Ii..LAi:IA AND INS.3CT CO?ITilOL 3.1 -- ---------- - "0.

(';mO No. Curna-2)

The 1,JIIO 1.12layia c o n t r o l d e m o n s t r a t i o n team c o n s i r , t i n ~ , o i

f o u r i n t e r n a t i o n a l personnel h2s bccn opcr.?iin:, th rout ,hout thc:

p e r i o d . Thcl s p r u y i n g f o r t h e Cii-st g e a r ~i l - i ich was c o ~ n p l c t c d i n

May 1952, h~2s been v c r y o;f;:ctivc! a:;,:~inst t h e l o c a l v e c t o r ,

A. n in imus . ", ,--. I n u ?ost-opcy;. t inr, : 1- !;:;11:1,rior?ctric s u r v c y conducted

scvcn months a f t . ; r s ; j r a y i n g 9 no nclr i i n f ~ c t i o i i o f m a l a r i a was

cncountcrod srzonz 129 i n r a n t I~ loo i : s l i d e s cxamincd . I n a r e a s

s i ~ r a y c d l:r?th Z?33 r.l[,;r,l, DDT, n o t c ::j.r:;li; sp,c;irxn of t h e v e c t o r

s:~!!cics \ i n s round iihcrc. !s i n t h c acljoin1r.i: unsprc?ycd :!rszi, 11.4

p e r man-hour worc c a u g h t . Thcrc was a l s o n o t i c e d a comple te

nbscncc of bed b u ~ s i n thc sp raycd promises .

Thi: s p r a y i n c o ~ ~ c r : j t i o r l s f o r t:h.: szcontl yc:nr wcrc c o n l ~ l e t c d

i n J a n u a r y 1S53, protecting 105,003 p e o p l s s c a t t c r . : d OVc? :I wide

a r c a o f 2500 s.1. m i l c s .

The work o f t hc ; M O s a n i t , z r i a n c ~ t t a c h c d t o thc: p r o j e c t

f o r t hu improvzmcnt o f r u r a l s a n i t a t i a n h a s c r c a t a d somc i n t c r c s t

i l l t h c l o c a l i t y . T h i s !rorl; i n c l u d e s t h c j ? r c p a r a t i o n of compost

f rom e o l l c c t c c l r s f u s c . This h a s a 1)lc;cc i n t112 1' c a l economy a s

i t c r c a t s s t11~ y ) o s s i b i l i t y o r n t i ~ i r d h a r v e s t i n t h ~ a r z a .

Th i s p r o j e c t h a s b-cn ~ ! d e q u a t c l y r u l f i l l i n ~ i t s lundzi: lcntal

t a s k o f t r 2 , i n i n ; n ~ ! t i o n ; i l r , b y orc ;a . r~ is ing s y s t z n r t i c c o u r s e s , b o t h

th : :o rc t ic : ; l and p r a c t i c a l , n l th*?ugh iil.: : , o v ; > ~ ~ \ j , ~ c n t i i a s n o t

z x p l o i t c d th.. t r a i r ~ i n ~ potontin!.it .ics o f .iilcl p r o j s c t i:o any

:p; , r -c iablc c!xtcnt .

SZ!dRC!G/2 4

P n ~ e GG &.

During t h o y o a r under r c y o r t 1 medica l o f i i c e r , 2 onto-

m o l o g i s t s , 1 s a n i t a r i a n , 4 m a l a r i a - a s s i s t a n t s , 1 2 n a l a r i a - i n s -

p c c t o r s , 1 5 s u p o r v i s o r s and 1 l ~ a b o r a t o r y t e c h x i c i a n hzvc bocn

t r a i n e d . D o t a i l s r e g a r d i n g t h i s t r a i n i n g a c t i v i t y will be found

i n tho .biicx t o t h i s Report .

WBERCULOSIS d D UCG VACCIii iirr'IOP" 2 2 -------

2 .2 .1 23 D o m o n s t r ~ ~ t i o n and T r a i n i n g Pro . icc t . Rmeoon ('dl10 No. Burma-3) (TAD 170. 3UR- 15) (UfTICI3'F i\Vo. LFEP-7)

Tho Contrc a t Rangoon c o n t i n u e d t o work s a t i s f a c t o r i l y

throuzhou'c tile year . The i n t e r n a t i o n a l t o m c o n s i s t s o f on0

S e n i o r Advisor? one X-ray Tcchn ic i an , one L a b o r a t o r y Techn ic i an

and onc P l tb l i c :ic,dt t h Nurse. +

Short .p ,es o i l o c n l , ?c r sonnc l 11avo bocn markod through-

o u t t h e p c r i o d b u t c o n s t m ' i r o p r c s c n i a t i o n s t o ~ o v o r n m c n t a r e

g r , l d u a l l y producing some r u s u l t s , though shor 'ca~c? s af f o c t i n g

Lko work of tho Contro s t i l l p ~ r s i s t .

