S A / R C 7 / 2 Page 43

DDT i n s u f f l a t i o n , a country-wide campaign a g d n s t th i s seasonal

scourge i n Afghanistan was launched i n the wiilter of 1'953-54.

About 1.25 m i l l i o n people and t l l e i r personal c lo th ing , bedding

e tc . were systenaticaJ.l;r delou.sed ::ith 10$ DDT by t r a ined terns .

m e cmpaign vas v e r y successful . Ir. the Kabul Province where

244,995 i n d i v i d u a l s were deloused, n o t 2 s i n g l e case of t ~ l i u s

was repor tcd, Fdr ther d e t a i l s a r e ,:iven uneer t h e s ec t ion deal-

i n g at11 "Epidemiology and I n t e r n a t i o n a l Quarafltineu.

2. PUEaIC HEaTti SEFXICBS

2.1 S t r e n ~ t h e n i n - : of Natioilall !3e?lth AdQ;ini s t r a t i o n s

!dEO a s s i s t a c e t o d-enonstrate coordinated and i n t e g r a t e d

h e a l t h s e r v i c e s on a h e a l t h u n i t ba s i s a s well as t o provide

f i e l d t r a i n i n g a r e a s f o r the t r a in i ; l r of pub l i c h e a l t h i~e r sonne l

continues. It i s considered t h a t t h i s form ai7 p r a . c t i c d t r e in -

i n g on tile n a t i o n a l b a s i s con t r ibu t e s t o the t o t a l l i ea l th service .

I n Burma, a f i e l d t r a i n i n g u n i t w i l l be s t rengthened by the

~ r o v i s i o n of EG s a n i t a r i a n f o r the developinent of s a n i t a t i o n

a c t i v i t i e s and a second train in^ cen t r e w i l l be e s t a b l i s h e d i n

an already se l ec t ed r u r a l a r e a t o t r a i n h e a l t h personnel o f all

I categories. I n Ceylon, i t i s planned t o expand the a c t i v i t i e s

of Kalu ta ra ? e a l t h U n i t by L:ic provis ion cf t;?e part- t i i l ie

s e rv i ces of an e p i d m i o l o ~ i s t , a s a n i t n r : ~ engineer and a h e a l t h

educator. I t i s ;slanncd t o e q ~ a n d t h i s u n i t i n t o an i n s t i t u t e

f o r t r a i n i n g of h c d t k ~ ~ e r s o v m o l . I n Ind ia , S t a t e T r o i J r m c s

i n hiGI3 i nc lude ass-is'iainco t o "eld t r a i n i n g areas. While having

, ~ r i n a r y emphasis on E.iCil, tLlese a r eas w i l l also provide f a c i l i t i e s

f o r t r a i n i n g i n h e a l t h educat ion, environ;nental s a n i t a t i o n ,

SE i+/ AC7/ 2 Page /Y_

n u t r i t i o n and o the r aspec ts of general p u b l i c h e a l t h ~ r a c t i c e .

The d r e a c i j e x i s t i n g Singur t r a i n i n g a r e a a t tacked t o t:'ia All

Indi? . I n s t i t u t e or :iygiene atid Publ ic ::cd.th i s being extended

t o inc lude school h e d t l i s e rv i ces and t r a i n i n g i n ;iealth

edv.cztion. Tk.rce h e a t h u.nit a r ea s i n I n d i a , nz1lal:r a t Singur,

Najafgarh and Poonamd.12, are a l so being uti l iseCl by ~ o v e ~ m ~ e n t

t o t r a i n he d . t h teacI-,ers f o r t he cornmun1t:r d e v e l o p ~ e n t programmes - an ' i l teres t ing exa ip le of the i n t e g r z t i o n cf g - o e r d comLmity

.... dcvcjlopmeilt and h e a l t h work. I n Indonesia, tL1.e 3andung h e , d t h

Pla! i s , a t p r e sen t , rec8ivir.C a s s i s t a c o froii? Mi0 i n teaching

an$ t r a i n i n g p r o g r m e s t o 1je expanded i n t he nea r f u t u r e t o . .

incluc?e a s s i s t m c e i n environraelltal s a n i t a t i o n an6 h e a l t h edu- - cetion. ~n Thailand, FOA i s providing a s s i s t a n c e i n t he

C3olburi t r d n i n z area. The Chiengnai aroa, h i c h i s r ece iv ing

a s s i s t ance I"r01il '&IO, has J l so been at tempting ac t iv j . t i e s i n the

broad pub]-ic h e a l t h I'ie1.d~.

Several coun t r i e s have been ~eviewin:: c c r t a i n nspocts

o i t h e i r h e a l t h l e g i s l a t i o n . km;; i s cons!.dering a new

Iiedic~31 Pra&-tltionersf Act. The Covernme?:t o f I n d i a have s e t 3.p

a cornzittee t o d r a f t a n o d e 1 p.2.blic h e a l t h act. f i e C.ovem:!snt

of Ceylon a re ctfidying l e g l s l a t i ~ n i n regard t o t he u t i l i z a t i o n

o? newly q u j l i f i o d ~ r a d u - a t e s of medicine. Tiie Goverunent of

Indonesia a r e inaking a compl c t e review or' t h e i r ba s i c hedt : :

l e g i s l a t i o n . Tnere i s a r e , d need f o r exchange o:,? informat ion

and experience wit11 regard t o h o d t l i l e g i s l a t i o n under v2~rying

condi t ions e s p e c i a l l y as i t r c l a t ~ s t o South E m t Asia. I t i s

hoped t c fin$. nechan i s i~s dur ing the cominz :.ears t o s t r eng t l~on

t h i s f o m of exchange of i i lformation between coun t r i e s i n t i e

region and bet-&an coun t r i e s i n o t h e r reg ions with s imi l a r

- ---L7 -"

SZl/RC'7/2 Page 45

2.2 Znviro?dnental, S a r i t a t i o n

& i s i n @ o,[l ol" t h e d e c i s i o n s 01 t h e Regional Co lmi t t ee

l a s t y e a r t h a t g r e a t e r s t r e s s shou ld be l a i d on envi ronmenta l

s a n i t a t i o n t h e R e g i ~ l i d . Oi'fi.ce c e n t r e 6 i t s a c t i v i t i e s on t h e

f u r t h e r a n c e o f g l a n s l o r i ~ ~ p r o v e r n e n t o f e!lvirom.ental s m i t a t i o r ~

I n Afghan i s t an , su'voys of envi ronmenta l s a n i t a t i o n

c o n d i t i o n s a r e be ing u r d e ~ t a k e i l a modest t r a i n i n g i!rogr=,e

h a s been developed. P i a ~ s f o r t h e t r a i n i n - o f r a n i t a r i m s a r e

a w a i t i n g governilent d e c i s i o n s .

In Burma, a L y e * n a t i o n a l g l a n i s under ww t o promote

measures f o r t h e improverncnt and exter is ion o f anv i ro ln ien ta l

s a n i t a t i o n f a c i l i ' i i e s i n r u r a l a reas . ,730re i s a t a r g e t o f 6 ,000

w e l l s o v e r t h e n e x t t h e e y e a r s . P lan; a r c a l s o ~ n d e r way f o r

s t r e n g t h e n i n g i n c r e a s e d i j a t c r s u p p l y f o r uTb& a reas . A VBiO

p u b l i c h e a l t h e n g i n e e r v i s i t e d Bu.nn,i is April 1954 t o a d v i s e t h e

government on t h e p o s s i b i l i t y o f 'WIlO/U7JICYF a s s i s t a n c e . These

p r o j e c t s arc exl;ect!:;il t o be i r i o p s r a t i o n b e f o r e tlle end o f 1954

and w i l l be l i n k e d ~c.i.i;ll tile n a t i o n a l programme. LTJICZF i s

a s s i - s t i n g the govertxient \]?ti? s u p p l i e s and cqulpment, WHO i s

p r o v i d i n g zG s a n i t a r y e.n,qinacr a d 5 s a n i t a r i a n ~ , . h i l e mqTAA h a s

p rov ided 3 s m i t a r y ecn(:i:leer t o t h e Iblinistry o f Soci- i l G f f d r s .

