醫務衛生署年報 Medical and Health Department Annual Report 1962-1963

RBB 40w

ANNUAL

DEPARTMENTAL

REPORTS

ONG

KONG

1962-63

THE ROYAL SOCIET for the Promotion OF HEALTH LIBRARY

RBB/40w

DIRECTOR OF MEDICAL

AND HEALTH SERVICES

27537.

22501293356

HONG KONG

ANNUAL DEPARTMENTAL REPORT

BY THE

DIRECTOR OF MEDICAL AND HEALTH SERVICES

D. J. M. MACKENZIE

FOR THE

FINANCIAL YEAR 1962 - 63

PRINTED AND PUBLISHED BY S. YOUNG, 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).

WELLCOM

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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

Paragraphs

28 - 37

38 - 41

45 - 63

64 - 67

68 - 72

III. WORK OF THE HEALTH DIVISION

Hygiene and Sanitation

Urban Areas

Rural Areas

Epidemiology

Quarantinable Diseases

Cholera

Notifiable Diseases

73 - 75

Ꮀ

Other Communicable diseases which are not

notifiable

Tuberculosis

Malaria Bureau

Social Hygiene Services

Port Health

78 - 94

95 121

122 123

124 - 180

181 189

190 - 202

203 - 209

jii

III WORK OF THE HEALTH DIVISION Contd.

District Midwifery Services

Maternal and Child Health Services

School Health Services.

Paragraphs

210 - 214

215 - 221

222 - 228

Dental Service

229 - 237

Forensic Pathology

238 - 240

Government Chemist's Laboratory

241 - 251

Government Institute of Pathology

252 - 268

Industrial Health.

269 - 273

Health Education.

274 - 277

IV. THE WORK OF THE Medical DIVISION

278 - 279

Hospitals

280

282

Government Hospital

Government-Assisted Hospitals

Outpatient Services

Specialist Services

283 - 341

342 - 360

361-367

368

369 - 380

Radiology

Ophthalmology

The Pharmaceutical Service

381 385

386 - 389

390 - 402

The Almoner Service

Physiotherapy

403 - 408

Occupational Therapy

409 - 416

Orthopaedic and Prosthetic Appliances

417 421

Medical Examination Board

422 - 424

Hospital Maintenance and Supply

425 - 430

Auxiliary Medical Services

431 440

V. DEVELOPMENT PROGRAMME

Planning Unit

Building Programme

VI. HOSPITAL COSTING

VII. TRAINING PROGRAMME

Doctors

Dental Staff

Nurses.

Midwives

Health Visitors

Radiographers

Laboratory Technicians

Physiotherapy

Other Forms of Departmental Training

Courses of Study Overseas

VIII. MISCELLANEOUS

Attendances at Conferences and Meetings

Visitors

Publications

Obituary

ACKNOWLEDGMENT

IX. MAPS

X. APPENDICES

Paragraphs

441

444

445

446

447 - 450

451 - 453

454 - 456

457 458

459

460

461 462

463

464 - 466

467

468

469

470

471

472 - 473

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

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1. GENERAL REVIEW

THE estimated mid-year population of Hong Kong in 1962 was 3,400,300 of whom some 40% are aged 15 years or younger. Living under condi- tions of average densities of 1,800 -2,000 to the acre in the urban areas with intermittent water supplies and some 25% of the urban population depending on a night soil conservancy service for sanitation, environ- mental conditions inevitably predispose to the transmission of the communicable diseases. The standard of nutrition is generally good, there is relatively full employment and standards of living are rising steadily as the rehousing programme develops.

2. Despite the conditions of over-crowding, the necessity to store water in tenement houses and the environmental conditions in the older tenement houses along the waterfronts and in the central districts of Hong Kong Island and the Kowloon Peninsula, the community health record during the year was remarkably good. The crude death rate remained low at 5.9 per 1,000 and the infant mortality rate declined further to 36.9 per 1,000 live births. The neo-natal mortality rate has remained relatively constant over the past four years ranging between 20.9 and 21.3 per 1,000 live births. The birth rate fell from 34.2 per 1,000 in 1961 to 32.8 per 1,000 in 1962 and the maternal mortality rate continued low at 0.48 per 1,000.

3. There were three important events which posed a definite threat to the public health. The first was the sudden and unexpected influx of illegal immigrants numbering some 140,000 in May and June. Later, in August, cholera El Tor again re-appeared and on the 1st of September, typhoon Wandu, which was the worst typhoon the Colony had experi enced since 1937, rendered many thousands homeless and made neces- sary many emergency centres for their reception and feeding. Despite these events, there were no related outbreaks of epidemic disease.

　　　4. The large influx of illegal immigrants at a time when cholera might be expected to recur had apparently no influence on the outbreak which began at the end of August. A number of immigrants were examined during the influx and the night soil from latrines at the recep tion centre where illegal immigrants were detained was investigated bacteriologically with entirely negative results.

5. The most important medical finding amongst these immigrants was the high incidence of active tuberculosis in the older age groups; some 68,000, who were permitted to stay in the Colony, were required to undergo a chest X-ray during the process of registration and the issue of identity cards. The findings are described in some detail later in this report, under the section dealing with tuberculosis.

6. There is reason to believe that among the motives prompting in- dividuals to come to Hong Kong from China is a need for medical treatment. Certainly many of those who do come legally or illegally are very soon to be found at Government clinics. The impact falls most heavily on the Government tuberculosis, leprosy and mental health services.

7. A very significant and important event during the year was the visit by Professor F. HEAF, C.M.G. and Dr. Wallace Fox who came at the invitation of Government to make an assessment of the current status of tuberculosis as a community health problem. Their report and recom- mendations concerned the provision of enhanced facilities and staff for the Government Tuberculosis Service, the development of additional case finding, bacteriological and B.C.G. vaccination services, the ratio to population of hospital beds for the inpatient treatment of tuberculosis and the urgent need for research to guide policy planning for the future.

8. The Report was accepted in principle during October by Execu- tive Council, subject to detailed examination of the implementation of the recommendations. The Report was then referred to the Medical Advisory Board which consulted the various voluntary agencies engaged in tuberculosis control and it was still under consideration by the Board at the end of the year.

9. On the 22nd August, cholera re-appeared in the Colony and over the next six weeks, a total of eleven clinical cases occurred. The only fatality was in a man who had been ill for three days before being sent to hospital and who died on admission, before treatment could be start- ed. The whole Colony was declared an infected local area on the 23rd of August and the last case in the urban districts occurred on 20th September. One further case, the last in 1962, appeared in a village community in the New Territories on the 12th October.

10. Again there was a very widespread distribution of cholera vibrios throughout the community with remarkably few clinical cases presenting as a result. Strict quarantine measures were applied to all contacts of clinical cases and the appropriate environmental preventive precautions

strictly enforced. Nevertheless, using the communal night soil as an indicator, the only conclusion to be reached was that there were large numbers of undetected carriers, excreting cholera vibrios, at large in the Colony.

II. A mass immunization campaign using cholera vaccine prepared in the Government Institute of Pathology had been conducted in February, March and April 1962, when 53% of the total population received vaccine. During the outbreak itself a further million people were inoculated. In assessing the epidemiology, it appears probable that the immunity induced by wide scale vaccination greatly reduced the attack rate of the disease in the face of the widespread distribution of the cholera vibrios.

12. During the outbreak, the routine sampling of night soil was in- tensified and from the 29th October, 1962 to the end of March 1963, no further cholera vibrios were isolated.

13. Of the other communicable diseases of importance, poliomyelitis and measles showed unusually high incidence. The notifications of paralytic poliomyelitis during the year were the highest on record and the vaccination campaign using a Sabin type oral vaccine, which was conducted in two phases in January and March 1963, is believed to have cut short an epidemic of some proportions in which Type 11 and Type III polioviruses were playing a predominant part. In previous years, Type I virus had been almost exclusively the agent responsible for paralytic disease.

14. An epidemic of measles of considerable size and virulence occur- red in the winter months of the year under review following a period of 18 months during which the incidence was unusually low. The common fatal complication was broncho-pneumonia and an investigation carried out by the Paediatric Unit in Kowloon Hospital showed that the age group most vulnerable to this complication was that of 6 months to 2 years of age.

15. The Working Party set up to advise Government on the organi- zation and scope of a comprehensive School Medical Service began work in May 1962 under the Chairmanship of Dr. the Hon. A. M. Rodrigues, O.B.E., E.D. The intention is to establish a voluntary contributory scheme whereby the school children participating will receive physical examinations at prescribed intervals by private medical practitioners who will also supply curative treatment for ailments normally dealt with in a practitioner's consulting room. The Report of the Working Party was

submitted to Government in March, 1963. Government will continue to provide for all schools the existing services for the prevention and con- trol of communicable disease, including immunization programmes and environmental health services.

16. The pressure on general hospital beds continued unabated, and, in fact, increased. This was barely contained by the use of camp beds in wards, on verandahs and wherever else they could be fitted in. The rapid rate of turnover of patients in the acute wards was also maintained by utilizing subsidiary convalescent beds wherever they could be found. In meeting this pressure, the Tung Wah Group of Hospitals played a significant complementary role, particularly in Kowloon where, from February 1963 onwards, the Kwong Wah Hospital accepted direct, from the Kowloon Hospital Casualty Department, up to 25 emergencies each day.

17. The Castle Peak Mental Hospital of 1.000 beds, opened in March 1961, was also under heavy pressure. By the end of 1962, it had been necessary by rearrangement of ward accommodation to increase the nominal bed strength to 1,119 beds. Despite this increase, the parole system continued to be extensively used as well as the day out-patient centres on Hong Kong Island and, later, at the Queen Elizabeth Hospital Specialist Clinic in Kowloon.

18. The general hospital building programme is going ahead rapidly and some temporary easing of the pressure on acute beds in Kowloon is hoped for in 1964 when the new Kwong Wah Hospital re-development plan for 1,270 beds and the new Queen Elizabeth Hospital have been completed.

19. The Queen Elizabeth Hospital of 1,338 beds is to be formally opened early in September 1963, and with this in view a Commissioning Unit consisting of the designate Medical Superintendent, Senior Matron and Senior Hospital Secretary was formed in January 1963. The greater part of the equipment for the hospital which had been ordered from outside the Colony had arrived by the beginning of 1963 and it is anti- cipated that all patients will have been moved from the existing Kowloon Hospital to the Queen Elizabeth Hospital by the end of December 1963. Kowloon Hospital will then be renovated and modified, to function as a general rehabilitation centre of 304 beds complementary to the Queen Elizabeth Hospital and as a medical and surgical tuberculosis centre of 184 beds.

20. During March 1963 site works started at the Queen Mary Hos- pital preparatory to the extensions necessary to modernize this Govern-

　　ment Hospital which was first opened in 1938 and which is also the Teaching Hospital for the University Medical School. The extensions will include new operating theatre suites, a new radiology department, ward units for an additional 180 beds and enhanced teaching facilities designed to accommodate an increased intake of medical students.

21. Voluntary agencies are also engaged in general hospital develop. ment projects. The Tung Wah Hospitals Board opened an extension of 180 beds at the Sandy Bay Infirmary on Hong Kong Island in December, 1962, and plans were in hand to build an Infirmary of 210 beds at Wong Tai Sin in Kowloon. In Tsuen Wan, work had started on the 72 bed Seventh Day Adventist Hospital and the Yan Chai Hospital Board was incorporated by statute, preparatory to raising funds to build, initially. an hospital of 100 general beds, also in Tsuen Wan. Proposals submitted by the Protestant Churches to build a general hospital of 600 beds in Kowloon, to be known as the United Protestant Hospital, were also under consideration by Government.

22. The Government outpatient clinic building programme is also going ahead. In North Point on Hong Kong Island, the Anne Black Health Centre was opened in September 1962 by Lady Black, the wife of His Excellency the Governor. Named after Lady Black as a tribute to her practical concern for the welfare of the people of Hong Kong. half the cost of construction was donated by Dr. TANG Shiu-kin, C.B.E.. LL.D., and a group of his friends. Government met the other half of the building costs and equipped the clinic which is also being staffed and maintained by Government.

　　　　23. The Royal Hong Kong Jockey Club also donated two further clinics, the Queen Elizabeth Hospital Specialist Clinic and the Wang Tau Hom Clinic. The former is in the grounds of the Hospital and is designed to provide outpatient consultant and follow-up services main- tained by the clinical Specialist Units in the Queen Elizabeth Hospital. The latter is a standard urban type clinic which serves a new and rapidly growing resettlement estate. Both have been equipped by Government and are maintained from public funds.

24. At San Po Kong on the outskirts of the Wong Tai Sin Resettle- ment Estate, the foundation stone of another standard urban clinic was laid by His Excellency the Governor Sir Robert Brown BLACK, G.C.M.G., O.B.E., in February 1963. To be named the Robert Black Health Centre, this clinic has been built as the result of a generous personal donation of half the construction cost by Dr. TANG Shiu-kin,

and the architect, Mr. W. SZETO, has given his professional services free as his contribution. The remainder of the cost of the construction, the equipment and the maintenance is being provided by Government.

25. A feature of Hong Kong has always been the philanthropy of her citizens. Another notable event was the inauguration of the Li Shu Fan Foundation for Medical Education and Research. This inauguration took place in March 1963 during a meeting of the Hong Kong Chapter of the American College of Chest Physicians. His Excellency the Governor performed the Inauguration Ceremony which was attended by the President of the American College of Chest Physicians and a group of eminent physicians and surgeons from that College. Modelled on the Mayo Foundation. Dr. Li Shu-fan, M.B., F.R.C.S., LL.D., has made over to the Li Shu-fanı Foundation assets to the value of HK$18,000,000, the interest from which will be used to make grants for scholarships for medical and nursing undergraduate and postgraduate education, for medical research and for hospital treatment of the sick poor.

26. No report on the Medical and Health Services would be complete without an acknowledgment of the many and varied complementary activities carried out by a number of voluntary agencies. These activities range from the maintenance of large hospitals to assistance to individual patients who are handicapped by disease or disability. The major volun- tary agencies which assist the Medical and Health Department in the care, rehabilitation and social aid of the sick and handicapped are listed in Appendix 5 and their services are gratefully acknowledged.

ADMINISTRATION OF THE MEDICAL AND HEALTH SERVICES

27. Statutory responsibility for the administration of the services safeguarding the public health in Hong Kong lies jointly with the Direc- tor of Medical and Health Services, the Urban Council, the Director of Urban Services, the Commissioner of Labour and the District Commis- sioner, New Territories. Executive functions in connexion with curative medical services and a number of aspects of preventive medicine throughout Hong Kong are the responsibility of the Medical and Health Department. The Urban Council is concerned with environmental sanita- tion in the urban areas of Hong Kong Island and Kowloon, through the Urban Services Department. The Director of Urban Services has execu- tive 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 personnel of the Medical and Health Department.

STAFF

28. 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 appointed Official Member of the Legislative Council. He is a member of a number of the Boards and Committees of volun- tary 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 Councils or Boards dealing with the registration and disciplinary control of Medical Practitioners, Dentists, Pharmacists, Nurses and Midwives.

　　　29. 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 environ- mental health matters. The Principal Matron is the Chief Nursing Officer and administers the Nursing Division which provides general and psy- chiatric nursing, midwifery and health visitor services. She is also a member of the Nursing Board and the Midwives Board.

　　　30. 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 Prin- cipal 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 Divisions are out- lined in Appendix 2.

　　　31. 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 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 institu- tions.

32. 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.

33. 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 Boards section is co-ordinated by the Boards Secretary.

34. The pharmaceutical and dispensing activities are the respon- sibility of the Chief Pharmacist, who also has inspectorate duties in connexion with the Dangerous Drugs and Pharmacy and Poisons. Ordinances.

35. The Government Chemist is responsible for the work of the Government Chemical Laboratory which undertakes the analytical, forensic chemistry and standards work in the Colony.

36. The Chief Hospital Secretary and his staff undertake 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 each of which is the responsibility of a Hospital Secretary. Assistant Hospital Secretaries are posted to the larger and more impor tant institutions within these groups.

37. Appendix I shows the establishment of the Department at 31st March, 1963.

FINANCE

38. The actual expenditure of the Medical and Health Department for the financial year ended 31st March, 1963 was $68,541,015 to which should be added a further $26,386,405 disbursed in the form of subven- tions. Capital expenditure on medical projects under the Public Works Non-Recurrent head totalled $28,262,729. These amounts represent 11.07% of the Colony's total expenditure during the year, and do not include expenditure on environmental sanitation by the Urban Services Department and the District Administration of the New Territories.

39. A Statement of Expenditure for the five years from 1958-59 to 1962-63 is shown at Appendix 3.

40. The total revenue collected from all sources by the Department totalled $5,119,102.

　　　41. The largest subvention was made to the Tung Wah Group of Hospitals which received $13,799,169. In addition, a further capital grant of $3,982,752 was made towards the cost of continuing work on the redevelopment of the Kwong Wah Hospital. Other large subventions were $1,180,000 to the Alice Ho Miu Ling Nethersole Hospital, $3,264,324 to the Grantham Hospital, $1,132,890 to the Hong Kong Anti-Tuberculosis Association, $743,179 to the Mission to Lepers. Hong Kong Auxiliary and $579,931 to the Pok Oi Hospital.

LEGISLATION

　　　42. The following legislation dealing with medical and health matters was enacted during the year 1962-63. Mention is made of the purpose of the more important ordinances in the body of this report.

Ordinances:

(i) Medical Registration (Amendment) Ordinance, 1962.

(ii) Penicillin (Amendment) Ordinance, 1962.

(iii) Dentists Registration (Amendment) Ordinance, 1962. (iv) Mental Health (Amendment) Ordinance, 1962.

Rules and Regulations:

(a) Poisons (Amendment) Regulations, 1962, (G.N.A, 60/62).

(b) Poisons List (Amendment) Regulations, 1962, (G.N.A. 61/62). (c) Poisons List (Amendment) (No. 2) Regulations, 1962, (G.N.A.

62/62).

(d) Dentists (Registration and Disciplinary Procedure) (Amend-

ment) Regulations, 1962, (G.N.A. 70/62).

(e) Dangerous Drugs (Amendment) Regulations, 1962, (G.N.A.

H12/62).

PROFESSIONAL REGISTERS

　　　43. There are five statutory bodies dealing respectively with the registration of medical practitioners, dentists, pharmacists, nurses and midwives. The Hong Kong Medical Council has statutory powers governing the registration of medical practitioners and has duties in connexion with disciplinary proceedings and offences; it is not an ex- amining body. The Dental Council, Pharmacy Board, Nursing Board and Midwives Board all maintain registers, regulate training, hold examina- tions leading to registration or enrolment and have disciplinary powers.

44.

At the 31st March, 1963, the number of persons on the statutory registers were as follows:

(Male)

Mental (Male)

1.135

412

108

2,146

123

2,068

WORK OF THE STATUTORY COUNCILS AND BOARDS

Medical Council

45. There were six ordinary meetings of the Council and five in- quiries were held during the year. Of the inquiries, two were in respect of disciplinary charges and two concerned the use of dangerous drugs by certain medical practitioners. One disciplinary inquiry, referred by the Preliminary Investigation Committee in March 1962, was heard by the Council during May 1962. A verdict of 'guilty' was returned and a sentence of three months erasure recorded; the sentence was however suspended for a period of two years on the condition that no further disciplinary offence was committed during this period.

46. The revised edition of the Council's Warning Notice was received from the printer during the year and was issued to medical practitioners during the month of November, 1962.

47. The Preliminary Investigation Committee met twice to consider disciplinary charges and both were referred to the Medical Council for inquiry. The first case referred to a charge of advertising and was scheduled for hearing by the full Council during April 1963. The second case referred to the issue of international certificates of inoculation against cholera without having inoculated the persons concerned. The Medical Council commenced this latter hearing during the month of March 1963, but the meeting was later adjourned to a date in April 1963.

48. During the year there were 79 applications accepted for full reg- istration and 2 applications for reinstatement were granted; 43 applica- tions for provisional registration were also accepted. A total of 8 names were erased from the register during the year as a result of death, de- parture from the Colony or failure to notify changes of address.

49. The fees payable in respect of full registration were increased during the year.

Dental Council

50. The Council met five times during the year to attend to routine business. Fees for first admission to the register were increased during the year and, in addition, an entrance fee was imposed for any examina- tion conducted in the Colony by examiners appointed by the Council. 51. There were 31 applications accepted for registration with the Council, of which 3 were for re-inclusion in the Register of Dentists; a further 12 applicants had qualifications acceptable without examination and were registered. Of the remaining 16 applicants, two sat the Council's examinations, passed and their names were entered in the Register. Six others were accepted for examination, five applications were rejected and three were under consideration at the end of the year. Pharmacy Board

　　　　52. The Board met four times for the transaction of routine business. There were twenty-nine applications for registration of which only one was accepted without examination; six applicants successfully passed the Board's examination and were admitted to the Register. Sixteen applicants were required to undergo further practical training before attempting the Board's examination and a further three applicants granted direct access to the Board's examinations to be held in 1963-64. Three applications were rejected.

　　　53. Under the Governmental scholarship scheme, a further two scholarships were awarded for the study of pharmacy in Australia. Nursing Board

　　　54. The Board met four times during the year. The requirements for the approval of Nurses Training Schools in Hong Kong were review- ed and brought into line with those to be introduced by the General Nursing Council of England and Wales as from the 1st January, 1964. After an exchange of letters with the General Nursing Council it has been agreed that all the existing approved Training Schools in the Colony will continue to be recognized for the purposes of reciprocity. Further consideration was also given to the revision of the general nursing examination syllabus by a sub-committee of the Nursing Board. Ex- aminations in general and psychiatric nursing were held in June and December, the results of which were as follows:

General Nursing

Preliminary Examination Final Examination

Psychiatric Nursing

Preliminary Examination Final Examination

Passed

Entered

TIL

- LI

352

285

213

189

55. The training in psychiatric nursing, which started in 1959, is now well established at the Castle Peak Hospital and the first two locally trained psychiatric nurses had their names entered in the relevant part of the Nurses Register following on the final examination held in December 1962.

56. Of 230 nurses applying for registration in the general nursing part of the Register, 215 were accepted of whom 181 were from the approved Training Schools in the Colony and 27 were nurses who had trained outside Hong Kong. Some of the latter were required before registration to sit and pass the Board's examination and others were referred for further training before being accepted. Seven nurses were re-admitted to the Register whose registration had lapsed during absence from the Colony. Three names were deleted from the Register, two on account of death and one on departure from the Colony.

57. No disciplinary investigations or inquiries took place during the year.

Midwives Board

58. The Board met quarterly and examinations were held during the months of April, July, October and January. A total of 186 candi- dates entered for the Board's examinations, of whom 170 were suc cessful.

59. There were 173 applications for registration and 171 were ac- cepted; 169 of the applicants had completed their training in Hong Kong and 2 who qualified in Australia were accepted without further examina- tion. Of the remainder, one was rejected and the other, who had com- pleted Part I of the Central Midwives Board examination held in the United Kingdom, was required to undergo six months further training before sitting the Board's examination. Three applications for restora- tion were granted and 2 names deleted from the register on account of death.

60. The Preliminary Investigation Committee met once to consider a disciplinary charge but found no grounds for an inquiry by the Board. 61. During the year, a revised edition of the Handbook for Midwives was approved by the Board and later issued to practising midwives and to Training Schools.

Radiation Board

62. The full Board did not meet during the year as the main business pending was the enactment of the proposed Radiation (Control of Radio- active Substances) Regulations and the Radiation (Control of Irradiating

Apparatus) Regulations. These draft regulations were being studied in the United Kingdom and were not received until towards the end of the year, when they were forwarded to the drafting sub-committee for con- sideration of the amendments proposed.

Medical Advisory Board

63. The Board met four times during the year and had under con- sideration the draft Medical Clinics Bill, the problem of cigarette smok- ing and lung cancer and the Report on Tuberculosis in Hong Kong by Professor F. HEAF. C.M.G. and Dr. Wallace Fox. Advice was given re- garding certain amendments to the Medical Clinics Bill, which was other- wise supported in principle, and on the problem of lung cancer. The Heaf/Fox Report was still under consideration by the Board at the end of the year.

II. PUBLIC HEALTH

GENERAL COMMENTS

64. The general level of the public health was well maintained throughout the year despite increasing densities of population in the urban areas, inadequate housing in the most congested areas, limited water supplies and some 25% of the population depending on a night soil collection service for sanitation.

65. During May and June 1962 there was a sudden influx of illegal immigrants from China estimated to number 140,000. In the following September typhoon Wanda rendered many thousands of residents home- less who were crowded together in emergency reception centres at a time when cholera was occurring in the urban areas. However despite these potential dangers no epidemic of serious proportions occurred.

66. Cholera El Tor re-appeared in August 1962, after a complete absence of any evidence of cholera vibrios persisting after the end of the 1961 outbreak when the last case had occurred during the first week of November. A severe epidemic of measles occurred during the winter months following on a period of 18 months of low endemicity. Notifica- tions of poliomyelitis during the year under review were the highest on record and a change in the epidemiological pattern was noted towards the end of the year, there being an unusually high incidence of paralytic disease during December and January (normally the months of lowest incidence) and a shift from Type I virus infections to Types II and III. There was a rise in morbidity from tuberculosis which appeared to be

directly related to the influx of illegal immigrants, particularly to cases in the older age groups amongst them. The incidence of chickenpox also increased but there were lower incidences of diphtheria, malaria and amoebiasis.

67. There was an overall rise in the notifications of infectious dis- eases but the mortality resulting declined. The crude death rate remained at the same level as the previous year, namely 5.9 per 1000 of popula- tion.

VITAL STATISTICS

68. The registration of all deaths and live births occurring in the Colony is compulsory under the Births and Deaths Registration Ordin- ance, Still-births are not registrable but the number of still-born children received by cemeteries and crematoria are recorded. Table 1 shows the annual returns for births and deaths during the past five year period.

TABLE 1

BIRTHS AND DEATHS 1958-62

Estimated

Told Live

Crude Live Birth Rate

Year

Mid-Year

Births

(per 1.000

Still Births Recorded

Total Deaths

Crude Death Rate

Population

Population)

(per 1,000 Population)

1958

2,748,000

106,624

38.8

1.297

20,554

7.5

1959

ILL

2,857,000

104,579

36.6

1,393

20,250

7.1

1960

2.981,000

---

110,667

37.1

1,680

19,146

6.4

1961

г. -

3,177,700

108.726

34.2

1.683

18,738

5.9

1962

3.400,300

111,905

32.8

1,560

20,324

5.9

69. The total of live births showed a slight increase on the figures for 1961 but the crude live birth rate dropped slightly by 1.4 per 1,000 of population and the crude death rate remained constant at 5.9. There was a natural increase of 91,581 persons, this being the highest ever recorded.

70. The mortality pattern continues to show the same trends observed during previous years, namely decreasing mortality from the communic- able diseases and an increase in deaths from diseases of later life, partic- ularly neoplasms and cerebro-vascular disorders. An analysis of mor tality for the years 1958-62 can be found in Appendix 4.

TABLE 2

INFANTILE AND MATERNAL MORTALITY 1958-62

Infantile Mortality rate (per 1,000 live births)

Neo-natal Mortality

Year

1958

54.3

---

1959

48.3

---

1960

1961

41.5

---

37.7

1962

36.9

rate (per 1,000 live births)

23.4

21.3

20.9

21.0

21.2

Maternal Mortality

rate (per 1,000 total births)

0.85

0.73

0.49

0.45

0.48

　　　71. Table 2 shows the recent trends in infantile and maternal mor- tality. The infant mortality rate has continued to fall but the maternal and neonatal mortality rates have remained more or less stationery.

72. An analysis of maternal mortality over the past 5 years is shown in Table 3. Toxaemias and haemorrhages of pregnancy were the prin- cipal fatal complications although there have been marked reductions in deaths from these causes in recent years.

TABLE 3

ANALYSIS OF MATERNAL MORTALITY 1958-62

Sepsis

Year

(excluding Toxaemias Haemorrhages Abortions

Septic Abortions)

Ectopic Pregnancies

Others

1958

.028

269

.250

.037

.111

.158

1959

N/A

.340

.226

.028

.066

.056

1960

.010

.179

.143

.045

.072

.045

1961

.009

.09

.027

.036

.027

.072

1962

0.18

.141

.185

.026

044

.062

III. WORK OF THE HEALTH DIVISION

HYGIENE AND SANITATION

Urban Areas

73. The Urban Council is responsible through the Urban Services Department for environmental sanitation in Hong Kong, Kowloon and New Kowloon. The Deputy Director of Medical and Health Services, in his capacity of Vice-Chairman of the Urban Council, is the co-ordinat ing link between the two Departments for the control of communicable disease by measures of environmental sanitation, food hygiene and pest

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 on the day to day management of environmental health problems. 74. 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 the co- ordination of all epidemiological measures to control the transmission 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 routine house inspections and regular visits to licensed food premises carried out by the Health inspectorate, much health education is possible in connexion with immunization campaigns and with the control of intes- tinal infections. With the assistance of qualified Health Visitors, the Health Officers maintain investigations into the sources of known cases of diphtheria, tetanus neonatorum, poliomyelitis, typhoid and certain other diseases.

75. These activities are closely co-ordinated with the activities of teams of inoculators from the Epidemiological Section of the Medical and Health Department, working under the immediate direction of area Health Officers and offering prophylactic immunization against small- pox, diphtheria, cholera and enteric fever.

Rural Areas

76. The Director of Urban Services has statutory powers controlling sanitation, food hygiene, cleansing, amenity and allied services in the townships and the more developed villages in the New Territories, while the District Commissioner is the licensing authority for all hawkers and premises where food is handled. The Medical and Health Department provides the curative and personal health services and the Principal Medical Officer of Health, New Territories, advises the respective authorities on all health matters affecting the area. The Medical and Health Department is also responsible for environmental health in rural areas. The main emphasis is on health education stemming from the curative services and designed to stimulate self-help in the villages through the development of simple measures which will improve en- vironmental sanitation.

EPIDEMIOLOGY

Quarantinable Diseases

　　　77. The whole Colony was declared a cholera infected local area in terms of the International Sanitary Regulations on the 23rd August on the laboratory confirmation of a case of Cholera El Tor and was declar- ed free of infection on the 8th October, 18 days after the occurrence of the tenth and last case in the urban areas. Five days later another case of Cholera El Tor was bacteriologically confirmed in the New Territories in the District of Yuen Long which district was declared an infected local area on the 13th October. No further cases occurred in the District and it was declared free of infection on the 29th October. There was a total of 11 cases with one death. No other case of quarantinable disease occurred during the year.

Cholera

　　　78. Following on the outbreak in 1961 and the continuing incidence of cholera in nearby countries, special preventive measures were taken throughout the year. These consisted of the routine bacteriological in- vestigation for cholera vibrios of all specimens sent to the laboratory from cases of gastro-enteritis and the routine sampling of night soil, sea water, well water and foodstuffs liable to be sources of persistence or transmission of cholera vibrios. In addition a mass cholera immuniza- tion campaign was carried out during February, March and April, during which 53% of the total population received the appropriate one dose of standard vaccine of 8,000 million organisms per ml. Particular attention was paid to the boat people who live afloat, the residents in the New Territories, the waterfront communities, food handlers and school children. In these population groups the percentage inoculated ranged between 85% and 95%. In all, over 1,600,000 inoculations were given.

　　　79. Quarantine restrictions were maintained throughout the year in respect of the infected local areas in the Philippines and the whole of Kwangtung Province. They were applied to Taiwan when it was declared infected in July 1962.

　　　80. The first isolation of cholera vibrios in Hong Kong during 1962 was from a case of suspected cholera admitted to the Lai Chi Kok Hos- pital on the afternoon of the 22nd August. This was not an imported case and no contact with individuals coming recently from infected areas could be traced. Laboratory confirmation showed that vibrio cholerae El Tor was again responsible, the strain being in all respects similar to the strains isolated in 1961. Thereafter, between the 22nd August and

the 20th September, there was a total of ten clinical cases of cholera, nine of which were confirmed bacteriologically. All cases were typical and the majority were severely ill. There was one death, the third patient, who died on arrival at the hospital after an illness lasting three days.

81. All house contacts of the ten clinical cases were isolated at the Chatham Road Quarantine Centre and, amongst the total of 126 con- tacts accommodated at the Centre, only 4 contact carriers were detected. These were all contacts of the first case.

82. The usual environmental preventive measures were applied, such as increased chlorination of the public water supply, the chlorination of all wells in the urban areas and the vigorous inspection of public eating places, food premises, markets and the control of itinerant food hawkers. Particular attention was paid to the collection and disposal of night soil and to the bacteriological sampling of the night soil conser- vancy tankers. All inoculation centres were re-opened for cholera im- munization and just over one million people were inoculated during the period of the outbreak.

