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238. The average attendances at ante-natal sessions were 43 as against 38 in 1960, but the average rate of attendances by each expectant mother dropped from 3.3 to 3. Post-natal clinic sessions are still the least popular and it seems that attendance is almost exclusively only by those who either suspect or are acutely conscious of an abnormality. During the year 24.09% of all women attending post-natal clinics needed some form of treatment.

239. All Maternity and Child Health Centres stopped their routine work during the cholera outbreak for a period of 2 weeks during which the staff worked full-time in the anti-cholera inoculation campaign.

SCHOOL HEALTH

240. The Medical and Health Department undertakes in all registered schools, through its School Health Service, responsibility for environ- mental sanitation, the control of communicable disease, immunization against diphtheria, smallpox and typhoid and health education. There is also a medical inspection and curative service provided for a limited number of participants in the existing contributory School Health Scheme. This latter scheme is under review and is expected to be replaced soon by a School Medical Service operated by private practi- tioners. To this end negotiations have been conducted with the Chinese Medical Association which has agreed in principle to assist with the launching of a comprehensive inspection and curative service; over 200 of its members have indicated their willingness to participate in a per capita contributory scheme.

241. During 1961 there were 24,330 pupils from 278 schools who were participating in the existing scheme. Medical inspections, clinic services, dental care and specialist eye and car, nose and throat investiga- tions and treatment were provided. The following table sets out the work done.

TABLE 21

ATTENDANCES

Medical Inspections 39,327

General Clinicr

Dental Clinics

47,405

34.086

ENT. Clinics 1,715

Eye Clinics

3,806*

Bospiter Admissions 63

• 1181 pairs of spectacles and 291 pairs of lena replacement were issued.

242, There were no epidemics of infectious disease but there was an increased incidence of diphtheria, 312 cases being notified. Except during the cholera outbreak, the main emphasis was on diphtheria

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immunization and 80,186 school children came forward for the full course of inoculations. This was part of an intensive campaign against diphtheria which included visits by Health Visitors to schools that had not applied for the services of immunization teams. The Health Visitors also held a series of meetings with headmasters of primary schools which had been arranged by the Health Education Officer.

243. During the autumn, special emphasis was also laid on vaccina- tion against smallpox and 67,484 vaccinations were performed in schools. 244. Special attention is also being given to tuberculin testing and the B.C.G. vaccination of negative reactors. This is part of a general investigation to check on the sensitivity state of pupils in registered schools throughout the Colony with a view to extending the B.C.G. service, as a routine, to all school children. Over a period of 4 months, 6,043 tuberculin tests were done and 1,527 negative reactors were given B.C.G. The positive reactors were investigated and known family contacts of tuberculosis, those with suggestive signs and symptoms and those with a 15 mm. or greater reaction were requested to attend for an X-ray examination. In these three groups a total of 484 were advised to attend for an X-ray: 384 of them showed no radiological evidence of disease and 65 were referred for full investigation at a chest clinic. The remainder did not co-operate by attending for X-ray examination. 245. Before being permitted to teach in registered schools, school teachers are required to undergo an X-ray examination. During the year 3,994 chest X-ray were taken and 29 teachers found to be suffering from active tuberculosis; in such cases permission to teach is refused and priority admission to hospital arranged. A further 270 teachers. after full investigation, were permitted to teach under supervision.

246. School premises are inspected routinely by Health Inspectors and all new premises or applications for extensions or alterations to schools are investigated to ensure adequate environmental sanitation. For this purpose 1,646 inspections were carried out and reports made on 67 plans for new schools or for extensions.

247, Health education activities included lectures by doctors and health visitors to teachers-in-training for whom visits were arranged to school clinics for practical demonstrations on the common health problems amongst school children. School visits by Health Visitors, home visits and talks to pupils and parents at school clinics are also routine activities that are an integral part of the work of the School Health Service.

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