I n Ceylon, -the g o v e r m e n t i s givin;; n a j o r a t t e n t i o n t o

the q u e s t i o n of e n v i r o m e n t a l s a n i t a t i o n a?? p l a n s f o r WIO/LTTICEF

a s s i s t m c e arc i n p rogross . The recors iendat ions m,?de by t h a

WHO p u b l i c h e a l t h e n e i n c a r , ~tii?o v i u i t e d Ccj lon i n March 1954,

a r e un2er c o n s i d e r a t i o n by t h e g o v e n c ~ e n t ,?nd i t i s proposed t o

o r g a n i z e trm p i l o t env i romlen td . s a n i t a t i o n schemcs a s we l l as

t o i n t e n s i f y t r a i n i n g o f san3. t r ~ . t i o n worlrers i n which WHO w i l l be

providinz a pub l i c h e a l t h engineer and UNICZF swppiies and

equip~ient . The Govern~~en t of I n d i a hzve w-i?zr consicieration an

ex t e r s ive na t iona l prog:,ax!!s f o r dcveloprycnt 0;' t!x rural. and

u r b m e n v i r o l ~ i e n t a l sa i l i t a t i o n activities %rov.gl?.o:::t thc:

countrq- and :lave developed. a n a t i o n a l pro:;ramo ir i t ! l tilt: ,:ssis..

tnncc! of FOA. A I;EO p u b l i c ~ h e a l t h engineer vi . ; i tsd se lec ted

S t a t e s of I n d i a ir , June 1954 i n conjunction Kith goveriiiient an&

FOB rei3resen-Latives t o explore t he p o s s i b i l i t i e s 02 i n t e r n a t i o n a l

ass i s tance . Negotiat ioi ls w i l l now be ;sroceedir?:; a s t o the ex t en t

of bGJO/UNICEF ass is tar ice i n co l l abo ra t ion x ~ i t ? ? the na t io -a l

prog?a;?ne.

I n Indonesia , -there i s a i;rod.iig concern ovzr the

probler~l of envirorc'ental san4.-ia.tior!. A Coordinating C o i i ~ i t t s e

h2.s >eon e s t a b l i s h e d t o promote j o i n t col.lsidcration mong those

agencies who are i n t e r e s t ed . i n tile prob1e:is o r e n v i r o l m e n t d

h y ~ i e n e . W I O w i l l z s s i s t the g0vermer.t i n !;eveloi?ing nation-

wide p l a n s by the prov is ion of consu l t an t sorvj-ces an6 t r a i n i n g

p r o g r s m e s wi thin a p i i o t a r e a project. A VKO pilbl.ic h e a l t h

engiceer v i s i t e d Indonesia i n Apiplil IS54 t o advis3 -the govern-

ment i n planning envlromnentd. s a - i . t a t i on a c t i v i t i e s . A b'L.10

consul tant made a survey o f s z n i t a r y condi t ions i n and around

air and sea 2 o r t s i n Indonesia i n Gep-te~iher 1953 and, on h i s

recom,~endations, the gcvermi~ent r?.ade a r eques t f o r a s s i s t m c e

under the Colombo Plan.

I n Thailand, the governlent has an environmental smi- .

t a t i o n p r o j e c t urider 14% with t n e a s ~ i s t t ~ l c e o f FOA wit!^ major

enp ' las is on water su9pljr and l a t r i n e programle, t r a i n i n g of

SF)p/RC7/2 Page 47

s a n i t a r y personnel and the i i rprovment of r u r a l a r e a s tkroug:~

h o d t h centres .

Tilo pro ' i le~ns of environmental s a n i t a t i o n were a l s o high-

l i z h t e d dur ing the year by the i i ~ f o r n a l conference of pub l i c

h e a l t h engine€-s h e l d under the join: auspices of W i O and the

Govermont 02 I n d i a i n Tiow Deihi from 2 t o 15 Dececlber 1953. A

group of i ,ubl ic h e a l t h engineers from Srifferent S t a t e s i n I n d i a

as trel l a s from lhiTla, Ceylon and Indonesia p a r t i c i p a t e d ir.

Seminar. 'l;ne Seminar provsd extremely useft&. Technical and

adminis t ra t ive reccmiendations r e l a t i n g t o water cupj?ly and

sewerage, environmental s a n i t a t i o n , p u b l i c h e a l t h e ~ g i n e e r s and

h e a l t h education were u d e . (See a n e x 6)

The Goverment of I n d i a have c i r c u l a t e d these recommen-

da t ions widely tl~rou.ghout the country and rec;uested t h e rosponsi-

b l o a u t h o r i t i e s t c i n d i c a t e t h a t s t e p s car, he tdcen t o i q l e n e n t

them. Othor g o v e m ~ ~ e n t s :lave becr. urged t o t ake s h i l a r act ion.

A reg iona l enviroixleiltal c ~ n i t a t i o ~ ? seminar dur ing 1955 i s

pl&-ned t o f o l l o w u ~ t h e xacomr;.endations and t ~ ; ;.lelp s t imu la t e

n a t i o n a l e f f o r t .

'Ihe governments i n the region p a r t i c i ? a t e d ir. t!le

e f f o r t s t o 2rovide d a t a f 07 t he e s t a b l i s h e n t of i n t e r n a t i o n a l

s tandards f o r qua1i.t;~ o: dr inking water. Tho d a t a c o l l e c t e d

werc discussed i n the informal conference of y~ub l i c h e a l t h

engineers and s u h i t t e d t o IGIO Headquarters f o r d o b a l evaluation.

It i s considered advisa :~ le t o fol low on the world-rCde study by

a r eg iona l advisory group t o be re-convened i n o rde r t o m&e

necessary recomuendations f o r an e x p i - t committce e w sc t e2 to

meet i n 1956.

2.3 Z m s i n g

I n o m at tem2t t o x s s i s t governiients i t has been

i-ealised t:at f o r tile 1\11 developner~t of at? exyar~c!od ! ~ e , d t h

:lrogranlme i t i s e s c e n t i a l t o s'ireilgtk~en en2 ~ . p , ; ~ a d e t!?c

nurs ing services . Oce of t he o~1.tstanding f a c t c r s faciilg

ll<ursi;l:l i n t h i s T E ~ ~ c : ? i s tile shor tage of iiro1.l ~: l .d. if i .ed

g e ~ s o n n e l , ; ~ a r t i c ~ ? . l = l y i i ? tila f i e l d of ~ u b l i c hea l th . %?era

i s considerable v a r i a t i o n i n nursiiig educat ion and nurs ing

rn se rv i ces t .boug:~out the ~ e g i o n . I n I n d i a , .!.:~:nla, ).nailand and

Indonesia t r a i n i n g i n pub l i c he,iltl: nursin:: h d s been intrciduced

r e c e n t l y with :!TAG a s s i stai lce. .U t!.~ovgh ni&wi?ery s e r v i c e s have

bec;? increased. and are "coin: giv:?i? .nil.ch a t t e n t i o n , genera l ly

spedririg they a r e a l so s t i l l ir:adcc,~!ate. While i n some a reas

nv.xs.iin; s e rv i ce j.s soread 'i:1ro1~.g!lo11i- t he countr:r 2nd a vide

v a r i e t y o f edcca t iona l programncs (Sotil a t cniier-gra?.a?.to an4

post-kradvate l e v e l s ) e x i s t , i n o t h e r s 0;ll.y 2 sidl group of

q u a t i l i e d nurse s i s avz i l ak i e t o d c v e l o ~ a11d expandad i l~l l '~ inC

s e x i ce.

