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·TABLE OF CONTEXTS Pago 1 3 4 6 6 9 10 10 . 13 1 List of persons who attended the Board a meeting 2. Agenda 3. Proceedings- (1) Opening remarks (u) Agenda item 1 - Confirmation of the proceedings of the fourth meeting (w) Discussion on agenda item 2-Report of the Food Adulteration Committee, Part II (1943) 1) Axenda item 3 -Statement regarding the prevention of persons suffering from infoctious diseases from travelling in public conveyances. (v) Discussion on asenda item -- Vemorandum on 'Anaemia in Pregnancy in India including Haematological Technique' forwarded by the Indian Research Fund Association (v1) Discussion on agenda item 7-Jemorandnmn on Post War Planning (vu) Discussion on azenda iter 6(a)-Consideration of a letter from the Secretary, Central Advisory Board of Education, containing a recommenda. tion that the Central Ads2501y Buard of Iducation and Health should jouatly consider the problem of the provention of blindness in India 6(b)- Consideration of & preliminary report by Lt. Col Sır Clutha. Slackenzie on Blindness in India " Kv) Discussion on agenda tem 7 --Report on the working of the Bihar Gov. ernment for the compulsory inoculation of pilgrims attending the Sitamarhi 1sure in the years 1912 and 1913 (v) Discussion on agenda item 8-A report on the preventive measures taken in Burudu Stole against kuinea-worm infection (*) Discussion on agenda item 12_Memorandum on the proceexungs and the recommendations uf the Food Conference of the United Nations held at Hot Springs, USA, un May-June 1943. (x) Discussion on agenda item 9(e)-A memorandur on the cooperation between Cıvıl and Multary authon lies in respect of sanitation uf labjur Camps attached to constructions for Defence Services. 9(b)-A menntandurn on measures for the prevention of disonsee in aroux Burrounding aerodromes (211) Discussion an agenda stemp 11-A memorandum on the appointment of a Director of Nursing Services in the Medical Department of such Province or State 15 18 10 20 in T. IN 1. Resolutions c 5. Aprendices : 1. A statement regarding the presention of persons une infectious diseases from travelling in public convoyance II. A note by the Central Advisory Board of Health relia randum on Anaemia in Pregnancy in India " forwashew, Resoarch Fund Association. III. Memorandum on Pont-l' Planning IV.

·ii Page IV. (a) A letter dated the 28th November 1942 from the Secretary, Central 43 Advisory Board of Education, containing a recommendation from that Board - that the Central Advisory Bnards of Health and Education should jointly consider the problem of the preventinn of blindness in this country. • (b) Memorandum by the Director General, Indian Medical Servire, on " Blindness in India. ". V. A report on the working of the scheme of the Bihar Government for 53 the compulsory inoculation of pilgrims attending the Sıtanarhi fairs in the yearu 1942 and 1043 VI. A report on the presentive measures taken in Baroda State against 05 gunet-worm infection VII. (a) Memorandum by the Government of the Unite! Provinces on the 50 cooperation between Cral and Military authorities in respect of the sanitation of Labour Camps attached to constructions for Defenco Services, (b) Memorandum on measures for the prevention of diseases in areas 50 surrounding aerodromes. VIII Summary of the replies received from the Provincial and Stato GI Convernrurnt showing the action tahen by them on the oriuS recommnendations mado at the presious four meetings of the Central Advisory Board of Health. - IX. Memorandum eubmitted by the Director Ceneral. Indian Medical 04 Seroxa, in the dry elment to Yussing Sertices in India and aprintment of Director of Nursing Services in the Medical Depart. minta of I'rovinces and States in India. X Memorandum on the Unitect Nations Conference on Food and 97 Arriculture, with #reciul reference to ste findings on the subject of Ford pilliealth » Dr W R. Lyhroyd, Director, Nutrition Iesearch, Indian Hesearch Fund A890Cutron, Connor, South India Xotr.-The Report of the Food Adulteration Committee, Part II (1943), has been printre parately and cries can be had from the Secretary, Central Adhigarv.Brand of Health The Memoranluin n Anaema in Pregnancy in India hing also been printed separately.

·List of persons who attended the fifth meeting of the Central Advisory Board of Health 1 The Honourable Surelar Sir Jugendra Singh, Jember-in-charge. Depart. ment of duction Heal:lz and Linds (Chairman) 2. In SKY Oulsnan, CIENCICS, Secretary to the Govern. ment of a Depirunent of Education, Henlth nnd Lanils. 3 Vajor (Tum JB Hante, CI, OBE. VIS. IMS, Director General Inn Verlical Service 1 Lievit (13+1 Lattt{ US Public Health Commissioner with the term ot of India Vemher Secretary) VAR DEPARTYFIT 5 Lt Col11 Jaarstant Director of Fygiene, Vedical Diri ratt 6) Horquarters 6 Wie ( od I' I ruír DRVO (FI) General Headquarters. RAILWAI DELASTUFUT RAITI Bound) 7 D H R Rustenorth. l'rincipal Medical and Health Officer, G. I. P. Tatad, lomby Criterit OF Vannes & Rao Bahadur Dr diesliin, Director of Public Health GOU ERVVENT OF BOYBAY 9 Vajor trenir'. A Cands II KS, IMS, Surgeon General 10 Ir Ki Guru Dinu Publc Health GOV FTNMENT OF BENGAL 11 The Ilonourable Khan Buur V. Jalaluddi Aluned, Minister-ul. charge, Public II alth and Local Sulf Government Department. 12 Dr Bokherjee Director of Pullie Ilealth. GUINWENT or TIC UNITFD PROVINCES 13. Rai Bahadur Dr AC Banerjea, CIE, Director of Public Health GOVER. VEYT OF THE PUNJAD 14 Colonel R Has, CII, IIS, Inspector General of Cıvıl Hospitals. 15 Khan Baladur Dr H Butt, Director of Public Health. GOVERNMENT OF 'Bintan 16 Ra: Baliadur Dr. B P Mazoomdar, Dircetor of Public Ficaitli. GOVERNMENT OF THE CENTRAL PROVINCts & BERAR 17. Colonel A H. Harty, CIE, INS, Inspector General of Civil IIospitals 18 Dr. R. L. Tuli, Director of Public IIealth. GOVERNMENT OF Assim 19 Dr S H. Paul, Director of Public Health NORTII.\'est TROVTIER PROVTXCE: 20 Colonel J P. Huban, O.BE, IM S., Inspector General of Ciril Hospitals.

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GOVERNMENT OF SIND
21 The Honourable Di Iemandas R Wadhwani, Minister-in-charge,
Ncdical and Public Health.
22 Lieut.-Colonel J E Gray, IM S., Inspector General of Civil Hospitals
GOVERNMENT OF ORISSA
23. Lieut-Colonel A N Chopra, 1 M S., Director of Health and Inspector
General of Prisons
COUNCIL OF STATE
24 The Honourable Mr P N Sapru.
CENTRAL LEGISLATIVE A SFIDLY
25 Sir Frederick James, O BE
INDIIN STATES
Hyderabad
26 Dr Mohamed Farooq, Deputy Director of Public Health
Hyeore
27 Dr P Parthasaratby, Director of Public Health
Baroda
28 Mr Motilal C Desai, Member of thư State Executive Council.
29 Dr N V Pandit, Sanitary Commissioner
Jodhpur
30 Dr. L D. Sarronyala, Director of Public Health.

·5 AGENDA I To confirm the proceedings of the fourth meeting held in Calcutta on the 26th, 27th and 28th Januar, 1912 2 To consider the Report of the lood Idulteration Committee 3 To hear a statuent rezul2 the pur vention of persons suffering from infectious diwases from travelling in public conveyances. 4 To consuler a niemorandum on Inna in Pregnancy in India includ. 11. Hafta 001 Teilinta forded of the Indian Research l'unit is itin!' 7 let a memor indum on Pint llur Mamin: 6 (al Tv 100-litet hated the ember 1912, from the Secretarp, HIT I irl of Liluetion, containing a recommendation frog thi nel that ih ntral Idusor Boards of Education and Histl. muki jo ut consider the problem of the prevention of Hindmens in this enuntri at an early date ch. To connder n priliku.rs report, dlated ith April 1943, hy Jajor Sir ('lutha Vacl.en on Blines in India" with a memorandum by thi Director-General IVS To considerari port on the working of the scherne of the Bihar Government the compulsort anulation of pilgrims attending the Sitemarli fair in the smars 1912 and 1943 8 To consider a report on the preventive measures taken in Baroda State ng unst -in mection a) To (onder dan on the operation between Civil and Military authorities in respect of the sanitation of Labour Camps attached to constructions for Defence Services. (b) To consider a memorandum ? ineasures for the prevention of deceases inamas surrounding we rodromes 10 To cons der il man of the reļille's recused froin Provincial and State Governmut showing the action taken by them on the various recommendation Unde at the prerious four meetings of the Central Advisory Board of Health. 11 To consider a memorandum on the appointment of a DirecFor of Nursing Services in the Medical D. patment of each Province or State 12 To consider a nemorandum on the proceedings and recommendations of the local Conference of the l'n tid Yations held at Hot Sprogs, USA, in Ins-June 1913 13 Any other business.

·Proceedings of the Fifth Meeting of the Central Advisory Board of Health, held in New Delhi on the 4th, 5th and 6th October 1943 First day's proceedings The Board met in the Committee Room of the Council House at 10-30 AV uncler the chairinansbip of the Hon'ble on Monday, the 4th October, 1913, of Education, Sudar Sir Jogendra Singh, Member-in-charge, Department Health and Lands, Government of India The Chairman read out the following message from His Excellency the Viceroy :- "When I spoke at the inaugural nieeting of the Central Advisory Board of Health in 1937 I pypressed the conviction, tlint the Board would serve a useful .*y of the problems of common interest purpose 117 nhabitants of the Provinces and States affecting thi in India dunng the past five years provide an authoritative basis for the development of health administration in many direc.. tions and show that my confidence was justified It is largely owing to the war and certainly no fault of yours that in many cases effect hus not yet been given to your recommendations We all are avons to ste after the war an era of detcrmed effort to raise the Indrit incared of living and I have no clouht that the work of the Board will be of irratssistane to Provincial Coverments an preparing their post-war plang Patates in the public health teld ***One of the main questions you have to consuler at the present meeting 18 planning for this post-war deselopment Flealth administration, if it 13 to de lieve any substantial results. demnils a considered programme, and attempt to del port mal with the many and variel problems involved any true It add to a dins paton of effort anil ol financial resources I would like to CHS Arun in that conner to the importance of securing that as our towns ehind the box and tuniti il shemes are prepir il on the right lines It his men s preat pleasure to ine to authorise the appointment of the intent JI, l Sur und I), velupihent Cumuuttee uh ch his recently heen announced II : Andisine that it will ronde results of the utmost folue Your work ar gul suur - 1b. ny at th:14 meeting will I know mysist that com 1:11. In its 19.1 can ·5 Iueet SD III 1 11 /۱ ۱ را ۱۰ را ۲ 111 4 11011 111 I intend to couves the above message to His Excellency on your bebalf. This was agreed to The Chairman: Gentlemen, the under tbe shadon of shortage of food. Buch us has not beco Inow Imi pa-sud under the British Crown i ood, good ord, sissent..l for health The production of food in thcors in any w 131 practie it is the responsibility of the Provinces It is a you for the plane and publists to innsider whether the needs of our jopulut viiran le net by m All India lood production policy or br dissen: 1 Mt. Ut This is bourser a digression, the 110UK on sittel hul tals to proude good it te ll the people Lime I ass on to the limits. I full it conve's our thanks to the 11 for their haid invitation to ideet at Bangalore 11 ht 1.4f this mutation as I could not fit my In ut I thought it unportant to hold 11 JUL! pistole Bath than to puront pone it too later date I am in horro unnot trust the future It is my import in the ve ir 1914 nuls tu hile the country i programime of agriculture levelupuurt vhack would all at providing nourishing Tool for all. A porumamine of health and tomme aum, at improving living conditions and a programetrie of educai (b) mulat equipping our whole population with knowledge lys hope that if our l.eople are physically fit and mentally alert, there is nothing that raniri unt their taking their proper place in the comity of Tuition, if political and cont integrity of India is maintained Gutleum tłu and befort Jou is farls laas ont, and you will wish to legin the discuss ull it with ds lille delay as possible So, I will only dwell to a U UWT on us twv litis of the agenda The one relates to an immediate problını, the sunitation of areas round military establishments. It is perhaps a sud commentary on the results of the efforts of the past half a century to mfuse sutury and health conditions that it is necessary to take special measures and mucur lurge tapenditure to protect our troops from disease But Lowever uppalutable it may be, there is no doubt of the ricus I bepe that we may derive from the special measures being taken in these areas, expepence which will be useful in the days of peace to come. Another item relates tu the problemig which huve to be tachled ta the future-the question of pust-sur reconstruction I thank you will 21501 watt le that of .ll the problems of the post-war period, none will be of noro vital concern than that of raising the standard of lıcalth wuch upling Iglier standurd of living Some say that this is a conomic inoblem, that to secure better livalth the economie conditions of the peoplu must be improved That is only u hale truth bulunced vion wouli, 1 th nk, be that steps to unprove economic conditions and measures to raise localie, staldırds inust go luuod in hand and are in fact to soine extent complementary of the innersity of the task of securing any reul unpro cincnt in health conditions, I need not speak. It is well known to But it is a task włatch I adi suru must be placed in the forefront of the post-war prograinine Iliope that the work of the lealth Sursey and Developinent Conım tter und I am appointing will be of material assistance to l'rovincial Governments as well as to 11 at the Centre in making reconstruc. tion plans If the problein is attacked with the resolution und determination that now goes to the prosecution of the war there should be no relfon why a intasuralılc advance should not be made within a reasonable time It will perlaps be too optimistic to hope that we inay see the end of the present struggle before our next meeting but at least we can look forward with confidence to the day when we may be able to replace tlie Sational War Front a Yational Health front and when the immense resources of men and mateial and the untiring energy and labour luich we have had to be devoted to the sent struggle can be turned to the task of the betterment of mankind Gentlemen, me co now begin with the agende. in their cumps A more you all ·AGENDA ITEM NO. 1. TO CONFIRAL THE PROCEEDINGS OF THE FOURTH MEETING HELD IN CALCUTTA ON THE 20TH, 27TH AND 28TH JANUARY, 1012. This was agreed to AGENDA ITEM NO 2. TO CONSIDER THE REPORT OF THE "FOOD ADULTERATION COMMITTEE." Lt.-Oolonel E. Cotter, the Secretary, in presenting Part II of this report drew the attention of the Committee to some of the inportant recommendations contained therein He sau that the report completed the widely intensive ftudy of this dillicult and rather complicated question of food adulteration anu that it was the result of a wide collection of information from the different provinces and States An important point recommended in the report concemed the regulnr submission of samples of food for examination by local bodies and that this should be spread over the months and over the year. If the collection of these samples was not properly spaced it would lead to defeating the Food Adulteration Act Another point which the committee emphasised was the importance of quick exaininations and reports of samples He also referred to the question of condoning offences Lnder this act he pointed out 1hat when neulteration was discovered the case was listed and there was usunils i dels of six months By that time everybody had lost interest and the case was condoned Recomendatione had been made for tightening this The Committee had gone to the length of even suggesting the class of magistrates who should trs such cases The Committee also suggested that Provincial Governments should consuler the question of appointing a special Inginerite do could keep pace with the cases and in support of this pointed out that one particular day in one city in this country there were as many af 4,10%) 1.6" under the Food Adulteration let which had not been disposed The report ise buggested that the Directors of Fublic Health should bo Watu with powers to supervise and control the working of this nct in local admun struttu on the lirits sof the Lal en m this matter by the Jadras Cavernment .11.0t the important recommendations contained in the report as the question of these loping each province a qualified and independ- 18 calre of public ht ulth analyet with a reasonable rate of pay and also a table status The Borat item se hi destrucl to stress was the question wettur ululterattal fixed cosuld be covered by putting a label on the contrincr. The term Adulteration tittee in Budying that this #wfoute I large number of purchsures were sliterate and besicles that it would be able to get slutseluhuh could be reul and unulerstood f the statements printed on the labels were inistenia umile compte leſs that reitne this shoull be done and that etc. to the Iru Italould be found in this can linally be a queste the user) Bind tu detil the sell tourht out aril solel recumintaa Sink but! Cuttex tch betto di special reference of miatters ייי Huy tinantrious !!!11 ) ادا ۱۲ ااه ·1 ܕܕܐ 1111: lcnܙ «Prini 1 ܙ ܙܢ 1 Gorernments had not realised their responsibilities in these cases and did not help with funds to the extent they could have done The Central Government could lil similarly criticised if such posts well taken away from locitl bodies, it would lead to a lot of mecessary criticism nhich would delay action, and kuch might present us from dischirme plir duties in the speediest manner possible Ir Sopiru te particular attuntur of the members to recommendations Sos 24 UR 30 in the rept heri thi ('onimittee had suggested that Trovincial 1-1-tur licht 1. had to frent thy (entral Legislature to nassr 1 to uir lot tout prowlithe listribution and trade, and, if Hirit <!!!, Helit the intritie Tuesures in some legal measures, 1 order the in foodstuff might incrense Ha thought 1. PENSport'..!! had a direct bearing on the V Yuld hope that Provincial Governmitints will partitaith motril tirisomit in this matter Sir Fredenck James 1.l'ult. 1 tl post mas extremely valuable and prire the yeneral pullic through broadrontall fi 1371 itt i 1l.. (otprnment It should not be kept in the admiterii fales of the tot: al proscial governmunits but should wirelt pooblad, discussed and written about He drew attention to four wan r lisendatorita contained the report (. Penalties iniposcul by magis. trutin uprethanel culterate the people's food we're not deterrent at all. b) thu Deator of Puhlie Health should be prien pouers to control the working of this dit to the creation of a cadre of public inalists in eu li province and and at the fans of a comprehensive l'uod it wluch would be applic } gout Jarot - da M C. Desai (Baroda) untimed the procedure adopted in Baroda State and faid that he was in full ngrennent with the recommendations contained in the, raft 1. perut t adulteration found in the State was 40 to 50 pe (**»nt and although something was being done incie remained to be done Rao Bahadur Dr. Ir. Adiseshan (Madras) lule agreeing with the recommendutirtis contained 12 the report suggested that the control of food produc- 11011 contres lould also be carried out Outlıg the practice followed in his. preunde in url that the Health Officers were virtually independent of the mul locuito or the accutive authorities and that they had been vested witli ilkint fut enfonce the provou of this art They had experienced dathi ule all that Ilutter of collection of samples evenly during the course of a with Verften, on arcount of difhcultos caused by tlie prevalence of ademics it was not always fen-ble to spread out the collection of sanples. 20 present 1.217 mmg with samples during their trust to the laboratories he peste that is used proof simpling equipment should be devised and brought tuto effect with a little delay as possible Dr. 3 Mookherjee (Bengal) outline the procedure adoptoel in Bengal in the collection and examination of samples and pointed out some of the difficulties experienced in hus province He suggested the destruction of all old sniples in the possession vi grocers want er sunable to prevent contusion In Bengal the (101enment had appointed a select committee to consider the Bengal Pure Jond Bill lont in the bu! had not been finally approved by the Legislature he was unable to coinment upon it Chairman: "Sır Trederick Jarries has raised the question of publicits. If the Boerd is Agreeable I do not think we should keep the press out In the case of all nation-building subjects, the greater the publicity and public interest, the greater the support we can art, and we might inrith the press so that the Jullest publicits could be given to these discussions ". This was agreed to Rai Bahadur Dr. A. C. Banerjea (U. P.) said that he was a member of the committee and that he agreed entirely with the findings and strongly supporter the recomendations contained therein He hoped that his prorince would accept those recommendations which were not alreads in smetice in 1 he Unitedi Provinces. He emphasised the necessity for the proper taking.

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·19 11 are 9 in connection with mari' products to take samples and help the local bodies in the walnu ní this set lle was rof the pinion that udulteration of foolstuff was general practise in urhwn areas In rural 176.s the producer, W! We the (+ vullna lutate sunt le proposed to eat luuself though this dicit scannils apply to tlir surplus aluch he proposed to send 11 thr). fuge et Oprindera the muddleinan or the truder who knowing that of the tu! be muhats writeripteil to luiterate untem c.ll 11 195 1. Dennaht that the present Ict would 20 i 119 to all this perilo al suport the proposal whole 3.4 urtedl Major Genera! R I. Candy (Bombay) 4xl that, so far they had hearel, the vanus citheulti Com'... dhur, ili na poli tuon of the Act He, }:/۱۱,۰۱۰۳ 11.11. 1!. l., ile nile otherf***?%< to the necessiti atliv ford trades These latter weie 1: bin it for instan the control of nurs tuants wild the everal thousand + IT! hatuali per the bra Ierch ints 11 )11:۳ ۱۱۱ Dung thu 114 three four months some ti pet at these pett merchants au consolidat ttu te tu. U blf a dozen co-operative socie. 1+ with located on the sublime teil and he suggested that the Blaulilinisin thua Illieerd in his opinion we 1101 oul to me. I wou to have a regular trading body with Id 1-1 ULIODS (onumunicated Most of the prtti troliinit 2010 the Act The lle artils advocated the appointl'ent of pubi'ul Aunts and that these need not be medical men The thurman pred that l'ruime kl (rement would make their pro- Lleins of health and murislument thur primirs concern If they gave their wholehearted attention to these matters he felt sure that the District Boards cr Local Boards woulil also foll» smt He also agreed with General Candy that they needed inure reluation about the laws of health and food rather than an armours of penalties anil more stringent laws If they could raise the mandard of living, proude model houses and give greater publicity to what they intended to do and destroy for (It's the purdal that sırouds their deliberations, the mouk ire able to brng to the notice of the public the need of having letter food He confessed with regret that « far politics bad taken up a great deal of the time of politicians and publicists and that problems wluch affect. «d the health and erluation of our people had been neglected Hc hoped that if greater publicity were allen to the problems then the Centre as well as the Provinces would turn their attention inore to thang that matter and these were better health, lytter food and better living conditions He also expressed 1 hope that the neu Tealth Committee which ad just been appointed would five then a programme of imposenient of health conditions in villages. He agreed with Dr Tuli that there was gond food in ullages and that it was only H.ecessary to analyse fond on tonns ble promised to see that the recommendations of thus commttee would be brouolit forcibly is the fintice of lrouincial Governments to give effect to them Sir Frederick James (Central Assembly) requested the Chairman to attach to the resolution parum.ph clealina wili the question of publicity and the eduration of public omuon its will as a prigriplt on the organisatrn of food trudes as pointed out by Major General Candy. The Chairman agreed The resolution as amended was carried AGENDA ITIN YO 3 TO HEAR A STATEVTXT REGARDING TIL PREVENTION OF TINSONS SUFFERING TRON IXFT.CTIOUS DISEASES TROM TRAVELLING IN PUBLIC COXVEYIXCES. 'The Chairman -33] that it was only for information and that no discussion was necessary

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·»: ܐ ܙܙ ܐܢ ܙnilteriu 1111tiu 11 in tackling at He hoped that a c'entral Coininittee trould be appointed for post-war planning and that all prosinces would co-operate with it The Honourable Mr. P. N. Sapru (Council of State) said that he attached er great important to el nom standards If the standard of living of people were to be raised he felt sure their health would also improve There Wire, of course +leeptions to the rule and that required cducation of public outon thong the lines Unless that was done so as to create a co-operatire instructed about it would not be possible to achieve theu aim whatever the health , hit tu Hi trioned the necessity of providing 11" e corded it Tlies soulil hare is machinery whereby it matt pati un l af und to get free medical attention HC pointed to: DHE+MTS of Cubaprehensive survey of the health conditions 111 11 1918 emulai he formulated for post-war work He lated that the Ifrat han er nt epucemics of cholera, typhoid, malaus hilt u this countri after the war and stressed the 1 muna duteh He suggested that the ques. 11 or powth beli tam !!!!_il pical attention and said that it Cbas "ther auhi lar establihed Rao Babadar Dr. R Adiseshan (Badras) said that the subject of post-war reconstruction unter the utile consuleration of hus Government and is l't tole the whole subject As regards public health 21late when had een submitted Dr B Mookherjee (Bengal) wire we the necessity of starting a scheme for the sel dit of beth oedtels in Bule a brief description of the propower chrine for 124pressing the health of the rural population in his province. The solemne ensured the building up f 5,000 dispensaries each with a doctor, a health assistant and dui Tier was alau a scheme for the introduction of sichtless luce He sale that hole cheme was still under the consideration of sub-ennustice and that full details were not available Rai Bahadur Dr. A. C. Banerjea (U. P.) stated that an officer from the Government of India irad been appomted in forinulate a scheme and his govern- Flient were considering the whole subject suth a view to decide on what lines thic work should proceed Pái Bahadur Dr. B. P. Mazumdar (Bihar) sud that bus Government were ale condering scheme for post-war developments and suggested.the necessilk of going alad with the with as soon as possible Dr. S. H. Paul (Assam) informed the members that a committee had been formed in lus province and he hoped that some scheme would be introduced very shortli. Dr. P. Parthasarathy (Mysore) in giving ng outime of the work done in Mysore State stated that the public health department began to function in 1929 and that in 1936 healtls centres were started with the co-operation of the Rochefcller Foundation A comprehensive statistical studs of the whole State was undertaken and had revealed a very earl, state of affairs However, several lenlth units were now at work in the State and it was lioped that health work would develop on proper Imes Dr. Mahmood Farooq (Hyderabad) stated that the Public Health depurtment m his State la formulated & nulle sear plan for the improvement of public health m the State As part of the postwar reconstruction programme his Government were in complete igreement suth the recomiendations mado by the Central Idiisory Board of Tealth from time to tine and the whole pro. gramme was to be considered very shortly. Lt. Col. A. N. Chopra (Orissa) said that unless they knew the finan. sint conditions of the province's would be ther could not commi clres to anything Erers thing depended upon finance and if they could moncy they would expand their activities in no time. Colonel J. P. Subar (North-West Frontier Propioce) said t ern. ment were considering post-war reconstruction and that when y 1

