Report on the public health / Southern Rhodesia.

  • Southern Rhodesia. Department of Health
Date:
[1949]
Catalogue details

Licence: Public Domain Mark

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

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    the rapid increase in populations served, there is a grave risk that the sewage works will be overwhelmed if their extension is not planned to keep pace with both the increase in population and with the ready availability of water supplies, the latter being a potent factor in the sudden increase in the “ dry weather flow ” arriving at the sewage works. Training facilities for nurses and for auxiliary nursing aides continue to increase. The two European nurse-training schools are receiving a sufficiency of applicants for training, although the wastage during this period remains high. During 1953, the first group of Coloured and Asian student nurses were accepted into the Salisbury Preliminary Training School preparatory to the opening of the Princess Margaret Hospital, due to take place early in 1954. Some difficulty is experienced in getting girls of the requisite educa¬ tional standard to cope with the theoretical subjects of the nursing course but it is expected that with the gradual expansion of the secondary schools for Coloureds and Asians, a better selection of students may be possible. In contrast, there is a very large increase in the applications for training as nursing auxilaries or orderlies from Africans and with the increase in the training facilities at both Government institu¬ tions and at Medical Missions, there is a very real risk of over-production of trained auxiliaries for the posts available in spite of the increased use of these groups, not only in Government and local authority hospitals and clinics, but in private clinics on farms and in industrial work. It seems probable that some restriction may need to be placed on the numbers to be accepted for training, since the African has not yet appreciated the fact that vacancies are bound to be given to the better workers, they are only too prone to the view that the mere acquisition of the qualification as an auxiliary entitles them as a right to secure employment and that at the place of their own selection. With regard to trained professional staff, the position has been more satisfactory than for some time past. Recruitment of medical officers and dental surgeons has been better than expected, and it is hoped, will remain so in spite of considerable expansion in several directions. With regard to trained nurses, the position has been even better. This is partly due to the availability of suitably qualified married women in most centres, but also to the policy which has now been adopted by using fully qualified African women to staff the main African hospitals under a minimum of European supervision. In the main these African trained nurses and midwives are learning to accept the responsibility of taking charge of wards, and in some instances are proving very efficient. Individual Diseases With the continuation of the residual insecticide campaigns, the malaria problem is progressively becoming less acute as the figures in the body of the Report show. There are very real risks that inadequate dosage of BHC or DDT, when applied without supervision or control will lead to resistant strains of mosquitoes, but the benefits to be gained are so apparent to the African population—even where these benefits are looked at more from the point of view of personal comfort than from the malaria angle—that it is inevitable that Native Councils and even individuals will insist on spraying. The Department of Health offers all the assistance possible in supervision and in training of personnel in order to lessen these risks. The position with regard to Leprosy continues to improve with the wider application of sulphone treatment. Although fairly large numbers of patients voluntarily present themselves for treatment in the two leprosaria, the results of modern treatments are so good that discharges outnumber the admissions. It is felt that as the value of the new treatment spreads to the more remote districts— as is already happening—more and more early cases will come forward. To encourage this, a film and film strips are about to be prepared for showing at African gatherings in an attempt to educate the public in the desirability of seeking treatment early, and in the excellent chance of cure under modern conditions. With the relatively small number of total cases in the Colony, there is some hope that this disease will ultimately be reduced to negligible proportions, especially if it becomes possible, ultimately, to pin-point foci of infection and have these carefully surveyed by examiners well experienced in the earliest manifestation of the disease. Fortunately, the year 1953 saw a marked remission in the incidence of Acute Poliomyelitis following the relatively severe experience in earlier years. To some extent, this may be due to lessened immigration, but a more probable explanation is that the previous epidemics have given rise to a high proportion of immunes in the general population, which immunity was acquired by a mild infection with the virus not recognized as such because it did not give rise to the complication of involvement of the central nervous system. On the other hand. Pulmonary Tuberculosis shows a much less pleasing picture. Whilst the position in Europeans remains static at a fairly reasonable level, the incidence in Africans, especially in the Midlands, gives grounds for disquiet. This incidence is not in epidemic form but is most apparent in the urban areas on mines. Every effort has been made to provide additional special accommodation both in Government institutions and by subsidizing medical missions willing to accept this additional responsibility, but there is still a considerable shortfall. At the same time, there has been, in spite of lack of special staff and accommodation, an increase in the campaign of Tuberculin—testing and BCG immunization. This has not only been
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