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July 22, 1899 ]
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CIHNA OVERLAND TRADE REPORT.
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« I have the honour to request that 5; the certificated officers of the Liverpool staff the Banitary Board may at their next regular were 52 against Hongkong nil. So that whilst meeting take into consideration the desirability the population of Liverpool is about three times of arging the Government to appoint à pro- that of Hongkong, its sanitary staff is nearly perly qualified assistant Medical Officer of five times as large, and this difference in num Health for this colony. The almost annual erical strength is accentuated by the fact that recurrence of epidemics of bubonic plague and more than half the Liverpool inspectors are men of small-por has convinced me that further holding certificates frem the Sanitary Institute, medical assistance is essential in my department, and to quote the words of the report of the and that such assistance to be reliable cannot Liverpool Medical Officer of Health, are men be obtained, as in England, during an epidemic, "whose previous training and occupation have as an intimate knowledge of the habits and been such as to fit them for the special daties customs of the Chinese of the locality and of they are called upon to discharge,' whilst the the complicated and diverse public health laws Hongkong men are recruited mainly from the and by laws of the colony is essential to the Army and Police where their previous training due performance of the duties of such office. cannot count for much in the work they are set to This knowledge can only be acquired by a per- perform. I do not infer that the men whom we manent officer, and in my opinion it is most employ are, in the slightest degree, unfit to be desirable that such an officer should be obtained come inspectors, but I do say that if it be con- from England at as early a date as is prac-sidered necessary at home to engage only those ticable
who are qualified for the work, it is a thousand times more essential to do so bere on account of the trying circumstances under which they have to perform their duties. These figures show most conclusively that our sanitary staff is not only greatly undermanned as compared with that of Liverpool, but that the qualifications of oar staff are not of such a high standard as is deemed necessary in Liverpool. The difficulties connected with sanitary work at home must be small compared with Hongkong. There, the bulk of the population are persons whose intel- at present constituted is only just ligence and training enable them to appreciate sufficient for the requiremen's of the co- the benefits of cleanliness and thus lessen the lony in ordinary non-epidemic times. What work of the Authorities. Here on the other we require in epidemic times is a medical hand the mass of the people are absolutely officer who will be out and about the town near- callous to their surroundings--they prefer dirt ly the whole of his time supervising the work to cleanliness and their passive resistance, if of the inspectors, etc., searching for cases of not active obstruction, will always constitute a epidemic disease, and reporting all the nuisances formidable obstacle to sanitary reform. Our he finds. In ordinary non-epidemic times one climate, our difference of language, and every M. Q. H. in my opinion is ample for the ra feature connected with local sanitation, combine quirements of this colony, especially seeing that to render the inspector's work one of difficulty recently a chief inspector and two ordinary in-personal discomfort, and even danger, and I spectors of nuisances have been added to the staff"
The following minutes were appended : The President." What is required is the addition of a medical officer to the strength of the medical department. In that ease during epidemics au officer could be seconded to assist the MO. H.; eg., Dr. Lowson might be sel free for this work. He with his plagne exper- ience and energy would be just the man for special plague work, had we another officer to undertake his duties. As I have already pointed out to the Government, the staff
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maintain that if we are to get the place into a healthy condition we require a larger staff, a Dr. Clark-I think all the members of the better paid, better housed, and above all batter Board must admit that if any Medical Officer supervised staff than any town of similar size is to keep in touch with the sanitary work and at home. The work of inspection to be effectual sanitary laws of this colony he must be con- must be thorough, and to be thorough means stantly employed in this department. If the that every nook and corner, every drain, slum, medical department wants farther assistance it blind alley, courtyard, and every other disease should I think he obtained independently of the producing centre where human beings congre needs of the sanitary department. My applica-gate to sicken and die, must be visited at fre- tion had no bearing on the class of work done by Dr. Lowson during periods of epidemic-work for which he is peculiarly fitted and which could not be done better by any one-namely, the care of the infectious sick and the conduct of post- mortem examinations. This is not sanitary work as generally understood, though undoubtedly equally important. An assistant M.O.H, should Lave had some training in sauitary work at home; he should possess the D.P.H., and should devote his time exclusively to the services of the Board, so that he can at any time take up the threads of my work and carry on the malita- farious executive duties of this department. I am emphatically opposed to the proposal made by the President."
Mr. E. Osborne--"I am strongly in favour of adopting Dr. Clark's suggestion and think the assistant M.O.H. should not be attached to the Medical Staff, but should devote his whole time to sanitary work. We shall never rid the place of plague, nor can we hope to cope with the disease, until we have an adequate staff of qualified men for sanitary work alone."
The Hon. R. D. Ormsby-"I agree with the President."
The Vice-President-"The matter requires very careful consideration.”