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·more tt.), 13 that the 11e'nt of Dr Committee was under consideration- He also agreed with colli's 5117eestion that a sc!l fod population would solve many of their problems (ineral (ants had tras attention to a great eril in the sustins dispens iranil hospital irrangements and Sind liad alco draw attentyou to the question of the promision of muri Inctors w nurses. He hoped that the new immittit li hu ben ppointed soull ne special attention to the later of the rod for those doctors and murses and up improuin tuu it!!! AGINTATIV 1+1 TONDILI'TI')DITED 28TH I TU! 112 ml uli irrus (TVTRII. IDVISORY 1. ۱۱۱۱۱۱ 1 {\T\}\1\4. PHENOMENDATION 1.V D1 RO 11:) TIIT THI' IN VTIL VISO: JORDS (11) ('ITION HIITU SILD JOINTLY CONSIDER THE POSITVI THI PIEVITION OF BLINDNESS IN THIS VTIT 1 WTI DITT (11) 1 (1) 1 I'll VIII. POT DATED) TH ATTIL 1943 :) ITIT 11. L. UNTIL ON ELINDNESS IN INDIA" 11/13 I VI VOI INDIVB} THE TIJ F 'TOR GENERAL, INDIAN VENT IL SERVICE Colonel (Now Major General J. B. Hanco, (Government of India) drew the 11. froutes in the report of Li -('olinel Sir Clutha Mackenzio and tliet til Su Gordon Joll, which hel liecii circulated He said that thrre opri tuo tuns in this item aluch required consideration The first was A S'. - 1147 three roull be a joint winmittıe of the Central Advisory Bandsflutnind leth who should meet and investigate the problemi of the population of blmness and the second was the consideration of Sır Cluths 17 H.- Vit Vaj the king Idward VII lind once said "ıf preventili uhy not present But helore this task could be undertaken it was very necessary to have clear ideas on the cause or causes of the disability li empeil to pri sent Inel poucessed ophthalmologists unsurpasseil in experience and devotion with a large store of accmulated knowledge on the >> of blandness I}One Ter, their experience was confined to the local artis in which the ir activities had lain and there was no comprehensive review lll the lat country as a whole Somethuar more comprehensive sas requned le such a review was not onlı esential but overdue It is, therefore, suxested that we should have a comunittee of educationists and molir il 11 he could consider the various problems namely medical, ecercaton. and relimitation He felt sure that their report would be of sert great value to them al Governments and Health Departinents in formunting their on approach to the task of preventing bliniinies in India On the question of treatment and reliabilitation of the notual blind vers little had been done except througlı the efforts of private uncoordinated enterprise and perhaps in some cases to the entreprise of those suho hail themselves lost their right He agreed with Sır Clutha Vackenzie when he said that the time nas ripe for giring the blird wider and better welfare services and an improved postian in the coinniuniti Although the number of men who hail become blind in the present War was up to now happils consulerably smaller than in the last great war, such cases had orcurred and were securing and this imposed upon both Government and the publie a dute of doing everything that malem knotledge and skill could do to compensate them for the sacrifice of their sight in their country's Je sincerely hopeil that the report when complete would be of great nssistance to all the Provincial Gorcrnrients and he hall hesitation in recommending to the Boanl the acceptance of the resolution which was placed before them The Hon'ble Dr. Hemandas R, Wadhwani (Sind) in supporting the adoption of this item liriefls outlined the position as regaris presention and treatment of the blind in Sind The snu that trachomn' as the main cause of blindness in his prórice and thnt althouglı much tas heing done a lot more remained to be cause no ·had been frained be thought thint it noull he put into patron 96 500 nu mnght he possibile Khan Bahadur Dr. A. H. Buft (Punjab) 28 geborert the criptom of the work that had lo con fuis fyrir All Gescument for stortrin some last voor u sural tante' en hul litt uppeunted to consider the questo in front fall aspects He himself hat abott i scheme kaliteli included everi sport of 17 al lupi in unitate II.- (murat 4114 already alert tcrios important parthull mint the rule in uhateser was possible with the funnet ble Ile ils porced that the centrul Cimermnt roull A2 thell , bul with the coronstruction comme auch bril alreads to ou nuntat hi hum Colonel R Hay Punjab. Į kelul Hi tron b the ('entral Cotcoilinent Ilchul that I 17 with other that th whole sclerc depeniled poti funds trol that (omernment funils woull not be capital lot that th) R1003 woulit les spent on tror.71115tion and the few print of lu 112 aning in com* of a quarter of a century If the people were well fel anil will curated they wouli demunal purc foni, proper and adente muroina spornst Dr L D. Sa-ronwalls Jodhpur mul that those was before a auh- Committee appuntend to the purp webshly State Dr R L. Tuli (Central Provinces) mean mutline of the esisting organisation in the province and at the centre and stressed the necessity for a properit reorganised Public Health See the entry Te 50stet the creation of a central institute of public heall under the control of tlie Public Healtlı C'onione who beldris upon the rulence of a perts in the various hranches of public health anıl who could act as a valuable Ipson officer betreen the provinces and the centre Fle also flygested the criation of a central puble health 4 which coul proucle pirert ticers who onla tarkle special Il lui peuta is tur id ample holla erxemir, malaria He also stressecl the necessity of small health units inch could work amongst the rural irtisert prosince Major General R. E. Candy (Bombay) saxl that his government was already ingin denen el 20 struction polician tlust the hero on all that was pensile The ful toox .t 83 lahls but u benerer any request was made by the puble lleilth Department they got a replı (ouchel in courteous languae bat irenclv indecisive It was not possible for them to prepare any kind of estimate as they did not know wlint the impact of the Indian going to be on the strinitards of salnries reqmeel by medical offers, and is not example he nen mell the rise in the salaries of all services after the end of the last lle felt that after this war also salaries would he fired at a much higher figure than the pre-war figure Ile stated that a dispensari doctor (sposed of anything from three hundred to six ferred patients a cor, which meant on an nur 25 to 50 patients per hour Te asked the Board that possible attention a patient could get if he was looked at for about a ininute. He, therefore, stressed the necessity of supplying terhnicians with some scientific training to theer diapensaries so that a proper dingnosis could be made Lleut-Colonol J. E. Cray (Sind) suggested the creation of more health centres and medical colleges to meet the shortage of loctors and nurses The Chairman in sinding up the debate ilren the attention of the members to come of the salient points which hnd been brought forward. He first stressed the neec sits for creating some funils for reconstruction TIe snid that after the war 19 ore! penple would get busy trith retrenchment schemes rather, than residing mones Ine drvelopment schemes Hence the necessity for every Tosince and State to start the creation of a fund for cartring out plans which were now under consideration. The Central Government would alkars help the provinces with money, muidance and leadership Fe said that the Hon'ble Ms. Sapsu kail daarn their attention to the matter of the supply of drugs, aral (1) ۱۱ ۱۱۰ (راد) ۲ ctc at ·. in mind 15 Khan Babador Dr. A. M, Butt (Punjab) gave a brief review of the work dono in his province He said that the whole question was considered by a confer. A Provincial ence which was held at the instance of his government in 1932 Advisory Committee was formed which issued propaganda material which was circulated to schools and Health Departments Carly this year another conference was called in Labore under the chairmanship of the Honourable Minister for Education in the Punjab when Sır Clutha Jackenzie tiho was present gave his advice on the various aspects of the question As a result of this a committee was formed and a questionnaire tras drawn up and circulated to all district Health Officers with a view to find out the incidence of blindness, its causes and the action taken in regard to treatment and prevention As soon as all the data vere collected further action would be taken He welcomed the proposal with a proviso that bis Government should not be involved in any financial commitments Dr. L. D. Sarronwala (Jodhpur) sard that his government would support the proposal Col. A, H. Harty (C. P., said that although there were government hospitals and blind ieliet assorlations in his province they were woefully lacking in measures for the blind and he felt quite sure that lus government would support all these proposals Major General R. E. Candy (Bombay) supported the proposal Chalrman in winding up the debate said that the plea for central finance made by Sir Frederick James would be carefully examined and that suggestion of Dr Rishworth to strengthen the comittee would also be carefully borne He felt sure that this coinmittee would do very useful work when appointed and the night of many people would be restored Sir Frederick James enquired as to how long Sir Clutha Mackenzie's appoitment would last General Fence said that it would last for about a year but that he would verify. AGEXD. ITIM NO 7 TO COXSIDER I REPORT ON TIIE WORKING ON TIIE SCHENT OF TIJE BIHAR GOVERNMENT FOR THE COM- PULSORY INOCULATIOX OF PILGRIMS ATTENDING THE SITA. MARIII FAINS IN THE YEARS 1912 AND 1913. The Chairman requested Dr B P Mazoomdar to explain the position. Dr. B. P. Mazoomdar (Bihar) stated that in accordance with Resolution passerl hy the Central Advisory Board of Health at its third meeting in July 1910 Ins Government decided to carry out indircct compulsory anti-cholera inoculation at Sitamarlu in 1912. A scherne was prepared by him at on esti. mote cost of Rs. 9,300) The Emdernic Diseases Act was introduced and the mula was held in the Sitamari area from March 21 to April 9, 1912. A considerrlile amount of propaganda was done in soine districts of North Bihar before the actual date of the opnmg of the mein. There was at ouce a strong oppo-tion to the enforcement of cholera inoculation nyd le regrettel to mention tlie fact that some of lus stall were assaulted and that various kinds of rumours were spread by_mniucherous people wtli a view to barassing their efforts in tlus direction. Ivstead of about 50,000 to 70,000 people who tised to attend the mels every year onlı 25,000 people visited the place and of these le was allo to inoculate 21,691-about 80-85 per cent. He was hapis to state that only fire suspected cases of cholera had occurred during the period of the festival In 1913 the mela took place from the 4th April to the 20th Ipril and his Governinent introduced the scheme again. This time they had 70,000 visitors out of whom 65,280 were inoculated about 10 per cent. A considerable amount of propaganda work was carried out before the actual date of the rela and this year lie was happy to say that there is very little opposition. Inoculations cro carried out at ten posts, nt milmas stations, in the running trains and in the mela arc3 Only six cases of cholera occurred and there was no ·ever Pall 16 outbreak of the disease cten alter the mein *88 Ofer, Ifo (olt guro that the Incazare was of SITT fent aportance and l hopind it would be adopted in Other places where Inrge marins ser hele trery San The Honourable Dr. Hemandas Wadhwani (Slad) will that lis tiovem. ment bad decvlrd to introduce compul-tymorulation initnted by Bihar, The Honourablo Mr. P. N. Sapru Council of State) congratulated the Direcwor of Public Health. Biline on the sick that *** being done by lein and be approved of the resulution 1. remurh bs Sir Frederik Jami'y und Jr Motilal C. Desni Rao Bahadur Dr. R. Adieshan (Madras) said that any fur 19 his province was concerned the necessity for aloption of the vyetem hnd not arixoa us vuder the provisions of the Vautrie Public Health Act the clovernment could straight. swas declare a festas al centre 19 an infected area or threatened orea if there Was uns risk Ile. Powers congratulated the Bilar Costrument on what The cerul it to be real's mariellons achievement Dr. B. Mookherlee (Bengah) and that it was very difficult to carry out co:11pulsory inoculation in all furs and festivities that took place in Bengal He have some information about the bug Ciangnagar rnela which wan kald u poroke every year In It wag not possible to get many doctors to do maculation work during the rush period he injured of the Board whether It won't be permissible for him tu utilise the servicey of medical students for this purpose He had great pleasure in supporting thats resolution. Rai Bahadur Dr. A. C. Banerjea (U. P.) stated that in his province faire were of a 111-Indiu nuturi and hu particulariy crew attention tis the difficul. tie wuch he experiented at the Kumbh Mela sluch attracts eiery year any thing from 10 to 25 Jahhs of people Although much had been done much mote remained to be done and he hoped that the Public Health Departments of the lighbouring provinces from here these pilgrans came to Allahabad woulu cu opt 2,11 with min samg that all pilgrins from other reas compulsory 10x witte bu for this pmceeded to the Karnibh mela It would gruly its her work and fuave them uttsulent time to do the rest Dr. S. A. Paul (Assam) stated thut thes had no such fans in lus province 118 by melits were bekl HD woule tulleser like to try this experiment. Dr. H. R. Rishworth (Railway Department No remarks Dr. Parthasarathy (Mysore) gave an inculence of compulsory cholera iroculation work carried out in his State where 15,000 people attendus a fair were all 110culated The experiment was carried out in other places niso quite gucressfully Dr. Mohamed Farooq (Hyderabad) stated that his country was a land of fairs and festivals as not less than 25,000 fairs took place every year in his 6tute. It us not possible to instituto compulsory inoculation measures all fairs but as far as those people who went to the big Pandharpur mela, he Wuz happy to state that 21,000 out of 25,000 people were inoculated against cholera IIyderabad State hod done its best as far as this fair was concerned und le felt sure that this system would be gradually introduced in other places. Lt.-dol. A. N. Chopra (Orissa) described the measures carried out by him in the big fair at Puri which was held that year. Nearly 80,000 pilgrims cut o! a tlal of 1 lakh were inoculated and there was no outbreak of cholera after the fnir. wer 11 Col. I, P. Hoban (N. W. I. P.) stated that there was no such problems in the North West Frontier Province and that compulsion was not necessary as trailers who came from Alghanistan accepted inoculation without the slightest difficulty. Khan Bahadur DT. A. N. Batt (Punjab) described the measure adopted in the 1948 sun eclipse fair at Thaneswar. That fair attracted anything from to 6 lakhsc! pilgrims and although compulsory inoculation of pilgrims * ·17 pot done he was happy to state that from the other sanitary measures taken by his department there was only one imported case of cholera who recovered quickly. In view of the fact that a considerable measure of success attended the Bihar Gorernment's measures, he would approach his governinent for the compulsory inoculntion of all pilgrims visiting Thaneswar fair next year. He would like to go a step further and suggest that all those pilgrims rho come to the fair without any moculation certificate should be prosecuted DI. L. D. Sarronwala (Jodhpur) stated that there were two very big cattle fairs lield in Varuur rier year and described the measures taken by the state authoritiem in presenting the spreading of the disease by compulsory inoculation Mr. Motilal C. Desai (Baroda) So remarks Dr. R. L. Tul 10. P. & Berar) stated that his prouince had lost been able to give effect to the recommendations of the Central Ads isory Board of Health on the subject of mass inoculation although every facility was given to intend. ing pilgrims for free cholera inoculation They had so far not enforced com. pulsori inoculation against the disease on pilgrims attending the fairs He however entirely associated huuself with the proposal. Major General E. E Candy (Bombay) while extending congratulntions to the Bihar Govt drew the attention of the members to the work carried out by the Government of Bombay at the bly landharpur fair in his province He stated thut Boinbay was the first prouince that carried out this work In 1936, 31,000 pilgrims attended the fur and in 1910, 173,000 and their experience during the last 7 years had shown that it wds possible to achieve 100 per cent. insculation People were gradually becunning an are of the benefits of inoculation and in 1912 57.000 people arrang ut the fair produced certificates of inoculation and 79,000 were inoculated on the spot that year They were taking similar measures in the case of big fair at Nasık which was beld after every ten years and he anticipated similar success at that furr Lt. Col. E. Cotter (Secretary) stated that he was glad to learn from the members that something had been accomplished on the qucation of indirect corirulsory inoculation of pilgruns assembling at big fairs in India. When the question was discussed in 1939 and 1910 general doubts were cypressed about the practicability of the scheine but after he saw the working of the subeme in connection with the Pandharpur festival his doubts were dispelled. He hoped that the District Medical Officers and Directors of Public Health would try ani impress on their governinents the advisability of this measure. They must, of course, be prepared for opposition in the beginning but he felt sure that they would get hearty and full co-operation from all concerned once they realised the benefits of this measure. Whut wag required was good propaganda and a reasonable amount of tolerance to opposition in the beginning. He also drew the attention of the members to the fact that inoculation did not imme. diately confer immunity from cholen. Inmunity was generally developed after 4 to 8 days and lie welcomed the news that pilgrims now-a-days were inoculated long before they leare their districts to attend festivals Inoculations should be arranged well before band and that could be done if we gave publicity in the areas from where the pilgrims came There was no doubt that the inesien e of cholera had come down considerably and he hoped that it would Trually disappear Ral Bahadur Dr. B. P. Mazoomdar (Bihar) enquired whether in the absence of properly trained medical men to carry out these inoculations anyone else trained to give inoculation could be utilised for the purpose Lt. Col. E, dotter (Secretary) replied that the Centml Advisorr Bront of Tealth hud accepted that inoculation of this nature could be done by s7nitary inspectors with the requisite training.

