I have also interviewed Sister Lily Poon, applicant for the remaining fellowship. She speaks English well and has some tuberculosis experience. Although officially a sister, she is in effect the assistant matron of the Infectious Diseases Hospital, The Director of Medical Services has put her forward as a suitable person to have a UNICEF fellowship, and I agree.
Evaluation of the Project
The existing facilities, plus WHO/UNICEF aid and Government matching, constitute a balanced programme which is more satisfactory, relative to the size of the problem, than is found in most other territories I have visited. This does not mean that it is adequate. In my opinion, it never will be so in the foreseeable future, because the more the facilities are expanded, the more sick people will tend to infiltrate into Hong Kong from South China to obtain the free treatment they cannot get elsewhere. This/afready happening. From my conversations with the Acting Governor and the Director of Medical Services, two things seem certain: firstly, the population is not increasing.... if anything, it is diminishing owing to refugees returning to South China; secondly, the number of sick persons, for whom Government is responsible, is going up and up. This especially applies to con- sumptives, lepers and the occupants of mental hospitals. The Govern- ment are unable to take effective measures to deal with this, so that we can only expect the situation to become still more unbalanced, more especially as the Chinese have shown an increased partiality for Western medicine in recent years.
For these reasons,
I advocate that further consideration should be given, both by Government and by WHO/UNICEF, to the prevention of disease.
This can be done in several ways:
(1)
(2)
(3)
(4)
More hygiene and public health propaganda. We know that the Chinese can be much influenced by this, as shown by the success of small-pox vaccination (I am informed that there is less small- pox in Hong Kong than in England!), by the results of the "Do not spit" campaign, and the remarkable way the Chinese mother has taken to the midwife trained in modern methods.
There is the nucleus of a health propaganda service, under a doctor of excentional initiative, but he needs equipment and staff. I am writing a separate communication to you on this subject which has, in my opinion, great possibilities. This nucleus could be expanded into a service for the whole Cantonese-speaking area, because a local leader of unusual drive is ready to hand.
B.C.G.
Cases of tuberculous meningitis in children are increasing; mordicates over, the age of incidence is getting younger and younger.
This a large reservoir of massive infection, and I suggest that a BCG campaign among the infants and children might be undertaken, with WHO/UNICEF assistance.
The provision, later on, of a colony where the chronics, and the homeless and incurable cases, can be segregated.
Slum clearance, provision of better housing and raising of the standard of living are of first importance, but I am obliged to put them last as they are outside our control.
I Recommend:
(1)
(2)
That the Hong Kong setup approximates to a balanced programe and that the WHO/UNICEF Project should proceed as planned.
That the mobile clinic-dispensary should be dispatched as soon as
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