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routine requirements are not available. For example, Col. Fehily has ready an ample team of vaccinators but at present they are idle because there is no vaccine lymph. A similar position exists in regard to equipment and textiles. Anything that can be done to hasten delivery of outstanding indents should be done and special priority given to any urgent requests from Col. Fehily for individual items.
3.
Prevalent Diseases and Means of Control. The three predominant diseases in Hong Kong are malaria, pulmonary tuberculosis and venereal disease.
The malaria situation has been alarming but is now well in hand. It is antici- pated that a nearly normal situation may be restored by the early spring although there will be considerable outbreaks of malaria in the interval. No meapcrin supplies, except those obtained from the Servicos, are available and this handicaps measures of control. The Malariologist has much work in hand and is being helped by the Service authorities. He requires to be relieved and it should be seen that
his relief is on the way.
Pulmonary tuberculosis is always with the Chinese but is worse than ever at the present time. It is impossible to ascertain the amount but evidence shows that privation has brought about a large increase. Other contributing factors are the conditions of housing and the universal spitting habit of the Chinese. The situation is a serious one and a qualified officer should be sent out to investigate and report. Meanwhile, methods of early diagnosis, including the provision of a mass radiography transportable apparatus, should be made available as a matter of urgency. The question of providing sanitorium accommodation for pulmonary tuberculosis cases so that they may receive the best care in the early stages of the disease comes within the purview of the officer sent out to investigate; there is none at present. The questions of overcrowding and bad housing conditions are referred to later.
Venereal disease is invariably a post-war problem. There has been a material increase in the Colony, both on the mainland and the Island. There has been a noticeable number of dual infections and the ratio of gonorrhoea to syphilis is now about equal. The great shortage of drugs handicaps the staff, although people are coming in freely for treatment. Col. Fehily has requested the services of a V.D. specialist officer to ensure best methods of treatment. He has just learnt that a specialist officer is being sent out but the person chosen can hardly be considered of sufficient standing to advise with authority on this problem; and the services of a really first class officer should be secured. Intensive treatment cannot be employed at present owing to lack of hospital beds.
a
Malnutrition is fairly prevalent though few frank deficiencies are apparent; state of sub-nutrition is, however, widespread. With the better availability of various foodstuffs nutrition should improve. There is much anaemia and this is often associated with malnutrition and other conditions such as ulcers and helminthiasis. All these, too, should improve with better feeding and treatment. A limited investigation into the state of nutrition of certain groups of the population is being undertaken and the results will be related to wage earnings with a view to providing an equitable wage to maintain a reasonable standard of living. These results will be prejudiced somewhat by the changing conditions that prevail at the present time. Research into nutritional problems should be continued and encouraged in every way possible, and meantime a watch should be maintained on the nutritional state of the main groups of the population.
There is a high incidence of physical disability in the Colony, much of which could be relieved. An orthopedic specialist should be sent to the Colony to report on the extent of the problem and advise suitable measures to deal with it.
In view of the high incidence of children diseases, the services of a Medical Officer with special training in paediatrics should be available permanently to the Colony.
4. Medical Institutions. The position is complicated by the fact that a certain amount of hospital accommodation has been wiped out, or requires to be reconditioned before use, and that the Services have been allotted a considerable number of beds that belong to the Civil Administration. A Committee sitting in Hong Kong in 1939 recommended the target to be aimed at should be five beds per thousand of the population for general purposes, Col. Fohily gives a present figure of 3,785 beds for all civil purposes, but this implies recovery of the beds
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