operative work is however carried out as office surgery' at the two major clinics. All told 3,751 operative procedures were carried out of which 1,012 were classified as major operations. The average duration of stay of each patient admitted to hospital was ten days.
377. A total of 127,370 attendances including 60,791 first attendances was recorded at the eye clinics. This total constituted a 22% increase over 1957. The Almoners carried out medical social investigations in approximately 12% of the new cases. During the last three months of the year the services of a Health Visitor were made available to the Ophthalmic Service and 642 cases of chronic eye disease were followed up in their bomes.
378. 2,940 school children were examined for ophthalmic defects and 2,817 pairs of spectacles were made and issued from the optical work shop.
379. Two legislative measures introduced during the year were that ophthalmia neonatorum was made a notifiable disease and the amendment of Section 30 of the Medical Registration Ordinance 1957. A preliminary assessment of the notifications of ophthalmia neonatorum suggests that the incidence is twice as high as in the United Kingdom, a not un- expected finding in the light of the differing social conditions.
380. The Hong Kong Society for the Blind has played an active part in measures designed to prevent diseases of the eyes leading to blindness. In addition to the campaign against unscientific and dangerous methods of treatment of eye disease by unskilled persons, a voluntary agreement was negotiated with the leading manufacturers of tinned milk to fortify all the products sold in Hong Kong with vitamins A and D and, in certain cases, vitamin B1.
DENTAL SERVICE
381. There are two sections of the Dental Service, one providing a general dental service, mainly to civil servants and their dependants and the other a dental service to school children within the School Health Service. The Dental Specialist is responsible for both sections and is assisted by 21 Dental Officers, seven of whom work in the School Dental Service. There is one school Dental Nurse. The staff of Dental Officers was increased by two during the year.
382. Only one new dental clinic was opened during 1958 and this clinic, although within the Kowloon-Canton Railway Headquarters building in Kowloon, is attended by civil servants and their families
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from all departments of Government. The dental clinics at the Tai Po Jockey Club Clinic and at the School Health Clinic in Tsuen Wan are now operating on a full time basis and not part-time as previously.
General Dental Service
383. Government has a contractual obligation to provide dental services to all monthly-paid Government servants and their families. now estimated to number some 100,000 persons. In addition a dental service is provided for in-patients in Government hospitals and for all prisoners in Her Majesty's Prisons. Emergency services, mainly extrac- tions for the relief of pain, are also maintained twice weekly at the Sai Ying Pun Hospital and at Li Kee Memorial Dispensary, fortnightly at Tai Po and Yuen Long and monthly at Cheung Chau and at Tai O on Lantao.
384. Dental inspections preparatory to full courses of treatment were carried out on 7,164 Government servants and their families. 2,390 of these were being treated for the first time in Government clinics. The comparable figures for 1957 were 5,303 and 1,439. This greatly increased demand has far outstripped the facilities available with the result that, apart from emergency treatment, the average delay in start- ing routine inspections and treatment is eleven weeks. The shortage of dental technicians has resulted in an even greater delay in supplying prosthetic appliances which is now, on the average, over six months, again excluding emergencies.
385. There were 23,256 visits by Government servants to the clinics and 24,162 visits by dependants. The number of persons completing courses of treatment which rendered them dentally fit was as follows!
Government Servants Dependants
School Dental Service
1957 1958 2,474 3,174 1,836 2,479
386. There are six school dental clinics with a staff of seven Dental Officers and one fully trained Dental Nurse. As the number of parti- cipating children fell from 32,336 in 1957 to 28,094 in 1958, the ratio of fillings to extractions rose from 56:100 to 92:100. However the large number of extractions necessary-2,656 permanent teeth and 12,574 deciduous teeth-is an indication of the extent of the problem of dental care in Hong Kong where nine out of ten children of six years of age have already been attacked by dental caries. In this connexion, the plans for the fluoridation of domestic water supplied have been
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