7EiO he19 i s ss v a r i d . a s L'le need 0;: d i f?erer! t areas.

Si::t;-one i r t e r n a t i o n d nurses are biorlcinz i-il t i 5 s Zeg io~ .

providing s e r v i c e s whic:i cover 2 wide r,:~n.ge of a c t i v i t y . Advisory

sorv izes both a t country ].eve1 ;11d f;?om the Re:;ional Off ice have

bee:? c ~ i i t i n u a d m d a s s i s t s ? c e i n s e t t i n g u;, a d i i n i s t r a t i v e

;roccdures, svparvi oory s e r v i c c s a d ]:)lar.ning f o r new o r r e v i a n

of e2risting pro:rmfi!es have been undertdcen. m i l e i nc reas ing

en!>kasis has k e n give? to teachiing progralmes, the a c t i v i t i e s

of WI-IO nui'ses have c o n t i - i b ~ ~ t e d d~^-e a r e ,iincd general ly towards

SEuRC7/2 Page 42

e s t a k l i s h i n g p r o f e s s i o n a l t r d n i n g p r o g r a m a s f o r all c a t e g o r i e s

o f n u r s e s both a t w-der-;,racluate and pos t -graduate ; ev? l s ,

upgrading e x i s t i n g e d u c a t i o n and t r a i n i n g c o u r s e s , promoting

special . t r a i n i n g :jro;ranr;les p l & ~ n e d t o meet s p e c i f i c needs , a s

f o r e x m > l e , t r & n i n g of 3CG Tecckncians , p r e p a r i n g p e r s o n n e l

f u r s 9 e c i f i c d u t i e s by ; leans of s h o r t t e r n couJ?s.-s, deve lop inz

f i e l d t ra in in ; : <weas , i n t e g r a t i n g p u b l i c b .ea l th t e a c h i n g i n t h e

b l s i c cu;,?iculua and deve lop in2 i n - s e r v i c e t ~ a 3 n i n g a s p a r t o f

the o v e r a l l p'og-am;le c f .work.

Spec j -a l i sed p r o j e c t s doveloped t o meet a g iven need

and i n whick n u r s i n g for:;s an i n t e g r a l art have i n most i n s t a n c e s

been l i n k e d w i t h t;.zLning prozra imes . The t ~ ~ . i cpgroach h a s been

used i n i t s f u l l e s t s ense and a c l o s e r e l a t i o c s l l i : ~ between

progrm;.!es i n t h e h o s p i t z l x!d p u b l i c h e a l t h f i e l d h a s been

e s t a b l i s h e d . D u p l i c a t i o n o l e f f o ~ t hes a s f a r as 9 o s s i b l e %en

avoided aiid c o o p e r a t i v e t e a c h i n g grograr;nes aevzloged.

S ince e v e r y groE;.r;inli:!c needs l e a d e r s h i p , an i m p o r t a n t

a s p e c t o f t h e s e t r a i n i n g pro[;ra;:r:?es h 2 s be:n t o p1a1 and vork

c l o s e l y wit12 t i e na t io ina l p e r s o n n e l r e s p o n s i b l e f o r t h e cont inua-

t i o n of t h e p o j e c t . Geue?c&ly s$e&ing, good matching personnel

have :xen p rov ided t o work t i1 t h ~ i . r ! . t e r n n t i o n d s t a f f b u t i n

a i'ew i n s t a n c e s no matching p e r s o n n e l Liis been f ~ ~ t i l c o m i n : .

A consc ioc . s i e s s o f the n e e d s of t?f r~i;.al peop le an6

the requirer,le!lts f o r t r a i n e d personnel. f o r xral s e r v i c e s have

brov-ght f o r t h nany ncw pro 'ule!~s.

Trainin;, prograxiaes ha.ve n o t i n many i n s t a n c e s been

p lanned s u f l " i c i e n t l y i n advance t o p r o v i d e aci.equatei:r t r a i n e d

Sq/RC?/2 Page 50

s t a f f f o r t he netr developments, and t h i s has o f t en delayed the

;lrogress of cew h e a l t h ;?roe;rs;~mes.

Assis tance ha:: been given t o bas ic t r 3 i n i n e 2::ogrammes

f o r nu r se s g1d n idn ives i n kfg:?anistan, iX~-mz, Ceylon9 I n d i a

and Thaila'd, ~ n d i t i s about t o be comence?. i n ? ' end .

P r o g r a ~ i i e s f o r graduate nu r se s have heen i n t e n s i f i e d .

The need i s evideilt f o r t eachers dlo have a b i l i t y t o t ransmi t

knowledge, f o r s i p e l ~ i s i n g nu r se s and f o r nurses t r a ined f o r

spec i a l i s ed nurs ing f i e l d s r equ i r ed t o meet the c a l l f o r

exi, ansion.

~ l l nur ses r ~ u s t teach, a p o i n t o f t e n overlooked because

of s t a f f shortages md pres su re of arL-iinis'irative cluties. I n

afidition t o the care of o a t i e n t s , c l i n i c a l teaching an$- super-

visiu;? of nursin:: s t uden i s alvl h e a l t h e d u c c t i o n o f t h e p a t i e n t

and h e r s e l a t i v i s n u s t for:: p a r t of a n u r s e ' s cvor:r-day

progi-mile.

As t he h e a l t h cduca-tion r o l e of t ' l e proi^c;sional. nu r se s

i s of considerable i a2o r t ance kccause or' t h e i r r e l a t i o n s h i p t o

the hone and con~iuniPj , e rqhas i s has Sacn placed. on t h i s aspect

of teaching i n iiil p r o j e c t s now i n onerat ion. S imi l a r ly , >,hen

p1:mning new prc;c.'cts e.g. f o r Trivandrur~ ( Ind ia ) and Ubol

(T- aila and) h e a l t h ed:lcztici? i s given s p e c i a l a t t e n t i o n .

PIidwifc~-,- s e rv i ces a r e c lo se ly l i n k e c with t h e o v e r a l l

h o d t i 1 s e r v i c e s o f a country and h where midwifery s e r v i c e s a r e

inadequate and nethods of t r a l s p o r t a t i o n i r : tir-5s of need a re

poo: i t i s a s z e n t i a l t h a t a high ' s t ,~da i*d of midwifery t r a l n i n g

i s :ievelo?ed. W i t h a view to l r o v i d e a nLicleus of m i l - t r a i n e d

l o c a l ;liid-,d.fe t u t o r s r o r t j l r i n ~ up the work of f u t u r e t r a i n i n g

=k/RC7/2 Page 51

of s tudent midw:ves, a cocrse f o r midwife - tu tors i s Soinz

developed i n Indonasia with W!IO s . , j s i~ t anc$ . I n I? r l i a ,a p z t -

t h l c coursc f o r n i d d f c l tc'ior; i s i n the gl?dxlinr; s tage and

dl >ossi>l;l:r be d.evelo;?ed i n conjunction wj.tb the wIO - assi .s tad Nursing Educatiot? P r o j e c t i n &;;>ajr. I n Indonesia

ti18 a idwife t u t o r s cou-se i s &GVSIC:IC.~. ~ ? l o n g ~ r i t h a course f o r

Wursinz Tu.to;s ar.3 f o r Pz.bli c Xealtl? I'iurses, Lh.e.ereby ena',3ling

co:lbi:icc? t o a ~ ~ l i ! l b cr* c e r t a i n s ~ b j ec t s . I@.i s y o v i d e s f o r

i n t o g r s t i o n o f tho vaTious aspec ts of the education prozrarmes

ead i ona tak ing i t s r igh t?u l p l ace i n the o v e r a l l p repara t ion

o l nur ses f c r teac2ing and a h i c i s t r a t i v e posts .