·eny 18 AGENDA ITIN XO 8 TO CONSIDEIL A NII'ONT ON THE PILL'EX- TIVE MEASURES TAKEN IN DIRODA STATE AGAINST GUINEA- WORM ISTECTION Mr. M. O. Desal (Birda) drcn the nttention of the committee to n machine invented m lus state for trenting infected well with luuo anni cained to the memorrs present the method emploned The Fork had neen carried on for the last four or fire senrs and the results nchieseni so fur werelery satisfactory., IR sevcral villagee the disense had practically appeared with this wethod of treoturient The Honourable Khan Bahadur Maulvi Jalaluddlo Ahmed (Bengal) va remarks The Honourable Dr. Hemandas R. Wadhwani (Sind) stated that guneaworin infection was fortunatels mit prevalent in die province but ho supported the views of the Barnde Government and state that every affort Trust te made to eradicate the diverse wherever it existed. Rso Bahadur Dr. R. Adiseshan (Madras) baul that in his province it was a very miportunt problem as the disease existed in 10 out of the 21 districts in the presidency It way a disease of rural areas and he felt that although umpg Tuethod inight use uren good results in Baroda, in his province the biological method hull given considerable success The inethol consisted in introducing tiny fish which could ent up the ciclops which caused the disease. It had been stated in the report that the river Banag was also infected This was the first time he had come across a river being infected with guinea-worm and he would like to know if similar experience had been recorded in other province in the country Dr. B. Mookherjee (Bengal) said that there was no guinen-trorm infection in Bengal He however recomnended the rotro luction of a large number of tisd 21: ench well so that the cyclops could be removed quickly Rai Bahadur Dr A. C. Banerjea (U. P.) said that guinea-worm was not a problem iu hus province Rai Bahadur Dr. B. P. Mazoomdar (Bihar) said that there was no infection of guinea-lorin in lus province Dr. S. I. Paul (Assam) said that there was no problem of gumen-worin in las province Dr. P. Parthasarathy (Mysore) stuted that control of guinea-worm started in his state as early as 1933 The late Dr. Narasımlınmurt during the course of his tour in some of the infected villages found some of the wells free from cyclops and a further mestigation resealed the presence of tiny fish wlucht esoured the cyclops. Since then sinlar fish was intioduced in other wells with the result that the dease more or.less disappeared from the afected willigers It woull be adsis.blo le sud to convert every step well into a draw well wherever possible and to carry on with biological control, Dr. Mohamed Farooq (Hyderabad) informed the members that this infec. tion was prevalent in four districts in his State in experiment with lime was carried out in disinfectiug the water. In some of the wells it was found that eylops disappeared within four hours of the treatment but they reappeared after a week and that was perlaps due to reinfection of the step wells which were very common in those districts. In order to eradicate this disease they had drawn up a policy of Lourerting all step wells into draw wells. Lt. Col. A. N. Chopra (Onss3) supported the resolution, Col, J. P. Hubaa (N. W. F. P.) Xo remarks. Khan Bahadar Dr. A. H. Butt (Punjab) stated that the infection was present to some extent in eight districts in the Punjab and that propaganda against this di-clip as being carried on Di. I. D, SarroqW3Ls (Jodhpur) stated that it was a big problem in his state and that infection was prevalent in nearly 800 villages. People in the State de percked upou open tanks containing rain water, as the water in inost 1 as ·19 of the weils uc brackish. The biological method was tried in some tanke but as these lanks dry up during the suminer the fish also die and the whole process had to be done over again . scheme for sinking well in every village was prepared and a benevolent fund had been started. It is hoped that something more useful not be done in the State in future Dr. N. v. Pandit (Baroda) stated that line control had been systematically employed in bis State for the last six years From experience it had been found that 8 lbs for each el! " enough to destroy the cyclops for the whole season and that the treatment was very useful in reducing the percentage of infection in the ullsges In the memorandum circulated to the members it had lees mentioned that monia chloride sals gsen for a week or ten days 11 ordnars sonda sud that it was enough to reduce the swelling in many cases. He would like to draw the attention of the members to this suggestion because it could be used effectively in villages where there are hardly any roads. The biological method had not been tried o fur but the difficulty was that the wells -dried on interier and they did not know how to keep the fish alive Dr. R. L. Tuli (C. P) stated that in his province 13 districts had returped sporulos The infection was there but the problein was not very acute. The ball tria rarious methods to eradicate the disease but so far had not met with complert muccess He promised to utilise the suggestion inade in the report and hoped that some benefit would result from there Dr & A Gandhi (Bombay) sad that there were only two districts in Bonbus I'reridtxt whxh had reported infection They had tried all the - methods that had beer nited so far and his government had finally docided that all step welon should be converted into draw wells The Chairman congratulated the Baroda Government on this pioneer work anil hoped that the control of guinea-worm would be accomplished The work hari made a good start and he hoped that it would be carried on Second Day's Proceedings. IGENDA ITEM XO 12-TO CONSIDER A MEMORANDUMI ON THE PROCEEDINGS AND RECOMMENDATIONS OF THE FOOD CON FERENCE OF THE UXITED NATIONS HELD AT HOT SPRINGS, U.SA, IN MAY-JUNE, 1913. Dr. W. R. Aykroyd was specially invited to give the members present some idea of the Food Conference held at Hot Springs, U.SA. Ho stated that in the note which he had presented to the Board he had tried to suminurise the most important conclusions of the United Nations Food and Agricul. turul Conference so filr as they had a bearing on public healtia In the first place the conference had strongly emphasised the importance of nutrition in public health The conference had enphasised that much disease was caused directly a indirectly through malnutrition and that of the dier was ir:proved general health, pusical efhcenes and capacity for work would also inercase. It was, therefore, necessary that public health people should jar the closest attention to nutrition wluch had become a recognised department of public health. Public health programes should be adjusted so as to give duo place and wcight to activities in the field of mutrition The note prejuled by him contained some of the rerominend.1tion made by the llot String Conference and he referred tsrie tls to some of these (a) Defiwney diseascs –There are a number of leficiency di cases in Toda wluch represent scrious public health problems and which require study and vigorous attach, for example beri-beri in certain parts of Jadt.s, osteoanuletis in the north, goutre in the Hunalavan footballs and a number of other important discases (b) The Conference had emphasised the importance of paving «pecial atten. tion to the nutrition of shint are called vulnerable groups, that is to say such persons as pregnant and nursing women, infants, pre-school and school children all of whon required exacting dietary requirements and Frere particularly likely ·to sutter from tho ill.effects of malnutrition. The Nutrition Advisory Com. mittee of the Indian Research l'unii A94cylation in considering lagi reek rationing schemes in Indın recommended that special attention should be paid to the needs of there groupa in rationing schemes, and that ns for 19 possible available milk supplies should be rreensed for crpretant nn mring mothers and chuldren It had also recommended the immediate deselopment of school fecamg sbcines to supplement children s ratione (c) The United Satione c'onference hall also relerrut to mational nutrition organisations and committee Inilin #couimittee of this mature 85 founded in 1n.lfi hs 1114 Bxredeny the Viceroy and find functioned since then, Its membership *08 priporehensile ind it nas qualitieil to deal with a wide range of smjects in comme trom with nutrition and its prirtient applications. The l'nited Nations c'onferenler had recommended that it worker or workers with specialırd trainmig in nutrition should be included in rach najor public heaith department The Jodinn Vutrition Advory Committer hnd chizitinsised thrat pomi for a number of vostre and certain provinces in India already had full tine nutrition *orkers, he wanted to see one in every prosince in the public health department .1t the Inst Nutrition Advisory Committee the need for such worror purtularly at the present time had ignin l een stressed in the following words "The present food (risis has further emphasised the importance of having trunn nutrition of cern itttu hed to the public health departments in all provinces The lack of such viticers in many provinces lins seriously weakeued the organisation needed for dealing with the urgent problems which have arisen in connection with the food wttution He requested the board to support thus recommendation of the cmployment of provincial vutrition Officers and the Establishment of proucial nutrition O tie's (d) The Latul Satmis c'onference luud stressed the nece ayity for basing igricultural policy on the Dutritional requirements of the population The indun Nutrition Advisory Comitntttee had taheu a practical step in that direc: uon by including an its unbership the Agricultural Adviser and the Animal Husbandrı Expert. The Hot Springs Conference had repeatcitly emphasised thun qurtun ut the insullution between the agricultural and Nutritional pols. It loud apunted an international food and Agricultural organisation The iluties and functions which would come into being at the end of the war of this new orgullsition were being planned by an interim comniission in Weshington under the churmanship of the Agent General of India, Sir . s. Daspar. si hoped that this internationul organisation would link up Path Daural nutrition committees in different countries in the worla. Representutives of 14 nations were present at the Hot Springs Conference gucl shey described what had been done in their respective countries. I felt thut the work done in India was goodl in comparison with countries outside western Europe und north linerid considerable amount of information on the foxi problem had been accumulated as a result of research orer a number of year. What was now required as the question of giving a greater degree of practical applieution to these tindings, The llot Springs Conference had been cnticised as highly utopian nr the American piring called it starry ered. Certain critics had called the report & string o! platitucles le, bonents, felt that the report contained a great deal ot good sense particularls as far as nutntion was concerned. There was food shortage all over the world a hich would persist for some years ofter the War and it was therefore necessary that in planning any scheme for post-war reconstruction full weight should be given to the findings of the United Nations Conference und de expresned a hope that the Central Advisory Board of Health would espres its Keneral approval of the findings and recommend that ful Btlention whould be given to these in the designing of reconstruction proframines cues as ·21 The Honourable Khan Bahador Maplri Jalaluddin Ahmed (Bengal) wbilo thanking the previous freaker said that the problem in Bengal at present 'AS not so much one of nutrition as of import of fron? They were quite awar of the necessity of nutrition deseloping on the lines suggested but their dift. culty has tbrit rise being the staple dirt in Bengal it was a very difficult thing for them to substitute it with other cereals The ugrulture department in his province had launched A rigoroue çrrit inore food campaign, and they hoped to produce rice fubstitutes huch would not impur the people's health. He would be very happy konses the suggestions of Dr Aykroyd to Bengal. The Honourable Di. Hemandas R. Wadhwani (Sind) stated that he had appcmted a nutrsty adining committee in his province last year consisting of experts from the medical, public health and Agriculture departments who were paying peal attention to the availabınty of different foodstuffs in different areas in Sind The Governinent had also appointed a special committee to enquire into the nutrition and health of the school children mud the Koahi Mumpul (unimitte. Here proudmg adelitional milk diet particularly to very poor bous in rchuet who could bent afford it H suggested that the teaclung of dentat cience m girls schools should be made compulsory and agreed with Dr Aykroyd that every proumre shou'd have A trained nutrition officer who could advise them on this prohle in which was the most important. The Chairman dress the attention of the Board to one or two points raised by Di Aykroyd He said that if the world needed a united world policy on ngriculture und mitrition Indu. lie felt wure needed i{ much more At present nutrition work was carried out at convor What was needed was a vital centre here and tht co-operation of the provinces who would follow the policy laid down by the entre If this was done both the shortage of food and the nutrition probiluru would acquire reality The Honourable Mr. P. N. Sapru (Council of State) stated that tne first thing which struck hina was that out of 44 nations wluch met at the Hot Springs Conference India was the only dependent country He hoped that in the post-war world India's point of view would be represented by a government which would be national in coinposition and character The second point which struck him was that the discussion was taking place at a tine when there was & grave food crisis iu Bengal and certain other parts of the country. It was not bis intention to go into the causes of that scarcity for whuch an indication of a possible solution had been advanced by Dr. Aykroyd. He had suggested that the world had shrunk und that they were pon thiühing in terms of interdependence in matters of food, and that the Hot Springs Conferenre was an indication of that inter-dependence. He felt that the centre must liavo greuter control over food production and food distribution and that lasing regar l to the needs of the Indian population, it should not allow the provinces to ruri riot Ile congratulated Dr. Aykroyd on his very lucid statement, and stated that the report revealed a close relation between proper food and health. It hod been suggested that the report of the Hot Springs Conference was a string of platitudes but some of the truest statements in the world were platitudes. Poverty invariably ineant a poor and insufficient diet and a raising of the economic stand.ırd of the Indian people was a first essential in improving nutrition Dr. Aykroyd bind inade a reference to food deficieney diseases. It WAR, therefore, necessary for them to ascertain the extent of the prevalence of such disease in the country. If they sere going to aim at greater national cfficacy they could not ignore the problem of nutrition, The other point which he would like to stress was the supply of milks to expertant mothers and children Dr. Aykroyd had told them about the national nutrition orga. nisatious in other countries and although they had a nucleus of such an crga. nixation he would recommend & wider basis to the composition of that com. mittee He would like to see the interests of the consumers represented on that organisation He would suggest to the Government of India the desirability of enlisting the co-operation of the All-India Medical Council in this ·in this activity As regards the quelmin of mutritional propaguoda rnd clucation be would like to joint out that this work to lips adapted to the circumstances of raclı country Indin wae 1,5 sub-continent and time diet 33 NA taken all over the country Tlse's soul base to find out the nutritional values of various foolstulls culties big different cateve4 and communities in this country and suggeat to them the prompter in which thome valurs could he 2110046 lle fully agreed with the utilapstion that there should be a CIA collaboration between boulth mutrition jindl norrutural authorities Invors happy to hear from lip Ishrosed that 14 har nu le tual nutritional records was contained force 1.4 me far belanul in comparison with countries out Western Europe nnd North America but he would like to see the reuen ut that riseure in applied on practice and the government rud the people 131nt alır. Is regards the constpmption of mulk he congilerid that mill was a pro important fontor in the national Indian chart On account of the ondern innghter of cattlo to which attention was drawn in the las mof the count of States the problem of agriculture had become veir difficult and the quality of ik had also gono dnun It was difficult to get adulterated mulk these days and he suggested that it would be wurth ubule andering the questions of using romlender milk Sir Fredenck James (Central Legislative Assembly) wested to know how the Government of Ind were treatmg the rucouiniendation of the Conference, and enquired from the Honourable Member its to what steps had been tului res He would do like to enter the observations made by the Hon Mr Sipru in regard to the importance of establesdung in this country the kuod ni Nutional Vutrition Organisation which was described in the seventh resolution of the Conference They had . India an advisory Nutritional Council and he wanted to know to shum it adreses Lt. Col. E. Cotter (Secretary) stated that the Idstory Nutritional Council advises the Indian Research Fund Association and that its recommen. dations were forwarded to the Government of Ind... through the Indian Ro. bcatch Hund Association Sir Frederick James (Central Legislative Assembly) said he would like to see that body hfted out of its present comparative obscurity and given a status not less than the status of the Centrul Advisory Board of Health in ads 191ng the Governnient of India He would also like to suggest the enlargement of the terms of reference of that body and endorsed the remarks of the chnirinan that the Government of Indja should hve own nutritional export on the spot at the centre Convoor 1213 a long way from the centre of things and certainly very far away from such provinees as the l'unjab and hund Fually he would stress the importance of education and publicity in all tratters connected with nutrition It ung no use during alyut the niost perfect dut in the world, if people won't take to it thout the Advisory Committee woukl Lear that point in sumi » lien publicity work ou mutrition wits carried on Mr. M. C. Dassi (Baroda) stated that he was very grateful to the compilers olihic report and the recommendations made therein. They uers sery clue uble It was just possible that indnuually some of the recommendations might not apply equils to all part of Indon, but collectately they hari a very llis Giosunmuut wity (unstdering the question of supplying unith to poor expu'turst and nung mothers on sobicol chi'itren Chitral Or,istuuta sel been establislied in India the States would not be He hope that when the for 14 Xajor General B. 1. Candy (Bombay) sul that lit could do nothing but this cold water og s! 14 hard lot sail an apologise to Dr Aykroyd in alyvno While someins with the sceuracy, logic and cogency of the facts prouzrel lie felt that it was the quantity of food and not the quality that ms tered it fit the quartits 338 not there because the purchasing power of 1.- people us: ter low. This bsd been amply demonstrted in Bombas the masses llo lcp dite ·where a rationing frheme was in force The shortage was due to the inability of the poor people to bus what was available The problem was neither of medical por public health nature but 0.1 which concemed the purchasing poner of the villager In Bombay it was sets difficult to get good will under sis annat a pund Thrre was a good deal of skimmed mulk imported and that was what they were taking at present It was impossible to get fresh vill and the pirksi charged wils besond the inenus of the poorest family. The findings of the conference were to his mind purely academic. What was required in that thr (untru Government as well as the Provincial Governient should come to thus kreat problem in India nf raising the general stallerende mit live of the people Our am cfforts should lie in iin. proving the matritise value of the food that people take He would suggest to the memarn to pass a resolution urging the government to increase the purobasi!! poups of the massion Colonel A. A. Harty (C. P & Berary w bude greemg with Major General Candi - remerhato's that the problem of nutrition in provinces should not be given tu litto -10 t. un lindud He did not object to such 7 cominittee bem appentel 11. rentre ber lint that committee would be niore or loun 13 the shape of all! usory boca rather than an executive body. Durury th many years that he had been in India he had come to wonder if there woon not cute long-t th Indians of many classe, to subsist on a mirimun lxoth fexml imel of oufort Whether it was a compiendable thing or not he was not prepared to it It had its vrtues, and it would be a very difficult task iu thing the luulets of the people He did not agree with the Hon'ble M Sarru when he would that the shortage of mulh was due partly to indiscrmmat lughter of cattle In other countries a much larger number of cattle wat slaughtered and let there was no shortage of milk In India there verc crorum quantities of cattle wbuh were not milk producing and were ct allowd to devour fodder The Honourable Mr. P. N. Sapru (Council of State) on a point of personal expiation, suid that he was speaking of war time conditions only and referred the Clarının to the delate in the Council of State where it was urged by the Hon. Syed Hussain Iman that in:lk producmg cattle were slaughtered indiscriminatels to the detriment of the agriculturists The Chairman and that what ' Harty wanted to make clear wus that they had been neglecting the feedlog of cattle His feeling was tliat if they could not fced human beings they could not feeil cattle either. Colonel A. H. Harty (C. P. & Berat) suid that they should reserve fodder for those cattle that produccd milk The Chairman s.id that it was purely a matter of feeling and breeding and thint in the last 20 years the milk veld the Punjab fail nearly doubled in soine districts Colonel A. H. Harty (c. P. & Berar) agreed with the Chairmun and said thut he hope that no coinmittee would be appointed in the provinces if the Board decided upon enlarging this work Dr. R. L. Tuli (C. P. and Berar) felt that the present problem was one of quantity rather than that of quality A Grow Nore l'ood Campaign had been going on full blast many proutes and to that should be added & produce moru imk cumpalg. A scheme lid been prepared 1 1113 prosince whereby neglected cattle had been collected and led scientifically with u ves to increase the production of mill. is regirile the establishment of a nutritional come antice in the Central Prouincen altlıough recoinmnendations had been made nothing has been done so far. The .ent was to find out 1.11 and 1.s of more and also to salemised people against the ri nling their produkt lock an Agriculturist was alması in deht Today he is well off by only selling per cent of his produce and hoarding up the test for better ·21 priers le manner sted hunerli kith the other member in thinking Dr, Lykroju for the vere valuable contribution that he had maile to the debate Colonel R. Hay (Punjab) anid that his linsetet bad met citrined Ir Ashroud meminimum infot:41 bout tlint this soul lor vers led to consider ang receptie bevindt oop porropieral put up by its centri donory Board of Itelth I. Porrman los fine nimenitnciation of the valuable assistance shuria lle lihersid lind niet them in the past and the congratulated hun 16 mellom the Sysil 11 home plus belure then this very valuable inema. randın o fiind Colonel J. P. Haban N. W. F. P.) fasolreed the formation of Nation! Nutrition to matter with fe Pt the starlard of physical fitness and efficient in the country Lt. Col. A, N. Chopra (Orissa felt that altherund elle ne commendations were extretneis valuable this was thot the time to conner them lle agreed with the current icon of the formation of a centro communities throue recommendations when received should be the out The main thing required at present has to find out in and means of increasing the purchasing power of the individual. If that was done the localth problem sa le quotatically soked or at ads rate inate rally released Dr. Mohamed Farooq Hyderabad, inforined the Board that his Government had met up a fund culto de pruutinent ind that a nutrition expert had been Apported by the State Litensise diet surveis fold been carried out parti. cularl in identititoris such as zu bearing houses, bools and colleges. They had very wluble stata all while to bome their recommendations and he recommended that thus offer with l his hairulage und information should be reprefented on the Fixed Control Department Dr. P. Parthasarathy (Mysore) tartead that los government has appointed : Sbxecrul acer uso was trabal by Dr Ailroyd n mtritional work small cummmattrad te bifurter He Holi furour of forming a provincial Commt un that the members of the dous interested in partments may come together and understand the problem and inahe necessari arrangements 11c effect to thwr recoininendations for improving nutritin orations of the people It had leon x steel by some members that the purchasing power of the people abould be increased but I doubted whether it was possible to do that Dr. F R. Rushworth (Railway Department) no runurks Dr. S. #1. Paul (Assam) supported the recommendations Ral Bahadur Dr. B. P. Mazoomdar (Bihar) Hated that lety poseruent bad Appomted a nutritional expert who was carrym mut extensive diet surveys amongst various groups of people He ngreed with the suggestion of the forma. tion of Pronumeral Nutrition Advoort Committees and felt sure that his gorern. ment would consider the recommendations of the Centrnl Adrisory Board of Health fasourably Ral Babadur Dr. A. O. Banerjea (U. P.) stand that a Central Committee should be forned which should immediately conder hox to utilise to the beat advantage the existing resources of the country to save the population from starration: Rao Bahadar Dr. R. Adiseshan (Madras) ernlained to the members the atepe taken bir hie Giovernment for the Grow Yore Food Campaign If the object el retablishing a Princis) Sutrition Comniittee was to increase the production of vier which not the samle dirt of the geopile he felt cure that his Government Oui rire i annmra). Lt. col. 2. Ootter (Secretary) thanked the Chairman for giving hini opportunity to exsniame s maris in order to correct some erroneous impres. an pions Asier ont of the discussion. Ne agreeil with the suggestion that it was restesary to raise the status of the present Nutrition Advisory Committee and to vilon ite in uence on that it onuild become a more immediate instrument Altier to Gostmment TIe would, however, recommend that only experte to ·at was 25 in their own particular line should be taken on this committee Ang person with just general vague expressions of opinion would cut no ice with the alert body of rising Indian fcientists who were raising the standard of this Committee year by year to a higher level He added that one of the best contributors tas & State's representative froin Hyderabad The Hot Spring: Conference had been enticized toy inany but he felt that those criticisms could not be applied to the Indian Vutritional Adusory Committee as fudenced by its proceedings of the previous week which had been placed before them They would see that the problem had been dealt with in practical and constructive way both in regard to the general situation and the urgent requirements of Bengal He did not agree with the suggestion of (ol lnrty that provincial om. mittees were no good and that the work rivuld he left to one officer alone in the province The main trouble ther were faced with was to implement the knowledge that they had got on from its own experience of the prorices he felt that without a strong lue.. omittee nothing would ls achieved They had trained a highly qualitied nutritional officer frır the 1' Pat Teat expense and considerable effort This officer worked in the Irons THE on nutrition for a period of 3 or 4 inonths lic was then posted on some bir duty ind nutrition work was forgotten The Chairman in summing up the debate pointed out that when nutritional experts indicated the needs of our population for the agricultural department to rane production of all kinds in that these needs could be provided for He wonderert bou much tme liislators and provincial ministers devoted to the vital problem of production and nutrition as compared with other problems Did they spend even a Werk in their legislative councils to consider los production could be incred! This question had to be tackled persistently to attain ans result He was lateful to the European Group who had taken up this question in the last session of the legislature Su Frederick James (Central Legislative Assembly) enquired whether this report would be tables in the next session to give them an opportunity to raise the question The Chairman ud that they needed the spur of public support in these matters and he agreed with Minjor General Candy that if they were going to achieve rythmg they would have to take violent action Mr Sapru and other members had suggented raising of the standart of the general population The whole matter depended on the price the agriculturist not for lus produce and he hoped that Ins friends Mr Sapru and Sir Frederick Jumes would consider the question of stabilising the prices of Agricultural produce In his own opinion it was necessary to have some sort of it point developiment board which would consider these prolile nis together master of dealing with them in separate compartments The best diet that lie had coine across of was in i ball community in a place called Humza near Gilgit, where the people were able to walk co miles and back in one day. If you require greater efficiency from your sorhers you hovo to feed them well, and that is where tlie nutrition department had done very little work The Honourable Mr Sarru had pointed out that we were mainly a vegetarian country and the consumption of milk was very poor as compared with other countries which had a varied diet Some parts of India did not get three ounces of inilk per capita, while in England with its varied diet he was told that the consumption was about 56 ounces He was glad to hear this ner expression---starry-eyed He felt that it was only those people a ho could walk in the light of the stnrs that could achieve romething. Unless they had ligh iveals they could not work up to them, and the tentest ideal they must have was to feed the population. As for the question of the different diets in the yonous provinces he felt that it as possible to provide a diet which would be palatable in all areas For instance most of the millets could be melted in such a way that the ree eating ·They reduced people could easils dienst them That was a problem which had to be tackled One point ahich he felt hr munt eniplinarne in "Pay frenter attention to thean economic pohlene and Ines los politiea, becaurer the foundation of polities are men and it von mahr men, politice w follor". He did unt agree that Indians rejoierd in living on a munmun diet That was not so the qurtart of three good low-cause this find o apare something for other things that they nereden and he felt that increasing production in nii directions voulu be the only remmede AGEVI ITEN Vf) L.) TD) 'ONSIDERA (OOPERITION BETWEIT (ITIL IN IRISPIT 11 TIITSIVITITOVOR TA) 1)\STRITIOS 11: DELEVI'S SERVICES (6) TO CONSIDER I JETONI PIU OS WASURES FOR THE PRE- VENTION OL' DISTISLSIANTIS SIRROUNDING RODROMES. Rai Bahadur Dr. A. O. Banerjea (U. P.) explanned some of the dithcultes which he had come across in trung to establishi laatson between the ensil and militury authorities. He stated that « lcge mumber of big lulur camps kurd been estabilandied for bulitary projects in rural areas near Cantonments and near certul urls are not pesnice The mullitation of these camps especially those located in rural area> Was proxir The cul department had very little orgaSution for the station of such sunt rural areas and close luxson betwen the avi and multary uuthoritats as needed to deal with the conditions under which these labeur forces murl. It prst when the proumeral Government asked for wtormation it was told that the matter wts secret and that nothing could be divulged lle fauled to undertawl derxu the emplorueneric of a Labour force of 10 thousand could be kept a secret The state of ff.ulrx kent on for some months until on epidemic of choler. broke out. It was only then that help 89 ugked trom the civil departmtnts which was gladkeri While inatters had undoubtedly smiprosed there will still that things which required further imzrovement There were ex cam klien lie hul refered a point to the 1.D.M.S of the area only to be told to refer it to comand On reference to the corn. mand he was asked to write to Gill atud on reference to i IQ tie sas asked to refer to the central orduance command By the time he could get any answer the epidemin stuntoon got comphented and the anthorities had to butt in and to take measures on then onn responsibility and then of course, the question of who should be responsible for payment for the wrice rendered CAMO up Ile apprecinted the witculties of the militars authorities in works of this kind luch lead to be pushed through quehls The work uns entrusted to contractors who as every one hrew attached sery little mnapertince to tha sanitation of labour campis under their charge or to the furnish and welfare of the labour force which they employed. The inevitable result of an epideinic was that the labourers ran DUN And they laul to be therusted namn harp to main that the sanitation of camps entrusted to the cisl authorities mas looked after butisfactorily As regins Bantation rund new.norolrores bruit in the porosince some by the RAF Am somme by the l'nited States forces therand encountered wimulir difendere He could not mention lins many Aeroudmoues hart been putalliheil in lus porosince. .11 that lie nater in hring forward we the question of insuplirsol Inti-malarial drugs required to muntre tropuit fired the moderosIronins to present infection of the ulitars staff working the prin Ile land made indents its early as Juls but unfortunately I had nomeired a suppilan farTie de not know where thie (149 171 eur Ile would like to inpres, on members that the civil givir. men als in animu, to give all the help nud co-operation to the tatloss authorities ] timer notice ras giipon our provided ther were tolalart their jobetian and their responsibility 1. it was all for the civil machinery to work at the same speed Ile kould also point out ne the pillir Hara!!! but eserrthing possible that coukl be done 88 & holi-11'lma! They neciled however, to be told som to approach. where to a pra', ordul, would be responsible for the necessary finance, Ne WAS ·Dz. 4. Pn Lisboro (Ballkay Department) asociated himself with all the remarks that had been made by Dr Banerjes He said ibat the talnara kero Laterested in this question of samntation in defence cams established in rear where there were large railway cttlements far from or not in the vicinity of local sell-governing boards or inunicipalitirs He did not agree with the policy of making contractors responsille tre the suinitation of these camps. Contrac tors sinply increased the contract rite nnd give very little useful retum in the shape of efficient sanitstion 1} the Peionce Department could not do this work it should be given to the cul uuthorities stating exactly what so wanted and he felt sure that the CV Authoritine rould do this work more efficiently tban sos contractor Then again song of the taminton mensures were of a semi permanent nature and if the contractor was to provide for these thies remained bis property lle would liggent that the benefits of these sanitary measures should be secured for the pople living in thoac arts and not to the contructor and he requested that this point of us should be brought forward when considerms any post-war planne scheme He would like to stress certnin points, The undesiratulats of leasing responsibility for sanitation to con tractors, (2) the question of foll and enrlnotre', (3) the establiment of liaison committees, (4) the question ol cost which should be drinted to the Defence Department and lastly (5) the question of the people living in these areas benefiting from any permanent or semi-permanent sanitary neasures en. forced in that area Lt. Col. H. S. Milna (War Department) drcu the attention of the Board to a letter which had been issued by the Engineer in Chief on the 8th December 1041, in which the policy in this inatter was clearly stated He promised to Bec that the letter would be reissued with fuller instructions so that no further difficulty should arise in future As regards the channels of approach he would provide a list of the military authorties who should be reproached in These areas Wing Commander F. Crawford (War Department) stated that he was sympathetic to all that had been said by Dr Banerjee and described some of the difficulties which he himself had erperienced The question of finance which was generally fixed at Rs 6,000 for each area per annum was one difficuity: The institution of efficient sanitary and medical urrangements for villages round about an aerodrome was by no means a simple matter. The work took time On the question of obtaining stores he faced great difficulties largely on account of the difficulty in getting suitable containers and the fact thnt proposals liad to pass througlı several departments before they could be settles As regards the American aerodromes lie was not in a position to state anything as he did not know what arrangements frould be made hy the Americing for 1024on with the local civil authorities While they were pending Rs 6,000 for samtation round each of the RIT aerodromes per year the Americans were spending the same sum per month The thought it would he better if grants were made to the RAF in the form of a block grant Lt. Col. A. N. Chopra (Orissa) stated that he had not experienced difliculties in 1125 prosince Ite, however, felt that Rs 6,000 was not sufficient for the efficient performance of the work The coat of laying and stores required liad gone up consideralıly and it us alınost impossible to do anything satis. factorily with the grant placed at their disposal Khan Babadur Dr. A. H. Bett (Punjab) described his experiences in early stages of thic schierne and particularly in connection with the planning of gitary measures round about berodromes le 228, lokerer, happy to nigrm the members that things had improved non and that there was close liaison between his officers and ile Air Force people and the work was running smootlily. Ilis government would be only too glad to consider any recommen. dations made by this Board on these questions R30 Bahadur Dr. R. Adiseshan (Madras) stated he had also encountered similar difficulties in his prorince The contractor never looked after the sani. Wation of the camp. This work was now being done by the Public Health Department a monthly statement pas sent regularly to the Garrison Engineer 11 v the fery ·on the in Madrss, who delucted the pipenditure form tl'e arms contactuen and passed it on to the Public Itealth Departmrnt Tho Donourable MI. P. N. Sapru (Council of State) aufgested that the expres; sion about pamer slinul la substituted for 'croly camp because the word cools' had got into but louis Third Day's Procidlogs. AGENDA TUV V 11 TO CONSIDER NETORASTYCH ON THE ALMOINTMENT OF DIRECTOR OF NURSINO SERVICES IN THE MEDICAL DIPANTITYT OF LICII PROVINCE OR STATE. Major Qendral J. B. Hanco (Covoromoot of Lodla) stated that in order to anges the reasuny luch led to the rather circunscribed suggestion Agents of appointing a superintendent of Nursing Services on the stod of regis terud medicul ouers of 'rounces and States, it was necessary for them to buy some commepo") of the nur-ing situation in India as it was at present. He would like to elupliu4144 Cutlami gurticular uspects of the problem. The ideal basis was to havo one surse for four beds ma bospital The ratio of nurse! to population in the L'nited Kingdoin us 1 to 371, the ratio Bombay Bengal. ! P. thu l'unjab, und Bitur wus 1 nurse for 27.000 of the population, and tuklay Indies is w whulu tho ratio was 1 nurse for 67,000. It could be seen, therefore, that there was a very grent shortage of nurses both for the armed forces and for the civilian needs of the country. He had been informed try General Paton, Surgeon General wath the Government of Bepgal that the Medical College Hogutal mn Culcutta alone, had a sliortago of TO nurses Present difficulties were further en phasised by the mability to staff with nurses Proemergency hospitals opened in Bengal for victim of the present famine. bationers were being nen an intensive truining for three months in Bengal to lunk after these famine patients, but could not thereafter give that care and shill in mursing winch washential for these patients It woull be apparent to the member that both the quantity and the quality of nursing judged by even the most visersative standaris spre very scanty IIe had been often told that the profession did not appeal to Ind in women He, hose ter, felt quite sure that this was 23 Leute staternitat The late fr Deodhar hnd no trouble in obtammg the numbers required from Indian ladies of the highest status, und be felt that the members present would support fum in his state. ment when he said that there was no doubt either of the devotion of Indian ladies or of their capabilities for training The chief cause of shortage was to be found far more in the conditions of work and training existing at present in the profession What was lacking was adequate off duty leisure, adequate accoinmodation, adequate feeding and adequato facilties in the cngo of proba These conditions did not exist tionary nurses for study of their profession except in some hospitals in Presidency towns Accommodation for nurses and probationers under training was of the menint type Young girls who strongers to each other were herded together four or five or bis in one room with beds louclung each other and in these rooms they rere expected to spend their off duty hours and at the same time to study their profession. Frequently they were expected to do their own cooking He thought that unless these conditions were remedied no progress could be expected Madras had made some efforts in providing Public Tlenlth nurses but he WAS SOFTY to mention that there was nothing in this country approaching the ruhlie fealth nurse as known is England and America As for male nurses in no country in the worlls us there a tester opening for such than in India. The Army authorities were training a large number but this, of course, was just a very small teringing it sit heen suggested that this Board should recommend the inarston e a I'msineial ne State Nursing Service in the Provinces and Sustry IIe canep this most prsential recommendation because such gersics *Olqosile arthing like a future for its memhers and a collective voice !Ythe ta profesena. He hoped that it would be received and cops! dose! laro...?!. were ·Major General P. I. Candy (Bombay) while ating with the remarks of the Director General, Indinti diedical Service on the unsti-Iactory condi. uons of the nursing price as a whole in India said that the re meds susgeled #39 vot 60 tahun it looked Speaking for Bornhuy be forted out that train. ed aurres were working throughout th. l'respines Ilir man dificults was in the fact that thrs could nine mot ang building acromionown His Gover. ment bsd accepted a number of scheine for the imjurist in'nt of the nurbug profession particularly for these murera under training and so on but they were faced with the alıflıcults of filing utly port of quarters for tliem The standard of providing one nurse for "sory four body 111 boapital had been adopted by the Bombas Surunk (el Out of the GA 11Urbes 27 per cent must be fully trained and rosterable with thu 13:00hy Sursing ouncil Dhculties existed in the forination of a l'rovincial Nursing Sinuirt there was the question of language, four distinct language, Kites apokalith the Bombay l'residency. Another difficult there with that nuran nere larg, IF controlled by the Nursing Council Vos it bad bull buggested that a Superintendent of Nursing should be appointed who wenilul du something anda laying down the curriculum But this work has at pru nt nt dom his the lurt Coul and he felt sure that they would not like to be deprived of the privilege Major Goneral -J. B Hance had spoken about the quality of the type of numes who should take up training In impression in that girl who came from rural arena did not possess sufficient cducation to take on this work fle referred to the admirable work done in this certion by the late Mr Drondbur The menials employed 1 hospitals were wlways underpaid and this along. with the whole questior of the employment o' memel, was to further complica. tion. Although he was mpathetic with the notion he was sceptical us to whether it is going to do is niuch good as they really wanted He would like 'this Bourd noininate sul commutta we would lut down one bort of standards of the number of per-uns required for ttery department in a liospital iucluding nurses He would suggest the introduction of technicians and the abolition of the existmg order of memals who were usually the scum of the town, lazy pullerers or professional burglars Until these mnenials were done away with the right topic of nursing would fit ver bi obtamed He did not thunk that the appointment of .n Inspectress at the top would vary then u greut deal further in solving this probleins Colonel A. I. Harty (C. P. & Berar) said that they were woefully lacking in nurses in his prosince and that living conditions were dreadful Their working conditions were no better and unless these algo Here improved they could not hope to encourage respectable girls to come up for traming He fully agreed with Major General R I Candy's remarks but he was very unxious to do something in his province where the nursing question was very ucute He welcomed the suggestion for the appointment of a superintendent of nursing and thought that such a person might supply the special kind of drive that inen could not supply She would also be able to supervise the nurses and he thought that from thus sinoll beginning, better results might be obtained in the future Dr. A. L. Tull (O. P. & Berar) wlule agreeing with all that had been said previously care a brief description of a scheme "Village Sister" which had been introduced by his Government to improve conditions in rural areas Candidates for this work were selected from villages and taken to district hospitais where they were trained for one year in elementary nursing and infant welfare work. After that they were employeå in rural areas. They were paid Rs 15 monthly for whole-time and Rs 10 montbly for part-time work in villages. Although they namata11.1.1 render first aid to the people in the suffering Is Government Jie fel this Board hole-heartedly. Dr. N. V. Pandit (Baroda) said that they had no difficulty in recruiting midwives and nurses in his State They olsays sought the help of women's institutions in order to induce somen to take up this work. He sugrested instructions to the probatiorsers should be given in the vernacular of the fisv ·and that they should not be made to do funcil work of eight to ineise bours a day from the sery beginning Sude bs ride with this training girls slould also be given a truining in frighel, as that would merease their eficiency and perhaps Alkotlicir attendance lle luni no phyppction to the appointment of o superinten. dent of nursing but lir helt ute that unless the subject was approached through women s institutions ther would not loe able to attract the right type of girl Dr. L. D. Sartonwalls (Jodhpur) satel that on account of prevalent social customa thes me not turen able to find led girls slio serp willing to take up thus profession They were therefore, compelled to start tramming classes for male nurse's on the imys of the l'unjul Prrently busy ciosernment had put up a scheme for training nuri's 1) their una lueil Aculist and with just that amount of Lnxhali education hieks suuld enable them to read prescriptions or general instructions Colonel R. Lay (Punjab) stated that the nursing problem in the Punjab *** a nightmare both tu patients uni ammistrators Discussion on this question nas long over due und be felt thnt hus Government would give their fullest con ederation to any recommendation made by tlus Donri Beades the nurses required for indoor patients they must have nurses for outdoor patients, in the Punjab the outdoor putients numbered about one lakh per day and taking one nurse for over hundred patients they required a thousand nurses for this work alone Then ugain the question of nursing in the home had to be considered. On account of the prevailing social customs it was very difficult for them to get girls to take up this profession At the present moment although girls acre coming forward for the medial course they were not willing to take up the nursing profession Colonel J. P. Luban (North-West Frontier Province) stated that his ex. perience was exactly the same as had been mentioned by Colonel R. Hay and stressed the necessity of providing better accommodation, and better protection on Supervision over the we're under tramang He also suggested that their sales of pvmay be no adjusted as to attrnet the right type of persons. Lleut.-Colonel A N. Chopra (Orissa) strongly supported be suggestion for the npromeniunt of a permtendent of turning on a stuft its he felt that this Work could only be done in women and not by inen Dr Mohamed Farooq (Hyderabad) supported the resolution Dr. P. Parthasarathy (Mysore) stated that 1119 Government bud appointed & committee to go into the whole question of nursing The points of reference srere uniformaty of wards for training of nurses, the question of implomracne of marral vurses, lesion of the scale of pusat a few other pronto mal wistnuty of the standard of tranno le states that they tudd as framing mistitutions in the State Unfortunately their standard WR4 much lower than the streerd injited by other Heatern countries. The sport is in die Stade were finding it (lulticult to cope with the oth ond as far as public health nursing 13 cxeu eneil the -itieu was still roure acute and he would request for some Fuulance on this points The supportion of the Borl for the appointment of à stresintunurit of nursing would lie put before lis liorernment for considera- + s retion Dr. J. R. Rishworth (Rallvay Departmeat) hosted thate a course of home pup-inly be alle compilare in our schols in the semuncular so as to bring to ik null of linguisthir avantages of nursing, D:. $. R. Pael (Asse) u forted the resolution, Es Bibadu Dz. B. P. Nascondar (Bihar) supported the proposal as there *75*7*3! dirth o! qualefed alines for nork both in tonds and in rural areas. Rul Babel: D:. A. O. Badtrita (V. F.) stated that his Government had Ciermi sirr * "nin autres and there were at present 200 nurses undergoing Geriment had also agreed to provide funds for buildings and to apcinta Dicek? Superintendent of Nursing.

·Firstly lic Lleut.-Colonel J. E. Gras (Sind) said that the nere in forord! the forma. tion of a provincial nursing stand for thr nipininint o? surintendoni of nursing Their dificult: vas finance Thes were very plint of nurses and it Irad leer superated to thrin that if the prospurial Govt mrrni cos!3 tale over the nursing question there was a very chase of that fitting the rulina:585 for this course ulucl. kould li gen to them in the veranCult Ile alipynted the proposal Dr. B. Mookherjee (Bengal) supported Major General 1 Il canlı & 411,95. tion for tlie Jyoninent of a comunittre slors noull lay down fund..for trainms tules better rulutuents sete ERC 1 tl so nuiters it would lie fry difficult to driw upon the right type of rogamus for than forl. Rao Bahadur Dr. R. Adiseshan (Madras) lrrose the attention of the members to two points, mentioned in a notc written on the subject lys the Surgeon Generi to the Government of Madras General Stott The first was on the question of the appointment of Director of Nursing now changed into Superintendent, and the second was on the question of the tenure of the 41.prontament There any no doubt about the shortage of murses in the Medical Department out in the Public Health Department were even worse affected IIe supported the resolu. tion before the Board Sir Frederick James (Central Legislative Assembly) wlule agreeing with the main outlines of the resolution suggested one or two modifications wouli like to see as a preamble the statement of the Director General circulsted to all Provincial Governments and States and secondly he would like to draw attention to the necessity of creating public opimon on the matter of recruitment of nurses By public opinion, he meant that of the whole medical profession and the Ministers and Advisers to Gotemment to as to convince them of the necessity of an efficient and well paid nursing service. He recalled one unfortunate action of the late ministry of Madras in reducing the pay and emoluments of the nursing services in that province, He had led a deputation to the Prime Minister on this subject but unfortunately that minister was also the Finance Minister and said he sau no reason whatsoever for a highly paid female nursing service, as he felt that what the patients required were orderlies on Rs 12 a month At the fourth meeting of this Board it had been recommended that the Central Government should consider the constitution of a Central Nursing Council in order to co-ordinate the ---." Unfortunate- By this recommendati be proceeded with without consul quired of the Board whether they were rot asking the Provincial Governments to do for Jess urgent things at present and he instanced the time spent by the Central Legis. lature on the Dellt University Bill The Chairman said that he did not agree that this was time wasted Sir Frederick James (Central Legislative Assembly) continuing suid that it was necessary to observe certain priorities even in war time because of the mpulse to do sonething about this work during war time was lost they would have to wait for a numler of years after the war before any tłung could be done and he hoped tlut Government would seriously take up this matter IIe felt that perhaps the political parties of the future may have their own' particular proframmes to get tlırougin and this might still further endanger the existing position and it was all the more necessary for some central body to gre direction and assist in mamtaining the proper standards of nursing He also felt that there was a necessity for somebody to deal, not only with interpro mcial reciprocity of registration, but also reciprocal registration with the autborities in countries and States outside British India that during his last risit to the Middlo Last he had found Indian Nursing Sisters Jle was very happy to mention doing magnificent work, and he loped that when ther trould come back to India after their wide experience, they would be able to gut much better treatie than they did in the past.

