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be polluted, and in those wards where there are patients suffering from infectious diseases where the infective matter is thrown off with the excretions from the bowels and kidneys, the danger of the spread of such diseases to others in the ward is undoubtedly very great. To each two beds there is a rough wooden covered commode which is far from being air-tight. This commode as a rule is only cleansed once in the twenty-four hours. There are no closets set apart for the patients to go to; they must, therefore, use this rough commode. The staff use the ordinary Chinese latrines, and these appear to be well attended to and kept in good order.
(e) In considering this part of the question there are two points which, to
my mind, must be kept steadily in view, viz. :—
(a) The patients are mainly paupers.
(b) A very considerable number of the patients taken to the Hospital are only taken there when in a moribund state and they are designelly taken there to die and not with the hope that their sufferings may be alleviated or that they may possibly recover under careful medical treatment.
be
With regard to (a) it must be remembered that the cost of housing, feeding, nursing and providing medical attendance and medicines, etc., etc., to these pauper patients is not borne by the ratepayers of the Colony as such but by the charitably disposed persons of the Chinese community who subscribe to the funds of the Hospital. It may urged that both grants of land and public money have been made to the Hospital and that these may be viewed as the ratepayers' contributions to the funds of the Hospital. However, I have always been given to understand that the primary object in establishing" the Hospital was to assist in abolishing the hideous dying houses that at one time existed in the Colony.
While clearly recognizing the importance of managing a hospital for paupers with the most rigid economy-more especially when such hospital is entirely supported by vòluntary contributions—yet I feel bound to record my deliberate opinion that it should be made a rule of the Hospital that every patient, on admission, should have a bath, even if only a sponge bath, and be then supplied with a clean suit of hospital clothing. This would be a marked improvement in the sanitary administration of the Hospital and a source of genuine comfort to the patients themselves. The cost of carrying out this improvement would not amount to very much.
With regard to (b) it may be urged that the place is not primarily a hospital, but a building to which moribund Chinese may be taken to die and thus avoid a death occurring in the family dwelling. This peculiar custom is no doubt-to Western minds-very objectionable and much can be said against it. However, it has some advantages. In the vast majority of Chinese dwellings of the poorer classes there is no room in which a dying person can be placed and left in quietness. Besides this, if the moribund are not removed from the poorer class dwellings then public mortuaries to which corpses may be at once taken become almost a necessity.
Because of these and other circumstances I do not consider it would be a wise policy to discourage the removal of moribund patients from the poorer class dwellings. to the Tung Wa Hospital, and I say this well knowing that in not a few cases such removal may be the immediate cause of death.
I have the honour to be,
Sir,
Your most obedient Servant,
HUGH MCCALLUM, Sanitary Superintendent.
The Honourable J. H. STEWart Lockhart,
Colonial Secretary.