campaigns which are carried out under the immediate supervision of Medical and Health Officers.
170. By the beginning of 1960, the outbreaks of cholera and small- pox reported during 1959 in nearby countries of South-East Asia had subsided and no case of either disease occurred in the Colony.
171. The number of persons entering by rail through Lo Wu showed an increase of 14.8% over the previous year; of the total of 488,187 persons inspected there, 37,825 were without valid documents and were vaccinated against smallpox,
DISTRICT MIDWIFERY SERVICES
172. The dramatic fall in maternal mortality during recent years can be attributed, at least in part, to the widespread desire for attention during labour by trained personnel in a hospital or maternity home. Owing to existing housing conditions the preference is for institutional midwifery and only six per cent of all births registered take place in the home. By December 1960, there was a ratio of one maternity bed for every 66 births.
173. Prior to 1959, Government policy in the urban areas was to provide specialist institutional care in the Tsan Yuk Maternity Hospital, in the maternity block of Kowloon Hospital and in a few maternity homes attached to existing clinics; all other areas were served by mid- wives based on clinics and offering facilities for domiciliary midwifery in the surrounding districts. Despite the domiciliary facilities available, the greatest part of the normal midwifery was conducted in Govern- ment-assisted or private hospitals or in private maternity homes. This demand for institutional facilities has now been recognized in the development plan and all new clinics under construction or being planned for the urban areas will include maternity beds for normal cases wherever the district needs warrant the provision of such service. One such clinic was opened during the year, at Aberdeen, and plans have been prepared on this basis for six more. At the Jockey Club Clinic in Kennedy Town opened on 7th June, 1960 a domiciliary mid- wifery service was arranged; the demand for this service was so poor that, at the end of the year, five beds were provided in the clinic. Within a fortnight there was a marked increase in the number of ante-natal attendances at the clinic's Maternal and Child Health Centre and the beds were soon fully utilized. In the New Territories, the policy
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has been and still continues to be to include maternity beds in all new clinics.
174. The work of the Government Midwifery Service during 1960 is summarized in Table 21.
TABLE 21
GOVERNMENT MIDWIFERY SERVICE 1960
Maternity beds in hospitals Maternity beds in maternity homes (urban)
337
(rural)
TO 119
Midwives (excluding hospitals)
15.416 230
Cases attended (excluding hospitals)
Average case-Inad for each midwife (excluding hospitals)
175. Thirty seven per cent of all births are attended by midwives in private practice, the great majority taking place in small maternity homes of from two to six beds. The Supervisor of Midwives, a Govern- ment Senior Medical and Health Officer, is responsible for the regular inspection of such homes and for general supervision of the work of the midwives; in this task, she is assisted by a qualified Health Visitor. The work undertaken in 1960 by these midwives is outlined in Table 22.
TABLE 22
PRIVATE MIDWIFERY SERVICE 1960
Number of midwives in active practice Number of registered maternity homes
Number of beds
Maternity home deliveries
Domiciliary deliveries
Total deliveries
193
117
$17
38.143
3,260
41,403
176. Apart from their role in safeguarding the lives of mothers and infants, the midwives of the Colony play an extremely important part in general public health measures, for they are all trained to perform vaccinations against smallpox and to administer B.C.G. to new-born infants. It is due to the efforts of these midwives, both Government and private, that 71.5 per cent of all children born during 1960 received B.C.G. protection-a measure which has resulted in a dramatic fall in child mortality from tuberculosis.
MATERNAL AND CHILD HEALTH SERVICES
177. In this most important and popular aspect of the work of the Department, the emphasis is on health education and the prevention of
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