I Introduction
The Medical and Health Department provides a wide comprehensive spectrum of medical and health services for the community of Hong Kong. The ever-increasing population, the rising expectation of the people coupled with the constraints of limited financial and manpower resources have imposed a heavy strain on the provision of these services. Attendances at all the existing clinics and health care centres had been on the increase. To cope with the continuing increase in demand, the Medical and Health Department has embarked on a comprehensive medical development programme which includes the construction of four major hospitals and 21 additional clinics and polyclinics in the coming decade,
For the 1986/87 financial year, the Medical and Health Department's expenditure was $2,774.5 millions. Subventions totalling about $1,268,1 millions are also being made to many non-Government medical institutions and organisations. The capital expenditure on hospitals and other buildings furniture and equipment was $458.2 millions.
good.
II Health of the Community
The general level of health of the population in Hong Kong remains This is largely due to anti-epidemic and disease surveillance measures, developments in preventive and personal health services and general improvement in the socio-economic conditions of the population. This progress is further reflected in the highly satisfactory health indices and the general low incidence of major communicable diseases,
The estimated mid-year population of Hong Kong in 1986 was 5.53 millions, an increase of 1.4% compared with the previous year.
It was also estimated that about 23.1% of the population were under 15 and 7.7% were 65 and over.
The crude death rate was 4.7 per thousand population. Figure 2 shows the age specific death rates in Hong Kong for the year 1986. The five major leading causes of death in Hong Kong were malignant neoplasms, heart diseases, cerebrovascular diseases, pneumonia and various injuries/ poisoning. The commonest forms of malignancy in Hong Kong were cancers of the lung, liver, stomach, colon, nasopharynx and oesophagus.
The total number of registered live births in the year was 72 211, a crude birth rate of 13.1 per thousand population compared to 14.0 in 1985. In the same year, the infant mortality rate remained a low level of 7.7 per thousand live birtha. The major causes of infant deaths recorded were congenital abnormalities (37%), anoxia, hypoxia and birth asphyxia (28%), immaturity (9%), infections specific to perinatal period (4%) and pneumonia (3%). The maternal mortality rate was 0.03 per thousand total births as compared with 0.05 in 1985.
III
Communicable Diseases
A total of 30 cases of cholera were reported in 1986, of which 23 were local cases and 7 were imported cases. All the cases occurred between May & October, but there was a local outbreak towards the end of July and early August, and Hong Kong was declared a cholera infected area in accordance with the International Health Regulations of the World Health Organisation.
Between 28 July and 20 August a total of 21 local cases were reported. Epidemiological investigation revealed that there was a clustering of cases in the East Kowloon region, with 14 patients residing or working in Kwun Tong and that they had consumed food prepared by hawkers in the Kwun Tong area, prior to the onset of symptoms. A common source was suspected to be responsible for this outbreak.
The other cases occurred in Shatin, Tsim Sha Tsui, Tsz Wan Shan, Mong Kok, Sham Shui Po, Kwai Chung and Yuen Long. These were considered to be isolated cases.
Public Health and preventive measures were immediately stepped up, and an ad hoc Interdepartmental Co-ordinating Committee on the Control of Cholera was established to advise and co-ordinate the various preventive, control and publicity measures.
The concerted efforts of the different departments involved in the imposition and enforcement of the various stringent food hygiene measures helped greatly to arouse public awareness of the cholera problem and no further local cases were reported from August 6. As a result, Hong Kong was declared to be cholera free on August 19.
Of the remaining two local cases, and the other in October in Wong Tai Sin.
one occurred in June in Tai Po
Hong Kong remained free from other quarantinable diseases. There was no report on common communicable childhood diseases such as diphtheria and poliomyelitis. Only one case of whooping cough was reported.
Two cases of rabies in humans were reported during the year. Both persons had been bitten by dogs while in China and developed symptoms after their return to Hong Kong. In these two cases, a 68-year-old woman died in March, and a 37-year-old man died in August, The single indigenous case of animal rabies was reported in November.
During the year, 143 cases of malaria were notified, most of them imported cases, with the probable source of infection in China, Pakistan, Vietnam and India. Eight indigenous cases were identified in the same period. These cases occurred in Sai Kung, Yuen Long and North New Territories districts, and Ping Chau (Mirs Bay).
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