·He was, then it The Honourable Mr. P. N. Sipru (Council of Slate) «tated that he agreed with the viens ! Vajor General Di Camily Thir prejudre Surs *.36 iyang uut in Ireland (m17" leru i te taking to it an derapa negabytes *1):r rusts are bein that faldetzen did 10 Bohetrit girls to go out to [linum they asisted today authente preciso thin proud for the formation of povinciil nursing services 1. Tirane to gile the nu*** frenter security of tenke, greator tegurite horse than liat cher were enjoying int present, and gres*** PHIN activities la rigordt the appointment of a Suferinte. that of Vurning To the meat of Inapretor Tieneral of Cow Hospita's com ther Surgery Courrier le land in the slegliteet olujection, buit. Lvou miltbra? Pothu brani terten in unitattu to name on the educated and Illuential sedilen in a nebo prosince for their co-operation in thus work. Vor en ** Winute to stand in neuerk en llo che connected with the firs of Mulusthrop corduritative negenerations, would certainly hare great interce 19th their susters and mild lip better able to break through such nocecnt prej; dire as rxistes 15 Ishans indels graust the nursing profession Ther required the weheartid congue site of the medical outliorities niso One other room whicle be wild like to inention is on the question of the employment of niz es by private me to attend to cases of illness in their lignes The d.. culties of the middle clon people were very great It was not possible for them to pay Rs 15 or 1- 20 per day for a nurse What they would like in India Was something cheaper within the means of a large number of people. 114 would also suggest that these murses he trained in Indian languages, and that they be provided with adequate accommodation and friendly supervision. The Board should Jso take up the question of training male nurses particularls to sunt the needs of certain proriaces. A 111 le The Chairman confeshed that they had been rather class in conserving the resources of the land, and because the land was poor, the services were also necessarily poor Str Frederick Jamee had spoken of priorities but he hoped he would rernember the fact that itnless resources both in land and ngriculture und industry were developed, they would never be able to raise the services to the level of western countries The income per head in India was only Rs 5 compared with an income of Rs 255 per read in England The difference between these two incomes revealed the distance between the services winch we coull gre to the people in India He expressed a hope that legislatora in India would concentrate on production and unprose the economic conditions of the country, as then only they would be able to achuce the The Direotor Genernt had jointed out that there is a grert shortage of ourses but he would also point out that there was a great shortage of doctors will they bring in the proportion of one to 10,000 of the population in this country think it necessury to appoint another sub.committee, as the existing committee woukl survey the whole field and mndicate the needs of the population Tamme for education had been prepurest, and he hoped a similar jirogramme for health to inect the needs o' the Leople would als te forthcoming. He was in favour of the unintent of superintenilent of nursing services who could desore here whole uttention to this particular problem. The idea of training Village fraters tot in the Central Proymees 1588 A good one and as their numbers inutilmeli pored the sould be of aseistance to the rural population. Te ampied with the streeting that all these discussions should be implemented AS 50° A* Jusile, otherwise they soul't be latile. Jie not A pro The Donourable A:. P. X. Saptu enquired about the amendment syggested hy S: Froilerek Jales. The course inlained the member that it would be included in the Neso ·33 AGENDI ITO NO 10-TO CONSIDER A SUMMARY ON THE RIVITES RECEIVED TROJI I'ROVINCIAL AND STATE GOVERNMVTS SHOW- ING THE ACTIOX TIKIX BY TILJI OY THE VARIOUS RECOMENDI- TIONS VIDD AT THE P'RFIJOI'S FOR VETTINGS OF THE CENTRIL ADVISORY BOARD OF HEH.TKI Dr. P. Parthasarathy (Mysore) infornard the firmabits that the load sent information about the worl that there ind time out wil reference to the Meet) Intions paccert log the teatrit Wit Ifralt! The had not been able to tale action on all the pretthithsenrift on thor and not becance thry did not want to dow1 Up Arcont of the evicting conditione Hc would lile the B. LISE with me ty as to rlirthurs thr subjects discussed at its mer ting should be classified onls under Publir lionth or under both Public Health and Medical The matouts and welfare work had heen carried out in his Stitc tort. Hic ('rries Sexet It was not possible for a quasi-officin) orga-11 Holy 11th, 10 de justice to thus sorh anel lic would be grateful fris the lardantire The Honourable Ms P. N Sapna Council of State, in the aidents of the Board to relieu of the National ( OJ L Womcat in Incın passed at the 7th Bimal Conference of that built in 1940 which recommended to the Government of India thit oppuvainent of in All-India Sursing Council for the purpose of co-ordinating the title of the pilla! nursing registration councils, and, the establiment uniformly brigh standard of tho nursing in the country. He thought thint thiet brudd piased a smat Icsolution nt their Calcutta Session also, and he would like to know the vicis of the Provincial Governinents on this question Lieut.-Colonel E. Cotter (Secretary) rud that thus resolution was forwarded to tlin Government of India ul had pointed out thut legislation for setting up Euch a Centrul Nursing Council could only be proceeded with in consultation watli the l'rovincial Governments Sir Frederic James (Central Legislative Assembly) enquired whether tiro subject was still being exanuned The Chairman sugge ed that perliajis th might have a non-statutory hody Su Frederick James (Central Legislative Assembly) stated that such a body would lave no authority It would only be odyscry What was requiel was come statutory body on the lines of the All-India Medical Council who could perform tlic junctions suggested in the resolution, nanıcly the co-ordination of the activities of the Provincial Nursing Council, and advise on all problems connected with nursing and the establishment of an uniform system of education and so on. He would like to ensure, that these proposals were at least sont round the various provinces and states, and if they did not care for thens, well, thut was tlic end o! the matter The Chairman assued him that lie would ece that it was done. The Honourable Dr. Hemandas R. Wadhwani (Sind) stated iliat it liad leen ment.oned previous that it was not possible for Gosernments to mike any appreciable progress in carrying out the larger fulienirs recommended by the Board. lie thought that it was due to the follou ing tliree reasons- Firstly as Sir Frederick James had already runarhed that heads of the Gov. crnments did not pay much attention to the work of the Government Medica and Public līcaltli Hepirtnients. He was a medical man and ho could say at openly that these departments were always considered as minor departments. When he was a Monster of Irrigation and Public Jiralth in 1037, three-fourths c! his work was done le lais Secretary Ne considered rublic lealth and Medical Reportments 1s in ajor departments but unfortunately in other provinces liere non-medical men were linisters they thought otherwise. At the present moment the suggestions coming from the Centre were dealt with by the Secre. tarics cien nithont the knowledge of the Ministris. Thus between the head ·31 Medical Department and the Sonsters there :13 no medical in In the PWD the Chief Engineer in gorpulls the Secretary to the Gorernment in that departinent lle would therefore suggest that in rivers prosince the bead of the Aledical and Public Health Dipartment should buil Secretary to the Government Il that was not agreed to be still as of the opinion that the Assistant Secretary of the Superintendent of that Secretarint, stwulel be a medi cal man Without the help of a medde man in the Secretariat it as itnpos. sible to carry out at du sury schicines winch molt loen prut forward, as nonmedical mon did not pay due attention to such proposals On a pres1014 Oension he had sigested the creation of Loual Health Boards with persons ulio went techniky mletied to understand the necessity for car, rymg out the health programme Ilis friend this lionourable Mr P N Sapru had commented upon that by siying that such a strugestion would go against the principle of local self-government But that was not lus intention The only point he wanted to emphasis was that these local bodies should include teclinical people who could take an mtelligent interest in nation-buikling schemes This They miglit be medicul men or persons with some health qualifications was not erntrary to the principles of local sell.government as these technical bodies would concentrate only on health mitters The last point which he would like to dwell upon was the question of reciprocity between the different provuces and he gave the following mstances – Every year the Sind Government had been sending out 17 students to the chifferent provinces for medical training as there was no Jedical College in the Province They had to pay over a lahlı of Rupees for admission fees alone. This should not be the case There should be reciprocity and cery Goverment should give proper facilities Another instance which he quoted was telegram from Madras saying that they would charge 50 per cent more for quinine This he thought was directed against Ius province on account of their food policy Sind was a deficit province and they had to pay a huge loan to the Government of India They were not profiteering for the sake of any personal gain and lie failed to understand why this excess should have been charged by the Madras Government There should be a regular reciprocity between the different provinces and he would request this Bourd to consider these points very carefully The Chairman wlule agreemg with the remarks of the previous speaker suggested that the Centre ought to help and restore ordmary normal conditions. le thought "federated India can do all that you want Lt. Colonel A. N. Chopra (Orissa) agreed with the Honourable Dr Hemandas R Wadhwani's suggestion to make the Inspector General of Civil IIospitals o! a prouince a Secretary to the Government just as the Chief Engineer was the secretary to the Governinent in that department Tho Chairman kiggested that they should close the discussion as it was not on the agendu The consideration of the Resolutions sus then taken up. The Honourable Mr. P. N. Sapru (Council of State) requested that the report of the Food Allulteration committe a discussed under Item No ! on the Agenda should be circulated to the press This was agreed to Itens Xo 2. 4 and 5 were accepted without comments Si rroderick James (Central Legislativo Assembly) suggested that the report of the Jomnt Committee on blindnes, le circulated to both the Adrisory Boards and that the levendent of India be asked to take action on any recommendatros curtained there without waiting for the next meeting of these bodies This *** 3 Tord to lieenlut.rs ca teens so 6 and 7 sere accepted without comments. In Irsolution is 8, the word "suitable" substituted for the word W33 ·The draft Irsolut on any Itrti, Major General R I Candy (Bombar) diritto Prosinaa! Xursing Sit! tid. 1 (1 : ! ! ! item The Chairman of "ITET The Honourable MI P Sapru (Council o: Sta!*) required furtlips 11 rost of Sumenti The Honourable Khan Bahadu: Mauly: Jalalu 1 'in Ahrnt (BC.al' Imre grec with the The Honourable Mr P N. Sapru (Council of Stale) Molifer from the suggests this the inte Til trenit !..Sinare The Reconition as there The I ۱۱ ۱۰ ۱۲۱ ۱۲ ۱۱۰ ۱۱ ۱۰ Mayor General R & Candy (Bombay) tontuted Lieut. Colonel E Cotter (Secretary) - Ilibin tl 11:11, tombril 11 the valutun to decide the wall the thieting of the line Circumstone lud compelled them to bolel 11 to 11!1f ins Dal! misal Bangalort in hul betra dtidurd.orginnils They had received an intation from Baroda but after dis 116101 warlo Mr Jostalde, it was the idle to leave the result oper In view of the diffeultics of truport incilities durme the commor thir Hon'ble Mr P Supru ruffested that for the liriol of the war ilustmisht meet in Delhu itself The Chairman in winding up the firocredings of the meeting thanked the menibers on behilf of hmself and the Government of India, particularly thioso provinces and States who had sent their representaties Ile would have been very happy to see adusers and ministers to Government and to have had the benefit of their advices for the formulation of future policies, as he felt that the work that tirry were doing was for the good of the picople in India The Honourable Dr. Hemandas R. Wadhwani (Sind) proposed vote of thanks to the Chair The Honourable Khan Bahadur Maulvi Jalaluddin Ahmed (Bengal) seconded the proposal The Honourable Mr. P. N. Sapru (Council of State) in supporting the vote thanked Lieut Colonel E Cotter, Rao Bahadur Dr KCKE Raja, Major General JB Fanee and Vir SIT Y. Oulsam. The merting then terminated il ·In the Seretary to the 11e stron The only these techmeal Mirial 1): 71751..!!! It Voreng teman morir un PWDthn Chic! Irrations is is gesunpulls their sur computers to the liovernment ia that dosartir! 11: sivil I thiesto se toit in very grosince the beid of thin Vertral and I'll liralt 1. print should be inuerun! I'th: 13 * 1: nee poidi fos utill 12 of the opinion that the Arane?"4 s. carties are intrepid wise of the Secretisht, alculd be a med en 111 117) to help of an in the Secretarmat e impose Fille ruimti ministres mifit fit put forward, as no Indien 'n 11 din ilti tv to such file 011 A presp.112 ou man ton la 1 "; the first of Lont Health Boards with yo tuanze elo urtolonn :). qu thaheel to inderatand the procesity for cat ring out the balth programir 1114 fronta frosperable de P. y. Suprukad commented that his sin, that the trul fongainst the Bruciple of fre il moll gate TIC: But that 14 not 1114 mite nitron ramt lie wanted to us in these thinne lucial bodies slould include them! cal people who could tahre alt untelligent interest in nation-doing schemes The's might be nut preparisis with sette balta qutications. Thu? was not entrary to the principles per al self.posernment a bodies usileterotriti only in health matters The 1set point which he would libero ta dwell upp us the questions of reciprocity between the different provinces and le gase the follow mg stunts - Evers vrar the Sind Government had been sending out 17 students to the difierent prouincen for medical training as there was no Medical College in the Province They had to pay over a lakh of Rupees for admission fees alone This should not be the line There should be reciprocity and every Govern ment should give proper facilities Another ustunce which he quoted was telegram from Madra4 saying that they would charge 50 per cent, more for quinine This lie thought was directed gainst liis province on account of their food policy Smd vas a deficit province and they had to pay a huge loan to the Gorernment of India They were not profiteering for the sake of any personal gain and he failed to understand why thus excess should have been charged by the Mudras Goverument There should be a regular reciprocity between the different provinces and he would request this Board to consider these points very carefully The Chairman wlule agreeing with the remarhs of the previous epeaker sug. gested that the Centre ought to help and restore ordinary normi conditions. IIe thought "federated India can do all that you want" Lt.-Colonel A. N. Chopra (Orissas agreed with the Honourable Dr Hernandax 1 Wudhu anu's suggestion to make the Inspector General of Civil Hospitals of a province a Secretary to the Government just as the Chiet Engineer was the secretary to the Government in that department The Chairman suggested that they should close the discussian as it was not on the ugenda The consideration of the Resolutions as then taken up. The Lonourable Mt. P. N. Sapru (Council of State) requested that the report of the Food Allulteration Comin:ttee is discussed under Item No ? on thie Agenda should be circulated to the press Tlus has agreed to Item No 2, 4 and 5 sere accepted without coniments, Sir Frederick James (Central Legislative Assembly) suggested that the report of the Joint Committee on blindness bu circulated to both the Advisory Boards and that the Cioterment of India be asked to take action on any recommenda. trong contsined there without waiting for the next meeting of these bodies. This was teed to je-olutions on items No. 6 and 1 were accepted without comments. In Besolution No 8, the word "suitable" **Rimilar." wag substituted for the trord ·on r (10) The licensing op haulers oo) the conle?ring olegal potere on local taltb staff for establı-hing the identits of bau) cre in casa ca doubt are csson. al for an eficient administratus this lluitsu! 17* (11) Instead of legislating from the citolo fo] luliarit:n, 11 16 esirable to provide an !!! *+, bl. Goting all th: sisting enactments ...!!! With ..., Tot l'ordt snittiin minus its, and this oppiament Jurubel itu...!!!lomanzis": ngislation (12) Prosius 1-10 take dvantage of the 11-propy na rok till 11 il. (sunt . Inila .lc. 935, and ri yu-l that the ir lentils n Irt in the control f food prorlustini dintrit1111111 cil (131 It No. -1911-15?-11. In non tritis. n 1.01 csire to men the firxution of unprortant frelstuffs on ns to ensure list that will lor sitslaetori in quality and quantity 15 mill to reduce thcost of their distribution the puble, TH, por nuit of ... pornture ofort suggested i valull. st. toride the realisation of the objects and the Governinientos I's 1.1 51.1.1 pis partu ular nitent on to Duuon of uly to lose it the " ratine primiple. (141 Thlr.rrrsweth, wink ibit, in order to improve the food suprly of the people Governments will take tarls steps to five elect to these recom. niruditions It considers that recommendations (1) to (10) can be put into force now without waiting for the comprehensive legislation and ndministrative measures contemplated in Recommendations (11) to (13) (15) The Lord recognise that, in order to mule a definite advance in the control of fond adulttration and in iniprusing the food supply of the community, Loth in respect of quality and quantity, it is essential to ensure that the closest possible co-operation is securei between Governments, local authorities, those who are engaged in the production and distribut on of food and the general con- $iuning public The enforcin-nt of legal measures against infringements of 'the lay are undoubtedly essentul for improvement but, without the intelligent co-operation of all those who are interested in the problem, no sitecess will he achieved in a reasonable length of time The Board therefore desires that wide publicity should be given to the recommendations of the Food Adulteration Committee and that special stress should be laid on the necessity for securing the goodwill and collahoration of the food trade in the campaign for the improvetment of the community's food supply (16) It is also desirable that the various Food Trades should organise them. selves into a number of representative bodies to fac litute discussions between consumers and producers and to spread the necessary information amongst the less well-informed members of such bodies. Item NO. 4. A MEMORAXDUM ON "ASAEMIA IN PREGNANCY IN INDIA INCLUD ING HAEMATOLOGICAL TECHNIQUE" FORWARDED BY ΤΙΣΕ INDIAX RESEARCH FUND ASSOCIATION, The Central Adsisory Board of Health desires to place on record its appreciatiou of the great service that has been rendered by the Indian Research Fund Association ibrough the investigations into the problem of anaemin in pregnancy conducted under its nuspices and through the publication of the invaluable inemorandum on the subject bp Drs. L E. Napier, M. I Neal Edsords and C, R. Das Guptı. The memorandum, which has now been made arailable to Goremments of Provinces and States and to their health advisers, should be of the greatest value to these authorities in the organisation of prerentive and curative measures against this important cause of inaternal morbidity and mortalits. The Board therefore recommends that earnest consideration should be given by all interested in the subject in India to this "Memorandum on Anaemia in Pregnancy in India" Item No. 5 A MEMORANDUM OX POSTWAR PLAXYING. The Centml Adrisory Board of Health is of the opinion that the improv ment of liealth conditions is a matter of vital concem to the country and ·subject 19 plans for a drtermined effort to raise the standard of health and to proside adequate presentate and curatuse health services for the people should boy placed in the forefront of the pastwir in einprent programme Further the Board considers think the programe should be based on a com prehensive arter of all napeats at the health prabilost It welcomes the appointment of the Health Surrey and Darclopment Committee and Fou!? Etre-g the importance of completion of the Committro's work at the earliest possible date Item No. 6 (a) A LITTER DATE:1) 2011 DECEMBER 1912, I'NOVI TIIC SECRETARI, (EVTRU, 1)ISORY BOARD OF EDUCATION, CONTAINING A RECOVVENDATION IRON TILT BOND TILAT THE CENTRAL UDVISON BORD) OT ini ITION 4.0 MI: ULTIT SHOULD JOISTIY (ONSIDER TITE, PROBLEM OT THE PREVENTION OF BLIXTXESS IN THIS TOM\TRY IT AX EIRIY DITE. (b) PRPLIVIURY REPORT, DATED THE SPRIL 1013 BY LT-COL SIR (LITIA JICKENZIE, OG BLINDNESS IN INDIA" WITELA AEWORLDUN BY TIIE DIRECTOR-GENERAL. LJ.S. The Central Advisory Board of HIсalth notes the wish of the Central Advisory Board of Education that a Joint Commuttee of both Boards should consider the problem of the prevention of blindness It also notes with appreciation the iuluable interim report on Blindness in India by Lieut-Colonel Sir Cluthu Mackenzie and requests the charman to appoint a Joint Committee of the C'entral Advisory Boards of Health and Education to examine the with special reference to the causes and prevention of blindness in India an! to Sir Clutha Mackenzie's recommendations and their practicability. The Joint Committee should report to the tuo parent Boards.. Item No. 7 A REPORT ON THE WORKING OF THE SCHLME OF THE BILIR GOVERNMENT TOR THIS COMP'L'LSORY INOCULATION OF PIL- GRUMS ATTENDING THL SITAMARII FAIRS IN THE YEARS 1913 IND 1913 The Centrul idvisory Board of Health congratulates the Government of Bihor on the successful experiment that has been carried out at Sitamarht for enforcing n scheme of mdirect compulsory inoculation of pilgrus attending the festivals at that place in 1942 und 1913 The large percentage of pilgrims that were moculated as both occasions and the considerable intasure of co-operation from the public which developed in 1943 as a result of intensiteeriucation of the people and of the tactful handling of those who proved obstructive in 1942 ore pront of the wallingness of the general public to submit to measures intended for their own benefit if they are approached in the proper way The Sitamarhi Report is commended to Provincial and State Governments for consuleration suth a view to similar action in respect of selecteil festival centres in their areas as reconmmended by the Central Allvisory Board at its tlurd meeting in July 1010. Ilom No. 8 A NEPONT ON THE PREVENTIVE MEASURES TAKEN IN BARODA STATE AGAINST GUINEA WONY INFECTION The Central Adsisory Board of Health commends to the Governments at Provinces and States the Report on the successful preventive measures taken in Barnia State against quinea-form infection and expresses the hope that action will be taken on suitable lines by other Gosernments in whose territories the dixeare constitutes public health problem. Item Nos. 9(a) & 9(b) (0) - MIMORISDIJI OX Tiin sở {}{ITS}) .IUTHORI '. CIVIL TION OF LABOUR CAJTS." NIT.. DEFENCE SERVICES. FOR ·un- OF 91h) -MEMORAXDIOS VEISURES FOR THE PETEXTION DISE.ISIS IN INEAS 11:ROTIV IDIOVES The Central Iduisory Board of Helth (On-Iloit that then lohruir casa € started by the War Destinat it is sernthalt): 1: in flim iriririt of the ealth and simutation of curlions and of inholstril on 7s 17 primits to bem, there should by Jose collatioration to turn the instani mitir uthorities both for the pursuing and for the top of all the part1 iealth measures Ini Orellos thuit (18! Purifum has to fuland " imtnil uficiently in svona to potrait of their br na bronchi inin normation, it is lesirable that is being protein prannsluit of the intraute morts should be firen by the War 1) portrue lot to L'OC" Tonetunents 2. The Bonnie the difli ultira propter nut lir l'insirrul Directors of Publir Health the working of the Cristup artisementu utt) ritirulir rference to the establishment of linson between the ciul 11,1 militar health, authorities, the apportionnent of extind this qurchion of applina It reron. mends that the Clufirin Tira'th ind in Department and Mar 1. portinent of the Government of The houdel tot. tateltate strps to late thirar dificul. ties removed 3 The Bount recommend that, when the present emergency is over, the rural health org in sations in areas surrounding aeroorlames should not be discontinued his the Governments concerned on the ground that with the stoppago of grants froin the Central Ciovernment, no money will be available for their maintenance The ai should be to incorporate these rural organisations in the framework of the general health scheme which Governments will doubtedly prepare as a part of the post-ar planning 4. It is essential to incorporate the doctrine of self-help in these schemes, the villagers le ng encouraged to partie pate by contributions in money, in kina or in labour, since such participation in addition to being raluable measures of health education will help to lighten the cost of the schemes Item No. 10 A SUMMARY OF THE REPLIES RECEIVED FROM PROVINCIAL AND STATE GOVERNMENTS SHOWING THE ACTION TAKEN BY THEME ON THE VARIOUS RECOILLYDATIOXS MADE IT THE PRE- VIOUS FOUR JILETXGS OF THE CENTRAL ADVISORY BOARD OF HEALTH The Central Advisory Board of Health notes that in any cases Governmcats have not found it possible to give effect to its recoininendations The reports on special health problems prepared by committees appointed by the Board and the different nicinoranda on various subjects discussed at the previous four meetings afford useful surgestions for planning health policy in many directions and the Board wishes to emphasise the necessity for utilising the information thus placed at the disponal of Gojernients in their schemes for post-war lenltlı developrnent. Item No. 11 A AIMORINDUN OX TIIL APPOINTMENT OF A DIRECTOR OR NURSING SERVICES IN THE MEDICAL DEPARTMENT OF EACH I'ROVINCE OR STATE The Central Advisory Board of Health considers that the development of nursing services is one of the most uinportant tasks for all Governments in this country. The number of sanctioned posts in hospitals is quite inadequate in most cases to proride proper mursing to patients.' A reasonable though not ideal basis for calculating the number of nurses required is that of one nurse for four les Caleuinted on this basis the number of nurses requ.red for existing hospitals in British India is almost double the number now employed. The majority of the hospitals are experiencing serious difficulty in securing the services of trained nurses The need for increasing the number of sanctioned prests for nurses in hospitals and for providing the facilities necessary for the training of an adequate number of candidates to fill these posts is therefore urgent.

·provincial cadra of Hurse the designed to 10 2. Tlie Bonni tol opinion that the deficients is due entre alu to the an. sitisfactors conditions in aliich the trima nnd isock of the nursing profession is carried out, more espezialis conditione affecting prorixion ol of duty leisure pccommodation, feeding and ndoqurte facilities for study. The Bourd is of opinion that substantii improienicut in the respects must be effected it the Hur un profession is to spil to that larg seeturn of the Indian public from which recruits roull, in more Infotrables circunstance, le drawn. 3 That I entral Visert Bound of Isilth als inutis the attention of Gor. cununts of P'rosincet States to the large opening shich cxists for the «m.ployment of tromne male nuses and recommends that in these areas where the training of such many in 110$ in foret', earl steps be taken to introduce it snimate stops to move the existing unsatisfactory situat on the Berd recommends to the livre mise unt of Indnud Governments of Provincay und Status - (1) the creation of provinen nursing service with a 11 the font autant for posts about the wank of staff nurse or stuff medwife and lot? Pinoy tv all ruhs (The llon ble Ki Bahadur Vulvi Jalaludin Whmed, Vinister's Charge, l'ublic Health and Local Self-Cosminent Depurtinent, Bengal, the llun 'bit P Supru and I tjor tieneral 1 II Canis, C I.E., KES IM$, bunge linal with the Government of Bombay, dissented from this 14 Solution) (11) the creation of just ut Superintendent of Nursin. Services on stad of the Admistrative Aledicu Otileer in the larger Provinces for ile general udmistration ut the services, for the distribution of Government grants-in-ad 102 the organation of nursing education both under-graduate and post-graduate, tor the Nintenance of mmformt on service enlighten und stimulate locul uuthorities and for the development of the service ir an orderly and co-ordinated manner (1) the creation of a Central Nursing Council at an early date as recom. Inended by the Buil at its tout meeting 5 The Bourd agrees that, for the smaller provinces, a combined post of Registrar to the Nurses Registration Council anil of Superintendent of Nursing Services is likely to meet the situation Item No, 12 MEMORANDUM ON THE I'ROCEEDINGS AND RECOMMENDATIONS ON THE 1'001) CONFERENCE OF THE UNITED NATIONS HELD AT JIOT SPRINGS, USA, IN MAY-JUNE, 1913 The Central Advisory Board of Health considered the recommendations of the United Nations conference on Food and Agriculture on the subject of Nutrition. It endorses the stews the Conference on the far-rcaching effect of nutrition on public health and recommends that full attention should be gisen to its findings in planning reconstruction, with the objective of improving the diet and health of the population. It strongly recommends that a trained nutrition worker should be attached to Provincial and State Health Depart. Tents and that Provincial and State Vutrition Committees should be estab- Jiba Such Committees cannot, however, function successfully unless they are guiled by expert advic- on nutrition questions (Slujor General B. II. Candy desserted froin this resolution.) The Centrul Advisory Board of Health observes with approval that the Xuw utrition Idslury Committee of the Indian Research Fund Associa. tiva las been dealing with urgent problems arising out of the food situation. With referente tu liesolution No. 7 of the United Nationg Conference on the establishmeat of National Nutrition Organisations, the Board recommends that the Goverument of India should iminediately investigate the need for modifying or deseloping India's present Yational Nutrition Adrisors Committee is order is provide a national organisation for India with the functions described in the The solution. It consider the applicat on in practice of the results of nutrit:03 Itseareh to be of the greatest in.portance.

