4. On the Mainland a similar state of affairs exists in the older parts of Kowloon. The population, probably over a million, has increased greatly since the end of the Second World War.
5. Much has been written of the squatter problem in the twin cities and on the periphery of Kowloon, Here is a largely agricultural population abruptly transplanted to urban conditions with sketchy water supplies and environmental sanitation; there is casual employment and insecurity of tenure of dwelling places by virtue of the squatting. Here the social disruption which breeds so much physical and social ill-health stands out in contrast to that of the established residents of Victoria and Kowloon.
6. In the New Territorics, with a population estimated at about 360,000 life is much more stable and the intensive wet cultivation of food crops fosters a way of life traditional over many hundreds of years. There is a higher standard of physical fitness and the health problems tend to be those of the parasites rather than the acute and chronic bacterial infections. Similarly the fishing community lives a self-contained and traditional life largely undisturbed by the influences of urban development. Nevertheless in some areas of the New Terri- tories light industry has developed rapidly since the war and the influx of labour has brought social problems in its train.
7. Piped water supplies of a high standard of purity are now available to the urban community even though the hours of supply are necessarily restricted and one water point may serve many families, In the urban areas it is true to say that wells and well water are strictly controlled and their permitted use limited to flushing. In the New Territories the larger centres also have the benefit of a protected supply; otherwise, the level of acquired immunity measures up to the supplies from unprotected sources.
8. Not unnaturally in the circumstances, covironmental sanitation poses a problem of staggering proportions. Great strides have been made in the provision of sewerage but the major part of the urban population is still served by bucket latrines. The great demand for the traditional fertilizer for the intensive agriculture of the New Territories means that disposal of night soil presents no great problem once a system of collection and distribution has been solved. This has been achieved to a greal extent on an ad hoc basis pending the introduction and development of modern and safe systems of disposal and utiliza- tion of sewage for agricultural purposes.
9. There is little real malnutrition in the Colony but there is a good deal of subautrition, largely due to imperfectly balanced diets. Fish and pork are plentiful but although, generally speaking, there is no grave shortage of protein it is rarely included in adequate quantities in the average customary diet.
10. The health problems therefore are those of a major port and industrial centre in which there is an unprecedented density of popula- tion. The population increase that has taken place over the past ten years has far outstripped the capacity to provide, within a short period of time, housing, water, sanitary services, schooling and medical care to accepted modern standards. Accordingly, it is against a background of overcrowding and, as yet, inadequately developed environmental health services that the work of the year has to be assessed,
ADMINISTRATION OF THE MEDICAL AND HEALTH SERVICES
11. Statutory responsibility for the administration of the services safeguarding the public health in Hong Kong Hes mainly with the Director of Medical and Health Services, the Urban Council, the District Commissioner Now Territories and the Commissioner of Labour. Executive functions in connexion with curative medical services and a number of aspects of preventive medicine throughout the Colony are the responsibility of the Medical Department. The Urban Council is concerned with environmental sanitation in the urban areas of Hong Kong and Kowloon through the Urban Services Department, The District Commissioner has executive functions as the Health Authority for the New Territories and administers its environmental sanitary services. The Labour Department has an Industrial Health section staffed by officers of the Medical Department. Similarly Medical and Health Officer personnel are seconded in an advisory capacity to the Urban Services Department and the District Administration, New Territories.
STAFF
12. The Director of Medical and Health Services is the Head of the Department, the chief adviser to Government on medical and health policy, and an official member of the Legislative Council. He is a member of a number of the Boards and Committees of voluntary organizations engaged in medical and health work whose activities receive substantial support by way of Government subventions. He is also the Chairman of the statutory Boards dealing with the registration
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