83. It was possible to conduct a detailed epidemiological investiga- tion of each case that occurred and the results were consistently baffling. Specimens of foodstuffs in the infected premises were all cultured and were all negative for cholera. Positive swabs were, however, obtained from certain of the latrine buckets, from a chopping block used for the preparation of food in one instance, and in several cases from water in kitchen drains and on floors. One roof tank used for flushing a water closet yielded vibrios but the well which supplied the tank was negative.

84. On the night of the 10th September, nearly three weeks after the first case occurred, the first positive culture of cholera vibrios was obtained from a tanker containing communal night soil. This was in the course of routine random sampling and thereafter all night soil tankers in use in the urban areas of Kowloon and Hong Kong Island were sampled twice nightly. An interesting picture emerged. Within the next 10 days positive cultures of cholera vibrios were obtained from tankers serving 12 collection routes in Kowloon and 10 districts on the Island. It was possible in three instances to trace the infection back through the hoppers serving the tankers to latrine buckets. One bucket came from a public latrine and further investigation was not possible. However, in the two other instances, one in a tenement building and the other in a roof top squatter community, it was possible to obtain rectal swabs from the residents using the infected pail. All these swabs

proved to be negative. Positive cultures continued to be obtained from the communal night soil over a period of twenty-six days.

　　　85. On Monday the 8th of October, no case having occurred since the 20th of September, the Colony was declared free of infection. The following Saturday, the 13th of October, another case of cholera was confirmed; this occurred in a fishing village in the district of Yuen Long in the New Territories. In view of the fact that vibrios had disappeared from the communal night soil in the urban areas and that this particular village community could be readily controlled from a quarantine point of view, only the District of Yuen Long was declared an infected local

area.

86. Epidemiological investigations again revealed a very interesting situation. The community consisting of 410 people were all rectally swab- bed and a total of 16 contact carriers were confirmed and placed in quarantine. Two of the contact carriers were members of the patient's family and of the others ten were children below the age of 10 years, all of whom had close physical contact in the home or at play.

87. Intensive sampling of the water of the tidal river by which the village was situated and of the surrounding ponds used for the rearing of fresh water fish produced no cholera vibrios either agglutinable or non-agglutinable. All foodstuffs, particularly fish and fish fry, and other possible sources of infection were also consistently negative. The only common source of infection appeared to be the child contact carriers who played together on the mud banks and swam in the river.

88. The contact carriers were all treated with oral streptomycin and isolated until three successive negative specimens of stool had been obtained. No further clinical cases appeared and the district was declar- ed free of infection on the 29th October.

89. It is believed that Hong Kong was free of cholera vibrios during the period November 1961 to August 1962. Throughout this time, on a routine basis, all specimens sent to the Government Institute of Patho- logy from cases of gastro-enteritis were investigated for cholera vibrios. The first positive culture obtained was from the first case of cholera which appeared on the 22nd of August. The sampling of communal night soil tankers, which had been carried out three times each week throughout this period, gave entirely negative results until after the first case of cholera had been confirmed. It was only some 18 days later that cholera vibrios began to appear in the night soil and over the next two weeks there was a very widespread dissemination of the infection.

throughout the night soil collected from the urban areas. Yet a total of only 10 sporadic clinical cases appeared, of which 9 were confirmed in the laboratory. The tenth case was clinically a moderately severe cholera but the bacteriological investigations were consistently negative,

90.

　　The appearance thereafter of one confirmed case in a rural area with a total of 16 contact carriers, none of whom had symptoms sug- gestive of cholera, in a group of 410 persons indicated an highly infec tious organism but of limited invasive powers.

91. The sporadic appearance of relatively few clinical cases despite the widespread distribution of cholera vibrios in the community is be- lieved to be due to the fact that the infection was re-introduced into a population well vaccinated against cholera many of whom had received vaccine on more than one occasion. Some 76% of a total population of 3,250,000 had received vaccine in August and September 1961. The following spring 53% of the whole population was again vaccinated. During the outbreak in August 1962 a further one million doses of cholera vaccine were given.

92. From October 1962 to March 31st 1963 routine laboratory in- vestigations continued, during which particular attention was given to night soil tankers. All tankers in use were sampled twice each night and not one positive culture of cholera vibrios was obtained during this time. Similarly, cases of gastro-enteritis and specimens taken from samples of water and foodstuffs which could be possible sources of persistence of the infection were all negative. Further, non-agglutinable vibrios were only recovered rarely.

93. From experience gained during the cholera outbreaks in 1961 and 1962 three important tentative conclusions have been reached. The first is that the source of persistence of cholera is the human bowel and that the symptomless contact carrier is the essential agent in the trans- mission of the disease either in an endemic area or from an endemic area to an uninfected area when epidemic conditions may arise as a result. The second is that the organism is an highly infectious one but has limited invasive powers in a well-vaccinated community. This would explain the sporadic appearance of the disease either in the endemic areas where cholera is constantly occurring and the community has some degree of herd immunity as a result, or in a well-vaccinated population where cholera vaccine has had sufficiently wide acceptance to produce a degree of artificial immunity equivalent to that produced by the natural occurrence of the disease. The third is that standard cholera vaccine

sufficiently comprehensively applied is an important epidemiological tool which should not be discarded. The important factors here are that the vaccination cover must be sufficiently comprehensive and mass inoculation campaigns repeated at regular intervals.

　　　94. These conclusions are necessarily tentative but future experience of cholera in the region, which is to be expected for some time to come, may well give the opportunity to study further the evidence that appears to support them.

NOTIFIABLE DISEASES

95. During 1962, there was an increase of 12.62% in the incidence. of the notifiable diseases, particularly tuberculosis, measles, chickenpox and poliomyelitis. The rise in tuberculosis notifications is, however, attri- butable to the large number of cases discovered by the examination of illegal immigrants who entered the Colony during the year and a sub- stantial increase in the total notified by private practitioners. Diseases such as diphtheria, malaria and amoebiasis showed a decrease and the total mortality from all notifiable infectious diseases declined by 5.4%.

96. Free immunization against smallpox, enteric fever, diphtheria and cholera continued to be available to all members of the public at all Government Hospitals, clinics, Port Health Inoculation Centres and District Health Offices. In addition, inoculation teams visited schools, resettlement estates and other densely populated areas in conjunction with mass immunization campaigns.

　　　97. A summary of the prophylactic immunizations given is at Appendix 6.

Amoebiasis

　　　　98. A further decrease in the incidence was recorded, a total of 195 cases with 9 deaths being notified as against 215 and 12 deaths in the preceding year. The case fatality rate remained low at 4.6%.

Bacillary Dysentery

99. There were 795 cases of bacillary dysentery with 13 deaths during the year as against 742 cases and 8 deaths in 1961.

100. Much intensive health education in the prevention of the dysen- teric infections is carried out, by Health Officers, amongst those connect- ed with the handling, preparation and sale of food. There were 148

carriers detected amongst case contacts and all were given treatment and not allowed to return to work until three consecutive stool speci- mens had been obtained. The common organisms isolated were S. flex- neri and S. sonnei,

Chickenpox

101. A widespread outbreak of chickenpox occurred during the first quarter of 1963 with the incidence peak occurring in March. The total number of cases notified during the year was 707 as against 498 in 1961. The mortality remained low, there being 5 deaths recorded as against 7 deaths in the previous year.

102. The intensive immunization against diphtheria which com- menced in the autumn of 1959 was interrupted for the second year in succession by an anti-cholera vaccination campaign. The incidence of diphtheria, however, continued to decline, a total of 1,022 cases being notified during the year as compared with 1,334 in 1961, 1,450 in 1960 and 2,087 in 1959 when the number of cases notified was the highest recorded in any year. Over 75% of the cases in 1962 were in children under the age of 10 years, with more than 50% occurring under the age of five. There were 154 carriers detected amongst the case contacts as compared with 95 in 1961 and 35 in 1960. All carriers were isolated in hospital until they were proved free of infection.

103. The case fatality rate for diphtheria, which had been showing a continuing decline in recent years, rose from 8.2% in 1961 to 10% in 1962.

104. C. diphtheriae mitis continued to be the predominant causative organism and only in rare instances was an 'intermedius' or 'gravis' strain isolated.

Enteric Fever

105. A total of 826 cases was notified compared with 742 in 1961 and again the peak of the incidence was in July. The number of deaths due to enteric fever was 21 compared with 24 in the previous year giving a case fatality rate of 2.5% as against 3.2% in 1961. Twenty-eight car- riers were detected as against 26 in 1961 and all were treated and ren- dered negative. Facilities for inoculation remained freely available to the public and the annual campaign was maintained in schools. Food hand- lers and the staff of licensed restaurants, eating houses and water boats are required by law to submit to inoculation with TAB annually.

Malaria

　　　　106. There were 794 cases notified of which 434 or 54.6% were re- corded in the Sai Kung District of the New Territories.

Measles

　　　　107. The incidence of measles remained low, after the extensive epidemic in the winter and spring of 1960-61, until September, 1962 when the increase in notifications heralded the start of another major epidemic. The number of deaths, mainly due to broncho-pneumonia, remained high, reflecting the incomplete notification of this disease. There were 2,317 cases notified with 326 deaths.

Tuberculosis

108. Tuberculosis remains the major public health problem in Hong Kong. The control programme has so far shown results mainly in the prevention of tuberculosis amongst children and in the reduction of mortality at all ages. The problem is considered in detail in paragraphs 124 to 180 below.

Poliomyelitis

　　　　109. There were 363 cases of paralytic poliomyelitis notified during the year which is the highest incidence recorded since 1948. During July of peak of 78 cases occurred followed by a gradual decline, with 12 cases being reported in November. Thereafter there was again a sharp increase with 27 cases occurring in December and 35 during January. This was contrary to all previous experience as these are normally the months of lowest incidence.

110. During the summer months, as in past years, Type I poliovirus was predominant but in November, December and January, Type II and Type III were the predominant strains isolated. It appeared that the epidemiological pattern was changing.

III. A mass vaccination campaign, using a Sabin trivalent oral vaccine, had been planned to take place in two phases in January and March 1963. The first phase in the urban areas covered ten days from 2nd to 11th January, and oral vaccine was given to children in the age group most at risk, namely those aged between 6 months and 5 years. The campaign in the New Territories was extended to the 31st March to cover the small and more isolated village communities, the aim being to 'seed' the virus in each group within as short a time as possible. After the first phase, the incidence of paralytic disease declined sharply

and a committee of clinicians and pathologists investigated fully all cases notified as poliomyelitis which occurred thereafter to ensure that the causative strain was not related to the vaccine virus.

112. The second phase started on the first of March and was again continued for 10 days with an extension to the end of the month for the rural village communities.

113. During these two phases a total of 389,992 children received the oral vaccine which represents 66% of the child population aged 5 years and under.

114. Notifications of poliomyelitis fell sharply after the first feeding of the oral vaccine and during February and March only 13 and 4 cases respectively were reported.

115. This vaccination campaign had been planned some six months ahead to take place early in 1963, during the months of minimal cir- culation of the entero-viruses as gauged by surveys carried out during the two previous years. It seems certain that there was a change in the epidemiology and that a most unexpected outbreak of poliomyelitis due to Type II and Type III strains was halted by the oral vaccination campaign. The results of the campaign are now being assessed and it is hoped to publish a paper in the scientific press later in 1963,

116. In order to assess the antibody response to the vaccine, blood specimens were taken before vaccination from 194 children. Of these, 79 with no polio-antibodies were selected for follow up, all being in the age group 6 to 12 months. Rectal swabs were taken from the children prior to the feeding of the vaccine and out of 71 tested only 2 were positive for poliovirus. The overall percentage of triple negatives for polio antibodies in the age group 6 to 12 months was 40.5% and the most susceptible age group was below 9 months. Conversion rates were very satisfactory for Type II (98.5%) and Type III (95%) but for Type I the rate was only 66%, which may have been due to interference by other viruses at a time of year when the enterovirus carrier rate is known to be rising.

117. These same children were further investigated to ascertain the establishment of the vaccine in the intestinal tract. The average duration of excretion of vaccine poliovirus after feeding was found to be about 4 to 5 weeks. In general Type II was dominant and grew first in most of the children, followed by Type III. In the majority of these children Type 1 poliovirus appeared after the second feeding of vaccine. This is in accordance with previous world experience.

Ophthalmia Neonatorum

118. 310 cases were reported as compared with 250 in 1961.

Puerperal Fever

　　　　119. Two cases, both fatal, were again recorded during the year and both occurred following delivery in the home without the help of a doctor or a qualified midwife.

Scarlet Fever

120. Sporadic cases occurred throughout the year. 19 cases were reported as against 29 in 1961.

Whooping Cough

　　　　121. 98 cases with no deaths were notified as against 47 with 1 death in the previous year.

OTHER COMMUNICABLE DISEASES WHICH ARE NOT NOTIFIABLE

Influenza

　　　　122. The notification of influenza is entirely voluntary. Cases reported during the year numbered 6,374 with 39 deaths compared with 6,223 and 39 in 1961. The A2/57 (A/Asian 57) strain was active during the year as indicated by twelve isolates obtained at intervals from throat washings.

Tetanus

　　　　123. There were 139 cases notified during the year of which 82 occurred in new-born infants, mostly among those delivered at home, in villages situated in the New Territories. In such cases, assistance by an untrained person, the use of unsterile material and instruments and the common practice of applying raw ground ginger root to the umbilicus as a styptic combine to give a grave risk of tetanus neonatorum. Children attending Maternal and Child Health Centres are given routine immuniza- tion against tetanus using the toxoid preparations. The health education of parents and others in the areas most affected is a slow process, despite the very considerable efforts of the health staff of the New Territories.

TABLE 4

SPECIFIC MORTALITY RATES OF SOME NOTIFIABLE INFECTIOUS DISEASES 1962

Propor- tional Mortality

Specific death

Case

Disease

Cases

Deaths

fatality

rates per

roles per

rates %

100 deaths

100.000

from all

CONSES

Dysentery

Enteric Fever

Poliomyelitis

Cholera Amoebiasis

Bacillary Unspecified Typhoid Paratyphoid

Cerebrospinal Meningitis

Diphtheria

9.09

0.005

0.029

195

4.62

0,044

0.264

789

1.64

0.64

0.381

· ·

J J

772

2.33

0.089

0.528

I L

5.55

0.015

0.088

363

14.33

0.256

1.525

70.00

0.172

1,026

1,022

102

9.98

0.502

2.991

Measles

2,317

326

14.07

1.604

9.561

י ז

Puerperal Fever

100.00

0.010

0.058

Tuberculosis

14,263

1,881

13.19

9.255

55.166

Notes: 1. Total deaths from 1.1.62 to 31.12.62 were 20,324. 2. Estimated population for mid-1962 was 3,409,700,

TUBERCULOSIS

124. Mention has already been made of the visit of Professor F. HEAF, C.M.G., the Adviser on Tuberculosis to the Secretary of State for the Colonies and of Dr. Wallace Fox of the Medical Research Council Tuberculosis Research Unit in London. The pattern for the existing Government Tuberculosis Service was determined in 1952 and a review of the organization which has developed over the past 10 years for the control of tuberculosis and the results of that policy was timely. The Report submitted and the recommendations made are still under con- sideration by Government.

125. Broadly speaking, the policy has been to protect those most vulnerable to the fatal post-primary manifestations of the disease by vaccination with B.C.G., to provide outpatient facilities for the ambula- tory treatment of as many tuberculosis patients as possible and to reserve the limited hospital accommodation for the care and treatment of those patients not responding to ambulatory treatment or in need of surgical operations to hasten recovery. With the magnitude of the problem pre- sented by an incidence of active disease of 2% of the adult population it has been physically and financially impossible to provide institutional care of the order entailed if all infectious cases were to be isolated.

　　　　126. The measurements that can be applied to assess the results of this policy have been largely in connexion with mortality rates. The total morbidity and the pattern of morbidity have not yet been detailed and will not be until a scientifically based investigation can be carried out on a comprehensive scale. However, certain morbidity trends are emerging which indicate a pronounced shift in the distribution of the disease within the various age groups affected. In short, the youngest age groups now show a definite response to the preventive measures applied, while morbidity and mortality are heaviest in the adult popula. tion. Accordingly, while the general incidence of the disease remains about the same level, the heaviest morbidity and the categories of dis- ease most resistant to treatment tend to be concentrated in the age group of 45 years and above. That this is a legacy of the influx of refugees some twelve years ago, who are living longer with well estab- lished fibro-caeous disease, which is partially or wholly resistant to treatment with first line drugs, there seems to be no doubt.

Tuberculosis Mortality

127. The number of deaths recorded from all forms of tuberculosis during 1962 was 1,881 compared to 1,907 in 1961 although the deaths recorded from all pulmonary manifestations of the disease actually increased from 1,592 in 1961 to 1,654 in 1962. The mortality rate has nevertheless continued its downward trend and there has again been a substantial fall in the percentage of tuberculosis deaths under the age of five years related to the total tuberculosis deaths.

TABLE 5

DEATH RATES FROM TUBERCULOSIS 1932-62

TUBERCULOSIS

Percentage of tuberculosis deaths below

$ years

Year

Population

Death rate per 100,000

Percentage of Total deaths

1952

2,250,000

158,8

18.4

34.3

1953

יז

2,250,000

130.6

16.0

36.2

1954

2,277,000

126.3

14.9

31.2

1955

2.340,000

120.0

14.7

28.0

1956 ..

2,440,000

107.0

13.6

25.0

1957

2,583,000

103.6

13.9

21.2

1958

2,748,000

83.8

11.2

19.6

1959

2,857,000

76.2

10.7

19.2

1960

2.981,000

69.9

10.8

10.5

1961

■

3,177,700

60.0

10,2

11.5

1962

3,400,300

55.3

9.25

5.74

г.

128. The marked reduction in the tuberculosis mortality in children under five is attributed to the vaccination of new-born babies with B.C.G. This practice, started in 1952, now has wide acceptance both by parents and by all agencies engaged in midwifery. In 1952 only 4.33% of new-born babies received B.C.G. but with increasing co-operation by all persons engaged in midwifery this has now risen to 81.59% of all births registered in 1962.

129. In the adult age groups, between 1952 and 1962, the average age of death from tuberculosis has risen from 25 years to 46 years, and this shift of mortality has been most obvious in relation to pulmonary disease which accounts for 87.9% of all tuberculosis deaths. During the same period, the total deaths from pulmonary tuberculosis have fallen by 32.7% and the change in the pattern is illustrated in Table 6 below.

All Ages Minus 32.7%

TABLE 6

AGE VARIATION IN TUBERCULOSIS MORTALITY 1952-62

percentage of 1952 figures)

(Expressed as

Under 5 years 5-44 years

　　　　45-59 years Minus 96.5% Minus 61.2% Plus 20.7%

Over 60 Plus 130.3%

130. In addition to the ageing of the population of Hong Kong, there are two further factors which have a bearing on this situation. The first is that the introduction of effective chemotherapy is prolonging sub- stantially the life of patients with chronic fibro-caseous disease, and the other is the prevalence of the disease among the older people coming into Hong Kong from China.

Tuberculosis Morbidity

131. During the past decade, the annual notifications of cases suffer- ing from tuberculosis have varied in number between 12,000 and 15,000, The origin of such notifications during 1962 was as detailed in Table 7.

TABLE 7

NOTIFICATIONS OF TUBERCULOSIS (ALL AGES) 1962

Government Chest Clinics

LII

Other Government Institutions

Tung Wah Group of Hospitals

...

10,691 1,680

-J

801

Other Non-Government Institutions and Private Practitioners 1,091

14,263

　　　　132. The total of 14,263 notifications is some 1,679 more than that of the previous year and can be attributed to the large influx of immi- grants during the months of April and May and to the increasing co- operation by private practitioners in notification.

133. The morbidity rate of the disease, as measured by the ratio of notifications for each 100,000 of population, has declined from the peak figure of 689 in 1951 to 419 in 1962, the lowest figure have been 396 in 1961. As in the mortality figures, there has been a marked change in the age distribution of reported cases; since 1954, the incidence rate amongst children under five years of age has declined by 83.6%, while that for all persons over that age has fallen by only 15%.

　　　　134. The decline in the incidence of the disease in children under five is attributed to the increasing acceptance of B.C.G. vaccination. Despite the fact that a considerable proportion of these young children lose their tuberculin sensitivity within a period of two years after vac- cination, it does appear that some degree of protection nevertheless persists. In Hong Kong an investigation has shown that, in common with experience elsewhere, the actual drop in sensitivity over a period of 18 months amongst previously known reactors was 33%. Revaccina- tion with B.C.G. on entry to school is at present being considered and preliminary investigations regarding the procedures to be adopted, and their extent, are under way.

135. According to the notifications received, tuberculous meningitis in children under five has been slow to respond to control measures and it was thought that one reason may be that the total may have been inflated by errors in diagnosis. During the year a system of cross-checking of the notifications and the diagnosis was introduced, since when the total number of deaths recorded as due to tuberculous meningitis has fallen from 165 to 79.

　　　　136. In the past, when an individual attended a Government Chest Clinic for the first time, no inquiries as to origin have been made. Early in 1962, it appeared that the proportion of patients recently arrived in the Colony who were attending had increased considerably and an investigation into the incidence of imported disease was started. From this survey it appeared to be reasonable to conclude that attendances at Chest Clinics were relatively heavy among those who had resided in the Colony for six months or less, and that among this group there was a greater proportion of extensive disease, and a higher proportion of drug resistant disease.

137. Following on this investigation, there occurred the mass entry of illegal immigrants in April and May and between June and September over 68,000 of this group applying for registration were submitted to a chest X-ray. This group had a much more average age and sex distri- bution than the previous group of arrivals investigated early in the year and they were more preoccupied with getting work than with medical treatment. Preliminary assessments indicate that in the younger age groups of the illegal immigrants, tuberculosis was less prevalent than in the urban population of Hong Kong, but that in the elderly immi- grants some 15% had active tuberculosis. Also amongst the immigrants 81% of the active disease was resistant to one or more of the drugs in standard use, namely streptomycin, INAH and P.A.S.

138. The major problem now facing the tuberculosis control services is the detection and treatment of pulmonary disease in the elderly, many of whom are suffering from extensive and drug resistant disease.

Work of the Government Tuberculosis Service

139. All cases attending the Government Chest Clinics are given treatment free, irrespective of origin. The increasing volume of work undertaken at the Government Chest Clinics during the past five years is detailed in Table 8.

TABLE 8

WORK OF GOVERNMENT CHEST CLINICS 1958-62

1958

1959

1960

1961

1962

First attendances

39,454

39,008

35,991

40,146

43,519

Cases of tuberculosis discovered

12.270

14,406

12,937

15.270

16,54I

Total attendances for treatment

803,326

1,655,100 2,001,960

2,204,058

1,901,425

Under treatment from previous year

9,132

13,733

16,062

16,433

17,714

Started treatment during the year...

11.546

11,357

12,617

12,381

12,190

Completed treatment

1,048

2,064

3.724

3,776

4,935

Failed to attend

3.048

5,391

4,975

4,987

5,371

Admitted to hospital from chest

clinics

1.511

1,587

1,592

889

921

Still on treatment at end of year

13,733

16.062

16,433

17,714

17,372

140. Treatment at the Chest Clinics is by ambulatory chemotherapy. which includes daily injections of streptomycin six days each week combined with oral PAS and INAH, for a period of six months. At the end of this period, the oral therapy is continued for a period of up to two years from the start of treatment. Some chronic cases with positive sputum are maintained for long periods on INAH with the

intention of ultimately rendering them 'catalase negative'. Hospital ad- mission is arranged for those patients whose treatment can be expedited by surgical or other means or who, for medical or very pressing social reasons, require in-patient treatment.

　　　　141. There are four full-time Government Chest Clinics which, in addition to normal day-time working, offer one evening diagnostic session each week. Part-time clinics are maintained at twelve other centres and a sessional advisory service is provided at four other centres maintained by voluntary agencies. In addition to these specialized sessions, routine sessions are provided for the daily injections of strep- tomycin at a number of centres, for the convenience of patients who cannot travel regularly to the full-time clinics.

142. Case-finding is not practised on any scale as the available services are already heavily committed to the care of those patients who present with active disease. All Government employees undergo an annual X-ray examination and similar surveys are undertaken, on request, of employees in industrial concerns and private institutions, subject to certain conditions concerning sick-leave and re-employment for persons found suffering from active disease. Otherwise, little case- finding is performed, but this aspect of the control programme will require detailed consideration in the near future. The results of surveys undertaken during the year are shown in Table 9.

TABLE 9

X-RAY SURVEYS- -1962

Government Conditional

Employees Surveys

Prisoners

39.232

20,019

5,852

5,311

2.009

1,036

408

412

323

1.04

2.06

5.52

Total examined

Clinically re-examined

Active tuberculosis

Percentage active tuberculosis

　　　143. Following the diagnosis of a case of tuberculosis, Tuberculosis Workers visit the patient's home and arrange for the examination of the family and other close household contacts; those under eight years of age are tuberculin tested and those over that age are X-rayed. During the year a total of 17,353 contacts were fully investigated, the findings being detailed in Table 10.

Under 8 years of age

TABLE 10

CONTACT EXAMINATIONS 1961-62

Tuberculin Tests

Clinical findings of contacts showing Positive Mantoux

Percentage of Contacts

tuberculosis

Over 8 years of age

Result of clinical

examination

following

'Contact' X-rays

Percentage of contacts

tuberculosis

Negative

Positive

[Active T.B.

Inactive T.B.

Suspicious T.B. Free of T.B.

1961

1962

831

611

3.102

3,493

125

200

510

453

2,375

2,803

LII

2.34%

2.31%

found to have active

- LI

Active T.B. Inactive T.B. Suspicious T.B. Free of T.B.

421

289

665

374

...

11-

1.002

753

12,390

11.775

--L

2.91% 2.11%

found to have active

Tuberculin Testing and B.C.G. Vaccination

144. Mention has been made previously of the effect of B.C.G. vaccination of the new-born. However, some 20,000 unvaccinated infants are added to the community each year, but this number is appreciably reduced through the Maternal and Child Health and School Health Services where tuberculin testing is carried out on children not known to have received B.C.G. vaccination at birth. During the year, 52,634 children were tuberculin tested in Maternal and Child Health Centres and schools of whom 25,996 were negative and received B.C.G. vaccina- tion.

145. Children under three years of age who have not had B.C.G. but who show a positive tuberculin reaction are given INAH for one year in an effort to minimize the risks of a progressive primary tuber- culosis. During the year 88 such children were discovered at the chest clinics and a further 100 through the Maternal and Child Health Service. There were thus 188 under treatment during 1962 as compared to 147 during 1960.

Surgical Tuberculosis

Thoracic Surgery

146. Outpatient sessions for patients who need or have had chest surgery are held at the Wan Chai Chest Clinic by the Government Specialist in Thoracic Surgery and the Thoracic Surgeon from the Grantham Hospital. These sessions are held weekly and fortnightly respectively. In consultation with the staff of the Clinic, cases undergoing ambulatory chemotherapy who require surgical investigation or treat- ment are seen by the Thoracic Surgeons and the lines of investigation and treatment are planned. Thereafter, the patients are admitted to the Grantham Hospital; on discharge the subsequent follow-up takes place at the Wan Chai Clinic.

147. The numbers of cases seen during the past 3 years have been:

Government

Thoracic Surgeon

Grantham Thoracic Surgeon

First attendances Subsequent attendances

Total

1960 1961 1962

103

112

137

147

125 108

803

891

926

262

321

355

906

1,003 1,063 409 446 463

Orthopaedic Surgery

148. Outpatient sessions are conducted at the Sai Ying Pun and Kowloon Chest Clinics for patients with bone and joint tuberculosis and are maintained jointly by the University Consulting Orthopaedic Surgeon, who is the Professor of Orthopaedic Surgery, and the Govern- ment Orthopaedic Specialist. Additional sessions are also held by the permanent staff at these two centres for patients requiring routine treat- ment and supervision. The surgery is carried out at the Grantham Hospital. Thereafter, routine medical treatment and ancillary services. such as physiotherapy, the fitting of appliances and medical social work are carried out by the personnel attached to the relevant clinic.

149. Attendances at these sessions over the past four years have been:

First visits Subsequent attendances

Total

L-L

1959 1960 1961 1962

617 441 415 397

3.503 4,001 4.618 3,685

4,120

4.442 5.033

4,082

150. The analysis of the location of bone and joint disease in the new cases presenting has been:

1959

1960 1961

1962

Spine Hip

303

202

197

125

115

109

Other bones and joints

189

145

103

LLI

Total

617

441

415

397

151. The number of cases presenting with orthopaedic tuberculosis has again shown a reduction. This is mainly a post-primary disease with a predilection for children between the ages of 6 and 12 years. Although post-primary tuberculosis in Hong Kong is diminishing rapidly, its incidence in this particular age group has not yet been materially affected. It is expected that the total of cases of orthopaedic tuberculosis will decline markedly within the next four years when children vaccinated with B.C.G, during the period 1957 to 1959 move into this susceptible age range.

Radiology

152. The total number of examinations carried out during 1962 on behalf of the Tuberculosis service by the Radiology Branch of the Department was 263,982 as compared with 305,088 in 1961, and almost one-third of these were performed by the use of 35 mm. or 70 mm. films. The static and mobile X-ray units attached to the Tuber- culosis Service are maintained and operated by the Government Senior Radiological Specialist and his staff. There is a very close co-operation and consultation between the Tuberculosis and the Radiological Services in all aspects of the diagnostic and routine supervisory radiology.

Bacteriology

153. The Government Institute of Pathology undertakes all bacterio- logy for the Tuberculosis Service. The number of direct smear examina- tions rose from 47,984 in 1961 to 86,281 during 1962, while culture and resistance examinations accounted for a further 13,710 procedures as against 12,000 in the previous year. In addition an investigation was carried out during the year on the sensitivity of the organisms from new patients attending the tuberculosis clinics for the first time. This survey is as yet incomplete, but preliminary results indicate a very high level of primary drug resistance, i.e. a large percentage of patients who deny previous treatment for tuberculosis are found to be excreting resistant bacilli.

Medical Social Work

　　　　154. One Senior Almoner, eleven Almoners and 55 Tuberculosis Workers are attached to the Tuberculosis Service. Their responsibilities include the interviewing of patients and their families, arranging hospital admission, hospital visiting, the home visiting and supervision of patients on ambulatory chemotherapy, assistance in money and in kind and rehabilitation.

　　　155. As soon as the diagnosis of tuberculosis is confirmed all patients requiring treatment or supervision are interviewed. The original interview is a comprehensive one and is based as far as possible on all future requirements while under treatment. During the year 11,754 new patients were interviewed, a slight increase on the previous year's figure although the total number of interviews was 33,412, being a fall of 10% as compared to 1961. Much additional interviewing is done subsequently by the Almoners' Clerks, who also maintain treat- ment record cards and distribute drugs to be taken routinely by mouth.

156. Admissions and re-admissions to hospital from the chest clinics. are arranged by the Almoners and this involves documentation, the financial aspects, advice to employers of patients being admitted to hospital and the maintenance of waiting lists. While the majority of patients still express a preference for hospital treatment, there is a growing number who express preference for out-patient treatment. Due to increased pressure, the reasons for which have been outlined pre- viously, the beds available for hospital treatment were in greater demand during the year and the number of persons on the waiting list at the end of 1962 was 374 as compared to 273 in December, 1961.

157. Ward rounds by Almoners, in company with the medical staff, are carried out as a routine and each patient is normally seen individ- ually at least once each month as well as by appointment if required.

158. The Almoners' Section is responsible for the preparation and maintenance of attendance registers of patients on outpatient therapy. After the initial interview by an Almoner, a Tuberculosis Worker pays a visit to the home, gives advice on hygiene and makes arrangements for contact examinations. In addition, irregularity of treatment or non- attendance is followed up by home visits. However, because of limited staff, much of the routine regular visiting has to give place to visits connected with irregular attendances or default from treatment. Patients are allocated on a district basis and the Tuberculosis Worker is attached more or less permanently to her district and works from the relevant

full-time chest clinic. At the chest clinics these workers also assist with reception and documentation duties so that there is a continuing per- sonal contact with the patients both at home and in the clinic, which promotes confidence.

159. The Tuberculosis Workers are recruited from girls of good education and intelligence and are given in-service training for a period of 6 to 12 months before being allocated to their districts. They are not fully-trained nurses nor are they trained social workers.

Assistance to Patients

160. There is a Tuberculosis Assistance Fund available to the Senior Tuberculosis Almoner which amounted to $300,000 in 1962. Assistance to the dependants of patients under treatment in hospital is the principal object and disbursements are made on a formula based on previous family income and the continuing family commitments. During the year 280 families received an average weekly grant of $26.38, as compared to $24.61 in 1961. In addition, milk powder issued on the basis of one pound each week to each patient was a charge on the fund. Miscel- laneous disbursements such as travelling expenses of patients coming from outlying districts for X-ray were also made from the Fund. Surgical appliances for cases of orthopaedic tuberculosis were given to 93 patients at a cost of $6,964, of which $3,947 came from the Assistance Fund, the remainder being subscribed either by the patient or by voluntary agencies.

