28
2
(c) Reserve. The authors of the scheme very rightly realised that, though the estimates had been prepared with the utmost care, it would be necessary to create a reserve for "Unforeseen the amount of which they fixed at 380,000 francs.
ง
In the Supervisory Commission's view, such a sum would not be excessive. Furthermore, it should be left to the Secretary-General to decide when, and in what circumstances, the reserve may be drawn upon within the limits of the scheme.
ANNEX.
ANTI-EPIDEMIC PLAN DRAWN UP BY THE SUB-COMMITTEE OF THE
HEALTH COMMITTEE.
The terms of reference of the Sub-Committee, in conformity with the resolution of the Council of October 5th, 1937, consisted in drawing up, with the least possible delay, a plan to assist the Chinese Authorities to organise a campaign against epidemics.
In fulfilment of this mandate, the Sub-Committee was inspired by the following guiding principles:
1. The plan has been based on the utilisation of a credit of 2,000,000 Swiss francs and its execution should not entail, directly or indirectly, expenditure in excess of this sum. It has been found necessary, therefore, to provide a sufficient reserve to ensure the execution of the work and its development, as circumstances may require. This reserve has been approximately established at 350,000 Swiss francs.
2. The Chinese Authorities themselves would assume responsibility for the work's being carried out. The technical plan to be elaborated has as its one object the reinforcement of the technical collaboration already existing, and this in view of the unexpected and exceptional circumstances of the hour; in other words, to advise and support the competent Chinese technical services.
3. The plan has been based on previous experience, and at the same time adapted particularly to present conditions and local necessities. In this connection, the Chinese Government and the Health Section have given useful indications concerning the conditions on which the plan should be based and the particular needs which should be met.
4. In accordance with the findings of the Assembly, the work to be carried out must be limited as regards geographical area and the methods of action employed; that is to say, in view of the enormous extent of the territory and size of the population, it is necessary to avoid too great a dispersion of the staff and material which would tend to prevent homogeneous and co-ordinated effort. This does not imply, however, that the effort should be strictly limited to one region.
In view of the above considerations, the Sub-Committee believes that the general organisation to be set up should provide a technical staff of wide experience and of adequate material. It should be of sufficient elasticity in action, so that it can be divided up should circumstances render it necessary. Finally, the organisation should have sufficient mobility so as to be able to move its constituent units rapidly.
Furthermore, the scheme cannot be based solely on prophylactic action. Provision must necessarily be made for measures against existing epidemic foci; the isolation of suspected cases, their observation and facilities for precise diagnosis,
The best method to attain this end consists in the establishment of mobile units adequately staffed and provided with the necessary technical equipment and emergency supplies.
The action of these units should be reinforced by a general stock of sanitary and medical material placed under the control of an administrator; each unit should be able to draw on this stock according to its needs and available supplies. This stock should enable the mobile units to be furnished with additional supplies for organising out of local resources the means for the isolation and observation of the sick.
A mobile unit should be based on:
1. Staff
An Epidemic Commissioner, leader of the unit;
a specialist medical officer in epidemiology and bacteriology;
a sanitary officer;
a medical organiser of area units;
an assistant (locally recruited);
a mechanic (locally recruited).
2. Material: A prophylactic unit provided with the necessary apparatus for bacteriological diagnosis (laboratory), for delousing (mobile shower-baths), for disinfection, for disinsectisation. This unit should be provided with drugs, vaccines, sera and emergency supplies. This equipment could be strengthened from the general stock according to needs.
3. Transport: Twelve motor cars or light lorries.
*
EX
*
It is important that the legal status of this personnel be clearly defined in view of the conditions under which they will have to carry out their work.
―
Having regard to the available funds, the Sub-Committee note that it is possible to constitute three such units and to assign an area of action to each unit.
Around these units, and in accordance with their recommendations, the Chinese Health Authorities will be able to concentrate, based on a considered plan of health organisation adapted to the region and to current necessities, their own medical and health organisation as well as such units as may be sent from abroad (Red Cross, etc.).
In this way, a coherent and co-ordinated action may be realised within the limits of the credits voted by the Assembly, developed and adapted in the course of time to the changing circumstances, under the responsibility of the Chinese Government. This organisation could form a nucleus around which any further assistance from other sources that may be offered to the Chinese authorities could be grouped according to needs and under well-defined conditions.
Finally, the Sub-Committee considers it essential to establish in China an Epidemic Commission consisting of the Head of the Chinese Health Administration, of the Technical Adviser of the League of Nations to that Administration, and of the three Epidemic Commissioners.
This Commission would ensure the necessary co-ordination between the component elements of the Health Mission of the League of Nations in China, as well as between the three Commissioners, the Chinese Administration and the League's Technical Adviser.
The Commission would send periodically technical reports to the Secretary-General in order that the development of the Mission's work in China may be followed.
One Epidemic Commissioner
One physician bacteriologist.
One sanitary officer.
Estimated Expenditure
A. COMPOSITION OF ONE UNIT.
1. Staff.
One medical organiser of area centres One assistant (locally recruited).
One foreign mechanic (locally recruited)
Insurance:
One Epidemic Commissioner
100,000 Swiss francs
Swiss francs
40,000
30,000
30,000
30,000
20,000
8,000
158,000
One physician bacteriologist
One sanitary officer
at 8,000 Swiss francs X 4
32,000
One medical organiser
One assistant, I mechanic (50,000 Swiss francs at 4,000 Swiss francs
X 2}
8,000
40,000
Transport to and from China:
Epidemic Commissioner, physician bacteriologist, sanitary officer,
physician (6,500 Swiss francs X 4)
=
26,000
26,000
224,000
2. Supplies.
(1) Mobile delousing apparatus
6,250
(2) Two mobile preventive laboratory units
11,000
5,000
88,750
3,000
66,000
180,000
3. Transport.
Twelve motor-cars or light lorries and spare parts Maintenance of cars (twelve at 3,000 Swiss francs per annum)
60,000
36,000
96,000
Carried forward.
500,000
(3) Portable shower baths and delousing tent
(4) Medical and sanitary equipment, including transportable
accommodation
e.g., tents.
Supplementing local resources for anti-epidemic work for twelve months. Lighting equipment and upkeep for twelve months. Supplies for one mobile prophylactic unit, for twelve months:
Soap, clothing, vaccines, sera, quinine, medicines, tinned
milk, etc..
(5)
DO
SQ
29