i
direction of the University Consultant Orthopaedic Surgeon and the Government Orthopaedic Specialist. Medical, clerical, nursing and social assistance is provided by Government and all necessary out-patient treatment is carried out in the various Government clinics. The radio- logical investigations are undertaken by the Hong Kong Anti-Tuber- culosis Association or by the Government Radiological Service, depend- ing on which of these facilities is most easily available. Hospital treatment is provided in the surgical wards of the Queen Mary and Kowloon Hospitals, at the Grantham Hospital, at the Sandy Bay Convalescent Home and at the Ruttonjee Sanatorium.
110. The number of new cases presenting at these orthopaedic clinics continues to decline and the new cases are of comparatively recent origin. It is believed that the greatest number of chronic cases has now been treated and that the falling attendance at the clinics is an indication of the effect of B.C.G. vaccination in infancy upon the incidence of tubercular bone disease in the youngest age groups.
Radiology
111. All radiological work in connexion with the Government Tuberculosis Service is carried out by the staff of the Radiological Branch of the Department, under the direction of the Senior Radio- logical Specialist. Static X-Ray units are installed in the major clinics and subsidiary centres are served, as far as possible, by two mobile units. The increase in the radiological work undertaken can be seen from Table 10.
TABLE 10
TUBERCULOSIS RADIOLOGICAL WORK 1959-60
Total exposures
Large films or papers
Bacteriological Examinations
1939
1960
194,181
234,181
128,894
146,784
112. All bacteriological work for the Government Tuberculosis Service is carried out by the staff of the Government Institute of Pathology under the direction of the Government Pathologist. A con- stant watch is kept for atypical acid-fast organisms resembling the tuber- culosis bacillus, but the number found and identified have been very few and do not pose a clinical problem.
2.8
Hospital Treatment
113. The detailed distribution of beds for tuberculosis in the civil bospitals throughout the Colony is shown in Appendix 10; this repre- sents the average number of beds available during the year for the treatment of tuberculosis. For convenience, a summary of the distribu- tion is given in Table 11.
TABLE 11
TUBERCULOSIS BEDS IN HONG KONG 1960
Government Hospitals
Hong Kong Anti-tuberculosis Association Tung Wah Group of Hospitals
Haven of Hope Sanatorium,
Other Government-Assisted Hospitals Private Hospitals
Total
216
*70*
326
210
26
241
1,889
• Includes Carbam Honda). Ruwonjer Sunandriam & the Flexi Memorial Home. 114. In addition to the beds available to the Tuberculosis Service in the Government Hospitals, there are 444 beds in the Grantham Hospital and 336 beds in the Ruttonjee Sanatorium, which includes the Freni Memorial Convalescent Home, Admission is governed by the need for using the beds to the greatest advantage and they are occupied mainly by patients whose recovery can be bastened by medical, surgical or orthopaedic treatment or who require emergency admission for com- plications arising during ambulatory chemotherapy. Segregation of open cases on a large scale is not yel possible, but this aspect of control is being studied by voluntary organizations and it is probable that long- term isolation facilities for an increasing number of infectious and chronic cases may become available in the near future,
Radiological Surveys
115. No general population surveys have, as yel, been possible. However, during 1960 small pilot surveys were carried out in Resettle- ment areas with the object of learning case-finding techniques; results were disappointing as co-operation by the public was very poor. Although facilities are available now to launch these surveys on an increasing scale further investigations will have to be made into methods suitable to local conditions which will ealist public interest and co- operation.
20