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Session of the Regional Committee. The meeting, held at the Grantham Training College from 5th to 12th September, was opened by the Governor, and Dr, G. Graham-Cumming, Acting Director of Medical and Health Services and the leader of the United Kingdom delegation, was elected Chairman, Observers from other United Nations agencies and a number of other affiliated organizations also attended,

II. PUBLIC HEALTH

GENERAL COMMENTS

34. The outbreak of Asian Influenza which occurred during the months of April, May and June was the only major epidemic episode of the year. Next in importance was the increase in the incidence of Diphtheria. Tuberculosis again showed an increase in the total number of cases diagnosed, but this increase is believed to be due mainly to the improved and extended diagnostic facilities. The incidence of other major causes of illness showed no significant variation over the previous year.

35. The Colony again remained free from the formidable epidemic diseases of Cholera, Plague, Smallpox, Yellow Fever, Epidemic Typhus and Relapsing Fever. For the second ycar in succession there was no case of rabies, either human or animal.

36. There was a gratifying drop in the number of cases of the enteric fevers, the total being the lowest recorded since 1950; the case fatality rate was the lowest on record.

37. The major health problem in the Colony is undoubtedly Tuber- culosis. Under the conditions of density of population and over- crowding pertaining to the urban areas, the magnitude of the re-housing problem is such as to render significant progress in this direction slow in relation to the urgency of the situation. Great strides have been made in re-housing and in the resettlement of squatters, and as much progress as can be expected has been made within the physical limitations of land, materials and cost. Therefore the ambulatory out-patient treat- ment of Tuberculosis allied to the preventive measures of B.C.G. Vaccination and of prophylaxis in contacts, constitutes the only logical approach to the problem.

VITAL STATISTICS

38. Compulsory registration of births and deaths occurring in the Colony is required under the provisions of the Births and Deaths

Registration Ordinance. The Director of Medical and Health Services, who had been the Registrar of Births and Deaths since 16th October, 1931, ceased to act as such as from 1st April, 1957, when the function of the registration of births and deaths was taken over by the Registrar General. A scheme for the reorganization and decentralization of the Births and Deaths Registry was implemented late in 1956, and as a result, additional registries have been established in various districts throughout the Colony.

39. The number of 97,834 registered births again exceeded all previous records. It was 1,088 more than in 1956 which was itself a record year. Taking the estimated mid-year population of 2,583,000, the crude birth rate was 37-9 per thousand of population, which was slightly lower than the rate in 1956 of 39-7 per thousand.

40. On the other hand, the total number of deaths from all causes was only 19,365, just seventy more than in 1956, 285 more than in 1955 and ninety four less than in 1952. The crude death rate was 7-5 per thousand of population, compared with 7·9 per thousand in 1956. 41. The net natural increase in the population of the Colony during 1957 was thus 78,469, as against 77.451 in 1956.

42. There were 1,245 still births recorded. which gives a pro-natal wastage of just over ten for every 1,000 of all births. The number of children dying in the first month of life, always the most dangerous period of a child's life, was 2,330, giving a neo-natal mortality rate of 23-8 in every thousand live births. This shows a slight decrease over 1956, when the rate was 242 per thousand live births.

43. Deaths of infants under one year of age numbered 5,436, which is 28-07% of deaths from all causes as compared with 30-6% in 1956. This gives an infant mortality rate of 55-6 per thousand, compared with 60-9 per thousand in 1956. Of an increasing number of babies born, an increasing number is surviving. On an average 268 babies are born in the Colony each day, of which at least 249 survive their first year of life; in the past it would not have been unusual for at least one hundred of them to die before their twelfth month of life. This dramatic success is a tribute to those engaged in the maternal and child health services; none the less this improved situation is posing fresh problems in regard to medical services, education, employment and housing.