A p h o t o f l u o r o ~ r a . p l ~ i c survc.y h a s bcon i n 1)rogross i n

Rangoon and o v e r 30,000 pcoplo be longing t o a p p a r e n t l y h e a l t h y

s c l o c t c d g roups i n v i i r i o u s p c r r . t s of tho c i t y trcrc survcycd. On

t h c b a s i s of a p r c l i r n i n a r y a n a l y s i s of sonlo 175:!3 c a s c s t h e

morbici-i t y r a t e of tuberculosis w i t h i n t h o s c g roups appears to

bo as under . A s t o t h c o v c r a l l m o r b i d i t y of t h c :tangoon popu-

l a t i o n , no dcpcnclablc d a t a h a s b c ~ n obt;dnod so f : :~r .

Age No. of 7'1, :: t::.!,:nL Obsc r v a t i o n groul2s cxxnincc s c a s e s c a s e

No. -% - Yo. K-+, 15- 19 1 ,599 18 1.1.3 7 0.43 25 1.56

20- 24 5,257 59 1.12 55 1.05 1.1'1. ?., 16

sEA/RC6/ 2 Page 67

& e No. o f Trea tment O b s e r v a t i o n - g roua s gz9~incc s cases;, ---- c a s e s

N O .. (9 ?Jon

50- 59 454 13 ,3.96 30 6 . 6 1 4C 10.57 --- -- ---

A l l a g e s 17,526 438. 2.45 371 2-09 805 4.55

T u b e r c u l i n s u r v c y s c a r r i e d o u t mon[ ,s t children i n v a r i o u s

u r b a c c n t r c s i n Burma i n d i c n t c t h a t the h i c h e s t r c . t c s were

found i n urban arr!:!s i n t o whicll r c fu i ; cc s fro1.1 war s t r i c k e n d i s -

t r i c t s csljcciaJ.l. y migi.;,.tcd. Thus R?.n:;oon shows 76% of p o s i t i v e

r c n c t o r s amon:si; botl l s c x c s i n t h c 15 yc;.rs a[;c g roup , a d Syrian

and B a s s c i n short$ 70% i n con .Lr2 . -d i s t inc t ion t o Le.s.!?io ~ i n d Elandday

which sliow rc spuc t ivc1 .y 4::$ ;nd 810;;. Tihc t u l ~ c r c u l i n p o s i t i v c

r e a c t o r s i n Rangoon s h o ~ r t!?::t t h e i n f c c ' c i v c ?ate i s m u c h g r c a t e r

mong c h i l d r c n ~ ? t t c n d i n g s c h o o l s i n thc , ~ ~ o s t c o n g e s t e d a r c a s

and i t may bc s a f e l y d.cduccc! t h a t overcrowding i s a m a j o r f a c t o r

f o r sprc::d of i n f c c t i o n i n Lhosc ,clrc;.s.

DuTing t h e yr1a.r ;. s c r i c : s of d i s a s t r o u s f i r e s bu . r~ l t o u t

considcr,:.blc x c n s of Rarlgoon. A n m b c r of' c o n f e r c n c c s was h c l d

a s t o t hc rnc?suros i ~ l ~ i c h should. be "ikon i n conncc$ion w i t h rc -

b u i l d i n : of t h c a r c a s t o n r c v c n t t h c sprc,-d o f t u b e r c u l o u s

i n f c c t i o n . The foll .owing rccorniiicnd;!tions wcrc made 2nd i t i s

hol7od th2.t LI r c p o r t w i l l be l n t c r ~ . v a i l a b l t ' as t o t h e i r e f f i c a c y .

(1) The t u b e r c u l o u s f a m i l i e s be segreg , - ted from t h e

r e s t o f t h e community i n a number of b a r r a c k s which w i l l depend

on i;hc nunbor of f a m i l i e s .

(2) I n s t e a d of ;:.l-.l.ot:l;ing :i fr: :~l: . i ; : : : .to I. l~c.rr:!r:l. o f 5

roorils, o n l y 4 f m i l i e s be p l a c e d i n one b a r r a c k l e a v i n g one

room sjlare. T h i s s p a r e room i s t o be used a s a dormitory f o r

2 t o 4 i n f e c t i o u s p a . t i e n t s o f t h e s a l e s e x d u r i n g t h e n i ~ h t .

The r eason f o r reserving one room i n each bs?:raclr a s a

s l e e p i n g q u a r t e r i s because t h e danger of i n f e c t i o n i s g r e a t a r

d u r i n g t h e n i g h t l.ihen t h e t u b e r c u l o u s p a t i c n t s s l . e c ~ i n t h o

s,me room wi th ot11r.r morn1:ers of t h e f a m i l y ;.ncl t h e c o n t a c t i s

con t inuous and c l o s e . Altliough t e c h n i c a l l y t u b e r c u l o u s l'ami-

l i e s a r c t o be s e g r e ~ a t c d from t h e r c s t of the community t l i c rc *

1dll bc no e x t c r n d indic : i i ions of t h i s 1,y demarca t ion of t h e

l ~ o u s e so tiirct tho t u b e r c u l o u s p a t i e n t s may noid f c c l t h n t they

a r e be in2 sti:matizcd i n any way, I t h a s becn ostl imcted t b o t

the maintenance p e r bed i n tile Rangoon Cencrd l I I o s p i t j l tuber -

c u l c s i s wards ~<or l rs o u t t o about :;yats 750 p c r mnum f o r b a s i c

n u r s i n g and o t h e r s e r v i c e s and d i e t . A t t h i s c o s t 1.0 f , m i l i c s

can be i s o l a t e d . a s desc'ibed above. T h i s a r rangement marks a

new d e p a r t u r e i n preventive work i n t h i s rog ion and t r i l l be

f o l l o m d w i t h i n t c r o s t .

