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found to exist, which at that time were considered to be insurmountable, but he (Dr. Clark) now thought the time had arrived when, they should secure registration, and having once secured that, then he would suggest the payment of a small fee to the midwives, say of 50 cents, for giving notifica tion of births, and the infliction of a penalty on those who failed to notify any birth to the proper authorities. If any midwife could be proved to have attended a birth of an infant, and not, within, say a fortnight, given notice of it, then, he (Dr. Clark) thought a penalty should be inflicted. That would go in some way towards enabling them to exercise some sort of supervision over the infants in the Colony. At the present moment they had no supervision, cr any exact particulars as to the number of births or deaths. The infants were handed in to the door of convents and received with thanks if they lived they were christened. He thought they might without bringing the power of the law to bear, ask or urge the convent people to give them particulars of the children they received, and, he thought, in some cases, legal proceedings might be taken against the parents where neglect could proved. He (Dr. Clark) had suggested in his annual report for last year that the bodies of all persons who died in the con- vents should be sent for proper medical examina- tion. Many of the infants were brought in, in a moribund condition, and the doctor was not in a position to say what it was suffering from. If a proper examination was made they would be able to prove their statistics, and in some cases be in a position to proceed against the parents for criminal neglect. Those were the sugges- tions which he had to make, and he was prepared to move :
(1) That no person be permitted to practice as * midwife in this colony without a licence from the Registrar-General.
(2) That a small fee be paid to midwives for every birth reported by them to the Registrar- General.
THE HONGKONG WEEKLY PRESS AND
(3) That the Board recommend the Govern- ment to obtain the services of some three or four female visitors whose duties should be to visit Chinese family houses of the poorer class, and exercise some supervision over the care of small infants.
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He (Dr. Clark) might say in connection with these poorer classes that they welcomed the visits of women far sooner than they would a Sanitary Inspector in uniform. The recent lamentable accident has showed how scared the Chinese became on the arrival of an Inspector in uniform in their buildings. The female visitors would dispense with all uniforms. They could go round as a sort of "District Visitors, such as they did at home, and he was quite sure they would do a great work among the poorer Chinese. Again he would move:- (4) That the convents be required to keep a register of all infants received by them, and to obtain as much information as possible con- cerning them.
(5) That the bodies of all persons dying in the convents be removed to the public mortuary for medical examination.
Dr. BELL remarked that there was a great difficul'y about defining midwives. What was a midwife in China? Did they consider any body who came along and took out a certificate
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■ midwife? Immediately they sanctioned that kind of thing they would constantly come scross cases in which there were some trouble, 28 thoss
people had no training, and when they happened to be prosecuted, and they got into the box, and said "We did our best, there would be no result. The trouble was to define a midwife, for they had no place to train them in Hongkong. Some cases which had come under his notice were too awful for words. That was the trouble in England, how to define such women. Once they licenced people of that sort, the so called midwives would run about and do as they liked, saying, they had their licenos to do it it would not benefit the Chinese, as far as midwifery was concerned.
Dr. CLARK thought that question did not Brise. Whether they called them midwives or nurses, he did not care. Any person who attended in any shape or form upon any other person within ten days from childbirth would be able to give them additional information, They did not want to recognise midwives who
(May 20, 1901.
had no training; they were thinking of the | death-rate was 8.1, per 1,000.- infants after they were born.
the coloured races was quite su kole
Mr BREWIN Why not make the mother and father responsible 7
· Dr. CLARK—We do!
Hon. F. H MAY said that the resolutions covered such a lot of ground that he thought it would be well to refer them to a sub- committee. There was one thing, it was against the law of the Colony to put a dead body at the door of a convent, or anywhere in the public streets, and at the present time there were a number of their gallant defenders assisting goodness knows how many police to prevent that being done. And, not withstanding that, there they were, with the full knowledge that it was being done, looking on smiling at it. He did not see why they should do so. There was a law against any person removing a dead infant from a house, and it was also an offence against the law to deposit a dead body in the street. He moved that the resolutions be referred to a sub-committee consisting of Dra. Bell and Clark, and Mr. Fang Wa Chuen.
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The motion being seconded, was put to the Board, and carried, Mr. BREWIN adding that instructions might be given to the sub-com- mittee to find out what steps the Government were taking to deal with the question, for Dr. Hartigan had stated that he had some years ago funished a report to the Government on the whole question.
THE "HEALTH REPORT.
The Secretary read the following minute from the Colonial Secretary on the subject of the Healh Officer's report for 1900 :—“ The Medical Officer of Health reports that the deaths among Chinese from chest diseases was heavier among the boat population than on land. This does not agree with the following paragraph in wi ich he emphasises, in the some what sensational manner in which this report has been prepared, the statement that the pro- portion of deaths from respiratory diseases which is stated as 51 per 1,000 is intimately associated with overcrowded and insanitary dwellings. I find further that, as shown in the appendix, the deaths from respiratory diseasA among the non-Chinese was 5.69 per 1,000. I should like to have an explanation of this.”
