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HEALTH
were admitted to hospital for treatment during the year. Among patients who accept admission for treatment the level of co-operation is excellent, there being only a very small proportion of discharges against medical advice.
A rehabilitation scheme, which was started by the Lutheran World Service as a pilot project, has proved very successful and has become a permanent part of the overall treatment programme.
The Government Tuberculosis Service operates full-time and part-time clinics in all areas where the distribution of the population warrants such activities. All diagnosis and treatment is free. There are five full-time chest clinics equipped with radiological facilities and treatment is available at these and at sixteen subsidiary centres. Treatment sessions are held in the evening at the five main centres for patients who cannot attend during the day.
Once a diagnosis of active tuberculosis has been made, a regime of ambulatory chemotherapy is instituted. The standard treatment is intensive for the first six months, after which each case is reviewed. Those who respond satisfactorily are placed on a less intensive regime, while those who remain infectious are admitted to hospital for investigation into the resistance of the organism and for treat- ment. In this way large numbers of active cases are rendered sputum negative and can live at home and remain at work without danger to others. All family contacts of such cases are investigated and all necessary action is taken. Cases in need of hospital treatment for pulmonary or orthopaedic tuberculosis are assessed for priority of admission as beds become available. Almoners attached to the Tuberculosis Service maintain social histories and operate a tuber- culosis assistance fund for those in need of financial or material aid while under treatment. There is a staff of tuberculosis workers who undertake home visiting, health education, clinic duties and contact tracing. They also investigate the circumstances of those defaulting from treatment.
During the year a total of 24,606 patients received continuous anti-tuberculosis chemotherapy on an ambulatory basis at govern- ment clinics, of which 765 were on reserve anti-tuberculosis drugs. A total of 1,251,534 attendances were recorded. Case finding by means of X-ray surveys is carried out by Government. There is an annual X-ray survey of all government servants and free surveys are carried out, on request, in schools and in industrial or
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