regular visiting has to give place to visits connected with irregular attend- ances or default from treatment. 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 documenta- tion duties so that there is a continuing personal contact with the patients both at home and in the clinic, which promotes confidence.
147. The Tuberculosis Workers are recruited from girls of good education and intelligence and are given in-service training for a period of six to twelve months before being allocated to their districts. They are not fully trained nurses nor are they trained social workers.
Assistance to Patients
148. There is a Tuberculosis Assistance Fund available to the Almoner section of the Tuberculosis Service which amounted to $300,000 in 1963. Assistance to the dependents of patients under treatment in hospital is the principal object and disbursements are made on a formula based on previous family income and the continuing family commitments. During the year 260 families received an average weekly grant of $27.71, as compared to $26.38 in 1962. In addition, milk powder issued on the basis of one pound each week to cach 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 the Fund. Surgical appliances for cases of orthopaedic tuberculosis were given to 100 patients at a cost of $7,814, of which $5,196 came from the Assistance Fund, the remainder being subscribed either by the patient or by voluntary agencies.
149. Another source of assistance is the Samaritan Fund at the disposal of the Principal Almoner. A total of $1,674 was given for travel- ling expenses such as are incurred by orthopaedic cases attending clinics.
150. Donations in kind of rice, noodles, cooking far, beans, clothing and blankets were also made possible through the generosity of C.A.R.E. 151. 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. A total of 400 patients were referred to these welfare agencies for assistance.
34
Rehabilitation
152. 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 number of patients in the 40-45 age-group who are unskilled workers with chronic disease and who have undergone thoracic surgery; these present a difficul re-employment problem. The Lutheran World Federation operates a rehabilitation scheme whereby patients recommended by organizations dealing with the treatment of tuberculosis are resettled either in agricul- ture, in small home industries or in other suitable employment. The Lotal number of patient referred during the year to the Lutheran Tuber- culosis Project was 107, as compared to 56 in 1962. There is very close consultation and co-ordination between Government staff and the per- sonnel of the project.
Hospital Services
153. 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 chemoth- erapy, 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 they play an essential role in Hong Kong. While Government has established and developed outpatient facilities on a major scale, the provision of hospital services had been predominantly the role of the voluntary agencies. Thanks to the practical co-operation of these voluntary agencies, who receive substantial Government subventions, a co-ordinated system of hospitalization has been developed over the years.
154. During 1963, 1,727 beds were available for the in-patient treat- ment of tuberculosis. Of these, 55% were in the two tuberculosis hospitals and the convalescent home maintained by the Hong Kong Anti-Tuber- culosis Association. The other institution dealing exclusively with tuber- culosis is the Haven of Hope Sanatorium at Junk Bay in the New Territories.
155. Beds for tuberculosis in Government Hospitals are in the Lai Chi Kok and Cheung Chau Hospitals. During 1963 there were 72 beds at Lai Chi Kok Hospital and 42 beds at Cheung Chau Hospital. The latter are used largely for young adolescents with positive sputum who
35
■