and responsibilities.

PORT HEALTH

　　　166. The Port Health Administration is responsible for all measures designed to prevent the introduction of quarantinable infectious diseases. into the Colony; for the sanitary control of the ports of entry by sea, air and rail; for the carrying out of the provisions of the International Sanitary Regulations as embodied in the Quarantine and Prevention of Diseases Ordinance; for the compilation of epidemiological statistics and reports and for the general organization of prophylactic vaccination campaigns. There are also statutory responsibilities under the Hong Kong Merchant Shipping Ordinance. A weekly exchange of epidemio- logical information is maintained with the World Health Organization Epidemiological Station in Singapore.

167. All persons entering the Colony through the recognized ports of entry by land, sea or air are subject to a quarantine inspection and all immigrants without valid vaccination certificates are vaccinated against smallpox.

168. Other routine work carried out include the deratting and dis- insecting, including fumigation, of ships; sanitary duties in the port and airport, including supervision of water supplies; control measures to keep the port and airport free from Aedes aegypti; inspection of all vessels carrying more than twenty unberthed immigrants; a service rendering medical advice by wireless to ships at sea is also maintained. In addition to routine work, the Port Health Jaunches, equipped with stretchers, first aid equipment and radio-telephones, provide an ambu- lance service in the port area.

Prophylactic Vaccination and Other Measures

169. The Port Health Office is responsible for the provision of vaccination facilities for travellers making international journeys and for the general organization of immunization campaigns in the Colony. Inoculators are posted to twenty five centres throughout the Colony and are responsible for the field-work of these inoculation and vaccination

campaigns which are carried out under the immediate supervision of Medical and Health Officers.

170. By the beginning of 1960, the outbreaks of cholera and small- pox reported during 1959 in nearby countries of South-East Asia had subsided and no case of either disease occurred in the Colony,

171. The number of persons entering by rail through Lo Wu showed an increase of 14.8% over the previous year; of the total of 488.187 persons inspected there, 37,825 were without valid documents and were vaccinated against smallpox.

DISTRICT MIDWIFERY SERVICES

172. The dramatic fall in maternal mortality during recent years can be attributed, at least in part. to the widespread desire for attention during labour by trained personnel in a hospital or maternity home. Owing to existing housing conditions the preference is for institutional midwifery and only six per cent of all births registered take place in the home. By December 1960, there was a ratio of one maternity bed for every 66 births.

173. Prior to 1959, Government policy in the urban areas was to provide specialişt institutional care in the Tsan Yuk Maternity Hospital, in the maternity block of Kowloon Hospital and in a few maternity homes attached to existing clinics; all other areas were served by mid- wives based on clinics and offering facilities for domiciliary midwifery in the surrounding districts. Despite the domiciliary facilities available, the greatest part of the normal midwifery was conducted in Govern- ment-assisted or private hospitals or in private maternity homes. This demand for institutional facilities has now been recognized in the development plan and all new clinics under construction or being planned for the urban areas will include maternity beds for normal cases wherever the district needs warrant the provision of such service. One such clinic was opened during the year, at Aberdeen, and plans have been prepared on this basis for six more. At the Jockey Club Clinic in Kennedy Town opened on 7th June, 1960 a domiciliary mid- wifery service was arranged; the demand for this service was so poor that, at the end of the year, five beds were provided in the clinic. Within a fortnight there was a marked increase in the number of ante-natal attendances at the clinic's Maternal and Child Health Centre and the beds were soon fully utilized. In the New Territories, the policy

has been and still continues to be to include maternity beds in all new clinics.

　　　174. The work of the Government Midwifery Service during 1960 is summarized in Table 21.

TABLE 21

GOVERNMENT MIDWIFERY SERVICE 1960

Maternity beds in hospitals

LLI

337

---

Maternity beds in maternity homes (urban)

LII

---

(rural)

119

ILL

15,418

Midwives (excluding hospitals) Cases attended (excluding hospitals)

Average case-load for each midwife (excluding hospitals)

270

175. Thirty seven per cent of all births are attended by midwives in private practice, the great majority taking place in small maternity homes of from two to six beds. The Supervisor of Midwives, a Govern- ment Senior Medical and Health Officer, is responsible for the regular inspection of such homes and for general supervision of the work of the midwives; in this task, she is assisted by a qualified Health Visitor. The work undertaken in 1960 by these midwives is outlined in Table 22.

TABLE 22

PRIVATE MIDWIFERY SERVICE 1960

Number of midwives in active practice Number of registered maternity homes

Number of beds

-- J

ILL

Maternity home deliveries

Domiciliary deliveries

Total deliveries

IL-

FIL

IIL

LIJ

ILL

ггг

193

117

LIJ

517

38,143

3,260

41,403

176. Apart from their role in safeguarding the lives of mothers and infants, the midwives of the Colony play an extremely important part in general public health measures, for they are all trained to perform vaccinations against smallpox and to administer B.C.G. to new-born infants. It is due to the efforts of these midwives, both Government and private, that 71.5 per cent of all children born during 1960 received B.C.G. protection-a measure which has resulted in a dramatic fall in child mortality from tuberculosis,

MATERNAL AND CHILD HEALTH SERVICES

177. In this most important and popular aspect of the work of the Department, the emphasis is on health education and the prevention of

disease. All facilities are provided without charge, and once disease, exclusive of minor ailments, is detected the child or mother concerned is referred to the appropriate branch of the curative service for the investigation and treatment necessary. When cured the patient is en- couraged to return to the relevant clinic. The Health Education of groups of mothers in the clinics and of individuals while home-visiting is a permanent and continuing activity of the Health Visitors. The advice proffered is generally much appreciated, especially in the infant welfare clinic sessions and it is an encouraging sign that, during 1960, nearly one-quarter of all children born in Hong Kong were brought by their mothers, or sometimes by their fathers, to these sessions. In the clinics. all forms of group education are available: simple talks, film and puppet shows, flannel-graph illustrations, practical demonstrations and group discussions are widely used, the choice of medium depending on the subject and on the audience.

178. Clinics are held in both full-time and part-time centres and there are sessions for ante-natal and post-natal cases, for infants aged 0-2 years and for toddlers aged 2-5 years. The work performed during 1960, as compared to that of 1959, is detailed in Table 23.

TABLE 23

MATERNAL AND CHILD HEALTH SERVICES 1959-60

Number of full-time centres Number of subsidiary centres

- U

LIJ

JIL

Number of ante-natal sessions each year New ante-natal attendances

1959

1960

гг.

1г.

1,922

2,023

17,418

20,296

Total ante-natal attendances

---

ILL

61,891

77.741

Number of post-natal sessions each year

789

816

New post-natal attendances

ILL

3,530

4,686

Total post-natal attendances

4.870

---

6,399

Number of infant welfare and toddler sessions

each year

4,012

ייי

4,358

rrr

...

New infant welfare attendances

24,102

29,634

Total infant welfare attendances

LII

292,360

307,956

New toddler attendances

4,125

---

5,052

Total toddler attendances

35,538

40,187

Total home visits

46,248

59,071

179. Two full-time centres were opened during the year in the Jockey Club Clinics in Kennedy Town and Aberdeen; the latter replaced a part-time centre which had been maintained in cramped and unsuitable

　　premises. Additional work undertaken consisted of ante-natal and infant welfare clinics held once a month in Tai O. on Lantau, and of infant welfare clinics held twice weekly in the Wong Tai Sin Resettlement Estate.

　　　180. The infant welfare sessions are undoubtedly the most popular aspect of the work of this branch of the service but many mothers still regard these clinics as centres primarily for the treatment of ail- ments. However an increasing number are now appreciating the need for routine inspections and the discussions of minor problems and the 'well baby' concept is becoming much more widely understood. It is encouraging to report that during 1960 only 1.53% of infants attending for the first time at infant welfare clinics showed any abnormality. Immunization against diphtheria, whooping cough and tetanus is given as a routine, using a triple vaccine. Smallpox vaccination is given where necessary and all children not known to have had B.C.G. are tuberculin tested, those with a negative reaction receiving B.C.G. Those who are tuberculin positive but without pathological signs of active disease are given prophylactic I.N.A.H. for a period of one year.

　　　181. Toddler clinics are increasing in popularity, mainly by 'promo- tions' from the infant welfare sessions. Here the inculcation of good habits of hygiene receives the emphasis so essential for the future health of the child.

182. Ante-natal sessions held in Government Maternal Health centres show the satisfactory average rate of 3.8 attendances by each expectant mother; however, the number of women who take advantage of the facilities offered represent only eighteen per cent of the total number of pregnancies. This is largely due to the demand, previously mentioned, for institutional midwifery and the consequent attendances at hospitals or at private nursing homes for ante-natal examinations. As this usually means a 'booked bed', this is all to the good.

183. Post-natal clinic sessions are still the least popular and, as 22.08% of all women attending present some defect, it would appear that the need for a post-natal examination is, in general, appreciated only by those who either are acutely conscious of an abnormality or who wish to take advantage of an opportunity for an investigation which will banish anxieties regarding their state of health.

SCHOOL HEALTH

184. The School Health Service has two main functions in the schools of the Colony. The first comprises the control of environmental sanita-

tion and communicable disease as a general public health measure applied to all registered schools. It includes the dissemination of health education to school children, parents and teachers. During the year, the main effort continued to be concentrated on raising the level of immunity to diphtheria.

185. The other function is to provide personal curative services, including dental and ophthalmic facilities, to a limited number of voluntary participants in a fee-paying scheme. The entry to this scheme. has had to be limited since 1955 and during 1960 the number of participants was 24,919.

186. To provide curative services for all school-children in the Colony, numbering some 600,000 is beyond the staff and other resources of the Medical and Health Department. Consequently, a scheme is being considered for the replacement of the existing limited service by a service in which private practitioners would be invited to accept respon- sibility for curative services, within defined limits, to all pupils on the basis of a per capita remuneration. It is proposed that entry to the scheme would be voluntary and would be financed partly by contribu- tions from participants and partly by a Government subsidy. Detailed proposals for the scheme have been submitted to the Hong Kong Branch of the British Medical Association and to the Chinese Medical Associa- tion and, at the end of the year, were under discussion with the Council of the two Associations.

INDUSTRIAL HEALTH

187. The health of workers in factories and in other industrial undertakings is the statutory responsibility of the Commissioner of Labour. The Industrial Health Section of the Labour Department which is staffed by personnel seconded from the Medical and Health Depart- ment, is chiefly concerned with the prevention of occupational disease and the protection of workers against health hazards arising from their working environments. To this end, an advisory service is given to industry on problems connected with the hygiene of workplaces or with the provision of clinic or first-aid facilities. Investigations are made into the working environments of trades known to be hazardous to health and medical supervision is maintained of workers in certain dangerous trades such as those in which lead or luminizing powders are handled. Health Visitors carry out individual case work on injured persons claiming compensation under the Workmen's Compensation Ordinance.

　　　188. With the co-operation of private practitioners and Government Medical Officers, cases of silicosis and of industrial dermatitis are notified to the Industrial Health Section. Surveys of working conditions in quarries and stone-grinding factories continue and further X-ray surveys have been carried out on quarry workers exposed to the risk of silicosis.

189. Field surveys continue into the contamination of various work- ing environments by toxic gases or fumes or by dust and temperature and ventilation studies have been made in a number of factories.

　　　190. Lectures on Industrial Health are given to probationer Labour Inspectors, Health Inspectors, Health Visitors and medical students of the University of Hong Kong. First Aid training classes for industry are organized by the Industrial Health Section and are conducted by the St. John Ambulance Association.

HEALTH EDUCATION

　　　191. A better appreciation by the Colony's population of the basic principles of environmental hygiene and the prevention of disease continues to be the main health objective. A very wide field is covered by many branches of the Medical and Health Department and all avail- able methods of Health Education are used in the various programme undertaken. In general, those methods designed for individual or group education have proved the most effective, being used with success in the Maternal and Child Health Service, the Tuberculosis Service and the Social Hygiene Service. On the other hand, methods suitable for widespread dissemination of health education, as in the immunization campaigns, are accorded a somewhat apathetic reception.

192. Certain other departments are concerned with various aspects of Health Education in their respective spheres. The Inter-departmental Committee on Health Education, formed during the previous year, continued to concentrate its efforts on the furtherance of the anti- diphtheria campaign.

　　　193. The co-operation of all voluntary bodies interested in health topics is actively sought and Kai Fong Associations and Welfare Societies are particularly active in this field. A most encouraging development during the year was the interest taken in the subject by the Women's Section of the Kai Fong movement, which organized a three-month drive throughout the Colony to promote improved standards of maternal and child health.

IV. THE WORK OF THE MEDICAL DIVISION

194. General comment has already been made on the heavy and increasing pressure on the clinic and hospital facilities. The programme of hospital and clinic construction and of staff training which got under way in 1957 is now beginning to show results. It is anticipated that, by the end of 1963, with the completion of the two major hospital projects in Kowloon and a number of large clinics in the urban areas and the growing townships in the New Territories, there will be a significant easing of the present shortage of these facilities,

HOSPITALS

195. The year marked a number of events of major importance in the expansion of curative and preventive services available to the population of the Colony. The inauguration of the School of Nursing for the Queen Elizabeth Hospital has doubled the facilities for the training of nurses. The opening of the Castle Peak Hospital has provided for the first time a near adequacy of beds for mental illness. The third phase of the new Kwong Wah Hospital was launched and there were welcome extensions to other existing hospitals, both Government and Government-subsidized. In addition, there was the opening of the Canossa Hospital on Hong Kong Island, an extension to St. Theresa's Hospital in Kowloon, both privately-maintained institutions, while the Fanling Lutheran Mission Hospital of 70 beds was opened in March, 1960, in the New Territories.

196. By the end of March 1961, there were 37 civil hospitals and nursing homes in the Colony, of which 13 hospitals are maintained wholly by Government; 10 hospitals are managed by voluntary or missionary bodies which receive recurrent subventions from public funds. There are 9 private hospitals and 5 nursing homes. Details of the accommodation provided are at Appendix 10. An analysis of the work done at the Government and Government-assisted hospitals is at Appendices 9 and 11.

Queen Mary Hospital

GOVERNMENT HOSPITALS

197. This, the largest of the Government hospitals, is an acute hospital situated on Hong Kong Island and is the main specialist centre for the Colony. It is also the teaching hospital for the Medical Faculty of the University of Hong Kong and is one of the two main Government centres for the training of nurses.

　　　198. Of the hospital's 601 beds, 234 are under the clinical care of the staff of the University Departments of Medicine, Surgery, and Obstetrics and Gynaecology; in addition, there is a combined University and Government Paediatric unit of 29 beds. The remaining 338 beds are allocated to the Government clinical units, each unit being headed by a Government Specialist. Out-patient sessions are held regularly by both University and Government specialist staff, the former mainly in the Jockey Club Clinic, Sai Ying Pun, and the latter in the Violet Peel Polyclinic mainly but also in certain other Government general clinics,

199. The administration of the Queen Mary Hospital is the respon- sibility of the Medical Superintendent, who is a Principal Medical and Health Officer of the Department, and who is assisted by a lay Hospital Secretary. Nursing care and all ancillary facilities, both medical and non-medical, are maintained by Government.

　　　200. There is no out-patient department at the Queen Mary Hospital, but the Casualty Department is the only public casualty centre on Hong Kong Island with the necessary full time specialist cover. This department receives, therefore, most of the traumatic, emergency and forensic cases arising in a densely populated area of one million inhabitants.

Kowloon Hospital

201. This is the main acute hospital and casualty centre for Kowloon and the mainland portion of the New Territories and serves a popula- tion of two million people. The beds are grouped in clinical units each of which is headed by a Government Specialist. All hospital staff is provided by Government and the hospital is a Training School for general nurses and midwives.

202, Kowloon Hospital has been under heavy and increasing pressure during recent years and emergency extensions have been necessary. A block containing two wards, each of 34 beds, and four operating theatres was opened in April 1960, but this only temporarily relieved the strain. By the end of March 1961, two more wards of semi-permanent construction and containing 108 beds had been opened. Thus, the total bed strength of the hospital rose from 339 beds on April 1st, 1960, to 521 beds on March 31st, 1961, an increase of 57 per cent. The average duration of in-patient bed occupancy during the year 1960 was 7.4 days. An indication of the heavy load carried by Kowloon Hospital is given in Table 24 which details the work carried out during the last five years.

TABLE 24

KOWLOON HOSPITAL 1956-60

1956

1957

1958

1959

1960

Maternity Cases

General In-patients (excluding

2,867

יי

2,861

3,472

3.646

4,372

maternity)

7,256

7,819

10,695

13.242

16,052

Out-patient attendances

481,169

547,026

558,010

532,492

547,592

Not

Casualties attended

Available

51,986

70.191

71.627

80.333

Operations (excluding minor

ones)

4.629

4.884

5,704

6,571

7,584

203. The large out-patient department adjacent to the hospital deals with general cases and also serves as a centre for specialist out-patient sessions conducted by the staff of the hospital clinical units who also hold specialist sessions at certain Government clinics in Kowloon and in the New Territories. The Casualty Department, attached to the out- patient centre, attended an average of 219 emergency and accident cases every 24 hours throughout the year.

Tsan Yuk Maternity Hospital

204. This is the main specialist obstetric hospital in the Colony and is maintained by Government which also provides the Medical Super- intendent, the resident house officers and the nursing and administrative staff. Clinical work in this hospital of 200 beds is the responsibility of the Professor of Obstetrics and Gynaecology in the University of Hong Kong assisted by members of the University staff and by a number of Government Medical Officers. All tuition of medical students in obstetrics is conducted here and it is the Colony's main teaching centre for student midwives who have not previously qualified as general nurses.

205. Ante-natal and post-natal sessions are held regularly. In addi- tion there is a special clinic for medical conditions complicating preg- nancy, a social hygiene clinic for venereal disease, and a Family Planning Clinic staffed and run by the Family Planning Association of Hong Kong.

206. Routine admissions are now limited to cases registered in the ante-natal clinics, which are in the main primiparae, 'grand' multi- gravidae, women with a previous abnormal obstetric history or referred cases requiring specialist care; such admissions comprised 94.8% of the total. The remaining 5.2% of cases admitted were suffering from complications of pregnancy or labour and were referred by practising

midwives, private practitioners or the Government Midwifery Service. As Tsan Yuk now deals with all complicated cases the duration of in-patient stay has been increased, with a corresponding reduction in the total of cases admitted.

207. The work of the hospital during the year is detailed in Table 25.

TABLE 25

WORK OF THE TSAN YUK HOSPITAL 1959-60

1959

1960

Total admissions

8,196

7,251

Total deliveries

7,440

6,416

Still-birth rate (per 1,000 total births)

13.97

9.70

Neo-natal mortality rate (per 1,000 live births) Maternal mortality rate (per 1,000 total births) Percentage operative deliveries

F4.31

12.17

0.80

0.16

14.12

20.12

Lai Chi Kok Hospital

208. This hospital, situated on the outskirts of Kowloon, is accom- modated in converted buildings and performs three functions. It receives all cases of infectious diseases requiring admission to hospital which occur on the mainland part of the Colony; it serves as a convalescent unit for the Queen Mary and Kowloon Hospitals and it provides a number of beds for tuberculosis patients. For the convalescent and tuberculosis patients both physiotherapy and occupational therapy are provided on a full-time basis, while the Hong Kong Branch of the British Red Cross Society maintains a school for long-stay child patients.