733 need l o r c u ? ~ l i c h e a l t h nurses has 3een s t i a u l a t e d

, as ewandcd h e d t h p?ozi-aAu.ss =e lam.^. kE0 a s s i s t a i ~ c e i s

being. s iven f o r acadecic c i u r s e s t 3 i s n a t u r ~ i n Ind ia , 3 u m a

and Y ~ a i l a n d . Indones ia w i l l SG added t o the l i s t s:lortly.

Training T a c i l i t i e s .?oj.' e f i s t i n z nurs ing personnel have

beer. cor.c;iCara'~ly expandel a:d six shoi-t t e n 1 ccnu-rses placned

t o prepara nu r se s f o r teaching, su:~crvisory and spec id l i s ed

p o s i t i o n s k3vc been co?ducted a74 54 rursEs ':enefi'ieC! frola t h i s

t y p of t r a in ing .

Training of a=r;lliar:- personilel h a s i t s o 3een i n c l ~ i d e d ,

as t h i s Categoz:. of personnel i s of grorbnz i~?$ortance. Fbr

e x m > l e , i n I n d i a t h e r e a r e thousands o f I 1 D d s 1 l 7k~c have had no

:?olmal t r a i i i i ng but WIIO 2y v i r t u e o,* their ;?u~:?er alone :lust be

considered t o be f U f i l l i n g a l a r g e fNidwi:ery" f'unction.

B e r e f o r e , a "da i suf ' t r a i n i n g scileae i s being ir?plemer,ted at',

ass i s t ance Zror:. UNICSF ~ d t ! ~ a v i e x ~ t o a&Ani: t k l s group of

people more uso;'ul. The sc::.&~e i s al.so i a t ended t o r a g u l a r i s e

mq/i(C7/2 Page 52

t h e i r s t a t u s md t o p o v i d e f o r proper s ~ ) e i v i s i o n o f t h e i r

r Training 1 7 f K L i s and ntlies ca togor ics o f a u x i l i a r y

nui-sing personnel i s a l so bekng c a m i e d c u t i n conjunction

~ r i t l l kJ50 p r o j e c t s i n aurma, Indonesia, Inc'ia and Did land .

I n Ceylon a s s i s t a n c e has been given i n tha t r a i n i n g of 400

msrgency nurses.

Eva new p r o j e c t s m r e i n i t i a t s e d u r i n ~ the r e a r a i d

f o u r a r e about t o coizflence. Three p r o j e c t s have Seen success-

i U l y completed en6 tke t.IIrc0 staff tfithdravrn zccording t o plan.

Tr:slve purse aducators llavs bacn assigncd t o general scimols

o r nurs ing, n ine t o aidvifo:y schools (inc:I-uZj.a: oiic 2 o s G

c e r t i f i c a t e course i n r;iidwifery) and s i x t o schools of pu?iLic

h e a l t h nursin;. - I n adclitioc, 34 to 40 n w s e s n e working i n

the p u b l i c i ~ o a l t h f i e l d , w i t h proSQcts i n Matsrnj! an?. Child

i e a l t h , Tuberculosis , BCG, Venereal Disease, 'Irzsds, Hea l th

Education and School Zs2.tk-1 p r o g r a e s a s wel l a s i n surveys

o? nurs ing needs and admini s t r a t i v o and sU:?o?visory s s r v i ces.

Tra in ins has fornzd. an i n t e g r a i part oi' ever? ll;.ograil::le and has

included both i n s t i t u t i o n a l ane d o n i c i l i a r 7 ::q,erience.

'Phc r e s u l t s achicvc-d Pmin: tilt --e;l unzer review have

been ancouraging and maw urgen t nurs ing needs have been n e t .

Pluch nore rerdains t o ' ~ e done i n t h i s f i e 1 6 d t h o u g k a good d e d

has k e n .,accomplis;ied.

2.4 b t e r n a l and Child H e d t h

MC3 P r o j e c t s i n o: jerat ion have develo1~e2 wi th varying

d e p e e s of s u c c ~ : ~ s s . flowever all of them hav.3continued to p l v

a valuable r c l e i n t?:~ i e v 3 l o p ~ n t of cocntry-..&do MCIi services .

s~q/ric7/a Pose 53

Kd0 h a s n a i n k i n e d c lo se col1ab~: 'a t ion i n a l l these a c t i v i t i e s

with UNICEF whac.~ ha; ;,rovi&eL supol ios and equipment.

Throughout the reg ion t i lore has been en increas ing

moun t o f i n t a r e s t anc! a c t i v i t y i n a a t e r n a l and ch i ld heal th .

Nat ional I'iCi prograr;uos are exerging i n d u o s t a l l t he

coun t r i e s .of t h e region. Zqa i l s ion 0;: s e m i c o s and t r3 in ing of

gersonnel , with due u q h a s i u on tho needs of r u r a l a reas , form

Q.e general p a t t e r n i n n o s t -0,: t ha cccn t r i e s .

E:ga.nsion 02 i*eivices sc :Tar has been mainly i n t h e

fom of an inc2ease i n tko number of "Il.iC3 Centresi(. Tno term

'I4M Centre", h o ~ ~ v e r , carnot xl~iiys be t&en a t i t s f acz

v d u e . A n iiC!i cen t re sho1Ci.d cover both r.iatelmd a>d ch i ld

healt;l , a t t end ing to t l ~ ~ :lsoc"s of ch i ld ron from concept ion t o

adol.escenca. A l l grougs 02' l l e d t h i~e r so ime l should coope?ate

i n a nrograrmo cov~?i i ig cu ra t ive a s well 3s prcvent lve aspects , .

v,rell integrai;od ,w i th t h e o v e r a l l hed t ! l progracunes, i nc lud ing

enviromeiital. s a n i t a t i o n , n u t r i t i o n znd h e a l t h education, T.ie

~ 1 3 r o a c h should be through the cor.~sunity, although most

e f f e c t i v e con tac t s are a t i n d i v i d u a l l e v z l s . T.;.we me c l e a r

t r a a d s ~. of dev31wnc:it i n t N s ~2iyec t ion - I n d i a l z y s s p e c i a l . .

i n t e r o s t on M a ; dovalopment i n Co-wl~uili ty Davelopnent Fro j e c t s ;

I n & m a , Coylon md T$ai lan? t!ae trenc'i i s towards Zoa l th Un i t s

covering nuxerous, as;jects of pzevent ive anc? cu-rat ive care;

Indopes ia . . i s e s t a ' d i shin:. new b!GT cen t r e s i n ' o r ngar dispensar ies .

Bowever, ~ L I Q f a c t rwain.5 t h a t today i n mmy c o u n t r i e s of t i r i s

reSion z s i n g l e hand.& ~cidwi:'s,covsrin,- a po;,ulation.of 25,@0

o r more, of ten r e p r e s e n t s an 'rliCnt -- ConL bra, dEiou&Li-she can give

only o b s t e t r i c a l case and t h a t a l s o t o a v e r y r e s t r i c t e d

number. There i s nothing wron,? about t h i s , a s long a s i t i s

r e a l i s e d t h a t such a cen t re i s nnly t he nucleus of an MCH

cen t re t o be developed t o fill s t r e n g t h a s soon a s poss ib le .