161. Another source of assistance is the Samaritan Fund at the dis- posal of the Principal Almoner. A total of $3,416.20 was given for travel- ling expenses such as are incurred by orthopaedic cases attending clinics.

162. Donations in kind of rice, noodles, cooking fat, beans, clothing and blankets were also made possible through the generosity of C.A.R.E,

163. When it is not possible or expedient to assist patients from the resources available to the Tuberculosis Service they may be referred to other agencies such as the Social Welfare Department, the Family Welfare Society. Foster Parents Inc., and many other similar organiza- tions. A total of 283 patients were thus referred to other welfare agencies for assistance.

Rehabilitation

164. Ambulatory treatment for the majority of patients who attend the Government Clinics means that the greatest number can continue at work, or spend relatively short periods in hospital before returning to

their jobs. However, there is a considerable proportion of patients, in the 40-45 age group, of unskilled workers with chronic disease who have undergone thoracic surgery and who present a difficult re-employment problem. The Lutheran World Federation operates a rehabilitation scheme whereby patients recommended by organizations dealing with the treatment of tuberculosis are resettled either in agriculture, in small home industries or in other suitable employment. The total number of patients. referred during the year to the Lutheran Tuberculosis Project was 56, as compared to 58 in 1961. There is very close consultation and co- ordination with the Government staff by the personnel of this project which offers every promise of success and a much wider field of con- structive rehabilitation.

Hospital Services

165. The magnitude of the Tuberculosis problem in Hong Kong is such that it is not physically possible to segregate and treat in hospital all cases of active open tuberculosis. The place of ambulatory chemo- therapy, recently assessed on a scientific basis in Madras, has proved itself in practice over the past ten years in Hong Kong. However, hospital beds are necessary to any system of control and treatment and they play an essential role in Hong Kong. While Government has established and developed outpatient facilities on a major scale, the provision of hospital services has been predominantly the role of the voluntary agencies largely subsidized by Government. Thanks to the practical co-operation of the voluntary agencies, a co-ordinated system of hospitalization has been developed over the years.

　　　　166. During 1962 there were 1,748 beds set aside full time for the inpatient treatment of tuberculosis, 52% of which are in the two tuber- culosis hospitals and the convalescent home maintained by the Hong Kong Anti-Tuberculosis Association. The other institution dealing exclusively with tuberculosis is the Haven of Hope Sanatorium at Junk Bay in the New Territories.

　　　167. Beds for tuberculosis in Government Hospitals are in the Lai Chi Kok and Cheung Chau Hospitals. During 1962 there were 72 beds at Lai Chi Kok Hospital and 42 beds at Cheung Chau Hospital. The latter are used largely for young adolescents with positive sputum who have to be debarred from school until they are sputum negative. The Tung Wah Group of Hospitals maintains tuberculosis beds mainly for patients with disease of long standing.

168. Tuberculosis beds were distributed as follows during 1962:

Government Hospitals

-1

Hong Kong Anti-Tuberculosis Association:

Grantham Hospital

...

Ruttonjee Sanatorium (Including Freni Memorial

Convalescent Home)

Tung Wah Hospitals

Haven of Hope Sanatorium

Private hospitals

Total

IIL

148

568

336

356

230

110

1,748

169. The Lai Chi Kok and Tung Wah Eastern Hospitals provide emergency tuberculosis beds for the admission of acute emergencies, such as haemoptysis and pneumothorax, which are brought to the two Casualty Departments of the Queen Mary and Kowloon Hospitals. Such cases are admitted either direct or as soon as resuscitation has been effected at the receiving hospital and the patients are fit to move. These are temporary arrangements until such time as a new wing with emer- gency facilities is available at the Ruttonjee Sanatorium and the present Kowloon Hospital is converted to its future role, which will include a tuberculosis until of 184 beds, after the Queen Elizabeth Hospital has become fully functional early in 1964.

The Work of the Voluntary Agencies

The Hong Kong Anti-Tuberculosis Association

170. This is the largest and longest-established of the voluntary agencies working exclusively in the field of tuberculosis. It maintains two hospitals and one convalescent home, containing a total of 904 beds, a B.C.G. Clinic, an outpatient clinic for the follow-up of discharged patients and a Tuberculosis Insurance Scheme. Supported by voluntary donations and some endowments, the Association also receives sub- stantial annually-recurrent subventions from Government.

171. The Association works very closely with the Government Tuber- culosis Service and now provides in its two hospitals almost exclusively the facilities for thoracic and orthopaedic surgery required for the treat- ment of tuberculosis. Admissions to both the medical and surgical beds of Grantham Hospital and, to a lesser extent, the Ruttonjee Sanatorium are now largely in respect of patients referred by the Government Chest Clinics although both hospitals also arrange admissions direct for their own referred cases.

The Grantham Hospital

172. Opened in 1957, this hospital is equipped as a modern chest hospital. An extension which was completed early in 1963 provided an additional 84 beds to make the total 624, and also contains a physio- therapy department and a school for the training of nurses for the British Tuberculosis Association Nursing Certificate. Run on a fee-paying non-profit making basis, the hospital provides private, semi-private and general ward accommodation for fees of $35, $24 and $18 a day respec- tively. During 1962, Government maintained 492 of the beds in the general wards, including 48 beds in the new extension. Government also provides the clinical staff for 252 beds and undertakes the medical social work for patients in the 492 beds it maintains. The follow-up of patients discharged from these beds is undertaken at the Government Chest Clinics.

173. For purposes of clinical supervision of Government-sponsored patients within the hospital, there are the Grantham Pulmonary Unit of 240 medical and surgical beds, the Government Pulmonary Unit of 138 medical and 34 surgical beds and the joint Grantham-Government Ortho- paedic unit of 80 beds. The Medical Superintendent, responsible to the Grantham Hospital Management Board, is in charge of the medical ad- ministration of the hospital and has clinical charge of the Grantham Pulmonary Unit medical beds. The Grantham Thoracic Surgeon has clinical charge of the surgical beds in that Unit. The medical and surgical beds in the Government Pulmonary Unit are under the clinical supervi- sion of the Government Senior Tuberculosis Specialist and the Govern- ment Specialist Thoracic Surgeon respectively. The orthopaedic beds are in the clinical charge of a visiting consultant in Orthopaedics. All staff throughout the hospital is provided by the Association with the excep- tion of Government Medical Officers posted to the Government clinical units whose salaries are recovered from the Association. The Government Specialists act as consultants and no charge is made for their services. The Ruttonjee Sanatorium and Freni Memorial Convalescent Home

174. These two units are the responsibility of the Ruttonjee Sana- torium Management Board and are run as one. In the Sanatorium of 226 beds, medical, surgical and orthopaedic work is carried out, while the Convalescent Home of 110 beds is for patients who are under drug treatment but sufficiently well not to be in need of special nursing care. Consultant services are supplied by the University Professorial Units of Medicine, Surgery and Orthopaedics. Medical and Senior Nursing staff are provided by the Sisters of the St. Columban Missionary Order.

175. In addition, the medical staff of the Sanatorium maintain the B.C.G. and 'follow-up' clinic in the Association's Headquarters situated next door to the hospital, and undertake the X-ray and medical work in connexion with the Tuberculosis Insurance Scheme.

176. The work done at the Ruttonjee Sanatorium and the Freni Memorial Convalescent Home during the year ending 31st March, 1963 was as follows:

TABLE 11

ADMISSIONS TO THE RUTTONIEE SANATORIUM AND FRENI MEMORIAL

CONVALESCENT HOME

1960 1961 1962

Adults through Government Clinics

350 289

439

Children (Pulmonary) through Government Clinic

Children (Orthopaedic) through Government

Clinic

Other admissions and re-admissions

252

302

427

Total

693

678 985

111

The Tung Wah Hospitals

177. This group of three hospitals has a varying total of between 250 and 350 beds occupied by patients with tuberculosis. These beds are almost entirely occupied by cases of a chronic type and the turnover is accordingly relatively slow. No special subvention is made to support these beds as the total recurrent expenditure of the group is met by a Government subvention. In the busy maternity wards of these hospitals the B.C.G. vaccination of new-born babies is carried out by the Govern ment Tuberculosis Service staff.

The Haven of Hope Sanatorium

178. Maintained by the Junk Bay Medical Relief Society, this inter- denominational Protestant Mission Sanatorium provides 230 beds for the medical treatment of tuberculosis. No major surgical or orthopaedic work is undertaken. The Sanatorium staff also maintain a tuberculosis out- patient and 'follow-up' clinic at nearby Rennies Mill and carry out some tuberculosis survey work amongst the villagers in the Junk Bay area. Government maintains 80 beds in the Sanatorium for the free treatment of New Territories villagers and also gives a small annual grant towards the cost of the X-ray survey work.

Other Voluntary Agencies

　　　179. The Lutheran World Service developed in 1961 a pilot rehabili- tation scheme for patients with arrested or cured tuberculosis. This scheme has now become well-established and its activities are being expanded as additional facilities become available.

Private Hospitals

180. There are 110 beds provided in private hospitals, some of which are classed as charity beds in which treatment is given at low cost or free. There is also a considerable amount of ambulatory chemotherapy given by private practitioners, but there is no information at present available either on the numbers of patients under treatment or the results of treatment.

MALARIA BUREAU

　　　　181. The Malaria Bureau, under the direction of the Specialist (Malariology), is responsible for all malaria control operations through- out the Colony and, in certain instances, also undertakes the control of the breeding of culicine mosquitoes. In addition, lectures are given on malaria and allied subjects to various groups of health personnel under training, and expert advice is given as required 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

182. The important malaria vectors are A. minimus and A. jey- poriensis var. candidiensis. Malaria control in the urban areas is based chiefly on anti-larval measures consisting of training and clean weeding of hill streams, ditching and oiling. Anti-malaria oil continues to be employed as the main larvicide, although Gammexane Dispersible Powder and Diazinon are also used on a limited scale in areas where the application of oil is unsuitable, such as in rice fields and irrigation ditches leading from seepages to rice cultivation. The urban control programme includes Hong Kong Island and, in Kowloon, an area extending from just beyond Lai Chi Kok in the West to Lei Yue Mun in the east, and as far north as the Kowloon Reservoir. Also included in the programme are certain circumscribed rural areas in the New Terri- tories such as Rennie's Mill, the township on Cheung Chau Island, Chi Ma Wan Open Prison and the Shek Pik dam site in the South of Lantau Island.

183. The results of anti-larval operations, as checked by routine adult mosquito catches and larval collections, are satisfactory and the incidence of natural malaria transmission in the controlled areas con- tinues to be virtually nil.

184. In most of the New Territories, control by anti-larval or anti- adult measures is at present impracticable because of the scattered population, the widespread traditional wet cultivation, and the unpro- tected contiguous borders and islands. The main line of defence against malaria for disciplined groups stationed in the New Territories therefore consists of such anti-larval measures as may be practicable in their immediate vicinity, screening where possible, and chemo-prophylaxis.

185. The cost of control measures during the year was 33 cents per head of population protected.

Incidence of Malaria

186. Malaria is a notifiable disease, and the returns of the past five years are set out in Table 12.

Year

1958

1959 *1960

---

1961

1962

---

LLL

LII

ILF

TABLE 12

MALARIA 1958-62

Cases Notified

Deaths

...

659

442

-J

833

812

794

* The waking of routine blood smears of all febrile children of 10 years and younger attending

Government clinics in the rural areas was instituted in 1960,

187. 91.1% of all cases notified were from outside the protected areas; 53.9% of the cases came from the area surrounding the town of Sai Kung on the east coast and 11.6% of the total from Lantau Island. Of the parasites identified 98.2% were P. vivax, 1.3% P. malariae and 0.5% P. falciparum.

188. Malariometric indices obtained from a survey carried out during the year in children between 2 and 9 years of age in 11 villages in the New Territories showed that the endemicity of malaria varied in different areas. Spleen rates ranged from 0% to 9% and parasite rates from 0% to 14.19%. A similar survey carried out during the previous year in 14 other villages gave spleen and parasite rates ranging from 0% to 40.2% and 0% to 20% respectively.

The Anne Black Health Centre on Hong Kong Island, which was opened in September. 1962. This building, providing out-patient and maternal and child health facilities, was erected from funds divided equally by Dr. TANG Shiu-kin, C.B.E.. LL.D., and his friends, and by Government.

請再帶兒童前往服用預严

羽共两次方有預防效力

TAILUO

HALF CUBES

The Child of a fisherman receives her vaccine on a lump of sugar during the mass immunization campaign against poliomyelitis conducted in 1963.

Laboratory

189. The Bureau Laboratory continued to carry out the routine identification of mosquitoes and the examination of blood smears collect- ed at surveys or submitted from outlying dispensaries. Of 1,471 A. minimus and A. jeyporiensis var. candidiensis and 161 other anopheline species dissected during the year, none were found with sporozoites. In addition precipitin tests were carried out for the study of their feeding habits. Other activities of the Bureau included lectures and demonstra- tions on anti-malaria work to medical students, Health Inspectors and Health Visitors.

SOCIAL HYGIENE SERVICE

190. This service, which is the responsibility of the Social Hygiene Specialist, consists of three branches dealing with dermatology, venereal diseases, and leprosy. Facilities for the diagnosis of skin conditions are of considerable importance in bringing to light cases of latent syphilis and of early leprosy. Accordingly, the service is organized to provide 9 centres for purely dermatology clinics; in addition there are thirteen social hygiene clinics, where venereal infections and leprosy undergo investigation and treatment, although a number of cases of skin disease may also attend these clinics. The Wan Chai Hospital provides in-patient accommodation for the treatment of skin disease in women and children and a few dermatology beds for male patients are available at the Kowloon and Lai Chi Kok Hospitals; in addition, some patients with skin diseases are admitted to the Queen Mary Hospital for teaching purposes.

　　　191. The post of Social Hygiene Specialist which had been vacant since October, 1960, was filled during the year.

Venereal Diseases

192. The venereal disease clinics serve members of the public, sea- men of all nationalities, pregnant women referred from Maternal and Child Health Centres and gynaecological clinics, prison inmates, patients in the Castle Peak Hospital, patients referred from the Medical Examination Board, and applicants for emigration to the United States and Canada. Any treatment required is given free of charge. In addition, a large number of dermatological conditions are seen and treated at the venereal disease clinics. There has been, in general conformity with world statistics, a rise in the early syphilis rate during the year, but the in- cidence has shown no rise in the teenage group of the population as has been the case in U.S.A., the United Kingdom, Australia and Europe.

193. The incidence of gonorrhoea has remained fairly stable, but further control of the disease remains a problem because of difficulty in diagnosis in chronic cases, especially in females. Laboratory methods involving the use of fluorescent microscopy are about to be introduced. Penicillin is normally the first line of treatment but resistance and anaphylaxis continue to increase. Other antibiotics have strict limitations. from the points of view of the supervision of administration and of cost. Research into this problem is at present being undertaken.

194. The incidence of early and late latent syphilis continues to fall. This is to be expected if the overall diagnosis and treatment of syphilis over the past ten years has been effective; however, the large influx of immigrants during the year will probably have some affect on the in- cidence of late latent syphilis as it has in other aspects of public health. 195. Ante-natal blood tests for syphilitic infection are carried out as a routine on pregnant women attending Maternal and Child Health Centres. The following table shows the results over the past seven years. The value of this routine investigation is reflected in the low figures for congenital syphilis in babies under one year.

TABLE 13

ANTE-NATAL BLOOD TESTS 1956-62

1956 1957

1958

1959

1960

1961

1962

No. of Tests (Clinics &

Hospitals)

26,083

27,330

28,026

wives)

%% of Positive Rate

No. of Tests (Private Mid-

%% of Positive Rate

Cases of congenital syphilis

3.8

3.5

3.3

46,932 2.6

52,068 2.3

$1,449 1.6

53,954

2.2

5.464

4.623

5.583

6.269

6,805

6,940

9.640

3.4

2.7

3.2

2.3

1.9

1.4

1.2

recorded

Under 1 year

Over 1 year

116

131

196. The incidence of venereal disease in prostitutes, who attend voluntarily at the Social Hygiene Clinics either through contact tracing or for periodic investigation, has been under review since 1959. Table 14 sets out the results to date.

TABLE 14

Year

1959

1960 1961 1962

VENEREAL

No. of first attendances

DISEASE IN PROSTITUTES

V.D. not found

Gonorrhoea

Syphilis Early Lalent

Late Latent

1,086

692 (63.8)

235 (21.6)

63 (5.8)

952

613 (64.4)

124 (13.0)

69 (7.2)

96 (8.8) 146 (15.4)

806

$85 (72.6)

124 (15.4)

31 (3.8)

66 (8.2)

917

698 (76,1)

115 (12,5)

44 (4.8)

(60 (6.5)

{Figures in brackets represent the percentage of first attendances )

Leprosy

　　　197. Sixteen clinic sessions are held weekly in nine centres solely for leprosy patients, while two 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 253 new cases of leprosy were treated, of which 113 were leproma- tous, 120 tuberculoid and 20 diamorphous types of infection; 464 con- tacts were also examined. Of the infectious cases. 131, as against 124 in the previous year, 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 is maintained between Hei Ling Chau and the Social Hygiene Service.

　　　198. The treatment of surgical deformities in leprosy patients is carried out at the Maxwell Memorial Hospital at the Hei Ling Chau Leprosarium and a small number of cases have also been admitted to certain Government Hospitals. The rehabilitation of disabled non- infectious patients presents a difficult problem to voluntary agency and Government welfare services. The Hong Kong Society for Rehabilitation has accepted 24 of these patients for trade training.

　　　199. Prostheses devised by the Government Surgical Appliance Centre for patients with disabled and deformed limbs have proved to be of great benefit to the healing of chronic foot ulcers and the rehabili- tation of the patients.

Dermatology

　　　200. The dermatological clinics held at the nine centres recorded a total of 6,674 cases referred for an opinion. At the Social Hygiene Clinics there were a further 12,917 first attendance for skin complaints, which is 47.4% of the total of new cases seen at these clinics. Appendix 8 shows the incidence of the types of dermatological conditions seen in clinics.

201. The great majority of cases are those of coccal infections, especially in infants, due to the high humidity and a restricted water supply in the community. Self-medication with herbal preparations and the indiscriminate use of patent remedies give rise to another large group of dermatoses.

202. The incidence of industrial dermatoses remains low despite the increasing number of industrial workers in Hong Kong. The incidence of skin malignancy also remains low.

PORT HEALTH

203. 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 and the Asiatic Emigration Ordinance; for the com- pilation 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 epidemiological information is main- tained with the World Health Organization Epidemiological Station in Geneva.

204. All persons entering the Colony are subject to a quarantine inspection. Arrivals by sea are inspected at the two quarantine anchor- ages in Kowloon Bay and off Stonecutters Island respectively; arrivals by air are inspected at Kai Tak Airport and persons crossing the land frontier by rail at the Lo Wu Quarantine post. All immigrants without valid certificates are vaccinated against smallpox.

205. Other routine work carried out includes the deratting, disinsect- ing and fumigation of ships, sanitary duties in the port and airport, in- cluding supervision of water supplies control, measures to keep the port and airport free from Aedes aegypti, and inspection of all vessels carry- ing more than twenty unberthed immigrants. A service rendering medical advice by wireless, on request, to ships at sea is also maintained. In addition to routine work, the Port Health Launches, equipped with stretchers, first aid equipment and radio telephones, provide a sea am- bulance service in the port area.

206. Four Port Health inoculation centres are maintained for the convenience of persons requiring International Certificates for travel, two on Hong Kong Island and two in Kowloon, including one at the airport. Vaccinations are also offered free at these centres to members of the public. Inoculators are posted to various centres throughout the Colony and are responsible for the field work in connexion with im- munization campaigns which are carried out under the immediate super- vision of area Health Officers.

207. The new Terminal Building at the Kai Tak Airport was official- ly opened by H.E. the Governor on the 2nd November, 1962, and became operative on the 12th November. Out-patient clinic facilities are provided

in the Airport for Government servants working at the Airport and for their families. This clinic includes a vaccination centre for members of the public who require International Certificates of Vaccination and it also serves as a first-aid post.

208. Quarantine restrictions were maintained in respect of the Philip- pines and the Kwangtung Province, and were applied to Taiwan when it was infected with cholera in July 1962.

　　　　209. A case of cholera El Tor, the first to occur since the outbreak in 1961, was confirmed on the 23rd August and the Colony was declared to be an infected local area on that date. Further cases were reported and details of the outbreak are given elsewhere in this report.

DISTRICT MIDWIFERY SERVICES

210. The difficulties attending home deliveries under existing housing conditions and the growing appreciation of the advantages of the skilled attention available in institutions have resulted in a continuing decline in domiciliary midwifery. During the year only 3.5% of all registered births took place in the home and the maternal mortality rate, which has shown a dramatic fall in recent years, remained at the low level of 0.48 deaths per thousand births.

　　　211. It is now Government policy gradually to reduce facilities for domiciliary midwifery and to provide instead beds for normal mid- wifery in all new clinics constructed in urban areas where the needs of the district warrant this provision. In the New Territories the policy has been, and still continues to be, to include maternity beds in all new clinics. During the year two such clinics were opened in urban areas, namely, the Anne Black Clinic at North Point and the Jockey Club Clinic at Wang Tau Hom providing a total of 31 additional maternity beds.

212. The work of the Government Midwifery Service during 1962 is summarized in Table 15.

TABLE 15

GOVERNMENT MIDWIFERY SERVICE, 1962

Maternity beds in hospitals

359

Maternity beds in maternity homes (urban)

Maternity beds in maternity homes (rural)

147

Midwives (excluding hospitals)

Cases attended (excluding hospitals)

Average case-load for each midwife (excluding hospitals)

17,828

217

213. Midwives in private practice attended 39.6% of all births, the great majority of these taking place in small maternity homes of from two to six beds. The Supervisor of Midwives, a Government Senior Medical and Health Officer, is responsible for the regular inspection of such homes and for the general supervision of the work of the midwives; in this task, she is assisted by a qualified Health Visitor. The work undertaken in 1962 by the private midwives is outlined in Table 16.

TABLE 16

PRIVATE MIDWIFERY SERVICE, 1962

Number of midwives in active practice Number of registered maternity homes

Number of beds

Maternity home deliveries

Domiciliary deliveries

Total deliveries

184

115

546

42,327

2,227

44,554

214. All midwives are trained to perform vaccinations against small- pox and to administer B.C.G. to new born infants. It is due to the efforts of these midwives, both Government and private, that 81.6% of all children born in 1962 received B.C.G. protection, a measure which has resulted in a dramatic fall in child mortality from tuberculosis.

MATERNAL AND CHILD HEALTH SERVICES

215. In this most important and popular aspect of the work of the Department, which is maintained on a 'well baby' clinic basis, the emphasis is on health education and the prevention of disease. All facilities are provided without charge and, once disease is detected, unless the ailment is minor, the child concerned is referred to the appropriate branch of the curative service for investigation and any necessary treat- ment. When cured, the patient is encouraged to return to the relevant Maternal and Child Health Clinic. Health Education programmes for groups of mothers in the clinics and of individuals during home visits are permanent and continuing activities of the Health Visitors. In the clinics, all forms of group education are available such as simple talks. film and puppet shows and flannel-graph illustrations; practical demon- strations and group discussions are also widely used, the choice of medium depending on the subject and on the audience.

216. 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. Close liaison is maintained

between the Maternity Hospitals and the Maternal and Child Health Service to ensure the after-care of infants requiring special attention. The work performed during 1962, as compared with that of 1961, is detailed in Table 17.

TABLE 17

MATERNAL AND CHILD HEALTH SERVICES 1961-62

1961

1962

Number of full time centres

प्र

Number of subsidiary centres

Number of ante-natal sessions each year

2.131

2,195

New ante-natal attendances

22,99,5

23,203

Total ante-natal attendances

92,553

98,245

Number of post-natal sessions each year

857

931

New post-natal attendances

5,031

5,023

6.546 6,560

Total post-natal attendances

Number of infant welfare and toddler sessions

each year

New infant welfare attendances

4,815 5.103

Total infant welfare attendances

New toddler welfare attendances Total toddler attendances Total home visits

37,735 44,348

363,206

417,760

8,990

9,989

57,903

69,774

64,167

82,231

217. A part time maternal and child health centre was opened in the Kwun Tong Resettlement Estate in May 1962, which will, in time, be replaced by a full-time centre in the new Kwun Tong Clinic now under construction. The part-time centre in North Point was replaced by a full-time centre in the Anne Black Clinic which was opened in September 1962, while a new full-time centre was opened in the Wang Tau Hom Jockey Club Clinic in February 1963.

　　　　218. Ante-natal and infant welfare clinics continued to be held once a month at Tai O on Lantau Island and infant welfare clinics were held twice weekly in the Wong Tai Sin Resettlement Estate. The total attendance at Government infant and toddler clinics increased by 15.8% and new attendances by 15.5%; only 0.17% of these attending for the first time showed any abnormality,

219. Immunization against diphtheria, whooping-cough and tetanus is given as a routine, using triple vaccine. Smallpox vaccination is given where necessary and children not known to have received B.C.G. are tuberculin tested, those with a negative reaction being offered such protection. Children aged 3 years and under who are tuberculin positive, but without signs of active disease, are given prophylactic I.N.A.H. for a period of one year.

220. The Colony-wide average attendance at each ante-natal session was 44, as against 43 in 1961, and the average attendance by each expectant mother was 4. Post-natal sessions are the least popular and it seems that attendance is exclusively confined to women who either suspect or are conscious of an abnormality; 16% of those who attended for post-natal care needed some form of treatment.

221. Maternal and Child Health centres played an active part in the oral poliomyelitis vaccination campaign held in January and March 1963, and they provided all the specimens of sera and of faecal swabs for the virological and serological studies carried out by the Govern- ment Virus Unit in connexion with the campaign.

SCHOOL HEALTH SERVICES

222. The Medical and Health Department undertakes in all regis- tered schools, through its School Health Service, responsibility for environmental sanitation, the control of communicable disease, immunization against diphtheria, smallpox and typhoid and health education. There is also a medical inspection and curative service pro- vided for a limited number of participants in the existing contributory School Health Scheme. This latter scheme is under review and is expected to be replaced soon by a School Medical Service operated on a per capita contributory basis by private practitioners. To this end negotiations have been conducted with the Chinese Medical Association which has agreed in principle to assist with the launching of a compre- hensive inspection and curative service.

223. During 1962 there were 23,724 pupils from 253 schools who were participating in the existing contributory School Health Service. Medical inspections, clinics services, dental care and specialist ophthal- mic and ear, nose and throat investigations and treatment were pro- vided. Table 18 sets out the work done.

Medical Inspections

38,619

TABLE 18

WORK OF SCHOOL HEALTH SERVICE 1962

General Clinic

Attendances

41.947

Dental Attendances

30,060

E.N.T. Attendances

1,796

Ophthalmic Attendances

3,696*

* 1.708 pairs of spectacles and 247 pairs of lens replacements were issued.

224. There were no epidemics of infectious disease in the schools and there was a drop in the incidence of diphtheria, 254 cases being notified

as against 312 in 1961. A total of 137,971 school children were immuniz- ed against diphtheria with a full course of inoculations and a further 30,999 were given booster doses; 159.713 children were vaccinated against smallpox and 441,341 were inoculated against cholera.

225. Tuberculin testing has been carried out during the year as part of a general investigation to check the sensitivity state of pupils in regis- tered schools throughout the Colony with a view to extending the B.C.G. service, as a routine, to all school children. During the year 49,567 tuber- culin tests were done and 22,903 were given B.C.G. The positive reactors were investigated, as were known family contacts of tuberculosis; those with suggestive signs and symptoms and those with a 15 mm. or greater reaction were requested to attend for an X-ray examination. In these three groups a total of 648 were advised to attend for an X-ray: 505 of them showed no radiological evidence of disease and 104 were referred for full investigation at a chest clinic. The remaining 39 did not co- operate by attending for X-ray examination.

226. Before being permitted to teach in registered schools, school teachers are required to undergo an X-ray examination. During the year, 3,212 chest X-rays were taken and II teachers were found to be suffering from active tuberculosis; in such cases permission to teach is refused and priority admission to hospital arranged. After full investigation a further 154 teachers were permitted to teach under regular medical supervision.

227. Registered School premises are inspected routinely by Health Inspectors and all new premises or applications for extensions or altera- tions to schools are investigated to ensure adequate environmental sanita- tion and hygiene. For this purpose 2,866 inspections were carried out, and reports were made on plans for new schools or for extensions to existing schools.

228. Health education activities included lectures by doctors and health visitors to teachers-in-training; visits were also arranged to school clinics for practical demonstrations of the common health problems amongst school children. School visits by Health Visitors, home visits, and talks to pupils and parents at school clinics are routine activities which are an integral part of the work of the School Health Service.

DENTAL SERVICE

　　　　229. The Government Dental Service, under the direction of the Senior Dental Specialist, provides general dental care for the Civil Service as well as a School Dental Service, related to the School Health Scheme. In addition, emergency dental care is given to patients in Government

༄།

hospitals. in Her Majesty's Prisons and to the public at certain of the Government outpatient clinics. The work of the General Dental Service is shown in Table 19.

TABLE 19

WORK OF THE GENERAL DENTAL, SERVICE 1961-62

1961

1962

Dental Surgeries in operation

32*

Attendance by Government Officers

$2.039

52.974

Attendance by Dependants of Government

Officers

52.487

58,807

Attendances by General Public

25,797 26,596

130.323

138,377

Total Attendances

* Includes Tai O Dental Clinic used part-time only.

230. A Dental Officer and Dental Nurse, operating in each of six school dental clinics, have provided a service for participants in the School Health Service. It is worthy of note that the proportion of extrac- tions to fillings of deciduous teeth fell in 1962 to 1.8 to I compared with almost 2 to 1 in 1961. Also, the number of fillings compared with extractions of permanent teeth rose from 7.9 to 1 in 1961 to 10.4 to I in 1962.

Dental Epidemiology

231. In connexion with the programme of fluoridation of water supplies, which began in March 1961, a second survey of the dental health of children was carried out in 1962. This survey emphasized the high decay rate of children's teeth and the great disparity between the prevalence of dental caries among children and their use of conservative dental care. Children of six to eight years of age were found to have an average of 8.41 deciduous teeth affected by dental caries. An average of nearly one tooth per child had been extracted, but only one child in twenty-five had had a deciduous tooth filled. Children nine to eleven years of age were found to have an average of 3.49 carious permanent teeth, some of which had already been extracted, yet only about five out of every thousand of these decayed teeth had been filled.

232. It is confidently anticipated that the scheme of fluoridation of water supplies in which the fluoride level of mains water in the urban areas has been adjusted to the optimum for dental health will bring about a marked improvement in the teeth of children and in particular those born in 1961 and subsequent years. In the meantime dental caries con- tinues to remain a problem in Hong Kong, especially amongst younger children.

Dental Health Education

233. During 1962, the Hong Kong Dental Society again sponsored a Dental Health Week, from 22nd to 29th September, 1962. This week, during which the aim was to acquaint children with four rules for dental health, was an outstanding success. Various methods of publicity were employed and, according to a survey assessment made by the Society shortly afterwards, the competition had made a substantial impression, more than half the children interviewed being able to recite the basic dental health rules.

234. In January 1963, a dental health exhibition staffed by dental officers and auxiliaries was held as part of the Agricultural Show in Tung Chung, Lantau Island. Demonstrations of oral hygiene methods were given to villagers and fisherfolk of the district and to the visitors from further afield who attended the show,

　　　　235. In addition to these special drives, a continuous programme of dental health education was maintained in dental clinics throughout the Colony.

Dental Services provided by Private Agencies

236. A number of welfare organizations maintain free or very low cost dental clinics for the poor. Some of these are staffed voluntarily by Government and private dentists and Dental Officers of the Armed Forces stationed in Hong Kong. The Hong Kong Dental Society operates three free clinics during seven evening sessions per week, as well as providing volunteer staff for the Ruttonjee Sanatorium. The St. John Ambulance Brigade gives free treatment at its Hong Kong Headquarters Dental Clinic and at the Sandy Bay Convalescent Home. The Brigade also includes volunteer dentists among the personnel of its Penetration Squads which visit distant areas of the New Territories to carry treatment to people remote from ordinary medical and dental care. The Lutheran World Service and The Church World Service each operate a mobile dental clinic. These mobile low-cost dental services fulfil a very great need among the under-privileged people in resettlement areas, orphan- ages and the rural areas of the New Territories where very few dentists are in practice.

Control of Dental Practice

237. Two Dental Inspectors were employed throughout the year for the supervision and control of dental practice, carrying out regular in- spections of premises. There was one prosecution for alleged illegal practice of dentistry, and one person was convicted under the Registra- tion of Dentists Ordinance, 1959.

