X1000307-1952-53_Part01 — Page 23

1852

1957

Induction

195

68

Refills

1,880

A. P. T.

Pneumolysis

39

906

T

Abandoned

20

Induction

158

28

A. P. P.

Refills

2,753

351

Phrenic crush

207

71

Thoracoplasty

67

10

Bronchoscopy

11

6

Number of patients treated by Streptomycin &

PAS

154

136

167. It is obvious from the above that much more energetic treatment is being carried out in the hospitals and that, contrary to fashion elsewhere, A.P.T. still enjoys considerable popularity. It is the conviction of all medical staff engaged in treatment, that results from A.P.T. are much more satisfactory than in A.P.P. No case of pyopneumothorax following A.P.T. occurred during the year. This, it is belived, was due to the careful selection of cases and their subsequent careful management, At the same time the type of disease encountered in adulta in the Colony is of a less acute type than is found in many other parts of the world and thus the occurrence of this grave com- plication is much less likely.

158. No untoward result occurred following thoracoplasty but failure to convert the sputum occurred in two cases. These had giant cavities and, in other circumstances, might have been treated by lobectomy.

159. The administration of streptomycin with PAS was carefully controlled and this form of treatment was carried out în about one-fifth of the total number of cases treated.

Social Work.

160. All social case work in connexion with the tuberculosis patients is carried out by the Tuberculosis Almoner who, with her four assistants, constitutes the link between the purely

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medical side of the work in the clinic or hospital and the patient and his family in the home. All patients, as soon as the diagnosis of tuberculosis is made, are interviewed in the Almoner's department and details of social and economic circum- stances recorded for future reference. The social problems which normally beset the tuberculosis sufferer are considerably aggravated in the Colony because of the widespread overcrowd- ing and lack of employment and the burdens on the Almoners' section are very considerable. Funds amounting to $30,000 were made available initially for assisting patients for the year as compared with $100,000 in the year 1951-52, so that a drastic cut in the help given had to be made in the first 4 months of the year. Subsequently an additional $70,000 was made avail- able. The money from this fund is used in several ways and may be issued in the form of cash payments for dependents and for assistance in rehabilitation, or in the form of milk powder which is issued principally to patients undergoing out-patient treatment, and to contacts. A scale of weekly cash allowances has been laid down for guidance but these allowances are available only to early cases under treatment in hospital and who have been obliged to give up work to undergo treatment. The scale of allowances is as follows:

First Second Third

Dependent

LEI

Subsequent

#

$16

$12

$ 9

$ 5

161. Allowances are also made for such fixed charges as rent, school fees, etc. The maximum amount paid must not exceed 75% of the worker's wage. Often the allowance may be considerably less than this figure.

162. Re-employment of patients on discharge from hospital is not easy.

A few firms are prepared to give sick leave, with or without pay, to their employees and undertake to re-employ them when fit. In the majority of instances, however, sickness means loss of work with no hope of re-employment on restora- tion to working capacity as the market is already flooded with fit and healthy unemployed. As a result, the only available means of assisting hospital patients on discharge is by the

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