possible all forseeable social problems are thus settled before admission. saving much work at a later date.
173.
Visits are paid by the Almoner to patients in hospital, a weekly visit being the usual practice. When possible the visit is paid in conjunction with the medical officer concerned. On discharge from hospital all patients are given a small supply of drugs to ensure con- tinuity of treatment until arrangements have been made for further care at the clinic most convenient to the place of residence.
174. For patients under ambulatory treatment at a clinic, attendance registers are kept by the Almoners so that failure to attend or irre- gularity in attendance can be noted. Defaulters are visited by Tuber- culosis Workers without detay and are encouraged to resume attendance, the dangers of failure being outlined and explained,
175.
Drugs for oral administration are distributed through the Almoners section, usually by the Tuberculosis Workers. As the total of patients on ambulatory chemotherapy at any one time is in the neighbourhood of 16,000 the magnitude of this aspect of the work is considerable. The distribution of oral drugs as made up by the manu- facturers in packs containing one week's supply has been a great advantage.
Assistance to Patients
176. A sum of $250,000 was available during 1959 for assistance to patients. This aid was disbursed in the form of cash grants or additional food. During the year. 282 families received average cash grants of $23.25 each week compared to 238 families receiving average grants of $21.45 during 1958. Other cash grants, for travelling expenses, domestic help, rehabilitation grants and surgical appliances for ortho- paedic cases, were also made.
177. Additional food, in the form of one pound of milk powder per patient each week, cost $99.488. This form of aid was supplemented by assistance in kind consisting of 10.982 C.A.R.E. food parcels and 6,000 lbs. of fortified noodles.
The Tuberculosis Workers
178. The greatest part of the home visiting is carried out by the Tuberculosis Workers. Trained specifically for duties most suited to local conditions, they have no nursing training as their work is mainly on the social side. They are responsible through the Senior Tuber- culosis Workers to the Almoner and each has duties in a clinic which
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cover reception, the maintenance of records and registers and assistance in the special clinics. Outside the clinic, each T.B. Worker is responsible for a district and afternoons are devoted to home visiting, health education and the organization of contact examinations.
179. The training is an 'In service' one and lasts for six to twelve months, the emphasis being on the practical side with a minimum of lectures on the elements of medical social work, record keeping and health education.
Tuberculosis Contacts
180. Efforts are made in the course of home visiting to have every close family contact of known cases of tuberculosis examined to exclude tuberculosis. Contacts under the age of 8 years are tuberculin tested, negative reactors being offered B.C.G. vaccination, positives being X-rayed. Other contacts are X-rayed at their convenience and without the need to first register at the chest clinics.
The findings during the year were as follows:
Under & years of age
Tuberculin Tests Clinical Findings
of T.T. Positive CASE6
Percentage of active
TABLE 13
Negatives
1958
1959
1,163
996
Positives
2.234
1,928
Active Tuberculosis
143
[10
Inactive Tuberculosis
37
65
Suspicious
384
324
Free of Tuberculosis
1,685
1.429
tuberculosis
4.33%
3.72%
Active Tuberculosis
385
336
Inactive Tuberculosis
183
159
Suspicious Tuberculosis
746
658
Free of Tuberculosis
7.070
6,856
tuberculosis
J.
4.59%
4.19%
Grand total of contacts examined
...
11.801
10.933
Over 8 years of age
Results of
Examination
following
contact X-ray
Percentage of contacts over 8 years with active
181. There has been a drop in the total number of contacts examined as compared with previous years, but there appears to be no significant change in the findings.
MALARIA DURDAU
182. The Malaria Bureau, under the direction of the Government Malariologist, is responsible for all malaria control undertaken in the Colony and, in certain instances, deals with the breeding of culicine mosquitoes. It also offers expert advice to the Armed Services, the Pest
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