of wailing lists. Waiting time for admissions is less than six weeks and, at the end of 1961, there were only 273 patients waiting of whom 120 were orthopaedic cases. The total number of admissions and re-admis- sions arranged by the Almoners was 1,529, a decrease of 63 compared with 1960. This was mainly due to re-allocations of beds in the Lai Chi Kok Hospital during the cholera outbreak and, before that, on account of the seasonal pressure duc to diphtheria.
170. Ward rounds by Almoners, in company with the medical staff. are carried out as a routine and each patient is normally seen individual- ly at least once each month as well as by appointment if required,
171. The Almoners' Section is responsible for the preparation and maintenance of attendance registers of patients on outpatient therapy. After the initial interview by an Almoner, a Tuberculosis Worker pays a visit to the home, gives advice on hygiene and makes arrangements for contact examinations. In addition. irregularity of treatment or non- attendance is followed by home-visits. However, because of limited staff, much of the routine regular visiting has to give place to visits connected with irregular attendances or default from treatment. At present each Tuberculosis Worker is responsible for an average of 1,350 patients while the desirable maximum case load is 900. Patients are allocated on a district basis and the Tuberculosis Worker is attached more or less permanently to her district and works from the relevant full time chest clinic. At the chest clinics these workers also assist with reception and documentation duties so that there is a continuing personal contact with the patients both at home and in the clinic, which promotes confidence. 172. The Tuberculosis Workers are recruited from girls of good education and intelligence and are given in-service training for a period of 6 to 12 months before being allocated to their districts. They are not fully trained nurses nor are they trained social workers.
Assistance to Patients
173. There is a Tuberculosis Assistance Fund available to the Senior Tuberculosis Almoner which amounted to $300,000 in 1961. Assistance to the dependants of patients under treatment in hospital is the principal object and disbursements are made on a formula based on previous family income and continuing commitments. During the year 274 families received an average weekly grant of $24.61. In addition, milk powder issued on the basis of one pound each week to each patient was a charge on the fund. Miscellaneous disbursements such as travelling expenses of patients coming from outlying districts for X-ray were also made from
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the Fund. Surgical appliances for cases of orthopaedic tuberculosis were given to 131 patients at a cost of $3.148.
174. Another source of assistance is the Samaritan Fund at the disposal of the Principal Almoner. A total of $4,232.55 was given for travelling expenses such as are incurred by orthopaedic cases attending clinics.
175. Donations in kind of rice, noodles, cooking fat, beans, clothing and blankets were also made possible through the generosity of C.A.R.E. 176. When it is not possible or expedient to assist patients from the resources available to the Tuberculosis Service they may be referred to other agencies such as the Social Welfare Department. the Family Welfare Society. Foster Parents Inc., and many other similar organiza- tions. Over 300 patients were thus referred. for assistance, to other welfare agencies.
Rehubilitation
177. Ambulatory treatment for the majority of patients who attend the Government Clinics means that the greatest number can continue at work, or spend relatively short periods in hospital before returning to their jobs. However, there is a considerable proportion of patients, in the 40-45 age group. of unskilled workers with chronic disease who have undergone thoracic surgery and who present a difficult re- employment problem. The Lutheran World Federation has launched a pilot rehabilitation scheme whereby patients recommended by organizations dealing with the treatment of tuberculosis are resented either in agriculture, in small home industries or in other suitable employment. The total number of patients referred to the Lutheran Tuberculosis Rehabilitation Project from the Government Tuberculosis Service was 58 and initial results have been most encouraging. There is very close consultation and co-ordination with the Government stall by the personnel of this project which offers every promise of success and a much wider field of constructive rehabilitation,
Hospital Services
178. The magnitude of the Tuberculosis problem in Hong Kong is such that it is not physically possible to segregate and treat in hospital all cases of active open tuberculosis. The place of ambulatory chemo- therapy, recently assessed on a scientific basis in Madras, has proved itself in practice over the past ten years in Hong Kong, However, hospital beds are necessary to any system of control and treatment and
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