largely in agriculture and fishing but there is also one rapidly growing established light industrial centre at Tsuen Wan.
5. The conservation of rain water in large reservoirs situated on the Island and in the New Territories ensures a pure piped domestic water supply in the urban areas and to the towns in the New Territories, However, the hours of supply are limited and one water point may serve a number of families. Wells and well water are strictly controlled in the urban areas and the use of this water is restricted to flushing, air- conditioning plants and, in certain instances, industrial use.
6. Water borne sewerage, much of it using sea water for flushing, is being installed in all new housing estates but there are still many tenements in the older parts of the twin cities which are served by bucket latrines. Night soil is for the main part transported to maturation tanks at Tsuen Wan where it is distributed as fertilizer for traditional wet soil cultivation in the agricultural areas of the New Territories. A certain amount is however disposed of by dumping at sea.
7. Real malnutrition is not common but there is a considerable amount of subnutrition which is largely due to imperfectly balanced diets and shortage of protein. This is to a certain extent economic but the customary dict of rice as a staple food with vegetable, meat and fish supplements is cheap and is traditional. Large quantities of fresh fruits are always available in the markets and are caten extensively by all sections of the community.
8. The very large influx of refugees which has taken place over the past twelve years, particularly in relation to the land and living space available, has naturally thrown a great strain on all services and the impact on housing, water supplies, sanitary services, clinics and hospitals has been of staggering proportions. The standards for the provision of these services that prevail in large modern industrial states are frequently quoted to emphasize the short fall in Hong Kong without due regard being paid to the circumstances that have dictated local conditions. In the face of these conditions the policy can only be to aim at modern standards, meanwhile using scientific methods and techniques, which have been of proved value elsewhere for the prevention of endemic disease, as may be practicable within the physical and staff resources available, Meantime, the long-term planning of hospital and clinic accommodation goes ahead hand in hand with schemes of training that will ensure that qualified personnel will be available when the institu- tions are ready.
9. The outstanding events of the year were the naming of the new Kowloon Hospital and the laying of the foundation stone. By gracious consent of Her Majesty The Queen the new hospital is to be called the Queen Elizabeth Hospital. On 7th March, 1959 His Royal Highness The Prince Philip. Duke of Edinburgh, laid the foundation stone of the new Hospital.
10. The major pre-occupations of the year have been the prevention of the introduction of cholera and smallpox, the control of diphtheria and the enteric diseases, interim measures to ease the shortage of hospital beds, the extension of the outpatient clinic services and the further development of the facilities for the outpatient and inpatient treatment of tuberculosis.
11. There were no major outbreaks of epidemic disease and no significant variations in the incidence of endemic disease. Higher levels of incidence of poliomyelitis gave rise to concern during the months of June and July but a careful analysis of the situation indicated that the number of new cases reported and admitted to hospital did not greatly exceed the number of new and recent cases of paralysis registered at the physiotherapy clinics during the same period of the previous year. The most discouraging feature has been a falling off in the response to immunization against diphtheria and the typhoid-para-typhoid group of infections.
12. Evidence of the use of barbitone as a vehicle for the volatili- zation of heroin came to light early in the year. This form of drug addiction is a most vicious one, producing a double addiction that is rapidly acquired and quite the most difficult to break. Heroin and barbitone are mixed, heated on a sheet of tin or aluminium foil and the smoke is inhaled through a paper tube.
13. Investigation revealed that there were large stocks of barbitone in the Colony for which there is virtually no medical or commercial use and it was obvious that rigorous control was essential in the public interest. Accordingly barbitone, pheno-barbitone and their salts were scheduled as dangerous drugs, import and export controls were imposed and barbitone and pheno-barbitone and their salts were placed on the poisons lists, and so made obtainable only on the prescription of a registered medical practitioner.
14. Mention has been made in previous reports of the problem of the refugee doctors who possessed only qualifications not registrable in Hong Kong. It was eventually decided that the operation of Section 27
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