FORENSIC PATHOLOGY

238. All medico-legal work in connexion with the investigation of crime is carried out in laboratories situated in the Police Headquarters building. These laboratories, under the direction of the Specialist (Forensic Pathology), 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, during the year, a series of talks on *Emergency Child-birth' were given to women police constables. The Specialist (Forensic Pathology) is Lecturer in Forensic Medicine at the University of Hong Kong.

239. Work undertaken in 1962 is detailed in Table 20.

TABLE 20

WORK OF THE FORENSIC PATHOLOGY LABORATORIES, 1962

Examination of victims and suspects

Attendance at scenes of crime

Attendance at courts

Medico-legal examination of weapons

Examination of hairs, fibres, etc.

Examination of clothing Miscellaneous Examinations

Blood grouping (Medico-legal)

Blood grouping (Police Officers)

Lectures to Police Officers

Identification of nature of meat-dog, cat, etc.

Chemical examinations

Assistance in Raids

Breach of Pharmacy and Poisons Ordinance and

Penicillin Ordinance

Unregistered Medical Practitioners

Abortionists

Unregistered Dentists

Public Mortuaries

499

128

376

598

386

1,745

523

LLI

240. The two public mortuaries, one on Hong Kong Island and the other in Kowloon, are under the supervision of the Specialist in Forensic Pathology. It is to these institutions that all cases of sudden, unnatural or uncertified deaths are sent, including deaths in Police or Prison cus- tody, exhumed bodies and human remains. An account of the work done in the mortuaries is listed in Table 21.

TABLE 21

PUBLIC MORTUARIES 1962

Total number of bodies received

Total number of autopsies performed

Number of bodies claimed

Number of bodies unclaimed

Deaths due to natural causes

Deaths due to unnatural causes

Victoria

Kowloon

1,256

3,145

704

1.445

830

1,711

426

1,434

914

2.441

342

704

GOVERNMENT CHEMICAL LABORATORY

　　　　241. The Laboratory carries out analytical and consulting work of a very varied character for Government Departments, the Armed Serv- ices, commercial firms and private individuals.

　　　　242. The total number of samples examined during the year decreased by about 4% as compared to the previous year, due partly to a drop in the number of specimens submitted for biochemical analysis as an increasing amount of such analysis is now being under- taken by the Chemical Pathology Unit of the Government Institute of Pathology.

TABLE 22

WORK OF THE GOVERNMENT CHEMIST'S LABORATORY 1961-62

Samples Analysed

1961

1962

Biochemical

13,720

14.326

Dangerous Drugs Ordinance

9,871

9,963

Dutiable Commodities

8,029

8.212

Water and Waterworks Chemicals

2,513

2,681

Food and Drugs

1,128

1.147

.-.

Forensic

...

1,177

1,002

Toxicology

852

690

DJI

ייי

Dangerous Goods Regulations Commercial

1.498

343

488

632

Import/Export (Prohibition) (Specified Articles) Orders Miscellaneous

787

1,437

42,074

40,440

243. The major part of the work is concerned with biochemical analyses, narcotics control and the assessment of dutiable commodities. A great variety of work was done for the Police during the year, which

६६

included cases of forged or altered documents, the examination of counterfeit gold, tear gases, exhibits from the scene of 'hit and run' accidents and material from explosions, acid throwing and arson. Over 500 specimens of drugs of various kinds were examined in connexion with infractions of the laws relating to the sale of poisons and to the possession of prohibited insecticides.

244. The toxicological work comprised mainly examinations of specimens sent from hospitals and mortuaries in connexion with accidental or suicidal poisonings. The pattern of substances taken for purposes of suicide did not differ significantly from previous years, insecticides being the commonest, followed by hypnotics, disinfectants, and cyanide.

245. Specimens of dangerous drugs examined were mostly seizures from pedlars but included a considerable number of exhibits from heroin manufacturing establishments raided by the Police. Heroin, barbitone and opium account for nearly all narcotics seizures in Hong Kong.

246. The volume and range of dutiable commodities examined for assessment or remission of duty were similar to those in previous years. There was a slight increase in the examinations of water and waterworks chemicals as a continuous check was maintained on the level of fluorida- tion of the public water supplies, samples being taken daily from each station at which fluoride is added. The regular examination of all domestic supplies continued throughout the year and a further survey of wells was made on Hong Kong Island.

247. The number of samples of food and drugs submitted for examination under the Public Health and Urban Services Ordinance showed a slight increase over the figures for the previous year. Particular attention has been paid to milk and to products containing preservatives. Although 22% of the milk samples submitted during the year were found to be adulterated, the extent of adulteration showed a significant decrease during the latter six months of the year. The adulteration generally took the form of added water but in some cases evidence was obtained of reconstituted milk being sold as fresh milk.

248. A large number of samples were examined for the presence of preservatives, and both non-permitted preservatives and excessive con- centrations of permitted preservatives continue to be found in a number of locally-manufactured products.

249. During the previous two years, the examination of edible oils, and in particular sesame oil, has shown a high rate of adulteration with

mineral oil, in some cases up to as much as 95%. As the result of legislation introduced during the year, this practice is now prohibited and oils examined during the last few months have shown a notable improvement in quality.

　　　　250. Work carried out for Government departments included the assessment of standards in connexion with tendering the subsequent deliveries and the examination of inflammable and other dangerous goods seized by the Fire Services Department. The number of com- mercial samples dealt with showed a marked increase and covered a very wide field, including alloys, oils, chemicals, drugs, firecrackers, paints and textiles.

251. An argon vapour-phase chromatograph was acquired during the year and has proved useful in the examination of adulterated liquors and essential oils.

GOVERNMENT INSTITUTE OF PATHOLOGY

252. The Government Institute of Pathology, situated on the upper floors of the Sai Ying Pun Polyclinic, undertakes the major part of the clinical pathology and all the public health laboratory work for Govern- ment in the Colony and for some of the grant-aided hospitals. There is a major branch of the Institute in the Kowloon Hospital and small clinical laboratories are maintained at the Lai Chi Kok and Castle Peak Hospitals. There is also a branch laboratory, in Caine Lane, for the manufacture of vaccine. The work of the Institute during the year is detailed at Appendix 15. The University Department of Pathology carries out the routine clinical pathology for the Queen Mary Hospital, and a Virus Unit in that Department is staffed from the Institute but operates under the general supervision of the Professor of Pathology.

253. The Vaccine Section of the Institute continued to manufacture standard cholera vaccine of 8,000 organisms per millilitre, and main- tained a reserve of 2,000,000 ml. Over 3,000,000 ml. of the vaccine were used in the course of mass anti-cholera inoculation campaigns. held during the year.

　　　　254. A systematic examination for V. cholerae in night soil from collecting vehicles was carried out throughout the year and stool speci- mens from cases of gastro-enteritis were investigated routinely for vibrios. In addition, the investigation of water from all sources and of other possible vehicles of infection such as fruits, vegetables, fish and shell fish for cholera organisms was continued throughout the year.

On the occurrence of the first clinical case of cholera on the 22nd August, 1962 a twenty-four hour cholera diagnostic service was established at the Institute in Sai Ying Pun and in the Kowloon Hospital branch of the Institute for the investigation of all cases of gastro- enteritis and suspected cholera.

255. Table 23 details the examinations for vibrios carried out during the year from sources other than patients and their contacts.

TABLE 23

Water from sea

Water from wells

Tap water

Swimming pools

Pond water for fish fry

Sewer swabs

Fresh water from local junks

Fresh water from incoming junks

Vegetables and fruits

Fish and fish swabs

Nightsoil and manure

Cooked food

Others

Total

615 1,079

133

186

591

445

916

[1.489

338

15,881

256. Of the 3,754 specimens taken from patients and contacts, the following were positive for V. cholerae. (Table 24).

TABLE 24

Specimen collected from

Faeces

patients' homes

Vomitus

Patients

Contacts

Night- Kitchen Misc.

soil utensil swabs

Nightsoil collected by U.S.D.

Toral

146

257. Non-agglutinable vibrios were isolated during the period August to December, 1962 in 29 instances.

Virus Laboratory

258. The Virus Laboratory is equipped mainly for diagnostic and survey work in connexion with entero-viruses. During the year, three faecal surveys were carried out in the months of January, April and June. Specimens of faeces were taken from Chinese children under the age of five years, the methods of sampling and examination being the

　　same as in previous surveys. The findings again showed that polio-virus and other entero-viruses are distributed widely in the normal child population. Type I poliovirus was the only type found in these surveys, while in 1961 Types I and III were prevalent. The results of the surveys carried out between June 1961 and June 1962 are shown in Table 25.

TABLE 25

POLIOVIRUS AND OTHER ENTERO-VIRUSES IN THE 0-5 AGE GROUP 1961-62

Date

Number examined

Negative

Positive Poliovirus Type 1 Type II Type III

Total

Positive other entero-

viruses

June 1961

258

143

24 (9.3%)

91 (35.3%)

August 1961

247

116

11 (4.4%)

120 (48.6%)

November

1961

238

198

2 (0.8%)

38 (15.9%)

January 1962

211

190

5 (2.3%)

16(7.5%)

April 1962

207

168

5 (2.4%)

34 (16.4%)

June 1962

263

170

15 (5.6%)

78 (25.0%)

　　　259. In conjunction with the International Social Service and the Lederle Corporation, children in Hong Kong orphanages destined for adoption into families outside Hong Kong were given trivalent oral poliomyelitis vaccine. A total of 912 children were fed the vaccine in two doses at an interval of 6 to 12 weeks.

　　　260. In order to assess the antibody response to the vaccine, samples of sera were collected from 69 children before the first feeding and again four weeks after the second feeding. Rectal swabs were also taken from this control group prior to the first dose and again four weeks after each feeding. Prior to feeding, poliovirus type I was isolated in 3 cases, and other enteroviruses in 7 cases, the remainder being negative. The virus excretor rate 4 weeks after the first feeding was found to be 31.6%, being equally shared by poliovirus types II and III; 4 weeks after the second feeding the excretor rate was 3.4% for type III only. A total of 69 serum examinations carried out prior to vaccination showed the pres- ence of type I antibody in 92.7% of the children, type II in 18.8%, type III in 52.1% and only 3 children were negative for all these types of antibody; 41 Sera tested four weeks after the second feeding showed a high conversion rate to all three types of antibody. The results are shown in Figure I.

FIGURE I

CONVERSION RATE OF ANTIBODIES-POLIOMYELITIS 1962

100%

50%

pre-vaccination

post-vaccination

Type 1

Type 2

Type 3

261. The results of routine diagnostic examinations carried out by the Virus Laboratory on specimens received for virus isolations and serological studies are summarized in Tables 26 and 27.

TABLE 26

ISOLATION OF POLIOVIRUS, 1962

Nature of Number specimen examined

Negative Total

Positive Pollovirus Type 1 Type II Type III

Faeces

448

182

266

227

Throat swabs

Clinical Cases

C.S.F.

ד.

Brain Tissues

Contact Cases Faeces Convalescent

L +

1,759

1,502

257

219

Facces

TABLE 27

ISOLATION OF OTHER ENTEROVIRUSES-1962

Nature of specimen

Number examined

Negative

Positive

Virus isolated

C.S.F.

Throat swabs (throat

washing)

Brain Tissue

Faeces

103

Coxsackie A 9 in 1 case Coxsackie B 2 in 1 case

B 3 in 2 cases

B 5 in I case

ECHO type 1 in 1 case

7 in 2 cases

262.

Unidentified

14 in 1 case

4 cases

　　　　　　From time to time throat washings from suspected cases of in- fluenza are investigated to ascertain the prevalent strain. There were twelve positive isolates obtained during the year which were antigenically identical with the A2/57 (A/Asian/57) strain.

Vaccine Production

263. The Vaccine Laboratory prepared and issued the following quantities of vaccine during the year.

Vaccine

Anti-smallpox vaccine

Anti-rabies vaccine 2%

Anti-rabies vaccine 4%

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

Anti cholera vaccine

---

Prepared

Issued

44,292 ml.

38,854 ml.

43,050 ml.

45,000 ml.

37,150 ml.

38,170 ml.

55,670 ml.

49,600 ml.

11.900 ml.

2,308,950 ml.

3,065,600 ml.

68,400 ml.

200 ml.

Anti-plague vaccine

Autopsies

　　　264. Pathologists from the Institute also carried out postmortems at the Queen Mary Hospital and Kowloon Hospital, including medico-legal cases dying in these hospitals. During the year, 421 such autopsies were performed.

265. Technicians from the Institute undertake the routine post- mortem examination for plague in rodents sent to the Public Mortuaries

by the Pest Control Unit of the Urban Services Department. Of 69,161 rodents examined none were found to be infected with plague.

Blood Banks

266. 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 this was undertaken by the Government Institute of Pathology.

267. Donations of blood received during the year exceeded by some 230 pints the total for 1961. Although the greater part of the blood again came from members of the Armed Services or from visiting Royal Navy and United States warships, there was a further increase in blood donations from 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 consider- able amount of blood was.donated direct to the Blood Banks by relatives of patients in the various hospitals. The sources and distribution of blood received by the Blood Banks are detailed in Tables 28 and 29.

TABLE 28

SOURCES OF BLOOD DONATED, 1962

British Red Cross Society

Patients' relatives and friends

Other sources

Total

---

7,964 pints

1,327 pints

1 pint

9,292 pints

TABLE 29

DISTRIBUTION OF BLOOD, 1962

Government Hospitals

Government-Assisted Hospitals

Private Hospitals

Military Hospitals

Manufacture of Plasma

Preparation of Coombs Reagent Unusable due to various causes

Total...

г.г

6,303 pints

2,205 pints

231 pints

48 pints

123 pints

2 pints 262 pints

9,174 pints

268. Despite this encouraging increase, there is still a serious short- age of blood to meet all demands. In fact, supply was barely adequate to meet the emergency needs of the acute hospitals and much elective surgery had to be postponed for varying periods for lack of blood. Unless the situation improves greatly in the latter part of 1963, when many more acute beds will come into use, there will be a very grave shortage of this essential aid to modern therapy. Much propaganda is being directed by the British Red Cross Society to attain a significant increase in the number of Chinese donors, as the Armed Services, other temporary residents and visitors cannot be regarded as other than an evanescent source of supply. The people of Hong Kong owe a great debt of gratitude to those donors who, though only temporarily resident in the Colony, give blood for general use.

INDUSTRIAL HEALTH

　　　　269. The health of workers in factories and in other industrial under- takings is the statutory responsibility of the Commissioner of Labour. The Industrial Health Section of the Labour Department is chiefly con- cerned with the prevention of occupational disease and the protection of workers against health hazards arising from the working environment. Advice is offered to industry on problems connected with the hygiene of work places, the use of protective clothing and equipment, and the provision of clinic or first-aid facilities.

270. Investigations continued into the working conditions in trades known to be hazardous to health, and medical supervision is maintained of workers in certain dangerous trades such as those in which lead and radio-active substances are handled. Health Visitors carry out individ- ual case work on injured persons claiming compensation under the Workmen's Compensation Ordinance.

271. The contamination of various working environments by toxic gases, fumes or dust, was the subject of a continuing field survey; tem- perature and ventilation studies have also been made in a number of factories.

　　　272. The cleansing of aircraft contaminated by radio-active dust, following on nuclear explosions in other parts of the world, involved

extensive monitoring of rags and mops used for cleaning. Where indicat- ed, advice was given to employers regarding measures necessary to protect personnel engaged in this work.

273. Lectures on Industrial Health are given to probationer Labour Inspectors, Health Inspectors, Health Visitors and to 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

274. A better appreciation by the Colony's population of the basic principles of environmental hygiene and the prevention of disease con- tinues to be the main health objective. A very wide field is covered by many branches of the Medical and Health Department as an integral part of the service, and all available methods are used in the programmes undertaken. In general, those methods designed for individual or group education have proved to be the most effective, being used with particular success in the Maternal and Child Health Service, the Tuberculosis Service and the Social Hygiene Service.

275. A number of other departments are concerned with various as- pects of Health Education in their respective spheres, and the Inter- departmental Committee on Health Education formed in 1959 acts in an advisory capacity on any matters related to Health Education which may be referred to the Committee.

276. The co-operation of all voluntary bodies interested in health topics is actively sought and Kaifong Associations and Welfare Societies are particularly active in this field. Many of the Kaifongs take a lively and practical interest in the health problems of their respective districts and co-operate in immunization campaigns and in education on environ- mental hygiene.

277. The Health Education Team, formed during 1961 in the New Territories, was active in promoting better standards of hygiene and living conditions in rural areas and in preparing the way for immuniza- tion campaigns. The two 'floating clinics' donated by the Royal Hong

Kong Jockey Club and the 'flying doctor helicopter service combined curative treatment with advice on environmental hygiene and the preven- tion of disease during visits to isolated coastal and inland villages.

IV. WORK OF THE MEDICAL DIVISION

　　　278. All clinic and hospital services provided by Government con- tinued to operate under heavy pressure throughout the year. There is no doubt that the demand by the general public for medical and health services of all kinds has been steadily mounting in recent years. This pressure is not only caused by the additional numbers requiring atten- tion but also by an increasing tendency to turn from traditional Chinese medicine towards western methods of treatment.

279. Figures II and III show the outpatient attendances, the provi- sion of beds and the admissions to Government hospitals for the five- year period 1958 to 1962:

FIGURE 1

OUT-PATIENT ATTENDANCES AT GOVERNMENT CLINICS

1958-1962

New cases

6,000,000

Repeal attendances

5,000,000

4,000,000

3,000,00-0

2,000,000

1,000,000

1958

1959

1960

1961

1962

5,000

4,000

3,000

2,000

1.000

80,000

70,000

60,000

50.000

40,000

30.000

20,000

10,000

FIGURE HII

HOSPITAL BEDS

(Excluding Maternity Homes)

TOTAL HOSPITAL DEDS

GENERAL BEDS

Government

Governmcal-Assisted

Private

774

BEECH LOL

61 62

58 $9

TOTAL CASES ADMITTED

GENERAL CASES ADMITTED

LIINILLY

HOSPITALS

　　　　280. At the end of 1962, there was a total of 9,514 beds available in all hospitals in Hong Kong, excluding those hospitals maintained by Her Majesty's Armed Forces.

　　　281. An additional 503 beds in private maternity and nursing homes were also available. Details concerning this hospital accommodation are given in Appendix 10 and an analysis of the work done is set out in Appendices 9 and 11.

　　　282. No new hospitals were opened but extensions to existing institu- tions and redeployment in the use of accommodation resulted in a total, on balance, of 73 more beds being made available for inpatient treat- ment; details of these increases are given in the paragraphs dealing with the individual hospitals concerned.

GOVERNMENT HOSPITALS

Kowloon Hospital

　　　283. This is the main casualty and emergency receiving hospital for Kowloon and the mainland part of the New Territories. The Casualty Department maintains a 24-hour service and an average of 11.1 cases were seen every hour throughout the year, a total of 97,246 attendances being recorded. This is a 12% increase over the figures for the previous year.

　　　284. The outpatient department of the hospital now sees general cases only since the specialist outpatient clinics, with the exception of the orthopaedic clinic, moved to the new Queen Elizabeth Hospital Specialist Clinic in King's Park which was opened in September, 1962; the total number of outpatients seen in the year at Kowloon Hospital was 596,398; those attending at the new Specialist Clinic at the Queen Eliza- beth Hospital from 12th September, 1962 to 31st December, 1962, numbered 23,728.

　　　285. The number of inpatients admitted for treatment to the 574 beds of the hospital was 29,977, an increase of nearly 30% over 1961. There was a small decrease in the maternity admissions due to the partial closure of the Maternity Block as a result of damage caused by typhoon Wanda in September 1962. This damage required major re- pairs which took some 6 weeks before the normal operations could be resumed.

286. All in-patient units of the hospital continued to be hard- pressed; the surgical units recorded an increase of some 20% in admis- sions and in major operations compared to 1961. The medical unit again showed a rise in the number of admissions resulting from acute cerebro- vascular accidents which totalled 198 compared to 136 in 1961; only 66 were admitted in 1959.

287. The orthopaedic unit dealt mainly with patients admitted as a result of traffic accidents and industrial injuries; such patients constituted some 60% of the unit's work during the year.

288. The Gynaecological branch of the Obstetrical and Gynaecolo- gical Unit admitted some 70% of its cases as emergencies; 9% of these were ectopic pregnancies and 41% miscarriages or abortions. In Obste- trics, the Caesarian Section rate rose from 6.35% in the previous year to 8.24% in 1962. The trial of the vacuum extractor instrument was continued and was successfully used in 43 deliveries in place of low forceps.

289. The Paediatric Unit opened a new outpatient session in the Maurine Grantham Health Centre, Tsuen Wan, in September 1962 and, in the same month, the Salvation Army Convalescent Home in Cheung Chau became available. The latter institution has been used particularly for cases of rheumatic fever with heart disease, 23 children with this condition having been sent there for convalescent care during the latter part of the year.

290. Table 30 sets out the work of the Hospital during the past five years.

TABLE 30

KOWLOON HOSPITAL 1958-62

Including Casualty and Outpatient Department

1958

1959

7960

1961

7962

Maternity Cases

3.472

3.646

4.372

4.749

4.578

יז

General Inpatients (excluding

Maternity)

30,695

13,242

16,052

Total Outpatient attendances

$58,010

532,492

547,592

19,459

605.654 596,398

25.399

Casualties attended (included in

above figures)

70,191

■L

71,627

80.333

86,218

97,246

Operations (excluding minor

ones)

5,704

6,571

7,584

9,257

11.748

יי

Mortality (expressed as

centage of admissions)

per-

6.2

5.5

6.4

6.5

7.6

Queen Mary Hospital

291. This hospital on Hong Kong Island is the largest Government acute general hospital in the Colony. Bed accommodation was increased during the year from 601 to 623 beds by an internal re-arrangement of wards, following the removal of tuberculosis cases to the Grantham Hospital.

292. As the University Teaching Hospital of Hong Kong, the Univer- sity Departments of Medicine, Surgery, Orthopaedic Surgery, Paediatrics and Gynaecology, each under the direction of a Professor, carried the clinical responsibility for a total of 323 teaching beds; in addition the Government units in Medicine and Surgery also undertake the training of undergraduates. The other clinical units, comprising Radiology, Thoracic Surgery. Neurosurgery. Anaesthetics, Ophthalmology, Ear. Nose and Throat Surgery and Obstetrics are staffed entirely by Govern- ment medical staff.

293. The large Casualty Department, which is the emergency and accident centre for the whole of Hong Kong Island, dealt with 46,589 casualty cases during 1962, this being almost double the number of cases seen in 1960.

294. In-patient admissions continued to rise, with a total of 21,311 patients treated during 1962; an increased provision of temporary ac- commodation in the wards and on verandahs was therefore necessary and a daily average of approximately 120 additional patients, over and above the accepted complement of 623, were under treatment during the year.

　　　295. A Renal Laboratory and Artificial Kidney Unit was inaugurated during the year, following the gift by a private donor of a Travenol Twin Coil Artificial Kidney Apparatus to the University Surgical Unit. Research work was also carried out on the use of intra-arterial infusions of nethotrexate and leucovorin in the treatment of advanced cancerous conditions. This work was supported by grants from the Cancer Inter- national Research Co-operative and, later, by the Li Shu Fan Medical Foundation.

296. Towards the end of 1962 work began on extensions to the hos pital which will provide some 180 additional beds together with new operating theatre suites, X-ray facilities and improved teaching and research accommodation for the clinical staff of the University Profes- sorial Units.

297. Table 31 sets out the work of the Hospital during the past five

years.

TABLE 31

QUEEN MARY HOSPITAL 1958-62

1958

1959

1960

1967

1962

Maternity Cases

1,975

1,962

2,144

2,324

2,429

General Inpatients (excluding

Maternity)

12.994

13.224

15,133

15,923

18,882

Total Outpatient allendances

44,845

53,306

47,437

58,559

67.291

Casualties attended (included in

above figures) ..

18,101

22.307

23,402

41,936

46,589

Operations (excluding minor

ones)

7,230

7.212

8,160

8,420

9,681

Mortality

(expressed as per-

centage of admissions)

7.3

7.5

7.0

7.3

6.6

Tsan Yuk Hospital

298. This is the main specialist obstetrics hospital in Hong Kong and the teaching and training centre for medical students and student midwives in obstetrics. The clinical supervision of the 200 beds is under- taken by the University Professor of Obstetrics and Gynaecology, assisted by both University and Government medical staff.

299. Admissions are restricted generally to patients requiring special- ized care and comprise primiparae, grand multigravidae and abnormal cases. Some 4% of admissions (305 patients), however, are emergency cases with complications which are referred from other sources, partic- ularly private midwives and Government maternity homes. There were no maternal deaths in the Hospital throughout 1962.

300. Outpatient sessions are held daily at the hospital; ante-natal attendances during the year totalled 34,786.

301. A small research laboratory in the Hospital conducted investiga- tions into haemolytic disease of the newborn among Chinese babies and into the ante-natal blood chemistry of pregnant women.

302. Table 32 below sets out the work done at the hospital for 1961 and 1962:

TABLE 32

WORK OF THE TSAN YUK HOSPITAL 1961-62

1961

1962

Total admissions

7.774

7,340

Total deliveries

6,664

5,993

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

12.34

10.68

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

13.71

11.70

0.77

Nil

21.13

20.63

Castle Peak Hospital

　　　303. This hospital for psychiatric patients, originally of 1,000 beds, has been in full operation for little more than 18 months, but pressure on accommodation has already increased to an extent which has called for the provision of additional beds in a number of wards.

　　　304. Psychiatric cases from the whole Colony are admitted to this hospital and the great majority of these are now presenting as voluntary patients.

　　　305. The Hong Kong Psychiatric Centre situated on Hong Kong Island is the main outpatient department and is combined with a Day Hospital which also provides observation, treatment and supervision for patients on parole' from Castle Peak Hospital. Commencing in October 1962, two new psychiatric outpatient sessions were held weekly at the Queen Elizabeth Hospital Specialist Clinic.

　　　306. Training in Psychiatric Nursing was successfully continued and is referred to in paragraph 456. Fifth year medical students also spend a week in residence at the hospital to receive practical teaching in psychiatry.

　　　307. In therapy, a number of new psychopharmaceuticals were tried but the oldest of the phenothiazine group-largactil-continued to be the basic standby for controlling schizophrenics, a new drug, trifluor- promazine, having proved too toxic. In mania and other states of agita- tion with excitement a new compound, haloperidol, was introduced and found to be very useful. In depressive states the use of the mono-amine oxidase inhibitors continued to be effective and also reduced the need for electro-convulsive therapy.

　　　308. Occupational Therapy plays a very considerable part in the management of psychiatric patients and a comprehensive range of ac- tivities was organized very successfully throughout the year. Additional premises became available adjacent to the hospital for workshops in one of two large huts which had been previously occupied by a Cadas- tral Survey Unit of the Public Works Department.

　　　309. Psychiatric social work was undertaken by almoners attached to the main hospital and the outpatient day hospital. Discharged patients and their relatives formed an organization called the New Life Mutual Aid Club, which was registered officially as a Society during the year; the Club aims to promote the mental and physical health of its members, to help with social problems, and to induce a better understanding by

the public of the problems of mental disease and the promotion of better mental health.

310. Tables 33 and 34 below show the work of the Castle Peak Hospital and that of the Psychiatric Centre, Day Hospital and Out- patient Clinics respectively during the year.

TABLE 33

CASTLE PEAK HOSPITAL 1962

Male

Female

Total

Total admitted 1st admissions

Re-admissions

854

544

1.398

473

344

817

Total admissions

1.327

888

2,215

Discharged, including transfers and deaths* Total patients treated in hospital

Voluntary patients

---

ILL

1г.

• There were 35 male and 10 temale patients who died in hospital.

1.357

830

2.187

2,148

1.347

3,495

1,095

820

1,915

TABLE 34

Day Hospital

Admitted Discharged Total treated

HONG KONG PSYCHIATRIC CENTRES 1962

Male

Female

Total

110

204

104

196

126

120

246

---

Outpatient Clinics

Hong Kong

Tsuen Wan

Queen Elizabeth Hospital

First Attendances

Subsequent Total

Attendances

1.164

14.713

15,877

198

1,013

1,211

160

Total

1.428

15,820

17,248

Drug Addiction Treatment Centre

311. This pilot venture for the voluntary treatment of male drug addicts at Castle Peak Hospital continued on the same lines as in the previous year. One new feature of importance in 1962 was that all patients discharged had remained in the Centre for the full six months

　　period of voluntary treatment agreed to on entry; this reflected the con- siderable improvement in staff/patient relationships and in the co- operation of the patients which is a result of the experience gained in the management of drug addicts over the previous two years.

312. There were no changes made in the methods of treatment used but it has become increasingly apparent that the essential therapeutic problem is the prevention of relapse and much attention has been given to follow-up and community measures with this problem in mind.

313. The Pui Sun Fraternal Association-Addicts Anonymous' was formed in mid-1962. This group experienced some initial difficulties but, following on an effective re-organization, they became the responsibility of the Categorical Aid Department of the Lutheran World Service which had rendered substantial financial aid to the Association on its forma- tion. More than 100 discharged patients had voluntarily joined the Association by to the end of December, 1962. Experience elsewhere of groups like these has not been altogether happy, but every attempt has to be made to assist the addicts to help themselves. It is of vital impor tance to give them a heathly substitute for the old patterns of interest and activities they have shed, and to encourage mutual aid amongst them. The almoners have worked hard in this direction and much de- pends on the continued support they and their colleagues can give to this Association.

314. Several members of the staff of the Society for the Aid and Rehabilitation of Drug Addicts attended the Castle Peak Centre for in- service training in preparation for the opening of the Society's Treatment Centre at Shek Kwu Chau.

315. Occupational Therapy is essential for the well being of the patients and the benefits of an incentive scheme became apparent during the year. A system of small groups of about 6 patients each, working at selected occupations, has been found to be very satisfactory and pro- ductive. Apart from work therapy, a wide selection of recreational activities are made available, including football and badminton matches, swimming and walking parties and, indoors, table tennis and mahjong; there are also film shows twice weekly.

316. A number of research studies were undertaken during the year and are still continuing. These studies concerned the epidemiology of addiction based on socio-economic data, psychiatric investigation into the initiating factors giving rise to drug taking, an explanatory trial of

aversion treatment by giving, at the same time as the drug, continuous faradic electric shock, further work on the Nalline Test and, finally, radiological studies on lung changes occurring in drug smokers.

317. Table 35 below shows the numbers of male patients treated at the Centre during 1962.

TABLE 35

Patients registered for treatment

Patients admitted

FIL

Patients remaining from 1961

Patients discharged

ILF

(All patients remained in the Centre for 6 months)

Lai Chi Kok Hospital

360

122

120

318. This hospital has 481 beds which serve three categories of patients; 150 beds are allocated for infectious diseases, 72 for pulmonary tuberculosis, and the remaining 259 beds for convalescent patients from Kowloon and Queen Mary Hospitals.

319. Physiotherapy and occupational therapy units are maintained at the hospital, the former dealing mainly with the orthopaedic convales- cent patients and children with poliomyelitis, while the latter deals with the long stay convalescent and tuberculosis cases.

320. Total admissions during 1962 numbered 7.953; of these 2,445 were cases of infectious disease, including tuberculosis. Of the remain- der. 5,307 were from Kowloon Hospital and 201 from Queen Mary Hospital.

321. Five cases of cholera were confirmed out of 43 suspected cases admitted during the outbreak which occurred between August and October.

322. There were 874 patients admitted with diphtheria, most of whom were extremely ill when first seen as shown by the fact that 222 of them required immediate tracheotomy. The mortality from the disease, however, showed some decrease compared to the previous year.

323. Tetanus neonatorum, unfortunately, continued to be distress- ingly common and there were 55 deaths from this disease. Almost all had been delivered at home in the New Territories without adequate postnatal care.

324. Details of the infectious cases requiring admission to the Lai Chi Kok Hospital and the Sai Ying Pun Hospital are shown in Table 36.

Sai Ying Pun Infectious Diseases Hospital

　　　325. The limited accommodation in this old hospital, which is part of the former Government Civil Hospital in the western district of Hong Kong Island, continued to be severely taxed during the year. With a nominal strength of 88 beds, there were seldom less than 100 patients accommodated, the resultant overcrowding making strict isolation and prevention of cross-infection a difficult problem.

　　　326. The pattern of infectious disease in the patients admitted mainly followed that of the previous year and there was a further decrease in the number of cases of tuberculous meningitis seen. The case fatality rate for measles and diphtheria also showed a significant decrease although the children suffering from these diseases are nearly always admitted at a late stage and with severe complications. Bacillary dysentery was more evident during the year and admissions due to poliomyelitis were more than twice those of 1961; the latter disease has, however, shown a phenomenal drop in incidence since the oral vaccination campaign conducted early 1963.

