Report of the Director of Medical and Sanitary Services / [Ceylon].

  • Ceylon. Civil Medical Department.
Date:
[1940]
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Director of Medical and Sanitary Services / [Ceylon]. Source: Wellcome Collection.

    13/14 (page 13)
    (c) The Departmental Manual. The Departmental Manuals have not been revised for many years. As a result, the officers of the Department find it difficult to obtain, readily, instructions on a particular subject from a number of circulars issued from time to time. There are already three Sub-Committees func¬ tioning to compile a revised Departmental Manual broadly divided into three sections, Medical Health, and Accounting. Simultaneously with this revision, the question of printed forms is being taken up. A Committee has already been appointed to review all printed forms now in use in the Department and to recommend changes with a view to economy, greater efficiency, and better co-ordination. (d) Communicable Diseases. Special mention should be made of plague, of which there has been no case since August 23, 1938. This freedom is due to the fumigation of all grain and contact cargo arriving at Colombo from plague-infected ports. Colombo has been declared free from infection on February 24, 1939, in terms of article G of the International Sanitary Convention of Paris. It is to be noted that new areas are being affected by malaria, e.g., outbreak in the south¬ west part of the Island during May-July, 1940 [vide 2 (a) of Section 2, Communicable Diseases, of this Report]. (e) Maternity Services. Provision in a sum of Rs. 3,500 was for the first time made in the Estinates for 1939—40 under the item “ Travelling expenses of Medical Officers summoned to attend urgent maternity cases ”. This enables, in addition to the other existing facilities, the grant to poor mothers of domiciliary medical aid by hospital medical officers in difficult and abnormal midwifery cases which do not permit of the safe transport of the case to the nearest hospital. Similar provision has been continued in the subsequent estimates. At present, subsidies are given by the Department to Village Com¬ mittees for the employment of some of their midwives. But the Village Committees, particularly in remote areas, find it difficult to attract trained mid wives to their service owing to the absence of opportunities available for transfer, higher salary, and pension. The absorption of these midwives into the Department has been approved by the Executive Committee of Health, and further details are now under consideration. A special Medical Officer of Health has been placed in charge of an investigation into infant and maternal mortality in Ceylon. His findings will be a satisfactory guide to future development of maternity services. It is encouraging to note that more and more local authorities are willing to have their areas proclaimed under section 55 of the Medical Ordinance. (3) Recommendations for Future Work. {a) Health and Malaria Control Scheme. This scheme has been described in my previous Administration Reports. It ensures a sus¬ tained attack on malaria which can never be tackled in isolation of other health problems. Besides, control is not possible without continuous work. A few more Field Medical Officers and other personnel are necessary to cover the whole of Ceylon. It is relevant to point out that new areas are being affected by malaria with consequent complications of the problems of control. Colonization, agriculture and irrigation schemes, as well as the facilities for quick travel now available, have brought in their quota of new problems. It is therefore imperative that this health scheme should remain a permanent feature, administered centrally by the Department of Medical and Sanitary Services with all the field work adequately supervised. To what extent local authorities, including Village Committees, should contribute towards the cost met by the Central Government in the provision of health services is a matter that should receive the careful consideration of the Financial Relations Commission to be appointed (vide page 87 of Sessional Paper XIV. of 1939). (b) Local Authorities and, Health Personnel. The practice of loaning the services of the Department’s Sanitary Assistants and Public Health Nurses to Urban Councils at a consolidated rate fixed with the concurrence of the Treasury should be extended to include other types of Plealth personnel as well as other types of local authorities, e.g.. Village Committees. This system will ensure uniform standards of recruitment, training, transfers, as well as of work on approved lines. The Departmental Medical Officers of Health serving in Urban Council areas have at present no statutory authority as such. It will be in the best interests of their work if they are given such powers without any derogation from the authority of the Chairmen. These are problems of the future. So far as the past and the present are concerned, I shall be failing in my duty if I do not refer to the good co-operation extended to the Department by the various local authorities. (c) Hospital Policy and a Dispensary Survey. It is the policy of the Department to improve the standard of the Provincial Hospitals so that the services rendered there may bear satisfactory comparison with the General Hospital, Colombo. For this purpose, some of the buildings have been extended and improved, and qualified Surgeons and Physicians appointed wherever possible. The services of qualified Obstetricians, Dental Surgeons, Ophthalmic Surgeons, and other specialists should be made available in all these institu¬ tions. The appointment of Assistant Surgeons and Physicians, &c., and the periodical transfers of some of the junior Visiting Staff of Colombo Institutions to outstations and vice versa may also be considered.