·APPENDICES
!
(Oultan
APIENDI. I
(1611 ITEM VO 3,
Statement regarding the prevention of persons suffering from infectious diseases
from travelling in public conveyance
The Central Advisory Boaril v Italih sitrusse at its lant illoting in
January 1912 t's the
truth Joni sulit
Je Ta Enfering from
contagious dise 14. 1r in train In Jubili
1b. Board while
recognisin, that in 111unidentiteinntrol the morcrients of persons
suffering from wfitivus di-e.at can barula (fotive usloa thiey form art of a
?
i wider scheme under wel 14 femral health an ir mire nel med and the
health adunnistration of the cours raisot te ut demiteks higher level of
cffirit:ct than that much molo il potisnil desired that the question of
erclung sont practual point that in control should be further cramıncd.
2 It is considered that in view of the difinult transport problems with which
the railwar authorities have to contend the present tune mopportune
for vestigating, in conjunction with the rainav authorities, the possibility of
improrements in control The Yulinatuin of this question las accordingly
· been postponed for the present
JS

·S'TENDIX II (GEYD ITEM X. 1) A Note by the once of the Central Advisory Board of Health on the "Hema randum on Anæmia in Pregnancy in India", forwarded by the Indian Research Fund Association lumis occupies n higli place in the list of causes of inaternal suorbidity and mortality in this country In many places it is second and in some it 33 first mong the different cairney of material inortality and, as a contributory factor to death, its importance is probably even greater. Sulla mforination av 14 010111able indicates that maternal irortality is bigha throughout India Different Insentigations in limited areas havo provided figures ranging from 100 per 1.0XX) live bartlig to the almost incredible sud probably ciceptional figure of 137 untermal dentlis per 1,000 live births in one district of Assam in which a spreul enquiry was carried out by Dr. Margaret Balfour, With buch hili rites for maternal mortality it is clear that anana, one of the principal causes, is in health problem of primary importance Between 1925 and 1939 anoma in pregnancy was investigated by a number of research workers under the auspices of the Indian liesearch Fund Associa In res vf importance of this public health problem the Scientito Advisory Board of the Indian Research Fund Association recommended that Alemurandum dealing with the results of these enquiries as well as the standard technique iu regurd to humatologicul inethods and methods of survey should do publisfied and submitted to the Central Advisory Board of Health with the object of drawing the uttention of all Provincial and State Governments to the very important subject of anæmla The Memorandum which is now being submitted to the Board coutain a revew of the present position regarding anæmia in pregnancy in India, note on the standard technique in respect of hematological methods and to other sections entitled "The need for anemia centres" and "Conduct of 11 anæmia enquiry, with forms' The Memorandum should therefore prore be of great value to the Governments of Provinces and States for the investi gation of this important health problem and it is to be hoped that action mal be taken to survey the extent of anæmin present in various groups of th poprulntion and to apply such preventive measures as are desirable. tior ·43 APPENDIX NI (AorsD4 ITEV No. 5) Memorandum on Post-War Planning The Gorernment of Indu. addresse J l'rovincial Gostmments on the subject of planning for post-war deveniment in the health field in the Department of Education, Health and Land letter \o D 2312-11(C), 43, dated the 18th Septeinber 1913 It is suggested that the general question ri planning for post-war derelopment and the position of health turonstruction schemes in the general post-sar prourallinie -hould be disi Usaed at the next rreting of the Central Advisor Board of Health ·IPINDIX IV (loryre (test Yo. () 6(a).- To consider a lciler, dated 2017 Decembor, 1912, from the Secretary, Central Advisory Board of Education, containing a recommendation from that Board that the Central Advisory Boards of Health and Educatice should folntly consider the problem of the prevention of blindness in this country at an early date In a letter to the berretary, Central dvisory Board of Ilcalth, dated the 2011. Idecember 1912 the severeliity, Central desiry Board of Education, state: thint that Board at itu peath meeting held in January 1912 adopted the follo:sing regnummendation of a committee uppointed by them to examine the question of adopting i uniform Drulo Code in the schools for the hund India The Central Adsory Boaris € Education and Healtii should cisti consider the problem of the prevention of blindness in this country at u carly date." 6(b). -Memorandum by the Director-Gebers), Indian Medical Service, O "Blindness in Iadla" The problem of the blind u India 18 a subject that might well lave engage the xt'ention of the Central Iduisory Board of Health carlier. If the definitie of bluducts is widened so as to include all persons who are so blind as to? unuhle to perforin any worls for which dye sight is cssential' tho figure for th umber of the blind in lusk has been estunated as somewhere tetueen or and the millions It is therefore evident that here exists an immenso feld the ainelioration of suffering and of poverty and for turning Solpless dependen into socually useful citizens and an economic asset to the community. In this cominction bus been fortunate that the struccs of Lieut-Cols Clutha Mackenzie could be seeured for the investigation of the problem of t! blind Di Indon This work for St Dunstan's in New Zealand and many oth parts of the world is universally known In January this year the Governm! of India apromted him as an Officer on Special Duty in the office of ! Director Generul, Indian Medical Service, in order to investignte the extent blunduesg in India and its cause, to carry out a survey of existmg societies 1 the cluention of blind children and of the means of employing blind men er momen and to prepare a scheme for National Organisation for the Blind ITo has prepared an interim report in which he has covered the groui Inort successfully and there is material here for the basis of 1 Euccessful atta on this considerable social and preventive problem. A copy of the report attached 11,4 ingin proposal is for the formation of an Indian Natiounl Society for t bund und, this will, no doubt, have the full eupport of the Roard. It is i commended that this report shoull be relerred to a small but representati con mittee consisting of members of this Board and of the Advisory Boari Ixcation. IXTERIM REPORT OS BLINDNESS IN INDIA BY IJCUT. COLONEL SI CLUTIA MICKENZIE, OFFICER OX SPECIAL DUTY, OFFICE O TUIT DINECTON-GENERAL, INDIAN MEDICAL SERVICE 1. YATUTE OF TIE TISK The thellir of birdre's in India is not a problem-it is n task. To kno in the ratio of Windress car le substantially reduced; and se know also th in sm by nih ve can pucate and give employment to those whose blind pass has int heen presenter Our work, therefore, is to discover the hes mars er means of putting this knowledge into further effect. We bare ro tret esilerec as to the precise extent of the blind pop Tem cersus n! 1931 puts the number at 1,379 but congu$ figures ? ulation ·45 notoriousls uurchiable in sul, mitt the oli TIT OG Kiinan. basin; his estimate on detail prints of the ruritorus W.71in etiain dis. tricts in Bengal and tal me the definition blindnes ng "omen is blinil who can't count thr fingits fan foto thril bomul Ilgesinend up to the eres", believes the totall. I to top of sub}. thumth. 191 con4114 It the definition met te that trick adiptor in te nest for blind welfart SU 1181117ls tobited on to thabile in forlonin any work for which le lit in l. mint han estimate rould again. zi the least, be double }it, in this litlir 11 fure is on mill on or tro mulus 1!11!!!! sin fin trop rasti al word. --a untk vluch will teli list reduce the number of four besar 11 our struts 21 many into t (1731370 alls uwful anilhalier citizens The wurl has its two main surs- (a) the prevention and of hlupiness, and (b) the admitimit (mb14 y 120 * sal welfare of the Wind 2 THE POINT AV Cukier I'UINDNISS For long decades a bie bors of men hon Kleistilled and devoted service ► the treatment of (ve discares In conneition with this report figures surlied by the Administrative Medical Oficers show that in Brita-li India, eje ospitals, eye wards in veneral luospitals and uccredited organisations aro innually treating boint 1,333,561 patients, of whom upproximalely 118,233 re 112-1 athuts and 1.155,326 out-patients The number, too, treated by jualified ophthalınolets in private practice must be very large Nevertheless huge field for work manns Colonel Kirwan estimates that 50 per cent of present blindness is curuble, others place the percentage of curable and preventible at a substantially higher figure The causes of blindn-sm India and the measures necessary for its prevention and cure have been expertly dealt with the publications of the societies devoted to the prevention of blindness, in medical journals and in works by leading eye-men, and at present the Intest knowledge is being collected with a view to the preparation of a concerted plan. The task set me at this stage is "to investigate the extent of blindness in India and its cause and to carry out a survey of the existing societies for the education of the blind children and of the means of employing ned blind men and women in sheltered industries and to prepare a scheme for the creation of a National Organisation for the Bhind of India". A direct connection exists between the prevention of blindness and the giving of welfare services. It is manifestly better in crery way to prevent a person becoming blind than to hare to educate, employ and care for bim as a blind person throughout his life. Not only is there no comparison in cost but all his suffering. Vandicap mil economic loss is avoided. On the other hand, we cannot eliminate blindness altogether. At a minimum it must be the work of two, if not threr generations, before we can achieve the 50 per cent reduction which Colonel Kirwin believes is possible, and the blind population, cren then, sill still numlicr several hundred thousands A large body of opinion in India feels that tho time is ripe for giving this group wider and better welfare services and an improved position in the community. So that is our task on the one hanil to assist in every way the great work of reducing blindness to the minimum, and on the other, to bring education, employment and happier times to those who must inevitably remain blind. 3 Tng PRCSFXT POSITION OF WELFARE YORK Orer the past Tears a umber of societies hare been started for the purpose or part-purpose of giving education, employment or telfare services to tlic blind. Of these 33 are in existence todas; and they may be briefs classified in the following was: 25 are societies for the blind only: 6 Arc for deaf-mutes as well as the blind; It is in combination with a roor nsulum, and 1 with a cripple home of the total 6 are in Indian States and 37 in British India. in ·ilen 10 They are controlled, I liga Pros meinl Government; 4 bis Indian State Governments, 13 by sexistins created for the purpose, nnd 9 by Christian Missions, wale of appear to lie privately run. Iltogether they have a total enrolment of 1.160 lind people, of whom 03 are males ani 159 are femintes Ilults among them number 109, while children number 997 The majorits of the recente a small pensure of Government and/or municipal nu! Xo cehools have limen established in Assam, Orissa. North- West I'rontier Prorince nr Baluchistan Agunnt the mensits of the task thus represents an oxtremely smail, though gallant effort Sereralls humide apped by Tuch of noney faced by a apathetic public ille quipped with stuff thuy baie been able to make but little change m the life of the munss of the blind Yet they have show'n convincingly enough that the wind of Inella nro is .pt pupils and as heen learners as th: blind of uns, other country The children in the higher classes are most pro ficient ut Bruille, at type writing, at musio and at various handicrafts; but the big problem the societies have not been able to solve is the employment of the trained blind Lack of money anil public apathy are, of course, a constant contributory ditheults, but there are two other major causes-(a) training on not altogether appropriate lines, and (h) the competition of beggiog. 4 REASONS FOR THE YOX-SI CCES4 OF EVPLOYMENT The training has been copied in too wholesale a manner from Britam, and America with too great a blas towards academic learðing and too much eruphasts on Braille The result is young tiho. though they can read and write Well, have only the remotest prospects of earning for themsels es. Almost none of the 33 schools can give a satisfactors account as to the employment of their el-trainees The aim of education is to equip young people to ear their living and to take their full part in the life of the community. not succeeiling in this, bome modification in method iz due. The changes need to be towards a heying-in better with the general life of India, taking blind welfare work singer boy stage, marching in step with the general social advanceincnt of the people, rathar than attempting undue short cuts straight to the point which western bland welfare work has reached It has taken the west at least a bimdred and fifty years to bring its work from the point where almost the whole of the blindt had no choice but to be poverty-stricken beggars. The odserse circunstances in the Indian picture have been common to all lands, and have lind to be met by a painstaking process of trial and error. Nererthe legs with the advantage of the knowledge gained in the west, plus that of the schools which have done a yoluable pioneer work here. we should be able to cut the century and half to considerable degree. That the exruling so ieties in India should not have achieved more is no reflection upon them It was, and is, o plase through which the work has to pass in its crolution towards better things, and it forint a good foundation on which to build further 3 THE FACTOR OF DEOGIXO Beggm, the oldest traditional occupation of the blind kas been their Least coau petitur. It is in essence the "Social Security systent" of past centuries. The sanous religious enjoin upon their followers to give generously of what they have to the four, the crippled and the sick, and they will find favour in Gol'x bisht Though this sistein has many abuses, though it is Jxesting to the dignity of inan. set it has guaranteed the helpless against aliut A sI«! number of the blind in India have long found some sort of tmpnent in teļi atida [4636* froin sacred work, in temples and mosques, ia muz., birçin anl thing, in punkali pulling, husking and grinding grains, but rex: hare lern le mars. The earnings of be gars vary considerably Rs. 6. 15, a uonth and tien irte. To poor parents a small blind child is actually .: Fuset, capable o leir: hired out to professional beggars for four and fire arres a dsr l's:23!15 to sxial stigina is attached to blind people begging; and cosequentls, socicles for the blind find it difficult to interest many of If it is

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·VEN 6011 mesures מר 18 Noon pie is done to restli chorally lis the National Institute for the Bime on London, hd sibular mottarsation in indsisablo here. This course do strongly divintel u thie Report of the Uniturni Braille Code Comitte, 1913 () Bruille am Talling Berk Liberty central as well a4 a number of povucial libraries, is dit be, both for alle and for the talken: luok (This lutter to a closelopment English speaking countries of tur vist sellers explete works ir sporch rikuried on lonx-puying hitjmopilione record Hengekopp mehipinos to suppland 11 rast friis los cortics for the time anii Diaries bom the newrels free) (ri Resumo Depurtwen! Conrermed math the investigation of nes avente, of oniplayment for the 11:11! Piet mellials of traing new apparatus ard (1) National flirlfure Department - While the wel vols, voriships and nelink: societiea ido all in the lower vrect's to train and establish the blind, meich of the advania velutilainen spring the full co-operation of Forernments official hodies and the public Various legislative enactments are necessary a fierting both the prevention of blindness and the education and employment men parang similar other countries In mosi Land text, to offer the come disadvantage of the blind, and the extra cos to which then lire tout, through the need to emplos escorts 22 par douby it in now an established practice for concessions to be granted to blanc people in inspect of transport, admission to cinemas and other entertainment Hailio venees and so forth, while npparatus for the blind is usually sulmitter rint free, and special reading mutter carried at concession rates through th post The seeing public has to be celueated to support societies for the blin? to purchase the goods from their wo kuliops and to make te of the services canhe Wind penple All these are tasks such can be done more effectirel' s Votsonal Sorirts, neting for the whole rather than br scattered individus units Another of its tushs in to help in initiating steps in areas where insufficien sersas exist, for the setting up of schools, workshops and other facilities ar to assist in the running of appeals and the maintenance of revenues bs th Prouinch, societies It would publish a small journal with articles on developments in techniqu and to hest scu 34549 in touch with enh other's work. Teriodically it woul Organ- Alt och unference to enable workers to meet to discuss problem and exchange reperiences It is eRreply necessary to say that the vigorou functioning of this department 15 temmentul if ulistnntial progress 19 to be mnde (1) ifter C'are' Department -- prosent lack in India #proper systes o stes Much of the flaxt xl money and on the TYVE DE the blin in my parts of the world has lutherto byen than nsay breause of the lac of wideniente terre orginations It is of small sertise to train blin vorher, and then to turn him out into an unsympathetic world to feel lo In al fut a minimunol cases he will fail to make his way. It i paarestial that the wriety, which has traine1 hima, skoukl find a job for him wywaniem in required on tools, and place to work and on otherwis eriting porn startet, an that there should be an officer of the society wh cin 1. him notirls and birlp him to surinout the orcasional difficulties which will fire lion - The altep-rarr service nften pmridles toy material at basic coat Arlina tn find a market for finished provis XXL Suels on bosse sur le priment in act as a model. It may be necessary for the MASCING AND CONSTITUTIOX. It *i!? le gathered imm the foregoing that the services required are very pengitrahle, an! that both a large nutlay in capital and in annual maintenance is requireil Olin kellare nork has alwack bren pioneeren of private philanthrops, and erlo alan it lav ymseil Ila pretiryl success hace gorernments hegin to abore intan 1 msrurenant In zome spheres gosernments liave now taken chart 1 ·va VUA Oasawa The complete field of services to the blind, iu u modern country such as Britam, coler the following A comprehensive Blind l'ersons Act, charges local authorities throughout Butsu with the responsibility for makig necessary provision for the blind people of their areas and to debiting the cost to the rates, plus some contribution froin the central governmitt Under this and other Acts affecting blid Kelfare, such as the compulsory education of blind children, every urban and country authority sees to it that there is provision for the education of chuldren and facilities for the vocational training and the employment of the "emplozuble blind". The local authority males allowances to the workers on a sliding scale in relationship to their earn. ing, to augment their names and cornpe niste them for their louer earning poner congrared with seeing worl.crs, je "employable" blind are paid sustenance allos ences by the local authorities In uddition to this main provision a variety of reparate or associated societies pie special services-sunshine homes for preschool blond children and babies; instructions to parents as to the care of blind chulidreu, bol dung schools and colleges for specinlly able clildren and the children from wealthier lonies for fugher education in the professione, inusic, etc., u specual school for messages, classes in sighted beliools where bind pupils work aloigside feeing pupils, special classes for the deaf-blind and the mentally backward blind; students' librarics of hand-written bruille words for the use of blinit students and adults who wish to study specin suljects; after-care departments to see to the placement and success of the blind who take up independent employments in the cominunity; co-operatire marketing Agencies for menuinc tures from blind workshops and Biome workers; libraries of Bille, Joon and talking book works; a wide service in Brille periodicals, mille printing presses; voluntary workers for transcribing books into Braille: clubs for entertainment, music and sport; lome visiting societies to teach the blind) who cannot leave their homes to read and unte; do home duties and simple handicraft: homes for the aged and in alıd blind; nasociations for the feachers of the blinit; traria unions of blind workers; and so on.

·50 These represent des clopments, specialisativus and telincments which can and will bo fitted into the work in india stayo by stage as resources and the chunying social order allow. Today, iu Britun, the Domnunioos und America as a result of t1114 systum, the employeble bilerad are contributing an integra Eliare of the war-effort. Horhshops for the blood are turning out great quantitie. of sar materials. Many blind vorhers liavo tuhen their place at the assembl benchies in muntion and aeroplane factories, some are owners, directors 0 managers of plants on war work, others operate war telephone exchanges All posts, many are marre, farmers, ar lenturies and so forth. . Ih employable blind coinmunity as a whole proudly takes its competent place i the war effort in Indi can follow 011 Or a convincir II AGISTRAL IVITIL POLICY rorpi:01 IVCIAL SOCILTIES. On but section of the foregoing comprehensive field should we first bem! There ale two main tields for the employinent of the blud, (a) sheltere puidustiits, carried out in special workshops, where the blind workers atten as glued workers do at ordmary commercial factories and ear wages, an (b) the various independent occupations which the trained blibd such as 1911, must, furning, sloup her pink asurance whenues, me-sage and Alte lutter tielu honeter, calls for fur higher expenditure than the format] it calls too tor a sighted public much inore highly educated in the needs ar the capacity of the blind cummunity It is a stage which will need to be desi lopid later Moreover, most blood people belong to the poorer, less intelliger section of tbe community, men who cannot be trained to lead successful lives : independeert unts, and so if we are to be guided by the principle of the greate good to the greatest number secoue to the conclusion that at the present stis our mam line of uction is to go a simple education and manual training whic will have at its end permanent wage-earning employment in sheltered worl shops Once, one or more sinull, suund, praetual units of this kind are firmly estal listed each l'rosinie they can be used as a foundation for expansion. of the most important things is to use them as a successful us demonstration of what can be done iu ordue to convert sceptical members tancuments into timu believers and friends of the system. They can be use for press and cinema purposes o those recruiting hex blind pupils in th districts, us be given fucts and toure's to conunce parents of blind childre and young blind men of the practical money value of tranung iis tune 50€ un simr unity can be established her tenses, and other departments but clfire work added to these sound foundations In the type of unit, the boiling and grounds stwuld be divided into tu #garuto urrats arscctm--- (u The serut and school boys bounding department, playground, etc (b) The Hurtado, qarter for Hult workers and grounds. "To by ste sith the texted objective of trainmg the boys for manual trades i buitend workshop, 2003t of the present primary school training wants but tinta unitation Thor al diritto anil literary education should be guaplıtied The stilren sley'l bo wirutted at about five years of age, it born blind, o i! fty, other sight after the line of fire, within a year of the loss THY Run' not fenzin in the whool after the age of about 15. During thes of sight ms!}{bus is best confined to simple education in the reuding ! uit of their mother tongue, simple arithmetie and knowledge of simpl, *!**.*rt uni trastuernent calculations, personal lxgiene, music, phos cult! Speal, rns, limone domestic duties and mitt li time on haut work, toje!?""sing this approach tie age for masing on to the workshops Latteris I'! lip puitmmtinn or four hours 1 us on their future trodde Diane the ruli, saps of our bikling-up of hind welfare irork the {"jºs var!, sloull z'nt liesitate to trominate the staş of any pupils laching

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·aspects, are not discussed at all. These will lo dlouli vitit in the fiual report, but it is hoped that what is snid does give a broad and region the picture of the situation is it is and the work before us. The co-operation, which is heing aboun lig creryone associated with the work, is most helpful, and thero seems to bo esers where a deep and sery enrnest desire to see a big step forward in this full of social effort and to assist in it I believe I am justified in saying that, from my experience of the lash few month, opinion is ripe for the making of the effort and that a concerted [peni wonlo find a generous response throughout the whole country A lvig appeal, as me koost, lis not only the effort of rnung funds, but all the publicity, associated with it, 19 n fue education in the public, particularly in the direction of influencing parents and friends ni the blind to send thers for training ·APII VIIVI AUF Itiy A Report on the working of the Scheme of the Biha: Gorennon: 13: Compulsory Inoculation of Pilgrims attending the Sit:7321h ta the years 1942 and 1943. ! The Central Lun 15. list in third is in July 103) adopted the ruirt sth - D'Imoltito it. T!'. thn mability of atrod uchi Iwwer vinuli, in plan her c. mr. and recommended that mountal and into (tutte lonill uls tlin l'undharpur scheme for Communities in the thesabull for a start select ultahide to Innen fri! Irwiput them !!! As 1. по 14 know on! 11 1111 - Trention of the Board 1. thun 1 SUR 11 hinarla in the district of Muzaffarpur Wedeler tent ITU.!!!111. 11. - 1.scourging succes bas already been without ille lur le lat 1:11. und 1913 15 grils the enforcement of muculation und the control of cholern The reports sent by the Director of Public Health at the two festivais un liriefly suminarised below. In 1942 the festival started 2181 Marco and ended on 6th April A notafication was issued by the Proxmelal Gorernment under the loademic Discuses Act makmg it compulsory, between 21st Murch und 911 April 1942, on all pilgrims and visitors to the Rannatam far at Sitamarhi to be moculated against cholera within the previous 613 months before they entered the mela area Before the coinmencement of the mela considerable amount of propaganda was carried out in order to inform the public of the uns und objects of the mchele Letlets were distributed, postum were put up at many railway stations and other important places, a doctor was sent to Sitamarhi well ahead of the festival to inform the people of the proposed measures and press notes were issued. Nevertbeless there was con-iderable opposition to the scheme from the public Further, those who were responsible for the organisation of the festrval, shopkeepers and other businessmen in the area also protestel against the introduction of a measure which they considered was found to keep awav usitors and pilgrims apã thus affect their incorne The enforcement of the scheme was not devoid of trouble in its early stages However, inany uninoculated pilgrims who forcibly entered the mela area were induced to go back and others were inoculated by the doctors on duty I'he majority of the women visitors could not be inoculated No arrests were made and no canes were instituted under the Epidemic Diseases Act; but with tactful handling of the people it was possible to inoculate about 80–85 per cent of thoso sho visited the festual T'je number of visitors to the festival vluch had in previous sealu been about 50,000 dropped in 1912 to about 25,000 Froin the point of view of presenting tlic spread of cholera this inoculation campaign proied ennently satisfactory. Sporadic cases of the disease had occurred in soine parts of furaffarpur district prior to and during the festival, but the disease showed no increuse uitor tlie inela which liad usually been the case in previous years. During the period betreen 21st March and oth April 1942 only five suspected cases of cholernt were reported in the festival area and all the patients recovcred. The report far 1913 gives a brighter picture of the response froin the people than that disela-ed in the report for 1913 Esery attempt was made as in the previous sear to come the operation of the public ly morning them of the real objects of the scheme I trielling dispi*11477 motor van of the l'ublic fIealth Department with loud pealers, ophone, poster, pamphlets, leaflets ang matices taures the districts of Dirblingn (huspuran and Nurafi.irpur frou tvleiclı pilgruns generally attend this festival. In addition other forms i pro This duci. paganda such as publicity through the press "ere also ulcited tional work among the people durme the two years 1912 and 1913 apresrs 11 have borne frunt liewe the Diretor of Public Health has stated that in 1913 ·the ntmosphere in die li the inoculation cimpatgi was conducted appeared to be quite congenul and that there wils se seriolis opposition from the people, On the prenent occasion about 70,000 utors and pilgrims attended the festiva? and of three about !KD dier tent' site lexultered As regarls the inculence of cholen, Situmor and the neighbouring villages hac outbreaks of cholera before the perlat Flowever durmg the festival perind only six cance of the disease were reported it or near Sitamarku town and o! these one pronte fatal The Director of l'ublic Health bas stated that there Pin to vice that immunised people for the Sitamarhi fair bad spread the infertion to other place in view of the succesful experiment at Sitamarhu it is hoped that the Goveminents of other l'ros inces and States will use effect to the recommendation the committee of the Central Idrisory Board of Health

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·from the date at adınınıstiation of lime, samples of soter ure re-examined by the well net in order to ascertain whether any Cyclops are present or D... Experience has shown that thirce "luning operations are sufficient to destroy the Cyclops completely Treatment vf cast's The following methods of treatment were adopted (0) Oral treatment Amonium chloruit in i dose of grans per adul wus gilen first thing in the morning with curds for one weck. This was seen to reduce the plug and to drive out the worm to the surface (u) Local treatment -The niouth of the worin hes touched with pure carbolic acid and the wound, if septic was dressed with carbolic lotion, 1:40, for a few days This procesy tears the sound and destroys the embryos of the worm 'reatment with a constant dribble of water was also recommended. Some cases were trented by mjecting the body of the worm with mercury por chloride lotion 1 10,1) It was reported that the mornis came out quickly. Acriflame maslo nected with good results The success achieved by these measures is indicated or the results obtained in four heavily infected villages, the relevant figures for which are set out below -- Number of patients in Name of the leg. Topolation 1939 39 1939 40 19.40 41 70-41-43 1942.43 Kunbus T l'aten Govala T. Chanasma Ada, Taj Ilar) Varech Tal Patan 10 37 80 225 018 1,893 366 wat 8 7 난 is tarto tubulue statement showing the results obtained in all the sixty plected villages is attuched to the4 Report Blou never krutifying the be results may appear to be, no permanent suppres 4101 of the infection can be achieved without protecting the water supplies - the affected are against re-infection by the carrying out of sth structural chunges ay may be necessary ined by securing the intelligent co-operation of the people through their proper mstruction in the mode of transmission of the disease Presenti» of re-infection of the Inrge step sells along the caravan routes is a inutter vl supreme jmport.ince from the point of view of the health of the people in the ends concerned In carrying out the necessary structurul changes it will no doubt toe !!! in propriate to destruy their artistic features Ins additiinat me that may be invest in meeting both these re qanenty will be Iki prelulture of public tunela The comparalice statement ou inn yuin normianes in the North Veheana Dutrict, Barnila Sutr. for the yran 1935 39 and 1942.13. l'asry in the year Population 4. u! 11.16 Kenarka 1934 33 14:43 Iuber Tul 1 Mn 31 313% 1. 1 Ige' 423 153

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·(NTI-GUINEA-WORM WORK ,, E- HANDLE WORKS THE GCAR AND ROTATES THE FANS IN OPPOSITE DIRECTICYS. FUNNEL AND DI PIPE TAKE THE 5CLUTION OF THE LIME TO THE BOTTOM OF THE TANK. AI VALVE TAKES THE SOLUTION TO THE BOTTOM CF THE WELL. A2 VALVE. REMOVES THE SOLID RESIDUE. B1 & ARE MERE BANDS FOR ADDING STAENGTH 82 TO THE MACHINE. SOLUTION IS FILLED UP ONLY TO THE TOP OF THE BAND BI. AJ