209. The extremely heavy incidence of diphtheria experienced during the winter of 1959-60 was not repeated during this last year and only twelve beds were re-allocated temporarily to deal with the number of diphtheria cases admitted. In fatal cases the cause of death was either overwhelming toxaemia or advanced bronchopneumonia not responding to the administration of various antibiotics. Over ninety per cent of the cases admitted had received no prophylactic immunization, and, of the remainder, most had received only one injection of toxoid.

210. As in previous years a number of cases of typhoid were admitted but mortality remained low. In measles, a high case fatality rate reflects the advanced stage of the intercurrent bronchopneumonia encountered in such cases on their arrival in hospital, many being seen too late for treatment to be able to take effect.

211. Other infectious diseases admitted were tetanus, mainly tetanus neonatorum, tuberculous meningitis, amoebic and bacillary dysenteries, poliomyelitis and encephalitis.

212. A small quarantine unit of four beds was added to the hospital during the year.

Sai Ying Pun Hospital

213. This hospital on Hong Kong Island is used entirely for the treatment of cases of infectious diseases, of which the main types seen are as detailed previously for Lai Chi Kok Hospital.

214. An increasing number of shigella and staphylococcal organisms are being encountered which show strong resistance to the common wide-spectrum antibiotics and in certain cases furadantin and kanamycin were the only therapeutic substances of effect. Admissions of patients suffering from acute rheumatic fever are also increasing, almost all being children, but is of interest that four adult cases were seen during the year, all female.

215. The work of the two infectious disease hospitals is summarized in Table 26.

TABLE 26

INFECTIOUS DISEASE HOSPITALS 1960

Diphtheria Typhoid Tetanus

-rr

Amoebic Dysentery

Bacillary Dysentery

Poliomyelitis

Tuberculous Meningitis

Measles

IL-

Cases

Admitted

Deaths

Case Fatality Rate (per cent)

1,510

5.96

343

1.46

168

47.62

131

2.29

...

234

1.28

124

13.71

41.03

249

19.68

St. John Hospital

216. This hospital of 100 beds, situated on the island of Cheung Chau, is staffed and maintained by Government, the buildings being leased from the St. John Ambulance Association. It not only offers in-patient and out-patient facilities, but serves as a base for the floating clinic covering the Colony's south-western waters and as a convenient centre for various specialist clinics. There are 42 beds set aside for patients convalescing from pulmonary tuberculosis. Patients requiring major surgical procedures or other specialist in-patient care are trans- ferred to the appropriate hospitals on Hong Kong Island.

Wan Chai Hospital

　　217. This small 30-bed hospital, originally intended for the in-patient treatment of venereal disease amongst women and children, is now primarily an institution for the care of female patients with skin diseases and a busy dermatological out-patient department is maintained there.

　　218. Out-patient facilities are also provided for the treatment of women suffering from venereal disease and for the examination of known female contacts.

South Lantau Hospital

　　219. This small hospital of 17 beds serves the workers on the Shek Pik Reservoir project and the villagers on the south-west coast of Lantau Island. The Medical Officer-in-charge is also responsible for the dispensary at Mui Wo, serves as Health Officer for the area and visits the sick bay at Her Majesty's Prison at Chi Ma Wan.

Mental Health Service

220. March 1961, saw the completion of the Castle Peak Hospital providing modern facilities for the accommodation and treatment of 1,000 psychiatric patients. With this institution as a nucleus, it has been possible to expand the basis of the mental health service by the conver- sion of the old Victoria Mental Hospital into a day hospital and centre for out-patients and by the commencement of out-patient sessions at certain other clinics. The work performed during the year is outlined in Table 27.

TABLE 27

MENTAL HEALTH SERVICE 1959-60

Patients admitted to hospital

New out-patient attendances

Repeat out-patient attendances

Attendances of discharged in-patients

1959

1960

г.

1.497 752

1.687

845

5.205 449

7.685

227

　　221. A further step in the advancement of the Mental Health Service was the enactment of the Mental Health Ordinance, 1960, which embodies a number of liberal concepts and simplified procedures pertaining to the treatment and care of the mentally ill that are in keeping with the progress made in psychiatry during recent years. The Ordinance will be brought into effect later in 1961.

　　222. A block containing 120 beds has been set aside in the Castle Peak Hospital for the treatment of drug addicts who voluntarily request

assistance to conquer their craving and who are prepared to surrender their liberty for six months. This latter has been made possible under the provisions of the Drug Addicts Treatment and Rehabilitation Ordinance of 1960.

223. In the therapeutics of mental illness in Hong Kong, chlor- promazine and trifluoperazine remained the most effective of the tran- quillizing drugs while certain of the monoamine-oxidase inhibitors have proved of value in the treatment of depressive states. All orthodox physical and biological methods of therapy are employed, including leucotomy. Protracted individual psychotherapy is limited by the large case load borne by the individual medical officers, but group psycho- therapy is used, especially for out-patients and day patients.

Prison Hospitals

224. Hospitals under the care of Medical Officers are maintained at the Stanley Male Prison, the Victoria Remand Prison, the Lai Chi Kok Female Prison and the Tai Lam Prison which is used exclusively for the rehabilitation of prisoners who are also drug addicts. A small sick-bay at Chi Ma Wan Prison is visited regularly by a Government Medical Officer.

225. At Stanley Prison there is a hospital of 82 beds for the accom- modation of prisoners who require treatment for conditions which do not warrant transfer to another hospital. Regular visits are paid by specialist staff from the units in general medicine, tuberculosis and social hygiene. In July 1960, an in-service course of training for Prison Hospital staff was commenced.

226. At Victoria Remand Prison, the hospital has been expanded to a total of 30 beds to provide isolation facilities and to accommodate the numbers of drug addicts under remand who are suffering from with- drawal symptoms. One of the prison blocks is being converted into a Psychiatric Observation Unit which will eventually be fully staffed by trained mental nurses. This unit is to be under the clinical control of a Psychiatrist who is a member of the Mental Health Service seconded to the Prisons Department and who also pays regular visits to all main prisons and training centres to advise on the numerous psychiatric and personality problems encountered amongst prisoners.

227. The specialized prison at Tai Lam Chung for the treatment and rehabilitation of convicted male drug addicts continues to give encouraging immediate results, but no assessment of the relapse rate after discharge has yet been possible.

GOVERNMENT-ASSISTED HOSPITALS

The Alice Ho Miu Ling Nethersole Hospital

228. This hospital, operated by the London Missionary Society has 281 beds and offers general medical, surgical and maternity care; there is also a large out-patient department. The hospital caters for all classes of patients but the major part of its work is amongst the poor; it is supported by a substantial annual subvention from Government funds. Serious staffing difficulties were encountered during the year but, in spite of these, the hospital continued to make an essential contribution to the Colony's medical services.

The Tung Wah Group of Hospitals

229. During 1960, the Tung Wah celebrated the ninetieth anniver- sary of its founding. This charitable organization in the Chinese tradi- tion is managed by a Board of Directors elected annually and provides medical care, primary school education and various welfare services for the poor. It maintained three hospitals, namely the Tung Wah and the Tung Wah Eastern Hospitals situated on Hong Kong Island and the Kwong Wah Hospital in Kowloon; in addition there are two infirmaries. These institutions are maintained in part by voluntary contributions raised by the Board of Directors and in part by a large annual sub- vention from Government. There is a total of 1,650 beds in the five institutions.

230. The work of the hospitals and infirmaries is subject to the general direction of the Tung Wah Hospitals' Medical Committee which consists of representatives of the Tung Wah Board of Directors and of Government under the chairmanship of the Director of Medical and Health Services. The Medical Superintendents of the three hospitals are Government Medical Officers on secondment,

231. General medical and surgical facilities are available and each hospital contains a large maternity unit. In addition to the treatment and care of acute cases, accommodation is provided for patients with chronic illnesses requiring prolonged hospitalization and the two sepa- rate infirmaries are maintained for the care of those suffering from incurable diseases. Consultant services are provided, either by specialists in private practice or by Government specialists; all such services are given voluntarily.

232. During the year, extensive renovations of the older parts of the Tung Wah Hospital were completed. The construction of the new Kwong Wah Hospital continues to progress satisfactorily; phase two

of the development scheme, which replaces accommodation in the old buildings, was completed during the year and work on phase three was begun.

Pok Oi Hospital

233. This hospital, situated near Yuen Long in the New Territories, is maintained by a Board of Directors and is largely supported by charitable donations augmented by an annual Government subvention, An extension of 74 beds was opened by His Excellency the Governor in January 1961; this brought the accommodation in the hospital to a total of 124 beds and also provided badly-needed ancillary services in- cluding an operating theatre, a laboratory and radiodiagnostic facilities.

234. The general administration of the hospital is under an Execu- tive Committee comprising six representatives of the Board of Directors and six representatives of Government. A Government Medical Officer is seconded to the hospital to act as Medical Superintendent. Hei Ling Chau Leprosarium

235. This institution is maintained by the Mission to Lepers, Hong Kong Auxiliary, with the aid of a substantial recurrent subvention from Government. It contains accommodation for up to 540 leprosy patients, and the Maxwell Memorial Medical Centre provides fifty beds for the care of patients undergoing reconstructive surgery or suffering from

intercurrent disease.

236. There is a close liaison with the Government Leprosy Clinics, and all patients, who are mostly infectious, are admitted through these clinics. Treatment is mainly by the sulphone group of drugs; ditophal by inunction has been tried but was not popular with patients. Recon- structive surgery was carried out on a number of patients and much work has been done on the prevention of damage to anaesthetic hands and feet. The staff of the Leprosarium produced a simple booklet of rules to instruct patients how to prevent injuries and deformities of the limbs.

237. The work done during 1960 is outlined in Table 28.

TABLE 28

WORK OF HEI LING CHAU LEPROSARIUM 1959-60

1959

1960

Number of admissions

138

[19

Total number of discharges

119

116

- - -

Number of discharges with 'negative' certificate

---

Deaths

LII

IIL

Reconstructive operations

189

LIJ

196

238. All patients on the island are expected to work in accordance with their physical capacity and previous occupation; training is avail- able in agriculture, cottage industries and in certain light industrial occupations. There is a primary school for child patients, the staff of which hold evening classes for adults and social activities continue as in a normal community.

Tuberculosis Hospitals

239. Reference has already been made in paragraphs 130-132 and 134-136 to the work carried out by the Grantham Hospital, the Ruttonjee Sanatorium, the Haven of Hope Sanatorium and the Sandy Bay Convalescent Home.

OUT-PATIENT SERVICES

240. The year 1960-61 was a notable one for, as previously stated, it marked the completion of the first stages of the planned building programme. Four clinics of varying size and scope were opened, three of which were built and donated by the Royal Hong Kong Jockey Club. The largest of these is the nine-storey polyclinic at Sai Ying Pun, which accommodates a large general out-patient department, chest and social hygiene clinics, a radiodiagnostic and superficial radiotherapy department, modern out-patient teaching facilities for all clinical units of Hong Kong University and the Government Institute of Pathology. Other Jockey Club clinics completed were at Aberdeen and Kennedy Town, each of which contains a general out-patient clinic, a dental centre, and a maternal and child health department; in addition, the former has a maternity ward of 26 beds. An out-patient clinic and maternity home of seven beds, built by Government, was opened in the small border town of Sha Tau Kok.

241. In addition to general out-patient clinics, regular specialist out-patient sessions were maintained at a number of centres by the tuberculosis, social hygiene, medical, surgical, ophthalmic, maternal and child health and ear, nose and throat services.

　　　242. Evening out-patient sessions are held at seven of the larger clinics in the more densely populated areas, which last from 6 p.m. until midnight. On Sundays and public holidays, clinic sessions are held at four centres in the urban area, two on each side of the harbour; these sessions cater for patients in need of emergency attention during week- ends and public holidays.

243. The New Territories contain fifteen out-patient centres, in seven of which one or more doctors are stationed permanently. The more remote areas of the New Territories are served by two mobile dispen- saries and two 'floating clinics'; the latter are launches, donated by the Royal Hong Kong Jockey Club, which provide curative and preventive facilities to isolated centres on the eastern and western coasts and on adjacent islands. At the end of March 1961, the first of a series of experimental visits by helicopter was undertaken by a small medical team to certain isolated villages on the eastern seaboard where direct sea-to-shore communication is often impossible owing to weather conditions.

244. Reference has already been made to the increasing pressure on Government out-patient clinics. This pressure has been no less severe on such clinics maintained by Government-assisted institutions or by the various missionary and charitable organizations.

245. At Appendices 12 and 13 are details of the work done during 1960 at the out-patient departments of Government and Government- assisted institutions throughout Hong Kong.

SPECIALIST SERVICES

246. There are Government Specialist Clinical Units of medicine, surgery, obstetrics and gynaecology, anaesthesiology, dentistry, neuro- surgery, ophthalmology, orthopaedic surgery, otorhinolaryngology, pathology, psychiatry, radiodiagnosis, radiotherapy, social hygiene, thoracic surgery and tuberculosis. In addition, the Professors and certain Senior Lecturers of the University Faculty of Medicine act as consultants in medicine, surgery, obstetrics and gynaecology, orthopaedics, pathology and paediatrics. Certain of the Government Specialists act as Honorary Consultants to the Tung Wah Group of Hospitals and others give part- time services as lecturers in the Faculty of Medicine.

RADIOLOGY

247. The Radiological Service, under the direction of the Senior Radiological Specialist, maintains radiodiagnostic, radiotherapeutic and medical physics facilities. Such facilities are provided mainly for Govern- ment hospitals and clinical services, but consultant services are readily available to certain Government-assisted hospitals and, on request, to private medical practitioners. In addition, the Service undertakes the instruction of medical students of Hong Kong University in the basic

　　principles of radiology and it conducts in-service training courses for both radiologists and radiographers; such courses are fully recognized by the various examining bodies in the United Kingdom.

Radiodiagnosis

　　　248. This branch provides a diagnostic service in nine Government hospitals and clinics in the urban areas, operates two mobile mass radiography units, and provides assistance to the Tung Wah Group of Hospitals, the Pok Oi Hospital and the Alice Ho Miu Ling Nethersole Hospital. All aspects of radiodiagnostic work required by the Medical and Health Department are covered, including the radiological work for the Tuberculosis Service; the number of X-ray examination performed during 1960 increased by 9% compared with 1959.

　　　249. During the year a radiodiagnostic department with three fully- equipped X-ray rooms was opened in the Jockey Club Clinic, Sai Ying Pun, together with a smaller department attached to the Chest Clinic in the same building. Much-needed extensions to the X-ray department of Kowloon Hospital relieved some of the pressure resulting from the rapid increase of work in that institution,

Radiotherapy

　　　250. This section is based entirely at the Queen Mary Hospital except for a recently-completed superficial radiotherapy unit in the Jockey Club Clinic, Sai Ying Pun. Deep X-ray and radiocobalt machines are used, a large stock of radium and radiocobalt needles is held and facilities are available for the use of radio-isotopes in the diagnosis and treatment of disease.

　　　251. The major part of the work is amongst patients suffering from malignant disease, most of whom are treated as out-patients owing to the shortage of beds, Details of the work performed during the year are given in Table 29.

TABLE 29

WORK OF THE RADIOTHERAPEUTIC SECTION 1959-60

No. of new malignancy cases seen

...

1959

1960

684

962

217

377

- 1 -

11.865

15,572

348

318

152

220

134

No. of new benign cases seen Total attendances for treatment Cases of nasopharyngeal carcinoma Cases of carcinoma cervix uteri Cases of carcinoma breast

Medical Physics

252. This section, under the immediate direction of the Senior Physicist, assists in the planning and development of radiotherapeutic procedures, provides a radiation protection service and prepares radium and radio-isotope appliances. In addition, it operates a workshop which undertakes the maintenance, repair and calibration of all Government radiological and physics equipment and produces numerous gadgets for the improvement and development of radiological techniques.

DENTAL SERVICE

253. The Government Dental Service, under the direction of the Senior Dental Specialist, provides a general dental service for the Civil Service and a School Dental Service. In addition, emergency dental treatment is given to patients in Government hospitals, in Her Majesty's Prisons and at certain of the Government out-patient clinics.

254. There was a rapid expansion of the general service during the year, seven new dental clinics, comprising thirteen surgeries, being opened. Of these, the most notable was a three-surgery clinic, situated in the Central Government Offices, which incorporates a number of innovations including high volume suction apparatus designed and made in Hong Kong. The expansion of the work can be seen in Table 30.

TABLE 30

WORK OF THE GENERAL DENTAL SERVICE

Dental Surgeries

1959

1960

16*

29*

LII

27,026

39.018

27,615

42,216

IIL

19,907

24,789

74,548

106,023

Attendances by Government Officers

Attendances by Dependants of Government

servants

Attendances by General public

Total attendances

• Figure includes one mobile unit used partly for School Denial Services.

255. Six school dental clinics are maintained for participants in the School Health Service. Although the proportion of fillings compared to extractions continues to rise, over nine thousand extractions were necessary during the year. It is confidently expected that this indication to the extent of dental caries in children in Hong Kong will be con- siderably reduced in a few years' time as a result of the fluoridation of the Colony's water supply.

256. Delays continue to occur in starting routine inspections and treatment in persons not suffering from emergency dental conditions.

　Even greater delays occur in the provision of prosthetic appliances, owing to the shortage of dental technicians. The appointment of a qualified Dental Technologist during 1960 and the establishment in December 1960 of a course of training in dental technology, for six students annually, at the Hong Kong Technical College should materi- ally improve this situation in the near future.

Dental Services provided by Welfare and Missionary Organizations

257. A number of welfare organizations maintain free or low-cost dental clinics, many dentists in private practice giving their services. free of charge for this purpose. The Hong Kong Dental Society also operates free evening clinics in the urban areas. The St. John Ambulance Brigade opened a dental clinic in its Hong Kong Headquarters' building for the treatment of under-privileged children by civilian and military dentists who give their services without charge. Two mobile dental clinics provide free or low-cost dental treatment for poor people in the New Territories, in resettlement areas and in orphanages; one unit is maintained by the Church World Service and the other by the Lutheran World Service.

Control of Dental Practice

　　258. Two Dental Inspectors were employed throughout the year in connexion with the supervision and control of private dental practice, including regular inspections of premises. There were fourteen prosecu- tions for alleged dental practice by unregistered persons, and seventeen individuals were convicted of this offence.

OPHTHALMOLOGY

　　259. This Service, under the direction of the Ophthalmic Specialist, operates two full-time centres, one on Hong Kong Island and one in Kowloon. It also holds regular sessions in a number of urban and rural clinics. In addition, the Mobile Ophthalmic Unit, maintained by the Hong Kong Branch of the British Red Cross Society for work in the New Territories, was staffed during the year by members of the Service. Operative procedures have been limited to a certain extent by shortage of beds, but much surgery is now carried out in the operating theatres of the two main clinics, the patients being followed-up by Health Visitors. During 1960, over eighty per cent of the operations performed were on an out-patient basis and the complications arising have not exceeded those that would be expected after comparable surgery in hospitals. Refraction clinics are maintained for participants in the School Health

Service and an ophthalmic workshop provides spectacles, on a fee- paying basis, to those children requiring them.