327. Five cases of cholera were admitted to the special cholera annexe of the hospital during the outbreak in August and September and all responded well to treatment; 38 contacts of cholera cases were also admitted for observation during typhoon Wanda when it was impossible to reach the Quarantine Centre across the harbour.

　　　　328. Table 36 details the cases of infectious disease admitted to both Sai Ying Pun Hospital and Lai Chi Kok Hospital.

TABLE 36

ADMISSIONS TO INFECTIOUS DISEASE HOSPITALS ·1962

Cases Admitted

Deaths

Case Fatality Rate (per cent)

Diphtheria

1.245

7.63

Typhoid

416

1.20

Tetanus

179

39.11

Amoebic dysentery

105

2.86

Bacillary dysentery

591

1.02

Poliomyelitis

318

13.21

Tuberculosis meningitis.

56.52

Measies

245

9.39

St. John Hospital

329. Consisting of 100 beds and a general outpatient department, this Hospital serves the island of Cheung Chau and the neighbouring islands on the western sea-board. Specialist clinics for tuberculosis, paediatrics, medicine, dental, eye, social hygiene and skin diseases are also held at the hospital. Patients who require specialist medical or surgical treatment in hospital are transferred to Hong Kong Island.

330. There are 42 beds set aside for patients with pulmonary tuber- culosis who need in-patient supervision. These beds are largely occupied by adolescents with open lesions who cannot be allowed to attend school until they are rendered sputum negative.

331. A complete renovation of kitchen facilities was carried out and a badly needed hot water supply system was installed in the hospital during the year.

Wan Chai Hospital

332. 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 also maintained.

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

South Lantan Hospital

334. This small hospital of 17 beds, two of which are now reserved for maternity cases, serves the workers on the Shek Pik Reservoir project (now nearing completion) and the villages on the southwest coast of Lantau Island. The Medical Officer-in-Charge is also responsible for the dispensary and maternity home at Mui Wo, and for sick prisoners and staff at Her Majesty's Prison at Chi Ma Wan; he also serves as the Health Officer for the area.

335. Outpatient clinic attendances have more than doubled since last year; the figures for 1962 were as follows:

Mui Wo Dispensary

South Lantau Hospital

Shek Pik First Aid Post H.M. Prison Chi Ma Wan

26,416

11,640

15,007

21,390

Total

74,453

Prison Hospitals

　　　336. Four hospitals with a total of 186 beds are maintained within the prison compounds at Stanley Prison, Victoria Prison, Tai Lam Prison and Lai Chi Kok Female Prison.

　　　337. H.M. Prison Hospital at Stanley for male prisoners is the largest of these hospitals and has 90 beds for all purposes; 1,042 patients were admitted for treatment during 1962. A large outpatient clinic attached to the hospital dealt with an average of 550 prisoners daily including those attending the specialist sessions for tuberculosis, venereal disease, leprosy, eye diseases and dentistry.

　　　338. Selected blood donors amongst the prisoners gave a total of 575 donations of blood during the year in response to appeals from the Hong Kong Branch of the British Red Cross Society.

339. H.M. Prison, Tai Lam, houses convicted male drug addicts. The vigorous programme of treatment and rehabilitation which is carried out here has given very encouraging initial results though no accurate assessment of the relapse rate after discharge is as yet available.

　　　340. H.M. Prison, Victoria, has a special Psychiatric Observation Unit for suspected cases of mental disease in prisoners. This unit, which admitted 173 such cases during 1962, is under the clinical supervision of the Senior Specialist in Psychiatry.

　　　341. The female prison at Lai Chi Kok has a small hospital ward. including maternity beds, which is under the care of the Medical Superintendent of the Lai Chi Kok Hospital.

GOVERNMENT ASSISTED HOSPITALS

342. Financial assistance mainly by means of an annual subvention is given by Government to eleven hospitals maintained by voluntary organizations.

　　　343. Paragraphs 165 to 180 mention those institutions which are concerned solely with the care of tuberculosis patients.

The Tung Wah Group of Hospitals

　　　344. This group comprises three large hospitals and two infirmaries. Incorporated in 1870 by statute which is based on the charitable aims and objects of Chinese tradition, a Board of Directors is elected annually. Management of the hospitals and infirmaries is delegated by the Board to the Tung Wah Hospital Medical Committee which is under

the chairmanship of the Director of Medical and Health Services and is composed of the Chairman of the Board of Directors, the three Principal Directors of the Board, a prominent Chinese citizen appointed by His Excellency the Governor, a member from the Permanent Advisers to the Tung Wah Board, representatives from the Government Finance, Public Works and Medical Departments and the Medical Superintendents of the Hospitals. The Board of Directors raises large sums annually from donations, charity functions, public appeals and a flag-day. This money is devoted mainly to capital expenditure on hospitals, primary schools and welfare services for the poor. Government gave a subvention of $13,799,169 in 1962-63 to meet the recurrent expenditure of the hospitals and infirmaries.

345. Each hospital provides general medical, surgical and obstetric facilities. In addition, wards containing an average of 250 to 350 beds are set aside in the hospitals and infirmaries for the accommodation of patients with tuberculosis. A Group Medical Superintendent and three Medical Superintendents are appointed by Government to the hospitals and Government Nursing Sisters are seconded to the Nurses Training school as Tutors. All training and other activities are conducted in Chinese. Consultant Services are given voluntarily by private medical practitioners and, in some instances, by Government Specialists.

346. Patients are admitted through large out-patient departments maintained at each of the three hospitals. A number of acute medical and surgical conditions are treated and there is also accommodation for patients with chronic disease requiring long periods of inpatient care. The infirmaries cater for many suffering from incurable or disabling diseases who cannot be cared for at home. The obstetric service is an extremely busy and important one and one third of the babies born in the Colony each year are delivered in the three Tung Wah Hospitals. The work done is detailed at Appendix II.

347. The major occupation of the Directors at present is the redevelopment of the Kwong Wah Hospital in Kowloon. The building is being done in five phases; the fourth phase, which was started early in 1962, was nearing completion at the end of the year under review and work had commenced on the fifth and final stage.

348. In addition to this major project, an extension to the Sandy. Bay Infirmary, accommodating 180 patients, was opened in December, 1962; this provides a much-needed addition to the accommodation available for chronic and disabled patients. At the Tung Wah Hospital,

43 mentally-defective patients are now being cared for in a renovated block of the old Hospital; these wards were formally opened in February, 1963.

The Alice Ho Miu Ling Nethersole Hospital

　　　349. This hospital now provides 300 beds for general medical, surgical and obstetric care and maintains a large outpatient department. The increase in beds was provided to meet the new requirements of the Hong Kong Nursing Board and the General Nursing Council of England and Wales in respect of a Nurses Training School.

350. Demolition of the old East Wing and Nurses Quarters was commenced during the year to make way for new buildings which will provide further ward accommodation, a nurses block and medical staff quarters.

Pok Oi Hospital

351. Situated on the outskirts of Yuen Long in the New Territories, the Pok Of Hospital provides 118 beds for the treatment of medical and minor surgical illness that do not require specialist medical or surgical care. There are operating theatre, radiodiagnostic and laboratory facilities of a simple nature. It is managed by an Executive Committee consisting of six representatives of the statutory Board of Directors and six representatives of Government. The Board of Directors provides charitable services in the Chinese tradition and raises funds from voluntary sources for the capital and recurrent costs. These are augmented by Government subvention on a deficiency grant basis. A Government Medical and Health Officer is seconded to the Hospital as Medical Superintendent.

352. The foundation stone of a new out-patient department was laid by the Director of Medical and Health Services on the 30th March, 1963. The completion of this building will mark the first phase in a plan for the expansion of the out-patient and in-patient facilities of the hospital which is designed to meet the needs of the increasing population in that area.

Hei Ling Chau Leprosarium

353. Maintained with the aid of a substantial recurrent subvention from Government by the Mission to Lepers. Hong Kong Auxiliary, on an island six miles from Hong Kong, the Leprosarium contains accom- modation for up to 540 leprosy patients. The Maxwell Memorial

Medical Centre provides fifty beds for the care of patients undergoing reconstructive surgery or suffering from intercurrent disease and a further 15 beds for male patients with tuberculosis. The construction of a Physiotherapy Unit and a ward for patients with tuberculosis, for which funds were raised by the Marianne Reichl Aid to Lepers Group, was completed in September. The opening ceremony was performed on the 3rd November, 1962 by Dr. N. FRASER, Medical Secretary of the Mission to Lepers, who was formerly the first Medical Superin- tendent of the Leprosarium. The Unit provides sufficient space and equipment for physiotherapy and occupational therapy. The ward of 4 beds is intended for women patients suffering from open tuberculosis as well as leprosy; however, in the absence of any such women patients this ward is at present used for men.

354. There is a close liaison with the Government Leprosy Clinics and all patients, the majority of whom are infectious, are admitted through these clinics. Most patients are treated with a combination of two drugs, particularly DDS, thiambutosine, sulphetrone and thiosemi- carbasone. However, all modern drugs available are used in the most suitable combinations necessary to achieve the quickest possible cure and very detailed records continue to be maintained. Vadrine was employed in the treatment of patients resistant to other drugs but, like etisul, it was found to be very variable in its results.

355. During the year 284 surgical operations were performed of which 265 were to correct the deformities of leprosy. A new procedure was adopted for wasting of the thumb web and applied in 28 cases with promising results. The bone grafts used for the second stage of nasal reconstructions have proved satisfactory and show on sign of being absorbed.

356. 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. Social activities continue as in a normal community.

Our Lady of Maryknoll Hospital

357. This hospital was opened at the end of 1961 and is adjacent to a large resettlement estate area in Wong Tai Sin. The building of an additional wing to the hospital is now in the planning stage.

४०

358. A re-arrangement of the wards has increase the accommodation slightly during the year and there are now 55 beds in general wards, 4 in private wards and 20 cots. The Hospital is staffed by the Maryknoll Sisters, assisted by locally-trained nurses and midwives. A large general outpatient department is also maintained which was attended by 26,316 patients during 1962.

Sandy Bay Convalescent Home

359. This Home is maintained by the Hong Kong Society for the Relief of Disabled Children and now has 108 beds as the result of an extension built during 1962. All beds are for children requiring long- term orthopaedic care. particularly for bone and joint tuberculosis, most of whom have previously undergone major surgical operations at the Queen Mary Hospital. A school teacher is provided for the children by the Hong Kong Branch of the British Red Cross Society. London Missionary Society Maternity Clinic, Sheung Shui

360. This Maternity Clinic of 10 beds is conducted by a missionary Nursing Sister of the Society, assisted by locally appointed staff. Ante- natal and maternal and child health sessions are also maintained at the clinic. The Sheung Shui Maternity Clinic Advisory Board, consisting of local residents, supports the work and the London Missionary Society also makes an annual contribution towards running costs. This is augmented by an annually recurrent subvention from Government funds.

OUTPATIENT SERVICES

361. Pressure on all outpatient clinics continued to increase through- out the year. The outpatient clinics maintained by Government recorded some 6,094,000 attendances by patients, of which some 2,166,000 were

new cases.

362. New facilities which became available during the year included the three-storey Specialist Clinic on the Queen Elizabeth Hospital site which was donated by the Royal Hong Kong Jockey Club and opened in September 1962. The Anne Black Health Centre in North Point was opened in the same month by Lady BLACK, the wife of His Excellency the Governor; this clinic was built as a combined project between Government and Dr. TANG Shiu-kin and his friends who donated half the cost of construction. The Health Centre consists of an outpatient department, a maternal and child health centre, a maternity section of 8 beds and residential accommodation. In November 1962, a clinic was opened at Kai Tak Airport in the Terminal Building.

363. A standard urban clinic was completed at Wang Tau Hom, a rapidly expanding resettlement area in New Kowloon. This clinic, which was also donated by the Royal Hong Kong Jockey Club, was opened in February, 1963, and contains a general out-patient section, a maternal and child health centre with a maternity ward of 24 beds, and quarters for resident staff.

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

365. Evening out-patient sessions continue to be held at seven of the larger clinics in the more densely-populated areas and 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.

366. In the New Territories, apart from the fixed out-patient centres, two mobile dispensaries are operated on land while two launches act as 'floating clinics' and serve the more remote islands and the outlying coastal areas of the mainland. A helicopter flying doctor' service continued to operate once weekly to villages in the New Territories not easily accessible by other routes. The helicopter service was also used to transfer patients, in urgent need of emergency medical care, from outlying areas to hospital.

367. Appendices 12 and 13 show figures for the work done during 1962 at the out-patient departments of Government and Government- assisted institutions.

SPECIALIST SERVICES

368. There are Government Specialist Clinical Units of medicine, surgery, obstetrics and gynaecology, anaesthesiology, dentistry, neuro- surgery, ophthalmology, orthopaedic surgery, otorhinolaryngology. pathology, paediatrics, 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, ortho- paedics, pathology and paediatrics. Certain of the Government Special-

ists 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

369. The Radiological Service, under the overall direction of the Senior Specialist in Radiology, consists of three branches-radio- diagnosis, radiotherapy and medical physics. It serves mainly Govern- ment institutions, but consultant services are also available to Government-assisted hospitals and to private medical practitioners on request. The headquarters of the service is situated at present in the Queen Mary Hospital.

　　　370. The Senior Specialist and his staff undertake the instruction of medical undergraduates of the Hong Kong University in the basic principles of radiology. They also conduct in-service post-graduate training courses for radiologists leading to the Diplomas in Medical Radiodiagnosis and Medical Radiotherapy (D.M.R.D. and D.M.R.T. respectively) awarded jointly by the Royal College of Physicians, London, and the Royal College of Surgeons, England. Courses of instruction for student radiographers in preparation for the examina- tions for the Membership of the Society of Radiographers (London) are also maintained.

Radiodiagnosis Branch

　　　371. This Branch provides a full X-ray diagnostic service in each of the following Government institutions:

Hong Kong Island

Queen Mary Hospital

Tsan Yuk Hospital

Sai Ying Pun Polyclinic

Sai Ying Pun Chest Clinic

Wan Chai Chest Clinic

Medical Examination Board

Mobile Mass Radiography Unit (1)

Kowloon and New Territories

Kowloon Hospital

Kowloon Casualty

Lai Chi Kok Hospital

Shek Kip Mei Chest Clinic

Castle Peak Mental Hospital

Mobile Mass Radiography Unit (2)

372. Details of the work done during the year are shown in Table 37.

TABLE 37

WORK OF THE RADIODIAGNOSTIC BRANCH-1962

Branch Departments

Hong Kong

Queen Mary Hospital

No. of Patients

No. of Exams.

No. of films

X-rayed

taken

23,701

40,260

92,539

16,288

21.493

51,764

16,840

44,548

44.743

JIL

LIL

62,709

66,903

6,989

8,669

10,200

19.868

56,956

9.276

17,358

18,343

(471)*

(301)*

42,122

60,227

101,958

59,101

70,848

90.084

-- J

79,929

80,137

30,933

46,228

79,501

1,335

...

2,130

3,478

LII

2,681

2,962

5,028

2,233

2,413

2,827

ГГГ

791

849

LLL

1,076

(1,888)*

Sai Ying Pun Polyclinic:

General Section

Chest Section

M.M.R. Unit (1)

Tsan Yuk Hospital

...

Wanchai Chest Clinic

LLI

---

...

Medical Examination Board

Tung Wah Hospital

Tung Wah Eastern Hospital

Kowloon & New Territories

Kowloon Hospital

ггг

Shek Kip Mei Clinic:

Chest Section

M.M.R. Unit (2)

Kowloon Chest Clinic:

Chest Section M.M.R. Unit (2)

ггг

Lai Chi Kok Hospital Castle Peak Hospital Pok Oi Hospital

Kwong Wah Hospital

TOTAL:

374,796

521,773

705,537

*Not included in the total.

373. The total number of examinations performed showed an increase of 15% over those performed during the previous year, while the total number of individuals examined showed an increase of approx- imately 73.5%. This very large increase was in most part due to a mass chest X-ray survey of illegal immigrants during the summer of 1962.

374. New equipment received during the year included two Siemens' mobile image intensifier units. One is now in routine use at the Queen Mary Hospital and the other at the Kowloon Hospital. These units

greatly facilitate the work of the surgeons and radiotherapists in pro- cedures such as the pinning of fractures, the removal of calculi and the introduction of radium needles and tubes or of radiogold grains. With the facility, such operations can now be performed with only minimal interruption as there is no necessity to wait for films to be taken and developed. As a result of the speeding up of these operations, the conges- tion in the operating theatres has been relieved and the turnover of certain categories of beds in the two hospitals has been increased.

Radiotherapy Branch

　　　375. Facilities for deep X-ray, telecobalt, radium and radioisotope therapy, and also for diagnosis using radioisotopes, are provided at the Queen Mary Hospital, which is the headquarters of this branch. It also operates a service, mainly for superficial and contact X-ray therapy, at the Royal Hong Kong Jockey Club Clinic, Sai Ying Pun

376. Due to the shortage of beds at the Queen Mary Hospital, hostel accommodation has been provided at the Oxfam Hostel, Victoria Road, for some of the poorer patients receiving radiotherapy at the Queen Mary Hospital who live some distance away from the hospital. This Hostel is run by the Catholic Social Welfare Organization, Caritas, but free transportation between the Hostel and the Queen Mary Hospital is provided by the Government.

377. A comparison of the work done during 1961 and 1962 is shown in Table 38.

TABLE 38

WORK OF THE RADIOTHERAPY BRANCH-1961-62

Number of new patients seen

Number of new diseases diagnosed

Number of new cases of malignancy seen

Number of patients treated

г.

111

Number of new cases treated

1961

1962

1,504

1,564

1,509

1,564

...

1,079

1,089

1,501

1,792

1,105

1,236

1,193

1,366

888

935

42.475

...

46,343

179

291

182

199

ייי

17,228

17.806

796

727

---

272

479

312

Number of cases of malignant disease treated Number of cases of new malignant disease treated Attendances for X- and gamma-ray treatment Courses of radioisotope therapy given Radium or radiocobalt applications

гг.

Patient attendances at Radiotherapy Clinics Biopasies performed Radioiodine tracer studies:

Thyroid function tests Topographical surgery

rro

111

Physics Branch and Workshop Section

378. As in previous years the section, which is under the immediate direction of the Senior Physicist, has played an important part in the routine work of the Radiotherapy Branch, and has assisted in the train- ing of radiologists and radiographers. Its other functions consist of operating a radiation protection service for the Radiological Service and of giving advice and assistance to other Government departments in matters connected with radiation hazards and protection. The workshop section undertakes the maintenance, repair and calibration of all the radiological and physics equipment in the Department. It produced many spare parts during the year as well as electronic instruments and other devices to improve certain radiological techniques and the working efficiency of the Radioisotope Laboratory. This section has also been testing the new radiological and physics equipment for the Queen Elizabeth Hospital, prior to its installation.

Clinical Photography Service

379. This service, established in 1958, is now staffed with 2 Medical Photographers, one having been appointed towards the end of the year for training to work in the Queen Elizabeth Hospital Radiological Institute. During the year, the Photographers took 458 clinical photo- graphs, produced 607 projection slides for teaching purposes, made 517 X-ray reproductions for the radiological museum and for scientific publications for the perusal of the staff and students.

380. In addition, the senior Photographer gave demonstrations in medical photography to student radiographers and developed 1,610 radiation monitoring films for the Physics Section as part of the routine radiation protection activities.

OPHTHALMOLOGY

381. This service, which is under the direction of the Ophthalmic Specialist, maintains two full time centres with surgical facilities, one on Hong Kong Island and one in Kowloon. Ophthalmic teams also visit regularly on a sessional basis-clinics in urban and rural areas.

382. Owing to maintenance difficulties, the Mobile Ophthalmic Unit provided by the British Red Cross Society was finally withdrawn from service in the New Territories in December. 1962; it has since been replaced by another vehicle maintained by Government. During the year 219 eye operations were carried out by the Mobile Unit and a total of 2,143 patients treated.

383. Table 39 indicates the work of the Ophthalmic Service in 1961 and 1962:

TABLE 39

WORK OF THE OPHTHALMIC SERVICE 1961-62

New outpatient attendances

Total outpatient attendances

Operations performed

Home visits by Health Visitors Spectacles provided for children

1961

1962

76,214

83,852

---

204,811

236,416

4,011

4,056

3,218

---

3,260

---

2,[84

1.757

384. During the year 742 persons were registered as blind; the major causes of blindness recorded in these persons were as follows:- Cataract (33%), Kerato-malacia (19%), Trachoma (11%) and Glaucoma (10%).

385. The Almoners and Health Visitors attached to this service extended their work to cover the majority of those ophthalmic sessions which are held in the more outlying rural areas.

THE PHARMACEUTICAL SERVICE

386. The Headquarters of this service is at the Central Medical Store located in the Government Stores Compound, North Point. The Chief Pharmacist is in charge of a staff of two Senior Pharmacists. nine Pharmacists and 163 Dispensers, the majority of whom are posted in a total of fifty-two hospital pharmacies and out-patient dispensaries in various parts of the Colony. The Chief Pharmacist is a member of the Pharmacy Board and is largely responsible for the enforcement of the Ordinances dealing with Dangerous Drugs, Pharmacy & Poisons, and Penicillin. Two full-time Pharmacists carry out regular inspections of manufacturing houses, retail pharmacies and the dispensaries of Govern- ment-assisted and non-Government hospitals.

387. During the year considerable assistance has been given, by members of the inspector staff, to the Police in raids on premises involved in the illegal possession of Dangerous Drugs. Antibiotics and Scheduled Poisons. The work done in 1962 is shown in Table 40.

TABLE 40

PHARMACEUTICAL CONTROL 1961-62

Wholesale Poisons Licences issued Authorized Sellers Licences issued Listed Sellers Licences issued Antibiotics Permits issued

---

ייי

1961

1962

417

453

621

640

260

315

395

408

LLI

2,778

2,563

☐ 11

ггг

---

Licences for movement of Dangerous Drugs Premises inspected

Prosecutions

LLI

388. The Central Medical Store is the main depot supplying all Government medical institutions in Hong Kong and the surrounding islands with pharmaceuticals, medical and surgical equipment and sup- plies and medical gases. A branch, the Kowloon Medical Store, is the distribution centre for Kowloon and the New Territories. Manufacturing units for the supply in bulk of pharmaceuticals in concentrated form are maintained at both Stores. Parenteral fluids and other sterile preparations are manufactured at the Central Medical Store and at the Queen Mary Hospital Pharmacy. During the year, nearly 150.000 litres of miscel laneous parenteral fluids were prepared. Other sterile preparations, which included a wide range of ampoules for injection, ophthalmic solutions and ointments, totalled about 200,000 items.

389. During the year the Chief Pharmacist and his headquarters staff were actively engaged in the planning of the Central Sterile Supply Department of, and in the provision of instruments and medical equip- ment for, the Queen Elizabeth Hospital.

THE ALMONER SERVICE

390, Medico-social work, which is an essential adjunct to the cura. tive medical services of Government, is the responsibility of the Principal Almoner and a staff of 2 Senior Almoners and 52 Almoners. Amongst the latter is included the first male almoner to be recruited in Hong Kong a significant and welcome development.

391. The sudden influx of refugees in May, 1962 brought new demands and problems, not only in an increase of sick people whose claims on local relatives and friends was slight, but also in the greater need for careful explanation and documentation among those un- accustomed to the way of life in Hong Kong.

392. Almoners are attached to all the larger hospitals, to certain of the main clinics in urban areas and to the Tuberculosis, Ophthalmic, Mental Health and Social Hygiene Services.

393. In the larger hospitals and clinics the range of almoner services is wide and complex. The Orthopaedic and Neurosurgical Units require particular attention as the many accident cases need guidance and assist- ance when ready for discharge; schooling for handicapped children frequently presents difficulty and, due to the considerable help given by voluntary organizations, with which there has been close liaison, much has been accomplished in this sphere. The British Red Cross Society (Hong Kong Branch) provides a teacher for the children's wards at

Queen Mary Hospital and maintains the Princess Alexandra School in the Crippled Children's Home at Kwun Tong; the Salvation Army Convalescent Home at Cheung Chau received 92 children from the wards of Queen Mary Hospital during the year. For adults, the Kwun Tong Rehabilitation Centre provided accommodation and physical therapy for discharged orthopaedic cases and the Oxfam Hostel housed and fed 186 destitute patients undergoing radiotherapy. The need for convalescent and long-term beds for patients who are ready for discharge from the acute hospitals remains urgent if the present rate of turnover in such hospitals is to be maintained.

　　　　394. In the Mental Health Service, the almoner's work is rather more specialized and time-consuming, requiring skilled case work especially with the family of the patient; home visits are useful in this type of social work and nearly 1,000 such visits were made by almoners in 1962.

395. Drug addicts coming forward for voluntary treatment have also required much individual social work. Almoners assist in the selection. of voluntary patients for admission to the Treatment Centre at Castle Peak Hospital and deal with the problems arising in the families who are left at home during the patient's six months' absence, as well as with other difficulties which may become apparent when the patient is ready for discharge.

396. The almoners attached to the Social Hygiene Service are chiefly concerned with patients suffering from leprosy. The problem of employ. ment of these patients after clinical cure remains difficult as, apart from ostracism based on traditional fears, many of the patients are illiterate and unskilled.

　　　397. In the Ophthalmic Service, the almoners attend on a full-time basis at the two ophthalmic centres-the Violet Peel Polyclinic and the Arran Street Eye Clinic. A visit is also made once weekly with the ophthalmic team to the Yuen Long Clinic.

398. The in-service training of newly appointed almoners is organiz. ed by the Principal Almoner at the Harcourt Health Centre. Instruction and talks on medical social work are also given to student nurses, to medical students and to social studies students from the University of Hong Kong, to secondary School pupils and to other groups of potential social workers.

399. The Samaritan Fund administered by the Principal Almoner disbursed $19,681.50 during the financial year 1962-63. The main expen- diture was on fares for travel to enable patients to attend for treatment

and, in the case of Castle Peak Hospital, for relatives to see doctors. This fund relies entirely on private donations without assistance from Government and expenditure is therefore limited.

400. The Leprosy Fund expended $6,821,05 in the year, a rise of nearly 200% over 1961; the fund is used largely for assistance in paying rents for the accommodation of families of patients undergoing pro- longed treatment in the Hei Ling Chau Leprosarium.

401. Generous donations of free foods, made by C.A.R.E., the Catholic Relief Services, the Church World Service, the Lutheran World Service, the Boys and Girls Clubs Association and U.N.I.C.E.F., were available for distribution by the Almoners and are gratefully acknowl- edged.

402. The medical social work of the Almoner Service was greatly assisted by the ready co-operation afforded by the Family Welfare Society, the Church World Service. Caritas, the Family Planning Association, the Hong Kong Branch of the British Red Cross Society, the Lutheran World Service, the Salvation Army, the Hong Kong Cheshire Home, the Hong Kong Society for Rehabilitation, and the Po Leung Kuk. In addition, the Social Welfare Department and the Re- settlement Department continued to give valuable co-operation in their respective spheres.

PHYSIOTHERAPY

403. Full-time physiotherapy units are maintained in the Queen Mary, Kowloon and Lai Chi Kok Hospitals and in the Wanchai Poly- clinic. A part-time service was operated three days each week at Castle Peak Hospital, commencing in October 1962.

404. At the Kowloon Hospital, work again increased by approxi- mately 1,000 more treatments per month compared to the previous year. A sharp rise in the number of cases of paralytic poliomyelitis during the summer months was the main cause of this increase which called for the erection of a marquee in the Hospital grounds to provide temporary additional accommodation. Rehabilitation of selected bedridden patients. suffering from hemiplegia from the Kwong Wah Hospital was under- taken twice weekly in groups of 10.

405. At the Wanchai Polyclinic, re-training classes for poliomyelitis patients also had to be expanded during the summer. The Government Information Services made a film showing these children at their exercises which was later used in the oral vaccination campaign.

406. The unit in the Queen Mary Hospital was engaged in more specialized work for orthopaedic and neurosurgical cases; the installa- tion of overhead suspension frames in four of the general wards for these patients has proved a great asset in giving treatment on the wards. and saves considerable time hitherto occupied by the transport of patients to and from the physiotherapy department.

407. At the Lai Chi Kok Hospital there are large numbers of cases requiring physiotherapy amongst both the surgical and orthopaedic convalescent patients transferred from Kowloon Hospital and amongst the children with poliomyelitis admitted to the infectious diseases section of the hospital. During the cholera outbreak in the autumn a number of convalescent patients were moved to the Kwong Wah Hospital where their physiotherapy was continued by visiting staff from Lai Chi Kok who conducted sessions there three times each week.

408. The Training School, temporarily housed in part of the old Pathology Institute building in Caine Lane, continued its work during the year. Two students sat their preliminary examination in May and both were successful; seven new students were enrolled in September and have made a satisfactory start to their studies.

OCCUPATIONAL THERAPY

409. The activities of this unit are the responsibility of the Super- intendent Occupational Therapist, and are mainly in those institutions. which have large numbers of long-stay patients. The work is particularly valuable for psychiatric and drug-addiction patients.

410. At Castle Peak Hospital some 600 patients each day attended the various occupational therapy groups; activities for women patients included craft-work, toy-making, sewing, pottery-modelling, painting and music classes, while carpentry, rattan work, tailoring and gardening were the main occupations for men patients.

　　　　411. Considerable work was carried out on Government orders for making brooms, brushes and mops, and a selected group of patients was employed on making wooden crates for a local brewery.

412. Recreational activities, both indoor and outdoor, were organized on an increased scale during the year and included field games, concerts. film shows and other social activities.

413. In the Drug Addiction Treatment Centre at Castle Peak Hospital there was a particular need for occupational therapy activities.

The patients, who are all male, undergo voluntary treatment for their addiction for a period of six months and are in an entirely different category to those suffering from mental disorders who are housed in the main blocks of the hospital. The payment incentive scheme was most successful and added to the remedial value of the work done; it was found that the response and behaviour of patients was enhanced by separation into small working groups of not more than six persons. Sewing and tailoring work was undertaken for the Department's Central Linen Store in preparation for the opening of the Queen Elizabeth Hospital. Other groups helped in ward cleaning and kitchen duties and a construction group has been most useful both in concreting paths around the hospital and in the building of a pavilion in the grounds. A full range of recreational activities was maintained and relations between staff and patients were greatly improved in comparison with the early periods of this pilot voluntary treatment scheme.

414. At the Queen Mary Hospital, occupational therapy is less frequently prescribed as the great majority of in-patients are acute cases, but essential after-care for post-operative orthopaedic and neuro-surgical patients is increasingly prescribed and three specialized hand-looms were added to the ward equipment for this purpose during 1962,

415. The work at Lai Chi Kok Hospital is of considerable variety. being amongst tuberculosis patients and the convalescent patients from Kowloon Hospital. Weekly outpatient treatment and job-training ses- sions for men with amputated limbs were established during the year, with the object of giving these patients confidence and skill in the use of their newly-fitted prostheses. The majority were arm amputees eager to resume employment.

416. The Sixth Annual Exhibition and Sale of Work was held in the City Hall in October 1962 and was officially opened by Lady BLACK. The Exhibition showed, for two full days, a wide range of handicrafts by patients from all sections of the Occupational Therapy Service, and the sale of finished articles realized more than $7,500. In addition, sales of products throughout the year realized a further $25,592.

ORTHOPAEDIC AND PROSTHETIC APPLIANCES

417. This unit is staffed by an Orthopaedic Appliance Technician. 6 student assistant technicians and 7 artisans. Premises in the Harcourt Health Centre provided offices and workshops on a temporary basis, but

a permanent establishment is included in the new Jockey Club Re- habilitation Centre at Kowloon Hospital, which is expected to be completed in the summer of 1963.

418. The training of the student technicians has proceeded satisfac- torily, and the Institute of British Surgical Technicians in London, who scrutinized test examination papers, have now agreed to recognize this training for entry to its examinations.

419. The amount and variety of work undertaken have increased considerably; 577 surgical appliances, totalling HK$70,666 in value. were produced compared with 231 in the previous year. The output is, however, still insufficient to meet the demand, which now exceeds 100 new prescriptions per month from orthopaedic surgeons. Fees recovered against the cost of these appliances were $45,139, compared to $20,364 in 1961,

420. Apart from routine work at Government hospitals, outpatient departments and physiotherapy clinics, visits were made on request to the Sandy Bay Convalescent Home, the British Red Cross Crippled Children's Home at Kwun Tong and Hei Ling Chau Leprosarium. Co- operation with the Hong Kong Society for Rehabilitation, the Lutheran World Service and the Social Welfare Department was successfully continued throughout the year.