Tile main d i f f i c u l t y towards t h i s development i s the l a c k of

t r a i n e d personnel . MCH w ~ r k scads q u a l i f i e d personael wi th

s u c f i c i e n t p e r s o n a l i t y t o be able t o t each and convince the

others and the community. Whatever supp l i e s w. MEi c en t r e

may rece ive , they will be u s e l e s s without well t r a i n e d person-

nel . Increase of work should go hand i n hand with the

i nc rease i n t he number and q u a l i t y of personnel.

M C H p r o j e c t s i n Colombo (Ceylon), Delhi ( Ind ia ) and

Jog j aka r t a (Indonesia) have been terminated a s planned.

Pro j o c t s a r e being continue6 i n Afghanistan, Burma, I n d i a

(Calcu t ta ) and Thai lard (Ban&!<ok and Chiengnai). O f these ,

the Bangkok p r o j e c t w i l l r e t a i n only one staff member a f t e r

June 1954. A new MCH/Nursing p r o j e c t has been i n i t i a t e d i n

I n d i a (Hyderabad) and a School Xea l th p r o j e c t i n T l~a i land

(Chachoengsao). Inp l eaen ta t ion of 4 o t h e r MCEi p r o j e c t s i n

I i l l i a has been delayed by va r ious c i rcuustances . ' They a r e now

ewoc ted t o come i n t o opera t ion i n the l a t t e r ha l f o f 1954.

P lans have been developed f o r th ree more p r o j e c t s i n I n d i a

(Nysore, Madhya Prades i~ and Bombay) f o r inplementat ion i n 1955.

So f a r , WiO a s s i s t a n c e t o na t iona l e f f o r t s i n t h e MCH

f i e l d has been mainly i n t h e form of demonstration and t r a i n -

i ng p ro j ec t s . Ewer l ance h a s shown t h a t t.Us type of p r o j e c t

can make va luab le con t r ibu t ions t o developiilents throughout the

country i n providing exawples, i d e a s and more t r a i n e d porsonnel.

SEA/RC7/2 Page 55

To meet the i nc reas ing necd f o r evaluat ion and assessment of

t echnica l approaches, m e t h o d o l o ~ r and p r a c t i c e i n M E programmes

it i s desil-ahle t o provide f o r a constant in te rchange o f i n fo r -

mation between MCX workers a t n a t i o n a l and r e g i o n d l e v e l s .

Nuch a t t e n t i o n dl1 have t o '3e ;)aid i n t he near f 'uture t o under-

graduate and post-graduate teaching cf p a e d i a t r i c s and p a e d i a t r i c

nursing. The 1 -5 year group i s s t i l l g r e a t l y neglected. School ,

h e a l t h , al though shoving t rends of development, i s s t i l l l agg ing

behind considerably.

2.5 &nulation.&\d&-~

The p i l o t s t u d i e s i n family planning conducted by the

Goverment of I n d i a i n co l labora t ion with the Divis ion of

Population S tud ie s and a s s i s t e d by two WHO f i e l d workers, which

comilenced i n M a y 1952, terminate& i n March 1954. The r e p o r t

i s being s u t x i i ~ t e d to Goverwent of India . A s i t conta ins

important d a t a on f i e l d procodu?es f o r similar work i n o the r

c o u n t r i e s , i t i s !loped t o g ive i t a wide c i r c u l a t i o n a f t e r

c learance rritll t he Government 09 India.

2.6 K u t r i t i o n

Specia l emphasis was l a i d a t e e TAO/WIO South E a s t

Asian Conference he ld a t Bandung on t4e proVems of p r o t e i n

mal-nutr i t ion and on impoving nethods f o r t h e d i s sen ina t ion of

informat ion on nu t r i t ion$ . m a t t e r s t o t h e publ ic . The r e s u l t s

of this conference were brought t o the a t t e n t i o n o f all the

coun t r i e s i n t h e region with the r e q c e s t t k a t cons idera t ion be

given t o the problems of p ro t e in mal -nu t r i t ion as a major p u b l i c

h e a l t h problem. There i s a considerable amount of rosearch

which h a s been undertaken i n almost all t'?e coun t r i e s i n the

SE A/RC?/:! Page 56

r eg ioh but t h i s research has no t been s u f f i c i e n t l y t r a n s l a t e d

i n t o programmes o f pul3l.L~ h e a t h a c t i v i t y . The Indian Council

of f4edica.l Research Nu t r i t i on Advisory Group s tud ied some o f

the recomneitdations a r i s i n z ou t oi' t he Dqdv.ng meeting and

f u r ~ h e r ac t ion i s ':einC t A e n .

T;I,: W10 Med icd ; I ~ ? t r i t i o n i s ' i r\?centl:r proceeded t o

Burma and, i n co l labora t ion with FAO, i s expected t o organize

ail over -a l l n u t r i t i o n p rog rz~me under the > E n i s t r y of H e a l t ~ .

I n Ceylon, t he Depaxkcnt of Nu t r i t i on of t h e Medical

Research I n s t i t u t e cor,tinues t o undertake a c t i v i t i e s i n r o -

lat i ,nn t o is~proveinent of n u t r i t i o n i n co l l abo ra t ion with t he

Di rec tora te of Healtn Sei-vices. These a c t i v i t i e s i nc lude

research, p u b l i c heaXth education, t r a i n i n g of personnel and

the improvement of i n s t i t u t i o n a l diets. Tlic recoi l lendat ions

of clxe I G O d i e t i t i a n , who comjletod h c r ro rk i n J u l y 1953,

a r e novr under cons idera t ion by a D o p a r h e n t a l Corni t tee .

I n I n d i a , the I n s t i t u t e of Nu t r i t i on (Coonoor) cont i -

nues i t s a c t i v i t i e s i n rc :carcll,in t r a i n i n g of personnel and i n

h e i l t : 1 promotion in n u t r i t i o n . Proposals a r e under d i scuss ion

with -the Minis t ry of E e a l t : ~ t he I c d i a n Council of Medical

Research f o r t he developinent and coordinat ion of the inve s t i -

gat io :s i n tho prevent ion of p r o t e i n mal -nu t r i t ion i n ch i ld ren ,

?or an exciiange o f s c i e n t i f i c workers betweei? i n s t i t u t e s f o r

t3h.c coordinat ion .of work i n r ~ r o t e i n m d - n ~ t r i t i o n a s well as

s p e c i d g ran t s t o un ic r take a p r c ~ r a r ~ x l - o f i n v e s t i g a t i o n i n t o

the s u i t a b i l i t y a n d reparation or^ foods producec! i n I n d i a f o r

t h c improv.e;?ent of d i e t s o f i n f a n t s and chi ldren. Another

SEURC7/2 Page 57

proposal , which i s u n d ~ r study by the Ind ian Council of

Medical Research and the Government of I n d i a i s to co l l abo ra t e

wi th WHO i n the i n v e s t i g a t i o n of blood dysc ra s i a s bel ieved t o

be due t o mal -nu t r i t ion and t o f i n d a p r e c i s e apgroach on a

global bas i s which w u l d he lp e l u c i d a t e some of the problems

involved i n tile anaemias and t h e i r r e l a t i o n t o n u t r i t i o n a l

problems.

I n Indonosia, the WO Medical N u t r i t i o n i s t ha s been

a s s i s t i n g the government i n continuance o f i n v e s t i g a t i o n s under

the I n s t i t u t e of Nu t r i t i on , Djakar ta , i n t o t h e problems of

prote in-mal-nutr i t ion with spec i a l r e f e rence t o c h i l d r e b and

p l ans a r e under way f o r a n u t r i t i o n c l i n i c programme t o coordi-

n a t e research , c l i n i c and pub l i c h e a l t h a spec t s of t h i s

problem.

