FIFTH REPORT - World Health Organization

286 FIFTH REPORT ON THE WORLD HEALTH SITUATION
Category
and admission
requirements
General assistant
nurses :
Junior Cambridge
school certificate
Psychiatric assistant
nurses :
Junior Cambridge
school certificate
* 1970 data.
Duration Number of Number of Number of
of study schools students graduates
(years) (public) 1971/72 1972
. 2 years 49 10
6 months
. and service
training 2 10*
Communicable disease control and immunization services
As a result of the malaria eradication programme,
the number of malaria cases was reduced from an
estimated 250 000 in 1958 to 11 000 in 1972. Transmission
still continues in certain problem areas,
though on a lesser scale. The tuberculosis control
programme started in 1960 with a mass X -ray and
BCG campaign. By the end of 1969 the control
activities had already covered 70 % of the population.
At present case -detection is carried out by mass X -ray
and sputum examination. Direct BCG vaccination
is given to persons aged 19 years and below. There
was an outbreak of cholera El Tor in November 1972.
The following immunization procedures were carried
out in 1972:
Cholera 188 428
Poliomyelitis 100 510
BCG 39 919
Diphtheria 39 289
Tetanus 39 289
Whooping -cough 29 703
Smallpox 29 000
Specialized units
In 1971 Sabah had 127 part -time maternal and child
health clinics. There were 28 dental clinics for schoolchildren
and adults, one hospital rehabilitation outpatient
department, one psychiatric outpatient clinic,
52 state and mining hospitals providing occupational
health services, five tuberculosis clinics, one leprosy
outpatient clinic, and 15 public health laboratories.
SARAWAK
Population and other statistics
At the last census, taken in August 1970, the population
of Sarawak was 887 292. Population estimates
and some other vital statistics for the period under
review are given in the following table:
1969 1970 1971* 1972*
Mean population . . . 945 061 968 997 994 535 1 017 887
Number of live births . . 26 959 29 612 28 772 30 340
(per 1000 population) .
Birth rate
28.5 30.3 28.9 29.8
Number of deaths . . . 4 515 4 775 4 924 4 751
' See also under Malaysia (p. 287).
Death rate
(per 1000 population) .
Natural increase (%) .
Number of infant deaths .
Infant mortality rate
(per 1000 live births) .
Number of deaths,
1 -4 years
Number of maternal
deaths
Maternal mortality rate
(per 1000 live births) .
1989
4.8
2.37
913
33.9
0.9
397
24
1970
4.9
2.54
907
30.6
0.9
486
* Sarawak Bulletin of Statistics, 3rd quarter, 1973.
26
1971*
4.9
2.38
907
32.0
450
1972*
The communicable diseases most frequently notified
in 1972 in government hospitals and dispensaries
were: tuberculosis, all forms, new cases (1546),
dysentery, all forms (362), typhoid fever (336), infectious
hepatitis (237), malaria, new cases (129), cholera
(118), leprosy (21), diphtheria (17), poliomyelitis (4).
Organization of the public health services
The Medical and Health Department of Sarawak is
an integral unit of the Federal Ministry of Health,
which determines major policies. The Director of
Medical and Health Services is responsible to the
Federal Minister of Health for the implementation of
health programmes and projects in the State. He is
assisted by a deputy director of medical services, an
assistant director of medical services (health), a
principal matron, a superintending pharmaceutical
chemist, a medical officer (training), a senior dental
officer, and a medical officer in charge of the Central
Medical Laboratory. Each of the five divisional
offices is headed by a divisional medical officer, who
is responsible for the direction and supervision of the
health services in the division. While each divisional
area is divided into districts, there is no administrative
unit at the district level responsible to the divisional
medical officer. District local councils are responsible
for maternal and child health services rendered in
health centres.
Under the second Malaysian development plan
(1971 -1975) the rural health service will be developed
according to the pattern of the Peninsular Malaysian
infrastructure. The State will be divided into health
districts, each district under a district health officer. A
health centre with its subcentres will be able to provide
a well -supervised, integrated rural health service for
25 000 inhabitants. It is intended to establish 200
health subcentres to cover the entire State by the end
of 1980.
Hospital services
In 1972 Sarawak had 20 hospitals and other inpatient
establishments providing a total of 2287 beds,
of which 2133 were in 13 government establishments.
The bed /population ratio was thus 2.2 to 1000 inhab-
4.7
31.3
951