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·00 Health and the In Force medical authouties in the saine area cau suitable schemes be worked out and put into force 1.1 oriler to establish close l111509 between .lir l'oice authorities and the Director of Public Health and the local health autlıorities, a Deputy Senior Peelical Oficer (Aut-alana) was appointed at the Headquarters of each Royal Air Force Group In this way it 19 understood that an effective Isuson has alcaly been established between the Air Force inedical authorities and the cul health authorities concerned 4 In addition to provuling funds at the life of lis 6,000 per nerodronie the War Department have also agreed to supply free of cost, froiu inilitary stocks, recessary, stores and equipment for prosecuting antimalarial measures in the ciul rural areas surrounding nerodromes. 3 It is suggested that any dificulties t'perlenkel in connection with the scheme should be discussed at the sting of the l'ential Advisory Board of Health 6 Wbile these measles were primanly designed to safeguard the health of the Air Force personnel and to ensure the operational value of the services, they are not without their beneficial effect on the villagers themselves who live around these aerodromies For the first tme they will have been given the benefit ut orgutused untimalarial and general dmt:try nieasures with sufficient funds und stuff providtil for their execution 1 Ipart from an ovement in the headth of the wluge communities Culed, the distubution of these rural health orgunisations all over the counts will provule opportunities for I'rovincial Public Health Departments to estimate the result of pplung lumited funds and stuff to rurnl populations lag unler varying conditions and of gesing the extent to which the co- Ginton of the lucul indubitants call be developed for improving tho sanita: t101 of their environment These organisations should therefore coustitute new line of attack on the rural Haitha problem and the experience that they pronucle should helps to plement the elderzience which certmn l'rovincial and forude livvermenin, hade komend in the past through the levelopment of health units with their standardised the truet ut organisation and higher types of brultls persemel An objection that was later advanced gunst the health ant nistein is that Provinciul und State Customments cannot under existing combativity after the expenditure necessary for consering their reen with a network of buch > l'hir die uns around trotaxtyanath mulattage be con bidend un alushile expierstuents towards the + welutinu of cheaper type of Hrulth orgull

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·62. importént health subjects by the representativcg of the Governments of the country will have littlo meaning unless the decisions reached at the conferences are studied wtb a ver to thru implementation as soon as favourable condition supervrne On the other hand, there are other recomniendations made by the Boare at the pa-l four meetings, which might have been accepted and carried inte coffee is health admmistintions in spite of the war. Examples are the recom mendnisons dealing with (1) the training of medical and health officers in putrition and the carryin; out o diet surveys, (2) ile adoption of the standards of purity for different articles of fooi rcccniendel ly the Food Idulteration ('on.m.ttee, (3) the provision of prenatal and postnatal clinics in all teaching hospitals (4) the establishinent of joint health boards for cooperation among loca roilway, military and civil liealth authorities for the solution of coinmon pro bleans, (5) the establishment of Boarels of Health at provincial headquarters and of health Lurcans at the headquarters of districts, () the car'yin out of an experiment on the lines of the Pandharpur schema for the onf 11 of compuls moculition of pilgrit; (7) imfirovenent in the teaching of hygiene in medical schools and colleges (8) the provision of facilities for the health education of teachers and school (9) the entablement of Physical Education Committees; and (11) the cultivation of pyrethrum in areas suitable for the purpose, in respect of some of these resolutions of th: Board the action so far tuken by <atan Governments has been cle-appuntı, but, in the case of others the pirogrens reported indicates a desire on their part to make such advance as is puest's under present day conditions Further, the extent to which differens Goventa las found it possible to give effect to each of these recommendat101 has and The detailed notes on indi dual subjects that are incar. frald or this tremorandum show what has been done in the various l'rovinces and States The following brief remarks are, howurer, made for the purpone of mga bud's se ve 11 of the progress reporter by Governments Nutrition classes were held in the Nutrition Research Laboratories, Coonour, 11. hie par from 192.16.1919 Trha tudod 1... mali

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·64 D, the confining of the functions of maternity and child welfare centre primarily to preventive work and the prevention of their assuming the functions of hospitals or dispensaries; as a ccrollarg the provi sion of greater numbers of rural dispensaries and of rural medica Oficers, I. research into the problems associated with maternity and child mellore work, and F the giving of grants-11-aul by Government to sell organized materuuty and child welfare schemes not only for stimulating local bullies to improve their services but also for giving the l'rovincial l'ublic Health Departinent a measure of control and superviso!! Over these schemes A l'ogts ut specially trained medical women devoting their whole time to the development of materms and chiki welfire work exist in the Provinces of Aladras, Bengal, the United Prorinces and Onssa and in Hyderabad State. In Madras nie is an Assistant Director of Public Health In the United Prorinces the maternity and chuld welfare organization is controlled by the provincial bra ich of the Indian Red Cross Society which employs & Director of Intermey and Child Welfare This lady works under the direct supervision of the Directori of Public Health, who is also the Vice-Chairman of the United Provinces Branch of the Imi liec ( Slety The Prouincu Giovernment fires an annual contribution of Rs 1,52,600 on the understanding that local maternity centres are mantenerl upproved imes

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·D, the confining of the function of muturmty and child welfare centres primarily to [itenantise with and the prevention of their assuining, the functions of hopitals or depar109; 18 a ccrollary the provi! noul of Ctetet qumbers of rural da emsies anel of rural 1.dical others; E. research into the problemi 11€90X74te'd sath matermty and child welfare work, and F the FD of rant--11-21. In (usentent to well-organized maternity nudiluild welfare selu nies liot only for stimulating local berdo's to improve their sers ces but also for giving the l'rovincial l'ulilie Ilealth Department atteisure of control and supervision ote these schermen A-l'outs of specully true! Helical women desoting their whole time to the developithunt of intermty and culi sellaire work evist in the Provinces of Afadras, Bengal, the United Frosinces and Orissa and in Hyderabad State lo Mr.is nie is an asrat unt Director of Publa Health In the United Prorinces tlie maternity and cloth were organisation is controlled by the provincul bru ich of the Indian Red Cross Society which employs a Director of Maternity and Chuld Welfare This lady works under the direct supervision of the Director of Public Health, who is also the Vice-Chairman of the United Provinces Branch of the lulu un lindro Seele The Provincial Government gives an annual contribution of Rs 1,52,600 on the understanding that local maternity centres are inaint meil approved me in the report the committee pointeil out that however experient this arrangement might have been in the past when public healtà departments were neither sufficiently developed nor suitabls staffed, it was open to argument wher ther the policy of delegating to a voluntars horli the provincial organisation of maternity and child welfare and the administration of Government grants-in-ard should be continent It is for couskleration whether the incorporation of this branch of public health activity with the other functions performed by the provincial Public Health Department will not in the long run prove more effective for the satisfactory des elupinent of the service Maternity and Chid Welfare will have a better status as an officer on the staff The provincial Director of of the Director of Public Health than as servant of a soluntry organisato ever though itnesou bus berns established between thes organisation in the groumeral Hoth Dinartment through the Director of Public Health being made the lurmu of the Sex jets Futher, the incorporation of the maternity and child wellire service in the prusmeral Public Health Department wil! Izelp towards the unililitum of preventie work in the liomes of the people on a org. 1,914 It is estable that a multiplauty of lealth visitors should bomber the Promes withe atsise sin aferent mitters, such as the health of the intan' il' nursing mother of the schoolclull or of a tuberculosis patient. A single piron with a mam trim stresolil be able to fue the necessary service in all them clintity and should, at the same time be able to win the confidence of the mother and the help to ensue that the teaching is translated into practice. Luths, it the Indt at freilits of the l'uyimual (invernment are to be utiliced for the desclopment of the maternity and cluld welfare orkansation, a voluntary 1xx1 1 dilim at this stork will find it more difficult to secure the necessiry coonlution for thin the presin at lublie lleulth Department. In Bun Hudderibu Stite juu Oringa the uchun dutors appointed to the purist behul spil trning in maternuts and child welfare mork. In Orissa. honeser, the des.oni nel the feat is "Superintendent of Medical lid to Women ACHI itin" as the other earth out the supersun! loth preventive anıl Juriin Leslth wort: In certain Prouincethe sonenlxtors engaged in the supervision of matter mity nne chill sell rr work aloring posinca special qualifications. The Central I'muine, Tiraint not op: Pepelent cit": hispur Health School anit Assistan! to in the trip of P If arry out the fun.inne nt ile Superinten, It is cleur that she cannit flestiselt *!,, clila se

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·86 Hyderabad. A proposal for the establishment of welfare centres throughout the State is under consideration by Government as part of a general public health scheme. Baroda --All maternity homes with 10 or more beds are prorided with lady: doctors Smaller homes are managed by midwives and by doctots -charge ol dispensaries in urban and rural areas. Jodhpur.--Two maternity and child welture centres with well trained staff bave been working in Jodhpur city for many years New centres with qualified staff have been started in some districts and it is stated that moro will be opened After the results achieved by the existing centres have become evident. C--The provision of greater facilities for the training of medical students and midwives in prenatal and po-tnatal work and the establishment of wellorganised prenatal and postnatal clinics in all teaching hospitals was the third recommendation for consideration by Governments of Provinces and States In the Provinces of Bombay, Delhi, Madras and Punjab, it is stated that the teaching hospitals provide adequate facilities for the training of medica] students in prenatal and postnatal work In Bengal some facilities for such traching exist in the Medical Schools and Colleges but they are not considered adequate and the resolution of the Board has been brought to the notice of the authorities of teaching institutions with a request that existing facilities should be improved In the l'nited Provinces the curriculum medical studies in the Lucknow Unuersity includes prenatal and postnatal clmics and the training is given in the department of Obstetrics and Gynrecology of the Faculty of Medicine of the University In the Agra Medical College no regular antenatal and postnatal clinics are conducted, but the students given training in antenatal care in the out-patient department of the Thompson hospital and in postnatal work in the indoor words where patients Are admitted for confinement In Bihar the existing facilities for prenatal and postnatal training of medical students and pupil miawives are stated to be adequate in the Patna Medical College hospital In the hospital attached to the Medical School hospital at Darbhanga the students are given facilities to examine cases in the in, and out-patient departments but' no special clinics of are are held lu Orissa prenatal and postnatal clinics are field at the Lady Hubback Maternity and Child Welfare Centre, Cuttack, and at the Cuttack lieneral fiospital In Hyderabad Stute provision exists for prenatal and postnatal clinics at the two central hospitals of the city. In North-West Frontier Province and Buroda there are no medical schools or colleges, but special facilities for such training have been prouded for midwives, nurse-dais and dais. In Sind no ection seems to have been taken except to bring this resolution of the Board to the notice of the respective authorities of the teaching hospitals in the Prormice and of the Sind Nurses, Midwives, Health Visitors and Dais Council In the Central Propinces no action has 80 far been taken and the question of providing fregier facilities for the training of meilical stuudents and midwives in postnatal und prenatal work will be consulerel by that Government only after the war D.-The Committee laid emphasis on the preventive aspect of the work clore at the child welfare centres and stated that these centres should not Busuite the functions of a hospital or dispensary. The replies state that, in peneral, the preventive aspect of maternity and child wellare work is emphaeiend in the different princ.. As a comllary to the roommendation that the work of child welfare centrpe Tould be insinis preventive the Board stressed the siew that greater numbers of rural dispensahes acd rural medical officers should be provided The roles show that Ingress is being inade in this direction in a few places i'ne inataret tre Gonnent n! Bombas kiire sinctioned the appointment n! sme na Kitaiilinen medical practition or for rural areas of whom 270 linse tull, tirem agmintal In: Hudentsat recomendavins for the expansion of niral emal nil at under the considertion of that Government

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·ES The Food Adulteration Committee has now comleted its examination of the legislative and administrative aspect of bu proble: and its report is before the Board tor consideration The replies from Prorinces and States whos that the recommendations of the Boarsl lave largely been deve rted bs the Princes In respect of individual standards for particular aytiles of foreleetain Goreniments have not form it possible to accept tlie standards reeon.rded by the Board. As thicse variations will be brought before the Cent1 Committee for Food Standards it is not considered necessary to include them here Leprosy Committee's Report. Leprosy and its control is another important tealth problem which was com. prehensively dealt with by & special committee appointed by the Board. The recommendations contained in this report were accepted by the Board st ita fourth meeting in January 1942 In commending the report for consideration by the uuthorities concerned the Board drew special sttention to the following: - (1) The particular susceptibility of children to the disease and the paramoud' iinportance of the prevention of infection among thern (2) The responsibility of provincial and local authorities for maintaining is isolation at least those persons who are in an infective stage of the disease, se segregation of infective patients continues to be the most important messure against leprosy (3) Control of the admission of patients from other prosinces into leprosy institutions in individual provinces by Jimiting the Government's capitation grant for future admissions to patients of the province concerned, except in respect of infective cases. (4) The carrying out of leprosy surreșs on the lines of the Report of the Lepirosx Survey Sub-committee of the Indian Research Fund Association. (5) Antileprosy propaganda in schools and in teachers' training mstitutions Especially m vew of the inportance of the control of the disease amongst children (6) The desiralulity of the attention of the Medical Council of India being drawn to the paragraphs in the report which deal with the question of adequate training for doctors in the diagnosis and treatment of leprosy. These remarks of the le prons Committee relate to an improvement of the teaching in leprosy during the unlerfruunte course as well as to the provision of facilities for posttrudunt traimme on the subject (1) Idol of non-infective cases of leprosy, if necessary, in the general sarili mul of afective cases in the infectious wards of hospitals 14. The establisluuent of a Leyrary Institute of Iwia by the Governinent 4 โพไรงเ (9) The red for an antileprosy polier in the Provinces witli reisamable uncind prosim, this poles should incluile the establishment of Provincial Storrum in net as the hub of antileproef work in the Prosiner the *** frontinent of l'remen) 1.pront Officer with high mede al qualifications and widdi spirience of antiepima work (10). The sle-rability of a comprehensive Ict incorporating the existing and I rozjertul liggulation on lopmost, necesity for Inahing infectiv 111fective cases of leptons untiti shle, the ile sırability of mo. isting legal gimining with its to facilitating trusel by lepers iment in Ir piermi institutions The time that has alarnid sitice the report was receive (mment. But then too woort to expect any substantial ai!.. o't it tevorentinos Such limitel Altonas has fra muineus in mariee below In Delhi 1! is stated that & surser cirtie Tank Oferr of the British Empire la in vicienee of the disraer and that it has cars to take elskarate measures Ine control 10 of well as non Gior- 1910 bil Alesd becn

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·The 70 of leprosy surveys cannot be undertaken and the question will receive special attention when conditions return to normal. The Madras Public Health Act, which makes all cases of leprosy notifiable is being amended to make it applicable only to cases of "open leprosy", end restrictions have also been suggested in the amending bill for regulating the transport i public conveyances of persons suffering from the disease.. The resolution of the Board recommending an improvement in the teaching of leprosy in the medical curriculum was forwarded to the Medical Council of India, which sent a copy of the resolution and of the relevant extracts from the Leprosy Committee's report to the British India Universities included in the First Schedule to the Indian Medical Council Act, 1933, for report as to the arrangements which exist in the affiliated colleges for the teaching of the subject A summary of the information received was placed before the Executive Committee of the Medical Council of India at its meeting held on the 26th March 1943 The Committee directed that it be suggested to the various Universities that special training in the diagnosis and treatment of leprosy. ON modern lines should be provided for the students of medical colleges, various Universities were accordingly addressed by the Secretary, Medical Council of India, and the replies received from the Universities are summarised below Patna University - It is stated that special instruction in the diagnosis and treatment of leprosy on modern lines has already been included in the medical curriculum of the Patna University and the students of the final yeur of the Prince of Wales Medtcal College are given six lectures with practical teaching every year at the leprosy clines Andhra University --Special instruction in the diagnosis and treatment of leprosy on modern lines is send to be provided for the students of the Andhra Medical College Calcutta University --Tlie replı states that leprosy is taught in the Medical Colleges und demonstrations and climes are given to the students in the outdoor hospitals of the skin «lepartment. Luchnow University.--Special ustruction in the diagnosis and treatment o leprosy on anodern imey is said to be provided for the students of the King (ieorge's Medical College. There is a ski outpatient subsection attached to this hospital where hnal year students get clinical instruction on diseases of the skin including leprosy Ten attendances are essential In addition to bis tuo attendances at the leprosy hospital are compulsory. The University authorities consider thut facilities for short postgraduate training in leprosy may be provided at different institutions were enough material is available for those who specially undertake this work, Bombay Uhrersity --As diagros) and treatment of leprosy are already included in the course of study n the medical course of the Bombay Unuersity It is said that no special attention is called for in this behalf. Jadras University.--Tlie decision of the Coinmittee has already been for- *arded to the principal, of the Medal Colleges for information and guidance. rovision has already been inude in the University for imparting Instruction, in the treatment of leprosy as contemplate in the re-olution of the Com- Dittee. Punjab University - It is stated that lectures with demonstrations on leprosy are deinered is the l'rouincial la proy Officer to the 5th year students during the inonth of October path year The Vedical Faculty considers that the rent tracking arrangernent for the undergraduates is sufficient; the Additional teaching should be carrierl out at the mostgraduate stage, Ibe establement of a Leprosy Institute of Indin has been recommended to the Government of India by the Board While its establishment -will are to bits in-troner till after the rir, it is considered that the details of sh, mon soul nos tres diccusarit in order to get ite establishment agreed h in racirl. TŁus i considerable amount of delay that would nthomion .

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·72 of the results of a prolonged study of the cholera problem under the auspwer of the Inulin Re-cinch Fund Association lai indicated this as a promising line of attack on the dreare. Tlierc hins been some amount of oserlapping in tlie sesolirtións passed by the Board at the successive meetings. For instance, the importance of using anti-cholera vaccine lifepired from true strains of the cliolera organismi way einphased at both the second and third inuitings Such repetition was clone mirposely in order to stress the importance of the recommendatiou. In the follow mg paragraphs the mam lines of action suggested by the Board for the control of cholera are briefly stateil and the exteut to whiclı action on such luies has been taken in the l'rostlices and States is indicated. The measures recommended by the Boaril are ~ 1 Implementation by Government of the recommendations contained in the various Martin (unumittees Reports prepared durmg 1913-16, particularly II Com'ctos with the control of cholera The Pilgrim Comunittees' reports were issued btween 1913 and 1916 and relate to the Provinces of Jadr.is, Bombar (including Smd). Bihar und Orissa. the United Provinces, Punjab, Bengul a c'entral Prosinces In these Pro. Vilces l important festival centres were sisted and detailed instructions were given in the reports for the control of Rucli centres from the point of view of the health and comfort of the pilgrin The replies from the outer l'rinces, l'unjab Bengal and Bihar state that us for its posible the le continendators of the l'ilgriu Committee3" reports lonxe berri currus ont us huile m (Mitual Provinces and Berar it is statel that the recomme mention could not be implemented for want of funds. The invernment of Bombay have replied that the recommendations of the Provin. cul Pityruns Corunuttee have beell Curried out at Pawulharpur filir In Madri at is stated that, on the basis of the recommendations of the Polyrum ('ommittee w the retual permite of the malligement of fair and festivals, mom ruum was fire purest is far back as 19:23 for the gundance of local bodies anul the public sealth stat Inngements for water supply, conservines, food Cortrol mostre gatim mund treatment of infect1011 disent, anti-cholera inoculatinn, te nire ud to be made both at the festival centres muul at places en in106 2 190 nipples of noti-cholera acci emplosul in medical and public Troth de Juurteste utl be prepared from the true struts of a chioleme The coolera Lule innutietured at the Central Research Institute. Kin will not at the Pracal Laboratories are made from the trive trans The replies show that all Gone ratnent except those of Bihar nnd Orissa are Hulles de sul froin el suure Thir Pulilte Health Department 13:lsir mil Om olit at their supplies from certain commercial firing in It is printed out that, in oriler to ensure that the cholern vaccines se popisuel do their trip prepriseil from true strains of cholera ythrio, it has dron obilizator on the firms to olt.un trnje straints of the ubrio froin the Tractor of the Central Hoge 1l In-titute, the King Institute or the Calcutta b- of Tropical V-line In Bohur .. proposal is under consideration for the propulfat tiine of her macine in the public health Inboratory of the Timsit It ! ritmul that suplim of thinlera vacum supplied be these femmest lys thi Bihor Pub... Heilth Department to the central Ile-earch 5. **, K-ul ! in front !u!» m Organd sitting thients use leen nude for il. 3!!!!!!?? of simple in the pros nei il public health loborutors. chi Ircial 101 State Government shoul.l drar up definite ani! papilare finthe insirs crinstrol of all festival centres in their territories mildar, incell 11 Torla cm instructions for the guidance of local nft:- C. res;<1, * !- the 1918.tina o individual festirls anil of the routes 1+1 till bus tha pilims I'll gipsos," **** from the control of the health conditions in maine tiralert are mad in mnt Pmsinces Instances are the Kumbh Melax

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·vince. concerned (1) To meet the cost of health measuits, iucluding inoculation of pilgrins at the festival centre, the imposition of taxes ou pilgrims and on vehicles qd animals entering a festival area has been recommended, the funds tbus collected being kept apart from the general revenues of the local body or Government -collecting them and handed over to the Pilgrim . Committee of tbe festival cenilie for being used strictly for the benefit of pilgrims In Sind a pilgrim tax of annas 2 is levied in respect of the Lal Sahbaz fair, the inoney collected being utilised by the Sanitary Board which is responsible for the control of the fair In the United Provinces a pilgrin tax is bewgcol lected through railways at some of the important pilgrim centres of the Pro The amounts so collected are credited to the local bodies concerned on the condition that it should be utilised for the benefit of the pilgrims So Jurther action lias been taken a view of the decision of that Government not 1) introduce for the present a scheme of compulsory moculation. In Bihar no power: 1xzl at present for the Provincial Governmen; to impose a prigriin tas nr a tax on vehicles or animals entering the festival centres. In view of the fact that the Provincial Legislature bas ceased to function for some time, it has not been considered expedient to undertake the necessary legislation until the legislature starts functioning again In Madras Presidency provision already exists in Section 118 of the Public Health Act In Bengal, while there is no provision under any Provmcial Ict for collecting pilgrim tax or a terminal tax of any kind, . smeharge is bemy level under an executive order on all tickets issued by the steainer companies engaged in the transport of pilgruas proceeding to the Ganga Sagar Nela In the Central Provinces tales can be levied, with the approval of the Commissioner of the Division, on pilgrims, afirmuts and shops or booths The niones so collecte must be credited in full to Government and expenditure in connection with the fair would lst met fron the grant placed at the disposal of the Deputy Commissippi by 'Rosenment In respect of furs the management of which has been entrust ed to fur conuttees the Deput, c'onmissioner can open an account for each fair with Busb approved by internnent, deposit the receipts in the Bank and duthurte revendititre from this fund for the purpose connected with the fair, In Orissa terimul tur on railway passengers is levied under thr, Bihar anel Orimat Pletce's of Pray Act, 1920, the proceeds of which are spent on mproving the sanitary conclition of the pilgrin centres concerned In-Bombes the Bomb District Vlum pallet, 1940)1 an the Bombay Municipal Boroughs Act, 1925, pronado for the imposition of a tax on pilgrims for expenditure on the hulth and coursemenee of pulgrims and for the admistration of the proceerli of the tox box plan commuttees The Issore Gorernment have permitted the Piration of parim tas in certain places No pulgran committees have et b) forinted the fund collected from the tax are nemmnistered by the Iron nie concerned In llvlerabud Stuate the recommendation itgarding the 117.1 99 %) of plurim tax has been crepteil by Government. The questior of uimstruciun of the funds mes collected by the Pilgrion Committee and no by ice local i els now being considered (e) The utilisation of the services of specially traineil sanitary inspector kr carrying out 1** uludlen under the supervision of qualified medical inen, In Vadis 19 Berbuay Presidencies and in Hyderabad State the services 0). such inspectors are utilised for the purpose On the other hand, the Govern. et c'the l'entral l'rovinces are not in favour of employing non-medical med! '!os esrying out inoculation while from Sind and Mysore State it is reportei ilst there has fertio difficults in getting medical men for such duties. In the L'nieru l' y..ers a city for the training of sanitary inspectors for this purpose **lem afraid by Giovernment and arrangements are being made for tl.eu trains 11. Bir . 1 l.nl the initier is uniler consileration by the It-tv Gost pripranta d) Tt - fone suppls of racine bis figurinents to Inent bodieu. In De!: OpoTen, Vndena, Central liounces and in Hyderain) S*** antiebeler vaccine is supplied free of cost by the Governments conerined in the frozlk. In Soil Cholera varcine seems to have been supplied

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·require loca! sistem of 76 indiscrimmate pollution of the soil and to encourage the use of bored-hole and other cheap forms of rural latrines, Do special action has been indicated in the reply In the Central Provinces it is stated that a scheme is under preparate tion by the Director of Publte Health wich will in due course be considered by that Government. The Governments of the States of Hyderabnd, Baroda and Mysore also point out that no cholera endetnic areas exist in their territories In Hyderabad the question of proyulmy safe water supplies and improved conservaner in the rural areas is stated to be receiving the attention of the Public Health Department Development of Public Health Organisations in the Provinces and States The question of developing public health organisations in the l'rou11ices ard States was discussed at the first and second meetings of the Boure! The recom. mendations of the Boarel include (A) the enactment of the necessary legislation, wherever it does not exist, in order to enable Gorernments to bodies to appoint medical officers of health and to lay down svitanle conditicias regarding the recruitment, qualifications and terms of serrice of health ofher. (B) the allotment of ate funds Governments and local borlies for the development of public health organisations and the formulation of public health schemes in municipalities and districts and the mistitution of a grants.jn-aid from Governnients to local bodies towards the same end; (C) the establishment of a Health Board at the headquarters of the Prorince or State And of Health Bureaux or Conimittees in each district in order to promote ordinated effort in preventive medicing between the Medical and Public Health Departments, (D) the establishment of Health Init" in the different frovinces and States and an expansion of the actiuties of these health units to wider areas and to larger populations and (F) the passing of * consolidated Public Health Act in each Province or State A - In the Provinces of Madras, United Provinces and Punjab it is state} that powers already exist for the l'rovincial Governments concerned to require local bodies to appoint medical ofhvers of health and to regulate the condition of service This is also the case in the North-West Frontier Province where the Punjab Municipal Arts in vpemtion In Suid it is reported that the I'rovmcial Covernment has acquired powers by an amendment of the Bumbu Local Boards Act for the compulsory appoiarneat of health officers by local bodies and that, as the response from these bodies has not been satisfactory. Government after wanting for a reasonable period of time contemplates taking action to enforce the appointment of these others This Guvernulent Dails 150 prescribed suitable conditions regarding the recruitment, qualifications and terms of serske of health otheers and anntary inspectors In Benrul the ques tion of in legislatun tune cosernment to compel local bodies to appoint health whers has been jumpa till after the war. lowers alread, erist tit this l'ense for liovertient tous douantitable coniitions for the recruut. mert, qualifientions and terms of service of liealth otficers and sanitary inspec. tors In Assim the question is under the consideration of Government ID the t'entral Prosaces & Public Health Bill on the lines of Madras Public Health 12 11o docen drukousl lit ito antsileration buily be e'n postponed till after the Hell, de lite for nintent, qualifications, etc heutthonos.nl winit.si intor 1:"13e rails hron frhin In Bihar ten lloga, live wiresis men porno sith tlehe other mail mubordinnte staff The Government propers to complete the scheme in the remaining ris districte o! this Province In fire of these health oflicers have already been appointed, The Pr. de TI alth Department of Mysore was reorganised in 1929 with qualified bols of an 'it ile styrtlinste staff In Hderabad State the potention o! exprra Inayl torlies en anpimnt rrederal officere nl Joeaiths is under cottminnblirpatrulental orelore thinninn muitahle conditiore for recrunt: . qui-tuun***, alearly exist The nereesitt for legislation in this pont will to creilrif mann prised district henlth schieme noir under enn .*" br roreminent i sinrtinei Barola cits inunicipalité prnplore fullsmus] fer! Festih i ne and Government consider that the incomes mal crunt ipilities an} district boards are not sufficient to enable them to