TABLE 31

WORK OF THE OPHTHALMIC SERVICE 1959-60

New out-patient attendances Total out-patient attendances Operations performed

Home visits by Health Visitors Spectacles provided for children

1959

1960

ILL

73,846

79,075

161,302

192,397

4,787

5,001

2,562

3.370

2,702

2,392

260. A survey of blind persons was conducted during 1960 on similar lines to that undertaken in 1953. The most important change has been the marked decrease in the importance of blindness ascribed to keratomalacia; only two children were discovered to have been blinded by this deficiency disease during the past seven years. Blindness due to trachoma has remained at a comparatively constant level, but all such patients are over the age of forty and no new cases are pre- senting in children. There is a marked increase in blindness due to geriatric causes. The details of the two surveys are shown in Table 32.

TABLE 32

INCIDENCE OF BLINDNESS BY CAUSE IN HONG KONG 1953 AND 1960

Cause

Percentage of Total Blind Persons

Keratomalacia

Cataract

Trachoma

ILL

Injury and infection

Syphilis

Ir.

Congenital defects

Glaucoma

N.S. Uveitis/Optic Atrophy

Others

1953

1960

-..

...

7.5

3.5

elm

2.5

1.5

100.0

FORENSIC PATHOLOGY

261. All medico-legal work in connexion with the investigation of crime is carried out from laboratories situated in the Police Head- quarters building. The laboratories, under the direction of the Principal Forensic Pathologist, are staffed jointly by the Medical and Health and

　Police Departments. Lectures are given in various aspects of medico- legal work to Police personnel and the Principal Forensic Pathologist is Lecturer in Forensic Medicine in the University of Hong Kong. Work undertaken during 1960 is detailed in Table 33.

TABLE 33

WORK OF THE FORENSIC PATHOLOGY LABORATORIES 1960

Examinations of victims and suspects

Attendances at scenes of crime

Attendances at court

IIL

ггг

412

160

IL-

ILL

105 507

Medico-legal post-mortems

Medico-legal examinations of weapons Examinations of hair, fibres and other slides

Examination of clothing

Examination of miscellaneous articles

Blood-grouping (Medico-legal)

Blood-grouping (Police Officers)

Lectures to Police Officers

Assistance in Raids

...

ייז

111

ILL

89 465

721

445

---

1,977

492

Breaches of Pharmacy and Poisons and Penicillin Ordinances Unregistered Medical Practitioners

Abortionists

JJI

Unregistered Dental Practitioners

Public Mortuaries

JIL

---

　　262. Two public mortuaries are maintained by Government, one on Hong Kong Island and the other in Kowloon. It is to these institu- tions that all cases of sudden, unnatural or uncertified death are brought; hence they lie correctly within the sphere of forensic pathology. Con- sequently, in May 1960, the mortuaries were transferred from the control of the Government Pathologist to that of the Principal Forensic Patho- logist. At the same time, administrative arrangements were made with the judiciary to expedite the formalities concerning the issue by Coroners of permission to undertake post-mortem examinations and of permits for burial.

263. An account of the work done in the Mortuaries is in Table 34.

TABLE 34

PUBLIC MORTUARIES 1960

Victoria

Kowloon

Total number of bodies received Total number of autopsies performed

1,271

2,616

1,161

-- J

2,377

Number of bodies claimed Number of bodies unclaimed

746

1,162

525

1,454

TABLE 34 (Contd.)

Deaths due to natural causes Deaths due to unnatural causes

Sex

Male Females

Unknown

111

Victoria

Kowloon

993

ILL

2,159

278

457

838

1,620

433

995

1,261

2,606

זזו

ILL

247

311

ILI

303

456

225

365

211

202

479

ILL

-- J

118

431

IIL

360

175

Race {

Age groups

Chinese

Non-Chinese

Over 60 years 45-59 years

30-44 years 15 - 29 years 1-14 years

LII

1 month - 1 year Under 1 month Age unknown

Still births received

GOVERNMENT CHEMIST'S LABORATORY

264. This laboratory carries out a wide range of analytical and consultant work for Government Departments, for the Armed Services and for commercial and industrial concerns.

265. The work of the laboratory increased by seven per cent during the year compared to 1959, and is outlined in Table 35. During the year the major part of the work was concerned with biochemical analyses and with the examination of narcotics.

TABLE 35

WORK OF THE GOVERNMENT CHEMIST'S LABORATORY 1960

Biochemical

Narcotics Control

Dutiable Commodities

Water & Waterworks Chemicals

Samples Analysed

20,230

13.724

7,148

731

353

1,029

723

230

I-L

492

...

Food & Drugs

Forensic

Toxicology

Dangerous Goods Regulations

Commercial

г.-

---

Import/Export (Prohibition) (Specified Articles) Orders

Miscellaneous

Total

ILL

IIL

553

45,224

　　266. The chemical examination of public water supplies is carried out as a routine, as are analyses of samples of food and drugs for adulteration. Apart from the close co-operation with the Police Depart- ment in narcotics control, a wide field of exhibits were examined in connexion with crimes ranging from acid-throwing and manslaughter by motor vehicle to counterfeiting. Of interest has been the use of paper chromatography for such diverse purposes as the identification of ink in a forgery case and the proof that certain discharged oil came from a particular ship.

267. Toxicological examinations were predominantly for cases of human poisonings, either accidental or suicidal, for homicidal poisoning is rare in Hong Kong. Only one accidental death from parathion poison- ing was seen during the year, as the import of this very dangerous organophosphorous insecticide is now prohibited. Suicide by poisoning is common, the much less toxic organophosphorous compound mala- thion being the most widely used, followed in frequency by barbiturates and cyanide.

　　　268. Work in connexion with dutiable commodities was carried out for the Department of Commerce and Industry and the checking of standards of a wide variety of commodities was undertaken for the Government stores and for certain commercial firms. Analyses of alleged inflammable materials and other dangerous goods are carried out for the Department of Fire Services. In this connection an investiga- tion was undertaken into a tenement fire, followed by an explosion, in which seven people lost their lives; this was traced to the storage of organic blowing agents used in the manufacture of foam rubber and the storage and use of such agents have now been placed under control.

269. In the industrial health field, a survey was undertaken, in conjunction with other Departments concerned, into the occurrence of methane gas in wells in the Kwun Tong industrial area and experiments are continuing into methods of controlling this problem.

　　270. A native sulphide of arsenic, known locally as 'Hung Wong". is widely used in traditional Chinese medicine, particularly in powders for insufflation into the mouth and pharynx. This is a formal contra- vention of the Pharmacy and Poisons Ordinance, but chemical analysis and subsequent animal feeding experiments have shown that 'Hung Wong' is not assimilated to any appreciable extent and that its administration, either internally or externally to the skin, produces no ill-effects. However, as an irritant powder when insufflated into the inflamed or infected throats of children it has given rise to unfortunate

complications. Meetings were held with the Herbalists Guilds to seek their co-operation towards the abolition of this form of traditional medication.

GOVERNMENT INSTITUTE OF PATHOLOGY

271. For over fifty years the pathology services of the Medical and Health Department have been conducted from premises in Caine Lane on Hong Kong Island. In July 1960, the Government Institute of Pathology moved into modern and more commodious premises in the Jockey Club Clinic, Sai Ying Pun, retaining part of the old building for the purpose of vaccine production only.

272. The Government Institute of Pathology provides clinical pathology and public health laboratory services and branches are maintained in the Kowloon, Castle Peak and Lai Chi Kok Hospitals; at the Queen Mary Hospital, all routine clinical pathology, excluding medico-legal work, is carried out by the University Department of Pathology.

273. All branches of public health bacteriology and of clinical pathology are provided at the Government Institute including a newly- established chemical pathology division; the work undertaken has in- creased by 12.4% compared to 1959. At Appendix 15 is a summary of the examinations carried out at the Institute and its branches during 1960.

274. In the field of haematology, 2,942 members of the Auxiliary Medical Services were blood-grouped during the year by staff of the Institute. Incidental to this very necessary measure a picture of the A.B.O. distribution amongst southern Chinese was obtained. Results are shown in Table 36.

TABLE 36

BLOOD GROUPS IN AUXILIARY MEDICAL SERVICE PERSONNEL

Chinese

Non-Chinese

Blood Group

.LL

Total

Percentage

Total

Percentage

Frequency

1,140

40.16

48.57

781

27.60

37.15

699

24.62

9.52

217

7.62

4.76

Total

2.837

100.00

105

100.00

---

Virus Laboratory

　　275. A small Virus Laboratory, established in conjunction with the Department of Pathology in the University of Hong Kong, started work in May 1960. Apart from the surveys on poliomyelitis described in paragraphs 85 to 87 of this report, the laboratory has carried out virus diagnostic work, mainly in the field of influenza and entero- viruses, and has prepared its own stock of neutralising sera.

　　276. Primary monkey kidney cell tissue is employed chiefly for the cultivation and identification of viruses, but Hela cell cultures and amnion cell cultures are also used.

Hospital Mortuaries

　　277. In May 1960, the supervision of the two public mortuaries was transferred to the Principal Forensic Pathologist. However, medico- legal autopsies on patients dying in the Queen Mary or Kowloon Hospitals are performed by medical officers on the staff of the Govern- ment Institute of Pathology.

Examinations of Rodents

　　278. Technicians from the Institute of Pathology continue to examine, as an anti-plague measure, all specimens sent to the public mortuaries by the Pest Control Section of the Urban Services Depart- ment. These examinations which are performed in an unit attached to these mortuaries are detailed in Table 37.

TABLE 37

EXAMINATIONS OF RODENTS 1960

Number of rats examined

JJJ

ILI

Number dissected and examined microscopically

324,376 123,093

120

Nil

Number subjected to complete bacteriological examination Number found infected

Vaccine Production

　　279. The Government Institute of Pathology prepares a number of vaccines which are used by the Medical and Health Department or distributed free to registered medical practitioners as a public health measure. The amounts prepared and issued during 1960 are listed in Table 38.

TABLE 38

VACCINE PRODUCTION 1960

Amount Prepared

Amount issued

Anti-smallpox vaccine Anti-rabies vaccine 2, Anti-rabies vaccine 4%

---

50,396 mls.

23,377 mls.

32,280 mls.

37,080 mls.

29,240 mls.

28,000 mls.

Anti-typhoid-paratyphoid vaccine (Adult) Anti-typhoid-paratyphoid vaccine (children)

61.350 mls.

36,600 mls.

71.800 mis.

44,650 mls.

Anti-plague vaccine

28,060 mls.

600 mls.

Anti-cholera vaccine

34,750

P.P.D. Tuberculin diluted and issued 8.550 mls.

THE PHARMACEUTICAL SERVICE

　280. The purchase of drugs, dressings and instruments and their distribution to Government and, to a lesser degree, to certain Govern- ment-assisted institutions is the responsibility of the Pharmaceutical Service under the direction of the Chief Pharmacist.

　281. During the year the headquarters of the Service was able to expand its previously limited accommodation at the Central Medical Store, located at North Point on Hong Kong Island. There is also a branch Medical Store in Kowloon which acts as the distribution centre for Kowloon and the mainland part of the New Territories. Manufac- ture in bulk of certain pharmaceuticals is undertaken at both these centres and fluids for parenteral administration are prepared at North Point and at the Queen Mary Hospital.

　282. The Chief Pharmacist, who is a member of the Pharmacy Board, has important responsibilities in connexion with the enforcement of the Ordinances dealing with Dangerous Drugs, Pharmacy and Poisons and the control of antibiotics. He has a staff of qualified pharmacists of whom two are occupied full-time on inspectorial duties. The inspec- tion of premises, both manufacturing and retail, and of their records, is carried out regularly.

TABLE 39

WORK OF THE PHARMACEUTICAL SERVICE 1959-60

Parenteral fluids prepared

Other sterile preparations

г.

1959

104.325 litres 106,362 items

1960

116,000 litres

120,475 items

TABLE 39 (Contd.)

1959

1960

Wholesale Poisons Licences issued

350

414

Authorized Sellers Licences issued

Listed Sellers Licences issued (Part II Poisons

only)

282

536

Antibiotic Permits issued

203

223

　Licences for movements of Dangerous Drugs Premises inspected

309

294

L.104

1.625

Prosecutions initiated

THE ALMONER SERVICE

　　283. Under the conditions existing in Hong Kong there is a vast amount of medical social work necessary to support the curative services; the provision of this facility is the responsibility of the Principal Almoner whose staff of Almoners is distributed amongst the hospitals, the larger clinics and certain specialist services. Responsibilities addi- tional to the day to day medical social work include the administration of the Samaritan Fund and of the Special Treatment vote, the distribu- tion of free foods donated by various welfare organizations and the in-service training of newly-recruited almoners. The Almoner Service also participates in the training of medical and social-studies students. and of social workers undergoing in-service training in various other Government departments.

　　284. At the Queen Mary and Kowloon Hospitals much of the work of the Almoners was devoted to the orthopaedic service, particularly in connexion with accidents and early rehabilitation. In the Queen Mary Hospital considerable time was devoted to patients with cancer under- going radiotherapy. In the convalescent wards of Lai Chi Kok Hospital, the most difficult problem that continued to arise was the finding of suitable employment for the disabled.

　　285. At the Tsan Yuk Maternity Hospital the Almoners arranged for diversional therapy to be started, through the good offices of the Hong Kong Branch of the British Red Cross Society, amongst women who spend prolonged periods in the hospital due to various complica- tions of pregnancy.

　　286. With the opening of the Castle Peak Hospital and the establish- ment of a mental day hospital, there was an increase in the number of Almoners working in the Mental Health Service. An important and additional aspect of the work has been the collection of the social histories of patients requesting admission to the Drug Addiction Centre

and the provision of social assistance to the families of patients under- going treatment there.

　287. At the larger out-patient clinics, the medical-social needs of various aspects of the general curative service are met as far as possible and certain Almoners work full-time with the Tuberculosis, Ophthalmic and Social Hygiene Services, particularly in the leprosy branch of the latter.

　288. The assistance and co-operation of the Family Welfare Society, the Church World Service, the Lutheran World Service, C.A.R.E., the Family Planning Association, the Hong Kong Branch of the British. Red Cross Society and the Po Leung Kuk in the medical social work are gratefully acknowledged. The Social Welfare Department continued to give close and valuable co-operation in this field.

Samaritan Fund

　289. Expenditure from this fund rose by $569.75 to a total of $15,057.50 during 1960. As in previous years, most of the grants were in the form of travelling expenses and the re-imbursement of loss of earnings to the escorts of disabled patients.

Special Treatment Vote

　290. With the establishment of the Surgical Appliances Section of the Department a wider range of assistance can be given to amputees and to other physically disabled persons. Consequently there was a marked increase in expenditure from this vote, rising from $20,518 in 1959-60 to $31,730 in 1960-61.

PHYSIOTHERAPY

　291. The Headquarters of this service is at the Physiotherapy Training School which was opened during the year in part of the old Pathology Institute on Hong Kong Island. Physiotherapy units are maintained in the Queen Mary, Kowloon and Lai Chi Kok Hospitals and in the Wan Chai Polyclinic; regular visits are also paid to the Castle Peak Hospital.

　292, Clinics for post-poliomyelitis cases are held at the Wan Chai Polyclinic and in the Kowloon Hospital where treatment and the fitting of appliances is carried out on the advice of the orthopaedic surgeons; hydrotherapy tanks are available at both centres. The size of the classes of children being taught medical exercises increases steadily and all the mothers are also taught how these exercises can be continued in the

home. In a number of cases very irregular attendances has prevented any improvement in the condition of the children and Health Visitors of the Maternal and Child Health Service assist by paying home visit to stress the importance of continued physiotherapy.

293. At the Queen Mary Hospital the number of pre and post- operative chest surgery cases referred for physiotherapy have shown a steady increase and the regular supervision of breathing and other exercises has produced excellent results. There has been further expan- sion of the work of the physiotherapists in connexion with the work of the Neurosurgical Specialist.

294. For the convalescent cases at Lai Chi Kok Hospital, there is close co-operation with the occupational therapists in rehabilitation, particularly of the orthopaedic cases. There is a slowly growing number of paraplegic patients in this hospital and, although each is now provided with a wheel chair, their return to normal community life is made difficult by prevailing housing conditions and by difficulty in obtaining suitable employment.

ORTHOPAEDIC AND PROSTHETIC APPLIANCES

　　295. The appointment of a Surgical Appliance Technician has enabled an expansion in the numbers and variety of prostheses which can be produced in Hong Kong. During the year the major part of the work has been directed at developing methods for the production of artificial legs which are suitable for the climatic and social conditions existing in Hong Kong. This has included an investigation into methods. of reducing the time required for their production, while retaining the standards normally attained only by experienced artisans of long standing.

　　296. Two student technicians were recruited for training in this field and efforts are being made to encourage local suppliers of appliances to improve their standards.

OCCUPATIONAL THERAPY

　　297. The Senior Occupational Therapist, assisted by a staff of Occupational Therapists and Handicraft Instructors, is responsible for providing diversional, specific occupational and re-educative therapy throughout the Department. These activities are concentrated in the institutions where there are 'long-stay' patients, namely the Queen Mary, Castle Peak and Lai Chi Kok Hospitals, while a small unit has been

maintained in the Mental Day Hospital on Hong Kong Island following on the transfer to Castle Peak Hospital of all in-patients of the Victoria Mental Hospital.

　298. A sum of $69,500 was available for the purchase of raw materials and miscellaneous stores and for the provision of incentive payments". Articles produced were sold by the Welfare Handicrafts shop in Kowloon and at the Annual Exhibition of Crafts at the Mental Hospital. In addition, a number of items such as brooms and waste paper baskets are made in quantity for the Government Stores Department,

299. Incentive payments are made to patients in the Castle Peak Hospital who produce articles for sale; this money is used to pay for entertainments such as film shows, Chinese operas, concerts and Chinese dinners. A wide range of articles is produced including paintings, rattan and wooden furniture, baskets of many types, toys, needlework, tape- stries and woven articles,

　300. The opening of the Drug Addiction Centre in the Castle Peak Hospital has created certain problems in the provision of diversional therapy; a start has been made by the provision of musical instruments and by the organization of physical exercises and ball games. A wider variety of activities is being developed in order to prepare the discharged addicts for resumption of their employment and their re-integration into the community.

　301. At the Queen Mary Hospital occupational therapy has been gradually increasing, mainly amongst longer-stay patients suffering from tuberculosis or from orthopaedic conditions which require therapy designed for the early rehabilitation of injured limbs.

　302. At Lai Chi Kok Hospital there is a wide field for both specific and diversional occupational therapy, and archery and quoit games have been commenced for wheel-chair patients. Close co-operation has been maintained with the Physiotherapy Department, particularly in the assistance of disabled patients in the re-acquisition of skills for the essential activities of daily life.