I n Thailand, a Divis ion of N u t r i t i o n has been const i -

tuted. FOA i s g iv ing a s s i s t a n c e i n t h e form of personnel and

suppl ies and equipment f o r the development of n u t r i t i o n i n the

country.

Spec ia l mention i s Bade of t h e a s s i s t a n c e given b.7

UNICEF f o r a soya bean p i l o t p l a n t i n Indonesia and o f the

development of t h e sa fe milk programme i n Bornbw.

Aris ing o u t of the work of the Study Group i n 1952 i n

which the importance of i o d a t e s as a p rophy lac t i c measure i n

the prevent ion of g o i t r e was underl ined, s eve ra l coun t r i e s i n

the region a re contemplating ac t ion programmes.

R short- term consu l tan t v i s i t e d several. coun t r i e s t o

survey the n u t r i t i o n aspec ts o f MCH polic-J and t o make recornmen-

d a t i o n s f o r f u t u r e ac t ion i n t h i s very important f i e l d . Another

SEuRC7/ 2 Page 58

short- term consu l tan t i s a t p r e s e n t i n Indonesia and i s

i n v e s t i g a t i n g the soc io log ic a spec t s o l mal-nutr i t ion.

2.7 Mental I I e d t i l

T~iere h a s been no r e d progress made dur ing t h e year

i n t h i s f i e l d . Tlze A l l I n d i a I n s t i t u t e of Mental I iea l th h a s

been cons t i t u t ed but WIO a s s i s t a n c e t o this programme i s

hindered because of f i n a n c i a l d i f f i c u l t i e s md i n a b i l i t y t o

f i n d the necessary e q e r t s . WIiO a s s i s t a c e t o Thailand i n

the e s t ab l i s lmen t of a mental hygiene c l i n i c has been delayed

a l s o because o f r e c r u i t m e ~ t d i f f i c u l t i e s .

E q e r t s i n r,lcntal h e a l t h arc d i f f i c u l t to ob ta in f o r

1-2 yea r s and a so lu t ion h a s been sought by the proposal t o

provide short- term consu l t an t s - such a provis ion i s baing

con temp1 ated f o r BurmaS Ceylon and Inclia.

Major emphasis i s t o be l a i d , dur ing the nex t two o r

three years , on determining with governments a e a s of WHO

a c t i v i t y i n this f i e l d , Probleins concerning l l~en ta l hosp i t a l s ,

b e t t e r d i agnos t i c and t rea t r -ou t f a c i l i t i e s , s e r v i c e s f o r mental

de fec t ives and problems a r i s i n g o u t or' ~ i r b a n i z a t i o n and indus-

t r i a l i z a t i o n , a l l need considerat ion.

The f i e l d of occupat ional h e a l t h i s of growing i n t e r e s t

i n uany coun t r i e s o f t h i s reg ion , i n view of tlie r a p i d i ndus t r i a -

l i z a t i o n t h a t i s taking place . WHO has been able t o undertake

only a l i m i t e d anount o r worli so far.

The I n d u s t r i a l Kygiene Uni t a t t h e A l l I n d i a I n s t i t u t e

of Hygiene and Publ ic Healti1 h a s been a s s i s t e d f o r t he p a s t two

SEuRC7/2 Page 59

y e a r s by a p ro fe s so r o f i n d u s t r i a l hygiene. This Unit h a s

undertaken toaching and tr ainini; a c t i v i t i e s f o r s tudents of

indus t r ia l . hygiene a s well a s publ ic h e a l t h and nurses. I t

has a l so undertaken s p e c i a l i s e d r e sea rch and has given ass i s t -

ance t o i n d u s t r y i n co l l abo ra t ion w i t h the Minis t ry concerned.

I n connoction with the t e x t i l e i n d u s t r i e s , advice has been given

on the r e l a t i o n s h i p of c l i m a t i c condi t ions t o t;le worker' s

h e a l t h and long- term and short-term programmes have been

recormend.cd which a r e under conslderatiori 02 the Minis t ry - concerneti. ~ ~ e c o n ~ ~ ~ ~ d a t i o n s have a l s o been given t o the j u t e

indus t ry .

A s:mposium on i n d u s t r i a l l i en l th which was sponsored

by the Indian Council. of Medical !?esearch wss at tended by a

WHO r ep re sen ta t ive . FOA has <also been o f a s s i s t a n c e t o I n d i a

i n t h i s 3:ield.

I n Indonesia , an i n d u s t r i a l hygiene consu l tan t was

provided by t h e ILO. Bzis consu l tan t worked i n c lose collabo-

r a t i o n with bfiIIIO Area R e p e s e n t a t i v e . The primary a c t i v i t i e s

o f the consu l tan t wore t o survey tho e x i s t i n g condi t ions i n

regard t o i n d u s t r i a l lzygiane p r a c t i c e and t o a s s i s t the govern-

ment i n undertaking t r a i n i n g programmes i n t h i s f i e l d . Aris ing

out o f these recommendat-ions, which were c tscussod with WHO,

the Minis t ry o f Labour has reorganized i t s adminis t ra t ion.

A proposal f o r the l s t a b l i s h n e n t of an i n d u s t r i a l hygiene

i n s t i t u t e i s being a c t i v e l y pursued. This i n s t i t u t e w i l l be an

indopendent body with a board of d i r e c t o r s which w i l l i nc lude

r e p r e s e n t a t i v e s of t h e b l i n i s t r j or' Soc ia l A f f a i r s and the

Minis t ry o f Hea l th a s i d 1 a s the i .!inistry o f I n d u s t r i e s and

aiqiIc7/2 Page 50

Economic Gfairs. Th i s institute 2.s disiy;~~e,cd t o u n d e r t a k e

t h c ;~romot ior ! o f occu.pai;ionLl .!?.erJth a c t i v i t i e s a?lcl. l;rain;.!lg

of porsonnol .

I n Caylou, t k w e 2 s a!: i n d u s t Y i : L Il.:rgieie ~ 3 v i s i o n

i n t;?e DeA.e?.t;::c:it o f La::cr.~' s'or ?-;^.- ". C cievclo?;,!,:r,t and e x t e n s i o n

r;.: :-.cJlth ~ : l r v i c s s it:! i n 2 u s t r i o s 9 in t r , 3 s t igz t ion a1.3 prcvont io l l

c:? o c c u i ~ a t f o r d ddisoare arid improvem<?r.t c:' sz:itai;io?.. A

csrt:+al i n d u s t r i a l hyg iene l a b o ~ . a . t o r g unde r r ,rg?.nization i n

Coloobr v i l i ;.rovic?.e f a c j l i L i , ? s f o r f i e l d i n v ? . ; t i g a t i o n .

Thc: r a j o r ccnc.?rn cY tile Rel;lond. 0l" ice har; been t h e

0 yro:~ot ion of c?~n:.:e c a j . l a b c r ~ . t i o n 5ctwee2 .:Le Minis -Lr ias o~.

