C.A.A. Medical Branch
145
Hong Kong
QUARTERLY REVIEW
The incoming Civil Affairs Administration inherited a multifarious legacy of medi- cal problems at the cessation of the period of enemy occupation. During a period of close upon four years of Japanese control it would appear that most of the ordinary rules of hygiene had been in complete abeyance. Garbage and refuse of all descriptions had been allowed to accumulate in huge heaps in the main streets of the Colony, costly sani- tary fittings had been ripped out in a wholesale and senseless manner, drains were blocked, half a century of painstaking anti-malarial work had been undone by four years of almost total neglect, the reservoir filters (normally cleaned weekly) had never been touched, signs of malnutrition were rampant among the populace and both hospital and out-patient facilities were pitifully inadequate. The task of a simultaneously tackling each of these and many other problems was a gigantic undertaking, but it may be stated, in general, that a comparison of the state of affairs of the Medical Service of the Colony as it was then and as it is now demonstrates at once that some real progress has been made.
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The earlier work was carried out under three major handicaps:- first, the delayed arrival of several of the key members of the staff; second, the non-arrival of any of the carefully planned in-coming medical supplies; and third, the almost total lack of transportation. Preliminary visits of inspection often had to be made on foot, and only in recent weeks have the bare minimum needs of transportation been met. The medical and health institutions of the colony were found to be in a state of utter neglect. Build- ings constructed for a specialised purpose had been damaged and diverted to other uses with entire disregard to suitability or economy. Much of the apparatus and equipment of the hospitals had been destroyed in a senseless manner. Vital parts of such apparatus as remained had often been removed, and sometimes found again in the most unpredictable places.
A.
HEALTH SECTION
Infectious Diseases
There have been no epidemics of infectious disease, which is most fortunate as we are in no position to meet them. Hong Kong is in a particularly vulnerable posi- tion owing to its proximity to China and the fact that a number of major infectious diseases are endemic or epidemic in parts of Kwongtung and neighbouring Provinces, with which Hong Kong is normally in daily contact through mass movements of persons. going and coming for commercial and social reasons.
One of the most serious menaces to Hong Kong is the danger of Plague, especially now that the rat population has increased so alarmingly. Rats are now to be seen regularly in places where one would least expect to find them.
The danger of a cholera epidemic has been removed for the time being as this is not the cholera season.
So far only one case of smallpox has been notified but it is unfortunate that the vaccination campaign, planned two months ago, has had to be held up owing to lack of sufficient calf lymph. Smallpox is one of the diseases most readily pre- vented as vaccination is easily done and offers adequate protection.
The incidence of tuberculosis is believed to be very high as a natural conse- quence of years of undernourishment but there are no figures on which to base a scientific estimate.
Malaria
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Dr. J.B. Mackie resumed duty as Malariologist at the time of liberation but acted as "D.D.H.S., in addition, for several weeks owing to the delayed arrival of Lt.-Col. T.W. Ware, A.D.H.
In September, malaria was rife throughout the Colony. Not only had the Japanese neglected all the former anti-malarial drainage but all types of new breeding places for anophelines had appeared as a result of war-damaged or neglected roads, nullahs, drains, houses, sanitary fittings, etc.
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