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K. DEVELOPMENT OF THE PUBLIC HEALTH ORGANISATION IN THE BRITISH ARMY.
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L-PROPOSALS FOR A SANITARY ORGANISATION
FOR GREECE.
In 1886 Lord Wolsey wrote- "The Sanitary Officer as a general rule is a very useless functionary. In future so long as this fad continues my recommenda- tion is to leave him at the base.
Following this lead the Combattant Officers treated the Army Doctors as a class which must be endured but which ought not to be encouraged. The status of the Army Medical Officer dropped and with it the recruitment of suitable men. The corps became poor in quality and insufficient in quantity. The more it went down hill the more if lost prestige with the Combattant Service and the more difficult be came the organisation and control of measures for the prevention and cure of dis- ease. The vicious circle or rather the vicious spiral continued until it was found impossible to fill the establishment. Doctors refused to join a Service where they were looked down on by those who had been fellow students in school and in college. The blame was placed on the British Medical Association for not encouraging its members to join when it should have been placed on the shoulders of those who considered themselves the senior service, and who refused to recognise the just claims of the Medical Officers.
The South African war showed the folly of this policy. In an average army strength of 208.000 there were in two and a half years 58,000 cases of Enteric with 8,000 deaths. There were 7,000 killed in action. The incidence rate was therefore 110 per 1,000 per year and the death rate was 15 per 1,000 per year, among a body of carefully picked men operating in what is generally considered to be one of the most salubrious districts of the world.
After the war every effort (except that of offering proper status and pay) was made to stimulate recruiting. Officers visited the various medical schools and univer- sities landing the advantages of the service but with little result. Good men would not join.
At last radical changes were made. The corps was created a Royal Corps, its Officers were given full military rank and titles and equality with the Combattant Officers. Competition for admission became active, and the establishment became complete.
During the Great War on the Western Front with an average army strength of 1.250.000 there were in four and a half years 7,500 cases of Enteric" with 266 deaths. The incidence rate was 1.33 per mille per year and the death rate 0.048 per mille per year.
Prior to the war sanitary work has been carried out by the Regimental Medi- cal Officer. During the war as the need for specialisation became more apparent the separation of the Medical Corps into Sanitary and Clinical Units became more and more complete.
At the close of the War it was realised that a re-organisation was necessary to allow for the differentiation of duties required by the development of medical science and to ensure the proper promotion of those men who desired to specialise in the important branches of Hygiene and Pathology. The Service was therefore divided into three branches, the Hygiene Branch, the Pathological Branch, and the Medical Branch, each under its own Director and all under the general supervision of the Director General of the Army Medical Service This is the organisation as it is to- day.
Dipreco.
League of NATIONS HEALTH ORGANISATION,
Collaboration with the Greek Government in the Sanitary re-organisation of
The Under Secretary of State for the Greek Government in a letter to the Medical Director of the Health Section of the League requests the assistance of the Health Organisation of the League in the sanitary re-organisation of Greece.
League declares its willingness to help and proposes that its President and permanent Vice-President together with Professor Leon Bernard, Sir Geo. Buchanan and the Chairman of the Malaria Commission should hold themselves at the disposal of the Conneil of the League of Nations and the Greek Authorities to give assistance if so desired in the matter of carrying out enquiries and giving advice.
The League sent to Athens to make surveys as a foundation for advice :—
Dr. Rajchman Medical Director of the League.
Prof. Haven Emerson of the University of Columbia.
Dr. Allen McLaughton of the U.S.P.II. Service.
Dr. C. 1. Park of the Australian Commonwealth Health Service. Prof. B. Boric Director of the Institute and School of Hygiene Zagreb, Dr. M. D. Mackenzie of the Health Section of the League Nations
The president and permanent Vice-President of the Health Committee. Sir Geo, Buchanan, the Chairman of the Malaria Commission and Prof. Pittaluga Pro- fessor of Parasitology of the University of Madrid and member of the Malaria Com- mission went to Athens and met the survey committee on April 7th, 1929.
Extract RECOMMENDATION OF THE COMMITTEE.
Satisfactory results cannot be obtained from any mere expansion of the pre- sent system or lack of system. The Public Health Service to be effective must be arranged on a new basis.
The technical personnel of the P.II. Service whether working in the centres or the provinces should consist of men thoroughly trained in modern methods of pre- venting disease and in the modern practice of hygiene.
tors.
The Public Health Service should have Sanitary Inspectors and Health Visi-
The establishment of new technical services and of a School of Hygiene is essential
At first experts from abroad are necessary.
Greek Officers should be sent abroad to study pending the completion of the School of Hygiene. Hospital nurses and sanitary inspectors should start training now.
A nucleus of the permanent Hellenic Health Service should be started at the earliest practical date. It should consist of a School of Hygiene and new technical service at the Centre (Athens) and in the province of the personnel responsible for the areas selected for the scheme.
There should be a Central Sanitary Administration to which should be trans- ferred those central services which at present are included in other Ministries It should be an under secretariat of health under the Prime Minister.
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