1930-02-19 — Page 7

THE HONG KONG DAILY PRESS, WEDNESDAY, FEBRUARY 19, 1930.

PREVALENCE OF TÜBERCULOSIS IN THE COLONY.

MR. M. K. LO'S PLEA FOR PUBLIC SANATORIUM

AND DISPENSARY TREATMENT.

DEBATE AT SANITARY BOARD MEETING.

An important debate on the prevalence of tuberculosis in the Colony, and the need for Government provision of Sanatorium treatment, was initiated by Mr. M. E. Lo at yesterday's meeting of the Sanitary Board.

Mr. Lo quoted figures showing the extent of the disease in the Colony and emphasised that in Great Britain it was accepted, that consumption was curable and measures were taken which he would like to see made the model for Hong Kong.

After Mr. Braga and Dr. Koch had supported Mr. Lo, Dr. Wellington, while expressing very great sympathy with Mr. Lo's aim, pointed out various difficulties, in applying recognised samatorium treatment to Chinese patients, and moved an amendment expressing the Board's concern at the prevalence of the disease and calling upon the Government to consider measures to make conditiong of residence less likely to cause tuberculosis, and to provide an infirmary for chronic cases.

The Chairman, Mr. G. 1. Sayer, supported the amendment which was carried, after further discussion by four votes to three.

GOVERNMENT ASKED TO TAKE ACTION.

MR. M. K. LO'S PLEA. REVIEW OF DISEASE RAVAGES

IN HONG KONG.

Mr. M. K. Co,in moving the "motion, said:-Sir,-In connection with my work as Chairman of the Tung Wah, Hospital last year, I was very much impressed by the fact that there did not appear, to be any existing facilities for the treatment of tuberculosis cases along modern lines. There were numerous cases in the Tung Wah, which, on account of the lack of Accommodation, it was found im possible properly to segregate: I intended all along to bring this question before the Board for its deliberation in the hope that some-. thing might be done.

A LEAD FROM TSINGTAU.

be the common centre for the diag; | MR. J. P. BRAGA'S SUPPORT. nosis and for the organization of the treatment of tuberculosis in each area and that it should act as a clearing-house for and be link- ed up with

a system of sanatoria, schools, etc." hospitals, farm eoloaies, open-air

The functions of the tuberculosis dispensary, of which there are 133, 443 of these being provided by loca! authorities, are:-

(1) Receiving house and centre of

diagnosis.

(3) Centre of curative treatment and supervision, of domicili- ary.cases. (1) Centre for the examination

of contacts,

(5) Centre for "after care." (6) Information bureau and

it as the promised land" with that ray of hope that under its honevolent roof, if no radical eure can be assured, alleviation at least of their sufferings can be obtained.

DR. KOCH WANTS À SANATORIUM.

+

THE CHAIRMAN'S VIEW.

The Chairman' said he supported the amendment. He continued that the Director. had criticised Mr. Lo's

I heartily support the motion befigures which referred to respiratory fore the Board,

diseases. Such figures cannot be brought to prove that tuberculosis had increased, nor car they be adduced as showing the need for a tuberculosis Sanatorium. The ar- gument that because the percentage of Chinese deaths due to tuber. culosis was shown to be higher in 1929 than in previous years did not tend to show that there was BD increase in the disease.

Dr. Koch expressed his great satisfaction that they had such an ardent health advocate as fr. Lo. The unfortunate thing was that all sorts of motiuns are sent in to the Government, but nothing happens, It was like going against a blank

wall.

The financial problem would pro- bably be troublesome but to the out sider it appeared that the Govern- nent wasted a lot of money on fantastic plans, money which could used for hospital work. In the construction of a hospital it was necessary to throw away a lot of money all the time, and six or eight million dollars would be necessary. In such schemes it was not possible to get much encouragement and the official answer

is that attention would be given in due time.

It was an anomalous position, he continued, that the Director of Medical and Sanitary Services should be a member of a Board without any authority.

The Chairman reminded Dr. Koch that he was getting away from the subject under discussion, where- tor was in a position to advise upon Dr. Koch said that the Direc Covernment and that was what they were looking for."

Dr. Koch continued that, a Sann-

The Hoa. Mr. J. P. Braga, who supported the motion, said: The motion before the Board is one regarding which there can be notoriuns was very necessary and it two opiniona The only question on was for the Government to say which opinions may be divided is whether they could provide one. As regards that feature of the sub-recommendations but nothing came the financial aspect of the proposal. Some time ago a man was sent by the Rockefeller Institute and made

་

DR. WELLINGTON'S REPLY.