I t i s undcr s tood t h n t t h e b~lildinr. : ; ,.>t i~l:~n6~~:l.;~.y t:.?.; 7L~.n6.sr

c o n s t r u c t i o n . Equipment c,nd s u p p l i c s a r c under procurcmcn t.

Team now a t Rangoon can t a k e o v e r a t R,mddcry.

The f o l l o w i n g t rc . ininZ activities arc i n p r o g r e s s :

( a ) 30 s t u d c n t s u.ndeygoin: H o d t i ? A s s i s t ~ n t s t ra inin: : a r c being ~ i v c n p e r i o d i c l c e t u r o s on t h e p r o v c n t i v o 3s;occts of tube r - T

c u l o s i s .

( b ) & a l l g roups o f m c d i c d u n d c r g r a d u a t c s 7 t o 10 i n nun~bor r e c e i v e d a s c r i c s of l cc -Lures on cp idemiology, d i a g n o s i s , p r c v e n t i o n and t r c a - b e n t o f tuberculosis.

( c ) Courses of l o c t u r c s a r c g i v c n t o s tudc i l t n u r s e s , s t u d c n t P u h l i c I I c z l t h Nursos and s t u d c n t Lady IIlerJ th V i s i t o r s . Thc g roups v a r i e d i n nunbcr of p a y t i c i p a n t s from 15 t o 5.

( d ) 2 L a b o r ~ t o ~ y and 2 X-rry T c c b n i c i a n s f o r a rninor c c n t r e i n Rangoon m.d f o r work w'ith t h c mobilo u n i t a r c being t r a i n c d i n t h c c c n t r e .

The f o l l o w i n g umcmoranda" Ihavc been p r c p a r c d f o r tcach-

i n g purposc s :

3CC- Vr:ccination Rcidiolo~:r i n Pulmonary Tu.bcrculo sis Ep idcn io logy or" T u b c r c u l o s i s Tubcrcu. losis Con t ro l Programme and i t s appl. icai; ion i n Bu 1-ln a .

Tuberculosis and P o v c r t y O r g a i s a t i o n 3f S c r v i c c s of t h o T u b c r c u l o s i s T r a i n i n g

C: D c n o n s t r a t i o n Ccn t r e , 1:an~oon. S a m ~ l c s u r v e y by tu::crculi!? t c s t s j.n R,lngoon.

2,2,2 TEl Lcc Lurcr* Raivoon jieil ical C o l l c a o ( 'dIO !-TO. i3Uma- 10 (TAB P ~ c . ilIJR-23)

Thcrc b2.s bcr:n d i f f i c u l t y i n f i n d i n g a s u i t a h l c candi-

d a t e . The scopc oi' t h i s p r o j c c t ? . r i l l bo considerably widcncd

t o undcr t sJ<c , f o r t h e govortlmcnt, tile o r g a n i s a t i o n o f t l ic tubcr -

c u l o s i s d i v i s i o n i n t h c r ccogn i sud D i r c c t o r a i - c of I i o d t l l Sc rv iccs

w h i l s t a c t i n & a s t h ~ ~ o v c r n m c n t l s Adviser on Tubercu los i s .

2.2.3 2. C O G . V a c c i n ~ t i o n (\;El0 No. ~ u m x (UITI CEF No. F2P- 10)

During t h e scconcl h a l f of 1252, t h e authorities i n

s L d z r i c s of l o c d p c r s o n n c l rircrc r c v i s c d , a miniinuni p c r i o d of

~~- t h r c c months f o r a d o c t o r t o work n i t h t h e campaign was agrcod

t o ; a b l a n k e t s a n c t i o n f o r 1 2 teams bras i s s u e d which h e l p c d

much t o e x p e d i t e t h e r e c r u i t m e n t of l o c a l 1.enrns. It:; ., rcsu3.t

i h c pace of \rork was acce1er:i ted :;nd t h e pi-ogra~~irle ;$as c;iit-:nded

t o a mass campaign. The succes:: ol" t h e p ro , - r amc o;.res n ; r e s t

d e a l "c tt~i! c l o s e co-ol.)cratior! -[:hat h a s been e s t a b l i s h e d bei'weei~

thc 3Cl; t e ; !ns , t h e medical a u i l l o r i t i e : , t h e m u n i c i p a l : ~ u t h o r i t i c s ,

and t h e l o c q l v i l l a{ ; e o f f i c i a l s .

Dur inz t h e n e r i o d August ,52 - June lS:52 approxirr ia te ly

219,230 p e r s o n s wero t e s t e d and 96,7C4 v a c c i n a t e d , i l m s b r i n g i n g

t h e t o t a l t o 1,012,:',1:; t e s t e d and 253,030 v n c c i n a t c d .