MEDICAL EXAMINATION BOARD

303. This Board performs the medical examination of all new entrants to the Government and the Auxiliary Defence Services. Mem- bers of the Civil Service prior to confirmation to the permanent establish- ment, promotion, or transfer outside Hong Kong are also medically

examined by the Board. In addition, work is carried out for countries which require prospective emigrants to submit a certificate of physical fitness. Each examination involves a comprehensive physical examina- tion, certain routine laboratory investigations, an X-ray of the chest and any other special investigations which may be considered necessary. Specialist advice is available from the Government clinical units.

304. The work continued to increase during 1960, and it was found necessary to post an extra medical officer to the Board for a period of four months to assist in reducing the waiting list. The work of the year is summarized in Table 40.

TABLE 40

WORK OF THE MEDICAL EXAMINATION BOARD 1959-60

New examinations Re-examinations

· ·

Govt. Appointments

1959 7960

Aux. Defence Units 1959 1960

Miscellaneous

Total

1959

1960

1959 1960

7,125 6,284 2,192 3,764 5,433 2,436

2,187

137

9,454

8,570

3,902

6,281 9,411

10,889 11,717 4.628

6,089

218

175 15.735 17,981

Annual Total

　　305. Of the persons referred for a specialist opinion, the great majority are suffering from abnormalities of the respiratory system. Pulmonary tuberculosis accounts for the rejection of 88.5% of all persons rejected as unfit for service. The analysis of the causes of rejection is given in Table 41.

TABLE 41

UNFITNESS BY CAUSES 1959-60

(per 1,000 total examination)

1959

1960

Pulmonary Tuberculosis.

60.12

41.27

Diseases of the Respiratory System (excluding

tuberculosis)

2,41

1.84

Diseases of the Circulatory System

2.66

1.06

Diseases of the Alimentary System

1.01

0.11

Diseases of the Skeletal System

0.50

0.06

Diseases of the Genito-urinary System

0.50

0.33

Diseases of the Nervous System

0.57

0.44

Diseases of the Endocrine System

0.38

0.39

Diseases of the Eye System Diseases of the Skin System Miscellaneous diseases

1.90

0.22

J-J

0.69

IL-

0.06

1.14

0.83

IIL

71.88

46.61

Total ...

　306. The Board also undertakes the immunization of candidates appointed to posts which carry special risks. Immunization procedures. consist of tuberculin testing and Schick testing followed by B.C.G. or diphtheria toxoid vaccination as required and T.A.B. inoculations.

BLOOD BANKS

307. The blood donation centre, maintained by the Hong Kong Branch of the British Red Cross Society on the Hong Kong waterfront, continued to collect and distribute blood to the Blood Banks at the Queen Mary and Kowloon Hospitals; the laboratory work in connexion with blood donations was undertaken by the Government Institute of Pathology.

308. Although the greater part of the blood donated again came from members of the Armed Services or from visiting Royal Navy and United States warships, there is a gradually increasing band of regular donors amongst the Chinese residents and the Donors Club, under the guidance of the Chairman of the Hong Kong Branch of the British Red Cross Society, continued to expand its activities. In addition, a considerable amount of blood is donated directly to the Blood Banks by relatives of patients in the various hospitals. The sources and distri- bution of blood received by the Blood Banks during the past two years are detailed in Tables 42 and 43,

TABLE 42

SOURCES OF BLOOD DONATED 1959-60

British Red Cross Society

Patients' Relatives and Friends

LL-

Other sources

Total received

TABLE 43

DISTRIBUTION OF BLOOD 1959-60

Government Hospitals

Government-Assisted Hospitals

Private Hospitals

Military Hospitals

Manufacture of Plasma

Unusable due to various causes

י - -

6.860 pints

712 pints

74 pints

7,646 pints

-- J

5,383 pints

1,400 pints

231 pints

15 pints

105 pints

400 pints

Total issued

7,534 pints

HOSPITAL MAINTENANCE AND SUPPLY

　　309. This branch of the Medical and Health Department is the re- sponsibility of the Chief Hospital Secretary, assisted by a staff of Hospital and Assistant Hospital Secretaries. There are two group Hospital Secretaries, one at the Queen Mary Hospital and the other at Kowloon Hospital, who are responsible for the routine supply and lay administra- tion of the medical institutions on their respective sides of the harbour. In addition, one Hospital Secretary is working in the Planning Unit at Headquarters and another is stationed at the Castle Peak Hospital. Assistant Hospital Secretaries are posted to major institutions within the two main groups.

310. The function of this branch is the maintenance of the routine administrative work in the hospitals and clinics. This includes the supply of fuel, rations and medical and surgical equipment, the main- tenance of equipment and furniture, the recruitment and discipline of all male menial staff, the maintenance of transport, the accounting for hospital stores, and the initiation of alterations, maintenance and repair work to the fabric of buildings. The Chief Hospital Secretary is also the Departmental Welfare Officer and the U.N.I.C.E.F. Liaison Officer.

　　311, During the year, preparations were made to transfer the day- to-day running and maintenance of the steam and engineering services. in the major institutions to the Electrical and Mechanical Engineering branch of the Public Works Department.

Staff Welfare

　　312. The Medical and Health Department Staff Welfare Associa- tion was inaugurated in July 1960, an event closely followed by the formation of a Branch of the Association in Kowloon. Staff recreation centres are provided in the Queen Mary and Kowloon Hospitals and the Association continues to support a number of welfare schemes to aid the families of members or of pensioners; notable assistance was rendered to an Hospital Orderly whose house collapsed during Typhoon Mary with the consequent loss of many of his possessions.

313. A new departure has been undertaken in the Jockey Club Clinic, Sai Ying Pun, where the staff canteen and a light refreshment kiosk for out-patients are being administered by the Association.

　　314. Staff relations continued to be very good and there were very few cases requiring disciplinary action, in relation to the size of the staff concerned.

UNICEF. Projects

315. Despite supply difficulties encountered by U.N.I.C.E.F. during the early part of the year, the skimmed milk distribution was reduced by less than 10 per cent: 102,852 lbs. of milk powder were distributed to welfare organizations throughout the Colony and the total number of supplementary meals given at feeding centres was 1,096,589.

AUXILIARY MEDICAL SERVICE

316. Recruitment for the Auxiliary Medical Service was continued under the provisions of the Essential Service Corps Ordinance, 1950. The Service reached a strength of over 4,500 men and women who, in the event of a major emergency, are trained and available for the expansion. of hospital and ambulance services. The Medical Defence Staff Officer is responsible for the routine administration and training activities. The Director of Medical and Health Services is the Unit Controller. The ambulance and first aid sections of the Service come under the opera- tional control of the Civil Aid Services during an emergency.

317. By March 1961, three sub-units were active in the New Terri- tories at Tai Po, Tsuen Wan and Cheung Chau and are progressing well. During Typhoon 'Mary' the members of the sub-unit on Cheung Chau rendered valuable aid in rescue and welfare operations.

318. Emphasis is on training and the First Aid Demonstration teams, one on each side of the harbour, have continued to do very good work. Members of ambulance teams have attended the Casualty Depart- ment of the Queen Mary Hospital regularly at week-ends and have gained valuable experience in the expert handling and treatment of casualties; others have been attached to the Ambulance division of the Fire Services Department where they gain valuable practical experience.

319. Co-operation with the Civil Aid Services continued to be of a high standard. During the year, four combined Civil Defence Exercises were staged which covered most of the urban areas of the Colony, The use of wound-faking and acting techniques have contributed con- siderably to the attainment of a marked degree of realism during these exercises.

320. Over sixty per cent of the members of the Auxiliary Medical Service had their blood groups determined during the year, and a further eighteen per cent notified their individual grouping.

TABLE 44

WORK OF THE AUXILIARY MEDICAL SERVICES 1960

Total members

Number of qualified Auxiliary Dressers

Number of qualified Auxiliary Nurses

Number of qualified Drivers

Courses of Instruction:

Basic First aid

Basic Auxiliary Dressers

Auxiliary Dressers Ward Course

L-J

Auxiliary Nurses Hospital Training

Ward Refresher Course

Telephonists/Message writing

Driving

Storekeeping

4,558

996

ILL

380

150

ILI

111

IIL

504

V. TRAINING PROGRAMME

DOCTORS

321. Undergraduate training is carried out at the University of Hong Kong which confers the degrees of M.B., B.S., recognized by the General Medical Council of the United Kingdom. At the present between 35 and 50 students graduate each year from the Faculty of Medicine, but the University, in consultation with the Medical and Health Department, has planned to expand facilities to enable an annual output of eighty doctors.

322. Post-graduate training for higher qualifications is under the supervision of the Panel on Post-Graduate Medical Education which consists of University and Government members. A number of clinical posts in the major hospitals are recognized for post-graduate training by the majority of the examining bodies in the United Kingdom, In most specialist fields, the Department is now assured of an adequate supply of doctors holding higher qualifications who will be needed for the staffing of the Queen Elizabeth Hospital. Certain specialities such as anaesthetics and psychiatry do not as yet attract a sufficient number of recently-qualified doctors to enable a satisfactory training programme to develop.

323. For the third year in succession, the Part 1 examinations for the Diplomas in Medical Radiology in Diagnosis and Therapy were held in the Colony and the assistance of the Examining Board in England in according this facility is gratefully acknowledged.

DENTISTRY

324. To meet Hong Kong's need for more dentists, Government awards annually seven scholarships to candidates selected by a Com- mittee consisting of members of the Department and of the University. By the end of March 1961, there were thirty five Government dental scholars studying in Australian Universities; six scholarship students. returned to Hong Kong having graduated as Bachelors of Dental Surgery in the University of Malaya.

325. Three dental nurses assumed duty in Hong Kong after training overseas, two in New Zealand and one in Penang; no student dental nurses were sent for training during the year. The role of the Dental Nurse is to carry out preventive and minor operative work under the supervision of a Dental Officer and so enable the dental surgeons to concentrate on the major aspects of conservative and curative dentistry,

NURSES

326. One of the major events of the year was the opening by His Excellency the Governor in September 1960, of the Sisters' and Nurses' Quarters and the School of Nursing at the Queen Elizabeth Hospital. It is anticipated that during the next five years an output of 120 trained nurses each year will be required to staff the new hospitals and clinics. planned or under construction. This new School has doubled the Government facilities for the training of nurses, the other Nurses' Preliminary Training School remaining at the Queen Mary Hospital.

327. The new School of Nursing is a two-storied building connecting the nurses' quarters and the sisters' quarters for the Queen Elizabeth Hospital. It contains two air-conditioned lecture theatres, two model wards, a diet kitchen, libraries and study rooms and it is equipped with all modern teaching aids.

328. There is full reciprocity of registration between the Nursing Board in Hong Kong and the General Nursing Council of England and Wales. In Government hospitals the medium of instruction is English, while in the other approved nurses' training schools, which are at the Tung Wah Hospitals, the Alice Ho Miu Ling Nethersole Hospital and the Hong Kong Sanatorium and Hospital, the teaching is carried out in Chinese. Each year a number of qualified nurses go overseas to gain further experience in different aspects of nursing.

329. At the Castle Peak Hospital a course of training for the Registered Mental Nurse Certificate of the Nursing Board is conducted

by a qualified Tutor. However, female applicants for training in Psychiatric Nursing have been very few, largely due to prejudice and a lack of understanding of modern mental hospital techniques.

MIDWIVES

　　330. Registered general nurses who have trained in the Government Schools of Nursing are expected to proceed to a one-year course in midwifery, conducted in English as the teaching medium, in the maternity wards of the Queen Mary and Kowloon Hospitals. Nurses who have trained in the other approved training schools can also take a similar course, conducted in Chinese, in the maternity wards of their respective hospitals.

331. For student midwives who are not registered nurses there is a two-year training course conducted in Chinese by Government staff at the Tsan Yuk Hospital,

HEALTH VISITORS

332. As in previous years, a course of training was held at the Harcourt Health Centre for ten student Health Visitors. Each entrant to this course has previously obtained qualifications both in general nursing and in midwifery. After one year's tuition and study, the students take the examination for the Health Visitor's Certificate which is conducted by the Hong Kong Examination Board of the Royal Society for the Promotion of Health.

RADIOGRAPHERS

　　333. The training for radiographers at the Queen Mary Hospital in radiodiagnosis is recognized by the Society of Radiographers in the United Kingdom. Examinations for both Parts I and II of the Member- ship of the Society have been held annually in the Colony for a number of years.

LABORATORY TECHNICIANS

334. The Government Institute of Pathology is recognized by the Institute of Medical Laboratory Technology in the United Kingdom as a teaching laboratory from which entrance can be gained directly to the Intermediate examination of the Institute. Up to and including 1960, it has been necessary for the students to go to the United Kingdom to sit this examination and to subsequently undergo a further period of instruction there for qualification for entrance to the Associateship

examination. However, agreement was reached with the Institute to hold an Intermediate Examination in Hong Kong in May 1961, and, at the same time to assess the feasibility of holding such examinations regularly in the Colony in future years. The accordance of this facility by the Institute of Medical Laboratory Technology is gratefully acknowledged.

335. The Laboratory maintains an in-service course of training for Medical Laboratory Technicians which follows closely the curriculum of the Institute of Medical Laboratory Technology and which leads to a departmental examination necessary for advancement in the Service. The content of the course enables those suitably qualified to enter later for the Institute of Medical Laboratory Technology examination.

PHYSIOTHERAPY

336. In September 1960, a Physiotherapy Training School was established and the first course of instruction began. The School is accommodated in converted premises in the old Pathology Institute on Hong Kong Island and will remain there until the completion of the Queen Elizabeth Hospital in Kowloon when there will be a properly designed and equipped School of Physiotherapy.

337. The course is a full-time one and is conducted by qualified Physiotherapy Tutors. The syllabus follows completely that laid down by the Chartered Society of Physiotherapy in the United Kingdom.

OTHER FORMS OF DEPARTMENTAL TRAINING

338. Courses of training are held for Dispensers and Tuberculosis Visitors. These do not lead to a recognized qualification, but prepare those concerned for appointment to permanent posts on the Establish- ment after they have passed a departmental examination.

339. A preliminary training period of three months including lec- tures, discussions, visits of observation and practical work is arranged for Almoners who enter the Department with the basic qualifications of a University Degree and a recognized Certificate or Diploma in Social Studies.

340. Table 45 sets out the various categories of training undertaken departmentally during the year:

TABLE 45

DEPARTMENTAL TRAINING 1960

Appointment

Resignation

Strength

Passed

at 31.3.61

Probationer Assistant

Physiotherapist

Student Assistant

Radiographer

2001

イカン

Student Dispenser

Student Laboratory

Laboratory Assistant

Student Medical Laboratory

Technician

Student Nurse

123

292

Student Male Nurse

Student Nurse (Psychiatry)

3(c)

Student Male Nurse (Psychiatry)

26(d)

Student Midwives

Student Midwives (Registered

Nurses) ..

Student Health Visitor

Tuberculosis Visitor

Probationer Almoner

יי

(b) Final Parı.

(c) In addition, there are 7 student nurses (Psychiatry) training in United Kingdom. (d) In addition, there are 10 student male nurses (Phychiatry) training in United Kingdom,

341.

COURSES OF STUDY OVERSEAS

　　　　　The following table sets out the courses of study outside Hong Kong attended by officers of the Medical and Health Department during 1960-61:

Appointment

Course of Study

Place of Study

Source of Funds

3 Medical Officers

г.

Fellowship, Royal College of

Surgeons

U.K.

Government

1 Assistant Medical

Officer

Diploma in Public Health

Singapore

Hong Kong

Junior

Chamber of

Commerce

I Almoner Class 1

Training in Anti-Tuberculosis U.K.

Government

Work

2 Male Nurses

Orthopaedic Nursing

U.K.

Government

| Male Nurse

Dermatological Nursing

U.K.

Government

| Sister Tutor

| Nursing Sister | Specialist

■

Up-to-date Teaching Method

U.K.

Government

Blood Transfusion

U.K.

Government

Oral Surgery and Advanced conservation Technique

U.K.

Government

Place of

Source of

Appointment

1 Assistant

Physiotherapist

1 Almoner Class I I Medical Officer

Course of Study

Membership, Chartered Society U.K.

Study

Funds

Government

of Physiotherapy

Medical Social Work

U.K.

Government

Diploma in Medical

U.K.

Government

Radiotherapy

I Medical Officer

Diploma in Medical Diagnosis

U.K.

Government

I Medical Officer

Fellow of the Faculty of

U.K.

Government

Anaesthetics, Royal College

of Surgeons

I Dental Officer..

Oral Surgery

U.K.

Government

1 Assistant Dental Officer

Public Dentistry

U.K.

Government

I Nursing Sister

Nursing Administration

U.K.

Colonial

Develop-

ment and Welfare Fund

1 Male Charge Nurse. Fellowship of the Institute of

Technicians in Veneroology

U.K.

Government

3 Medical Officers

Membership, Royal College of

U.K.

Government

Physicians

I Physicist

2 Medical Laboratory

Technicians Grade II

I Male Nurse

| Health Visitor 2 Radiographers

I Medical Officer

I Assistant Chemist

1 Nurses

· L

Hospital Physics

U.K.

Government

Associateship, Institute of

U.K.

Government

Laboratory Technology

Electro-Encephalography

U.K.

Government

Speech Therapy

U.K.

Government

Membership, Society of

U.K.

Government

Radiographers (Therapy)

Pathology and Histopathology

U.K.

Government

Forensic Training

U.K.

Government

Chest Surgery Nursing

U.K.

Private

5 Nurses

Plastic Surgery Nursing

U.K.

Private

1 Nurse

Diploma of Midwifery

Australia Private

Tutorship

J Nurse

Thoracic Surgery Nursing

U.K.

Private

VI. DEVELOPMENT PROGRAMME

PLANNING UNIT

342. This unit is situated at Medical Headquarters and was established towards the end of 1959. It is staffed by a Principal Medical and Health Officer and a Hospital Secretary. The functions are two- fold, to prepare a comprehensive outline plan for the provision of medical facilities in Hong Kong in consultation with the relevant branches of the Department and thereafter to undertake, in close liaison

with the Public Works Department, the detailed planning of each unit approved by the Finance Committee of the Legislative Council.

343. During 1957 an outline plan of development covering a period of fifteen years was proposed. This outline plan covered the minimum desirable but had to be related to building capacity and staff training. Accordingly, in 1959 a detailed plan for the five years 1960 to 1965 was prepared and submitted to Executive Council for approval in principle in June 1960. This approval was given, subject to the examina- tion by Finance Committee of the detail of each individual project included within the five year segment. Following on the census in March 1961, planning will start on the detail of the programme proposed for 1966 to 1972.

344. The Planning Unit prepares draft schedules of accommodation, staff and equipment for each project which is to be included in the estimates. These schedules are then examined with the Colonial Secretariat before submission to the Public Works Sub-Committee and the Select Committee on Estimates. If approved for inclusion in the Estimates, detailed schedules are then prepared and authority sought for sketch plans to be drawn. Once sketch plans are approved, working drawings can be started as soon as the project concerned is allotted its priority. On the completion of a project the Planning Unit arranges for its initial equipment after which it is handed over to the relevant branch of the Department responsible for its maintenance.