Mr.. Lo had taken comparative figures from the United Kingdom showing that the number of deaths from tuberculosis was 3.5 per 1,000 persons in 2,000. Our figuro for pulmonary tuberculosis was 17, but was it fair to draw comparisons in figures between the United Kingdom and Hong Kong.

OF seven

Mr. Sayer concluded by saying that in Mr. Lo's motion there was Board was concerned with preven no reference to prevention when the

tion rather than care, and further that the motion did not recognise the obvious difficulty of the Board's position. He therefore supported the amendment.

Major Cheyne said that he had" some sympathy with the original of the amendment he would support motion, but having heard the gist

the latter. He thought the amend- ment would meet the ciss better as notification and diagnosis would be furthered.

THOUSANDS OF CASES NOT

TREATED.

he could not take lying down the Mr. Lo, rising to reply, said that

figures, the source of which he had observations made on his mac of

man reading the report might have divulged. If he was wrong, all he could say was that any fair minded

abtained the same information.

the report by the M.0.H. it was He continued that on page 143 of

stated that it will be seen that the Colony." The report says BO fatal tuberculosis is increasing in and the words are in italics, The quotation justified the remarks ng far as figures are concerned.,

(2) Clearing house and centre ofject the Board, who are the advisers of them.

observation.

pertains to public health, need have of the Government in all that ap-

no concern. That is a question for other minds to concern themselves with. We must, therefore, confne ourselves to the point whether the time has arrived for the provision educational centre.

of a sanatorium for the unfortunate There are 452 institutions mainly victims of tuberculosis in Hong Since I laid down my office as entirely for pulmonary cases, of Kong. So many cogent reasons and director of the Tung Wah, I have which 19 are sanatoria, the total received a very interesting booklet available, relative beds being 22.202,

su much plausible argument have been advanced by the mover and the containing the Reports of the Medi-uf which 14,453 are in the sanatoria, seconder of the Resolution that it cal and Sanitary Departments for The above figures include institu-

is difficult I may say almost im the year 1926. From this book I tions maintained by local authori-possible-for us to vote otherwise have abstracted the following facts ties as well as by voluntary support. than for the resolution. which are truly alarming:

Versed in theory and gifted in Respiratory diseases

I feel I can say without any fear the practice of successful advocacy, notifiable: deaths from such dis of contradiction that the Authori- Mr. MK, Lo has forcefully put secondary state of the disease, The cases which could not go to the

ties in England. realising that his case beyond dispute. The au tuberculosis is a preventabile dis

tible and it remains for me orge

arg non-

greatly in sympathy with Mr. Lo's Dr. Willington said that he was desire to make provision for the treatment of chronic cases, but he was not entirely in sympathy with his idea of a Sanatorium for tuber- culosis alone. In his own experi- ence in the Malay States and Borneo, he found that the Chinese or Asiatic case will come to the hos pital for three weeks to a month and if given proper treatment and food they improve. They then feel they are cured and in spite of pro- tests from the doctors they go away only to return a few months later in 2 same thing happens and the patient he is incurable. •

prevention was better than cure, but Mr. Lo went on to say that it that was not a satisfying answer to the coolie who has got the disease. The Chairman had said that figures were useless, but it was necessary to deal with practical things. The Tung Wah

always full. Even 1 first stage cose could not get admittance. Thousands of

be admitted to the Government Tung Wah were not and could not

WES

1997: as causes of death in the ease, have in recent years adopted thorities he quotes are incontrover-then geta into the third stage when Civil Hospital...

cases amounted to 5,300 for 1928 as compared with the total of 3,834 for Colony they exsced any of the other Causes, being as much as 40 per

energetic and highly successful the case briefly for a sanatorium on which of course involves its control grounds other than those so ably measures directed to its prevention, cent, of the total deaths.

Nearly 6,000 deaths a year mean

and treatment. I submit that the advanced by the mover of the re- that on an average 10 persons die Plain difference between what is every day from lung diseases in being done in England and what is Hong Kong, and this figure woulding done in Hong Kong in this

solution.

Mi

up

of course be increased if we were regard is the difference between 1 of the Colony to proclaim that fresh air. Secondly it taught the to bear in mind the fact, referred activity and inertia.

to by the Hon. the Director of Medical and Sanitary Services in his report, that many Chinese leave the Colony to die in their native towns and villages when they feel that their end is ap- proaching.

England and Hong Kong Compared.

1019

1920

14.0% 10.9%

1921

16.9

1922

14.46

1923

13.3

1924

15.7

1023

1026

1027

1923

15.5% 15.3% 14.6% 17.4

Hong Kong's Diculties.