I @ a . l t h and LaSour i n t h e ::?- . ..,,AiotFon o ~ o c c u ~ ~ a t i o n a l '?a tlt:~

a c t i v l t i e j and t h e exi;e?sioil o f sue.'-.. a c t l - v i t i e s from t h e f i e l d

o f l e c t c r : ~ i . l s ?Cc t io r t o r.1oc,2? ! oecu::atioi? ,$t ! ? e d t i l ; ??ac t i con

2.5 ~ " ~ L l 3 f i -.

a1 ~ o v e ~ : x i o n t s ir : Zo!:.Lll E a s t A s i a 11.?r'2 i r f o m a d of

t h e r e s o l u t i ~ , r l on c i : ; ~ t a i :?ed.i;!l p r o g r m 3 s pass:d by t h e Sixtl-i

E e , ~ i o c a l Co.rn5.ttec and requLiat16. t c fnd icaLz t h e p r i o r i t : ? t h a t

shoulti ' ~ e &Fven t o ti.lis t.r;~e oi a c t i v i t y . I:? orde r t o yevicw

t?c zest a:~;:i-o-~rj.ak t,.;?cs o r a s s i s t a n c e which K O cov.lcl. a & e

, ~ v a i ; nbLo Lo :;o~erni:lei-i'i:s i n 1.ri.214 d f t:,.cse g e n e r a l c o n ~ i d u ~ a t i o n s ,

1 J- . I !:as ':!?en ;?roposec! ti ,.:rovic'.c: i n 1956 a ~le:-~t:L ::enlti? consul -

t a n t t o rev is^^ YhC! i i r e s c n t s t zCcs of d o r t d I-.o&th a c t l v i t i c ; . , .. t roug.?:out t : x ? e : i o ~ an6 t c nakc r o c o ; . ~ ~ e i i d a t i o u s f o r f u r t h e r

a c t i o n . The govormi,ler.ts v:? 3anna, Ce:rlon, I n d i a and I n d o n e s i a

have e p r e ; s e d 'ihei:? i n t e r e s t i i : -:!lo r l eve lo : ?~~en t or" de i - ta l

:-!eal-t? a c t i v i t i e s . S.tej3 9 iir;zrz 1:een take;: b r i ' i ; ~ k i l a t o r a i

azenc iss t o n e e t request; i n t .~is f i e l d . I n coun t r i e s where

urgent a a j o ; ~ e d t h pi-~';l!:~.,s zernd.11 t o '& tacklo2, the risks

o'l̂ diversion of u a n p o ~ m and li?:!ited resoi1.rcos from general

h e a l t h f i e l d s t o ciantal caze 2ro:i"mes silould be zecogni sed.

It i s thus c o n s i d e r 2 t!.a.i Cie:Ltz?. ninvzalth pro;;ra:wes shoult! be

p la i~ned with clue regr.xd t o t!:o naed.: o" and. resou?css

avz i l ab l e f o r , es well as 3 e s.?.or':a@ o f t rdnoc? persollnel

i n the g o n a r d health se:.viccs of the c~ i in t~ : : concernefi.

I& m.me, p l m s f o r 631ltd heQ.t;l i??OgTaXxOs i r i t ; ~ t he

a s s i s t ~ i c s of b i l a t a 7 a l a ~ g n c i e s are i n p r o y e s s . Six

: iygienis ts aTe being se: r t on r"ol1owsi:ips t o t h e den ta l

h y g i a n i s t s CGUi'SB i n 3Jew Z e d a i d on f ' e k 3 u r s s a e n t from LIIiICE?.

. The Governilent of Ceylon have lodgsd a r e q u e s t r d t h

the Coloxbo Plan Technical Cooperstion Bu~eau lor t:le semi ce s

of one senio? d e u t d surgeon an2 two den ta l t u t o r s i s t e r s m d I

tsacbAng equiymenli fro;: Now Zedam3 f o r tha 6 s u e l q n s n t o f

the Pzeventive Dent i s t ry Sche~le. U??I(XF has ::?en raquested t o

:>i'ovide supp l i e s mc: ~ q u i p n e n t f o r 15 dei i ta l c l i n i c s . A Colombo

Plari c o r i s u l t a ~ t from Net: Zzdiasd visi-i;ad Cc.:ilon atld recom~ended

t h a t em2hasis should be given t o p revent ive s e r v i c e s and among

o ther th ings a d i v i s i o n of do!ital h a a l t h and a school f o r d e n t a l

nurses be e s t ab l i shed i n Ceylon.

I n Indonesia , the govern;-.ent h2s requested t k e s e r v i c e s

of a H 0 den ta l h e a l t h sho r t - t om consultrtnt, who dl1 be

provided i n 1955. InConnsia h a s 2 d iv i s ion of & e n t d hggione - a mall notwork of dental. clinic.; . Plans f c r the i nc lus ion of

d e n t a l h e a l t h Servicc:S ~r i t i l in the school i l e d t h p r o j o c t s =e i n

g rog r s s s with UllICEF a s s i s t a n c e i n supp l i e s an^ equipment. A

f e l l o r i s : ~ i p i s be ing awardC;r! by X-10 i n t h e f i e l d of c h i l d r e n ' s

n r u v e n t i v e c ' ? n t i s t r y t o Ir.:lo?esi?,-..

I n ' h a i l ~ d , N A i s s u n : ~ o r t i n g . - d e n t a l hygiene

g20grautae w i t h i n schco l hea l th . p20;ects . Tqe g c v e r m s n t havz

a l s o r e q u e s t e d '&I0 f o r a s s i s t a n c e i n v a r i o u s a s p e c t s o f d e c t a l

3 c j l t h Zdiicatior. j c t i v i t i e s a r e go ing on, t o a

g r e a t e r ijr ic.i:$r ;3gree9 i n dl, c o u n t r i e s 0.:: t h e T G g i o ~ . ?L?OsQ

a c t i v i t i s s , however, i n a lmost 2.1 t:30 c o ~ l . n t r i e s nee?. t o

c t i l i ze t c :~~xir:ui:. ac?vzi.ta,-..j 'Lkic! e x i s t in: rs sourca s aic! t;o co-

orcl inato) and ;1l.ai1 f o r tila devclo~:no:;t oi' i ; ~ a l t i ~ eciucation

,liethocis i n 3xist:~n; aid "la:cefI h::slti-- progrcu;.as. Zle need

a l s o ~:ri:'ts t o ~ r ' o v i 6 s b a s i c in s ' i : xc t ion i c ,'?o?ern e d u c a t i o n

r:,ek':ods a!i . i ; o c l ~ n i ~ u e s 'ic o r i s n t d l c a t e g o r i e s ci' c x i s t i n g

ks3i t : I ~ l o r k e r s . Rsco:~:.~r~:L;.tio-~; have 'beer, :1,-iie f o r Y .. . o

i n c n ~ o ~ . a t i o n or" ? e s t - ~ - a d u a t r : ' t r ?Jn in ,~ i n h e a l t k educ?.t ion i i l

t h e r a g u l a r c:lrricu!.a 2s m 2 . l as i i e d C h eduicz.tion i r : t h e un%or-

; raduate ~ s d i c a l 2nd nu:':;L'::, curricula. S t r c s s h a s a l s o b s e l

lais on t:::2 i r : .)ortz~.ce of t r a i n i n g of non-modical ;lei-sons

ii1volvec! i;i co:!munit?r c?evd.opmant a c t i v i t i e s 5'1d t i la impor tance

o f . i n i o r d a t i o n a l and. audio-visuril. : i ~ i ; e r i a J . ~ i n t h e advanco~lent

of adu.cation of t h e i::::;l:-i; 5-n l-ie;;lLb ~ i i a t t e r s . Tke nee6 has

SEA/aC7/2 Page 63

most appropr ia te t o condi t ions i n South Zas t Asia. S i t ~ o r

unLi:r govej?nnent i n i t i a t i v s o r on s t i r ; ,u l~. t ion fro!;. mIO,

following a c t i v i t i e s a r e t h e highligl.-. ts i n elis f i e l d d u r i ~ , '

the year. The r e a l d i f f i c u l t y ;Jf?ich must G G ovorcone f o r

WliO i s i n f i nd ing adsc,uate f i e l d personnel .for t h e projects

planned wit:: tL3 govorn~en t s . A,l.thou,cLi sobin advar?.cas :lave

%en mado, t h i s d i f f i c u l t y 22s Gy .?c iieans bg3en ovsrcone.