F'roil J u l y 1352 t o June 1953, 5 d o c t o r s and DC t e c h n i c i a ~ s

have been t r a i n e d t h u s b r i n g i n g t h e t o t a l o p e r a t i n ? ; i n t h e f i o l d

t o 2 d o c t o r s and 52 t e c h n i c i a n s , k c c o r d i n g t o t h e ' p l a n o p s 1 2

tc!ams o r e s chedu led t o be worlting in t h c f i e l d by thc liiiddlc of

1953. Rut t!lis h a s n o t b e e n possi1:)lc due t o : : c v c r n l d i f f i c u l t i e s ,

e,:;, p a u c i t y of d o c t o r s and l a c k of i n t e r e s t o f d o c t o r s i n pub l - i c

I lcnlt l? vorl: and d i f f i c u : ! t l c s i n t h e I - ec ru l tnen - t o f z u . i t a b l c

t c c h n i c i a n s .

The w e l l c s t a b l i s h c d v c n o r r : ~ l l d i s c a s c s c l i n i c a t tho

Eangoon G e n o r j l H o s p i t a l and t h o f i v o u t l y i n ( : c l i n i c s :ire do ing

c,ood worl:. The Ran[;oon ( i ~ n c r a l f ios i : i t a l Vcnercn l d i s c a s o s c l i n i c L ~ ,

v a s :;hil'tcd c , a r ly t h i s y e a r t o i t s i1c;i acco!~r~loLiation which p r o v i d c s

b e t t e r f a c i l l ~ i e s and p r i v a c y t o p a t i e n t s .

T

m i h e P a s t e u r I n s t i t u t e and. t l l c 2an:;oon Genera l X o s p i t a l

l abora ior ; ! conLin7.c Lo ta1;e c a r e oi' t h e scro1o; ic needs of t h e

p r o z r a i13:e i n dan:;non.

Arran;emctll::: have heen ma~1.e t c coniluct rflass ' ~ l o o d t e s t -

in: of e~lplogrecs o; t-ihc Port C o a i s s i < , n c r 1 s o f f i c e and d.oclr work-

c r s . Survcys of otl.:.,r popu1.a. Lion ::rov.],s sil.c:? as e r~~p loye l ' s of

L L ~ C ?urzia i:ai:!~iays , li;nl:oon i - i v e r s i - t y s L ~ l . d ~ ? i ~ t s i-n;oon Cen.-ral

i I o s p i t a l ou t - and. i n -pa i ; i ? ,n t s , i nma tes of t h e d e a f and dvm;>

s c h o o l , and enployce:; of Kacllin S t a v c ~ior!rsho;?s wcrc ca l - r i cd

o u t .

An ap;>rox i-:,?ke t,&al of 21 ,?I-)O sy;?!-i-ilis cas.:r:. have Coa-

plctec; a ci:;ursc o l 8;rcl;:ren~t _'r,>.! ; c p t u , . , b . ~ r 1551 t o J u l y 15'53.

. . Tl-ic i'ol!.~t!ii.;,; 1::ave UI.!(IC? 0~1.i: i ; i ' , l ~ ~ l ~ n ; a t t l l c i',~t::;oon

GenZraL ::os;)l Lal VI) c l i i l i c : i .d 1':~s leu? I n s , i t u t e ; l nicdical

oI 'f icei . , 17 n u r s e s , 2 1 i n \ - e r t i , a i rors , 10 l a l ~ o r a t o r y t cch l? i c i a i l s ,

2 soc i j . 1 vioT!cc::s. 3esidc.5 t l l i ; , 1-c-tu.res P.:?G. c l i n i c dcrnonstra-

t lo, :s were unclcrtalzcr: lor rncc!icnl! 5 iuC:c!7L:, s L ~ d k i ~ t ; n u r s i s , lady . .

h e n l i h v i ; i t o r s , pi-1 die i ica l t;l nvr , : .~n : ; s ; ,udcnts , midwives an&

p u b l i c : i c s l t i l a s s i s t a n t s . 3 c t t e r c o o r d i n a t i o n has bccn e s t n ~ : ~ l i s : ~ c d w i i h t h e KC3

ccn c r c s . Slcod tc.::ti.nc; of ;>r ~ : , n n n L wor.lcn i n tl-ic c!.iffci'cni; i'lC!i

c e n t - i c s and a; ; ;.I-!c Uu;fi:rl!! !,o:;p.i.L:?l con t lnu,-s . Thc trc2tn:;lit .

of :?usbands anti c;i;ldincn a.t GooL:liffc has r c s i l l t c d i n more i l o o d s

L be in , ,,a::er, a116. m o r ~ : 'al;icnts :;i?tti"' .-,J treali :c!?t .

rflie pi andaln; V.11. C l i r : l c -!ti l ~ . ; - i o ' l t o r > ~ es-La:>li sht6. i n

J v l y 1:. -:2 made cvns id~: i .? : j l~ piqo:;rcss c:ursi!i ; thd ~ ; . ~ i o d unde r

SE WRC 6/2 Page 72

Tlie V.D. programme i n Burma i s i n i t s expansion phase

on a country-wide b a s i s . Venereal d i s eases c e n t r e s w i l l be

e s t a b l i s h e d a t each of the main d i s t r i c t h o s p i t a l s . F i e l d teams

w i l l work froin these cen t r e s doing case f i n d i n g ancl t reatment

dur ing t h e a c t i v e phase of t h e campai:;n. The se ro log ica l

l a b o r a t o r i e s e s t a b l i s h e d w i l l be capable o f expansion f o r

general p u b l i c h e a l t h examinations l a t e r .