345. A considerable proportion of the work of the unit is now concerned with the detail of the planning and equipment of the Queen Elizabeth Hospital which is expected to be completed in March 1963. Assistance has also been given to bodies engaged in the planning of Government subsidized institutions and to voluntary and other organiza- tions engaged in hospital and clinic construction. In this way effort can be co-ordinated with the Government development plans so that the services provided by all agencies can be as evenly distributed as possible.

346.

During the financial year 1960-61 sixteen projects were com- pleted and handed over. These projects varied in size from the 1,000-bed mental hospital at Castle Peak to a clinic and maternity home of seven beds at the border town of Sha Tau Kok. Twenty four other building or extension projects were in hand at the end of the year of which six were under construction. These projects are detailed below.

BUILDING PROGRAMME

347. An outline of the development projects completed, under con- struction or approved is as follows:

(a) New projects completed :

April 7, 1960

April 18, 1960 May 1, 1960

May 30, 1960

June 7, 1960

June 14, 1960 Junc 18, 1960

July 8, 1960

July 14, 1960

August 6, 1960

Sept. 5, 1960

Oct. 5, 1960

Dec. 14, 1960

Feb. 1, 1961

March 24, 1961 March 27, 1961

Sha Tau Kok Clinic containing a general clinic and a

7-bed Maternity Home.

Two Wards at Kowloon Hospital containing 68 beds. Polio-Virus Laboratory for the investigation of the

enteric viruses.

Fanling Dental Clinic in the Frontier Division Police

Headquarters.

Jockey Club Clinic, Kennedy Town containing a general clinic, a Maternal & Child Health Centre and a 5-bed Maternity Home.

South Lantau Hospital containing 17 beds, Lai Chi Kok Isolation Unit for the segregation of

suspected cases of the quarantinable diseases. Jockey Club Clinic, Sai Ying Pun containing general, Chest and Social Hygiene Clinics, specialist clinics for medicine, surgery, eye, ear nose and throat, obstetrics and gynaecology, paediatrics and orthopaedics, a Radiological Department and the Hong Kong Govern- ment Institute of Pathology.

Kowloon Hospital Staff Recreation Club.

Kowloon Hospital Operating Theatre Suite containing two major and two minor theatres and ancillary accommodation.

Queen Elizabeth Hospital Quarters for Nursing Staff containing a School of Nursing and quarters for 564 nursing personnel.

Cheung Sha Wan Police Clinic containing a general and

a Dental Clinic.

Jockey Club Clinic, Aberdeen containing a general clinic, a Maternal and Child Health Centre, a Dental Clinic and a 24-bed Maternity Home.

Kowloon Hospital Kitchen containing modern equipment and large enough to cater for any foreseeable expan- sion of this hospital,

Two Wards at Kowloon Hospital containing 108 beds. Castle Peak Hospital containing 1.000 beds for mental cases, of which 120 are being used temporarily for drug addicts, and the usual staff and ancillary accom- modation for such a hospital.

(b) Projects under construction on 31.3.61:

(i) Air Port Health Station -work is continuing.

(ii) Jockey Club Clinic. Shek Wu Hui- this is progressing well and

the building is expected to be opened in June 1961.

(iii) Kowloon Hospital--work on the conversion of the old nurses quarters to wards is in progress and is expected to be finished in July 1961.

(iv) Queen Elizabeth Hospital--construction of the main superstruc- ture is due to commence in June 1961, the foundations and basement having been completed in November 1960.

(v) Queen Mary Hospital Physics Laboratory- it is expected that

this will open in April 1961.

(vi) Wong Tai Sin Resettlement Clinic this clinic is expected to be

in operation by May 1961.

(i) Anne Black Clinic, North Point.

(ii) Kam Tin Clinic,

(iii) Kwun Tong Clinic.

(iv) Medical Department Store, Pokfulam.

(v) Queen Elizabeth Hospital Specialist Clinic. (vi) Sha Tin Clinic.

(d) Projects for which planning is in progress :

G) Combined Vaccine Institute.

(ii) Government Stores, Kowloon (Includes Medical and Health

Department Stores).

(iii) Jockey Club Clinic, Shau Kei Wan.

(iv) Jockey Club Clinic, Wang Tau Hom.

(v) Jockey Club Surgical Appliances Centre.

(vi) Li Kee Memorial Dispensary (Extension).

(vii) Li Po Chun Clinic, Tai Kok Tsui.

(viii) Queen Mary Hospital (Extension).

(ix) Sir Robert Black Clinic. San Po Kong.

(x) Tsuen Wan Clinic.

(xi) Yau Ma Tei Clinic.

(xii) Yuen Long Clinic,

VII. MISCELLANEOUS

ATTENDANCE AT CONFERENCES AND MEETINGS

348. The following table sets out the attendances by officers of the Medical and Health Department at Meetings and Conferences during 1960-61.

Appointment

　　Senior Tuberculosis Specialist Acting Director of Medical &

Health Services

Conferences etc. attended

"W.H.O. Seminar on Tuberculosis

IIth Session of the World Health Organization Regional Committee for the Western Pacific

Place

Sydney

Manila

Appointment

Principal Medical & Health

Officer

Senior Psychiatric Specialist

Surgical Specialist

1 1

Almoner Class 1

Principal Forensic Pathologist

Industrial Health Officer..

Senior Tuberculosis Specialist

Medical Specialist

Health Sister

Surgical Specialists. Orthopaedic Specialist Orthopaedic Specialist

Principal Almoner

L ·

Conferences etc. attended

*Public Health Conference, World

Health Organization

International Research Seminar and International Congress of Ger- ontology

6th

International Congress on Diseases of the Chest

Conference of World Federation

for Mental Health

Second International Meeting of Forensic Pathology and the Meetings of

of the College of American Pathologists and the Society of Clinical Pathologists

•W.H.O. Seminar on Occupational

Health

*17th Conference of Tuberculosis

and Chest Diseases Workers

Meetings of the Asian Gastro-

enterology Society

*Health Congress of the Royal Society for the Promotion of Health

18th Congress of Pan-Pacific

Surgical Association

8th World Congress of Interna- tional Society for the Welfare of Cripples and World Com- mission on Research in Rehabi- litation

International Conference of Schools

of Social Work and 10th Inter- national Conference of Social Work

Place

Singapore

San

Francisco

Vienna

Edinburgh

New York

.. Chicago

Tokyo

Cuttack,

Orissa,

India

Tokyo

Torquay

Honolulu

New York

Rome

Medical & Health Officer

First Congress of the Asia-Pacific

Academy in Ophthalmology

Manila

Funds provided by the sponsoring organization.

VISITORS

349. The following distinguished medical men and women visited Hong Kong during 1960-61:

General

(i) Dr. A. H. Randeli CHAMPION, a leading authority on plastic surgery from the University of Manchester and the Manchester Royal Infirmary, arrived on 4.4.60 on a two-day's visit.

(ii) Miss J. RITCHIE, Nutritionist of the Food and Agriculture

Organization of the United Nations, from 26.4.60 to 27.4.60. (iii) Sir Selwyn SELWYN-CLARKE, former Director of Medical Services,

passed through Hong Kong on 30.6.60 on a private visit.

(iv) Dr. David LIVINGSTONE of New Zealand, from 10.7.60 to 13.7.60. (v) Dr. D. A. BAIRD, O.B.E., Director of Medical Services, Sarawak, Dr. J. A. B. NICHOLSON, Deputy Director of Medical Services, North Borneo, and Dr. C. MARCUS, Director of Medical Services, Singapore, passed through Hong Kong on their way to attend the 11th Session of W.H.O. Western Pacific Regional Committee Meeting held in Manila between 12.8.60 to 17.8.60.

(vi) Dr. R. J. WALSH, O.B.E, an Australian authority on blood transfusion, blood chemistry and blood group genetics, from 27.8.60 to 1.9.60.

(vii) Dr. A. BRUNSGAARD, Chief Medical Officer, Ministry of Labour,

Norway, arrived on 14.9.60 on a week's visit.

(viii) Professor 1. G. W. HILL, C.B.E., M.D., F.R.C.P., Professor of General Medicine, University of St. Andrews, arrived on 30.10.60 for a two-week visit as a member of the Colonial Office Panel of Medical Visitors. Professor HILL visited most hospitals and many clinics during his stay. This was Professor HILL's second visit to Hong Kong having previously been here in 1956. (ix) Dr. F. G. YOUNG, Professor of Biochemistry in the University of

Cambridge, arrived on 24.11.60 for a two-day's visit.

(x) Drs. Ho Guan-lim and K. KANAGARATNAM, Acting Assistant Director of Medical Services (Hospitals) and Acting Assistant Director of Medical Services (Health) respectively, of Singapore, arrived on 6.11.60 on a four-day visit.

(xi) Dr. Erb па BANGXANG, Chief Medical Officer of Health and Acting Deputy Director General, Thailand, and Mrs. BANGXANG, arrived on 6.11.60 on a week's visit.

(xii) Dr. YONG Ma-ha of the National Kaing Saing Won Leprosarium, Sorokto, Republic of Korea, arrived on 27.11.60 on a week's visit.

(xiii) Dr. Manzoor Ahmad KHAN, Clinical Registrar of the Orthopaedic

Department, Mayo Hospital, Lahore.

(xiv) Professor Richard S. BOND of the School of Public Health, University of Minnesota, arrived on 22.12.60 on a two-day visit.

(xv) Dr. (Miss) R. SCHOENTAL, member of the British Medical

Research Council's staff at their Toxicology Research Laboratory in Carshalton, England, arrived on 11.1.61 for a short visit. (xvi) Dr. B. S. KURANA, Deputy Director General of Health Services,

India, arrived on 28.1.61 on a five-day visit.

(xvii) The following examiners of the Worshipful Society of Apothecaries of London conducted examinations for the L.M.S.S.A. during November and December: Professor J. H. DIBLE, LL.D., F.R.C.P.. Dr. Kenneth PERRY, M.A., F.R.C.P..

Dr. R. S. Bruce PEARSON, B.Ch., F.R.C.P.. Mr. E. G. TuCKWELL, M.Ch., F.R.C.S.,

Mr. Anthony CHARLES, T.D., F.R.C.O.G.

(xviii) The following examiners from the Examining Board in England conducted examinations for the D.M.R. (D) & (T) (Part I) in March 1961.

Dr. J. W. MCLAREN, M.R.C.P., F.F.R.,

Dr. H. F. Cook, Reader in Physics at the Middlesex

Hospital Medical School.

World Health Organization & U.N.I.C.E.F. Visitors

(i) Mrs. A. M. KESSLER of U.N.I.C.E.F.

(ii) Dr. F. O. MACCALLUM of the Central Public Health Laboratory at Colindale and W.H.O. Consultant on Virus Diagnostic Laboratories, from 5.6.60 to 14.6.60.

(iii) Dr. G. R. WADSWORTH, W.H.O. Regional Nutrition Adviser,

arrived on 4.6.60 and left on 9.6.60.

(iv) Dr. A. HUTCHISON, Medical Officer of Health, City & County of Kingston upon Hull, Guildhall, Kingston upon Hull, United Kingdom, and W.H.O. Consultant on Social and Occupational Health, arrived on 15.7.60 and departed on 19.7.60.

(v) Dr. J. BURTON, Health Education Officer. W.H.O. Geneva,

arrived on 25.10.60 on a short visit.

(vi) Mr. M. P. SIEGAL, Assistant Director General of the W.H.O. accompanied by Dr. I. C. FANG, Regional Director, from 17.1.61 to 22.1.61.

(vii) Dr. R. SANSONNENS, Chief Medical Officer of the Health Laboratory Services Section, W.H.O. Headquarters, Geneva, arrived on 3.1.61 on a short visit.

(viii) Mr. S. POLAK, Resident Representative. U.N.1.C.E.F. Thai Area

Mission, from 23.1.61 to 27.1.61.

(ix) Dr. J. C. TAO, Regional Tuberculosis Adviser, W.H.O. Head-

quarters, arrived on 13.2.61 on a two-day's visit.

(x) Dr. C. A. ALVARADO, Director of Division of Malaria Eradica-

tion W.H.O., arrived on 9.3.61 on a two-day's visit.

(xi) Dr. Stanley C. WIGLEY, Specialist Medical Officer (Tuberculosis) of the Department of Public Health, Territory of Papua and New Guinea, arrived on 27.3.61 on a week's visit on a W.H.O. Fellowship.

PUBLICATIONS

　　　350. The following articles were published by members of the Department.

Title of Article

Dental Health Education

of the Public.

Dentistry in Asian

Countries.

Tuberculosis Trends in

Hong Kong. A major victory for B.C.G. Vaccination?

Acule Haemorrhagic

Pancreatitis as a Cause of Sudden and

unexpected Death,

Ageing and Mental Health

in Hong Kong,

Powered Orthopaedic

Appliances.

Publication

Xi Psi Phi Quarterly,

Summer 1960. International Dental

Journal, September,

1960.

Indian Tuberculosis

Journal, March, 1961.

Bulletin of the Chinese

Medical Association. Hong Kong.

Proceedings of the

International Research Seminar on Ageing in relation to Mental Health: University of Michigan and National Institutes of Health, Bethesda.

International Society

for the Welfare of Cripples Technical Bulletin.

OBITUARY

Name and Title of Author Mr. Walter C, ALLWRIGHT, Senior Dental Specialist. Mr. Walter C. ALLWRIGHT, Senior Dental Specialist.

Dr. A. S. MOODIE,

Senior Tuberculosis Specialist

Drs. T. C. PANG, T. F.

TONG. Y. K. ONG and S. H. CHEAH, Department of Forensic Pathology. Dr. P. M. YAP.

Senior Psychiatric Specialist.

Mr. J. A. E. GLEAVE, Surgical Appliance Technician.

　　　351. It is with deep regret that the death is recorded, on 8th October, 1960, of Dr. G. M. THOMSON, Senior Social Hygiene Specialist while attending a Conference in Oslo. Dr. Thomson, who was a well known figure in the international field of venereal disease control. was respon-

sible for the initial organization and subsequent development of the Social Hygiene Service in Hong Kong. His quiet efficiency, kindly interest and high professional ability were admired and respected by his patients and colleagues alike,

ACKNOWLEDGMENT

352. It is again a privilege and a pleasant duty to pay tribute to all who have been engaged in the work of the Department. The summation of individual effort is expressed in the volume of work achieved by a loyal and hard working team, under continuous heavy pressure. It has been due to the support and co-operation of other Departments of Government, particularly in connexion with development plans, that urgently needed buildings and extensions have become available. A special tribute is paid to the Architectural Branch of the Public Works Department which made possible the early completion and opening of the Castle Peak Hospital.

353. The assistance of the many missionary, voluntary and charitable welfare agencies who do so much for the sick and needy in Hong Kong makes a very large contribution to the medical and health services as a whole. Their devoted work and essential contribution are gratefully acknowledged.

28th June, 1961.

D. J. M. MACKENZIE,

Director of Medical and Health Services.

SAMARITAN FUND

INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31ST MARCH. 1961

EXPENDITURE

Maintenance, capital grants, clothing, food and

---

travelling expenses, etc. Balance carried to Accumulated Fund

814,241.50 Donations 4.061.95

$18,303,45

BALANCE SHEET AS AT 31ST MARCH, 1961

INCOME

$18,303.45

LIABILITIES

ASSETS

Accumulated Fund as at 1.4.60

$15,813.20

Cash with Accountant General

$23,579.30

Surplus from Income and

Expenditure A/c

4,061.95 $19,875.15

Patients Deposits

3,704.15

$23,579.30

Certified correct.

G. AGADEG.

Certified correct.

S. C. CHENG,

for Director of Medical & Health Services. 31st May, 1961.

Acting Principal Almoner, Medical & Health Department. 31st May, 1961.

CERTIFICATE OF THE DIRECTOR OF AUDIT

The above statement of account has been examined in accordance with Condition 5 of the Schedule to Legislative Council Resolution dated 24th May, 1950 (G.N. No. A. 113 of 26th May, 1950 amended by G.N. No. A. 33 of 20th April, 1960). 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 statement is correct.

AUDIT DEPARTMENT,

Hong Kong, 8th June, 1961,

W. J. D. COOPER, Director of Audi.

NURSES REWARDS AND FINES FUND

STATEMENT OF RECEIPTS AND PAYMENTS FOR THE YEAR ENDED 31ST MARCH, 1961

Description

Amount

Description

Amount

RECEIPTS

PAYMENTS

To Balance forward (on deposit with Accountant General)

$1,000.67

---

By Purchase of prizes, certificates, etc. for the year 1961

$ 214.15

JIL

$1.000.67

Provision of tea on the occasion of presentation of certificates and prizes to Nurses and Dressers for the year 1961

786.32

...

$1,000.67

Certified correct.

G. AGABEG,

for Director of Medical & Health Services.

Certified correct.

B. G. SCHOFIELD,

Principal Matron, Medical & Health Department.

CERTIFICATE OF THE DIRECTOR OF AUDIT

The above statement has been examined in accordance with Condition 5 of the Schedule to Legislative Council Resolution dated 24th May, 1950 (G.N. No. A. 115 of 26th May, 1950). 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 statement in correct.

AUDIT DEPARTMENT,

Hong Kong, 8th June, 1961.

W. J. D. CoOPER, Director of Audit.

3.0

୮

нона коно

ISLAND MEDICAL

ILITIE

HONG

KONG

الحميد

HONG KONG ISLAND

1. Kennedy Town Jockey Club Clinic (a maternity home

with general outpatient facilities and a maternal and

child health centre).

Li Sing Primary School Clinic.

Ling Yuet Sin Infants' Home.

Tsan Yuk Hospital (a maternity hospital).

Mental Day Hospital.

Sai Ying Pun Hospital (infectious diseases) and Sai

Ying Pun Jockey Club Clinic (general outpatient with special clinics).

Tung Wah Hospital (a general hospital, with outpatient department and special clinics).

hospital).

21.

22,

23.

24.

Wan Chai Clinic (a dental centre, tuberculosis clinic, and physiotherapy department).

Ruttonjee Sanatorium (a tuberculosis hospital). Wan Chai Hospital (a hospital for venereal and der- matological treatment).

Harcourt Health Centre (a school health, maternal and child health centre and a male social hygiene elinic).

25. Hong Kong Sanatorium & Hospital (a general

hospital).

St. Paul's Hospital (a general hospital).

8. Alice Ho Miu Ling Nethersole Hospital (a general

Port Health Inoculation Centre, Marine Building. 10. Central District Health Centre (general outpatient facilities, Maternal and Child Health Centre and special clinics).

11.

Police Medical Post (general outpatient and dental facilities for police officers and their families).

13.

12. Victoria Remand Prison Clinic (general outpatient facilities for prison officers and their families, and general outpatient facilities for detainees). Port Health Inoculation Centre, Fung House. 14. Hong Kong Central Hospital (a general hospital). 15. Ilong Kong Families Clinic (general outpatient facilities for English-speaking Government servants and their families).

16. Canossa Hospital (a general Hospital). 17. Military Hospital, Bowen Road (a general hospital). 18. Medical Examination Board.

19. Violet Peel Polyclinic (general outpatient facilities with special clinics and an ophthalmic centre).

20. Eastern Dispensary and Maternity Hospital (a mater- nity home with general outpatient facilities).

26.

27.