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·regard to 78 as to the nature and scope of those health problems tive solution of whico requires co-operation between the cul and railway health authorities, and the second recommending that all Provincial and State Governnients should take steps to establish combined local health committees in those centres in which joint health problems require the co-operation of all the three authorities for their solution, The replies show that an encouraging measure of progress has beeu mude in a number of Provinces to implement these two resolutions of the Board lo Sind such joint boards have been established at each of the district headquarter tou try In the North West Frontier Province and in the l'unjab, it is stated that close co-operation already exists between the civil, military and railway health authorities lu both the I'rovinces, jomt committees liave been formed in 8 num. ber of places Sclietnes for anti-malaria work are carried out in co-operation. In Delhi Province it is stated that there is jutimate collaboration between the three authorities concerned in matters of mutual interest, particularly in the control of malaria, although a combined local committee as suggested og the Board has not yet been established In Madras Presulencı it is stated that the provisions in the municipal and local boards Arts and of the Public Health Act apply to a varving extent to the jurisdiction of the railsav authorities 13 the l'rouince and thut there is a considerable ineasure of co-operation between the civil and railway health authorities Yo mention has been made of the appomtment of a joint committee is recommended by the Board, nor 19 any informntion given regarding co-operation with military health authorities ID Bornba l'resident the stage so far reached is that of collecting information regardmg the extent and nature of health problems to be dealt with ih specific local areas, in the solution of which co-operation between civil and railway authorities should be sought As regards the formation of joint committees it 18 statel that the opinions of collectors have been called for A Committee w fornied for anti-in.ları.. measures in Poona aren, but it could do little or nothing for financial reasons In Orissa co-operation between the Public Health Department and railway authorities is stated to exist especially for the control of epidemies during fairs and festivals and also to s certain extent for the control of malaria along the ruluar lines Government of the Central Provinces state that the base on several occasions approached the military and railway authorities offering and viting co-operation on public health matters of common interest It has not been stated whether these efforts hare Buceeded in the establishinent of such co-operation for the solution of common in blerts In the l'nıtel Provinces information is being collected by the Director W l'uble Health frun the different medical officers of the railways connected with the Presince on the Immes incleated by the Board As regards the formation of in health cornthittee action on the lines sigasted by the Board has been postpner till alter the war, but instructions have been 1494ed to selected munu ipal medical officers of health to call together ad hoc meetings under the chairman. ship of the Distriet Vagistraley for considering general health matters when. ever thuis biecornes neces The replies froin the States o! Hytlerabad and Birale indate that cleanet co-operation already exista tutseen the civil, milie tars and railu tr mulici otficers In livre Suite a lucal health committtren Contituted by Cintrument and it cotisists of representatists of health atilling of the Oulun Militars station, Bingsion, the Vaira and Southern Writt. Hulus is, the swire State Rails us and the Bangalore Citr municiolin it's tl. Director of Publu Ilealth as its chainnan. Nutrition Surveys At first meeting of the Central Vivianry Board of Tealth subject ! !! *r** disse by the Board and recommendations were (1) Tir desistility training at Coonon a number of medical and health (T- in intim with us that they may be able to advise wigon! with cirlnutrition and deficiency disease n Tino desirsbility of culte ingo dietary surrers in each Prorince az? The on problems

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·80 F-The carrying out of statistical studies in the beld of medicine and public health with the utinost possible vigour with the aid of trained medical statistical workers. 4.--The catent to uluch public health statts have been employed in the mumepal and non-unicipal areas varies considerably ruong the Provinces and States and the exteni to which they can effectively supervise the work of registrurs of lurths and deaths differs corresponding!: tieneral mstructing to the inspiecting ofhcers of Revente and other departments to inspect the work of registrate of births and deaths during their tours seent to hire been issued in a number of proces incluilm; the United Provinces, Bombas. Matras Punjab and wore State In Bombat it is stated that inspectmg officers instruct registrars of birth and leatlıs and explain to thein the correct methods of registering vital statistics In the United I'ros inces in municipal areas ward nenbers are authorised to check statistics in addition to the health staff In Bcogala system has been introduced in some districts under which the records from the local areas are sent duect to the district bealth officer in those office they are compiled It is stated that this system has given better results on the whole B—Aledical registrurs are working only in the large cities of Calcutta, Bonubay, Mudras, Ahmedab.id .gra and t'a w more As an perunental measure the medical registrars have been working in the town of Amritent in the l'unjab) for the past two years In other areas, urban and rurnl. 10 Istdiend registrars are employed Various innethoxls are being tried in the different l'utilices and States for securing trame! non-medical sen for altruirtinent is reprstrin Thus, m the l'uted loumets, the proposal to 10 entrane the surk of registration at vitul statistics !!! nuntler nutnicijalities 10 6. Eniturs after they are gine'ui trung for three months at th. Prouin. tull1 lustitute Thin. prosill take frict only fter the war 111 Mudrais l'resklem registrar in municipal tours must posseus i minimum quuhtication equnvalent in the Inatriculation is well as trunmg jor s pfriod of a weeks in vital statistics fiven by a hrst class health otficer, ut hc must have the qualidation of a sanitary inspector In the municipalities of Delhi City, New Delhi and Notified Area Com. laittee, Coral nes in Delhi Province the cause of death Are verified by fpecial din curs apputuztel ly these municipalities for this purpose C-Amsters of (citrul compilation of the vital statistics frorn local areas has been brought into being in the Provinces of Sund, Bihar, Delhi and Puojab. T.e alene WAX in operation in Madras Presidency und in Jysore State before it ortumene by the (ful Istory Hours of Health 111 Bengal ehr ..' * lui, cun-ului bs thit Government, LOUS. 11 1. ...*** ti. (entrathin the work of curul iti dau beun jartmalls Art. Intl. Issant l'rutit, t... l'entral l'rosines amul Sorth West lih 1701 so far been taken on this resolution '1!. Lindstion c! the Buurd for the establishment of A Bureau of Vital Statiot' > under the cree of a trained medical statisticman in the head. portes (ca! ele ruit..! and State Publi Huth Department has card cu: 1. the l'unjab and Bubur In Bengala Superintendent of ?' w: aljrv 141 tramm his boerl appointed and the question o! **!!.,.:Brauc Sighist!'s is under consileration by th. 'l'rovincial in !.!. l'rryma aml Minore this pure.tu eri-ted with a 17! sinni hotelire the cominenilation of the Bone 113 In: Pr1,"rad Siatry the panlution 1:as nog so far Lees Norlameest la the Paard 11.! I'rovinzial and State Governments ..:!rt to the "! pr extent with the Central Gorenient's T1'. !!-3':! IL!! in repertoleride kal and other vital stats: L'art with an excellent respon from Coreminents all oret L ( Bepe ili reerlution 494 siisel Promincial Government

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·NO 80 F.—The carrying out of statistical studies in the field of medicine and public health with the utmost possible vigour with the aid of trained medical statistical workers A-The extent to which public health statts have been employed in the municipal and non-municipal areas varies considerably ruong the Provinces and States and the extent to which they can effectively supervise the work of registrars of births and leatlis differs collespondingly General instructing to the inspecting otheers of Revenue and other departments to inspect the work of registrars of births and deaths duing their tours seem to have been issued in a number ut provmies incluiling the I'mter Provmes, Bombas, Muchras. Punjab and Jyole State In Bombay it is stated that inspecting utheas instruct registrars of births and deaths and explam to them the correct methods of registering vital statistics In the United l'rosinies in municipal areas ward penibers are authorised to check statistics in addition to the health staff 11 Bengal a systein has been introduced in sone districts under which the records from the local areas are sont duect to the district health officer in whose office they are compiled It is stated that this system has given better results on the whole BAledical registrars are working only in the large cities of Calcutta, Bombay, Mulris, Ahmedabad, Igra and tau npore Ας an etperinental measure two medical registrars have been working in the town of Amritsar in the l'unjub for the past two years In other areas, urban and rural, medical registrars are employed Various methods are being tried in the different l'rounces and States for securing traine! non-medical tren for appointment o legenteilla Thus, m the United Posmen, the prom..! as to entrust the work of registration of vital statistics in muller municipalities 10 Baltars in Tuctors after they are gren frammy fo thuee months at th. Prosincal Hygiene Institute Tlus.jiroposal will take effect only after the war Madras Presxlency a registrar mn inunicipal tou nis must possess a miniruin qualitication equalent to the matriculation is well as training ior a period of six, wecks in vital statistics given by a first class health otticer, or he inust have the qualification of a sanitary inspector In the municipalities of Delhi City, New Delhi Mid Notified Area Cona. Inittee, Civil Lines in Delhi Province the causes of death are verified by special doctors appointed by these municipalities for the purpose. C.-A bystem of central compilation of the vital statistics froin local areas has been brought into being in the Provinces of Sund, Bjar, Delhi and Punjab. The scheme was in operation in Jadras Presidency and in Mysore State briore it was recommended by the Central dels isory Board of Health In Bengal the Jacus scheme s by considered us that Goserment. Jun (rss 1 Brodu Stute the centralisation of the work of complition las been puntually Currit il ulit In the l'rules l'rul Inice », the l'entral l'rovince and North Wes? Trontier l'rosince no action has so far been taken on this resolution. The recorurnendation of the Board for the establishment of Purenu c! Vital Statistics under the charge of a trained inedical statistician in the headl. quarters office of every Provincial and State Public Health Department has bien carried out in the l'unjab and Bihar. In Bengal a Superintendont of Statistics with appropriate training has been promted and the question of establishing a Bureau of Statistics is under consieleration by the l'rorinciul Government. In Madras Presidency and Mysore thus Bureau eunted with trained statistician in charge before the recommendation of the Board 193 mnade In other Provinces and States the resolution has not so far been ir pleinunted. • The desire erpieced by the Board that Provincial and State Busernnients should collaborate to the fullest possible extent with the Central Coseniunt's Public Ilealth Department in respect of epidermological and other stal stal.; tical info-ination has met with an excellent response from Gorenments sil over the country. Before this resolution ras paaged Provincial Government

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·Det 82 For the purpose of drawing valid conclusions there should be a preliminary bealth survey before prohibition starts in any area and periodical surveys at subsequent dates This is possible only if new areas are brought under prohibition. Prohibition started in certain Provinces when Congress Governments were in power and after the resignation of the Congress ministries no ares have been brought under prohibition. Prohibition is a highly controversial subject and an all-planned and imperfectly performed survey is likely to do more harm than good. The Board therefore agreed at their fourth meeting that, under existing conditions, it is not desirable to issue instructions to the Provinces concerned for carrying out health surveys of the inhabitants of the prohibition areas. Endemic Fluorosis At the suggestion of the Minister for Public Health in Madras that the problem associated with the presence of tluorine in water supplies was one suitable for investigation it was recommended by the Board that the PTO. vinces concerned should make such investigations and present the results. Two interesting reports submitted by the Governments of Madras and the Punjab were discussed by the Board at its third ineeting and three resolutions Kere pussed, the first tio relating to the Provinces of Madras and the Punjab respectively and the third relating to all other Provinces. To the Government of Madras it was suggested that steps should be taken to improve the nutrition of the people in the affected areas and that further research into the problem of cheap methods of removing fuorides in drinking water supplies under rural conditions should be carried out. Further work on this subject which has been reported from Madras does not include the special lines of action su gested by the Board. As regards the l'unjab the Board drew attention to the desirability of field 19vestigations regarding the prevalence of endemic fluorosis in those bere the drinking water supplies contain a lorge proportion of fluorides. IC was also suggested that this study might take into consuleration the diet ol the people of the affected areas and its bearing on the incidence of the disease. Upto the 14th May, 1911, 448 samples of waters from different sources in 27 of the 20 jistncts in the Punjab have been examined. The samples came froin 05 localities in those districts and of the total 89 gamples were from Kasur in Lahore district. In every case, the estimation of Quorine content was carried out by Sanchi's inethod as modified by Dr. C. G, Pandit, Director, King Insutute, Guinds The concentration of fluorine is higher than one part per million in 33 of tbe 25 localities from which samples were taken: In only one of these localities, ir Kasur it is definitely known that the condition of mottled enamel is endemic. JIcre the amounts of fluorine present in the water varied from 0 0 to 5.0 parts per million In waters from other centres, namely, Rohtak, Gambar in Montgomery district, Valahhel in Januali datrict and Chak Vo 143 in Lally ur district amounts higher than those found, i.e., 08, 6.0. 6.0 and 6 8 parts per million. Yo intonination is available as to whether in these and other centres from ul's water containing relatively bish concentrations of flourine were obtain. «4. testirations were esnied out to determine the prevalence or absence of !.tile enamel. It is !!! tba: the insestigatior's so far carried out surgest that I'ctintc! ha! sell waters higher than that o! deep well waters I! this should proru correct the policy in this Prince of frF!.wrl's by deep tube-cells, which is stated to be in progress, 1.6.11 medle any positie darges of endemic fuoris. To..cite: Porinera i! #31 recommended that it fluorosis constitutes a Eraldir!'-!. intestirations et coll be purtud on similar lines. areas were

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·service to in Cages available examinations are done in the Governgient Chemico-Bacteriological Luboratory at Karachi In addition all saipples sent to this laboratory from Government aided hospitals and dispensaries are examined free, In the case of local bodies the prst five sainples are elmoed free and subsequent samples at a charge of He 1 per sample. The Sind Goserument have also extended the facilities of this laboratory to Khairpur State for the examination of speci. mens from cases of infectious disease The United Provinces Gosernment are stated to be examining the possibility of utilising existing laboratory facilities at headquarters of districts In connection with the A.R.P., pathological laboratories have been opened at Benares, Cawnpore, Allahabad. Lucknow and Meerut It is not stated whether these are offering facilities to general practitioners and to doctors in charge of hospitals and dispensaries for the dugriosis of infectious disease In Bihar the Government, while acceptmg the principle of establishing labor:itories at suitable centres, have so far con. fired action to the examination of a proposal for establishing a laboratory at Ranch In Bombay the Haftkine Institute provides free laboratory private practitioners suspected of enteric fever and this concession has now been extended to clinical material from caseg of other infectious diseases In Vorth Il'est Frontier Province a Prosimual laborators exists at Peshawar and small laboratories in each district head- Quarter hospital At these examination of material sent by Government medical officers is done free of bars In Delhi Prorince all specimens from 6964 of infectious disease are examined free at the Provincial laboratory 1. Vadros Presidency, in addition to the King Institute. Guindy, two regional laboratory here been upeced at the Purskine Hospital, Madura, and at the Adlira Medical College Vizagpatam respectively Examioation of speci. mens submitted by niedical practitioners is done on payınent of the prescribed foo In the Central Prorinces laboratories were recently established at Amraoti and Raipur and the Provincial establishing fully equipped labor They are ako cominending to four of the laboratories under their respect tinctepong?*> In Onsta laboratory facilities of varying standarda ol efficiency exist in the I'mvincial Pathological & Public Health Laborntory, in the district Headquarter hospitals, in most of the sub livisional hospitals and even in a few rural dispersaries In youre laboratory facilities exist in the cities o! Bangalore and Mysore in Kolse Goli Fields and nt the headquarter o! districts In Nanti Central laboratory erist at hich crammination of c!ical material froin case4 of infectmus disease is carried out free of charge In forsm and Hyderabad the rubject 13 under conudention by the respectiva Garennents In Dentil it has bern deruled to postpone the consideration of the schere until the war emeprenev is wort while in the Punjab it has not teen mysit! s fotos!* *Put ( tlie pesolution nl the Dogni. of small o trained r . Bid Hosts 10 OTTOTdtag on Tuberculosis on The D1 del a: 1. tsi turcir; twi) Pteranil. submitted by the Tutes. Asistido!!!...the ot the Central Advienry Board c! Heath respective! catre-ct o!!! bouink and overcrowding T B, sed puin.lston points et the necessity for imitetas)....!!! cle:"; "9":1** aril ningrated areas in omnis in cities an!!rte mit 15 o! ***** pripits orre new Fausing acheme. cathe elementors liv!!... ! Te-1 of Botir hreitas. Av denne alrtna in c.3*2*** and the metalliskiriant of irod inzerning 3: Trin's :'»* -! replica online that apart frizure ! b.!!:: bolin TiT 1..!'. Ein ter 12 Siamo! N!:; the pelqha u do

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·service to in #vailable evtmın itions are done in the Giovernment Chemico-Dacturiological Laboratory ni Rischi Jou get all implie Rupit t') the litoratory Stumn Goverinent aided longitale mid despoil 15* are runner free In the case of local bodies the first inte imples are read trees auped gulose peent sumpies nt a charge of lie I per ample 11. Simul fuserntent he also extended the facilities of the laboratory to Thurpur State for the cenuntion of speci. Inens froni (Japan of infertils div> Prir alle I'rovine (isemment are stated to be examine the possibility of utilog criating laboratory facilities at beudquarters of ditipicta 111 contrition with the A.R.T. pathological Inborinney have been up Bed at Benitna, Cappu. Allsliabsd. Lucknow and Jerrut It is not to whetlus tlome are offering facilities lo general practitioners and to ditory 1!! charge of hospitals and dispensaries for the dugiosny of mfantjons die 131 in Mihrer the topirninent, while acceptmg the principle of rutablisluna iuboritorit utile centres, but so far cou. fit ed action to the examuuntain of a promul for estahlishing a laboratory at Ranclui In Bombas the Traithin Institut provides frce laboratory priate practitioners u perte! C1149 of enteric lever and this concr91011 has How been extended clinical material from cases of otlı mfect1114 lige 14 In Vorth Il'est Frontier Province a Provincial laborator eristy at Penawar und km 111 laboratories in each doutrict heid. quarter hospital It these eraminntinn of material ment by (oreriumcat mrdical officers 19 done free of ,harge In Delhi Province all specimens from cases of infectious disease are etamined free it the Provincial laboratory In Madras Presidency in naddition to the King Institute, Gundy, two regional laboratories have been opered at the Prskine Hospital. Vadura, and at the Ardhra Medical College Vizo sapatam rcpectively Pxomination of speci: mens submitted by medical practitioners is one on payment of the prescnbed too. In the Central Provinces laboratones were recently ustablished at Amraoti and Raipur and the Provincial Government are considering the possibility ol establishing fully equipped laboratones at Nagpur and Jubbulpore Thay sa also commending to four of the larger municipalities the establishment of small laboratories under their respective health officers, who are said to be trained bacteriologists In Onssa laboratory facilities of varring standards of efficiency exist in the Provincial Pathological & Public Health Laboratory, in the district hendquarter hospitals, in most of the sub-divisional bospitals and oren in a fen rural dispensaries In Mysorc laboratory facilities exist the cities Bangalore and Mysore, in Kolar Gold Fields and nt the headquarters districts In Baroda a Central laboratory exists at which eramination clinical material from cases of infectious disease is carried out free of charge In Assam and Hyderabad the subject is under consideration by the respectiv Governments. In Bengal it has been decided to postpone the consideration o tho scheme until the war emergency is vrer wuin in the Punjab it-tras no been possible so far to give effect to the resolution of the Board. in 0 0 0 Ifect of Bad Housing and Overcrowding oa Tuberculosis or The Boord discussed at its third meeting two memoranda submitted by the Tetereulosis , Association of India, and the office of the Central Advisory Boari of Health respectively on the effect of bad housing and overcrowding tuberculosis. The Board passed a resolution pointing out the necessity fo: improvement of housing by clearing insanitary and congested areas in town! and cities and for the exercise of rigorous control over new housing scheme: on the cleared slum are.rs, by the strict enforcement of building bye-laws. Any definite adrance in slum clearance and the establishment of improved housing conditions must necessarily be slow and the replies indicate that npart from generl instructions to municipalities and other local bodies for the en. forcement of building bye-laws, very little has been done by the Provinces the and States concemed. A briet indication is give 'ng paragraphs regarding the united action which has bee

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·BR replies receired from the Goreraments is not materially different from the conclusions reached by the Committee in their report which is quoted below -- "While the general situatiou on paper gound: satisfactory tbe lost standards cf personal and environmental hygiene met with in many schools are such . to forbid an easy acceptance t1120 all a well Than low standards lead to the conclusion that something 13 kmong sith the content of the sylla. buses and the methods of teaching hygiene broth in training institutions for teachers and in schools for children" Improvement of tho Teaching of ygiene and Public IIealth in Medical Colleges and Schools At the spaugural meeting of the Central Adrisury Board of Iloalth in June, 1937, the Bunt Idopted a rolution ruling the attention of Ciovernments of the Provincial Medical Councils and of the sledical Council of India to the Decenti fryruptusehent ! the time of digtet til public health ny pure of the medical colleges and schools' curriculs for medical qualification and registration A copy of the resolution was forwarded to the Secretary, Medı. cal Council of Indis, and to Provincial Gioieraments for the information of the Provincial Medical Councils The Medical Council of India obtained from the duttorent Unrersities, aluse qu ilitications uro meluded in the First Schedule of the Indian Medical Council Act, 1933, details regarding the instructioa given aod examinations held in the subjects of hygiene and public health as well as suggestions for improving the tenching of these subjects The replies recened from the Universities were wunmed sub-committee constig of Colonel J. As llulliga, IMS, Nate Balludur 1), 1). 1). Pandgu anul the Public Health Commissioner with the (lovernment of India, At their meeting held on 26/27th August 1940 the Executive Committee of the Medical Council of India, after considering the information given by the Universities and the remarks of the sub-committee, resolved "that the information collected should be forn arded to the Inspector appointed to inspect the examination and courses of instruction in the subjects of hygiene and public liealth and he will be requested to take notes regarding the development of health museums in various Universit es as well as to draif the attention of the authorities to the importance of the preventive aspect of medicine throughout the medical curriculum to which attention has been drawn in the Council's re comuniendation on provisional education No II(3) 2." Pecommendation No. II(3) of the recommendations of the Medical Cour cil of India reads as follows.. "That throughout the whole period of study the attention of the studen should be directed by his teachers to the importance of the preventive aspect of medicine and of measures for the assessment and maintenance of noring health" Licut -Colonel A. C Chatterjee, IJS, and Rai Bahadur D. D Pandy: were appointed as Inspectors and they carried out their inspection of the different Universities during the years 1940 and 1941. The inspection report: which contain various suggestions for improving the courses have been for Hardca to the Universities concerned by the Medical Council of India Opium Addiction and its Control in Assam Two reports on this subject by the Government of Aggam and by the Director, School of Tropical Medicine, Calcutta, respectively were discussed by the Board at its third meeting in July 1940 The Board recommended that copies of these reports should be circulated to all Provincial and State This lias been done. The Government of Assam bave now suspended the scheme. Hospitalisation and Treatment of Plague cases The Board discussed at its thiril meeting a scheme for the hospitalisation *** trentment of plague cases submitted by the Government of Madras and Governments ·The purpose inent sliould control the production of quinine in sirn! ,,, 87 commended it to the earnest consider ition of all (overnments *as to afford opportunities for the tield testing of the value of an anti-plague ferum manufactured at the Haffkine Institute Poinbay, and of sulphapyridine and sulphathiazole in the treatine int ni plugin Such trial bare so far been caried out on proper lines in th: 1. ttiah Rund 1: Bihar and at Latur in Hyderabad State The results obtained show that all the three forms of treatment produce a definite reduction in the case mortality rate of plague as compared with ordinary simptomatic treatment and the trials at Latur indicate that, of the three, sulphathuole appears to be the best For vanous reasons, such as the absence of plague or the cost of the scheme, other Governments have not pruel portunities for the experiment The reply from the Governinent of Madr is shous that provision has been made for such a trial in Hoon Tiluk of Salem distrut during 1943-14 Quinine Supplios in India As regards the resolutions on guinne supplies in India which were passed at the first meeting of the Board the enqury regarding cinchona cultivation which was proposed by the Indian Research Fund Association was carried out by Mr Wilson Deputy Director of Agriculture, Cinchona, Madras, and Dr. T. J Mirchandani Agriculturul (hemist, Bihar Government, and a report on the prospects of cinchonu cultivation in India was published as Miscellaneous Bulletin No 29 by the Imperial Council of Agricultural Research. The report was forwarded to Provincial Governments The other resolutiong dealt with. making India self-sufficient in the matter of quinine, the reduction of its price, control by the Central Gorernment of production, distribution and sale ani propaganda amongst the people on the value of the druy It is understood that the Bengal Gusernment have expanded their riprionin pluutations and are now producing about 60,000 llis a year. The Malrus (joyer. ment were unable to commit themselves to a large expansion programmes owinny to the capital cxpenditure insolved and the possibility of this dixcurry 4 chcap substitute for quinine but were prepared to work towards shumica e prince of self-sufficiency provided the Government of India guarnsterol # mwa belling price and an assured market Oning to the war hve further insya could be made in regard to these pmposals Wen Juvi won buy the Japanese steps were taken to bring as large on greu un frases short period method of production under which quinine casi 34 gears as compared with the normal period of alsout 7 years luve been made for 1,500 acres to be brought under this mortem otomoden. It is expected that at larut men, of total alkaloids will be obtained from this method of prodigreoms, 1:45.45 No action has been taken in regard to the proposal thint th. I'mon, ..... one of the producing Provinces, The position in regard to the price at which unchanged.

·88 The replies from the Provinces of the United Provinces, Punjab, Bihar, Delbı, Assam and the Central Provinces show thnt under existing conditions it will not be possible to forinulate programmes for implementing these recom- Inendations The replies of the Governments of Jadras and Bengal refer to their rural water suppls schemes which have been described in the memoranduin entitled "Water Supplies in Rural Arene" which was discussed at the fourth meeting of the Board in Bombay Presidency. In 1011. 12. 1919-43 and 1913-44 a provision of about Rs. 15 Inkhs each year was made in the budget for rural water supplies In 1937-38 a provision of its 10 lithhs had been made for the same purpose In the same way budget allotments were inade during the years 1938-39, 1939.40 and 1940-41 but the amounts allotted hare not been stated. Instructions Jave been issued for the investigation of urgent wnter supply schemes and the question of maintenance a regard to sillage water supplies is also said to be under consideration In Hyderabad State there in Well-Sinking Department with a Special Officer at its bend for the development of rural water supplies This Depart. mnent investigates the question of water scarcity as well as the extent of guinea-worm infection, and constructs neu wells besides remodelling step wells into draw wells The original annual grant of Rs. 35 lakhs was raised to Rs 5 lakhs in 1939 and 1940 and further increasell to Rs. 8 Inkhs from 1911 onwards The total expenditure by thug Department upto 1942 is about Rs 62 67 lakhs The Government of Mysore formed a rural water supply fund with the purpose of providing every village in the State with proper drinking water wells within five years District Committees have been formed in order to work out details for individual districts Recominendations regarding echnical details of the scheme are under consideration by Government. All-Iadla Nursing Copneu The Central Advisory Board of Health recommended at its fourth meeting chat the Central Government should consider the constitution at a very early cate of a Centrul Nursing Council in order to co-ordinate the activities of the I'rovincial Nursing Councils and to advise on nursing problems of common interest to all Provinces, to establish uniform standards of preliminary education for admission to schools of nursing; to arrange for supervising the courses of trammg and for insperting the conduct the examinations prescribed by the various Councils and other examming bodies throughout British India; to maintain a schedule of nursing qualifications recognised for interprovincial reci. prosity of registration and to arrange for reciprocal registration with authorities in countries and States outside British India. This recommendation of the Board was submitted to the Government of India, and in examining the proposal the Government of India in the Education, Health and Lands Department pointed out that legislation to set up a Central Nursing Council could only be proceeded with in consultation with Provincial Governments and that it would be difficult to ask them to under. take this work at the present time. It was accordingly suggested that a more profitable line of approach would be to consider whether a non-statutory body representative of the nursing profession could not be to consider and advise on problems relating to demobilisation, the recommendations of which may be conveniently passed on to the Provincial Governments and Nursing Councils. This suggestion was considered both sound and welcome because such a non-statutory body could be set up without much delay and could help to coordinate the views of provincial aursing councils, while the experience gained in the interim period would be most valuable when considering details for the final draft of the Bill to constitute an All-India Nursing Council. Accordingly the formation of a Nursing Advisory Committee with the following personnel has been suggested :-- Director General, Indian Medical Service (Chairman). Nenibers. Chief Lady Superintendent, Office of Director General, Indian Medical Ser: set up co ·1 ezist at present; en- 89 Chief Principal Vatron, Medical Directorite, One representatre from each statutory Sursing Council 'Three registered melical practitioners, and Three registered nurses nominated by the Governor General in Council This proposal is at present being examined by the Gorernment of India. Zoning of Industrial Areas The Central Advisory Board of Health at its fourth meeting in January 1942 discussed the problem of zoning of industrial areas and recommended to Provin. cial and State Government- astion on the following lines - (1) the passing of Town Planning Acts wherever such legislation does not (2) the appointment of & Director of Town Planning in order that expert device may be rivent line of authorities regarlmg schemes, and (3) the appointuent ut tiedusur oummittee at the beadquarters of each Trounce Stati the illelt wuch wall in lude the Director of Public Health, the Director of Town Planning and the Sanitary Engineer to Govern. mr.ct in might when ne lushi thi Diruitor of Industries, it representative of commerce or industry and the Chief Inspector of Factories Town Planning Acts exist in the Provinces of Sind, Bombay, Madrag, Punjab, and the United Provinces It is stated that in Bihar and in Bengal such legislation will be undertaken only after the war In Delhi Province the actment of a Town Planning Act not considered necessary because the Delhi Improrement Trust has been taking action for the relief of congestion in overcron ded areas through slum clearance schemes It has also in hand scheme for the provision of a suitable areu in which all future large scale industrial development would be located The New Delhi area is administered on the lines laid down by the original town planners of the new capital under the guidance of Sir Edwin Luttyens. In the Punjab the existing Town Planning legislation applics only to urban areas but steps are being taken to amend the District Boards Act so as to enable planning in rural areas also the drafting of a Toxu 1b.xnuung Bill us atated to be under the consideration of a committee consisting of the Director of Public Health, the Director of Town Planning and the Chief Engineer The replies from other Provinces and States do not state that a Town Planning Act is under contemplation. Town planning officers have been appointed in the Provinces of Madras and the Punjab as well ns in Mysore State. In Sind, it is stated that thero is a Consulting Surveyor to the Gost of Sind who gives adrice to local bodies whenever they refer questions to him, The proposed committee at each prosincia) or State headquarters to offer technical advice to (iont, and to local authorities and to industrial concenis re- Barong housing scheines lins not been set up in an I'movince of State. The replies from the Provinces of Madras, Punjab and Sind specifically state that it has not been considera necessity to att up a committee of the Liri propwed. Mosquito Control in Rural Areas The problem of controlling, rural mularin in particulurly important in India because the incidence of the dincane in the rural areas a definitely higher than Morcover, in the former the population is reattere that in urban centres over immense areas and there are usually line number of mater prile cuoni :1.3% which afford farourable breeiling places for mularus cm1 ronquiters, During me!!! making the institution of control menci'NS CRmls d*cult rears considerable success in the entrol of mularis rideries in rural areas bee been attained hr the spmrin e nelloost mith | Teirum is seeing The Central Advisory Bosc! Health ?! in order to kill adult mosquito its fourth meeting in January, 1942, discurund a tremendum hinh Director of the Valaria Institute o! India mattis ulicet onder that tion of Gorts to the desirabilits el emploring the medical love metri. The Bont als printed In Mysoro effectively epidemics of malaria in rural arras.