421. Experimental procedures on several new types of appliance have been developed with success, particularly on 'above knee' plastic sockets and 'below knee' prostheses which have resulted in the stand- ardization of component parts in plastic materials and a reduction in the costs of production. Further research work is in progress on the use of policocyanate foam as a casting jig for below-knee prostheses, on a pressure indicator for the determination of thrust in deformed feet and on a material to indicate areas of socket pressure in anaesthetic stumps of amputated limbs.

MEDICAL EXAMINATION BOARD

422. This Board performs the medical examination of all new entrants to Government employment and to the Auxiliary Defence Services. Members of the Civil Service prior to transfer outside Hong Kong are also medically examined by the Board. In addition, work is carried out, on request, for countries which require prospective im migrants to submit a certificate of physical fitness. Each examination involves a comprehensive physical check, 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. The work of the year is summarized at Table 41.

TABLE 41

WORK OF THE MEDICAL EXAMINATION BOARD 1961-62

New examinations..

Re-examinations

Annual total

Government

Appointments

Auxiliary Defence Units

Miscellaneous

Total

1961 1962

5,776 6,725

2,116 1,984 3,571 3,773 3,547

115

L06

8,007 8,815

3,081

7,150 6,855

9,347 10,498 5,663 5,065

147

107

15.157 15,670

423. Of the persons referred for a specialist opinion the great majority are suffering from abnormalities of the respiratory system. Pulmonary tuberculosis accounted for the rejection of 84% of all persons found as unfit for service as against 88.7% in 1961. The analysis of the causes of rejection is given in Table 42.

TABLE 42

UNFITNESS BY CAUSES 1961-62 (per 1,000 total examination)

1961

1962

Pulmonary Tuberculosis

LIL

50.60

---

44.29

Diseases of the Respiratory System (excluding

Tuberculosis)

2.84

6.76

Diseases of the Circulatory System Diseases of the Alimentary System

1.32

2.11

0.33

0.38

Diseases of the Skeletal System

0.13

0.06

Diseases of the Genito-urinary System

0.53

0.19

---

Diseases of the Nervous System Diseases of the Endocrine System Diseases of the Eye

0.59

0.45

...

0.20

0.19

---

0.53

0.51

...

ггг

гг

Diseases of the Skin

Miscellaneous diseases

Total

0,26

2.68

0.13

0.19

57.47

57.81

424. 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.

HOSPITAL MAINTENANCE AND SUPPLY

425. This function is the responsibility of the Chief Hospital Scere- tary, assisted by a staff of Senior Hospital Secretaries. Hospital Secre- taries 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 was working in the Planning Unit at Headquarters and another was stationed at the Castle Peak Hospital. Assistant Hospital Secretaries are posted to major institutions within the two main groups.

　　　　426. 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 maintenance of equipment and furniture, the recruitment and discipline of all male menial staff, the maintenance of transport and the initiation of 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.

427. A Hospital Services Section, which was formed during the previous year, is responsible for the day-to-day running and maintenance of the steam and engineering services in the major institutions, and is under the control of the Electrical and Mechanical Engineering Branch of the Public Works Department. Electronic equipment has again been maintained most efficiently by the staff of the Telecommunications Division of the Postmaster General's Department and grateful acknowl- edgement is made of the valuable assistance given by these two Depart

ments.

Staff Welfare

428. The Medical and Health Department Staff Welfare Association, with its branches in the Kowloon and Castle Peak Hospitals, provides staff recreation centres in the three large institutions of the Department. The Association continued to support a number of welfare schemes to aid the families of members or of pensioners.

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

UNICEF Assistance

430. The milk feeding programme, which is sponsored by UNICEF, continued throughout the year. Altogether 70,956 lbs. of UNICEF milk were distributed to welfare organizations throughout the Colony and the total number of supplementary meals given at feeding centres was 1,376,653, an increase of 176,634 over the previous year.

AUXILIARY MEDICAL SERVICE

431. Recruitment to the Auxiliary Medical Service was started in October, 1950, under the provisions of the Essential Services Corps Ordinance, 1950. The primary aim of the Service is to train and main- tain a corps of men and women who are available to greatly augment the Colony's hospital and ambulance services during an emergency. During recent years, however, increasing use has been made of members of the Service to support Departmental staff during outbreaks of infectious diseases and during mass inoculation campaigns.

432. Up to June, 1961, those joining the Auxiliary Medical Service were both volunteer and conscripted members. On the abolition of conscription in that month, conscripted members had the opportunity either to become volunteers or to resign. The loss of conscripted mem- bers has been more than balanced by the volunteers recruited and the strength of the Service at 31st March, 1963, stood at over 4,800 men and

women.

433. The Medical Defence Staff Officer is responsible for all routine administration and training activities, and the Director of Medical and Health Services is the Unit Controller. During a total Colony emergency, the ambulance and first-aid sections of the Service come under the operational control of the Civil Aid Services.

434. There are now 41 Ambulance Depot Teams spread over 24 districts of Hong Kong, Kowloon and the New Territories. Training has progressed favourably throughout the year, and keen competitions for the 'MacKenzie' shield, the Teng' cup and the 'Small' cup were of considerable value in improving the all-round efficiency of the Teams.

435. Demonstrations were given, during the Kai-fong Welfare Associations' "Traffic Safety Week' and during their Health Education Exhibition. These demonstrations consisted of First Aid, both when medical equipment is available on the spot and when improvisation has to be undertaken.

ર

　　　　436. Co-operation with the Civil Aid Services continued to be of a high standard, and during the year combined Civil Defence Exercises were staged in Hong Kong and Kowloon. The use of wound-faking and acting techniques have contributed considerably to a marked degree of realism during these exercises and also in the various competitions.

　　　　437. Twenty-two Auxiliary Dressers from the Ambulance Teams are on duty every Sunday with the Fire Services, and are gaining valuable practical experience in the use of equipment and in the routine work of the Fire Services Ambulance section.

438. The blood-grouping of all members of the Auxiliary Defence Units was carried out during the year, and all members of the Auxiliary Medical Service are now blood-grouped as soon as they are enrolled.

439. During the cholera outbreak in 1962, members of the Auxiliary Medical Service were employed on duties in the quarantine station and at inoculation centres. They were also employed on rescue and first-aid work in the maintenance of hostels for those rendered homeless when typhoon Wanda struck the Colony on 1st September, 1962. Auxiliary Medical Service men and women were employed as inoculators and recorders throughout the two phases of the anti-poliomyelitis immuniza- tion campaign held in January and March, 1963.

440. In March, 1963, the uniformed members of the Auxiliary Medical Service paraded for the first time as a body. The Parade was inspected by the Unit Controller after which he took the salute at the March Past. The success of this occasion was a tribute to the enthusiasm and keenness of the members of this branch of the Auxiliary Defence Services.

V. DEVELOPMENT PROGRAMME

PLANNING UNIT

441. The functions of this unit, which was staffed during the year by a Principal Medical and Health Officer and an Hospital Secretary, are: (a) to prepare outline plans for the development of medical and health facilities in Hong Kong, in consultation with other branches of the medical services concerned;

(b) to undertake, in close liaison with the Public Works Department, the detailed planning of projects approved by the Finance Com- mittee of the Legislative Council; and

(c) to give advice and assistance to voluntary organizations and other philanthropic bodies which are co-operating with the Government in the provision of medical facilities.

442. Since the formation of the Unit in 1959, the major part of its work has been devoted to the detail of the planning of the Queen Eliza. beth Hospital. By the end of 1962, with the new hospital nearing com- pletion and the greatest part of the equipment ordered, the Planning Unit's part in this major project was completed. Accordingly, on the formation of the Queen Elizabeth Hospital Commissioning Unit in January 1963, consisting of the designate Medical Superintendent, Senior Matron and Senior Hospital Secretary, responsibility for further action was handed over to this Commissioning Unit.

443. The Planning Unit has also been responsible for the imple- mentation of the plan for development of hospital and clinic services covering the period 1960-65 which was approved in principle by the Executive Council in June, 1960. Draft schedules of accommodation, staff and equipment for approved projects have been prepared and examined, in consultation with the Colonial Secretariat, after which they were submitted at the appropriate time to the Public Works and Staff Increases Sub-Committees and to the Establishment Committee. With the experience gained during the expansion programme of recent years, standard schedules have been prepared for various types of out-patient clinics, maternity and child health centres and maternity homes; these standards have been accepted by Government and have simplified great- ly the preparatory work required for the lesser projects undertaken by the Planning Unit.

444. Once approval of a new project has been given, sketch plans are checked, and, providing that no amendments are considered neces- sary, authority is sought for working drawings to commence; the project. is then allocated its priority and the Planning Unit supervises all stages of its development until it is handed over as an operational unit to the relevant branch of the Service.

445. During the financial year 1962-63 six projects which had been completed were handed over. On 31st March. 1963, six projects were under construction and another seven had reached a state where working drawings were being prepared; sketch plans of a further five projects had been completed by architects of the Public Works Department or by private architects appointed for the work. An additional twelve projects are listed in the Estimates for the year 1963-64 which await financial

approval and the allocation of a priority so that detailed planning can start. Progress of approved works is detailed below.

BUILDING PROGRAMME

April 1, 1962 to March 31, 1963

(a) Buildings or extensions to existing institutions completed during the

year:

September 9, 1962

September 12, 1962

September 29, 1962

November 27, 1962

February 14, 1963

March 31, 1963

Mui Wo Clinic Extension comprising labour

room and staff quarters.

The Queen Elizabeth Hospital Specialist Clinic- donated by the Royal Hong Kong Jockey Club, provides the outpatient consultant facilities for the Hospital's specialist units.

The Anne Black Health Centre, North Point

erected from funds provided equally by Dr. TANG Shiu-kin. C.B.E., LL.D., and his friends and by Government, provides outpatient facili- ties, a maternal and child health centre and a maternity ward of 6 beds.

The Airport Medical Clinic-provides necessary medical examination and inoculation facilities for the increasing air traffic.

The Jockey Club Clinic, Wang Tau Hom

donated by the Royal Hong Kong Jockey Club, provides outpatient facilities, a maternity and child health centre and a maternity ward of 24 beds.

Medical and Health Department Store, Hong Kong provides central general, linen and A.M.S. storage for all institutions on Hong Kong Island.

(b) Projects under construction on March 31, 1963:

1. Queen Elizabeth Hospital

2. Jockey Club Clinic, Shau Kei Wan

3. Jockey Club Kowloon Rehabilitation Centre

4. Tang Shiu-kin X-Ray Survey Centre and Dental Clinic

5. Robert Black Health Centre, San Po Kong

6. Queen Mary Hospital Extension, Stage 1 (re-alignment of approach

road)

31, 1963:

1. Kam Tin Clinic

2. The Lions Clubs Government Maternal and Child Health Centre

3. Kwun Tong Health Centre

4. Li Po Chun Clinic, Tai Kok Tsui

5. Sha Tin Clinic

6. Yuen Long Clinic

7. Queen Mary Hospital Extension, Stage II (operating theatres and

radiodiagnostic department).

(d) Projects for which sketch plans were prepared or received during

the year:

1. Combined Vaccine Institute

2. Jockey Club Clinic, Yau Ma Tei

3. Queen Mary Hospital Extension. Stage III (Professorial building

and quarters for nursing staff)

4. Tsuen Wan Out-patient's Clinic

5. Cheung Sha Wan Health Centre

(e) The preparation of sketch plans has not yet commenced on the

following buildings which are listed in the 1963-64 Estimates.

1. New Lai Chi Kok Hospital

2. St. John's Hospital, Cheung Chau: Outpatients clinic and major

alterations

3. Mental Defectives Home

4. Redevelopment of Sai Ying Pun Hospital Site

5. Shau Kei Wan Hospital

6. Castle Peak Maternity Home

7. Chai Wan Maternity and Child Health Centre

8. Hong Kong Mental Health Centre

9. Kowloon Dental Clinic

10. Morrison Hill Clinic

1. Tsz Wan Shan Clinic

12. Wong Tai Sin Clinic

VI. HOSPITAL COSTING

446. In last year's report figures were given of the costing of repre- sentative hospital units. Records have been maintained for the same units this year using exactly the same basis of expenditure for compari- son, and these are detailed in Table 43. The total cost in 1962 are somewhat higher in each case, but, since more patients were treated in these institutions, the average cost of treating each patient is less in most instances.

100

Unit

Queen Mary

TABLE 43

HOSPITAL COSTINGS 1961-62 AND 1962-63

1961-62

1962-63

Total Cost

Cost per bed per year

Cost per patient

Com per

Cost per

Total Cost

bed per

patient

frealed

year

treated

teaching)

Hospital (Acute

general and

$13.039,173

$19,119 $ 713 $13,753,733 $18,814,95 S 645

L -

$ 9.972,110

$16,931

$ 404 $11,263,708 $17,066.22 $ 376

Kowloon Hospital

(Acute general)

Lai Chi Kok

Hospital

(Infectious and

convalescent)

Tsan Yuk Hospital

$ 2,389,515

$ 4,968

$ 351 $ 2,303,730 $4,789.45 % 283

(Maternity and

teaching)

$ 2,124,747

$10,624 $ 240 $2,171,967 $10,859.83 253

Castle Peak Hospital

(Mental)

.. $ 5,360,478 $ 4.790 $2,519 $ 6,156,883 S 5.502,13 $2,635

VII. TRAINING PROGRAMME

DOCTORS

　　　447. The University of Hong Kong confers the degrees of M.B., B.S. which have been registrable with the General Medical Council of the United Kingdom since 1911. At present the Faculty of Medicine admits between 70 and 80 students each year, of whom, between 35 and 50 eventually graduate. After provisional registration with the Medical Council of Hong Kong, the graduates are required to undergo a 12 months' period of compulsory internship in posts approved by the University. There are plans to increase gradually the intake of medical students to about 120 each year between now and 1966 with the aim of graduating some 80 doctors each year.

448. A number of clinical posts in the major hospitals are recognized for post-graduate training by the majority of the examining bodies in Britain.

449. The post-graduate training of doctors in the Government Service for higher qualifications necessary for appointment to specialist clinical posts in general medicine, surgery, orthopaedics, paediatrics and obstetrics and gynaecology, is under the supervision of the Panel on Post-Graduate Medical Education, which consists of the University Clinical Professors, the Government Clinical Specialists and members

101

of the Medical Headquarters staff. The Panel meets twice-yearly to review the progress of the doctors under training and to make recom- mendations regarding the awards of study leave overseas.

450. The programme of training of doctors for the post-graduate qualifications necessary to staff the clinical units in the new Queen Elizabeth Hospital is now well advanced and the supply of well-qualified and experienced clinicians is assured in practically all the specialized fields.

DENTAL STAFF

451. No undergraduate training in Dentistry has yet been established in Hong Kong, but Government awards annually scholarships for the study of dentistry overseas. In February, 1963, three students joined the University of Melbourne, Australia, and, for the first time, three Hong Kong scholars were accepted for dental studies by the University of Otago, New Zealand. Altogether, since the scholarship scheme started in 1954, twenty-one students have returned to Hong Kong as qualified dental surgeons.

452. With the appointment of eight Student Dental Technicians in January/February, 1963, the third class of such students embarked on their four-year training. Initial training was transferred during 1962 to the dental laboratory of the Hong Kong Technical College. This labora- tory was set up by the college in 1960, and has been fully used in the evenings for the further training of dental technicians, most of whom have been in the employment of dentists in private practice. One hundred and twenty technicians were given short elementary courses in the first two years, and, in 1962-63, thirty places were available on two concur. rent 30-week evening courses of a more advanced nature. Judging by the heavy demand for places, these advanced courses, like the elementary courses before them, are fulfilling a very great need among privately employed dental technicians, many of whom have never received any formal training in their craft.

453. Dental Nurses, who carry out preventive and minor operative work in the Government Service under the supervision of Dental officers, are being trained in New Zealand and Penang. Six of these dental auxiliaries are now employed in the public service in Hong Kong. A further two student dental nurses were sent to Penang under World Health Organization scholarships during 1962.

102

NURSES

　　　454. During the year, courses of training continued satisfactorily in General Nursing, Psychiatric Nursing, Midwifery and for Health Visitors. The large increase, from 121 to 197, in the number of entrants to the General Nursing Course placed an increasingly heavy burden on the Matrons, Sister Tutors and Sisters who carry out the training.

General Nursing

　　　455. There is full reciprocity of registration between the general nursing qualifications of the Nursing Board in Hong Kong and of the General Nursing Council of England and Wales. In the Queen Elizabeth Hospital School of Nursing and in the Nurses Training School at the Queen Mary Hospital, the medium of instruction is English, while in the other approved Nurses Training Schools, which are maintained by the Tung Wah Group of Hospitals, the Nethersole Hospital and the Hong Kong Sanatorium and Hospital, teaching is carried out in Chinese. At the end of March, 1962, the following numbers were under training as general nurses.

Government Schools of Nursing Tung Wah Hospitals

Nethersole Hospital

---

Hong Kong Sanatorium and Hospital

Total

LLL

Women Men

Total

384

444

LLE

287

153

LLI

136

960

1,020

Psychiatric Nursing

456. The School of Psychiatric Nursing at the Castle Peak Hospital, now in its third year had 56 students in training, of whom 16 were women. Although the number of entrants to the Psychiatric Nursing course increased from 23 to 26, the response is not yet sufficient to meet the demand for locally-trained psychiatric nurses. The qualification is fully recognized by the General Nursing Council of England and Wales.

Midwives

　　　457. 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. The number of nurses taking this course increased from 60 to 82, which is

103

about the maximum which can be taught on the number of maternity beds available at present for training in midwifery. Nurses who have trained in other approved training schools can also take a similar course, conducted in Chinese, in the maternity wards of their respective hospitals.

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

HEALTH VISITORS

459. 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

460. The training of 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 of Radiographers (Diagnostic) are held annually in the Colony.

LABORATORY TECHNICIANS

461. 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. Approval has now been received for this Intermediate Examination to be held in Hong Kong.

462. The Institute 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 examinations leading to the Associateship of the Institute of Medical Laboratory Technology.

104

PHYSIOTHERAPY

　　　463. A Physiotherapy Training School, which was established in September, 1960, provides a full-time course of training in Physio- therapy. The course follows completely the syllabus laid down by the Chartered Society of Physiotherapy in the United Kingdom, and is conducted by qualified Physiotherapy Tutors. Recognition of this course of training by the Chartered Society is now being sought. Meantime, the School is accommodated in converted premises in the old Pathology Institute of Hong Kong Island, where it will remain until the completion of the Queen Elizabeth Hospital in Kowloon.

OTHER FORMS OF DEPARTMENTAL TRAINING

　　　464. In-service courses of training are held for Dispensers, Tuber- culosis Workers, Social Hygiene Visitors, Dental Technicians and Orthopaedic Appliance Technicians. These do not all lead to recognized qualifications but prepare those concerned for appointment to permanent posts on the Establishment after they have passed departmental examinations.

　　　465. A preliminary training period of three months including lectures, discussions, visits of observation and practical work, followed by individual weekly tutorials throughout the ensuing 9 months, is arranged for Almoners who enter the Department with the basic qualification of a University Degree in Social Studies.

466. Table 44 sets out the various categories of training undertaken departmentally during the year.

TABLE 44

DEPARTMENTAL TRAINING 1962

Appointment Resignation

Strength at 31.3.63

Passed

Student Assistant

Physiotherapist

Student Assistant Radiographer

9(1st year)

6(2nd year)

6(3rd year)

Student Dispenser

ليه

Student Laboratory Assistant

Student Medical Laboratory

Technician

Student Nurse

|77

384

Student Mule Nurse

105

Student Nurse (Psychiatry)

Student Male Nurse

(Psychiatry)

Student Midwife

Student Midwife (Registered

Nurse)

Student Health Visitor

Anti-Tuberculosis Worker

Almoner

Appointment Resignation

Strength at 31.3.63

Passed

· L

Course of Study

1 Principal Medical &

Health Officer

Medical Services Administration

COURSES OF STUDY OVERSEAS

467. The following table sets out the courses of study, outside Hong Kong, attended by officers of the Medical and Health Department during 1962-63 :

Appointment

Source of

Fund

Government

Place of Study

U.K.

| Senior Medical &

Health Officer

5 Medical & Health

Officers

1 Medical & Health

Officer

8 Medical & Health

Officers

1 Medical & Health

Officer

4 Medical & Health

Officers

2 Medical & Health

Officers

Membership, Royal College

of Obstetricians and Gynaecologists.

Membership, Royal College

U.K.

Own expenses

of Physicians

Membership, Royal College

U.K.

Government

of Physicians

Membership, Royal

Australia

Own expenses

Australasian College

of Physicians

Fellowship, Royal College

U.K.

Government

of Surgeons

Fellowship, Royal College

U.K.

Govt. &

of Surgeons

U.K.

Common- wealth

Government

Diploma in Public Health

Singapore

Govt. &

Jaycee

Scholarship

Medical & Health Officer

Diploma in Public Health

U.K.

Government

3 Medical & Health

Officers

3 Medical & Health

Officers

Diploma in Medical

Radiotherapy Diploma in Medical

Radiodiagnosis

U.K.

Government

U.K.

Government

1 Medical & Health

Officer

Fellowship, Faculty of

U.K.

Government

Anaesthetists Royal

College of Surgeons

106

Place of

Source of

Appointment

Course of Study

Study

Fund

2 Medical & Health

Officers

Diploma of Bacteriology

U.K.

Government

2 Medical & Health

Officers

Medico-legal Training

U.K.

Government

I Medical & Health

Officer

Diploma in Ophthalmology

U.K.

Government

I Medical & Health

Officer

Diploma of Psycological

Medicine

U.K.

Government

2 Medical & Health

Officers

Tuberculosis Training

U.K.

C.H.A. &

Govt.

1 Medical & Health

Officer

Dermatology

U.K.

Govt. & Sino-

British

1 Medical & Health

Officer

Diploma of Anaesthesia

Denmark

W.H.O.

| Medical & Health

Officer

Drug Addiction

U.S.A.

W.H.O.

2 Medical & Health

Officers

Diploma in Laryngology

U.K.

Own expenses

and Otology

2 Medical & Health

Officers

1 Assistant Medical &

Health Officer

3 Medical & Health

Officers

2 Assistant Medical &

Health Officers

I Medical & Health

Officer

2 Medical & Health

Officers

7 Assistant Medical &

Health Officers

I Assistant Medical &

Health Officer

I Medical & Health

Officer

4 Medical & Health

Officers

1 Dental Officer

Licentiate, Royal College of

Physicians, Licentiate Royal College of Surgeons and Licentiate Royal Faculty of Physicians & Surgeons Physical Medicine &

Rehabilitation

Primary Examination of

the Royal Australasian College of Surgeons Practical Training in

Periodontology

Licentiate, Medical Council

Canada

Own expenses

of Canada

Licentiate, Medical Council

Canada

Own expenses

of Canada

Licentiate of Apothecaries

U.K.

Own expenses

Hall

Licentiate of Apothecaries

U.K.

Own expenses

Hall

Licentiate Medicine & Surgery

U.K.

Own expenses

of the Society of

Apothecaries

Licentiate Medicine & Surgery

of the Society of Apothecaries

U.K.

International

Rescuc

Committee

Licentiate Medicine & Surgery

of the Society of Apothecaries

U.K.

International

Rescue

U.K.

Committee

Own expenses

U.S.A.

American

President

Lines

Singapore

Own expenses

U.K.

Government

107

Place of

Appointment

| Physicist

1 Senior Nursing Sister

Nursing Administration

(Hospital)

Course of Study

Study

Source of Fund

Radiation Physics

U.K.

Government

& Her

Majesty's

Govt, in

U.K.

Govt. &

1 Nursing Sister

Sister Tutor Diploma

U.K.

C.D. & W.

1 Nursing Sister

Neurosurgical Nursing

U.K.

Own expenses

2 Nursing Sisters

Thoracic & Surgical Nursing

U.K.

Own expenses

2 Nursing Sisters

Training in Plastic Surgery

U.K.

Own expenses

| Nurse

Ophthalmic Nursing

U.K.

Govt. &

B.C.N.M.F.

| Nurse

Midwifery Training

U.K.

Own expenses

| Nurse

Diploma in Dietitics

U.K.

Government

I Nurse

Training in Thoracic &

U.K.

Sino-British

Cardiac Surgery

| Nurse

Premature Babies Course General Surgery

Australia

Own expenses

U.S.A.

Own expenses

| Nurse

1 Nurse

Thoracic & Cardiac Surgery

U.K.

Own expenses

Australia

Own expenses

1 Nurse

Gynaecological Nursing

Australia

Own expenses

! Nurse

Neurosurgical Nursing

Canada

Common-

wealth

2 Nurses

Operating Theatre Technique

Canada

Own expenses

& Management

1 Nurse

Surgical Nursing

Canada

Own expenses

3 Nurses

Course on Ear, Nose &

Australia

Own expenses

Throat

3 Nurses

Infectious Diseases Nursing

Australia

Own expenses

I Male Charge Nurse

Venereal Diseases

U.K.

Government

I Male Nurse

1 Health Sister

Theatre Technique

U.K.

Govt. &

B.C.N.M.F.

Nursing Administration

U.K,

(Public Health)

Health Visitor

Speech Therapy

U.K.

1 Senior Male Charge

Nurse (Psy.)

Nursing Administration

U.K,

(Hospital)

108

Government

& Her

Majesty's Govt. in U.K.

Government

& Her

Majesty's Govt. in U.K.

Appointment

I Senior Almoner

2 Almoners Class I 1 Almoner Class II

| Dispenser

1 Senior Medical

Technologist

10 Medical Laboratory Technicians Gr. II

5 Medical Laboratory

Technicians Gr. Il

I Medical Laboratory Technician Gr. II I Medical Laboratory Technician Gr. II

Course of Study

Place of Study

Source of Fund

Orthopaedic & Medical

U.K.

Sino-British

Social Work

Medical Social Work

U.K.

Government

Social Work

Canada

Canadian

Common-

Training in Modern

U.K.

Sterilization Technique

wealth Government

Allen & Hanburys Ltd. Government

& Messrs.

Fellowship, Institute of

U.K.

Medical Laboratory

Technology

Associateship, Institute of

U.K.

Government

Medical Laboratory

Technology

Associateship. Institute of

U.K.

Own expenses

Medical Laboratory

Technology

Training in Vaccine

U.K.

Government

Production

Training in Forensic Science

U.K.

Government

VIII. MISCELLANEOUS

ATTENDANCES AT CONFERENCES AND MEETINGS

468. The following table sets out the attendances by officers of the Medical and Health Department at Meetings and Conferences during 1962-63.

Appointment

Director of Medical &

Health Services

Conferences, etc. attended

Place

() W.H.O. Cholera Conference

Manila

(i) 13th Session of the W.H.O. Regional

Committee Meeting

Manila

Dacca

Senior Specialist (Radiology)

Dental Officer

Chief Medical Technologist

(iii) Meeting of the Directing Council of the Pakistan/SEATO Cholera Research Laboratories

2nd International Congress of Radia-

tion Research

Annual Conference, British Dental

Association

Jubilee Conference of the Institute of Medical Laboratory Technology

109

Harrogate,

England Nottingham

University of Edinburgh

Chemist

Appointment

Specialist (Malariology) Specialist (Medical) Specialist (Neuro-Surgery)

Principal Medical & Health

Officer

Medical & Health Officer

Orthopaedic Appliance

Conferences, etc, attended

*F.A.O. Regional Food Legislation

Seminar

*4th Asian Malaria Conference

4th World Congress in Cardiology

Ist Asian and Oceanian Congress of

Neurology

*W.H.O. Seminar on Japanese B

Encephalitis and Other Arthropod- Borne Virus Infections

Place

Bangkok

Manila

Mexico City

Tokyo

1st Asian and Australasian Congress

of Anaesthesiology

Manila

5th International Prosthetics Course and the 2nd Pan-Pacific Confer- ence on Rehabilitation

Manila

Senior Almoner

Senior Specialist (Psychiatry)

Senior Specialist (Dental)

Pan-Pacific Seminar on Vacational Rehabilitation of the Disabled, the Pan-Pacific Workshop on Social Work and the 2nd Pan- Pacific Conference on Rehabilita- tion

*W.H.O. Conference on Techniques of Epidemiological Surveys of Mental Disorders

13th International Dental Congress and 50th Annual Session of Inter- national Dental Federation

Senior Medical & Health

Officer

Manila

Cologne

*W.H.O. Seminar on Food Sanitation

Manila

Funds provided by the sponsoring organization.

VISITORS

469. The following distinguished medical men and women visited Hong Kong during 1962-63:

General

(i) At the invitation of the Hong Kong Government, Professor F. R. G. HEAF, C.M.G., Secretary of State's Adviser on Tuber- culosis, arrived on 4.4.62 for a two week's stay to advise on the tuberculosis problems in Hong Kong.

(ii) Dr. M. TAMARUA, Assistant Medical Officer of the Department of Health, Cook Islands, arrived on 11.6.62 for a two week's visit.

110

(iii) Miss Violet V. B. BIGNOLD. Administrative Sister of the

Division of Infant Child and Maternal Health, Department of Health, Territory of Papua and New Guinea, from 25.6.62 to 13.7.62.

(iv) Dr. John C. Hargrave, Medical Officer of the Department of Health of the Northern Territory, Australia, arrived on 30.7.62 for a week's visit.

(v) Dr. YEH Eng-kung of Taiwan arrived on 1.8.62 for a week's

visit.

(vi) Mr. CAO Dinh Due of the Ministry of Public Health, Viet Nam,

from 8.9.62 to 21.9.62.

(vii) Drs. CAGAMPAN and SOLDEVILLA from the Philippines arrived

on 17.9.62 for a week's visit.

(viii) Mr. W. M. OLIVER of the Department of Periodontology.

University of Liverpool, from 17.9.62 to 29.9.62.

(ix) Dr. Roland CELLONA of the Bureau of Disease Control, Depart- ment of Health of the Philippines, from 17.9.62 to 21.9.62. (x) Dr. J. M. LISTON, C.M.G., Chief Medical Officer, Department

of Technical Co-operation, from 28.9.62 to 8.10.62.

(xi) Dr. M. YOSHIMI, Technical Officer on Dental Health and Assistant Chief of the Medical Affairs Section, Medical Affairs Bureau, Ministry of Health and Welfare of Japan, from 16.10.62 to 21.10.62.

(xii) Professor Sir Dugald BAIRD, Professor of Gynaecology and Midwifery of the University of Aberdeen, arrived on 15.10.62 for a ten day's visit.

(xiii) Dr. Michael FLYNN, Chief Medical Officer of the Metropolitan Water, Sewerage and Drainage Board in Sydney, from 17.10.62 to 19.10.62.

(xiv) Dr. C. S. LEE, Director of the Korean National Institute of

Health from 25.10.62 to 27.10.62.

(xv) A team of four experts, headed by Dr. D'Arcy HART, C.B.E.. Director of the Tuberculosis Research Unit of the Medical Research Council in Britain, the other members being Drs. Wallace Fox, I. SUTHERLAND and D. A. MITCHISON, arrived from England on 19.11.62 to examine, on behalf of the Govern- ment, the possibility of setting up an independent tuberculosis research group in Hong Kong.

111

(xvi) Dr. F. A. WARD of the Natal Blood Transfusion Service arrived

on 28.11.62 for a short visit.

(xvii) Dr. Jamil ANOUTI, Director General of the Lebanese Ministry of Public Health, from 29.11.62 to 3.12.62 and from 7.12.62 to 12.12.62.

(xviii) Dr. W. NEARY, Superintendent of the Sarawak Mental Hospital, Kuching, from 18.12.62 to 20.12.62 and from 1.1.63 to 4.1.63. (xix) Dr. Tio Swan Kiat, Principal Dental Officer of the Municipal Health Services, Surabaya, Indonesia, from 10.1.63 to 12.1.63. (xx) Miss Yun Soon-choi, staff nurse of the Severance Hospital,

Seoul, Korea, arrived on 15.2.63 for a week's stay.

(xxi) Dr. WONG Hin-sun, Assistant Director of Medical Services (Tuberculosis) of the Singapore Ministry of Health, from 18.3.63 to 22.3.63.

(xxii) Drs. K. C. DAS and B. S. VENKATASHAMANNA of India, from

20.3.63 to 23.3.63.

World Health Organization & UNICEF. Visitors

(i) Dr. D. R. THOMSON, W.H.O. Deputy Medical Adviser to U.N.I.C.E.F. Headquarters in New York, visited the Medical & Health Department on 17.7.62 to investigate the possibility of W.H.O./U.N.I.C.E.F. assistance.

(ii) Dr. H. A. P. C. COMEN, Professor of Medical Nutrition of the Royal Tropical Institute and University, Amsterdam, W.H.O. Consultant, arrived on 22.8.62 for a two day's visit.

(iii) Dr. F. Bruce RICE, Chief Dental Health Officer of W.H.O.

Headquarters in Geneva, from 6.10.62 to 10.10.62.

(iv) Miss Zella BRYANT, W.H.O. Consultant in Public Health

Nursing, from 8.11.62 to 11.11.62.