Tung Wah Eastern Hospital (a general hospital and outpatient departinent),

28.

St. John Ambulance Brigade Centre.

29.

Mount Butler Quarry Clinic.

30.

North Point School Clinic and Maternal & Child Health Centre.

31.

32.

North Point Health Centre (an outpatient department). Shau Kei Wan Public Dispensary (general outpatient facilities with special clinica),

33. Chai Wan Clinic and Maternal & Child Health Centre. 34. Stanley Prison Hospital.

35.

36.

Stanley Dispensary & Maternity Home (general out- patient facilities and maternity home). Grantham Hospital (a tuberculosis hospital),

37,

Aberdeen Jockey Club Clinic (a maternity home with general outpatient facilities and specist clinics).

39.

Military Hospital, Mount Kellet (a general hospital). Queen Mary Hospital (an acute general hospital with casualty department).

38. Matilda Hospital (a general hospital).

40.

41. Sandy Bay Convalescent Home (an orthopaedic hospital for children).

Lai Chi Ka

Sham Shui Po

KOWLOON PENINSULA MEDICAL FACILITIES

Meng, Koi Tour

You Ma

Trim Sha Tégl

ྋསྐ

Kowloon City

Hung Hom

victer

Kowloon

Bay

North Point

42.

43.

KOWLOON

Lai Chi Kok Hospital (an infectious diseases and convalescent hospital, with an Isolation Unit for the segregation of suspected cases of the quaran- tinable diseases).

Lai Chi Kok Female Prison Hospital.

44. Cheung Sha Wan Police Quarters Clinic (general out- patient and dental facilities for police officers and their families).

45. Li Cheng Uk Clinic (general outpatient facilities). 46. Shek Kip Mei Health Centre (general outpatient facilities with special clinics, a chest clinic and maternal & child health centre).

47. Tai Hang Tung Clinic (general outpatient facilities). 48. Precious Blood Hospital (a general hospital).

55. Kowloon Police Medical Post (general outpatient and dental facilities for police officers and their families).

56. Ashley Road Social Hygiene Clinic (a male treatment centre for venereal disease).

57. Kowloon-Canton Railway Staff Clinic (general out- patient and dental facilities for Railway staff and their families).

58. Tsim Sha Tsui Health Centre (a school health, maternal & child health centre, including a female social bygiene clinic and port health inoculation centre).

59. Hung Hom Clinic & Maternity Home (general out- patient facilities with special clinics and maternity home).

60.

61.

49. Sham Shui Po Public Dispensary (general outpatient facilities with special clinics),

62.

50. Mong Kok Clinic (general outpatient facilities).

51.

Government Ophthalmic Clinic-Arran Street (an ophthalmic centre).

63.

64.

52. Queen Elizabeth School Clinic.

53. Kwong Wah Hospital (a general hospital and infirmary with outpatient department).

54. Yau Ma Tei Public Dispensary (general outpatient facilities).

Ho Man Tin Maternal & Child Health Centre.

Kowloon Chest Clinic (a tuberculosis clinic).

Kowloon Hospital and Outpatient Department (an acute general hospital with casualty department and outpatient department with special and dental clinics

St. Teresa's Hospital (a general hospital).

Kowloon Families Clinic (general outpatient facilities for English-speaking Government officers and their families).

65. Li Kee Memorial Dispensary (general outpatient facilities with special clinics and a dental clinic).

66. Ngau Tau Kok Maternal & Child Health Centre.

屮

ז= -ז י

NEW TERRITORIES

MEDICAL FACILI

LANTAU

ано

DEC+

LAT

וי

TE CHAN

HONG KONG AND THE NEW TERRITORIES

זי

155

NEW TERRITORIES

67. Sha Tau Kok Clinic (general outpatient facilities with maternity beds),

68. Fanling Hospital (a general hospital),

69. Ho Tung Dispensary (a maternity bone with convalescent beds).

70. Pok Oi Hospital (a general hospital).

71. Yuen Long Dispensary (general outpatient facilities with special clinics).

72. Castle Peak Hospital (a mental bospital. 120 beds are being used temporarily for drug addicts).

73.

San Hui Dispensary (a maternity home, with special clinics),

74. Maurine Grantham Health Centre (general outpatient facilities with special clinics and a Maternal & Child Health Centre).

75. Sha Tin Maternity Home.

76. Tai Po Jockey Club Clinic (general outpatient facilities, special clinics including a dental clinic and maternity beds).

77. Sai Kung Dispensary (general outpatient facilities, special clinics and maternity beds).

78. Haven of Hope Tuberculosis Sanatorium.

79. Nansen Tuberculosis Rehabilitation Centre.

80. Peng Chau Clinic (general outpatient facilities and special clinics with maternity beds). 81. Hei Ling Chau Leprosarium.

82. North Lamma Clinic (general outpatient facilities with maternity bede).

83. St. John Ifospital (a general hospital and outpatient department with special clinics).

84. Silver Mine Bay Dispensary (general outpatient facilities with maternity beds).

85. Tai O Dispensary (general outpatient facilities, with special clinics and maternity beds). 86. Shek Pik First Aid Post.

87. South Lantau Hospital (a general hospital with general outpatient facilities).

APPENDIX 1

ESTABLISHMENT OF THE MEDICAL & HEALTH DEPARTMENT AS AT 31.3.61

Director of Medical & Health Services...

　　Deputy Director of Medical & Health Services Assistant Director of Medical & Health Services

---

TIE

Principal Medical & Health Officer

Senior Specialist

Specialist

Secretary

---

-77

ггт

---

ILJ

י ד !

ז.-

---

...

-- J

Treasury Accountant

---

Senior Medical & Health Officer

---

Medical Officer, Assistant Medical Officer, Woman Medical Officer, Assistant

Woman Medical Officer and House Officer

Dental Surgeon and Assistant Dental Surgeon

Government Chemist

IT-

---

Chemist, Assistant Chemist, Biochemist and Assistant Biochemist

Principal Matron

Scientific Officer (Medical)

Nursing Staff

Dietitian

Principal Almoner

---

LJ L

ILJ

...

ILI

LIL

367

---

1-1

ILJ

LJ-

1,849

---

ITI

---

Almoner Class I and Almoner Class II

Executive Grade Officer

Clerical Staf

---

LII

LIL

LII

　　Chief Pharmacist, Pharmacist, Dispenser and Dispensary Supervisor Superintendent Radiographer, Senior Radiographer, Radiographer and Assistant

Radiographer

J.J

Superintendent Physiotherapist, Tutor Physiotherapist, Physiotherapist and

Assistant Physiotherapist

ILJ

Senior Physicist and Physicist

Occupational Therapist

...

LIL

---

Chief Medical Technologist, Senior Medical Technologist, Medical Technologist

and Medical Laboratory Technician

107

Senior Laboratory Assistant and Laboratory Assistant

Chief Hospital Secretary, Hospital Secretary and Assistant Hospital Secretary... Health Inspector and Malaria Inspector

Senior Inoculator and Inoculator

Surgical Appliance Technician

Other Staff

---

ITI

---

297

132

- L

IIT

---

3,304

Total

---

6,492

---

101

APPENDIX 2

THE DIVISIONS OF THE MEDICAL AND HEALTH DEPARTMENT

Medical Services

Hospitals, general clinics and outpatient departments

-excluding New Territories.

Clinical Specialist Services.

Pharmaceutical Service.

Radiological Service,

Almoner Service,

Physiotherapy Service.

Occupational Therapy Service.

Medical Examination Board.

Health Services

New Territories-Curative and preventive.

Government Institute of Pathology.

Maternal and Child Health Service.

District Midwifery Service.

School Health Service.

Dental Service.

Tuberculosis Service.

Social Hygiene Service.

Port Health Service-including epidemiology.

Malaria Control Service.

Government Chemist's Laboratory.

Forensic Pathology.

Industrial Health.

Health Education.

International Health Liaison.

102

103

APPENDIX 3

STATEMENT OF EXPENDITURE FROM 1956-57 TO 1960-61

Particulars

1956-57

1957-58

1958-59

1959-60

1960-61

(a) Medical and Health Department

30,048,868 34,864,883 39,792,228 45,925,081

56,573,091

(b) Medical Subventions

7,411,263 9,706,931 14,178,093 18,988,424

21,910,889

LJL

LJI

Total

Total expenditure of the Colany.

...

1,706,233 1,408,976 5,755,291 15,442,311 12,369,272

39,166,364 45.980.790 59,725,612 80,355.816 90,853,252

Percentage of Medical and Health Deportment

Expenditure to the Total Expenditure of the Colony

469,544,298 532,679,217 589,958,367 709,953,996: 845,297,629

8.34%

8.63%

10.12%

11.31%

10.75%

104

APPENDIX 4

ANALYSIS OF MORTALITY FOR THE YEARS 1956-60 (Given as Percentage Total Deaths)

Disease Group

Detailed List Number:

1956

1957

1958

1959

1960

I. Infectious and Parasitic

001-138

16.2

16.6

14.6

14.2

14.4

Neoplastic

140-239

7.0

7.5

8.9

9.3

10.5

LIL

Allergic, Endocrine, Metabolic and Bload...

240-299

1.2

1.6

1.1

4. Nervous System and Sense Organs

300-398

4.9

4.6

5.3

6.2

7.2

---

5. Circulatory System

---

400-468

7.6

8.0

8.3

8.9

9.7

...

6. Respiratory

470-527

21.3

22.8

24.2

22.3

19.3

7. Intestinal

---

IIL

530-587

15.1

12.1

11.1

[1.3

9.3

8. Genito-Urinary

590-637

2.1

2,2

1.9

2.1

9. Pregnancy, Childbirth and Puerperium

640-689

0.5

0.4

0.3

10. Skia anb Musculo-Skeletal...

690-749

0.4

0.5

0.4

0.3

11. Congenital Malformations and Diseases of Early Infancy

12.

Ill-defined Causes

LII

13. Accidents, Poisoning and Violence...

750-776

11.2

10.5

10.8

9.3

10.7

780-795

7.5

8.2

8.0

8.7

9.5

...

E800-E999

5.0

4.8

5.8

5.7

---

105

Diseases

APPENDIX 5

INFECTIOUS DISEASES NOTIFIED CASES AND DEATHS 1956-60

Amoebic dysentery

Bacillary dysentery (Including

unspecified dysentery)...

Cerebro-spinal meningitis

Enteric fever (Typhoid & Para-

Chickenpox

Diphtheria

typhoid)

Malaria

Measles

ITI

ILJ

LIJ

1956

1957

1958

1959

1960

Cases

Deaths

Cases Deaths Cases Deaths

Cases Deaths

182

217!

262

239

334

560

550

424

663

678

273

280

278

304

714

1,239

129

1,555

134

...

2,087

116

1,450

789

728

816

997

773

496

447

659

442

033

709

875

786

191

743

176

710

192

105

244

254

262

148

...

12,155

2,629

13,665

2,675

13,485 2,302 14.302

2,178 [2,425

2,085

---

119

197

110

16,071 2,870

18,170 2,965

18,872 2,762 20,241 2,589 18,005

2,467

No record

33,700 |

11,659 | 25

5,727 |

*Ophthalmia neonatorum... Poliomyelitis

Puerperal fever

Scarlet fever

Tuberculosis

---

JLJ

Typhus (mite-borne) Whooping cough

Total

+Influenza

ILJ

Remarks: * Notifiable since June 1958.

† Voluntary notifications.

The above table omits rabies and the six quarantinable diseases -i.e. cholera, smallpox, plague, epidemic louse-borne typhua, yellow fever and relapsing fever no case of any of which was reported during the years.

APPENDIX 6

ANTI-EPIDEMIC PROPHYLACTIC IMMUNIZATIONS 1959 AND 1960

Immunological Procedure

1959

1960

1,034,138

573,848

36,245

30,634

--L

---

223,209

202,883

144,118

174,406

63,582

71,219

Anti-Smallpox Vaccination

Anti-Cholera Inoculation

Anti-Diphtheria Inoculations:

Jet Dose

2nd Dose

Booster Dase

JIL

...

10 r

---

Anti-Typhoid Inoculations:

1st Dose

2nd Dose

Booster Dose

Anti-Plague Inoculation

Anti-Typhus Inoculation

Anti-Rabies:

171

- P

141,342

97,902

101,174

78,103

92.712

38,374

...

TII

205

220

1,597

1.409

1st Dose

་་་

L..

3,577

3,717

13,872

12,846

Other Doses

Anti-Tuberculosis (B.C.G.) Vaccinations:

Infants

Others

LJI

62-261

79.169

8.518

I1,054

106

107

APPENDIX 7

ANNUAL INCIDENCE AND TREND OF VENEREAL DISEASE

Total New Patients

Total Attendances

Total (Except Congenital)

LIL

1951

1952

195.3

1954 1955 1956

1957

1958

1959

1960

17,934 23,565 37,392 36,652 54.853

32,490 31,391 27,841 28,980 26,281 152,294 149,237 213,091 223,031 203,701 180,148 193,674 203,954 213,026 213,733 3 215

3,216 6,969

6,825

4 232

3,628 3,190 3,372 2,680

2,091

SYPHILIS

Primary

Secondary

562

672

634 !

393

153

---

301

180

132

+ t

Early Latent

Late Latent

All Others

...

1,101

882

2,298

---

2,209

1,044

733

450

417

426

296

1,038

1,275

3,727

3,983

2,853

2,616

2,532

2,766

2,038

1,590

213

207

178

186

148

166

184

177

188

139

Under 1 year

164

Congenital

Over 1 year

111

116

131

Gonorrhoea...

LIL

י . .

6,903

8,546

11,623

10,785 11,309

10,609

9.881

8,360

8,362

6,506

Non-gonococcal Urethritis

870

770

869

776

HOO

644

481 ❘

591

Chancroid

---

2,347

2,400

2,507

2,365

2,468

1.614

685

294

324

873

Lymphogranuloma Venereur

Non Venereal Disease

Skio...

197

111

202

286

249

140

178

1,643

4,508

7,708

7,150

6,623

---

6,245

5,855

5.458

4,997 4,717

727

2,088

...

5,908

7,376

8,165

8,437

9,814

8,701

11,046 10,611

APPENDIX 8

CLASSIFICATION OF DERMATOLOGICAL CASES, 1958, 1959, AND 1960

Diagnosis

No. of cases 1950

No. of cases 19.59

No. of Cape

1960

Abrasions

Acne

---

Alopecia Areata

---

LIL

Boils, Folliculitis... Carcinoma

Contact Dermatitis

7. Clog Dermatitis

Eczema Atopic...

Eczema Infantile

10.

Eczema-Infective

0.64

110

1.09

0.71

0.62

0.65

0.66

0.54

0.41

0.48

516

14.69

1,566

15.65

...

1,849

15.04

0.20

0.22

0.07

604

17.19

1,667

16.66

2,244

18.26

0.48

0.59

0.20

0.25

0.47

0.59

172

4.90

453

4.53

548

4.46

137

ILL

3.90

215

2.15

122

0.99

15.

16.

17.

18. Impetigo

19. Leprosy

---

171

11. Eczema Scrotum 12.

Eczema-Miscellaneopur...

13. Exfoliative Dermatitis 14. Erythema Multiforme

Erythema Nodosum

Herpes Zoster

Ichthyosis, Xorosis

0.30

0.64

0.75

285

8,11

695

6.95

1,691

13.76

0.08

0.09

0.57

0.26

0.14

171

0.30

0.10

0.13

0.14

---

0.33

0.15

0.09

0.10

---

365

10.39

671

6.7)

554

4.51

2.13

135

1.35

124

1.01

20. Lichen Planus

21. Lupus Erythematous

22.

23.

Moniliasis Neurodermatitis...

24. Porphyria

25. Paronychia, Whitlow

171

-- I

0.11

0.12

0.03

0.48

0.39

0.31

0.20

0.09

JLI

105

2.99

463

4.63

54]

4.40

0.03

0.01

---

0.11

0.15

0.21

26. Pediculosis

---

0.68

0.28

27. Pompholyx

28. Prickly Heat

29. Pruritis

---

0.14

---

0.34

0.54

1.03

128

1.28

141

1.15

---

2.59

250

2.50

г.г

265

2.16

30. Psoriasis

31. Purpura

32.

---

Ringworm of Scalp

33. Ringworm of Body

34. Ringworm of Groins

35.

36.

Ringworm of Feet and Hands Rosacea

3T. Scabies

JL.

38. Scleroderma, Sclerodactyly

39. Tuberculosis of Skin

40.

Undetermined

41. Urticaria

יזי

42. Varicose Dermatitis/Ulcer

43.

Warts

44.

LL J

Seborrhoeic Dermatitis 45. Leucoderma

1.11

0.73

0.79

---

0.20

0.11

0.02

0.37

0.18

LJI

0.77

137

1.37

184

1.50

0.34

0.50

0.69

2.67

247

2.47

242

1.97

0.11

0.14

0.08

1.08

225

2.25

0.54

For

0.07

0.77

0.36

0.28

497

1-1

14.15

1,5.54

15.54

1,949

15.86

0.96

118

---

1.18

202

1.64

---

1.42

118

1.18

117

129

1.05

0.77

196

1.96

263

2.14

1.22

107

1.07

0.65

0.94

158

1.58

169

1.38

108

109

APPENDIX 9

IN-PATIENTS TREATED IN GOVERNMENT AND GOVERNMENT-ASSISTED HOSPITALS, 1960

CLASSIFIED ACCORDING TO INTERNATIONAL STANDARD CLASSIFICATION

INTERMEDIATE LIST OF 150 CAUSES

Inter-

Detailed

mediate

List

Number

Cause Groups

Cases Treated

Deaths

Govern-

redt

Govern-

Bent-

Assisted

Govern.

Govern-

Whole Colony

ment

Hospitals

ment-

Assisted

Hospitals

Male

Female

Sex Uo-

known

Total

1,034

3,743

102

717

1.191

543'

104

459

191

141

122

1,734

263

111

382

-ו.

---

ILI

133

· P.

434

200

14]

¦ ¦

---

...

A 1

001 - 008

A 2

010

Tuberculosis of respiratory system... Tuberculosis of meninges and

central nervous system

3 3

011

Tuberculosis of intestines, peri-

012 - 013

014 - 019

020

toneum and mesenteric glands Tuberculosis of bones and joints Tuberculosis, all other forms

Congenital syphilis

LJL

021

Early Syphilis...

024

Tabes dorsalis..

LJI

025

A 10

022 - 023

All other syphilis

026 - 029

A 11

030 - 035

A 12

040

Typhoid fever...

A 13

041 - 042

A 14

043

Cholera

A 15

044

A 16 (4)

(2)

S€€

045

(6)

046

ז..

047 - 048

A 17

050

General paralysis of insane...

Gonococcal infections

Paratyphoid fever and other

Salmonella infections

Brucellosis (undulant fever)....

Bacillary dysentery

Amoebiasis

Other unspecified forms of dysentery

Scarlet fever

---

Carried forward.....

| | |

396

205

1. г

2,745

5,026

200

937 | 1,452.

744

! 2,196

011

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Deaths

Detailed

List

Number

Cause Groups

Govern

Govern-

Covera-

Deaths

Whole Colony

ment-

01.01

Hospitals

mcot Assisted

Hospitals

ment-

Assisted

Hospitals

Male

Female [Sex Un-¡

Total

known

Brought forward.....