A h e a l t h educator wa.2 saCc ava i l zb l e t o t i e All Inj7ia

I n s t i t u t e o f Iiygiono aid Publ ic IIealt':. f o r 3 months per iod ?or

the teac,Mng and t r a i n i n g of :>os t z r adua to >rsonnel . 3.0 4

a s s i s t e d i n deve1opi; i~ a cur r icu l .a i i n h e a l t h education f o r

all ca"igorlcs of post-graduate students. The tenc:li~-:: c c w s e

:or i n s t r u c t o r s i n the :?ealt;? oducntion asac'cts of com~mit:r

developre!'t a c t i v i t i c s 1:2s ;J so an6.srtakcii. A sy:ocid h c d ti1

education coi?rse was given t c 51 D.P.i.:. s tudents , 9 p u b l i c

n e a l t h nursin.: st:lc!ents -4 i n d u s t r i d h jg iene s tudents , ~rilich

included f i e l d t r a i n i n s u n k i o;ei*rting condit ioi is and .the u s e

o f audio-visual u a t e r i a l . He ,dso v i s i t o d , a t ,~ovcrnmcnt reques t ,

s e l ec t ed s t a t e s i n I n d i a t o iiiscusv; t he >.czJ.ti? e d u c ~ t i o n prog-

rammes. Ar i s ing o u t of these v i . ; i t s recor:r~endations 7,rere made,

which a re p x s o n t l y under c ~ n s i f ~ o ~ a t i o n by t h e governments

concerned. The Goverment of I a d i a have c.n~.ei_. cons idera t ion a

l a n f o r the organisa t ion of a c e n t r ~ l h e a l t h education bureau.

I t s func t ion vould ' ~ e t o produce heal.th oducntion m a t o r i d , t o

o rgan ise deraonstratio;i cen t re a c t i v i t i e s mlnZ: t o c o o r d i n ~ t e

h e a l t h education prograimes i n the v a i c u s s t a t e s of the Union.

Assistance t o t3i.s p r o z r a m e i s expec te t fro^ FOB, Two I n d i m

3 I / R C 7 / 2 Pzge 64

S t a t e Govern.:e?ts ::3v3 roquestcc! h e a l t h eciucators w i t h i n

M% p r o j e c t s t o a s s i s t wit11 the 6 c v e l o ~ n c n t o f h e d t h cdu-

c a t i o n a q > c c t s of c h i l d h e d t ! ~ ~ o r k .

I n B~:urna, assi s tal l c: t o t h e C s n t r d - L!_I.l~dtll. Educat ion

Xiyeau has ?men p lanned d~1.i-ing IS54 b u t r ~ c ? u i t r . l e n t Cif l ' i -

c u l t i o s have dolayei! work.

I n Ceylon, t h e VRO ~:..oaJ.th o d ~ r c a t o r 2 a r t i d p a t e d i n

fundar!ie ?lt& edc.cation + ~ r o g r a i m e but was fo rcod i;o l e a v e

because of ;l.lness a t tile o;id of 1953. 'Pnc ~ o v e r i m e n t h a s

a s s i g i i ~ d a h e a ; l t l ~ z d u c a t o r t o fir! p r o j e c t t o c o n t i n u e t h e

f i n d m e n t a l e d u c a t i o n t r a in in : , i r o g r a m l e f o r r u r d devalop-

: .ant ~..n;rkc?s, t o a c h e r s e t c . A h e a l t h e d u c a t o r i s under

a c t i v c recru.it;;!eiit t c !-~clp itovelop ti2? cei?ti?al 5 .edt i . l

cc?.ucation a c k i v i t i e s a s we1.l a s t o p a r t i c i p a t e u i t h t h e

I'_~Juta.rs. t r a i n ; n ::70gra:ine f o r e x i s t i l ~ g h e d l t h workers. iie

>rill s h o r t l y assume d u t i e s .

have ! % i n co;!;.l,>tcc! t o a s s i s t ';;he alrertdy

e x i s t i n g ; i s a l t h ~ G . ~ , c a t i o n :~:rogi'amic o: t 5 e Gov::rri.ient of

Indonesia, , aic': l o r tlzc t r a i n i n g of pe r so?zo l i n h e p l t i l edu-

ca.tion. It i s l>lai?ned t 2 , l t ,! Jlc,9Jth ~ ! d u c a , t o r 1d2.i. be

provj.di.6 c ~ l l r i t 1 1955.

The Goverm,:c:?t of T:iailmcl 'equcz':;ecl i'o? a n u r s e

wi th l ~ a l t ! ? e d u c a t i o n e:;; cr:. ~ n c e t o ; 3rti c i s a t o i r _ t:le m~da-

menta l aCucdtion p r o j e c t i n Ubol. I ier r e c r ~ i - & l e n t i s i m d ~ r

m.\ - , I . li-c ? ,?quest fn:? a i:ic!dt:.1 educator t o i?.ssi:t t h e

hiini sti-,. of ::$aJ.t:l :has been ~,~ithd.?,3.1~. azc? i t i s m t i c i p a t e c !

t i l a t I F A r,ill. be unde-.t&fii,- t h e work. The d i v i s i o n of

h e a l t h e d u c e t i o n i n -the i~inistr;.oI* i i c d t h i i s u ~ l d e r t h i n g

SURC7/2 Page 65

a programme f o r tho .~xpa'1sion c:?health education a c t i v i t i e s

f o r sc;.~o.lool teache;'s i n school h e a l t h and f o r an i n s e r v i c e

training pro=lamae f o r pub l i c I ~ e a l t h off ' tcers. T h i s

;?rogrm.;. i s b ~ i i l g ass is . tcd by FQA.

3.1. &&&@cQ t o E d u c a t ; i n _ f r 1 ; ~ i t U t i o ~

Because of tho acute shor tage oE s h y s i c i a n s i n no&

o f the c o ~ : ? t r i s s of ti13 ReGon, a s s i s t ance t o medical. and

a l l i e s e d u c a t i o i ~ d in s t i t i ) . t i ons c i n t i n u e s t o be i m p o r t m t

f e a t u r e of our Education and Trainin= 2 r o e r m e . The short-

age i s nore acute i n *.c health se rv i ces , e s p z c i a l l y on the

p ~ e v o n t i v ? s ide , and t o J l l e v i a t e t h i s t o a degrso, one

goverc:ent enacted a 3 .?.w i n 1951 wi.rith!:ollia& li ce~ice from

newly graduated p ~ ~ ~ ~ s i c i m s a d d e n t i s t s u n t i l they have

served f o r a per iod 0;' t k r e c consecutivu y e a s i n tkr: govern-

n e n t ha l t5 serv ice , A t !.?.;s't tin o t h e r gove rmen t s i n

t he ragion 4 a ~ a under cocsidsra.tlon the enac taen t of s i m i l a r

laws. &is Covics g ivas a yirol of baa:? n.:-.dd doc to r s ?or

n a t i o n a l work and t!:? doc to r s b e n e f i t from. :-eal meeical

f i e l d axperLeilcs.

Thlo ser t7ices ox' twc po i ' e s so r s - one i n Ailatorny and

t h o e t i ier i n Physiology - have been ~ z d e a v a i l a 3 l e t o t h 3

F~ .cu l ty of Medicine, Kabul.

The Burnese rcqu-est f o r tm pro fe s so r s , v iz . , ono

f o r P!:ysiolo~;;- ayd one l o ? Prevent ive Flcdicine, i s beiag

a c t i v e l y pursuad. Tile r eques t l o r a & e c l s l i s t i n Medical

Muca t ion f o r t h e Heal th. Ass i s t an t s School, Railgoon, h a s

Seen ne t .