32
12
At present no settled policy or organisation for anti-malarial work exists and the control work has been on a restricted scale and largely of an experimental nature. The existing organisation is entirely unsuited for any extension of malaria preventive work especially as it is endeavouring to discharge two distinct though closely allied functions, viz. :-Research and Prevention These two lines are equally important and it is now universally recognised that preventive work to be efficient and economi- ca! must proceed hand in hand with research. At the same time research demands complete and uninterrupted attention and it is therefore not feasible for any indivi- dual to conduct both research and preventive work simultaneously.
I would like to stress the vital importance of the last two sentences not mere- ly in regard to malaria but as regards all modern public health work. The Public Health Officer cannot succeed unless he can be guided and assisted by an adequate team of whole-time research workers able to concentrate continuously on their re- search duties. Equally the efforts of the research workers will be sterile unless there is a powerful, well supported, and independent Public Health Staff in the field con- timously engaged on public health work and on nothing else.
There is in fact no public health ordinance in Ceylon. The Medical Depart- ment has rightly been pressing for one for many years.
While the preventive Officers in the field must possess very large and very wide powers, it is essential in the circumstances prevailing in Ceylon that they should receive the intimate co-operation and support of the administrative service of Government, of the Irrigation Department, the Public Works Department, the Agri- cultural Department and the Education Department.
But apart from malaria work a great deal more should be done in the way of ordinary public and private sanitation. People seem satisfied with the most primi- tive, insanitary and dangerous latrine accommodation.
REQUIREMENTS.
1. A central Medical Research Institute.
2. An improvement in Medical Training.
3. Separation of the Medical from the Public Health Service, and an increase in the Sanitary Engineering Staff and more powers to the former.
4. Improvement of the pay status and recognition given to the Health
Service.
5. Increase in the Staff of the Pathological and Bacteriological Depart-
ments.
One feature in Ceylon is particularly worthy of consideration by the other colonies---The Director of Medical and Sanitary Services is provided with a lay ad- ministrative Secretary. This is a most valuable appointment and is the means of freeing the Director from a mass of detail and office work for his more important professional duties.
The housing problems in some towns particularly Colombo and Kandy leave a great deal to be desired. Here again it would seem that inadequate powers have been conferred by the Legislature on the Public Health Officers in regard to condemn- ing houses unfit for habitation or prohibiting the erection of insanitary and unsuit- able premises.
It would seem that in Ceylon there has been either ignorance or suspicion of modern scientific sanitary teaching.
light.
Every advance even the small provisions for malaria have been an uphill
I can only conclude that before public opinion in Ceylon condemns Western scientific methods they should be given a fair trial.
- 13
CHAPTER III.
THE HISTORY OF SANITARY EFFORT IN HONG KONG.
A review of the Sanitary History of Hong Kong reveals a series of attempts to produce a machinery which would secure for the community the essentials of a healthy existence and a series of failures to obtain satisfactory results. Each failure was followed by an enquiry conducted in some cases by experts from home, in others by Local Committees and Commissions. Each enquiry ended in a report with re- commendations which in the majority of cases brought about changes in legisla- tion. These changes incorporated some but by no means all of the recommendations made. The result in each case was a compromise and as so often happens in com- promises disappointinent followed.
As far back as 1859 the Colonial Surgeon said:-"Hong Kong presents no features either in climate or position which should make it peculiarly unhealthy. Because of its situation, its natural advantages, and its weather, Hong Kong should be, the best drained, the best watered, and in every way the best regulated of towns from a sanitary point of view". He went on to say "Ordinance No. 8 of 1850 makes it unlawful to construct or reconstruct a house without a sufficient water closet and ashpit to the satisfaction of the Surveyor General. Houses recently built have been allowed to be erected without the slightest regard to any one of these particulars. The fact is there is legal machinery enough to enforce any and every reasonable requirement and to ensure the sanitary condition of the Colony, but there exists an unaccountable objection to putting that machinery in action".
In 1882-Mr. Osbert Chadwick was sent out by the Secretary of State to en- quire into the questions pertaining to water supplies, drainage and sewerage, housing and general sanitation. Mr. Chadwick described the sanitary condition of Hong Kong as very defective and calling for energetic remedial measures. supply is inadequate, the buildings are defective in design and construction and more alleys, more lanes, more open spaces, and more open areas to houses are re- quired".
"The water
He said he was agreeably surprised to find that the Chinese viewed the sub- ject of sanitation with intelligent attention and that there was neither obstruction nor apathy. The principal objections raised by the Chinese to sanitation were:— (a) the fear of increased taxation, (b) the fear of squeeze by public officials. "The Chinese are a docile people. Once let them see that the Government is in earnest in sanitation and whilst giving facilities for and interfering as little as possible with their social customs, there is a firm determination to enforce cleanliness, there will be little or no obstruction especially if the orders of Government are promulgated in the time honoured custom of proclamations posted on the houses".
"I am fully convinced that with firm yet gentle management and a little con- sideration of the wants of the people, a great improvement in the general sanitary conditions might be speedily effected, and that far from receiving opposition or causing an exodus of Chinese it would meet with their approyal".
"The Sanitary Staff requires to be operated under the personal direction of a full-time officer, a responsible European who need not be either a doctor or an en- gineer, but who would receive instructions from both the Colonial Surgeon and the Surveyor General. These two cannot spare the time for personal attention to detail such as is necessary for success; their other duties prevent them”.
The Colonial Surgeon in his report stated that what he had advocated in pre- vious reports and been repeated by Chadwick. Referring to the Chinese he said :—
"Seeing the benefits, it is acknowledged they receive from British rule, is it too much to expect that they should be required to conform to British laws instead of British laws (against the interest of the British people) being made to conform to Chinese ideas".
لیا
33
No comments yet.
Private notes are available after approval.