2,745

5,026

200

937 1,452

744

2,196

A 18

051

Streptococcal sore throat

LIJ

A 19

052

Erysipelas

A 20

053

Septicaemia and pyaemia

581

103

A 21

055

Diphtheria

LLI

LLJ

1,572

יו-

---

41]

A 22

056

Whooping cough

---

A 23

057

Meningococcal infections

LJI

---

A 24

058

Plague ...

JLJ

A 25

060

Leprosy

I LI

663

---

A 26

061

Tetanus

---

LLL

179

ILJ

102

A 27

062

Anthrax

гтг

171

A 28

080

A 29

082

A 30

081, 083

Acute poliomyelitis

Acute infectious encephalitis

Late effects of acute poliomyelitis

and acute infectious encephalitis.

145

---

A 31

084

Smallpox

...

---

A 32

085

Measles

268

וזז

---

A 33

091

Yellow fever

| | | │

1 1

107

192

A 34

092

Infectious hepatitis

121

.ז.

的

тгг

A 35

094

Rabies...

ILJ

A 35 (a)

(b)

(c)

(8)

03000

100

101

104

105

102 - 103

A 37 (0)

106 - 108

110

Louse-borne epidemic typhus

Flea-borne epidemic typhus (marine) Tick-borne epidemic typhu.... Mite-borne typhus

---

Other and unspecified typhus

Vivax malaria (benign tertian)

Carried forward...

JIL

ILI

5,210

5,912

499

1,018 1,752 9931

2,745

Govern-

Deaths

Gover-

Govern-

Deaths

Whole Colony

ment-

ment

Hospitals

ment Assisted

Hospitals

Assisted

Hospitals

Male Female

Total

koowo

5,210

5,912

499

1,018

1,752❘ 993

2.745

Inter-

mediate

List

Number

Detailed

List

Number

Cause Groups

APPENDIX 9-Contd.

Cases Treated

Govern-

ment-

A 38 (0)

123.0

(6)

123.1

(c)

123.2

(74)

123.3

Falciparum malaria (Malignant

Brought forcard...

A 37 (6)

(c)

30 30

111

Malariae malaria (quartan)

751

112

(d)

115

(e) 113, 114

116, 117

tertian)

Blackwater fever

Other and unspecified forms of

malaria

T17

Schistosomiasis vesical (S. Haema-

tobium)

JJ L

IJL

Schistosomiasis intestinal (S. Man- soni)...

LIL

LJI

Schistosomiasis pulmonary

(S. Japonicum)

Other and unspecified schia- tosomiasis

гто

---

}

...

A 39

125

Hydatid disease

LIN

---

A 40 (a)

(c)

(d)

A 41

A 42 (6)

0300 €

30€ 0

127

Onchocerciasis

LIJ

(5) 127

Loiasis...

---

127

Filariasis (bancrofti)

127

Other filariasis

129

Ankylostomiasis

---

126

(6) 130.0

(e)

130.3

Ascariasis

Tapeworin (infestation) and other

cestode infestations

Guinea Worm (dracunculosis)

Other diseases due to helminths

ILI

124, 128

130.1, 130.2

A 43 (0)

037

Lymphogranuloma venereum

Carried forward...

5,291

6,053

499: 1,018 1,753) 993

2,746

111

APPENDIX 9-Contd.

Cases Treated

Inter-

Detailed

mediate

List

Number

List

Cause Groups

Number

Govern.

meat

Hospitals

Govern-

Hotnt-

Assisted

Hospitals

Deatba

Covera.

Govern-

ment-

Deaths

Whole Colony

went

Hospitals

! Aselisted

Hospitals

Male Female

Sex Un-

kaowa

Total

Brought forward...

Granuloma inguinale, venereal

··

Other and unspecified venereal diseases! Food poisoning infection and

5,291 6,053

499

1,018 1,753 993

2,746

---

A 43 (6)

038

(c)

039

(2)

049

intoxication

(e)

071

Relapsing fever

072

Leptospirosis icterohaemorrhagica

(Weil's disease)

---

073

Yaws

---

LJI

087

Chickenpox

090

Dengue

LIJ

()

095

Trachoma

(k)

096.7

120

(m)

300

¦ Sandfly fever

Leishmaniasis

121 (a), Trypanosomiasis gambiensis. (b) Trypanosomiasis rhodesiensis

(n) 131

(0) 135

(p)|036,054,059,

063,064,070, 074,086,088,

trypanosomiasis

Dermatophytosis Scabies

PI1

All other diseases classified as

---

112

089,093,

096.1,096.6.

096.8,096.9,

122.132-134,

136-138

| | │

1 1

---

Carried forward......

5,446 | 6,109 508 1,020 1,760|

998

2,758

infective and parasitic

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Deaths

Detailed

List

Cause Groups

Number

Govern-

ment

Hospitale

Covers-

ment-

Amisted

Hospital

Cavern-

Govero-

ment

Deaths

Whole Colony

Hospitals

ment-

Assisted

Hospitals

Male Femalo

Sex Uo-

known

Total

Brought forward...

|- Г

5.446

6,109

508 1,020

1,760 998

2,758

A 44

140- 148

Malignant neoplasm of buccal cavity and pharynx

152

205

129

162

244

A 45

150

A 46

151

Malignant neoplasm of oesophagus. Malignant neoplasm of stomach

108

188

117

142

101

243

A 47

152 - 153

A 48

A 49

A 50

154

161

117

Malignant neoplasm of rectum Malignant neoplasm of larynx

Malignant neoplasm of intestine, except rectum

...

- +1

*22

17,

162 - 163

Malignant neoplasm of trachea.

A 51

170

A 52

171

and of bronchus and lung not specified as secondary Malignant neoplasm of breast Malignant neoplasm of cervix uteri

125

137

- 10

135,

124

259

112

110

115

350

128

138

A 53

172 174

Malignant neoplasm of other and

unspecified parts of uterus

107

---

A $4

177

A 55

190 - 191

Malignant neoplasm of prostate Malignant neoplasm of skin

| | |

A 56

196 - 197

Malignant neoplasm of bone and connective tissue

---

A 57

155 - 160

Malignant neoplasm of all other

164 - 165

and unspecified sites

366

333

124

205

353

208

561

175 176

178 - 181

192 - 195

198 - 199

A 58

201

Leukaemia and aleukaemia...

Carried forward.......

7,158,

7,551

817

1,823 i 2,760 1,933

4,693

113

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Detailed

List

Number

Cause Groups

Govern-

Deaths

Govern

Govern-

arat

Govern-

ment

Deaths

Whole Colony

Assisted

Hospitals

Hospital

Hospitula

mcot-

Assisted

Hospitals

Male Female

Sex Un-¡

known

Total

7,158 7,551

817

1,823

2,760 1,933

4.693

A 59

200. 203

205

Brought forward...

Lymphosarcoma and other

neoplasms of lymphatic and

baematopoietic system

PTI

A 60

210 - 239

Benign neoplasms and neoplasms

of unspecified nature

---

1,183

283

A 61

250 - 251

Nontoxic goitre

...

A 62

252

Thyrotoxicosis with or without goitre

253

A 63

260

Diabetes mellitus

201

136

114

A 64 (a)

280

Beriberi

(b)

281

Pellagra

ILI

(c)

282

Scurvy.

| I

(d)

283-286

A 65 (a)

290

anaemias

ITI

()

291

(c)

292 - 293

Other deficiency states

Pernicious and other hyperchromic

Iron deficiency anaemias

(hypochromic)

Other specified and unspecified

604

194

2 2-22 | | 2

· ·

A 66 (a)

241

anaernias

Asthma

---

2.31

116

207

371

---

28 1

זיו

(b)

240.

242 - 245,

253, 254,

All other allergic disorders, endocrine, metabolic and blood diseases

399

165

---

270 - 277.

287 - 289,

294 - 299

[4] 13

Carried forward...

10,376 ❘ 8.940 | 907 1,894

2,917

2,917| 2,070

4,987

APPENDIX 9-Contd.

Cases Treated

Inter.

mediate

List

Number

Detailed

List

Number

Cause Groups

Govero-

ment

Hospitals

Govern-

meat-

Assisted

Hospitals

Deaths

Govern

meat

Hospitale

Govern-

ment-

Assisted

Hospitale

Deaths

Whole Colony

Male

Female

Sex Un

known

Total

Brought forward...

---

10,376

8,940

907 1,894

2,917 2,070)

4,987

A 71

A 72

A 73

A 67

300 - 309

Psychoses

A 68

310 - 324

326

personality

A 69

325

A 70

330 - 334

340

345

353

Epilepsy

A 74

370 - 379

A 75

385

Cataract

A 76

387

Glaucoma

A 77 (0)

390

| Otitis externa....

(6)

391 - 393

(0)

394

A 78 (0)

380 384,

386.

388 - 389

---

1,892

* 42

---

Psychoneuroses and disorders of

Mental deficiency

Vascular lesions affecting central

nervous system

Nonmeningococcal meningitis Multiple sclerosis

115

Inflammatory diseases of eye

791

...

LLI

476

1,102

294

624

6291

601

1,230

...

161

· - ·

159

137

LIL

IT I

100

---

Otitis media and mastoiditis

Other inflammatory diseases of ear. All other diseases and conditions

...

of eye

LII

344

Carried for card.

* Among these-3 died of AL

14,434 · 10,580

1,281

2,537 3,589: 2,698|

6,287

I died of A80

4 died of Aa

2 died of A8]

2 died of A12

1 died of A‡o

4 died of A44

1 died of A84

I died of A57

1 died of A86

I died of A65(0)

14 died of A90

2 died of A70

died of A78(6)

1 died of A96

2 died of A114

115

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Deaths

Detailed

List

Number

Cause Groups

Govern-

Covero-

Pacot I

Govern-

ment

Whole Colony

Hospitals

Assisted

Hospitals

mment-

Assisted

Hospitals

Male Female

Sox Vo-

known

Total

Brought forward...

14,434

10,580 1,281

2,537 3,589 2,698

6,287

A 78 (8) 341-344,

350 - 352,

All other diseases of the nervous system and sense organs.

357

215

354 - 357,

360 - 369,

395 - 398

A 79

400 - 402

Rheumatic fever

A 80

410 - 416

Chronic rheumatic heart disease

481

206

160

246

A 81

420 - 422

Arteriosclerotic and degenerative

heart disease

117

280

118

424!

317

741

A 82

430 - 434

Other diseases of heart

280

710

194

171

158

329

A 83

440 - 443

Hypertensive heart disease

120

368

106

177'

116

293

A 84

444-447

Other hypertensive disease

142

334

48.

A 85

450 - 456

Diseases of arteries ...

---

166

74.

146

A 86

460 - 468

A 87

470 - 475

A 88

480 - 483

Other diseases of circulatory system Acute upper respiratory infections. Influenza

184

555

639

1,037

379

--1

A 89

490

Lobar Pneumonia

63:

108

A 90

491

A 91

492 - 493

A 92

500

A 93

501 - 502

A 94

$10

A 95

518, 521

Bronchopneumonia

Primary atypical, other and

unspecified pneumonia

Acute bronchitis

Bronchitis, chronic and unqualified. Hypertrophy of tonsils and

adenoids

Empyema and abscess of lung

Carried forward...

-J

JLJ

802

2,775

341

1.711

1,615

1,492

3,107

---

101

157

236

418

78.

165

385

-- J

26!

18,652

18,501

1,913

4,881

6,483 5,298

11.781

116

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

Deaths

Detailed

List

Number

List

Number

Cause Groups

Govero-

meat

Hospitals

Govern-

ment-

Assisted

Hospitals

Govern-

Deaths

Whole Colony

ment

Hospitala

Awisted

Hospitals

Male Female

Sex Un-

koowo

Total

Brought forward.......

18,652

18,501 1.913 4,881

6.483; 5,298

A 96

519

Pleurisy

27'

11,781

A 97 (a)

523

Pneumoconiosis

(b)

511 517,

All other respiratory diseases

520

362

520, 522,

524-527

A 98 (0)

530

Dental Caries

---

{0}

531 - 535

All other diseases of teeth and

A 99

A 100

A 101

A 102

A 103

540

supporting structures

Ulcer of stomach

231

JL L

900

532

541

Ulcer of duodenum

274

543

Gastritis and duodenitis

111

124

ร

550 - 553

Appendicitis

1,484

349

560 - 561

Intestinal obstruction and bernia

681

380

570

A 104 (0)

571.0

(8)

571.1

(0)

572

Gastro-enteritis and colitis,

between 4 weeks and 2 years Gastro-enteritis and colitis, ages 2 years and over

Chronic enteritis and ulcerative colitis

---

480 1,581

120

738

459

432

891

634

794

160

102

188

---

110

A 105

581

Cirrhosis of liver

IL L

LJL

364

266

155

223

A 106

584, 585

Cholelithiasis and cholecystitis

163

111

ILJ

A 107

536 - 539,

542. 544,

545,

573 - 580,

Other diseases of digestive system...

1,152

1,033

158

142

911

233

582 - 583,

586, 587

Carried forward...

25,724 24,311

2,345

6,004

7,567| 6,123|

13.690

117

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Detailed

List

Number

Cause Groups

Govero-

Covera-

Dent

Hospitals

ment-

Assisted

Hospitals

Deaths

Govern

mtal-

Deaths

Whole Colony

ment

¦ Hospitale

Assisted

Hospitals

Male Female

Sex Un-

known

Total

Brought forward.......

25,724 24,311 2.345 6,004

7,567, 6,123;

13,690

A 308

A 109

590

591 594

Acute nephritis

141

130

101

Chronic, other and unspecified

nephritis

162

484

1731

133

306

יי

A 110

600

A 111

602, 601

A 112

610

Infections of kidney

Calculi of urinary system

Hyperplasia of prostate

114

---

· -· ·

LJI

345

167

A 113

620, 621

Diseases of breast

IJL

A 114(0)

613

Hydrocele

(6)

634

Disorders of menstruation

194

326

| |-

601, 603,

605 - 609,

- 611 612,

All other diseases of the

614-617,

genito-urinary system

1,559

1,678

622 - 633.

635-637

A 115

640 641, 681 - 682,

684

Sepsis of pregnancy, child-birth and the puerperium

137

22222

A 116

642. 652,

Toxaemias of pregnancy and the

685 - 686

puerperium

---

750

201

A 117

643 - 644

670 - 672

-- L

A 118

650

---

Abortion without meation of

sepsis or toxaemia...

Haemorrhage of pregnancy and childbirth

...

535

617

---

A 119

651

Abortion with sepsis...

1,063

2,298

Carried forward...

30,900

| 30,464 |||||2,444 6,140

7,793| 6,337|

14,130

118

611

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

Detailed

List

Number

List

Number

Cause Groups

Govero-

mcat

Hospitals

Govern-

meat-

Assisted

Hospitals

Deaths

Govern-

↑ Govern-

Deaths

Whole Colony

ment

Hospitals

ment-

Assisted

Hospitals

Mile Female

Sex Un-1

known

Total

A 120 (") 645 - 649

Brought forward...

childbirth and the puerperium

30,900 30,464 2,444

6,140 7,793 6,337,

14,130

Other complications of pregnancy,

LIL

6,791

1,346

673 - 680

683.

(6)

687 - 689

660

Delivery without complication

7,139

37,707

A 121

690 - 698

A 122

A 123

720 - 725

726-727

Infections of skin and

subcutaneous tissue

Arthritis and spondylitis Muscular rheumatism and

946

651

279

rheumatism, unspecified

- J

A 124

730

Osteomyelitis and periostitis

176

A 125

737

Ankylosis and acquired

A 126(a);

745-749

715

musculoskeletal deformities

Chronic ulcer of skin (including

tropical ulcer)

216

игт

(b)

700 - 714

716

All other diseases of skin

410

214

All other diseases of

738 - 744

A 127

A 128

A 129

751

754

750, 752,

musculoskeletal system

Spina bifida and meningocele Congenital malformations of circulatory system...

All other congenital malformations..

203

1гг

190

161

! 1

107

753

755 - 759

A 130

760-761

Births injuries

JIL

17,

121

A 131

762

Postnatal asphyxia and atelectasis.. 379

210

90.

157

Carried forward...

47,391

71,376

2,571

6,310

8,029 6,507:

14.536

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Deaths

Detailed

List

Number

Cause Groups

Govern-

ment

Hospitals

Govern-

ment-

| Assisted | Hospitals

Govern-

Deaths

Whole Colony

rent-

ment

Boapitals

Assisted

Hospitals

Male

Female

Sex Un-

known

Total

Brought forward.....

47.391

71,376 2,571

6,310 8.029

8,029 6,507;

24,536

A 132(a)

764

Diarrhoea of newborn (under 4 weeks)

139

77.

133

(

765

Ophthalmia neonatorum

זיו

120

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

A 133

A 134

770

Haemolytic disease of newborn

198

111

284

202

486

769, 771,772 All other defined diseases of early

infancy

171

116

341

A 135

773-776

Ill-defined diseases peculiar to early infancy

521

755

131

599

542]

419

961

- LI

ILI

A 136

794

Senility without mention of Psychosis

328

129

122)

234

356

A 137(0)

788.8

Pyrexia of unknown origin

139

(b)

793

Observation, without need for

further medical care

463

775

788.9

All other ill-defined causes of morbidity

516

211

799. 657

1 1,457

...

789 - 792

795

Carried forward...

49,417 73,995

2,800

7.2539,923| 8,127)

118,051

121

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

Detailed

List

Number

List

Number

Cause Groups

Govern-

1000

Hospitale

Govern.

ment-

Assisted

Hospitals

Govern-

Deaths

Govern-

Deaths

Whole Colony

meat

Elospitals

ment-

Aniated

Hospitals

Male

Female !

Sex Un.

known

Total

Brought forward...

49,417 | 73,995 | 2,800

7,253

9,923 8,127

1 $18,051

AE 138 E810 E835 Motor Vehicle Accidents

85-4

112

166

...

AE 139 E800 E802 Other transport accidents E840 E866

1,169

AE 142

E912

AE 140 E870 E895 Accidental poisoning..

AE 141 'E900 E904 Accidental falls

Accident caused by machinery

324

15!

---

1,020

121

269

נט

AE 143

E916

Accident caused by fire and explosion of combustible material..

214

AE 144 E917, E918 Accident caused by hot substance. corrosive liquid, steam and

AE 145

AE 146

E919

E929

radiation

JIL

IIL

L. I

691

20.

Accident caused by fire-arm

Accidental drowning and submersion

...

---

110

170

Carried forward...

54,039 74,033 | 3,033

7,254 10,315 8,348

1 |18,664

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Detailed

List

Number

Cause Groups

Govern-

meat

mcat

Hospitals

Assisted

Hospitals

Hospitale!

Deaths

Govern- |

Govern-

maent-

Assisted

Deaths

Whole Colony

Mole Female

Hospitals

¡Sex Uur

koowd

Total

Brought forward...

54,039 | 74,033

3,033

10,3 7,254 10,315) 8,348| 1 18,664

AE 147

(a)

E920

Foreign body entering eye and adnexa

(6)

E923

Foreign body entering other orifice

268

(4)

E927

Accidents caused by bites and stings of venomous animals and insects...

