X
18
106
military and civilian camps. A school medical service should function again before the end of 1945.
K. Port Health Work
A general scuttling of shipping was most effectively carried out at the beginning of the. Pacific War. From this date, port health work ceased and was only carried out in a perfunctory fashion by the Japanese Forces during their occupation and then only in cases where ships were reported to be infected with cholera.
After the arrival of the British Forces in 1945; such port health work as was necessary was carried out by the Naval Authorities.
L. Summary
The period January, 1942 to August, 1945 was without doubt the blackest in the whole history of Hong Kong. Although the deaths from war injuries during the actual period of hostilities in December, 1941, were comparatively few (1,100 service personnel and about double the number of civilians), the deaths from violence and from starvation particularly in 1942, rose to appalling heights. During the Japanese occupation, the population fell from rather over one and a half millions to half a million. The invading forces made it clear that they intended to bring about a reduction in the population to this figure. They achieved their object but at what toll of pain and suffering!
The systematic starving of the bulk of the population over such an extended period-over three and a half years is likely to exercise a serious effect on the health of the community for many years to come, including an increase in the incidence of and deaths from tuberculosis. Hundreds of dwellings were destroyed by bomb, shell and fire during hostilities in 1941 and as the result of aerial bombings, but thousands of dwellings, and many valuable educational establishments (e.g., the University of Hong Kong, Kings and Queens Colleges etc.) were irreparably damaged by looters whose activities could have been stayed by the Japanese.
General hygiene (including water purification plants) suffered marked deterioration during the occupation of the Colony by a race which claimed to possess a higher standard of hygiene than any other in the world. The com- munity was deprived of most of its medical and health services, its chief hospitals being taken for Japanese troops, its maternal, child welfare and social hygienic clinics closed and vital preventive work against malaria neglected. There is, however, another side to an otherwise sorely depressing picture. The ruthless invaders have given the British an opportunity of proving to young China the sincerity of their belief in the policy not of eo called trusteeship (with its implication of superiority and patronage over an indefinite period) but of co-partnership in the reconstruction of a new and better Hong Kong.
The Pacific War has effectually "cleared the decks for action". It is the firm belief of the writer that the throwing overboard of the top hamper of vested interest, racial discrimination, and the cutting adrift of dead wood in the form of Europeans of mediocre intelligence, and lower ideals (replacing them by intelligent, highminded and unselfseeking Chinese determined to raise the low standard of the submerged nine tenths, and assisted by sym- pathetic Europeans who can make a very definite personal contribution to the community as a whole) will enable the ship to be steered int peaceful and happier waters.
31st January, 1945,
P. S. SELWYN-CLARKE, DIRECTOR OF MEDICAL SERVICES, HONG KONG.
19
APPENDIX I
Vital Statistics for Stanley Civilian Internment Camp, 1942-1945
Population at risk :-Average of 2,500.
I. BIRTHS.
Year
1942*
1943
II. DEATHS.—
No. registered
Rate per mille (uncorrected)
22
TO
13
6
8.8
4.0
5-2
3-6
1944
1945†
Year
No. registered
Rale per mille (uncorrected)
1942*
31
12'4
1943
18
7'2
1944 1945†
*40
32
16.0
12.8
III. MORTALITY AND MORBIDITY IN RELATION TO NUTRITIONAL FACTORS
107
In 1942, one death was recorded as due directly to malnutrition. In 1943, three deaths were attributed primarily to malnutrition. The figure giver for this year includes a death in Stanley Gaol which was, also, due to malnutrition and lack of medical care but does not include the deaths by execution in the prison of sever former residents of Stanley Camp In 1944, five deaths were recorded as being due primarily to malnutrition, and in thirteen malnutrition was a secondary cause. In 1945, six deaths were partly attributable to malnutrition and fourteen resulted from an air raid.
IV. INFLUENCE OF MALNUTRITION ON MORBIDITY.
Between March, 1942, when a special Nutrition Clinic was organised in Stanley Camp, and the end of the year, 725 individual cases of malnutrition came under notice, made up as follows:-
Nature of deficiency
Vitamin A deficiency
Vitamin B1 deficiency
Famine or protein oedema
Nutritional stomato-glossitis
Pellagra
Tropical macrocytic anaemia
Minor degrees of B1, B2, C, calcium and salt
deficiency
No. of individuals
219 338
I
6
161
Taking July, 1943, as a fair average, the following table indicates the distribution of nutritional diseases during that year :--
No. of individual cases
Nature of deficiency
Vitamin A deficiency Vitamin B1 deficiency-wet
-dry
Vitamin B2 deficiency
Total new cases
Total old cases
7
35
25
7፤
287
The ration gave a caloric value of approximately 1,600 at the beginning of the year and 1,500 at the end of the year. The important constituents included :—
protein, 45 11 gms.; fat, 20 19 gms.; carbohydrate, 298 44 gms. ; vitamin A, 10 347 i.u. vitamin B1, 132 i.u.; vitamin C, 73 mgs.; calcium, 0-2574 gms. ; iron, o 0127 gms.; phosphorus, 0.5116 gms.
* From 20th January.
† To 31st August.
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