CO885-(2-3) — Page 198

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PUBLIC RECORD OFFICE

THE

Reference :-

C.O.885

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PUBLIC RECORD OFFICE, LONDON

6. Structure and sanitary state.

c. Internal economy.

+

Constitutions.

e. Supervision and reports.

GIBRALTAR.

T

8

external control. ii. It is the interest of the contracting keeper to retain patients for whom he is paid as long as possible, and to treat them as cheaply as possible. iii. It is competent to him, as it is his interest, to minimise the intervention and supervision of medical men. Such a system, indeed, excludes the idea of curative treatment.

There was formerly a hospital in Gold Coast, but it was closed in 1861, in consequence of the refusal of the people to pay the poll-tax, and has not since been opened.

The Somerset and 24. There are very general sanitary deficiencies. Albany hospitals at the Cape are the only instances of sufficient space and ventilation; whilst at the Robben Island asylum only 500 cubic feet, at that of Sierra Leone 603, are allowed to each patient. At the Greys hospital, in Natal, two patients are sometimes placed in cells containing 7184 cubic feet, which is insufficient for one, whilst the nature of the building prevents ventilation.

The Somerset, Sierra Leone, St. Helena, and Natal hospitals are provided with some artificial sewerage and drainage. Of the other institutions, five have no artificial arrangements of this kind. The usual latrines are holes over uncovered gutters, leading into adjoining cesspools, which are occasionally cleared by hand.

25. In only three instances is there a resident medical officer. The St. Helena contract asylum is without any regular medical attendance, the parish doctor visiting only when summoned by the keeper.

It does not appear that there is in these colonies any general numerical insufficiency of nurses or keepers, the service of native or other coloured attendants being easily and cheaply obtained.

There is in the asylums the usual want of employment for the insane. The managers seem to be generally incapable of devising any occupation for them except in menial services.

There is reason to believe that excessive and arbitrary use of seclusion and restraint prevails in the Robben Island asylum;* and at the two others, though excess is denied, no records are preserved.

26. The Albany and Port Elizabeth hospitals at the Cape are managed by boards appointed by the subscribers, in both cases without the intervention of resident medical officer. The other institutions are,

any

it

directed appears, by their respective medical officers, generally non-resident, under the control of the governors.

The regulations which are at present in force at the Robben Island asylum were framed when it was much smaller than it is at present, work very badly, and require to be altered.

27. There is an universal want of any proper system of visitation and reports. At the St. Helena asylum there are no registers or records of any kind.

28. In the hospital of Gibraltar the ordinary evils of government by a board are aggravated by the board in this case being composed of representa tives of subscribers of different religious creeds, whose jealousies divert the resources from the general good. The asylum is a part of the gaol.

• See Part IV., s. 84.

▼

9

29.—ComparaTIVE TABLE of Hospitals and Asylums in the Mediterranean Division (with

Africa).

+

Nam

of the Institution.

. In Associated Anentity. In Single Rooms-

Size of Cabic Feet of Space

tille

per Heel De

Superficial

Ares, and

Average Numbers under) Treatment at

of

Interval between Beds.

nhe Time

(or Annual

Jant

$.

Adaniasiona

GINKALTAL

ACTES.

Hospital

Asylum

146

GARNIA.

Hospital

441

Ik

SAKA LEONE.

Hospital

L

9,080

sq. ft.

I

|

700-900

1,120-734

Kamber of Medical Offers, nad whether Resident and Restricted

La Practice.

of Keeper.

Number of Nurse

Average Duration up Treatment.

100-40

HI

50

4w 5

2 resident, not re-

7

89 days

stricted

1,064

ยูง

IL

4 ft. interval

-

I resident, re-

stricted

+

Aaylanı

FIL

21+

HU

10

003 general average)

ST. HELENA. Hospital

Asylu

CAFE.

Somerset Hospital Albany Hospital...

14

1 I

31

1,900

|

ii!

restricted

2-14 ft. interval 505 from cases not resulent nor

Trosted 1862 GA

2 bol poulent for

tricted

-

3 ft. 8 in. 36-

14-27

B

terral

1 but readent not

restricted

Noue

4 fl. interval

3 ft. interval

664 admissions 1 resident and va

-

8 ཎྜ

168

a

$

1 resident and re- to palieris

$5 daja

666 day

2:2 days

No cares de

die larges

7

12 days

atrictex

90%-1,816

12

7 not rendent wor

J

21 days

restricted

Port Elizabeth Hopital Robbeti Liland Asylum ...

F

Dak

9 not revilent mar

4

-90 days

restricted

2.

500

40 months

stricted

VATAL.

Grey's Hospital Dastan Hospital

HI

Sometima

patient

130-8

113 grow cases 1 not resident nar

7

in 718 foet

30 days

+M

4fL interval

92 gross cracs 1 ud fraudent nor

restricted

restricted

9

51 daya

NOTE. No answer has been received from Malta, but from other sources of information it appears that a model hospital is in course of erection there. (See Miss Nightingale's Notes on Hospitals," p. 104.)

AUSTRALIAN AND EASTERN COLONIES.

30. Hong Kong falls under no natural group. The prominent defects of its two public hospitals are the usual ones of sanitary condition and super- The public

vision.

31. There remain Tasmania and the Australian colonies. hospital and asylum of the first are apparently faultless in every respect, except that in the asylum three wards are very deficient in space. Since 1860 the hospital has been under the management of a board of twelve members, appointed by and responsible to the Colonial Government. The asylum is administered by nine Commissioners appointed by the Governor.

32. Of the Australian colonies, Victoria and Western Australia have furnished accounts of the condition of six public hospitals and two lunatic asylums. In this case, as in the other colonies generally, the asylums are inferior to the hospitals, not only in matters belonging specially to their particular province, but in the common requirements for sanitary and economical efficiency.

33. The four Victorian hospitals appear to be supported chiefly by private endowments and subscriptions. They are managed liberally, and are objects of general interest. The Yarra Bend asylum in Victoria, and in Western Australia the Perth hospital, appear to be supported by the colonial Governments; whilst the Fremantle hospital, and, apparently, the asylum at the same place, are portions of the convict establishment.

HONG KONG.

a. Funds.

34. The Melbourne and Fremantle hospitals alone are sanitarily efficient. 6. Structure and Of the rest, the Geelong and Castlemaine hospitals, and notably the two sanitary state. asylums, are very deficient in space. Geelong, Ballarat, Perth, and the Fremantle asylum have no proper sewerage or drainage, the last being also without baths or lavatories. There appears to be only a single latrine provided with water in the whole three-quarters of a mile over which the buildings of the Yarra Bend asylum are scattered.

35. The internal economy of these institutions seems to be generally c. Internal satisfactory. The Perth hospital and Fremantle asylum are the only ones economy. without a resident medical officer, and the staff of attendants is ample in all

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