A V.D. c l i n i c s t a r t e d func t ion ing a t t h e Ffoulmein

General Hospi ta l i n May 1953. Equipment and supp l i e s f o r opening

the Pegu and Akyal: c l i n i c and l a b o r ? t o r i e s are be ine gathered.

2.4 LEPROSY (1dEIO No . Burma-17)

This p r o j e c t s t a r t e d i n Augus'c 1952 with a l e p r o l o g i s t

and equipment and supp l i e s provided by ! d I O i s p rogress ing wel l .

Detec t ion of e a r l y cases among school -ch i ld ren has been organized,

i n Rangoon i n co-operat ion wi th the School Hea l th Serv ice ; about

300 cases were recorded wi th in 6 months. Two d iagnos t i c c e n t r e s

are i n ope ra t ion i n Rangoon. Treatment and follow-up are

c e n t r a l i s e d i n a newly e s t ab l i shed c e n t r a l "Specia l Sk in C l i n i ~ ~ ~ .

The out-door c l i n i c o f the Kemmendine Leprosy Sanatorium,

s i t u a t e d i n a suburb o f Rangoon, i:; maintained. The number

t r e a t e d i n Rangoon i s i n c r e a s i n g r a p i d l y ,

The government has handed over a two-s tor ied school

bu i ld ing t o be remodelled i n t o a Cent ra l C l i n i c and Tra in ing

Centre. A Burmese doctor experienced i n l e p r o s y and now under-

goihg a t r a i n i n g course i n l e p r o s y i n Ca lcu t t a under a t\MO

followship w i l l be placed i n charge of t h i s t r a i n i n g c e n t r e . .I

SEP/RCG/2 Paec 73

Tho c o n s t r u c t i o n of a new s t a t e s a n a t o r i m . f o r s p e c i a l

s k i n d i s c a s c s i s under way i n IItaulthym. T h i s sana tor ium i s

s p e c i a l l y inca r t Tor d c s t i - L u t e le:?rosy p a t i c n t s f ror~ . Sanzoon -2nd

ad joininy; d i s t r i c t s . The l ~ u i l d i l i g which w i l l be conp le t e d w i t h i n

t h o n c x t Pew r,ioni;hs, w i l l pi-ovide accornr:iodation f o r t r c a t m a n t

and r e h a b i l - i t a t i o n of 500 p a t i c n t s .

A s i x r lon ths l t r a i n i n g coursc f o r lei71:osy i n s p e c t o r s was

conducted by t i ~ c XI0 l e p i - o l o s i s t a t wliich 16 l e p r o s y i n s p e c t o l ' s

were t r a i n e d and p o s t e d t o d i f f e r e n t d i s t r i c t s o f Upper and Lower

3urma whcrc p r c v a l e n c o e l i r : p r o s y i s zbove avcrnze . Touring t h e

d i s t r i c t s w i t h i n ' h c i r j u r i s i d i c t i o n , c a s e f i n d i n g , t r e a t m e n t

on t h e s p o t o r r e f e r r a l t o c n n t T , d d i s t r i c t c l i n i c ,and nropagh-

tin;: t h e modcrn outloolc on l c p r o s y a r e some of' t h e i r i m p o r t m t

d u t i e s . 15 such teams a r c i n operation s i n c e t h o b c ~ i n i l i n g o f

March 1553. To pave tho w a f o r good. human r e l a t i o n s h i p s m d

co -opora t ion on t h o p::rt of o f : ? L c i a l s and i n f l u e n t i a l c i t i z e n s ,

D i s t r i c t Leprosy R o l i o f A:;soci;ltions have boon c s i a b l i s h c d o r

r c v i v c d .

Thc t - l r g c t of t h o ~ o v c r m . c n t t s carn?aisn, i n t ho f i r s t

i n s t a n c c , i s t r ~ . a t x l c n t or" 30 ,000 c a s c s g t h a t i s SO/;! of tho t o t a l

c s t imakc on Lhc b a s i s of 5 m:fi~ifcs-i; ci.~sc:s p c r 1 ,000 of populat ion.

T h i s volumc o f t r c n t m c n t , ~ ) rov ic l cd i t be regularly c o n t i n u e d ,

may s t z r t t o a . i f c c t !,rovr;Lcncc. Thc weak p o i n t i s n o t so much

tlic n m b c r tnlrcn i n t o c o n s i d c ~ a t i o n , b u t t l lc lcl.ck of g u a r a n t e e

a s t o c o n t i n u m c o o f r-::ular trc;:;i;mcnt. To tl1a.t ond, f u l l - timo

- s o c i a l workcrs a r c u rpen t l y nccdcd ~ a r t i c u l z r l y t o per form home

. v i s i t i n g i n Rangoon. A socond d c s i d o r a t u i i s i n c r c a s o of

SE&'RC6/2 Paeo 74

s y s . t c m a t i c a l i y s u p c r v i s c d f o c i i n t h e d i s t r i c t s , 8 t o bo addod

i n 1953, and a n o t h e r 3 i n 1951.

