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Numerically speaking, both dysentery (1,071 cases, 340 deaths) and typhoid (539 cases, 187 deaths) were of considerable importance from the public health standpoint and provided yet another index of the unsatisfactory health conditions prevailing in the overcrowded city.
Diphtheria (319 cases, 147 deaths) fortunately did not assume epidemic proportions at any time.
(Owing to the invasion of Kwangtung by Japanese forces it became impossible to transfer lepers to the settlement at Shek Lung and by the end of the year the number of inmates of the premises adjoining the Infectious Diseases Hospital at Kennedy Town had reached the figure of 133)
Two important decisions were made regarding the leper question during the year. Firstly, arrangements were made whereby the Catholic Mission received financial assistance to build accommodation for 200 lepers, to be increased to 400 in due course, in order to permit of the transfer of lepers from Hong Kong to Kwangtung, there to be maintained at the expense of the Hong Kong Government.
Secondly, legislation was enacted which gave the Director of Medical Services control over the inmates of the small settlement in Hong Kong, since these persons had been too little subject to discipline previously. Being able to wander at will they not infrequently committed felonies and misdemeanours both inside the settlement and in the town. A ruling was given by Government in this connexion, during the year under review, that convicted lepers should be detained in a special portion of the Prison built for the purpose. Under the former system, lepers who committed even serious felonies were duly convicted, sent to prison, but immediately released to the leper settlement.
However important the diseases already mentioned may be, and indeed are, both individually and in the aggregate, their importance is completely overshadowed by the tuberculosis problem which caused the death of 4,920 persons during 1938.
For every death it is probable that there are five or even ten sufferers from the disease, many of whom are at the moment passing on infection to their families and neighbours.
With the bulk of the population living in grossly overcrowded, ill-ventilated tenements, many of them workless or in receipt of wages which cannot possibly purchase an adequate dietary, exposed to mass infection owing to the universal habit of spitting and to the low standards of hygiene and ignorance of the mode of infection, it is not surprising that this disease claims such a heavy toll of life.
The line of attack against the disease has included the following measures: the appointment of a Nutrition Research Committee, the appointment of a Housing Commission and the drafting of town planning and zoning legislation, the appointment of a Labour Officer to investigate conditions of work and wages, the increasing of facilities for the discovery, isolation, education and treatment of cases, the education of the general public through the Press and wireless broadcasting system, and the expansion of the Health Services to enable better control to be exercised over domestic and municipal hygiene.
Additional preventive measures are contemplated in regard to the more adequate provision of hospital accommodation for "infectious" cases and to compulsory notification.
The question of a tuberculosis survey is under consideration and 10,000 doses for the Mantoux test together with the necessary syringes and special needles have already been obtained.
Venereal diseases are responsible for much ill-health both amongst the population and amongst the naval and military forces.