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Health, who is untiring in his devotion, his labours are not so productive of benefit as the conditions require, because even with the existing Ordinances there is neither the power nor the organization to remedy the past or prevent insanitary dwellings and insanitary areas being constructed in the future. The existing Ordinances, as will be explained later on, do not even secure sanitary dwellings. Moreover to prevent further overcrowding it is essential to raise the existing minimum of superficial area and cubic space permitted for each person and to spread out the population. In Kowloon there has been since 1861 land which could have been utilised, and since 1899 there is abundance of land on that peninsula. Land will also be available in Hongkong itself when the several reclamation schemes which are in hand and which are proposed, are carried out, and the projected tramway is begun and completed. But there will be little use of this land from a sanitary point of view if buildings and streets are permitted to be constructed which are insanitary and the rooms of the buildings are permitted to be subdivided into cubicles without windows, each cubicle accommodating as it often does an entire family.
7. With reference to the water-supply and sewerage, they are stupendous works which the Government may well be proud of. The gathering-grounds of the water- supply were, however, not calculated to cover a succession of years of comparatively `small rainfall or the enormous waste that always occurs when water is freely sup- plied in the houses of a large Eastern population. Hence the difficulties that have arisen with regard to scarcity of water for potable and for cleansing purposes. In my opinion, the sewers and small covered storm-water channels should not be de- pendent on the ordinary water-supply for flushing. It may, however, be said at once that neither the scarcity of water nor the system of the drainage has any- thing to do with the plague epidemics. I have only one suggestion to make with regard to the water-works and that is, that after filtration of the water at the Albany filter-beds it should be received into covered reservoirs. This has already been recom- mended by Mr. CHADWICK. The exposure of water in an uncovered tank after it has been filtered is wrong in principle as it is liable to contamination which, with typhoid and cholera occasionally visiting the island, is dangerous.
8. Having mentioned the circumstances which render Hongkong susceptible to re-infection from the mainland, more specially in epidemic years, and the conditions which favour plague endemicity in Hongkong itself, I shall turn to a consideration of the measures which are feasible and which should be taken to prevent the inhabit- ants suffering annually from plague. It is impossible to pull down the whole of that portion of the town inhabited by the Chinese and reconstruct it or any consider- able part of it, though there are districts, which I shall mention later, that must be treated in this way, while even with the most radical improvements rapidly effected, many years must necessarily elapse before any very great change can be effected. Under these circumstances it is important to concentrate every effort as regards plague prevention on the chief modes by which it spreads, and on organi- zation for its prevention. This concentration of effort is not to take the place of sanitary reform, but it will allow of the inhabitants living in comparative safety while the greatly needed sanitary changes in the town are being gradually effected.
9. The proximity of Hongkong to the Chinese Coast and the very intimate intercourse between the districts of Canton, the West River and Hongkong, together with the fact that the prevalence of the disease in the towns and villages of Southern China are not notified, renders the problem of preventing the importation of the disease specially difficult. I would suggest, if it can be arranged with the Foreign Office, that the Medical Officers of the Consulates in different parts, or the Consul himself, might submit a weekly bulletin as to the infected towns or villages in his district in Southern China. Arrangements might also be made with some of the leading medical missionaries for a similar bulletin, and it might be possible, with the concurrence of Sir ROBERT HART and the Chinese Authorities, for a weekly
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