2 . 5 PUBLIC KEIGTII ADVm (IbJEIO No. Burma- 1)

Tho p o s t o l tho P u b l i c Hr:;ilth Adviscr which was h e l d i n

abcyanco f o r somo,mon-bhs was n b o l i s h c d wi th t h o appointment of

V f i O Arca R c p r c s e n t a t i v o i o r Burma.

2.6 8 SOCIAL SZRVICES EiISSION TliIH0 No. C,II\!-9 E U ~ S O S ~

Tho UNTAL S o c i a l S o r v i c c s Miss ion t o Burma, wi th tho aim

t o p l a n , i n co-ordincttcd mannor, s o c i a l s c r v i c c s ? o r t h c coun t ry . i n tho f i o l d s of S o c i a l 'i?Clfarc, Labour and I n d u s t r i a l l l o l f a r c ,

P u b l i c i i c a l t h and l i c d i c a l Carc and S o c i a l Educat ion ' , conunoncod

work i n Octobcr , 1952, ,and c o n p l o t c d i n J u n c 1953. 1!JH0 was

r c p r c s c n t e d on t h i s Mf~ssion by a S c n i o r P u b l i c l i c j l t h O f f i c e r

who h a s submitbod h i s T o p o r t f o r i n c l u s i o n i n t h e b l i s s i o n ' s

Report which i s now bcing f i n a l i z c d .

2.7 mORG A I d I ~ ~ ~ ~ T , OF NED1 C&--@JD HGPLTII SSRVI CES (:RO No. PlIA- 2- 1- aur)

A t t h c rccluost of -the [;ovc;rnmcnt two oxpcr i cnccd WI10

P u b l i c I I c a l t h A~bnini.stra:i;ors l"rorAi t h c R c z i o n d OYficc :rcrc a s s i g n i d

t o i:u.rrna : f o r two wouks i n Au(:ust 1552 t o a s s i s t tkic govorn-

fiicnt i n roor::cmizing tho D i r c c t o r ~ : t c of bicdiccil 2 Fical th S c r v i c c s ,

D i r c c t o r a t c of liJori~cnls O C h i l d r o n f s Mc1fz.rc ;nd D i r c c t o r a t c of T

Chi ld Health S c r v i c c s i n o r d o r t o i n c r c a s e t h e i r ci ' . i icicncy i n

.SE A/RC(5/2 Page 7 5

a d m i n i s t r a t i o n ,"nrl t o coordinate the va r i ous types o f h c a l t h

a c t i v i t i e s and pro[;ramiix,s i n Burma. Thcy completed t h e i r a s s ign-

ment and subr.iittcd t h c i r rc; ,ort t o t h e government i n Sc2tcmber

1952. They havc i ~ ~ a d c valuable: and f a r r e z c h i ~ recomf i~nda t ions

f o r t h c rcor:anizat ion of t he Hca l th D i r c c t o r a t c .

Th i s r c 2 o r t was coi?sidcrcd : x t t h e C l s t . Meeting o f t he

Burma Nat iona l I Iea l th Council he ld on 17 January , 1953 and the

rccornmcndations o f thc kJHO e x p e r t s IhJCIT g e n e r a l l y accepted , and

a r e being irnplcncntcd wi th !lFIO assistance .

lJCI-I/Nursinn Pro 'c c t 7 bfH0 No . Burma-G 5-

fluch o f t h i s p r o j e c t d e a l s w i th n u r s i n z educa t ion and

trainln,. : . Nursing educa t ion and t r z i n l n g programmes havc continued

a t the Ranzoon General H o s p i t a l , Harcourt B u t l e r I n s t i t u t e and a t

M a n d a l ~ y H o s p i t d .

A t t h e Panflooii General Hosp i t a l and Nursin;: School , c l a s s e s

have been cont inued and 76 new s t u d c n t s were aclmittcd dur ing t he

yca r . T h i r t y one s t u d e n t s s a t f o r t he S t a t e f i n a l cxnmination,

thc r e s u l t s o f which a r c not yc t k i ~ o ~ ~ ~ n ~ A ward t each ing programme

i s p rog re s s ing s a t i s f a c t o r i l y and a Ward l ianual of b a s i c nursin:;

procedures ha s been developed and i s being used i n a l l wards.

A graph i l l u s t r a t i n e t h e l c c t u r e programme has been l ~ r e p a r e d .

A P u b l i c Hea l th Nursing Course was i n 1951 and

f i v e s t u d e n t s ~ r a d u a t c d i n J u l y 1952 and an a d d i t i o n a l 4 i n .April

1953. The s y l l a b u s was r e v i s c d and pu t i n t o use f o r the second

c l a s s . It i s envisazed t h a t a new c l a s s of 1 5 s tuden t s w i l l

s t a r t i n September 1953.

Assistance i n thc t ra inin; : programme o f l a d y h e a l t h

v i s i t o r s has been continued and the newly qual.ificd pub l i c

h e a l t h nurses have pnr t ic ipat ied i n the teach ing for t h i s course

f o r the f i r s t t ime. A new c l a s s o f 42 s tuden t s was r e c e n t l y

admitted f o r t r a i n i n g . The block system of t ra in in , : has been

i n i t i a t e d and i s p rogress ing s a t i s f a c t o r i l y . No Burmese t e x t

books are ye t ava i l ab l e and d e t a i l e d l e c t u r e no te s have t o be

t r a n s l a t e d and rilimeoeraphed a s a s u b s t i t u t e . Nursing procedures

have been t r ans l a t ed i n t o Durnlese and s tudents taught how t o

adapt these f o r use i n the home. A d i s t r i c t manual and h e a l t h

educat ion p o r t f o l i o are under ? r e p a r a t i o n ,

A t the Tyandalay General Hospi ta l b a s i c t r a i n i n g i.n in id -

wirifery continues and a t o t a l of 34 s tuden t s are i n thc School.

