X1000307-1956-57_Part01 — Page 9

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in 1955 to 16,071 cases and 2,870 deaths during 1956. largest variations from the figures of the previous year occurred in the notification of tuberculosis, diphtheria and whooping cough, all of which dropped considerably, and in malaria which shows a marked increase. The increase in malaria, however, was due to a tightening up on notification when it came to light that many doctors working in the areas not protected against this disease had not been reporting all cases seen. The enteric diseases, while continuing to remain somewhat of a public health problem, showed no increase on the figures for 1955, when the disease began to show evidence of coming under effective control after reaching very serious proportions in previous years. The incidence of the dysenteries showed little change but deaths from bacillary dysentery dropped dramatically from 37 in 1955 to 4 in 1956, the lowest figure on record for ten years. Approxi- mately 40% of cases of this type of dysentery occurred in children under four years of age, a state of affairs probably reflecting the congestion in the homes of the people and pre- vailing water shortage, with consequent difficulty in maintaining adequate cleanliness, more than any other factor. Overcrowd- ing also affects the incidence of measles and other infections spread by sneezing, coughing and spitting but interestingly enough cerebrospinal meningitis, which is generally regarded as a disease of congestion, shows a surprisingly low incidence. of 21 only. Poliomyelitis also, as notified, did not constitute any serious problem and indeed showed a decrease on previous years but investigations carried out on the blood antibodies of a sample of the population indicate that a large proportion of the local population appears to acquire a natural immunity to this disease at a very early age, which suggests that the infection is very widespread, probably in a very mild form producing only transient sore throats and fever. For the first time since the war no case of rabies either animal or human was reported. Campaigns designed to increase protection against smallpox, diphtheria and typhoid were conducted during the year and in this connexion it has been demonstrated that the loud hailer mobile van is much the most effective agent in stimulating public response. The number of births once more increased and there was no significant rise in the total number of deaths, indeed the crude death rate fell from 8.2 in 1956 to 7.9 in 1956. On the

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whole it can be said that the Colony maintained a very gratify. ing state of good health during 1956 despite many factors that still continue to be adverse.

Environmental Factors Affecting Health,

10.

The Summer climate is tropical and humid, which tends to facilitate the growth and spread of the causes of many diseases, and a large area of the Colony is not yet protected from malaria, although obviously very effective control is operating in the Island and in the built-up area of the Mainland. Water shortage remained a grave problem although longer hours of supply proved to be possible during more of 1956 than in the worst periods of former years. By far the most important health hazard however is the almost unbelievable congestion and overcrowding, particularly in the poorer class dwellings. Tremendous efforts have been made to cope with the squatter problem and this is gradually coming under control. During 1956 rapid strides were made in low cost housing development on a major scale but it will be long before these efforts effec- tively overtake the need and can be reflected in the health of the people. The tremendous swelling of the population in recent years has completely overtaxed all existing medical facilities and hundreds of patients have literally to be turned away from the doors of the Government outpatient clinics in the city areas daily. Industry is expanding so rapidly that it is proving difficult to control adequately all the health hazards involved with the available staff. Fortunately most of the larger manufacturing concerns and employers of labour have a real interest in the welfare and health of their workers and take steps to protect them by voluntary efforts. Unfortunately this is not always so, particularly of smaller mushroom busi- nesses, and strict observance of the regulations is not always found. Trade Unions, Kai Fong and other organizations have set up clinics and are trying to assist in alleviating distress. Though there is no true lack of food and no actual starvation nor any serious food deficiency disease there is yet much poverty and a great deal of undernourishment, a good deal of it due to ignorance of food values more than actual inability to obtain adequate food. The most alarming factor affecting health, amongst other things, during the year, though fortunately of short duration, was the October rioting. These riots, and the

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