Report on the public health / Southern Rhodesia.

  • Southern Rhodesia. Department of Health.
Date:
[1952]
Catalogue details

Licence: Public Domain Mark

Credit: Report on the public health / Southern Rhodesia. Source: Wellcome Collection.

    14/68 (page 4)
    orderly, one or more junior trained orderlies, female trained maternity assistants and untrained assistants in numbers commensurate with the numbers of patients treated. The “home-station clinics have each a trained microscopist. After considerable trial and experiment, a standard pattern has now been evolved which allows for one ,quarter of the final clinic building to be the first section built. This is L shaped and has three wards (total 24 beds), an out-patient room, which can also be used as an operating theatre and a dispensary/laboratory, as well as male and female sanitary block, the former being sited so as to fit in with the next stage of extension. Behind the building is a kitchen and storeroom connected by a covered way. The cost of the first stage of a clinic is now about £7,000. The second stage converts the L into an E shape by the provision of three more wards, an operating theatre, and a separate laboratory. The successive stages provide a third and then a fourth wing so that the final is H-shaped, with the kitchen centrally placed. From the first stage, two open-air wards for infectious disease cases, a mortuary, an incinerator and staff housing are provided. The latter is increased pari passu with the additions to ward accommodation. Where suitable electrical power is available at home-station clinics, small mobile X-ray units are placed. There are as yet many gaps in this organisation, but they are gradually being filled. No charge is made to any African patient at any Government clinic. The demand from both the employers and the Africans themselves for more and more clinics is increasing at an unprecedented rate, but it is essential for success that each demand be closely scrutinised so that the provision of Clinics is related to the population at risk, and that no medical officer is expected to supervise more clinics than he can adequately deal with. Experience has shown that this number is four, including his home-station. BUILDING PROGRAMME. The Departmental programme for new buildings has now reached very formidable proportions in spite of very careful screening before any item is added. The task of allotting priorities within this programme becomes daily more difficult because so many factors, other than availability of finance, have to be borne in mind. These factors include the possibility of obtaining building materials and of securing contractors able and willing to carry out the work. Furthermore, many of the projects are on a scale which will take three or more years to complete, hence careful selection must be made so that the ultimate aggregate of the -annual financial grants does not exceed the share of the building potential of the Colony allotted to Health matters. The problem is not made easier by the rapid increase in demand for curative facilities occasioned by the rapid influx of European immi¬ grants and the high rate of natural increase of the Africans (who double their numbers in less than 20 years) coupled with the enthusiasm with which, even in the most remote areas, they come for treatment on European lines. There is a grave risk that too easy a compliance with these demands will build up an annual bill for operational costs of a magnitude which the Colony will find difficulty in meeting and hence lead to an undesirable reduction in the funds available for preventive medicine. The need for more and more emphasis on the latter aspect of the work of the Health Department is only too apparent, but, as yet, it is difficult to educate the public into realisation that it is far better (and often cheaper) to prevent malaria, bilharziasis and other diseases than to maintain elaborate institutions for treatment. The success of the Mazoe Valley Project has gone some way towards this goal, but far too few employers of labour realise the value of adequate housing, sanitation and pure water supplies for their employees, or at least their realisation of the problem is not acute enough to lead to effective action being taken. Yet the most cursory consideration of the position should reveal the inefficiency of taking employees to a clinic for treatment of a disease, such as bilharziasis, if the conditions which caused the infection are unchanged, so that the employee is re¬ infected within a few days or week of returning from the clinic. On the one hand, there is the expense of transport, of treatment and the loss of working days for no permanent benefit. On the other, care in the provision of a piped water supply and sanitation would make certain that the treatment given was worth while and that real value wTas obtained for the expense. Research Facilities.—In addition to the work of the officers of the Malaria and Bilharzia Research Units, many of the Government medical officers undertake, in addition to their numerous routine duties, successful schemes of clinical and field investigations. These are encouraged to the full, but there are many other health problems which can only be tackled by whole-time workers with adequate