Domici l iary experience has bccn i n t e g r a t e d i n t o the curricu.lum

and i n fu tu re every s tudent will. receive t h i s valuable exper ience.

The ret:ruitment o f nursin:: student:: for. general. nurs ing has been

most d i sappoin t ing ttilis ho s p i t 2 1 5 s not t r a i n i n e s u f f i c i e n t

nurses t o f i l l t h c i r obrn vacant post:; l c t alone su2plyin;: t r a ined

nurses f o r o t h c r hospii:als and h e a l t h s i i rviccs . Govcrnmcnt i s

aware o f t h i s and i t j.s undcrstood t h a t temyorary n u r s i n ~ q u a r t c r s

a rc t o he e r ec t ed i n o rde r t o incrc:isc! l he nursin:; s t a f f ( t r a i n e d

and pun i l ) . 411 i i lscrvfce t r a i n i n g course fo r "Lcthesll both a t Ranpon

and Mandalay cofi~~!icnc~d i n Apri l and i n add i t i on a s e r i c s o f l e c t u r e s /

and deinonstratioins have bccn c ivcn t o midr!ives and l a d y h e a l t h

v i s i t o r s .

A s e n i o r n u r s e was ap],ointcd t o t h e p r o j c c t i n ~ o v c m b o r

1952. Shc ar r i .vcd a t a v c r y a p p r o p r i a t e t ime when t h c n u r s e s

i n t h o f i e l d wcre a sk ing f o r a s s i s t a n c e t o c o o r d i n a t e tho n u r s b g

a c t i v i t i c s and n u r s i n g p roc rm1!cs undcr t akcn by them i n conjunc-

t i o n wi th t h i s p r o j e c t . Slie h a s a l s o made i n i t i a l p r e p a r a t i o n s

f o r t h e proposcd D i v i s i o n of Burs lng i n t h c D i r c c t o r a t o of Iioalth

S c r v i c e s .

PIATEIWeL fl?D CIULD HEALTH 2.9 - - - - - - - - (WHO 110. Durna-61

Tho p r o g r e s s of thc EiCII p a r t of t h e PiCH/VD p r o j e c t dur-

i n g t h e second y e n r of i t s o p e r a t i o n h a s bccn v c r y s a t i s f a c t o r y .

To t h c i n t c r n ~ ~ i i o n d team was addod n s e n i o r n u r s e t o c o o r d i n a t e

t h e many n u r s i n g education a c t i v i t i e s undcr t h i s p r o j c c t . Thcse

a c t i v i t i e s (Tor d e t a i l s scc undcr ?>rursing) r d l l r e s u l t i n tho

a v a i l a b i l i t y of more and b e t t o r t r a i n e d l ~ o r s o n n c l f o r t h c expm-

s i o n o f MCH s c r v i c c s i n Burma and a s such t h o s e a r c o f b a s i c

impor tance .

Another i m p o r t a n t p a r t of tho t r a i n i n g programme i s tho

p a e d i a t r i c tr d n i n g o f medic& undorg radua tcs rnd g r a d u a t e s a t

Rmgoon of l ihich f u l l d o t a i l s , lrc c,iven below:

P a d i a t r i c Qi , . i n in~ . - -Mcdicd -- VIIIiO P e r s o n n e l E n g a e d : 2 P a e d i a t r i c i a n s . ---

L c c t u r c Courso

(1) P e r i o d : I-ov./52 - Fob./53 (3 months) I l c d i c d s tuc lcnts c n r o l l c d : 65

( f i n a l y e a r )

(2) P c r i o d : J u n c l/53 - Scpt . 30/53 bfcdical s t u d c n t s o n r o l l c d : G 5

(final y c a r )

P c r i o d : J u l y l/52 - J u n c 30/53 Groups o f 6- 1 0 Tourth- y c a r s t u d c n t s montlfiy.

( 1 ) Scni o r Cegn t o rx a r t P acdl&:!;,i c i *an s

P c r i o d ; Ju1.y 1/52 - J u n c 30/53 Numbor a s s ignod : 2 f o r f u l l p e r i o d .

(2) S h o r t Cour.sc (3. months1

PcrioB: t ia rch 1 - liay 21/53 Gr:irluatc d o c t o r s irom d i s t r i c i h o s p i t a l s : 2.

P c r i o d : J u n c l/53 - PIumbcr a s s ignod : 2

T h i s p a c d i < ~ t r i c t c a c h i n g r)ror.;r;>mlo sot:: 3. good oxamplo of what

c i u ~ bc done cvcn i n r n t h c r a s h o r t p e r i o d .