I am aware that the problem of Hong Kong is complicated by its fluctuating population. But surely this is put alid ground for the existing state of inertia.

very little value unless the case Sanatorium treatment. was of could be kept at least six months. Such detention was firstly for the benefit of the case, itself in toning graduated exercise and plenty of the body with good food,

patient to take care of himself when his lung had healed but was still quite tender. In tuberculosis of the lungs it took at least two years be- fore a patient could be said to be out of the wood.

A Sanatorium was not a magic institution was necessary. It was wand, but the existence of such an ironical kindness to say that im- proved housing accommodation would improve the position. For cart before the horse. present sufferers was putting the

Mr. Lo concluded that an obser vation from the M.O.H. to which he had referred must be viewed by him with grate concern, and he felt sure that other members would feel the same.

A Progressive Dolony. It is the privilege of every citizen Hong Kong is a progressive Colony I am one of the exponents of pro- gress. But in our most enthusias- tic moments we cannot be so blind to the fact that in the matter of public health and medical service, to be perfectly frank, we are striv

Mr. Braga said that the amend Dealing with the question ofment was excellent and had his ing in a sense to become progressive, segregation, Dr. Wellington said entire sympathy, but he was not in yet we are very much behind the that if the patient realised the favour of it as a separate motion times. Our principal hospital is

epidemic disease in a virulent form from a neighbouring port, there is пс segregation camp properly equipped and immediately avail. able.

Many of the eases could be treated had good food, fresh air and com- in their own houses provided they plied with conditions such as were to be found in a Sanatorium.

The amendment was put to the meeting and carried by four votes to three.

MURDER CHARGE FROM KOWLOON CITY

TWO PERSONS ÄRRESTED BY POLICE.

carried

In Hong Kong we have not a single sanatorium or any other in- stitution which pretends to deul The following table setting out with tuberculos's cases 18 such antiquated. We have no infectious danger that he was to others and in substitution for the original the percentage of total deaths (Chi- noticed in the Reports of the Medi-diseases hospital to speak of, and took proper precautions, complete motion which armed at providing a sest) due to all forms of tuber-cal and Sanitary Departments that, if we should be threatened with an segregation W28 not necessary.place. for patients. culosis for the last ten years shows in the opinion of the Medical that this disease, so far from being Officer of Health, this problem de- checked, is actually on the rise:-

mands urgent and special atten. tion by the Government, especially in respect of housing and over- crowding: Open spaces; and wider

By the last mail from Shanghai As regards respiratory diseases, streets: Spitting in public places, received the report of a dinner in these cases may or may not have a and smoke and dust abatement, the Model Settlement about ten bearing on tuberculosis, and he With this view I most respectfully the Press when the sims of the pared for 1928.

days ago to the representatives of went on to quote figures he had pre- agree. But I venture to suggest that the Government should go be board of directors of the Tsingtao yond this and face the problem of International Sanatorium were out- providing a large sanatorium. I lined, from which I gather that the According to the reports to which am of couree aware that the Gov-erection of a modern sanatorium I have referred the total of 17.4 per ernment, like every one of us, has for victims of tuberculosis at cent. is the highest yet recorded in to keep its expenditure within its Laushan, 30 miles from Tsingtao, the Colony.

income. But I cannot bring my was the principal aim of the direc- What is the position in England self to believe that a Colony which tore. At the present time, a sann- by Mr. D. G. Bannington called to contemplate an increase of off-building at Tsingtao, which as yet According to the book published is rich enough to be in a position torium is housed in a three-storey English Public Health Adminis-einl salaries amounting to over. has not been opened. The sana- tration," in 1881, the death from million dollars a year cannot find torium has been equipped with tuberculosis 3.5 per 1,000. ways and means to introduce some modern medical apparatus and will From that time.to 1007 the rate better medical services in the commence functioning next April. was reduced to 10. Since then the Colony, and thus to remove what I figures are definitely and continu- hambly consider to be a great blot ously on the decrease. I now quote on the fair name of the Colony as from Whitaker's Almanack for a healthy place of residence, 1930, at page 383: —

Time to Take Up the Question. CONSUMPTION AND CHEST DISEASES.

WaB

Rate per mil- Deaths. lion living

Year,

1021

33,505 -1022 ....................... 33,819

884

380

1923 32,007..... 1924 ........ 32,690...

B30

841

-1025

....................... 32,362....

•1920

771

791

755

30,108 1027 31,068 1928

20,709 Treatment in England.