Mr. OSBORNE said-The application of the Medical Officer of Health affords a fitting op portunity of considering the whole question of the sanitary staff, a staff which is, I think, admitted on all sides to be undermanned, and quite unable to keep pace with the growing requirements of the Colony, to say nothing of coping with the serious outbreaks of plague that recur with more or less severity each year. Comparing our sanitary establishment with that of Liverpool I find the following interest ing facts. In 1-98 the estimated population of Liverpool was 668,645 and that of Hongkong 254.410. The outdoor sanitary staff of Liver- pool numbered 97 and Hongkong 20 ; the indoor sanitary staff of Liverpool 22 against Hongkong
his short lease of life, how much not an intelligent community, such fess to be, guard and protect the publi and endeavour at all costs to acquire interests are damaged by these frequent to posterity a fair name for this colony.
emics of disease. Our industries suffer from scarcity of labour. Many of the Chinese put to an expense they can ill afford in movi their families to avoid the plague.” Our trade is curtailed every time we are. quarantine. The large coolie trafilo Straits plague and our progress and
at a standstill in
in
such disadvantageous circumstances.
course of time be jeop lised fore it behoves us to spare no expense providing ourselves with a sanitary staff wh minimum strength shall be capable of ensuring cleanliness through the City at all times, and to make whatever additions to the staff may be necessary to keep pace with the growth of the population. In connection with the application before us it seems to me most desirable that an Assistant Medical Officer of Health should be appointed, whose whole time should be given to the Sanitary Board, not only to assist in the general work of the Department but in event of Dr. Clark's absence, to take his Every man needs a change and even our defatigable Medical Officer of Health will quire a well earned rest before long and wo shall then have to fill his place by borrowing locum tenens, which considering the Import- ance of the office would not be a satisfactory arrangement. I therefore beg to move:
quent intervals by men whose intelligence and tact qualify them for the work and whose pay and position place them beyond the reach of those insinnating bribes which, if report speaks truly, are so freely offered by Chi- nese as a means of escaping from their obliga- tions. It may be said-Is there any necessity for this? Is Hongkong such an unhealthy town 13 to warrant the expenditure? Statistics tell us that the death rate here is practically the same as Liverpool, thereby pro- ving that we can get along well enough with our present staff. But statistics do not tell us that the total deaths at Liverpool in clude a large number of persons who are atttracted to its Hospitals and other medical charities, and the death of every stranger (to quote from the Liverpool report again) which occurs at those Institutions is included amongst the deaths of citizens and increases the apparent rate of mortality. In Hongkong the position is reversed; every Chinaman who can possibly do so leaves the colony for his home on the mainland the moment he falls sick, whilst of the Europeans and Chinese who can afford to spend their old age in retirement-how many. elect to do so in Hongkong? Hence our death rate loses its two most prolific sources of increase, viz., sickness and old age, and it would be interesting to know the comparative rates of the two places-Liverpool and Hongkong- were these circumstances taken into account. I think it would afford a revelation to those whỏ regard Hongkong as a haven of health. The intel- ligent individual, the sensible man, regards sound health as his most valuable asset his stock in trade so to speak, upon which in a great measure depends his future, and he guards that asset with the same jealous care and attention that a prudent man of business guards his capital. If then the individual values health so highly and sacrifices so much time and money, and prac- tices so much self restraint towards there quirement of good health and the extension of
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"That the Government be asked to appoint an assistant Medical Officer of Health from home who shall devote his whole time to the service of the Sanitary Board and that the Medi- cal Officer of Health be asked to draw up a brief report stating what other changes and addi- tions he considers necessary to the Sanitary Staff to euable it to effectually maintain the City-in a cleanly condition."
The VICE-PRESIDENT said that this was K big question. Mr. Osborne had given them some figures regarding Liverpool, but it was very difficult to compare the two places. He should not be surprised if one reason why they had a larger staff at Liverpool was the fact that the area of the city was so much larger than that of Victória. He had heard a com- parison made between the number of police per thousand of the population at home and the number of police per thousand here, but people who made such comparisons for got that this city was compressed in a very small area, and therefore did not require an many police per thousand of the population an English town which covered a much area. It was not 12 months since they mended an increased sanitary staff, and it not a fortnight since they received a specially qualified man from home, and he himself would like to wait a little and see what the effect of their new acquisitions would be before increasing the staff still further. He thought the whole matter required very carefully going into. - He had heard this city compared with Newcastle He believed their sanitary staff was now equal to that of Newcastle, which was a very large and important town. There must be some specia reasons for the enormous staff in Liverpo He begged to move that the question barefe to a committee of the Board for further con- sideration, and he would suggest as the sub- committee Mr. Osborne, the Medical Offeer of Health, and the President.
The Hon, R, D. OEMSBY seconded and the amendment was carried.
THE VOLUNTEERS FOR HOUSE TO HOUSE
VISITATION.
A letter was submitted from Dr. Clarks dated July 18th, was submitted. It said "I have the bonour to direct attention to, fact that the six gentlemen who have kindly volunteered for house to house, visitation have no official or legal locus view of the opinion of the Hon. Afto eral expressed in his minute tained in C. §. O. 1523/99, it necessary that they must be spectors of
nuisances.
not th
gentlemen of their standing in the would care to be so designated in the Gove ment Gazette, and in view of the fact that we
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