All the Almoners hold recognized professional basic qualifications in medical social work, while a number have additional post graduate qualifications obtained after study leave overseas. Almoners are attached to the larger hospitals, to certain of the main urban clinics and to the Tuberculosis, Ophthalmic and Social Hygiene Services. Additional re- sponsibilities are participation in the teaching of medical students, nurses, social studies students and in the in-service training of groups of social workers who are recent entrants to the Government Service. The Samaritan Fund, the Tuberculosis Assistance Fund and the Special Treatment vote are administered by the Principal Almoner and her staff while the distribution of free foods donated by welfare agencies is also undertaken by the Almoners.
398. In Kowloon, where the Almoners are in closer contact than most with patients from the very under-privileged groups, a general improvement in living conditions has been noticed during 1961. The Almoners have come across fewer people living in wooden huts with very poor sanitation and there has been less unemployment except amongst the aged and a small proportion of the physically unfit. Wages generally speaking are bigher and there has been less dire poverty amongst the sick. On the other band the social implications of many more emergency cases including traffic, industrial and household accid- ents, assaults and attempted suicides have demanded increasing attention. This change has had a definite effect on the lines of development of community services during the year, some of which have been initiated by the Almoners; in other instances help has been given with general planning and development. To all such community projects either in being or planned continuing help and co-operation has been given by the Almoners.
399. Hostel accommodation for cancer patients and accommodation for those needing residential care in the terminal stages of the disease are urgent problems. The part played by the Oxfam Hostel has already been mentioned while the inclusion of a cancer wing in the proposed So Uk Hospital on which work has started in Kowloon, is another step kowards meeting these needs.
400. The Caritas residential training centres for paraplegics at Aberdeen and Honeyville for male and female patients respectively are helping to meet another long felt need. In October 1961 a Cheshire Home was opened, in temporary premises on Hong Kong Island, which can accommodate 16 patients. These patients, who would otherwise occupy a hospital bed for very long periods, have shown a remarkable
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re-appearance of interest in walking and in generally 'coming back to life in the environmental conditions afforded by the Home,
401. The Special Schools Section of the Education Department now established has enabled the Almoners to arrange schooling for a number of handicapped children, the placing being made on the basis of a com- bined report from a doctor, an almoner and, where applicable, a physio- therapist. Assistance has also been given in the selection of pupils for the British Red Cross Society School for the Physically Handicapped at Kwun Tong which is to be opened in July 1962.
402. The Salvation Army Children's Convalescent Home in Cheung Chau was opened in October 1961. The Almoners and Paediatricians at the Queen Mary Hospital work very closely with the Salvation Army in the selection of child patients who require additional care in cheerful surroundings to ensure maximum benefit from hospital care.
403. The Lutheran World Service Rehabilitation Project has also already been mentioned in connexion with tuberculosis. Other rehabilita. tion activities maintained by the Lutheran World Service which are of great importance to the Almoners are schemes of assistance to the ex- patients club for those discharged from the Drug Addiction Treatment Centre, a plan to assist discharged mental hospital patients and their families and a project to provide wheel chairs for seriously disabled patients. Since this latter scheme was launched in November 1961, ten wheel chairs have been supplied.
404. The medical social work at the larger hospitals and clinics followed the pattern of previous years, covering a very wide and com- plex range of services. With the continuing heavy pressure on acute beds in the general hospitals the problems of convalescence under un- favourable home circumstances, and early rehabilitation and re-employ- ment are all of considerable urgency. To these are added the necessity for accommodation of cases of chronic illness and of the permanently crippled who require a radical adjustment in the way of living. All of these present a never ceasing challenge in the face of inadequate facili- ties. The many improvisation made and the degree of success achieved are a tribute to those who carry these responsibilities,
405. Expenditure from the Samaritan Fund during the year rose by almost one third to a total of $21,059 details of which together with the Principal Almoners report are at Appendix 16. This increase is due largely to the opening of the Castle Peak Hospital, some 22 miles from the centre of Kowloon which entails considerably more assistance to-
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