beda available in the Colony for the treatment of luberculosis is insufficient and the tuberculosis service had to resort to out-patient treatment by means of chemotherapy on as large a scale as possible. This service did excellent work but it is felt that it is as yet merely touching the fringe of the problem.
5. No substantial improvement was effected in general environmental sanitation and it was therefore to be expected that enteric fever and the dysenteries were very prevalent. Indeed the incidence of enteric fever was higher than in any previous year and the infectious disease hospitals were barely capable of dealing with the situation. Diphtheria too, was very common in the early months of the year but although the total number of cases recorded wus greater than in 1952, there was a reduction in incidence in the latter part of the year perhaps, in part, on account of the mass immunisation campaign carried out during the first quarter. Immunisation against enteric fever has also been actively pursued particularly in organized groups such as school children and employees of large firms, but the response of the general public was not nearly so good as it was for other immunisation campaigns.
6. There was no visitation of major quarantioable diseases and the Colony has remained relatively free from these for a number of years. The last outbreak of cholera occurred seven years ago and there has been no major outbreak of smallpox since 1947.
7. There was a further rise in the birth rate to 88.6 per thousand as compared with 92.0 per thousand in the previous year. The total number of birtha was 75,544. Deaths numbered 18,300 or 8.1 per thousand which is unusally low and is partly due to the influx of young adults since the end of the war which has given the Colony's population an abnormal age distribution,
8. The maternal mortality rate was 0.97 per thousand births as compared with 1.14 per thousand births in 1952 and 1.69 and 1.7 in 1951 and 1950 respectively. There was a further drop in the infant mortality rate from 77.1 per thousand live births in 1952 to 73,6, thus continuing the steady downward trend
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from 1947 when the infant mortality rate was 102.3 per thousand live births. The low infant mortality rate for the year under review can partly be attributed to the fact that 97.5% of all births were attended either by a registered midwife or a medical practitioner.
The building up of an Auxiliary Medical Service to operate in emergencies continued to be a major preoccupation and a satisfactory stage of progress was achieved by the close of the year.
10. On Christmas night the Colony experienced the worsal fire in its history in a squatter area. About 55,000 persons were rendered homeless. Two persons lost their lives and a considerable number received injuries which needed treatment. Government agencies and voluntary organizations provided immediate relief for the homeless and the Medical Department amongst other measures set up two temporary dispensarles to serve the fire victims. By the end of the year up to 200 cases daily were being dealt with. A temporary maternity hospital was also set up in tents and a maternal and child health centre was set up.
11. Amongst persons visiting the Colony during the year Dr. A. M. Wilson-Rae, Deputy Chief Medical Officer, Colonial Office, and Dr. Marcolino G. Candau, the Director General of The World Health Organization were of particular importance to the Medical Department.
Personnel.
12. The establishment of the Medical Department on 31st March, 1953 is shown in Appendix 1. There are in the Colony many medical men who are refugees from China but whose qualifications do not permit them to be registered under the Medical Registration Ordinance, they cannot engage in private practice but they can be employed by Government. This reserve of professionals was of great value and the Department could not have met its commitments without drawing upon it. The total number of doctors employed at the end of the year, including house officers, was 220, and of these 126 were un- registered.
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