The death rate as far as he could make out, taking the population of Hong Kong in 1928 as one million, was 1.7 per mille for pulmonary tuberculosis as a whole. This was, of course, high compared to about one per mille at Home.

tuberculosis and 25 per mille for

which-attended to the disease. At Home there were dispensaries Here also there are a number of dis Pensaries run by Chinese which could be conducted as tuberculosis dispensaries.

statement. was correct, but we had

A series of raids were out by the Palico on Monday fol

lowing the finding of the body of an old man in Kowloon city, who had apparently been done to death by a gang of robbers. The man, who was 67 years of age, lived at Shapo Street, Kowloon City, and was found dead tied to a chair and with his mouth tightly gagged."

It appears that part of the gag had been forced down the "man's threat and death was caused by suffocation. The gag is believed to have been deliberately thrust down the man's throat.

As a result of Police investiga- tions several raids were onrried out on Monday and two men were arrested and the authorities are believed to be connected with the hoping to get another man who is

dead man has been recovered.

FIGURES.

Mr. C. Y. Chu's Pioneer Work. Mr. Lo had said that there was Mr. C.-Y. Chu, it was stated, is dealing with tuberculosis alone the no Sanatorium here. If he' menft responsible for the movement to erect and equip a modern hospital hospitals which treat cases as such. for tubercular patients in Chizo. It seems to me that the time is While attending St. John's Univer. Many of them did not stay long now opportune for taking up this sity as a youth, Mr. Chu fell enough. A Chinese when he is ill, question, because we are singularly victim of the dread disease and en-ant to work, and that was not good unless he is too ill, insista on going fortunate in having as the Director tered sanatorium in Norway of Medical and Sanitary Services whera ho stayed a year and a half for tuberculosis. The patient must crime. A watch belonging to the such a highly qualified expert, on After residing in Norway for three wait at least six months. public health as the Hon. Dr. A. years, Mr. Chu returned to China.

What is required, Dr. Wellington 833. Wellington, who has already Coming in contact with Dr. C. C. concluded, was not a Sanatorium

spent so much time in reviewing Tong of the Peking Union Medical specially for those suffering from HEALTH OF THE COLONY. the whole question of, and collating Hospital and Mr. T. F. Soong, a tuberculosis but a place to put a. the necessary data in regard to Chinese lawyer at Shanghai, be ex number of chronic cases where no SMALL-POX & CONSUMPTION public health, as is shown by his pressed his desire to become identi-room could be found for them. He extremely illuminating report, 1fied with the erection of a modern would therefore move an amend- trust and hope that with his help hospital for tubercular victims.ment which did not entirely oppose and guidance the Government will The sanatorium at Tringtao result Mr. Lo's motion, but placed his lase no time in dealing with this ed, and now Mr. Chu and his asse wishes in another form. The amend matter..

eintes are planning to erect Bent was as follows:- modern sanatorium at Laushan.

It is a happy coincidence that the sponsor of the Hong Kong Sana- That this Board views with torium Schema is also a member of grave concern the increase of the legal profession. He can be tuberculosis in the Colony and confident of gaining adherents to an respectfully urges the Govern-praiseworthy a scheme. There is ment to take prompt steps with no end to the choice of suitable sites a view to making duo provision on the Kowloon hills, on the creat for the treatment of persons suf- of one of which, let us hope, the fering from such disease, includ- Hong Kong Sanatorium will be ing the provision of a properly built and on which the unfortunate equipped Sanatorium.

victims of tuberculosis can look on

In 1912 tuberculosis was made notifiable. Under the provisions of the Public Health (Prevention and Treatment of Diseases) Act 1913 and the National Insurance (and Finance Acts of 1911 local authori- tics were given granta-in-aid by way of encouragement to them to take effective steps to stamp out this disease. I quote from page 200 of the book to which I have referred :---

The scheme set out in the In- terim Report of the Departmental Committee on Tuberculosis · (Cd. 6164) has been generally followed. It laid down the principles that "the tuberculosis dispensary should

With these remarks I beg to move the motion standing in my name, as follows:--

A

|

Last weeks return of notifiable diseases shows 17 fresh cases of small-pox and 16 deaths. Other. notifiable diseases were typhoid 1 ("non-Chinese), scarlet fever 1 (non-Chinese), puerperal faver 1 (fatal).

The Board is much concerned at the continued high level of mortality from tuberculosis and urges the Government to consider In the record of deaths from non- if more effective steps can be taken notifiable diseases tuberculosis fatal- to ensure as far as possible that {ítire reached the high figure of 80. conditions of residence, in the All the cases were Chinese. Colony do, not lend themselves to the aggravation or contraction of the disease, and to consider the feasibility of providing some form of poor-law infirmary' for the care of chronic cases."

There were also. 4 deaths from influenza and Il from malaria.

On Monday & more cases of amall pox, (1, non-Chinese "), 1 case of typhoid and 1 of diphtheria were notified.

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