ULL

122

(d)

E928

Other accidents caused by animals...

ז ד

(e) E910-E911 All other accidental causes...

- - -

2,921

10 [

109

E913 - E915

E921 - E922

E924 - E926

E930 - E965

AE 148 E970-E979 Suicide and self-inflicted injury

528

210

131

341

AE 149 E980-E985

Homicide and injury purposely inflicted by other persons (not in war)

142

---

AE 150 E990 E999 Injury resulting from operations

of war

GRAND TOTAL...

57,968 | 74,044 3,120 7,25410,618 8,527

| 19,146

loter-

mediate

List

Number

APPENDIX 9-Contd.

Cases Treated

Detailed

List

Number

Cause Groups

Govern

Govern-

meat

Hospitala

mtot-

Assisted

Hospitals

Deaths

Govero!

Govern-

meut-

Deaths

Whole Colony

Totot

Hospitala

Assisted

Hospitals

Male Female

Sex Un

known

Total

AN 138 N800 N804 Fracture of skull

389

- 4+

宮

AN 139

N805 - N809 Fracture of spine and trunk

334

AN 140

N810

N810 N829) Fracture of limbs

1,296

113

AN 141 N830- N839] Dislocation without fracture

AN 142 N840 - N848

Sprains and strains of joints and adjacent muscle

AN 143

AN 144 N860- N869

N850- NB56|

AN 145 IN870- N908,

AN 146 N910- N929

IN930-

Head injury (excluding fracture) Internal injury of chest. abdomen and pelvis

Laceration and open wounds

Superficial injury, contusion and crushing with intact skin surface...

AN 147 N930- N936 Effects of foreign body entering

2,837

124

141

221

245

105

---

1,247

through orifice

275

AN 148 N940 - N9491

Burns

897

AN 149

N960- N979 Effects of poisons

JIL

686

108

AN 150

N950 - N959 N950 N959] All other and unspecified effects

'N980 - N999

of external causes

ILI

170

250

160

410

123

TOTAL..

8,551

320

695

400

1,095

124

APPENDIX 10

NUMBER OF HOSPITAL BEDS IN HONG KONG - 1960

Medical Surgical

Gynaecal- Tuber- culosis

ogical

Mental

Maternity Infectious

Observa-

tiva

Tatal

GOVERNMENT HOSPITALS :

Queen Mary

Kowloon

Mental

P11

Castle Peak Sai Ying Pun Too Yük... Lai Chi Kok

Wan Chai

227

229

---

104

189

---

140

240

---

ཋས།||

601

413

140

240

---

-1-

---

189

200

141

200

478

4 cots

...

110

* cradles

St. John

100

---

111

110

South Lantau Hospital

4 Prison Hospitals

GOVERNMENT-ÅSSISTED HOSPITALS:

• 17

125

486

629

216

300

337

2.82

2,432

† Tung Wah

Tung Wah Eastern

---

217

151

$17

650

---

יו

147

336

---

* Kwong Wah

Alice Ho Miu Ling Netheracle

Hong Kong Anti-T. B. Association,

Ruttonjee Sanatorium

285

139

보다

160

664

111

2BL

---

Grantham

Pok Oi

Hei Ling Chen Leprosarium

340

$20

3.40

530

---

124

540

Haven of Hope T.B. Sanatorium Sandy Bay Convalescent Home

PRIVATE HOSPITALS:

Hong Kong Sanatorium & Hospital

210

---

802

481

1,422

365

568

3,729

101

Precious Blood

---

St. Teresa'.

Canossa Hospital

St. Paul's...

Hong Kong Central

---

-י

יו.

---

100

יי.

Matilda & War Memorial

Nançan T. B. Rehabilitation Centre

11功15科功一

316

108

100

190

172

LII

Fanling

гг.

יו.

г11

---

444

241

139

1,150

125

Private Maternity Homes:

PRIVATE NUasing HomeN:

GOVERNMENT DISPENSARIES AND

MATERNITY HOMES:

Aberdeen Jockey Club Clinic

Eastern

Stanley

Hung Hom

LLI

---

Tai Po Jockey Club Clinic

Yuen Long

Sha Tau Kok

Họ Tung

Sai Kung

Tại

ггг

- -

Sen Hui

Sha Tin

Silver Mine Bay

---

Maurine Grantham

North Lumma Clinic

Peng Chai

LLI

Shek Pik First Aid Post

---

· · ·

---

APPENDIX 10-Contd.

Medical

Surgical

Gynaecol. Tuber. ogical culosis

Mental

Maternity

Infectious

Observa-

tion

Total

517

$17

悲在

189

204

GOVERNMENT HOSPITALS

GOVERNMENT-Assisted Hospitals

PRIVATE HOSPITALS

486

629

216

380

337

282

2,432

802

481

FIT

444

253

1,422

241

365

568

3,729

139

1,150

Private Maternity HOMES

$17

517

PRIVATE NURSING HOMES

GOVERNMENT DISPENSARIES AND MATERNITY HOMES

189

204

...

GRAND TOTAL

1,805

1,363

218

1,879

380

1,547

872

8,09-0

• Used for either Medical or Surgical cases.

+ Including 86 T.B. beds in Infirmary, Sandy Bay.

Including 130 beds (i.e. 45 Med. & 85 Surg.) in Infirmary at Kwong Wah Hospital.

* Including 45 beda used for either medical or surgical cases,

APPENDIX 11

IN-PATIENTS ADMITTED INTO GOVERNMENT, GOVERNMENT-ASSISTED AND PRIVATE HOSPITALS IN 1960, INCLUDING CASES REMAINING IN HOSPITALS FROM THE PREVIOUS YEAR

NAME

In-

Tuber- Meter-

General

Mental

Bedi

fections

culosis

nily

Total

CRITI

Code

七 ■

EFFRE

Government Hospitals:

Queen Mary

Kowloon

Sai Ying Pun Tum Yük

Mental

* Castle Peak

St. John

South Lanten

Wan Chai

Lai Chi Kok

יי

4 Prison Hospitals

601 413

14,887

184

2,144

17,277

15,702

116

196 4,372

20,424

463

1,169

1,664

200

1,042

7.407

8.449

140

240

2,539) 2,539

100

1.139

687

1,935

322

106

428

478

227

1,826

208

2,261

125 2,313

163

324

120

2,930

TOTAL

FIL

2,432

36,142 3,464

1,036

14,623

2,697

57,968

Government-Assisted Hospitals:

Tang Wah Group

Alice Ho Miu Ling Nethersole

Ruttonjer Sanatorium

FFF

1,650

24,636

260

1,687

34,876

61,459

281

4,242

2,542

6,911

340

983

1,029

Grant bom

Pok Of ...

111

-10

100

---

530

1,288

...

124 1,167

1,063

2,230

Hei Ling Chau Leprosarium

Haven of Hope Tuberculosis

Sanatorium

---

Sandy Bay Convalescent Honie

540

663

210

350

LLI

114

TOTAL

3.729 30,112

1,002

4.449

38,481

74,044

Private Hospitals:

St. Paul's

Canossa

Precious Blood

Hong Kong Suautorium

St. Teresa's

FIT

Hong Kong Central

Matilda and War Memorial...

Namen T. B. Rehabilitation

172!

1,865 190 i 1,592

140

246

652

2,903

1,754

108 2,515

141

175

2,905

316

6.796

197

250

1,773

173

9,189

100

2,279

725

3,080

3,016

220

3,318

718

122

907

Cenice

Fanling...

ILL

---

PPI

496

620

TOTAL

1,150

19,337

523

837

3,813

194

24,704

GRAND TOTAL

7,311 | 85,597 4.989

6,322

56,917

2,891

156,716

Figures included in Mental Hospital's returo,

126

INSTITUTIONS

APPENDIX 12

OUT-PATIENTS. 1960

NEW CASES AT GOVERNMENT AND GOVERNMENT-ASSISTED HOSPITALS, CLINICS AND DISPENSARIES

Dresd ing!

General Сhi-

Out- dren's patient Clicker

Ante. Poal. natal natel

|Gyoween-| Social

logical | Hygiene

Eye

Ear. Nope &

Tuber. colorin

Capunity

Threat

Ortho- predic

Leprosy

Trie

Psychia Derma- tological

Tatul

Hospitals:

Queen Mary

10,542

3,702) 101

Kowloon

44,353)

125,719

700

4941 3,319,

427

260

1,190

,223)

Mental

THA Yuk

436

6,663)

2.999

$1. Jobu

3,741

26,459

$3,920,

720

South Lantau

210

756

Stanley Prison

10,622

49,301

│1

Vistoria Remand Prisen

#51

14,724

Lai Chi Kok Female Prison

$1,594)

Tai Lam Chung Prison

5$7

1,958

1.926:

Clinics and Dispensaries :

Sui Ying Pas

Iri

Violet Peel

7,746

61.540

55,953, 1,500

44,522

77,728 76.757

| | | |

│││││

772

2344 $,799

16,279 40,333

219 1,095

604

203 93

31,604 980.234

ETS

10.100

65,815

1,058

116. 209

14,395

19.496

21.594

5,045

Ophthal mk Clinic

Violet Peel Ophthalmic Ginke

Arron Street

British Red Crom

Shau Kei Wan

Rennie's Hik Vu Kwai SL. Hobik Tears

Wan Chai Cheat Clinic....... Sai Ying Pun Cheat Clinis Kawloon Chest Clinic

LIJ

• 1,415

475

B12

1,235

1.762

12,491

44,459

4,239

L.861

132,258

208,260

12.421

44.057

4,239

1,36]

יי

207 162:

1,717

207

162

2,717

PIR

Shek Kip Mei Chert Clinic

PI1

12,551

441

1,389

10,246

7.142

13,001

1,891

10.265

Sacial Hygiene Clinic

7,154

26,201

705

Families Chare. Hong Kong Families Clinic, Kowloon

33.666

831. 4.684

46.

877

　　　　　　　　Polis Medical Post. Hong Kong Police Medical Post, Kawlegs..

6,688

1.042 3.937

4.75)

137

145

9.327 15.457

89:

*** 173

410

21,082

161i

Police Quarter Clinic, Chung

Sb. Wan

29,193

LIJ

436

6,458

4,619

11,510

Vistoria Remand Prison

Family Clinic

$77,

587

Oh Ma San Prison Clinic

1,300

Kezione-Conten Rahway C

T14

615

679

2,008

Mt. Bache Quarry Claië

605

1.044

$34

2,403

Port Health

1.959

1,959

Puble Dispensaries Hong

79,181!

350,225 158,459|

3,871

L.733!

Now Territories Dispensaries...... 23,934

85,413 43.533 10,300

305 767

3,786

939

557 1,452 5,065) 689 2,063 13.447

164

522

601,072

127,253

Hezlik Centra z

Harbour

Western...

Kowloon

Chại Lạn

H. Mun Tin

Shek Kip Mei Cracral

Total of Governmeal

Contitusion

---

Tung Wah Group of Hospital.

Alice Ho Miu Liog

Nethersele Hoepital...

Rullinjer Sanatorium.

Grantham Hospital Pak Di Hospital

Rennie's Hill Church Cliaia

Total of Government-Awirled

Costitution

3,276

241

410

4.1#

*#4

1.IM

1.866

5.67]

1.866

3,473

4,032

5,456

2,272

2,617

2,050

2.425

560,000

$76,718 450,405 21,311 8,944 6,672 30,462 77,702 6,756 77,642 114,915)

9,912) 162,623 43,303, 22,034 289 2,513

5,546

2,635 1,606)

2,712

336

999

1,197

1,924,493

251.618

7,191| 1,602 1,473] 1,173

5,054,

18,293

9,374 11,609 1,205 1,793

104

32,300 2,104

17.180

#.347

5.753 2.635 1,739

336

THE

304.952

GRAND TOTAL...

270,160 1,057,699 $26,035,

52,449 10,426 15,239 30,663 63,455 9,391 39,301 114,940 3,048

999 1,197 1,084

2,229,645

127

• Patients seen in the Hong Kong Univenity Eye Clinin.

APPENDIX 13

OUT-PATIENTS. - 1960

TOTAL ATTENDANCES AT GOVERNMENT AND GOVERNMENT-ASSISTED HOSPITALS, CLINICS AND DISPENSARIES

INSTITUTIONS

Drei- ing+

General CH.

Out-

dren's

Ante. դէ

natal

Palicote

Clinic

Post Gynaeco Social

logical Hygiene

Eye

Ein. Nove & Tbront

Tuber. culorin

Casualty

Ortho paedic

Leprosy

Pagohla. Dac

trie

tological

TOLAI

Hospitals:

Queen Mary

Kowloon

10,52 245,186)

4,572 175,065

210

5,319

3,453 17,048

602 2,486. 260 1,301

5.2641

Mental

Tu Yot

1.694

34,940)

3,453.

St. John

4.474.

33,100

South Lantan

1,570,

Stealey Prison

43,612

124,988

Victoria Remand Prison

1.396

64,801

Lai Chi Kok Female Prijoo

21.594

Tal Lain Chung Prison

5,268

92,027

499 0,301

23.402 1,403) $0.333

47,437

9.699

547,592

7,912

2,045)

203

3,640

121

3,033

3,574,

│TE

| | | |

40,307

85,338

11,753

126

413.

217,932

1,003

| | |

21H

66,415

| |

21,594

102,672

Clinics and Dispensarier:

Sai Ying Pun

Violet Peel

Violet Peel Ophthalmic Clinic

Ophthal

mic

Clinica

Arun Street

British Red Crom;

Shau Kei Wan

Renoie' Mill Wu Kwai Sha Mobile Team Wan Chai Chest Clinic Sai Ying Pun Chest Chinie Kowloon Chest Clinic... Shek Kip Mei Chent Clinic Social Hygiene Clinics... Families Clinic. Hong Kong Families Clinir, Koslova Palice Medical Post. Hong Kong Police Medical Post, Kowloom Police Quarters Clinic, Cheung

Şb. Wan

Victoria Reward Prison

Families Clinic

- ||

Chi M. Won Prison Chaie Kowloon-Canton Railuny

Mr. Butler Qarry (linie

Part Health

Public Dispensaries Hong

Kong & Kowloan

New Territories Dispensaries

Health Centres :

45,923 139.690

109,259, 90,190 $.8211 107,632

147)

8,3521

3.415! 1,549

4,424

1.767

270,862

88,505

3,534

1,761

44.377 105,305

3,689

337

175

1.777

| ││││ ¦ ¦ T

931

$42,084

44.377

105,305

8,070

3.689

937

175

2.777

$10,053

2,711

127!

512.081

118,076

118,079

680,804

1,731

222

692,757

$93,414

393,167

10,347,

13.997- 11.333 12,946| $1,009 11.441 20.025

1,39% 7,127

5.115

778

134 2019

1,003

1,403,

2,316

2,116

| | | | |

1 | 1

254,209 510,988 192,456 12,262 #6,451 107,501 104,613) 38,278

926 3,271

987

$70

3,112

7,702 1,605) 5,454 11,509 1,850 35.638 13,447

1,452,

213,733

242

421

135)

410 L6JE

133

26,329

246.742

| | | |

10,393

6,648

39,748

41.038

13,657

| |

││ | ¦ ¦

820

2.659

3,320

7,242

2,116

5,159

1,001:

997,552

1,221

404,724

Harcourt

Western...

Kowloon

Chai Woo Ho Mao Tin

Shek Kip Mei

Central

■

39,617 1.036

375

41,928 L.I14

427

50.043 5,429

14,55]

520

22,153 1,269

554

46.941 5,511 1,297 29.044

41,828

43,529

55,908

16,807

24,176

53,749

30,144

Pok Di Hospital

Alice Ho Miu Ling Nothežaole

Hospital

Buttonje Sanatorium

Grantham Hospital

Rennie's Mill Church Giais

450.

443,505 141,489| 27,0743 316 6,437

23,754, 5,924 13,324 1,173 20,740

Total of Government

Institutiona

Tung Wah Group of Hospitals,

247,123, 1,410,227) 410,254) 182,150) J1,851 19,877) 225,358, 189,409| 10,086| 1,786,793|| 124,312|

32,130

20,143) 99,330|

4.619)

10.399

5,667,939

17,766

9,798

19.775

1,844

698, 159

16, 190

15,095) 33,008 3,060 28.567

$37

154

2,159

│ET.

| | | | |

65,383 16,722

$54

53,243

31,063

Total of Government-Assisted

Institutions.

32.590'

יי

508,921 180,501 43,450 1,409, 37,177||

16,103) 9.798

38,430

25 1,844

862,324

GRAND TOTAL...

899,721| 1,919,148| 990,755) 175,616|| 13,340 27,054 225,350' 207,512. 27,884 1,625,203 124,537 31,907 33,380

• Patients seen in the Hong Kong University Eye Clinic.

8,619 10,999

6,530,263

128

APPENDIX 14

NEW TERRITORIES CLINICS, 1960

Out-patient Attendances

Dispensaries

New Cases

Total Attendances

In-patients

Deliveries

Domiciliary

Tai Po...

Ho Tung

Sha Tau Kok

Sha Tin...

Yuen Long

San Hui

...

---

זי.

37,043

62.712

2,054

ז..

2.403

5,919

730

9,739

20,041

260

7,265

12,655

614

---

31,641

69,709

2,281

4,324

8,340

940

Sai Kung

14,644

26.439

529

Tai O

Silver Mine Bay

Peng Char

---

30,519

40,002

506

8,318

10,856

139

7.833

10,664

142

Maurine Grantham

44,508

93,263

2,413

North Lamma...

5,044

7,668

Sbek Pik First Aid Post

5,542

8,813

Tai Po Travelling (East)

9.324

10,675

Yuen Long Travelling (West)...

1,086

1.163

Chee Hong Floating Clinic

LIL

2,666

Chee Wan Floating Clinic

5.350

13,139

Total

LIL

227,253

404,724

10,671

129

APPENDIX 15

GOVERNMENT INSTITUTE OF PATHOLOGY 1960

(0) SPECIMENS EXAMINED

(1) Protozoology and Helminthology

---

(2) Haematology

(3) Serology

(4) Bacteriology

(5) Mycology

(6) Public Health

---

J-J

➖ ➖ ➖

---

36,917

110,457

ILI

135,684

153,603

1,234

-H

7,898

---

2,339

54,527

ILL

---

LII

---

(7) Histology

(8) Chemical Pathology

(9) Clinical Pathology Examination

(10) Special Investigation...

(11) Virology

---

101

ז..

---

rto

---

TI-

---

ITI

---

Grand Total

(6) NOTIFICATIONS OF ANIMAL BITES

The following animal bite notifications were received during 1960:

25,622

174

1,601

530,056

Dog

Cat

Monkey

Pig

Other Animals

Total

Hong Kong

LIP

1,419

133

I,576

Kowloon

F4I

2,492

2,547

Total ...

3,911

175

4,123

Advice was given as to anti-rabies vaccine treatment and the following returna were received during 1960:

Treatment completed

Treatment not completed

Treatment not required

Total

Chinese ...

Non-Chinese

682

1,243

2.083

4,008

115

Total ...

707

1,279

2,137

4,123

130