Tho s c r v i c c s undc r t!iis p i .o j cc t , a s a m a t t e r of f a c t ?

a r c r e s t r i c t e d t o t h o a r c a s s c r v i n g a s d e m o n s t r a t i o n and t r d n -

i n g f i e l d s . liJork i n those a r c a s h a s bccn i n t c n s i f i o d both i n

Rangoon and Mandalay and t h e r c s g o n s c from t h c p u b l i c h a s bcon

s t inulc?. t ing.

An i m l ~ o r t a n t r c o r g a l i z a t i o n i n tl-~e n a t i o n & MCII s c t up

took p l a c c by b r i n g i n g a l l PICH nc t i v i t i c s undc r one D i r c c t o r n t o

o f t h c IIod1;li S c r v i c c s . t H t h tho n ~ a i l a b i l . i ' t ~ of more m d b c t t c r

t r n i n c d ;7crsonncl. f o r r u r a l ccn-Lrcs and p r o v i n c i a l h o s p i t a l s ,

t h o devclopmcnt of NCIi i n 23umia. c c a be v i s u d i s o d c l e a r l y i n the

n c n r future. I n t h i s rnannqr t h c activities under & i s p r o j c c t

c c n t r c d i n Rnngoon ?.nd EImdd2.y w i l l bccomc country-wid0 impoj.tmcc. F

2.10 l\rUTRITION (WHO No. Duma-15 & 2 G )

The shor t - t e rm consul tc in t p rov idod by I;MG complctod his

su rvcy i n October <;nd subrn i t tcd liis f i n d i l ~ p o ~ t i n Novcmbcr,

2 I n ac?ord;_ncc ~:ri.i;h his rccor%-acndations and a t t h c r e q u e s t

o f t h c eovcrnmcnt p r o v i s i o n h a s bcon nndc f o r n mcdica l n u t r i -

t i o n i s t and a b iochemis t t c c h n i c i m . w i t h r e q u i s i t e s u p p l i c s ,and

equipment t o a s s i s t i n o r g a n i s i n 6 a n u t r i t i o n s e r v i c e . Rcc ru i t -

mcnt i s unclcrway. I t i s cxpcc tcd t ih-t FA0 w i l l add a n u t r i t i o n i s t

rIic i : ic j .an t o thi: l ~ r o ji: c-t .

A s h o r t - t e r m consif i t , -nt i n f o o d 1iyf;icno w-:s - .ssigncd to

Surrn. f o r two trccks i n J u l y t o -.itvisc -nd 2ssist t h e g0vC~nmcnt

i n t h o i n t r o d u c t i o n . o f modern 2nd scientific mcthods i n s l z u g k r -

house c o n s t r ~ l c t i o n ?;ld -nd oper,-.tion ::nd i n s l ? c c t i o n of f o o d s

o f :\nim-1 or ic - in cLc. Hc h:ls complctcd h i s -ss ignment *'.nd h i s

report i s a~,i ,?i t i .d.

2.12 EDUCATIOI,! !$ID TRAINING

Assisi,:?rlcc t o Iic -~14:1? Assis i;,-.n.i;s School - R ? . ~ F : o o ~ --------- (\!&I0 710. 2umc-.-20)

The govcrnr,?cnt 11:,.s c!s L:+li. shed 2 i i c d t h Assis t ,? .nts School

t o t r - i n p,:r<-.-mcdic:~l p c r s o n n c l , +;he p e r i o d of t r - . i n ing bc ing

18 months. Thcrc ,.re 150 h c r l t h :!ssi s t : \ n t s undc r t r ~ i n i n g r.nd

they will be re,-.dy f o r p o s t i n g by t!lc cnd of 1953. Thc o b j e c t

of t r n i n i n e t h i s k i n d o f p e r s o n n e l i s t o m-kc t h e t r ? i n e c s cap- - ::blc o f do ing t h c p r c v c n t i v c work of ,-. ssni t ; , . ry i n s i ~ c c t o r ~ n d

a l s o t o g i v e medical s e r v i c e f o r minor i n j u r i e s , and t he col;moner

nicdical d i s ea se s . Tho govcrnmcnt 's p r e s e n t scheme i s t o p o s t

one such h e a l t h a s s i s t a n t t o the r u r a l h e a l t h c e n t r e f o r ,m a r e a

con>r i sin: 15 vi l l .agc t r a c t s L!l a i30pula'iion o f 'from 15,000

t o .10,000. This scheme de2)cnds ;'or i t s success on proper supor-

v i s i on . 11; h a s been considcrcd nccc s sa ry t o employ a specialist,

i n 1 ) a r s r n c d i c d educat ion t o a s s i s t i n t ho t o r~c ! l i n~ . Such a

s p n c i a l i s t i s under r e c ru i t r i cn t .

2 1 Fl3LLOWSiIT.P S

During t he pe r i od under review, '7 f e l l o w s h i p s were awarded

j.11 L c y r o s y , . tnacs thcs io logy, S t a t i s t i c s , TJ Cont ro l , ) l a l a r i a ,

Pub l i c i i oa l t h TTursing (Td) and N.C.11. Of tl icso, 5 a r c r c ~ i o n d .

m d 2 i n t e r n a t i o n a l ; 4 a r c i n -the f i e l d and tlic m a l a r i a fol low-

sh ip w i l l comcnce i n February 1954.