ENG-1976 — Page 118

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HEALTH

so that medical services can be made available within reasonable access. Future planning is to be better related to the needs of each area.

In addition to hospital services, the Medical and Health Department maintains services covering family health, school health, industrial health, port health, and the control of epidemic and endemic diseases.

For the financial year 1976-7, the Medical and Health Department's estimated expenditure is $453 million. To this should be added subventions to many non- government medical institutions and organisations totalling an estimated $197.4 million. The estimated capital expenditure on hospitals and other buildings, includ- ing furniture and equipment, is $22.9 million.

Health of the Community

Cancer and heart diseases are now the main causes of death in Hong Kong following the successful control of infectious diseases such as tuberculosis, once the number one killer disease. The infant mortality rate is now at a lower level than in many developed countries. This decline is due to improved environmental conditions, the development of maternal and child health services, and increasing public apprecia- tion of the value of these services.

Notifications of communicable diseases totalled 13,679 in 1976. One imported case of cholera was reported in July. The direct contacts of the index case were traced and one carrier was subsequently detected and treated. All the other necessary control measures were undertaken including advice to the public on the importance of observing simple rules of personal, environmental and food hygiene. A health exhibi- tion on the prevention of diarrhoeal diseases was also held in the same month. The routine examination of nightsoil samples for cholera organisms did not reveal any positive results.

The incidence and the number of deaths from tuberculosis continued to decline, with a policy of reliance on outpatient chemotherapy being pursued. About 98 per cent of newborn babies are vaccinated with BCG-probably the highest rate in the world. Tuberculosis is now rare under the age of 15.

Venereal diseases are treated free at social hygiene clinics. About five per cent of the patients are teenagers, but there has not been any increase in the incidence of the disease in the teenage group since 1971. Energetic control measures such as contact tracing, follow-up of defaulters, and routine ante-natal blood tests are all aimed at interrupting the chain of infection.

Leprosy has been brought under control. Leprosy patients who need hospitalisa- tion are treated in a general hospital, but the majority are treated as outpatients at special skin clinics.

Malaria transmission has ceased in Hong Kong. All cases notified during the year were imported. The vector does not exist in the urban areas or the greater part of the New Territories. However, anti-larval operations such as draining and clearing streams, ditching, and oiling are still carried out. In parts of the New Territories, screen- ing of buildings and use of mosquito nets constitute the main preventive measures.