(v) Dr. A. C. SAENZ, Medical Officer in Virus Diseases of the Division of Communicable Diseases, W.H.O. Headquarters, Geneva, arrived on 24.11.62 for a two day's visit.

(vi) Miss Doris T. MCPHERSON, Medical Records Librarian of the Princess Margaret Hospital. Toronto, Canada, arrived on 30.1.63 for a week's stay under the auspices of the W.H.O. to advise on the hospital records system for the Queen Elizabeth Hospital.

112

(vii) Dr. Alan H. PENINGTON, W.H.O. Area Representative, Taipei,

arrived on 18.2.63 for a four day's visit and discussed with this department the programme and budget of the W.H.O. for 1965.

(viii) Dr. P. J. J. van de CALSEYDE, Director of the W.H.O. Regional Office for Europe and Dr. A. H. TABA, Director of the W.H.O. Regional Office for the Mediterranean, arrived on 18.3.63 for a short visit.

PUBLICATIONS

470. The following articles were published by members of the department.

મં

Title of Article

Concurrent B.C.G. and Smallpox Vaccination in Newborn Babies.

2. Nosology of the 'Exotic

Psychoses'.

3. Orthopaedic

Prosthetic

appliance in Hansen's Disease.

　A Programme for the Establishment and Train- ing of Orthopaedic Prosthetic Appliance Technicians in Hong Kong.

　Porto-systemic Encephalopathy following Porto-caval Anastomosis. Hepatic Encephalopathy as a Psychiatric Problem. Gilles de la Tourette's Disease.

8. Cholera in Hong Kong,

1961,

Publication

Tubercle, London, 1962.

Acta Psychiatrica Scan-

dinavica, 1962.

Journal of Rehabilita-

tion in Asia.

Journal of Prosthetic Braces and Tech- nical Aids.

British Journal of Clinical Practice.

American Journal of

Psychiatry.

American Journal of

Psychiatry. Transactions of the

Royal Society of Tropical Medicine and Hygiene.

Name and Title of Author

Dr. A. S. MOODIE, Senjor

Specialist (Tuberculosis). and Dr. G. K. K. CHENG,

Specialist (Tuberculosis). Dr. P. M. YAP, Senior

Specialist (Psychiatry). Mr. J. A. E. GLEAVE, Orthopaedic Appliance Technician.

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

Dr. K. SINGER, Specialist

(Psychiatry).

Dr. K. SINGER. Specialist

(Psychiatry).

Dr. K. SINGER, Specialist

(Psychiatry).

Dr. G. E. YEOH, Principal

Medical & Health Officer in-charge, Sai Ying Pun Hospital, and Dr. T. M. TEоH, Principal Medical & Health Officer.

OBITUARY

　　　471. It is with deep regret that the death is recorded, on 16th February, 1963, of Dr. Leon FRIEDMAN, M.D., F.R.C.S., Orthopaedic

113

Specialist, while on local leave in Macao. Dr. FRIEDMAN, who was 49 years of age, was appointed in June 1962 and arrived in Hong Kong on 16th July, 1962; though he was only in the Colony for a short time before his death his able and efficient work in Orthopaedic Surgery at Kowloon Hospital was highly esteemed by his patients and his colleagues.

ACKNOWLEDGMENT

472. It is a privilege and a pleasure to again put on record a tribute and a grateful acknowledgment to the staff of the Medical and Health Department for what they have accomplished. The pressures have been heavy and the challenges many. With cheerful devotion and pride in their work, they have been greatly helped and supported by other Departments of Government and by the many Voluntary and Welfare Agencies whose dedicated work is a feature of life in Hong Kong.

473. Superlatives are commonplace in Hong Kong and this in itself is a tribute to the constructive energy, industry and intelligence of its citizens. They go from strength to strength by their own unaided efforts and are not dismayed by adversity. In fact, as a community, they thrive on it.

D. J. M. MACKENZIE,

Director of Medical and Health Services.

114

эней энен

ISLAND MEDICAL

*1*

HONG}KÔNG

HONG KONG ISLAND

1. Kennedy Town Jockey Club Clinic (a maternity home

child health centre).

with general outpatient facilities and a maternal and

Li Sing Primary School Clinic.

Ling Yuet Sin Infants' Home.

4. Teen Yuk Hospital (a maternity hospital).

H.K. Paychiatric Clinic & Day Hospital,

Sai Ying Pun Hospital (infectious diseases) and Sai Ying Pun Jockey Club Clinic (general outpatient with special clinics).

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

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

22. Ruttonjee Sanatorium (a tuberculosis hospital).

23.

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

24. Harcourt Health Centre (a school health, materna! " and child health centre and a male social hygiene clinic)+

25.

26.

27.

Alice Ho Min Ling Nethersole Hospital (a general hospital).

28.

117

10.

9. Port Health Inoculation Centre, Marine Building. Central District Health Centre (general outpatient facilities, maternal and child health centre and special clinics).

29.

30.

11. Police Medical Post (general outpatient and dental facilities for police officers and their families). Victoria Remand Prison Clinic (general outpatient facilities for prison officers and their families, and general outpatient facilities for detainees).

12.

13. Port Health Inoculation Centre, Fung House. 14. Hong Kong Central Hospital (a general hospital). 15. Hong 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).

31.

32.

Hong Kong Sanatorium & Hospital (a general hospital).

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

Tung Wah Eastern Hospital (a general hospital with outpatient department).

St. John Ambulance Brigade Centre. Mount Butler Quarry Clinic,

Anne Black Health Centre (a maternity home with general outpatient facilities, a moternal & child health centre, a dental clinic and a X-ray survey centre).

Shau Kei Wan Public Dispensary (general outpatient facilities with special clinics).

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

34.

35.

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

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

37. Matilda Hospital (a general hospital).

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

39.

40.

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

Lai Chi Kok

Sham Shui Po

KOWLOON PENINSULA MEDICAL FACILITIES

Mong, Kol Trull

You Ma

Trim Sha Taul

Kowloon City

Hung Hom

Victor

Kowloon

Boy

North Point

KOWLOON

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

42.

Lai Chi Kok Female Prison Hospital.

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

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

46. Tai Hang Tung Clinic (general outpatient facilities). 47. Precious Blood Hospital (a general hospital). 48. Sham Shui Po Public Dispensary (general outpatient facilities with special clinics).

49.

Mong Kok Clinic (general outpatient facilities). 50. Government Ophthalmic Clinic-Arran Street (an ophthalmic centre).

51. Queen Elizabeth School Clinic.

52. Kwong Wab Hospital (a general hospital and infirmary with outpatient department).

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

$4. Queen Elizabeth Hospital Specialist Clinic.

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 hygiene clinic and port health inoculation centre). 59. Hung Hom Clinic & Maternity Home (general out- patient facilities with special clinica and maternity home).

60.

61.

62.

63.

64.

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 clinica).

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. Wang Tau Hom Jockey Club Clinic (a maternity home with general outpatient facilities and a maternal & child health centre).

67.

Maryknoll Mission Hospital (a general hospital).

68.

Wong Tai Sin Clinic (general outpatient facilities).

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

69.

Air Port Health Station.

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

70.

Kwun Tong Maternal & Child Health Centre.

71.

Kwun Tong Rehabilitation Centre.

119

HONG KONG AND THE NEW TERRITORIES

NEW TERAITORIES MEDICAL FACILITIES

תק

нт 1

MAJA |

моне

NEW TERRITORIES

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

73. Fanling Hospital (a general hospital).

74. Shek Wu Hui Jockey Club Clinic (general outpatient facilities with maternity beds).

75, Ho Tung Dispensary (a maternity home with convalescent beds).

76.

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

77. Pok Oi Hospital (a general hospital).

78. Castle Peak Hospital (a mental hospital. 120 beds are being used temporarily for drug addicts). 79. San Hui Dispensary (a maternity home, with special clinics).

80. Maurine Grantham Health Centre (general outpatient facilities with special clinics and a maternal & child bealth centre).

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

82. Sha Tin Maternity Home.

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

84. Haven of Hope Tuberculosis Sanatorium.

85. Nansen Tuberculosis Rehabilitation Centre.

86. North Lamma Clinic (general outpatient facilities with maternity beds).

87. Peng Chau Clinic (general outpatient facilities, special clinics and maternity beds). 88. Hei Ling Chau Leprosarium,

89. Children's Convalescent Home, Cheung Chau.

90. St. John Hospital (a general hospital and outpatient department with special clinics), 91. Silver Mine Bay Dispensary (general outpatient facilities with maternity beds). 92. South Lantau Hospital (a general hospital with general outpatient facilities). 93, Shek Pik First Aid Post.

94. Tai O Dispensary (general outpatient facilities, with special clinics and maternity beds).

121

APPENDIX 1

ESTABLISHMENT OF THE MEDICAL & HEALTH DEPARTMENT AS AT 31.3.63

Director of Medical & Health Services

ILJ

LJL

Deputy Director of Medical & Health Services

---

Assistant Director of Medical & Health Services

---

Senior Specialist

Specialist

---

FIL

---

...

---

Secretary

---

Deputy Secretary

---

Senior Treasury Accountant

117

---

Principal Medical & Health Officer Senior Medical & Health Officer

TII

-H

LJ J

---

LII

.ז.

ILJ

Medical & Health Officer and Assistant Medical & Health Officer

Senior Dental Officer, Dental Officer and Assistant Dental Officer Principal Matron

---

Nursing Staff

ILL

Dietitian

---

Principal Almoner

Senior Almoner and Almoner

LIL

---

ILJ

LJI

---

TOP

---

IIT

---

JIL

ILJ

LJ L

Senior Pharmacist, Pharmacist, Dispenser and Dispensary Supervisor

Chief Pharmacist

ILI

Government Chemist

Scientific Officer (Medical)

---

Chemist, Assistant Chemist and Assistant Biochemist

TIT

---

Senior Physicist and Physicist

---

365

-+-

2,038

ггт

TII

147

---

-T

410

---

109

[14

---

F-J

LJL

+44

---

-- J

Chief Hospital Secretary, Senior Hospital Secretary, Hospital Secretary and

Assistant Hospital Secretary Executive Grade Officer

Clerical Staff

--1

---

- r

---

Tor

...

---

Superintendent Radiographer, Senior Radiographer, Radiographer and Assistant

Radiographer Superintendent Physiotherapist, Tutor Physiotherapist, Physiotherapist and

Assistant Physiotherapist

---

JIL

Superintendent Occupational Therapist and Occupational Therapist

Chief Medical Technologist, Senior Medical Technologist, Medical Technologist

and Medical Laboratory Technician

Senior Laboratory Assistant and Laboratory Assistant

Health Inspector and Malaria Inspector Senior Inoculator and Inoculator

LJ L

---

Orthopaedic Appliance Technician and Assistant Orthopaedic Appliance

Technician

Other Staff

---

LIL

---

Total

4,362

8,010

122

123

APPENDIX 2

THE DIVISIONS OF THE MEDICAL AND HEALTH DEPARTMENT

Medical Services

Hospitals, general clinics and outpatient departments

-excluding New Territories.

Health Services

New Territories-Curative and preventive.

Clinical Specialist Services.

Pharmaceutical Service.

Radiological Service.

Almoner Service.

Physiotherapy Service.

Occupational Therapy Service.

Medical Examination Board.

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.

124

APPENDIX 3

STATEMENT OF EXPENDITURE FROM 1958-59 TO 1962-63

Particulars

(a) Medical and Health Department

(b) Medical Subventions

...

1958-59

1959-60 ! 1960-61

1961-62

1962-63

LJI

39,792,228 45,925,081 56,573,091

64,064,336 68,541,015

14,178,093 18,988,424 21,910,889

25,009,269

26,386,405

5,755,291 15,442,311 12,369,272 9,836,801 28,262,729

Total

LIL

59,725,612 80,355,816 90,853,252 98,910,406 123,190,149

Total expenditure of the Colony

---

589,958,367 709,953,996 845,297,629 953,205,237 1,113,276,099

Percentage of Medical and Health Department

Expenditure to the Total Expenditure of the Colony! 10.12%

11.31%

10.75%

10.38%

11.07%

125

APPENDIX 4

ANALYSIS OF MORTALITY FOR THE YEARS 1958-62

(Given as Percentage Total Deaths)

Disease Group

Detailed List Number:

1958

1959

1960

1961

1962

1. Infectious and Parasitic

001-138

14.6

14.2

14.4

15.3

13.5

L.-

2. Neoplastic

ITI

140-239

8.9

9.3

10.5

12.3

12.4

---

TII

3. Allergic, Endocrine, Metabolic and Blood...

240-299

1.1

1.2

4. Nervous System and Sense Organs

5. Circulatory System

TII

тиг

300-398

5.3

6.2

7.2

8.3

8,4

---

400-468

8.3

8.9

9.7

10.7

11.0

ד.

6. Respiratory

470-527

24.2

22.3

19.3

14.8

13.9

7. Intestinal

530-587

11.1

11.3

9.3

7.7

6.8

8. Genito-Urinary

9. Pregnancy, Childbirth and Puerperium

10. Skin and Musculo-Skeletal...

11. Congenital Malformation and

Diseases of Early Infancy

590-637

1.9

2.1

2.0

2.1

...

---

640-689

0.5

0.4

0.3

690-749

0.5

0.4

0.3

0.2

0,2

750-776

10.8

9.3

10.7

11.1

11.4

12. Ill-defined Causes

780-795

8.0

8.7

9.5

10.4

11.4

ITI

13. Accidents, Poisoning and Violence...

E800-E999

4.8

5.8

5.7

5.9

7.6

APPENDIX 5

VOLUNTARY AGENCIES

British Red Cross Society

C.A.R.E. (Co-operative American Remittances to Everywhere, Inc.)

Caritas

Cheshire Homes

Church World Service

Family Planning Association of Hong Kong

Family Welfare Society

Hong Kong Anti-Tuberculosis Association

Junk Bay Medical Relief Council

Kaifong Associations

London Missionary Society

Lutheran World Service

Maryknoll Mission

Mission to Lepers, Hong Kong Auxiliary

Oxford Committee for Famine Relief

Po Leung Kuk

Pok Oi Hospital

Salvation Army

St. John Ambulance Association and Brigade

Society for the Aid and Rehabilitation of Drug Addicts

Society for the Protection of Children

Society for the Relief of Disabled Children

The Boys and Girls Clubs Association

The Hong Kong Society for Rehabilitation

Tung Wah Hospitals

United Nations International Children's Emergency Fund

126

APPENDIX 6

ANTI-EPIDEMIC PROPHYLACTIC IMMUNIZATIONS 1958-1962

Immunological Procedure

Anti-Smallpox Vaccination

Anti-Cholera Inoculation

JL+

---

Anti-Diphtheria Inoculations:

1st Dose

2nd Dose

Booster Dose

...

FIL

115

Anti-Typhoid Inoculations:

P+

ILJ

12737

1st Dose

2nd Dose

■++

Itt

Booster Dose

Anti-Plague Inoculation

Anti-Typhus Inoculation

Anti-Rabies

1st Dose

---

TII

1958

1959

1960

1961

1962

564,244

1,034,138

573,848

969,577

744,599

93,155

36,245

30,634

1,968,214

2,976,274

109,336

223.209

202,883

296,071

323,521

-- J

ILL

90,396

144,118

174,406

207,143

312,374

42,330

63,582

71,219

115,566

129,279

103,381

141,342

97,902

43,080

21,440

I+I

LIL

70,833

101,174

78,103

30,013

11,734

PAP

95,044

92,712

38,374

38,624

30,141

236

205

220

224

249

+10

+F+

1,082

1,597

1,409

981

275

Other Doses

---

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

Infants

Others

TIP

...

100

IIT

---

3,046

3,577

3.717

3,786

3,784

12,266

13,872

12,846

14,342

15,010

JIL

49,865

62,261

79,169

86,234

91,304

10,390

8,518

11,054

7,756

26,939

128

268

Year

APPENDIX 7

ANNUAL INCIDENCE AND TREND OF VENEREAL DISEASE

1952 1953 1954 1955 1956 1957 1958 1959 1960 1961

1962

Total New Patients

Total Attendances

LJ L

ILI

SYPHILIS

(Total (Except Congenital)

Primory

Secondary

Early Latent

Late Latent

All Others

Congenital

Gonorrhoea

Under 1 year

Non Gonococcal Urethritis

23,565 37,392 36,652 34,853 32,490 31,391 27,841 28,980| 26,281 25,819 27,264 149,237 213,091 223,031 203,701 180,148 193,674 203,954 213,026 213,733 182,049 179,135 3.216 6.969 6,825 4,232 3,628 3,190

3,372) 2,680 2,091 1,555 1,858

672

634

393

153

154

...

180

132

LII

JOI

ILI

882

2,298

2,209

1,044

733

450

417;

426

296

202

359

1,275

3,727

3,983

2,853. 2,616

2,532

2,766 2,038

1,590

1,173

1,216

207

178

186

148

166

184

177

188

139

119

103

ITI

Over 1 year

111'

116

131

74:

ITI

8,546 11,625 10,785 11,309 10,609

9,881

8,360| 8,362

6,506

5,997

5,747

...

Chancroid

...

ITI

2,400

Lymphogranuloma Venereum

Non Venereal Disease

111

4,508

249.

7,708 7,150 6,623 6,245

870! 770 869 2,507 2,365 2.468 1,614 209 286

776

800

644

481

591

509

453

685

294

324

873

635

356

140

178

5,855

5,458

4,997 4,717 4,293 5,489

Skin Disease

---

-- J

2,088

5,900 7,376 8,165 8,437 9,814

8,701 11,046 10,611 12,173 12,917 |

APPENDIX 8

CLASSIFICATION OF DERMATOLOGICAL CASES FOR 1960, 1961 & 1962

Diagnosis

No. of comm

1960

No. of cases 1961

No. of cases 1962

높은

15.

Abrasiona

Acne

---

3. Alopecia Areata

JIL

Carcinoma

Clog Dermatitis

Boils, Folliculitis...

Contact Dermatitis

Eczema-Atopic...

ITI

---

+F+

Eczema Infantile

10.

Eczema-Infective

11.

12.

13.

Eczema-Scrotum

Exfoliative Dermatitis

14. Erythema Multiforme

Erythema Nodosum

16. Herpes Zoster

17. Ichthyosis, Xorosis

0.71

0.94

1.33

+++

0.66

0.83

0.77

0.48

0.55

0.81

1,849

15.04

575

9.96

566

8.37

0.07

0.05

0.04

2,244

18.26

1,351

23.41

1,019

15.06

0.20

0,42

0.38

0.59

0.57

1.46

---

548

4.46

281

4.87

315

4.66

---

122

0.99

238

4.12

36L

5.34

LJI

0.75

0.10

0.22

LL-

Eczema-Miscellaneous..

---

1,691

13.76 1,242

21.52

1,931

28.55

0.09

0.13

0.04

0.14

0.19

0.16

0.13

0.19

0.09

P10

0.15

0.24

0.36

TIE

LIL

0.10

0.22

0.28

...

18. Impetigo.

---

554

4.51

256

4.43

292

4.32

19. Leprosy

124

1.01

1.59

1.44

107

117

---

20.

Lichen Planus

0.03

0.08

0.01

---

23.

24. Porphyria

25.

27. Pompholyx

21. Lupus Erythematous

22. Moniliasis

Neurodermatitis

Paronychia, Whitlow

26. Pediculosis

28. Prickly Heat

29. Pruritis

30. Peoriasis

31. Purpura

32. Ringworm of Scalp 33. Ringworm of Body 34. Ringworm of Groins

35. Ringworm of Feet and Hands 36. Rosacea

0.31

0.45

0.36

...

0.09

0.03

177

541

4.40

226

3.92

301

4.45

...

---

-- J

0.21

0.35

0.42

יי

0.28

0.04

---

0.54

1.07

0.42

141

1.15

0.90

0.75

. г.

265

2.16

0.99

1.17

0.79

0.83

100

1.47

---

0.02

0.18

0.10

0.15

--1

184

1.50

124

2.15

202

2.99

---

0.69

0.36

0.61

ILI

242

1.97

112

1.94

143

2.12

0.08

0.07

ITI

---

37. Scabies

38.

0.54

0.05

0.03

---

40.

41.

42.

43.

Warts

44.

45.

Urticaria...

Scleroderma

39. Tuberculosis of Skin

Undetermined

Varicose Derm./Ulcer

Seborrhoeic Dermatitis

0.03

0.01

0.28

0.24

0.16

ITI

1.949

15.86

303

5.25

207

3.06

---

202

1.64

1.61

130

1.93

I LI

129

1.05

0.64

0.75

263

2.14

1.71

134

1.98

0.63

0.73

1.26

Leucoderma

169

1.38

127

2,20

141

2.08

129

APPENDIX 9

IN-PATIENTS TREATED IN GOVERNMENT AND GOVERNMENT-ASSISTED HOSPITALS, 1962 CLASSIFIED ACCORDING TO INTERNATIONAL STANDARD CLASSIFICATION

INTERMEDIATE LIST OF 150 CAUSES

¡Cases Treated

Inter-

mediate

List

Detailed

List

Number

Deaths

Cause Groupe

Govern-

Whole Colony

ment-

ment

toto

Assisted

Hospitals

Assisted

Hospitals

Male

Female

[Sex Un-

toown

Total

A 1

A 2

001 - 008

010

Tuberculosis of respiratory system... Tuberculosis of meninges and

1,278

3,820

145

679 1,162

492

1,654

central nervous system

103

226

108

88!

781

166

---

A 3

011

A 4

012 - 013

A 5

014 - 019

A 6

020

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

Congenital syphilis

191

481

124

19!

---

021

Early Syphilis.

A &

024

Tabes dorsalis..

025

A 10

022 - 023

All other syphilis

026 - 029

A 11

030 - 035

A 12

040

Typhoid fever...

A 13

041 - 042

General paralysis of insane

Gonococcal infections

Paratyphoid fever and other

155

---

*** |

---

■+

527

...

273

Salmonella infections

LJ L

A 14

043

Cholera

*10

A 15

044

Brucellosis (undulant fever)...

[ 1

A 16 (0)

045

Bacillary dysentery

708

Carried forward...

■+

3,270

5,077

237

830

1,358|

6961

1,994

130

Excluding 20 Carriers who were treated in Chatham Road Quarantine Station,

† Died on arrival to hospital.

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Detailed

List

Number

Cause Groups

Govern-

ment

Hospitals

Govern-

meat-

Assisted

Hospitals

Govern.

ment

Deaths

Govern-

meot-

Assisted

Deaths

Whole Colony

Hospitals

Male

Hospitals

Femple

[Sex Une]

known

Total

A 16 (b)

046

Amoebiasis

(4)

047 048

A 17

050

Scarlet fever

A 18

051

Streptococcal sore throat

...

A 19

052

Erysipelas

---

...

A 20

053

Septicaemia and pyaemia

A 21

055

Diphtheria

A 22

056

Whooping cough

A 23

057

Meningococcal infections

A 24

058

Plague...

A 25

060

Leprosy

A 26

061

Tetanus

---

A 27

062

Anthrax

A 28

080

Acute poliomyelitis

A 29

082

A 30

081, 083

A 31

084

Smallpox

A 32

085

Measles

A 33

091

Yellow fever

...

A 34

092

Infectious hepatitis

A 35

094

Rabies ...

JLJ

A 36 (a)

100

Louse-borne epidemic typhus

Brought forward...

Other unspecified forms of dysentery

TII

3,270 5,077

237

830 1,358

636,

1,994

LJI

136

---

JUL

139

102

---

ITI

LII

1,307

48. 54

102

---

LJI

652

191

ILI

LJ J

---

343

-15

Acute infectious encephalitis

Late effects of acute poliomyelitis

and acute infectious encephalitis

...

192

291

LJL

373

303

...

158

162;

TIST

164

326

---

131

Carried forward...

6,060

6,328

549

937 1,742, 982

2,724

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

Detailed

List

Number

List

Cause Groups

Govero-

Number

ment

Hospitals

Govern-

ment-

Awisted

Horpitals!

Deaths

Govern-

Deaths

Whole Colony

ment

Hospitals

meat-

Assisted

Hospitals

Malc

Female

¡Sex Un-

known

Total

Brought forward.......

6,060 6,328

549

937

1,742

9821

2,724

132

---

A 36 (6)

(d)

A 37 (u)

(6)

(c)

3000 300

101

Flea-borne epidemic typhus (murine)

104

Tick-borne epidemic typhus...

LIL

105

Mite-borne typhus

102 - 103

Other and unspecified typhus

106 - 108

110

111

112

(d)

(e)

A 38 (a)

(b)

(c)

6 @ OS

115

113

114

malaria

123.1

123.2

(4)

123.3

116 117

123.0

Vivax malaria (benigo tertian) Malariae malaria (quartan) Falciparum malaria (Malignant

---

tertian) Blackwater fever

ILI

Other and unspecified forms of

Schistosomiasis vesical (S. Haema-

tobium)

Schistosomiasis intestinal (S. Man-

soni)...

---

Schistosomiasis pulmonary

(S. Japonicum)

Other and unspecified schis- tosomiasis

...

LII

...

- - -

TII

---

A 39

125

Hydatid disease

---

A 40 (0)

(6)

3000

127

Onchocerciasis

LJI

127

Loiasis...

- - -

127

(d)

127

A 41

129

Filariasis (bancrofti) Other filariasis

Ankylostomiasis

Carried forward.....

...

---

6,115

6,393

549

937 1,742] 9821

2,724

133

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Deaths

Detailed

List

Cause Groups

Govern-

Govero-

Govern.

Whole Colony

ment

Number

10000

ment Assisted

Hospitals

ment-

Assisted

Hospitali

Male

Female

Sex Un-

knowe

Total

Brought forward...

6,115

6,393

549

937 ❘ 1,742 982

2,724

A 42 (a)

126

Tapeworm (infestation) and other

cestode infestations

Ascariasis

...

ITI

122

A 43 (0)

1089866 So g600 800 9

130.0

130.3

124, 128

130.1-130.2

037

038

039

049

Guinea Worm (dracunculosis) Other diseases due to helmintha

Lymphogranuloma venereum

Granuloma inguinale, venereal

TII

Other and unspecified venereal diseases Food poisoning infection and

intoxication

Relapsing fever

Leptospirosis icterohaemorrhagica

(Weil's disease)

071

072

073

Yawe

+r+

- F

JJL

...

087

Chickenpox

132

...

090

Dengue

ILJ

095

Trachoma

096.7

---

120

---

(m)

121 (a)

090

Sandfly fever

Leishmaniasis

Trypanosomiasis gambiensis. Trypanosomiasis rhodesiensis

trypanosomiasis

Dermatophytosis

LII

JIL

---

(0)

(n)

131

135

Scabies

ITI

...

---

Carried forward...

---

6,338

6,626

551

937

1,746.

984

2,730

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

Detailed

List

Number

List

Number

Cause Groups

Govero-

Covero-

ment-

Deaths

Govern-

Deaths

Govern.

Whole Colony

ment-

ment Assisted Hospitals Hospitals

Hospitals

Assisted

Hospital.

Male

Female

Sex Un.

known

Total

Brought forward...

---

6,338 6,626

551

937

1,746

984

2,730

174

A 43 (p) 036,054,059,

063,064,070,.

074,086,088.

089,093.

096.1,096.6,

All other diseases classified as infective and parasitic

096.8,096.9,

|122,132-134,

136-138

A 44

140 - 148

Malignant neoplasm of buccal cavity and pharynx

JLJ

185

359

A 45

150

A 46

151

A 47

152 - 153

Malignant neoplasm of oesophagus. Malignant neoplasm of stomach Malignant neoplasm of intestine,

154

160

265

except rectum

JLL

A 48

154

A 49

161

Malignant acoplasm of rectum Malignant neoplasm of larynx

100

= ཚོཤྩ

*3*

165

205

301

108

126

147

160

307

113

A 50

162 163 Malignant neoplasm of trachea.

and of bronchus and lung not specified as secondary

190

264

146

186

143

329

A 51

170

A 52

171

Malignant neoplasm of breast Malignant neoplasm of cervix uteri...

174

219

104

386

203

148'

148

A 53

172 - 174

Malignant neoplasm of other and

unspecified parts of uterus

109

A 54

177

A 55

190 - 191

A 56

196 197

Malignant neoplasm of prostate Malignant neoplasm of skin

Malignant neoplasm of bone and

connective tissue

TIT

Carried forward.

---

22 1

8,053

8,396

799

1,669

2,492

1,840

4,332

Inter-

mediate

Detailed

List

Number

List

Number

Cause Groups

APPENDIX 9-Contd.

Cases Treated

Govern

Govaru.

zcat

Deathe

Covero-

Govern.

Deaths

Whole Colony

ment-

10700

Hospitals

Assisted

Hospitals

ment-

Assisted

Hospitals

Malc Fomalt

Sex Une

known

Total

Brought forward...

8,053 8,396

799

1,669

2,492 1,840

4,332

A 57

155 - 160

Malignant neoplasm of all other

164 - 165

and unspecified sites

565

635

208

283

467 289

756

175 - 176

178 - 181

192 - 195

198 - 199

A 58

A 59

204

Leukaemia and aleukaemia.

137

200 - 203

205

Lymphosarcoma and other

деор

A 60

210 - 239

A 61

250 - 251

A 62

252

plasms of lymphatic and haematopoietic system

Benign neoplasms and neoplasms

of unspecified nature

Nontoxic goitre

Thyrotoxicosis with or without goitre

---

· P.

A 63

260

Diabetes mellitus

---

A 64 (a)

280

Beriberi

(6)

281

Pellagra

---

(c)

262

Scurvy...

(d)

283 286

Other deficiency states

305

|||| 5.-2 N

113

JL,

171

1,397

325

- PI

339

327

353

151

-LI

A 65 (a)

290

(6)

291

A 66 (0)

247

Pernicious and other hyperchromic

anaemias

---

Iron deficiency anaemias

(hypochromic)

Other specified and unspecified

anaemias

Asthma

JLL

---

378

228

247

462

-יו

Carried forward-

---

JIL

11,652

10,927

1,133

2.069

3,179 2,303;

5.482

135

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Deathe

Death:

Detailed

List

Number

Cause Groups

Govern-

ment

Hospitals

Govern-

mment-

Assisted

Hospitals

Govern-

ment

Whole Colony

Hospital.

ment-

Assisted

Hospitals

Male Female

Sex Un-

known

Total

Brought forward...

་་་།

11,652 10,927

1,133

2,069

3,179 2,303

5,482

A 66 (6)

240,

242 - 245.

253 - 254,

I LJ

All other allergic disorders, endocrine, metabolic and blood discarce

LIL

489

170

ITI

270 - 277,

287 - 289,

294 299

A 67

300 - 309

Psychoses

LIL

IL J

2,554

A 68

310 - 324

326

---

Paychoneuroses and disorders of personality

1,873

A 69

325

Mental deficiency

225

A 70

330 - 334

Vascular lesions affecting central nervous system

846

1,996

502

653

772

725

1,497

A 71

340

Nonmeningococcal meningitis

157

A 72

345

Multiple sclerosis

- - -

A 73

353

Epilepsy

IL J

211

A 74

370 - 379

Inflammatory diseases of eye

A 75

385

Cataract

JLI

247

226

A 76

387

Glaucoma

TIP

136

Carried forward...

ITI

18,294 13,580

1,720 2,760 4,030| 3,084

7,114

137

APPENDIX 9-Contd.

Cases Treated

Deathe

Deatha

Inter-

mediate

Liet

Number

Detailed

List

Number

Cause Groups

Govern. | Govern-

ment

Hospitals

ment-

Assisted

Hospitals

Govern.

ment

Hospitals

Govern

ment

Assisted

Hospitals

Whole Colony

Male

Female

¡Sex Un-¡

Total

koown

A 77 (0)

(5)

(c)

390

391 - 393

394

A 78 (4)

380 384,

386,

388 - 389

(b) 341-344,

Brought forward...

Otitis externa.

ILI

Otitis media and mastoiditis

Other inflammatory diseases of ear... All other diseases and conditiona of eye

All other diseases of the nervous system and sense organs

...

18,294 13,580

1,720

2,760 4,030 3,084

7,114

PAP

PIP

114

314

---

350 - 352,

478

343

107

354 - 357,

360 - 369,

395 - 398

A 79

400 - 402

A 80

410 - 416

A 81

420 - 422

A 82

430 - 434

Other diseases of heart

A 83

440 - 443

Rheumatic fever

Chronic rheumatic heart disease

Arteriosclerotic and degenerative

beart disease

Hypertensive heart disease

102

דיי

JLJ

636

670

138

228

257

308

380

310

690

---

...