I
A letter from Dr. Clark in reply to this minute was submitted, in which the Medical Officer of Health said that "The number of deaths of Chinese from phthisis was 845 or 61.4 per cent. of the total deaths from the respiratory diseases. That phthisis was intimately associ ated with overcrowding, and insanitary condi- tions had been established beyond any possibility of doubt, and the mortality figures of the Colony bore out the statement.
LT3
17
"
71
1
To deal first with the different nationalities the deaths from phthisis last year were as follows:- Army, 2
out of a population of 2,568 Navy, 1
3,110 Mercantile marine, 5
990 Resident civil community, 20
8,140 The cases from the mercantile marine could not fairly be regarded as of local origin, being persons who were unable to proceed further on their journey, and were constantly left here by steamers passing through the port.
+6
+
a
Twenty deaths, therefore, remain out of population of 8,140, which represents a phthisis death-rate of 2.45 per 1,000.
**
for, in his (Dr. Clark's) opinion, by the Lect that many of the Chinese return to their native homes in the immediate vicinity when they are dying, whereas among the coloured races the Portuguese practically know no other home than that, and the Indians after protracted illness were unlikely to be able to meet the expense of journey to India. Dealing now with the ques tion of the higher phthisis death-rate among the Chinese bost population than amon
among the Chinese land population, Dr. Clark said he was of opinion that that was readily accounted for by the greater overcrowding which occurred among the former at night, for it must be remembered that except during hott.st period of the year
the boat population slept in the holds of the s small boats, or in the small cabin under the poop (in the case of cargo boats). That sleeping room would comprise from 250 to 300 cubic feet of air space, and would contain three or four indivi- duals which he (Dr. Clark) was sure was greater degree of overcrowding than existed even in the coolie lodging-honses on shore.
64
That was no new theory as to the causation of phthisis by overcrowling on shipboard, for precisely the same conditions prevailed in the old mercantile marine, and the same results followed, and it was only of recent years that the improved sanitary condition of the fore- castles of merchant ships had led to a reduction in the mortality from phthisis among the sailors
14
He (Dr. Clark) therefore submitted
(1) That phthisis is intimately associated with overcrowding and insanitary conditions.
**
(2) That the greater amount of phthisis among the boat population than among the land population is occasioned by the greater degree of overcrowding to which they are sub- jected at night.
尊苗
(3) That phthisis exists among the coloured races in this Colony to at least as great an extent as among the Chinese, because they live nnder the same sanitary conditions.”
The correspondence was Isid upon the table,
THE ERECTION OF PUBLIC BATHS. The SECRETARY read a minute from His Ex- cellency the Governor in which the opinion was expressed that among possible preventives to disease public baths were of great and pressing importance. His Excellency added that he had directed the Acting Director of Public Works to erect matsheds in various parts of the Colony, and he thought they were equally necessary at Hanghom and Kaumati, and the people should have an opportunity of washing themselves with hot water. He had also requested the D.P.W. to give an estimate of the cost in order that a Financial Minute might be
prepared. He had no doubt that the committee would approve, but the matter was pressing.
LIMEWASHING.
fort The limewashing return for the pas night showed that 2,235 houses had been cleansed...
THE HEALTH OF THE COLONT. The mortality statistics for the whole Colony for the week ended 27th April 1901, was reported to be 23.0, as against 26.3 for the corresponding 29.1, as against 23,8 in the corresponding period week of last year. That of 4th May, 1901, was of last year.
HEALTH OF MACAO. SUN It was necessary to enquire somewhat further into the nationalities of the deaths, when it
Dr. CLAFX-reported to the Board that p would be found that the 20 deaths were made was increasing in Macao. The ordinary death up as follows:-Portuguese, 8; Indian, 6; Japan-rate in the Portuguess Colony for the week ese, 2; British, 1; French, 1; Norwegian, 1; American, I. So that ont of a total of 20 deaths, only 4 occurred among the white population.
46
The white civil population numbers... 3,702 “The coloured civil population numbers 4,438 “Therefore the phthisis death-rate among the white civil population was 1.08 per 1,000, and comprised -1 British merchant from Manila, I French missionary, 1 Norwegian carpenter, (almost certainly a ship's carpenter, although not returned as such), and 1 American barmaid (alcoholic excesses being another important factor in the induction of phthisis, especially among women),
**The phthisis death-rate among the coloured civil community was 3.6 per 1,0 0, and these people live under precisely the same sanitare conditions as the Chinese, among whom the
ended 4th May, 1001, was 29.1. There were 17 deaths returned from last week. They could insist upon medical inspection of all arrivals from Macao.
little
Dr. BELL remarked that scarcely any one left Macao feeling ill; they preferred to stay there rather than leave for Hongkong. Hə had had some experience of that. For two years he had put the passengers coming over in line, and had examined them with result, for he never saw & He did not see the medical examination. and Canton. It absolutely no use
The Hon. F. H to overhaul, but all the junks not only the Hew
that
rould have