THE ALMONER SERVICE
385. Under the social conditions existing in Hong Kong there is a vast amount of medical social work necessary to support the curative services. The Principal Almoner has her headquarters at the Harcourt Health Centre and she has a stuff of 10 Almoners Class I and 30 Almoners Class II distributed between the Hospitals, the larger clinics and certain specialist services. Responsibilities additional to the actual medical social work include the administration of the Samaritan Fund. the Special Treatment vote, the distribution of free foods donated by C.A.R.E. and other welfare organizations, and the in-service training of newly recruited Almoners. There is also participation by the Alinoners in the training of medical students, student nurses, social studies students and in the in-service training courses run by the Social Welfare Department.
386. The staffing situation has improved over the past two years and during 1959 six Almoners completed their first year of in-service training and seven more were recruited. The ratio of experienced to inexperienced Almoners is still too low and only 24% of the staff had had six years experience or more.
387.
At the Queen Mary Hospital more work was possible amongst cancer patients undergoing radiotherapy and more time could be devoted to orthopaedic patients, particularly those attending the fracture clinic. At Kowloon Hospital the increase of over 2,600 hospital admissions proportionately increased the calls on the Almoners time. particularly in connexion with the orthopaedic accident service aimed at carly rehabilitation. There is necessarily a close contact with the Lai Chi Kok convalescent wards and one Almoner's time was devoted to this aspect of the orthopaedic work in both hospitals. At Lai Chi Kok the most difficult problems continued to arise in the finding of suitable employment for the disabled and in the rehabilitation of the paraplegics.
388. At the Mental Hospital, where full social records of all patients are most important, there are now four Almoners. The large number of patients who are out on parole requires a continuing close family contact if out-patient attendance are to be maintained and relapse avoided. Full case work was carried out for 951 cases compared to 724 in 1958.
389. The Tsan Yuk Maternity Hospital posed many problems deal- ing as it does with the complications of pregnancy. Arrangement for the care of the children of expectant mothers who required prolonged
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unte-natal in-patient treatment, referrals of babies to the M.C.H, centres. the care of orphaned children and advice, where sought, on family planning are all making greatly increased demands on the service.
390. At the larger out-patient clinics the medical-social needs of various aspects of the general curative service are met as far as possible. These include, particularly, child care problems arising from unsatisfac- tory home conditions and the difficulty of regular attendance at physiotherapy, mawrnal and child health and other clinics due to the household or employment ties of the mother.
391. Almoners work full-time with the Tuberculosis. Social Hygiene and Ophthalmic Services. There have been encouraging developments in the attitude of patients and parents to these services as a result, particularly in leprosy work.
Samaritan Fund
392, During the year, expenditure totalled $14,487.75 disbursed in 3.305 grants which is an increase of more than 40% over that of lust year. The majority of the grants were, as previously, in the form of travelling expenses and the re-imbursement of loss of carnings to the escorts of disabled patients.
Special Treatment Pote
393. Expenditure rose from $10,790 in 1958 to $20,518 in 1959 for the provision of surgical appliances to those who cannot afford the cost either in part or in toto. The Almoner concerned submits a social report on each patient together with the surgeon's recommendation and an estimate of the cost of the appliance. The Principal Almoner, after the appliance has been fitted, is then responsible for the submission of the account for payment from this vote. The arrival during February, 1960. in the Colony of a Surgical Appliance Technician on first appointment will greatly facilitate this aspect of the work of the Almoners.
394. The assistance and co-operation of the Family Welfare Society, the Silvermine Bay Holiday Camp, the Family Planning Association, CARE, the B.G.C.A. the Po Leung Kuk, the Bishop Ford Centre, and UNICEF in the medical social work are gratefully acknowledged. The close co-operation given by the Social Welfare Department of Govern- ment in the solution of problems of mutual concern in this field hás been particularly valuable.
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