17-

389

953

103

385

142

293

635

213

482

263

166

429

444 - 447

A 85

450 - 456

Other hypertensive disease Diseases of arteries

185

608

£7

LII

134

184

131

A B6

460 - 468

A 87

470 - 475

A 88

480 - 483

LLI

Other diseases of circulatory system Acute upper respiratory infections... Influenza

221

823

738

1,293

---

239

JIL

A 89

490

A. 90

491

A 91

492 - 493

Lobar Paeumonia

Bronchopneumonia

ггт

Primary atypical, other and

unspecified pneumonia

Carried forward...

101

---

...

LII

1,599

3,214

527

1,427

1,125

1,194

2,319

139

124

---

23,934

23,140

2,593-

4,920

6,550 5,416

11,966

APPENDIX 9-Contd.

Cases Treated

Deaths

Inter-

mediate

Detailed

List

Number

List

Number

Cause Groups

Govern

meal

Hospitals

Govern.

mcat-

Assisted

Hospitals

Govern-

Govern.

Deaths

Whole Colony

mcot

Hospitals

meat-

Assisted

Hospitals

Male Female

Sex Un-

known

Total

Brought forward.....

---

23.934 23.140 2,593

4,920

6,550 5,416

11,966

A 92

500

Acute bronchitis

182

---

A 93

501 - 502

A 94

510

Bronchitis, chronic and unqualified... Hypertrophy of tonsils and

225

392

136

adenoids

504

---

A 95

518. 521

A 96

519

A 97 (0)

523

(b)

511-517.

A 98 (0)

530

(6)

531 - 535

520, 522.

524-527

---

Empyema and abscess of lung Pleurisy

Pneumoconiosis

All other respiratory diseases

Dental Caries

All other diseases of teeth and

supporting structures

123

---

гог

841

695

12-18

£le=│

313

A 99

540

Ulcer of stomach

972

599

...

---

A 100

541

Ulcer of duodenum

413

...

A 101

543

Gastritis and duodenitis

215

141

A 102

550 - 553

Appendicitis

1,485

340

A 103

560 - 561

Intestinal obstruction and bernia

756

444

570

A 104 (0)

571.0

(b)

571.1

(c)

572

A 105

581

Cirrhosis of liver

A 106

584, 585

Gastro-enteritis and colitis,

between 4 weeks and 2 years

Gastro-enteritis and colitis, ages

2 years and over

Chronic enteritis and ulcerative colitis

Cholelithiasis and cholecystitis

Carried forward...

985

1,489

154

371

273

546

870

829

100

233

427

249

194

251

- 11

181

151

11:

32,370

29.199

2.997

5,561

7,356

6,009.

13,365

138

APPENDIX 9-Contd.

! Cases Treated

Deaths

Juter-

mediate

List

Number

Detailed

List

Number

Cause Groups

Govern-

Govern.

-10710

Govern.

oto1

Deaths

Whole Colony

meat-

Hospitals

Assisted

Hospitala

Hospitals

Assisted

Hospitals

Male Female

Sex Une

known

Total

Brought forward.

32,370 29,199 2,997

5,561 7,356 6,009

13,365

A 107

536 - 539,

542, 544.

545,

573 - 580,

Other diseases of digestive system

1,540

906

200

166 110

276

582 - 583,

586, 587

A 108

A 109

$90

Acute nephritis

591 - 594

Chronic, other and unspecified nephritis

A 110

600

A 111

602, 604

A 112

610

A 113

620, 621

A 114(0)|

613

(6)

634

Infections of kidney

Calculi of urinary system Hyperplasia of prostate

Diseases of breast

Hydrocele

Disorders of menstruation

---

154

253

417

132

167

334

181

436

209

119

124

...

161

337

---

(c)

601, 603,

605 - 609, |

611-612,

All other diseases of the

614-617,

genito-urinary system

1,686

1,556

622 - 633,

! 635 - 637

A 115

640 - 641,

681 - 682,

Sepsis of pregnancy, child-birth and the puerperium

163

684

A 116

642, 652, Toxaemias of pregnancy and the

685 - 686

puerperium

784

185

Carried forward...

37,955

33,413

3,311

5,781

7,747 6,334

14,081

139

APPENDIX 9-Contd.

Cases Treated

Govern-

Govern.

Deaths

Govern

Govern-

ment-

Inter-

Detailed

mediate

List

Number

List

Number

Cause Groups

Brought forward...

- LJ

Deaths

Whole Colony

woot-

10700

1030

Hospitels

Assisted

Hospitals

Assisted

Hospitals

Male Female

Sex Un-i

known

T'otel

37,955 33,413 3,311 5,781 7,747 6,334

14,081

339

503

ILI

1,656

2,636

LIL

104

7,484

821

6,899 | 35,644

ILJ

1,571

585

176

284

~ ' ' |

283

ILJ

... |

136

358

318

A 117

643 - 644

670 - 672

A 118

650

A 119

651

A 120 (a)

645 - 649

673 - 680

683,

1440

()

687 - 689

660

A 121

690 - 698

A 122

A 123

720 - 725

726 - 127

A 124

730

A 125

737

745 - 749

A 126(a)

715

(6): 700 - 714

716

(e) 731 - 736

A 127

738 - 744

751

Haemorrhage of pregnancy and

childbirth

Abortion without mention of

sepsis or toxaemia...

Abortion with sepsis...

Other complications of pregnancy, childbirth and the puerperium

Delivery without complication Infections of skin and

subcutaneous tissue

Arthritis and spondylitis Muscular rheumatism and

rheumatism, unspecified Osteomyelitis and periostitis Ankylosis and acquired

musculoskeletal deformities

Chronic ulcer of skin (including tropical ulcer)

All other diseases of akin

All other diseases of musculoskeletal system

Spina bifida and meningocele

Carried forward.......

- -

↓

CAR EN

415

---

LIL

IN Ứ

783

57,288. 74,639 3,338

5,801 7,760 6,395:

14,155

APPENDIX 9-Contd.

Cases Treated

Inter-

mediate

List

Number

Deaths

Detailed

List

Number

Cause Groups

Gover-

Govern-

ment-

Govern

Govern-

Whole Colony

MTAT

Hospitals

mcot Assisted Hospitals Hospital

ment-

Assisted

Hospitals

Male Female

[Sex Un-

known

Total

Brought forward...

57,288 74,639 3,338

5,801 7,760 6,395

14,155

A 128

754

Congenital malformations of

circulatory system..

108

381

.ז.

A 129

750, 752,

AD other congenital malformations.

299

413

69-

551

125

753

755 - 759

A 130

760 - 761

Birth injuries.

...

A 131

762

A 132(0)

764

(5)

765

(c)}

763,

766 - 768

A 133

A 134

770

769,

771, 772

A 135

early infancy

A 136

A 137 (0)

(6)

794

788.8

793

Postnatal asphyxia and atelectasis.

Diarrhoea of newborn (under 4 weeks) Ophthalmia neonatorum

Other infections of newborn

Haemolytic disease of newborn All other defined diseases of early infancy

773-776❘ Ill-defined diseases peculiar to

Senility without mention of Psychosis Pyrexia of unknown origin... Observation, without need for further medical care

(c)| 780 - 787 | All other ill-defined causes of

788.1-788.7

morbidity

ILJ

---

243

106

151

153

154

961

250

295

293

217.

154

371

121

185

...

---

110

28.

554

---

1,205

130

642

585,

480

1.065

492

173

216

403

619

219

333

---

542

927

---

757 i

537

937 753

1,692

141

788.9

789 - 792

795

Carried for card.......

60,603 79,262 3.725

7,047 | 10,242, 8,543|

3 18.788

142

Inter-

mediate

List

Number

Detailed

List

Number

Cause Groups

APPENDIX 9-Contd.

Cases Treated

Deaths

Govern-

Сотета-

Govern-

ment

Hospitals

ment-

Assisted

Hospitals

Govern-

meot

Whole Colony

Hospitals

meat-

Assisted

Hospitals

Mule Female

|Sex Un-1

❘ known

Total

Brought forward...

60,603

79,262

3,725

7,047 10,242 8,543 3 18,788

2,668

149

166

257

394

...

AE 138 E810 E835) Motor vehicle accidents

AE 139 E800 E802; Other transport accidents E840 - E866|

AE 140 E670-E895 Accidental poisoning..

...

476

гтг

4,361

128

122

185

545

AE 141 E900 - E904| Accidental falls

AE 142

E912

Accident caused by machinery

AE 143

E916

Accident caused by fire and explosion of combustible material...

AE 144 E917, E918 Accident caused by hot substance,

corrosive liquid, steam and

332

radiation

101

---

TII

1,134

Accident caused by firearm

AE 145

E919

AE 146

E929

Accidental drowning and submersion

116

---

LII

204 136

340

Carried forward...

70,629 79,318

4,108 7,047 10,851 8,926|

319,780

APPENDIX 9-Contd.

Inter-

Cases Treated

Deaths

Detailed

mediate

List

Number

List

Number

Cause Groups

Govern

ment

Hospitals

Gover

ment-

Assisted

Hospitals

Govern

Deaths

Whole Colony

1000

Hospitale

ment-

Assisted

Hospitals

Male

Female

Sex U❘ Total

known

Brought forward...

70,629 79,318

4,108 7,047 10,851 8,926 3 19,780

AE 147

(a) E920

Foreign body entering eye and adnexa

(5)

E923

Foreign body entering other orifice...

491

(c)

E927

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

111

(d)

E928

Other accidents caused by animals.

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

1,029

104

158

143

E913 - E915

E921 - E922)

E924 E9261

E930- E965

AE 148

E970 E979 Suicide and self-inflicted injury

503

224|

138

362

AE 149 E980 E985

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

199

AE 150 E990 E999 Injury resulting from operations

of war

---

GRAND TOTAL...

3,767 | 79,344

4,217

1,195 7,05111,195 9,126)

3 20,324

‡ Including 5,508 convalescent patients transferred to Lai Chi Kok Hospital from Queen Mary (201) & Kowloon (5,307) Hosps.

APPENDIX 9-Contd.

Cases Treated

Deaths

Inter-

mediate

List

Number

Detailed

List

Number

Cause Groups

Govern-

Govern

ment

ment-

Assisted

Govern-

ment

Whole Colony

ment-

Elospitala

EIospitals

Hospitals

Assisted

Hospitals

Male Female

|Sex UD-|

known

Total

AN 138

N800-N804 Fracture of skull

TIP

579

173

245

122

367

AN 139

AN 140

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

462

2,131

AN 141

N830-N839 Dislocation without fracture

---

149

AN 142

N840 - N848

Sprains and strains of joints and adjacent muscle

144

AN 143

N850-N856

AN 144 |N860- N869

Head injury (excluding fracture) 4.151 Internal injury of chest, abdomen and pelvis

---

103

།g

127

248

AN 145 N870- N908|

Laceration and open wounds

2,043

AN 146 N910- N929|

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

AN 147 N930-N936| Effects of foreign body entering

259

[

through orifice

568

---

AN 148 N940 - N949|

Burne

ILI

1,419

125

AN 149

AN 150

N960- N979

Effects of poisons

J0+

884

119

N950 - N959 N980-N999

All other and unspecified effects of external causes

230

345

248

593

TOTAL...

13,164

492

953

583

1,536

145

Institutions

GOVERNMENT HOSPITALS:

Queen Mary

LLL

Kowloon

Castle Peak

---

APPENDIX 10

NUMBER OF HOSPITAL BEDS IN HONG KONG - 1962

Medical

Surgical

Gynaeco- Tuber- culosis

logical

Paychin-

tric

Maternity

Infectious

Observa-

tion

Total

LLI

230

156

257

---

(d) 78

590

755

100

ཥྭ#||| │ཁྭ།|༐ │「ཎྜ

623

$71

(0)1,119

1,119

B.8

200

1:40

481

(5) 30

1:00

166

118

1.160

359

294

3.428

H.K. Pay. Cl. & Day Hosp.

Sai Ying Pun

Tsun Yuk...

Lai Chi Kok

Wan Chai

St. Joho

South Lantau

4 Prison Hospitals

GOVERNMENT DISPENSABIES AND

MATKANITY Homes:

Aberdeen

---

PIL

Eastern

Anus Black

Kennedy Town

---

.PI

ILI

Stanley

110

rי.

Hung Hom

➖ ➖ ➖

---

Tai Po

JJO

---

Yuen Loog

---

Sha Tau Kok

Shek Wu Hui

Hn Trung

Sai Kung

Tai (

Soo Hui

Sha Tin

---

LII

---

Silver Mine Bay

10-

...

---

ILL

JJL

Mancine Grantham

North LanıNIA

LJJ

Peng Chau

Shek Pik First Aid Port

110

* 21

231

252

וד '

APPENDIX 10-Contd.

Institutions

GOVERNMENTåssiated HOSPITALS:

Tung Wah

P11

Tung Wah Eastera

JIL

---

Kwong Wal

M11

---

Alice Ho Miu Ling Nethersole

Ruttonjes Sanatoriumi

111

Grantham

Pak Oi

---

LLI

Medical

Surgical

Gynaeco-

logical

culoria

Tuber Paychiatric Maternity

Infectious

Observa-

Total

tion

235

151

(e) 317

149

(/) 598

137

235

---

(X) 106

336

568

716

338

1,149

300

336

568

118

110

Hei Ling Chau Eeprosarium

Haven of Hope T.B. Sanatorium Sandy Bay Convalescent Honze Maryknoll Mission

PRIVATE HOSPITALS;

H.K. Sanatorium & Hosp.

540

117

230

---

Precious Blood

---

St. Terepe'

St. Paul's..

--L

---

- י י

огг

100

---

+50

1,225

$19

206

105

---

104

+91

➖ ➖ ➖

†288

---

...

JL.

---

Hong Kong Central

Matilda & War Memorin!

---

Fanling

---

-11

IIL

Nangen T.B. Rehabilitation Centre Children's Convalescent Home,

| IRNENS |

---

Cheung Chau

-10

2 | 1988 | 8 |

132 | | | |

1.490

464

569

** RAZA7 |

ULUME ŠIS

540

230

108

4,43

316

106

288

194

172

120

778

268

110

144

1,361

PRIVATE Maternity Homes:

438

PRIVATE NURSING HOMES:

Government Hoserrals, Dispensanına

and Maternity Home :

GOVERNMENT-ASSISTED HOSPITALS

PRIVATE Hospitats

611

755

LON

148

1,360

590

294

3,680

1,225

PII

519

306

1.490

464

569

4,473

778

268

110

144

1,361

Private Hatsanity Hours

---

PRIVATE NURSING HOMES

For

LIJ

GRAND TOTAL

---

2,643

1,542

350

1.748

438

1,162

1,672

870

10,017

146

Remarks: (a) Including 120 beda in Drug Addiction Centre. (6) Including 4 cats and 4 cradles.

(d) Including 12 general beds.

(*) Including 86 beds in Infirmary, Sandy Bay.

(f) Including 125 beds in Infirmary at Kwong Wab Hospital. (g) Including 30 beds used for either medical or surgical carer.

• Casualty holding beds.

† General beda.

APPENDIX 11

IN-PATIENTS ADMITTED INTO GOVERNMENT, GOVERNMENT-ASSISTED AND PRIVATE HOSPITALS IN 1962, INCLUDING CASES REMAINING IN HOSPITALS FROM THE PREVIOUS YEAR

NAME

Government Hospitals:

General

Beds

ID- Tuber- Mater. fectious culosit nity

CALL

casco

Psy- chiatric

CLICK

Total

Castle Peak

---

177

*1,119

3.495

Queen Mary

Kowloon

Lai Chi Kok

Too Yuk

St. John

Sai Ying Pun

-11

623

18,577.

117

188

2.429

21,311

---

574

24.605

443

280

4,578

29,977

-LL

LLI

481

283

2.155

198

+8,144

...

200

1,019

7,555

8,574

---

177

100

993

143

648

1,812

-11

612

1,613

11-

Wan Chai

South Lantau

251

2,243

309

146

166

B.K. Psychiatric Clinic

4 Prison Hospitals

Dispensaries and Maternity Hornes...

TOTAL

---

246

186

2,562

251

136

2,998

252

17,828

--|

3.680

49.048

4.460

1,077

33,062

3,948

†97,103

---

Government-Assisted Hospitals:

Tung Wab Group

Grantham

Hei Ling Chau Leprosarium

Buttonje Sanatorium

Alice Ho Miu Ling Netherole

Haven of Hope Tuberculosis

Sanatorium

Pok Oi ...

J--

Maryknoll Mission

-LL

Sandy Bay Convalescent Home

-rr

2,203

28,416

614

1.358 31,398

61,786

568

1,305

1,323

---

540

652

336

---

1,239

1,312

---

300

4,929

2,625

7,677

ILL

---

1260 118

432

437

3.450

2,031

5.489

---

ILI

360

484

108

107

184

TOTAL

111

4,503

37,303

1,339

4,545

36,150

79.344

Private Hospitals :

Hong Kong Sanatorium St. Teresa'

Canosaa

St. Paul'

Precious Blood

Hong Kong Central,

PII

Matilda and War Memorial..........

Children's Convalescent Home,

Faoling...

Cheung Chau

---

Nursing Homes and Maternity Homes

---

316

7,017

147

208

2,239

104

10.595

288

4,960

158

1,238

122

6,551

194

2,055

148

2,270

172

2,273

147

386

721

3,527

106

1,875

174

2,173

PPT

120 3,916

208

3,167

ггг

BB7

127

1,018

I-L

---

956

1.064

123

503

800

31 44,554

45,401

TOTAL

1,834 24,662

443

997 49,440

348

75,889

GRAND TOTAL

-LI

10,017 111,013 6,241

6.619 118,652

4,303 +252,336

Including 120 beds in Drug Addiction Treatment Centre.

† Including 5,508 convalescent patients transferred to Lai Chi Kok Hospital from Queen Mary (201) and

Kowloon (5,307) Hospitals.

* Including 30 beds in Nansen T.B. Rehabilitation Centre.

147

APPENDIX 12

OUT-PATIENTS 1962

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

INSTITUTIONS

Dress

General CLU

Out- dren's

Clinice patients

Aate- ontal

Pos- Gynaeco Social

fogical Hygiene! Datal

Exe

Eu. Nose & Throat

Tuber- culosis

Casualty

Ortho- paedic

Leprosy

Prychin- Derma-

Total

tological

27,264

3,971 176

781 *.713

Police Medical Post. Hong Kong Police MedienĮ Post, Kowloon... Police Quarters Clinic, Cheung

Sha Wan

10,181|

6.443 5.989

248

3701

5,030

8,493 12,606

5,114

6,308 13.280

1 1

133

Victoria Remand Prison

Families Cligie

1,115

Staley Prison Families Cliale

899

4.401.

Chi Mi Wan Prison Clinir Kowloom-Cantan Railway Clinic

3,609

4.560

1.1051

1,236

496

MI. Butler Quarry Clinic

403

1,031

906

Port Health Medical Poste

Queen Elizabeth Specialist

Clipie

TOG

544

†1,570: 2417

8741

Public Dispensaries Hong

Kong & Kowloon

4571

326

135.65)

New Territories Dispensaries...

Maternal and Child Health

433,853 150,651; 22,992 125,938 84,627 13.669

3,703

954| 1,866 1,318.

3691

5,221

659

990

Government Hospitals:

Queen Mary

12,466

Ramboom

49,724

507 154,300

213 693

603

470

6841

39:

2.226

1,539

955

Two Yok

1,440

6,197

3,290,

St. Jobs

2.443

10,736

15,469

6771

Sooth Leoli▴U

141

203

Stanley Priven.

3,024

42,382

Victoria Hemand Prison

647

13.009

Lai Chi Kok Female Prison

1,084

Tai Lan Chung Prison

430

3,575,

1,025 1.682

40,762

136

97,946

1,520

600.

103

156

T86

100

599

565

2,075

663

5.46

135

Clinics and Dispensaries :

H.K. Pryrkiatrie Clinie

Sa Ying Pun

8,122

Vialet Piel

35.774

97,562) 74.746 1,503 67,677 61,983

2,092

-2,612 1,601

1,102

1.020

2,403

Ophthalmic Clinics

---

71,640

　　　　　　　　　Wan Chai Chest Clinic... Sui Ying Pun Chen Clinio Kowloon Chest Clinic

Shek Kip Mei Chen Clinic Social Hygiene Choice..... Families Clinic. Hong Kong Families Clinic, Kowloon

10,911

7,798:

397

11,144.

452

57,338 310,337

10,927

30,020

1,120

47,583

12,456

1,709

6,762

| | | |

1.164

1,164

190,271

500

169,357

71,640

10,915

4.203

[1,161

8,572

8,585

34,799

4,752

8,889

23.857

26,209

24,635

1,150

9,300

4,169

3,237

2,740

706

241

4,966

363 2,329

3:1

762

737,092

531 1,027 6,291) 1.896 2,717 19,458

118

280,229

Centre:

Harcourt

Western...

Chai Wan

Central

Anne Black

Aberdeen

Kennedy Town

Kowloon

4,500

389!

5,238

4,4320 201

3701

5,013

1,591

530

478

1.571

8,279,

13.

107

3,521

2,332

336

FOT

2,775

2,172

1,521

261

3,954

2,594

420

181

3,145

4.716

708

459

5,883

Ha Han Tin

Sbek Kip Mei

1,996

120

1151

2,231

9.600 1,248

1,057

11.985

Total of Government

Tuntilation

LJL

304,380 999,555 459,673

35,155

11,502)

6,224 32,502

86.464

9,451

42,714 163,719) 3,341

1,279 1,430

9,450

2,166,727

Tung Wah Group of Hospitalı.

13,185!

Alier Ho Miu Ling

Nethersole Hospital.

Buttonjre Sanatorium.......

148,873 39,105 52,923 1,356 1,039

1,277 4,559

4.990

3,132

1,363, 430|

4401

Grantham Hospital

Pak Di Hospital

LII

924

Promir's Mili Church Clinic Maryknoll Mission Hospital

16.353 20,833 2,309

2,208 4,780-

140

267,644

37,469

40,499

2,308

4.700

Total of Government-Asiated

Costitution

L4,109 179,852 59,938 58,307

2,633 7,398

4,990 3,132

1,557

230

440|

332,794

GRAND TOTAL... ...' 318,449| 1,179,407 519,611

93.462 14.135

15.652|| 32,501 91,454 12,583

44,271| 164,157

3,681

1,279 1,414

9,450

2,499.521

* Patients seen at the Hong Kong University Eye Clinic. † lacluding 395 medical cases and 1,183 surgical cases.

148

APPENDIX 13

OUT-PATIENTS -

1962

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

INSTITUTIONS

Dress.

General Chil.

Out- dren's Patients Clinker

Ante-

natal

Post Gyurce Social Datalogical Hygiene

Eye

Ear, Nove & Throat

Tuber- culovir

Casualty

Ortho. paedic

telo

Leprosy Paychia Derma- tological

Total

Government Hospitala :

Queen Mary

Kowloon

Toon Yuk

St. Jabn

Bouth Lan

Standay Prison

13,466 299,358

89%

3,834

207,675 8,004,

12,429

991 500! 3,5541

1,094 6,207

46,589 97,246 18,211

174

ILI

LII

6,647

34.786

---

13,640 19,685

2,404

1,529

103

3,527

ITI

כון

14,437

107,874

36,188)

LIL

404 2,865

[3,536

28,838

| | | │

1,475

165

565)

3,090

| | |

1,337

939

40S

Victoria Remand Prison

Lai Chi Kok Female Prixon Tai Lam Chung Prisan

Clinice and Dispensaries :

H.K. Psychiatric Clinic Sad Ying Puo

Violet Peel Ophthalmic Clinics

Wan Chai Chest Clinic Sai Ying Pun Cheat Clinic

Kawloon Chest Clinic... Shek Kip Mei Cheat Clinic Social Hygiene Clinics... Families Clinic, Hong Kong ...| Families Clinic, Kowloon

Polier Medical Post, Hong Kost Police Medical Post, Köwloan Police Quarters Clink, Übrung,

Sha Wan

---

$1,765 160.153 126.398 106,213

101.306 *2,383

6.624

143

13,995

3,971 16,261

11.149

18,084 11,900 11,360 7,539, 11,831 17,479

179,333

270

*6,007

8,590

3,804

321,850 $41.766

292,190

395

11,014

| 1 |

16,051

7,175 17,283

Victoria Bemund Priwn

Families Clinie

1,315

Stealey Prison Families Clinic,

3,132,

11,165

Chi là Tan Priman Clinic

4.220

Karloan-Canton Huilway Clinic;

1,245

1401

480

Hi. Butler Quarry Clinic

2.064

2,379

1,946

Pool Health Medical Porta

חי

│ │││││

| | | | | │

Queen Elizabeth Specialist

Clipit ...

1290

+11,496 2,236

Public Dispensarios Hong

Kong & Kowloon

New Territories Dispensaries

370,298* 106,810

628,309 150,625

1,306

190,844 16,701 103,738 $7,365

1,309

$71

1,128 2,894 1,236 11,632 1,856 L,499

3,629 SS

2,623

7,677

2.399

15,231 5.1#7

52.275

19,458

Maternal and Child Health

Centre:

Harcourt

Weekern... Choi Wan Central

Anne Black

Aberdeen

Krourdy Tawo Korhon

Ho Man Tin

Shek Kip Mei

Total of Government

Totitation

43,213 1.645

637

47.902

720

393

19.359 1.294

467

36.019

132

21,407 1,007

143

24,227 4.0504

324

25.320 1,636

214

$3,100 3.942 20.336

1.083

129

150 1,290

1 |

TO.882 5,093

995.186) 1,612,680 920,446|| 160,065 14, 136 23,076 189,663| 242,423| 29,379 1,619,604| 171,780, 35,572

67.291

1,969

596,398

43,172

40,801

4,617

186,230

38,000

14,585

96,138

15.877.

15,877

2,509

362,126

$21.70

200,459

321,953

305,867

$85,175

292,320

15.405

16,692

221,513

20,232

11,325

42,833

36,849

40.642

1,404

14,797

14.198

3.604

6,383

892

791

23,728

160

11,689

1,517

1,112

1,014

1,247,510 517.997

45,515

49,095

21,320

1 TE

37,584

22,637

30,601

27,170

58.125

20.915

77,265

39,240

17,051 24,825, 6,094.928

Tang Wah Group of Hospitals,

40,715 399,172

104,373 67.547 1,462 5,769

Alice Ho Miu Ling Nethersola

Hospital

421 27,259

16,514 1,277 18.199

Rallonjer Sanatorium

Grantham Hospital

Pak Oi Hospital

Renate's Kill Church Clinke Maryknoll Mission Hospital .

Total of Government-Awisted ¦

Institution

2,772

31.032 38.527 6,093 21,052

16,650

12.654) 16,278; 438 1.955

13,993

657

1.706

[

401

4,760

་།

43,908 478,895 192,900 90,154 2,739

23,968,

16,659,

12,654

32,634

8.39 1.955.

661,021

63,670

13,993

657

79,21+

23.959

4,740

247,304

GRAND TOTAL...

(1,039,094) 2,091,575) 1,063,346| 250,219, 16,875 47,044, 189,663| 259,081

41,833; 1,652,236 172,619

37,527)

39.242 17,051 24,825, 6,948,232

• Potirota area at the Hong Kong Univemity Eye Clinic.

+ Including 5.173 medical cases and 6.323 surgical exper

144

APPENDIX 14

NEW TERRITORIES CLINICS, 1962

Out-patient Attendances

Deliveries

Dispensaries

New Cases

Total Attendances

In-patients

Domiciliary

Tai Po...

Ho Tung

Sha Tau Kok

Sha Tin...

Yuen Long

San Hui

Sai Kung

Shek Wu Hui

Tai O

JIL

Silver Mine Bay

Peng Chau

Maurine Grantham

North Lamma

Shek Pik First Aid Post

Sai Kung Travelling

---

Tai Po Travelling (East)

37,332

64.919

1,623

2,213

4,853

406

8,628

18,474

459

11,026

21.083

591

47,195

100,161

2,155

3,890

11,270

1,116

8,438

17,226

520

43,425

78,524

1,813

P11

18,696

22,684

360

8,950

11,705

171

6.141

8,590

160

---

59,992

120,245

2,401

6,710

9,505

+++

4.440

7,308

55-5

868

1.122

1,184

Yuen Long Travelling (West)...

1,059

1,069

Chee Hong Floating Clinic

Chee Wan Floating Clinic

4,701

4.882

12,750

Shek Wu Hui Travelling

...

834

878

Total

---

280,229

517,997

11,844

150

APPENDIX 15

GOVERNMENT INSTITUTE OF PATHOLOGY, 1962

(a) SPECIMENS EXAMINED

(1) Protozoology and Helminthology

(2) a. Haematology

b. Blood Grouping

---

(3) Serology

(4) Bacteriology

LII

---

...

T10

---

--L

LLJ

-++

(5) Mycology

(6) Public Health ...

(7) Histopathology

(8) Chemical Pathology

---

(9) Clinical Pathology

(10) Special Investigation...

(11) Virus Unit

---

...

26,483

121,797

4,469

+++

137,353

252,170

...

2,469

23,822

5,839

100,095

36,873

850

4,175

Grand Total

716,395

(6) NOTIFICATIONS OF ANIMAL BITES

The following animal bite notifications were received during 1962:

Dog

Cat Monkey

Pig

Other Antinals

Total

Hong Kong

Kowloon

1,742

124

1,881

!יז

3,241

3,325

Total ...

---

4,983

193!

5,206

151

152

APPENDIX 16

SAMARITAN FUND

INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31st March, 1963

EXPENDITURE

Maintenance, capital grants, travelling expenses,

etc.

$19,681.50

Donatious:

INCOME

The Hongkong & Shanghai Banking Corporation..

The Hong Kong Jockey Club (Churities) Ltd.

$ 2,000.00

$12,000.00

Dr. Tang Shiu Kin & Others Excess of Expenditure over Income

$ 1,481.00

$19,681.50

BALANCE SHEET AS AT 31ST MARCH, 1963

$15,481.00

$ 4,200.50

$19,681.50

LIABILITIES

ASSETS

Accumulated Fund as at 1st April, 1962 Less Excess of Expenditure over Income for the year

$20,462.45

Cash with Accountant General

$16,261.95

$ 4,200.50

$16,261,95

$16,261.95

Certified correct.

MAURA BENHAM,

16th May, 1963.

Principal Almoner, Medical & Health Department.

Certified correct.

G. AGABEG,

for Director of Medical & Health Services. 16th May, 1963.

CERTIFICATE OF THE DIRECTOR OF AUDIT

The above Balance Sheet and the accompanying Income and Expenditure Account have been examined in accordance with Condition 5 of the Schedule to Legislative Council Resolution dated 24th May, 1950 (G.N.A. 113 of 26th May, 1950 amended by G.N.A. 33 of 22nd 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 Balance Sheet and Income and Expenditure Account are correct,

AUDIT DEPARTMENT,

Hong Kong, 28th May, 1963.

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

REPORT ON THE SAMARITAN FUND, 1.4.62-31.3.63 Endeavours have been made to keep down the expenditure from this fund due to difficulty in obtaining sufficient income. Nevertheless, the expenditure of $19,681.50 this year exceeded income by $4,200.50. The greater part of this sum was used for the travelling expenses of patients who could not otherwise attend for the treatment recommended by the doctors, and of their relatives who could not otherwise come to the hospitals for the interviews which the doctors wished to have with them. The making possible of these journeys will have to be still further cut in the year 1963/64.

M. E. M. Benham,

Principal Almoner.

153

Diseases

APPENDIX 17

INFECTIOUS DISEASES NOTIFIED CASES AND DEATHS 1958-62

Cholera

Amoebic dysentery

Bacillary dysentery (Including

unspecified dysentery)...

Cerebro-spinal meningitis

Chickenpox

Diphtheria

---

Deaths Caser

1962

1958

1959

1960

1961

Cases

Deaths

Caser

Deaths Cases

Deaths Савев

Deaths

130

---

262

239

334

215

195

424

663

678

742

795

TIT

278

304

498

707

...

- LJ

1,555

134

2,087

116

1,450

1,334

109

1,022

102

816

997

773

742

826

659

442

933

812

794

786

191

743

176

710

192

1,727

435

2,317

326

---

105

244

254

250

310

гг 1

262

148

184

363

---

13,485

2,302

14,302

2,178

12,425

2,085

12,584

1,907

14,263

1,881

197

110

18,872

2,762

20,241 2,589 18,005

2,467

19,333

2,586 | 21,773

2,447

---

...

33,700 |

11,659 |

25 5,727 |

6,223 | 39 | 6,374 |

Enteric fever (Typhoid & Pura-

typhoid)

Malacia

Measles

---

*Ophthalmia neonatorum... Poliomyelitis

Puerperal fever

Scarlet fever

Tuberculosis

...

LJJ

Typhus (mite-borne) Whooping cough

Total

†lufiuenzo

Remarks:

*Notifiable since June 1958.

† Voluntary notifications.

The above table omits rabies, smallpox, plague, epidemie louse-borne typhus, yellow fever and relapsing fever no case of any of which was reported during the years.

✡

GPHK

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