Ch Mulavia.
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Some 720 deaths took place in 2,422 cases of malaria, a rate of 29.7 per centum. In the majority of cases P. falciparum was the infecting parasite.
(1) Relapwing fever.
CIMES.
Relapsing fever accounted for thirty-one deaths in seventy-seven recognised A case mortality of 40.2 per centum is unduly high and suggests that a number of cases failed to be recognised. The type met with resembled louse-borne Sp. obermeiri.
(ii) Other diseases.
(a) Tuberculosis.
Tuberculosis constituted by far the most serious single killing disease in 1946. Some 1,818 deaths were registered as due to this cause fortning almost 11 per centum of all deaths.
Intensive propaganda was carried out both through Government and private agencies in an effort to combat this scourge.
The Hong Kong Anti-Tuberculosis Association launched a publicity campaign aiming at the reduction of indiscriminate spitting, the early reporting of cases, improvement in housing and nutrition.
With assistance from a leading Chinese citizen, Sir Robert Ha Tang. the Association has purchased a mass X-ray unit and it is hoped to deal with up to 50,000 persons annually. Naval, Military and Air Force Services have agreed to cooperate in this work.
The Association intends to construct a sanatorium to supplement the rather alender resources of Government in so far as such institutions are concerned.
Films on "Nutrition" and "Housing and Blum Clearance" were shown to the general public and school children and aroused considerable interest.
Tuberculosia clinics are planned for both sides of the harbour to give advice and treatment to sufferers. Much valuable material is lost both in Government and and in commercial circles by neglect of tuberculosis in the early stages.
(b) Deficiency discones,
After a long period on a starvation dietary, it might have been expected that a considerable proportion of the inhabitants would still be found to be suffering from the results of privation. The reverse was the case. Only one death was attributed to rickets, two to scurvy, twenty-eight to pellagra and 1.318 to beri beri out of a total of 16,653 registered in 1946.
(e) Rabica.
Two deaths from human rabies occurred in 1946. Dogs were examined and Negri bodies were found. The general public was warned to report all cases of dog bite and 328 courses of anti-rabic trestraent were given during the year.
At one period an urgent appeal had to be made for the virus fixe, so that enough vaccine could be prepared locally.
The cooperation of the Police was obtained to enforce the muzzling order, and additions were made to the dog kennels to enable strays and suspected dogs to be kept under observation.
(d) Leprosy.
No deaths from leprosy were registered in 1946.
The Japanese had methods peculiar to themselves for eliminating leprosy from Hong Kong during the occupation. The Leper Settlement purchased by the Govern- ment from the Tung Wah Corporation prior to the Pacific War was allowed by the Japanese to fall into ruins.
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The few lepers who survived and escaped into Kwang Tung territory started to trickle back in 1946. In the absence of suitable accommodation in Hong Kong, the present policy is to send such patients to Sheklung where they are cared for by the Sisters of the Immaculate Conception in charge of St. Joseph's Leper Asylum.
One European leper was admitted to the isolation block of Kowloon Hospital and a few cases were treated at out-patient departments pending transfer to Sheklung.
China has such a vast reservoir of lepers that it would be impracticable to provide accommodation for all such patients who would desire to cross the frontier into British territory.
At a census carried out some years before the Second World War, there was evidence of about a thousand lepers in Hong Kong. The number, at present, is probably less than one tenth of that figure.
(ii) Helminthic diseases.
Ascariasis continued to be the commonest helminthic Infection in Hong Kong. Clonorchis and trichuris infections come second on the list, and ankylostoma and fascíolopsis are relatively rarely met with and no specimens of stools examined In either laboratory showed enterobius infection.
(a) Nightenïl dispoanl.
IV.
HYGIENE AND SANITATION.
(1) General Measures.
The main sewers were damaged and blocked during the Pacific War and the Japanese connected the sewerage system with storm water drains which had been uilowed to silt up. Consequently, a very considerable amount of rehabilitation was required in 1946 and only a portion of this could be affected owing to lack of materials and personnel. In particular, internal sanitary fittings which had been extensively looted were in short supply.
Two systems of disposal of human wastes are in operation in the urban area of the Colony, namely, by water-carriage sewerage and by bucket conservancy. Absence of sanitary fittings and of buckets at the start of the year prevented both systems from functioning properly.
In the middle of the year, it was calculated that less than a third of the nightsoil collected from dry-pan latrines was being removed to the nightsoil barges along the Victoria and Kowloon bunds, the rest was being thrown into street drains and into the storm water drains.. Marked improvement has taken place as the result of firm handling, but nothing less than a modernised sewerage system for both sides of the harbour will solve this urgent necessity which is long, overdue. Considerations of water supply, town planning and slum clearance and the desiguing of a method which will permit "matured" and relatively innocuous sewage to be used for fertilising the land in the Leased Territories together constitute the main reasons for delay to date.
Nearly 100 tons of human wastes are collected daily in the urban area. Rather less than one fifth is transported to maturing tanks in the Castle Peak district of the Leased Territories for sale as a fertiliser to the local farmers. The greater part is dumped at sea, pending the construction of additional batteries of maturing tanks ut Castle Peak and elsewhere in the Territories.
(b) Refuse dispoaut.
During the Japanese occupation there had been a complete breakdown in town cleansing. Vast accumulations of household and trade refuse were to be found on open spaces, bombed sites and even covering main thoroughfares in many parts of the urban area. Very few householders possessed dustbins and disposed of their wastea by depositing in the street or on the nearest heap of rubble, This state of affairs prevailed at the beginning of 1946. It was further aggravated by an inadequate number of lorries (kindly loaned by the R.A.F.) somewhat ill-adapted to the transport of refuse, and by a serious shortage of trained staff.
Efforts were made to persuade householders to acquire dustbins, but there was & not unreasonable disinclination in cases where theft of the receptacle placed in the street frequently took place.