Assistance in kind is provided by the department in the form of dietetic supplements, These supplements are not intended purely as a feeding scheme, but the diet is carefully chosen to provide items which would be likely to be lacking in the patient's normal diet and can be provided in a palatable form. The food is distributed by means of a specially fitted van, hot and ready for consumption, and delivered near the patients' homes. This scheme was started experimentally in November on the island, and met with a limited though increasing success, and has since been extended to the mainland, where the food is supplied at feeding centres kindly loaned for the purpose by the Social Welfare Officer.
Further assistance in kind is available for patients in the form of dried milk powder, which is distributed at the clinic weekly.
Such medicines as are required are distributed free.
Difficulty is experienced in placing tuberculosis sufferers in employment following discharge from hospital. Considerable prejudice is encountered against such individuals hut some success has been achieved by the Almoner's Department in fnding suitable employment for a few ex-patients.
Propaganda.
One of the local problems on the proventive side is the illiteracy of the population. It has been estimated that almost 90% of the patients attending the public clinics are unable to read. It is, therefore, extremely difficult to get health propaganda across to these individuals. Au anti-spitting campaign was intro- duced and very considerable improvements in the habits of the general population in this connection are apparent. Health education including information on tuberculosis is also disseminated by cinema vans using locally produced as well as imported films. The long term effects of this campaign can only be guessed but good results are hoped for. A number of posters are also widely distributed in public places.
Surveys.
The use of mass radiography is not immediately contemplated on account of the comparative youth of the tuberculosis service and the lack of trained personnel available to deal with the resulting situation.
Streptomycin.
This drog is readily available on the open market at reason- able price.
Its usa in Government hospitals is prohibited except
on the authority of a committee formed for the control of the use of the drug. Each case is assessed on its merits and ample supplies are available for approved cases free of charge.
(Spd.) A. S. Moodis,
A1.0. in-cherrge T.B. Clinic.
73
ANNEXURE G.
REPORT OF INFANT MORTALITY INVESTIGATION
COMMITTEE,
Director of Medical Services.
In March 1948, you appointed a Committee consisting of Dr. Lee Hah Liong as Chairman, Dr. R. K. W. Yang, Dr. E. T, Loke and Dr. Uttley as Secretary, to investigate the causes of Infoot Mortality and to make recommendations for the reduction of the high mortality rate.
Right from the beginning of the investigation, it was evident that there would be considerable difficulties in getting enough scientific data on which to base any conclusions. To collect any valid group of data would take two to three years. Deductions based on statistical evidence alone may be misleading, unless the umbers are sufficiently large, properly collected, and carefully and logically used. Although information such as could be supplied by the two best hospitals in the Colony, the Queen Mary and Kowloon Hospitals, might be useful, it was realised that cases going there are not necessarily the type of cases that the Committee wanted to investigate, and it was also felt that such esses were not a trae cross section of the population with which the Com- mittee was concerned, On the other hand, charity hospitals have plenty of good material, but no records. The above mentioned difficulties prevented any statistical survey being made and the Committee adopted a more practical method namely the inter- viewing of doctors and the investigation of post-mortem recorda and death certificates. Even with these limitations, it is the Committer's opinion that their recommendations are based on the actual prevailing conditions,
The Committos met a number of times and interviewed doctors and other workers when the following facts were brought to light:
(a) A steady fall in infant mortality had taken place from 660 per 1,000 in 1929 t 120 per 1,000 in 1947.
We believe that the following influences have been at work Over the year which will tend to modify conclusions:-
(1) Improvenient in the standard of living and in the
wage earning power of the poorer classes.
(2) Batter supervision in the public health services in
recent yeara.
(3) A steadily improving accuracy in the returns of
births and deaths especially in later years.
(4) Better appreciation of food values. Beri-beri, which used to lake such a heavy toll of infant lives, is not commonly seen nowadays.
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