·WIS that, while pyrethrum has been successfully bronn in Kashımır, in certain parts of the Punjab and North West Frontier l'rovnice, in the Nilgiris, Palni sud Cardamom Hills in South India, Gorernments should undertake to extend its cultivation in the areas where it is known to tlou119) and that they should also explore the possibility of cultivating it in other places. The discussion of this subject by the Central Advisory Board of Health and the success achieved by the use of ting method of malarta control in limited areas such as in Delhi Prorince hard no doubt helped to arouge interest in the spray-kıllıng of adult mosquitoes. As regards Delli Province the Chief Health Officer reports that "the rural population have taken kindly to it and that those who can afford it are willing to spend money and carry it out themselves As an instance of wwler interest among Provincial Public Health Departments in this inethod of control may be inentioned the fact that the demands from these Departments for supplies of pyrethrum extract during 1943, for civil use have been more than double the quantity trey obtained during 1942 The areas in which the cultivation of pyrethrum is being carried out have already been indicated The replies shor that experiments regarding its cultivation are also being made in Coorg, in Baluchistan, the United Provinces and Bengal It is reported from the Central Provinces that a small experiment carried out in which a pyrethrum extract was prepared locally by using kerosene oil on chopped perethrum flowers and this insecticide ras used for the spray. killing of adult mosquitoes in a small foreat village The experiment was on 80 Inall a scale that a more extended trial should be made before conclusions are drain regarding its effectivenesa Compulsory Revaccination against Smallpox In 1932 the Government of Madras made revaccination compulsory at interrals of 10 years for all persons living in the Prorince outside the City of Madras In Madras city this las sag introduced only in 1936, the interval between successive vaccinations being fired at 7 years The success achieved in the reduction of smallpox incidence was so conspicuous that, at the instance of the Goreinment of Madras, the subject of making revaccination compulsory was discussed by the Central Advisory Board of Health at its fourth meeting in January 1942 The Board expressed the view that Governments should intro- (luce such measures as miglit be necessary to make it possible to enforce the periodical revaccination of the population and thus make a determined effort 10 reduce the incidence of smallpox. Tlie period which has elapsed since the Provincial Governments received the opinion of the Board is short and the replies from the Provinces and States sliow that the Board's recommendation has not so far been carried into effect. The Gororntents of the United Provinces, Bihar, Bombay and Bengal state that the question will not be considered for the period of the war. Assam does not consider it necessary to make revaccination compulsory while, in the Cen. tral Provinces, the view held is that resort to compulsory revaccination R not desirable before primary vaccination is made compulsory throughout the province In the Punjah 1 bill is being drafted for making primary vaccination compulsory throughout the Province and for enabling local bodies to make reracuination compulsory at prescribed intervals In Orissa the vaccination lans prevalent in the Northern and Southern parts of the Province are different and in the mufied Vnecination Act that is under consideration, provision will be made for the enforcernent of compulsory revaccination. In Hyderabad Stato e Vnecination 13:11, which is under consideration by Gorerament contains provision for compulsory revaccination The Inclusion of more detailed Information in Public Realth Reports regarding the Administration of Sanitary Law in Urban Areas The Gorernment of the United Provinces submitted a memorandum to the Central Advisory Board of Health at its fourth meeting indicating the lines on ·91 which more detailed information regarding the cxisting sanitars defects and the measures taken to remmede them in urban crntres con hon incorporate in Provincial Public Health Reports The Bond monmoingan liat as fr.: possible, the suggestions contained in the meinoranduzi should be adopted lis the Governments of Provinces and States The Provinces of Assam Ons he und Sinnt as well as the State of Hyderabad, Baroda and Jodhpur bove accepted the recommendation of the Board The Government of Madras 12 and to the inclusion of such strane of information as would be useful and could, at the same time. be collected without a great deal of trouble In the Central P'rosince the decision Tearlieci is that the inclusion of all the suggested items of information subordon for oue rear as an experimental MSHITE tlint this dression will lor subject to alteration m the light of the dificultate prehneoil in mlecting compiling and publt-hing this additional informintion In Bengal the matter under consi. deration, while in the Punjab Imter Provinces ud Bombat the inclusion of euch information will not be done durmg the period of the war Prevention of Persons suffering from Infectious Diseases from Travelling la Public Conveyance Anteinent on this subject has been circulated to all the members as agenda iten. ) : for the fifth meeting of the Board Expenments carried out in Trichinopoly for Chionnating Water Supplies with Minimal Doses of Chloride At the second meeting of the Board in January 1913 the Minister for Public Health in Mudros referred to certam experiments conducted under the supe: vision of the Director, King Institute, Guinds, for chlorinating water supplies with numal doses of chlorine He also promised to send to the Secretary of the Board a note on the subject. Tlus note was received, 1,000 copies of it were priuted and there were distributed to the Governments of Provinces and States Only three replies have been recensed regarding the action taken by the res. pective Governinents In Sind cuples of the note were supplied to the medical other of bealth of Karaclu lyderabad, Sulkur and Shukarpur Municipalities, in the limited Pruunens to the Medical Officer in Charge of the Provincial IIgiene Institute and the Superintending Engineer of the Public Tealth. De. partswat and in Madma to the Sanitary. Lagineer, the Director of Public Health and the Director, King Institute, Guindy. Distribution of Icalth Literature by the Central Advisory Board of Health . The Scoredity of the Central Advisory Board of Health lias, within the post for rent.creuiated 19 the Provincial and State Governments as well y los theer Directors of lulila Health copes of seruus forms of literature dealing with health subjects Ilist of the innterial so far distributed is gisen ·+ 8 Report on the I'rospects of (inchon ('ultivation in Inelia hy vr A. Wilson, Dy Director of Agriculture, Cinchona, Valras 9. A note on "The sterilization of drinking water with minimal doses of chlorine" by the Director, King Institute, Guindy. 10 Model rules for meat inspection and for the inspection of slaughter houses. 11 Technical directions concerning the House Improvement Scheme of the Plague Control Service of the Netherlands Indian l'ublic Health Service. 12 Report on Tuberculosis in Burma, by Colonel S Lyle Cummins, C.B , OMG, MD., LLD, AVS (Retd.) 13 Posters on "Vegetable' and 'Teeth" issued by the Health Othcer, New Delhi 14 Pamphlet issued by the Chef Health Other, Delhi, contuning instructions in Urdu to peasants for the growing of fresh vegetable. 15 Type denigns of rat proof godowns constructed ut Ootac mund and Salem and of rat proof hut constructed in t'umbum Valley, Madura, Jadras. 16 League of Nations document No (H 1401 {C} Com Fxp. Alim! 50(2)], anted March, 1932——"Guiling principles for studies on the nutrition of populations", by Dr E. J Bigwood, Professor at the Untversity of Brussels, issued by the Technical Commission of the Health Organisation. 17 League of Nations European Conference on rural life 1039_-Technical docuinentation General Survey of medico-social Policy in rural areas, prepared under the auspices of the Health Committee 18 League of Nations publication "New technical efforts towards a better nutrition, Geneva, 1938" 19 League of Nations publication "World Health and the League, 1939". 20 League of Nations European Conference on Rural Life 1933-Technical documentation--Population and agriculture with special reference to agricultural overpopulation-Contribution by the International Institute of Agriculture (Document No 1) 21 League of Nations Euroneon Conference on Rural Life 1939--Technical documentation--Land reclamation and improvement in Europe, contribution by the International Institute of Agriculture (Document No. 4) 22 League of Nations European Conference on Rural Life 1939-General technical documentation-Sickness insurance and rural inedical assistance, prepared by the International Labour Office. 23. League of Nations European Conference on Rurnl Life 1939—General technical documentation-Nural housing and planning-Report prepared under the auspices of the Health Committee. 24. League of Nations European Conference on Rural Life 1939—General technical documentation --Recreation in rural areas-Report prepared by the International Labour Offica., 25 League of Nations European Conference on Rural Life 1939General technicul documentation-Intellectual aspects of rural life, prepared by the International Institute of Intellectual Co-operation. 26. League of Nations European Conference on Rural Life 1939 - General technical documentation-Co-operative action in rural lifo, Surrey prepared by - the Co-operation Service of the International Labour Office 27. League of Nations European Conference on Rural Life-General technical documentation-Rural dietaries in Europe-Annex. Report on bread. Report prepared under the auspices of the Health Committee. 28 Document No. II ---Economic and Financial, 1939, II-A. 2- Urban and Rural Housing 29. Annual report on the results of radiotherapy in cancer of the uterine cersis-third volume-Statts: of results obtained in 1932 and previous years (collated in 1038). 30 League of Nations document "The aims and organisation of museums of schools of Hygiene" by Prof. Pranenitz ·93 31. Health Bulletin do 27-Report of an enquiry into le causes of menul mortality in Calcutta, by Dr I 1. Seal Edwards, D., W.M.S.. haplessor of Maternity und Child Welfare, All-India Institute of Hygiene and Pubi.. Health, Calcutta 32 Health Bulletin No 29-Rice 33 Revised and enlarged edition of flealth Bulletin So 23–The Nutritira value of Indian Foods and the planning of satisfactory diets 31 Health Bullelip Xu I (revved edition)--Tookworin infection in India with potes on crmptoms trentinent and prophelaus lor p Maplestone, D.SO, DSc, MBBS, DTA & S and A K Mukerjee, JB 35 Health Bulletin to, i reused edition)- Dracontianis or guinegworm disease by P A Maplestime. DSO. D Sc MBBS, DT.M & Sand Sundar Rao, LMP 36 Fourth edition of Health Bulletin No 14–Molaria Bureau So 0-How to do a Malaria Surses reused by Lt.Col G Corell, IMS 37. Second edition of Health Bulletin No 1B-Valana Bureau No. 9- A Practical course for students of malarıology, revised by Dr I M. Puri, M Sc.. PhD, FRES 38 Health Bulletin No 21 (revised edition)- A note on hydrocyanic acid gas fumigation of rat burrows as an anti-plague measure, by Lt -Col W. J. Webster, MS IMS 39 Revised edition nf Health Bulletin No 13-Instructions for collecting and forwarding mosquitoes by Dr I M Puri 40 Memo on water sterilisation Chlorination and dechlorination. 41 Establishment of Inboratories at suitable centres for the free examina. tion of clinical material from cases of infectious disease Note by Col H Stott, O BE, VAS IMS Inspector General of Civil Hospitals, Bihar. 42 Radio talks on dicteties br MT A K Sundnrnjan. 43 Vysore Department of Health Education A short note on the working of the Bureau of Fealth Education 44 Intiuence of environment on the incidence of tuberculosis. Paper read by Lt. Col Cotter, IMS, at the 2nd Tuberculosis Workers' Conference, 1940 45 Health Bulletin No 11-Anti-mosquito measures with special reference to India, by I. -Col G Covell. I.M.S., Director, Malaria Institute of India (Fifth edition) 40 Health Bulletin No 16-Synoptic tables for the identification of the full-grown larvae of the Indian Anopheline Mosquitoes, by Dr. I. Ar. Puri. Entomologist, Malaria Institute of India, IV edition. 47. Healti Bulletin No 23-The Nutritive value of Indian foods and the planning of satisfactors dietsThird edition, revised and enlarged, 1041. 48 Tealth. Bulletin No. 2-Report on an investigation into the of internal mortality in the city of Bombay. by Dr. Jhirud, M.D.. B.S. 249. 'Flealth Bulletin No. 30—"Food and diet" (sritten for children)-by Dr. IV. R. Aflrord, A.D. *ŠO Healtli Bulletin No. 91The Home frequenting flies, their relation to diseases and their control-bs Dr. I. M. Puri 51. Pamphlet on 'Yellor Ferer'. 52. Yellow Ferer Diagnostic Chart 55. Report on the Medical Inspection o! School children and the most ima of Isciene in Schools her the Joint Committee aspintel lit the Contra! Adria sory Board of Health and the contra Adrier, m?..! Tungtion (1991 Report on Termes and its comm! in India ho the Committen primer his the Central Adrisort Ragni o! Tiralt! (1911) CAU seu (lond ).

·APPENDIX IX. (AGENDA ITEY No. 11) Memorandum by the Director-General, Indian Medical Service, on the Dovelopment of the Narsing Services in India and the appointment of a Director of Nursing Services in the Medical Departments of Provinces and States in Lodia. ROLE OF THE NURSE. The success of the work of the medical profession depends to a very large extent on an adequate supply of tramed nurses. The role of the doctor is to prescribe treatment, and m specual circumstances to carry it out, but the hour to hour care of the patient on which lus confort, looth physical and mental -depende, devolves on the nurse The value of skilled cure by a competent nurse would be difcult to exaggerate, the final issue, recovery or death, is not infrequently determined by the quality of the nursing services provided; but apart from this, the relief which sympathetic and skilful ate can give to the suffering and anxiety of the patient is a matter of no small moment to the course of his disease. per burses. attennurse. 7 13 SHORTAGE ur Versts In the "Indian Medical Review" published in 1939 figures are given showing the number of hospital beds available in India and the staffing of the bospitals The following table summarises the position : Hospital beds and staff in British India. Bels Beds Total Trained Untraine (Vd-wivos. Total рег beds. staff staff, train.d dant. JIospitals with 81,488 3,259 3,617 565 7,341 20 bods And over. Hospitals with 14,105 743 53 82 878 16 19 less than 20 beds. 65,683 4,002 | 3,570 847 8,219 Calculated on the reasonable though not ideal basis of one nurse for four Veds, the number of uurses required for 65,683 beds is 16,420 cr almost double the number now urnployed. Replies to a questionnaire on Nursing sued in 1942 show that the position has not materially changed. While individual hospitals in each province have experienced 110 difficulty lo securing trained nurses in adequate numbers, the majority of the replies, 74 out of 102, state that there is a shortage of trained nurses for cuul bospitals. The difficulties encountered in stufting military hospitals and the creation of an auxiliary nursing service are an additional index of the present shortage The inauguration, during wur-time, of post-graduate training courses for sister tutors and hospital nursing administrators at the Lady Reading Health School, Delhi, emphasines the urgency which the Government of India attach to schemes for improving both the quality and quantity of the nursing services avuilable, progressie hospital polies, with more beds, improved standards of service and treatment, and better working conditions in hospitals is to be expected after the war and will create a stil tenter demand for nurses in the not far distant future.

·95 From statistical evidence alone it ciip be definitely concluded that there is a serious shortage of nurse l'urther the replies to the questionnaire on Nursing şire eridence that the nuruly staff is only inaintained at the present low lerel bs the acceptance of candidates who are not up to the educational standard desirable. CONDITIONS OF SERVICE. Ibe shortage of nurips Ik closely linked with the conditions under which the nurses live and very Hospitals atr maintained by a variety of local nutho- Tities and private bodies and there is no untiurmity in the scales of pay and allowances or in the hours of work The accommodation und messing arrangements provided for the nursing staff difl'r wadek Long hours, uncomfortable quarters, indifferent food and lou saluries Inay, however, weigh less with the Prospective recruit than the lach of facilities for social life Unduly severe discipline in the wards, restrictions on the nurses' liberty of action during off dute hours, or las arrangements for her protection and security of tenure are additional deterrants to recrutment The mum total of the conditions of life and work of the nurse determine the status of the profession in the eyes of the public and the present lou status of the nursing profession in India is undoubtedly a basic cause of the shortage of nurses. IMPROVEMEXT IN THE CONDITIONS OF SERVICE. The staffing of hospitals and the conditions of service of the nurses rests at the moment with a variety of local authonties. The financial resources of these local authorities are limited and nursing service of good quality can only be made available within a reasonable time of additional help is forthcoming from provinent governinent sources Financial and is not the only form of help required The selection and posting of candidates for specialist posts, for general service and for training is a field in which expert opinion would be invaluable to local authorities The knowledge that expert advice was available on the conditions of rervice would do much to promote confidence amongst the nurses and to eliminate many of the obstacles to recruitment. I'ROVINCIAL NURSING Syrvice. The most effective solution to the problein of uding local nuthorities to sinprove the standard of nursing in Indian hospitals and of securing uniformity In the conditions of service would appear to be the creation of n provincial nursing service with a provineun cadre of nurses, in the first instance for the posts above the rank of xtaff nurse or staff muluife and later extending to all Turks. 12iRECTOR OF NULSAG. A necessary concomitant to the establislument of # jirovincial nursing service is the creation of an agency for the funeral adımım-trution of the serie, fur Ile ndministration of government pranto 19-and, for thic orgamsation of nursing education both undergraduate and furtofruduste, for an informatio vertice designed to enlighten umlaumulate local authorities and for the develui de it of the services in an enlerls, coordinated and reliels un ria siner. Until an :1'ncy fpecifically charged with the altern! of nursing is a stablished in each munce, the stimulo of nuring in li dawn licspitals are likely to train lose sting of the hospitals to be insele, cate, rursing education in le dupliazard, luunted and trane serial to the needs to communits and the conditins ? col to le unsttraetise to fulac! rotiocial Vuning is a specialist pression requinr: fr its sur! development, direction to form their stretti". as irreg! knowledge and evperience of the folregina: !! s atonpictive ter and a brond outlar. Onlr : ????,? the regingombrosio con . these conditions and the appointment c! well que desenterian in the medical department o caeh Province and State as Directre con throughout Inila status and education ·Services under the general supersision of the Administrative Medical Officer is recommended for the sound development of the nursing services throughout India In the major provinces a full time appointment will be necessary, in smaller provinces or in the larger provinces until progress has been made with the development of a provincial nursing service, a combined post of Registrar to the Nurses Registration Council and Director of Nursing Services is likely to meet the situation. URGEXCY OF THE PROBLEM, The present emergency has brought bome forcibly to the authorities responsible for the staffing of military hospitals the urgency of taking all possible measures to increase the number of trained nurses and midwives in the country The School of Nursing Administration recently opened by the Government of India will provide an adequately trained teaching staff but if students, both male and female, of good educational qualifications, are to be attracted to the profession, a concurrent improvement in the conditions of nuring service is the inatter of the utmost importance ·97 APPENDIX X (JULSD: ITEN.o. 12, Hemorandum on the United Nations Conference on Food and Agriculture, May 18th to June 3rd, 1943, with reference to its Andings on the subject of Food and Health by Dr. W. R. Aykroyd, Director, Nutrition Research, Indian Research Fund Association, Coonoor, S. India (Delegate to the Conference). The Food Coulere ulerts the lated Jations Conference on l'ood und Agriculture may be called for rburt-$us convened io cousider problems of food pruuuctiou, food diserbution with douture It was not primarily a health conference de beulth and nutrition experts were in a small minority. Severtheless the relation tietween proper ford and bealth was one of the basic ideas underlying its deliberations The slogan “marry health nnd agriculture", which inpressed the Lealue of Nations iu 1935 does not appear in its report but most up the subjeut matter and recommendations are in tune with it. Thu report, signed by the representatives of 44 nations, is thus of importance to public health authorities throughout the world DIET AND TIEALTH The Conference, after referring to the remarkable advance n the science of vurmtion which has taken place dummy the present century, summarised the bearms of the newer knowledge of nutrition on humiin affairs in the following four slntences "] Tlil kul of diet hoxh man requires for health his been established. 2 Investigations in many parts of the world have shown that the diets consumed by the greater part of founku are nutritionally unsatisfactory. 3. Drets huch do not conform with the principles of satisfactory nutrition lead to impaired physical development, ill-health, and untimely death. 4 Through diet a new level of health can be attained, enabling mankind to develop inherited capacities to the fullest extent". Strong statements were made on the subject of nutrition and lealth "Malnutrition ....16 the close and constant companion of poverty, both national and individual l'overty alınost invariably means a poor and insuffi. cient dict and the latter in the innin cause of the disndv.intage of the poor in respict of health, so clearly shora by statistics of disease and mortalits". It was suggested thint the high infant and childhood mortality in many countrios, inchi Iw3, has its ruota in mnlnutrition Diet deficiency reduces tesist. once to various kinds of disease, 1.9. tuberculo-is, and makes consalescence more difficult and prolonged. "There is a close relation between such diseases As booksorn and mnlaria and malnutrition. In the first place, the tronomie etficiency of n population in whirl they are sife is reduced and with it theicapacity to preluce or purchase an udequnte supply of fiel. Seconills, mul. nutrition decreases the power of the individual in earts the burde oi blowj. destroying diseases and impedes lois recose ry when the burien is decreaned or omarna by medical treatment Avious cinl is thus errated.

·99 power to build in every nation a people more fit, inore vigorous, more conpetent; a people with longer, more productive lives, and with more physical and mental stamina than the world has ever kuonn. Such prospects, remote though they may be should serve as a stimulus in undertakig immedinte tasks and overcoming immediate obstacles". "VULNERABLE" GROUPS The Conference laid considerable stress on the need for uproving the diet of various groups in the populatiou u lich ure specially ltable to suffer from the all-effects of malnutrition Among these are pregnant und nursing women, infants, pre-school and school chuldren and adolescents (e g. students). Matermity and child-weltule, school medical muspection and school-feeding schemes are included in the public health sphere and it is the responsibility of public health authorities to encourage their development with special reference to the nutritional side Such development is in general conformity with reports on maternity and child-selfare work in India and the medical inspection of school children which have been accepted and issued by the Central Advisory Board of. Health NATIONAL NUTRITION ORGANIZATIONS One of the formal recommendations was concerned with the establishment in each country of nutrition committees ur organisations which should includeauthorities on health, nutrition, economics and agriculture, together with udinimustiators and consumers' representatives In making this recommenda. tion the Conference tollowed the lead the League of Nations, which before the war had succeeded in bringing into being national nutrition committees. in a number of countries Some of these did sound and useful work It was further advocated that the national committees should exchange information. und experience and that representatives of the committees should meet regularly "to exchange views and to make proposals for any national and international. uction decends to tacilitate the progress of their work" It will be one of the tusks of the permanent organisation created by the Conference to arrange such meetings und in general to act as a link bettyeen national nutrition committees la bu lurge d country as India it would be advantageous of Provincial and State nutritiou committees could be established. Such committees could not, loneter, work effectively unless an expert on nutrition is included among its inernbers The Conference strongly recommended that "a worker workers with specialised trainwg on nutrition should be included in each major public health department. Such workers require adranced traning and wide krouledge of the subject, which can be attained only by special studs and research experience". EDUCATION ON NUTRITION. "Education in putrition is not simply a matter of urging the consumer to follon particular dietary practices. It is necessary to spread know ledge of nutrition throughout the whole community so that it may influence gorernmnental action and all who are in a position to influence the consumer in his choice of food. Those directly concerned with technical problems of nutrition need, of course, a high degree of specialized knowledge In the general instruction of the conimumty, however, emphasis should be laid on certain simple ideas and subjects. A variety of methods for spreading knowledge of nutrition can be emplored. Sunple facts about fool and diet should be taught in all schools. In the case of older cluliren, more extensive instruction may be given, supplemented by courses in home economics or domestic science for girls Children teach their parents, and the education of children helps to sprend knowledge of the subject throughout the country. Houserrires may also be taught directly by home viets or groups instruction. OF ·title Use cau be made ut grauted at www.duv sunn matrial tu tibb ide public about lourl all ult Luc: t. 1 D.) De huutu 1. mbleis, Justers, articles in the daily j'T IT study and wivuttu 11332111t">, educatiunul tlins, 51 dulujiliulse rcuidh, Jeft:21111011s, tabbits. The radio can also be used for this furion lu ceri si iuuntnes community groups can be (ULOUTH u to us nutriz1 questiuls unu cu-operative methods of dealwe uitbs fullt ins Du tuul pirului tion und Wisinabution un a community basis Education ou nutritiuu mu- tulupiled to the crcumstuce's uf each country, and the US OL Uruulu spiests of thie subject sil vary from place to place': XUR1710A AND AGRICULTURAL POLICY Sunce the waith us a commonly by lullueuitu uy the luud it culisumes, agriculturud puling must waistu vli is sclunut ustyment vi tue tuud requires ments of the populations 'Ilus nuplius clusu cullubulution between buaith, outrition shu uyricultural authorities univus balduids ot adequate nutri. son bure been spyruled by nutrition workers, these recountend the amounts of nutrients or quer culs tituents ulcessary to ensule for human beings a biga level of us.wu uuu vitulty, w ou tar as tius cun bu cusured by diet. One of these-bu2 put 201 by the balluwal descaru Councu, L. S. A., w 1943- 15 quuluu ili LLL Louhivule iu pult suu trusluitd now terms of calories, .protuus, mumus, ea , lilu juuus per cupils per year. The National Research Counud sluncem wcaldo esseulully racha una varied diet coutawwag an abuu. dalul uluda, wital, 60, Vestlables de fruits and a rt ut.vely low proportiun vi leikuis--1 do Slundulu ciustly Installing that diawn up w 1930 by iuc Tucu Lussuu ou ulillion vi che league of Nations. Now 11 budou slundu w wypted as the mediule gush ma poor and ill-fed country, the bulk uulluutbu olumluduud caisliub level of diet is su great that the Huu ut the stauduru us i gulve tu national food, agricultural and economo policy is lost. It becomes necessary, tuercture, tu sei uy luvre easily uttupable gouls for purposes of practical nutritive work liecomuudutivus tor mprove ment must be su udjusted as to rule the earsting level of diuts tu u degree wluch as not beyond the bounds of PULLILU, possibility and wlubs, ut all events, mukos it loss rumutu trom the opuloum' stundurd. "With the continued and expandog upplication of science to thie desclopmeut of the world's food resources, lucul mterinediate golls can be gulually aired on the direction of the ultunute objective The first olll' 111 poistamine nutritional polities, is to estimate the average CURSUL of the warmis fuwls by the population concern d, preferatlos un The rough duit ubout food intuito su obtained oliould be chacheut by family ilut -urness. The state of nutrition of the population should be insector that meal and public health workers In this sy the defects 11 the 11a1101. let wul be made nu mirst The adjustment of afirorulural 1211 m pou tu correct the defect, fullour, when the Casting level of dit is a los orie, an "interius cuite olje tive" ?15 desired above must be somet Ofter the fint tint is enough fool, without much Tema for variety 11 quilts Il, Lontit, l'ou.lu frel sin be in de avail. able, and there is the anti spre destre ni tamen, qualitative defits in the dict, , in int sle of protein, vamms, etc. will be very coolerably roluced **"1 culla bass ·mins 100 in themselves of high nutritive value but which may be of importance in that they sacrease the attractiveness of monotonous diets. Vanous traditional methods of preparmg food may have more virtue than modern zutrition workers suspect. "Nutritional and agricultural policies which igriore traditionnl methods of enlivening' monotonous diets may defeat their own ends Such inethods should usually be regarded with respect .. ..... The aim of those whose task it is to secure the improvement of nutution should be to frame their policies so that they are in tune with and can become part of the social tradition". VARIOUS QUESTIONS, The Conterence referred briefly to various other subjects of public health interest Among these are the desirability of minimisag losses of nutrients during the processing of fooil and the "fortification" of foods by vitamins and Vitamin concentrates Recently processes for millmg wheat hare been intro. duced in Canada, Great Britain and the United States of America which have the ctfect of produemg a flour acceptable to the consumer, retainng a high proportion of the vitamins and other nutrients present in the original grano. On the other hand, it is now the general practice in V S A. to enrich refined wheat flour used for bread-making and other purposes by adding to it synthetic vitamins of the B group Oming to the production of synthetic vitamins cheaply on a laige scale. the question of 'fortifying" foods by additional vitais becoming one of great interest and importance The earliest example of successful "fortification" is "vitaminised" margarine, 1.e., margarine to which concentrates of vitaims A and D hare been added to give it a vitamin content equivalent to that of good butter The Conference did not recommend the indiscriminate distribution of synthetic vitamins as a public health procedure After the war, there is likely to be an enormous hoom in the production of synthetic utamins and the place of synthetic vtanuns in public health programmes is a question which must be uppruached cautiously by public health authorities. The Conference remarked that "hunthetic vitamins are of great value in the medical treatment of deficienes «Iedes .d av tre useful for prophylaxis in certain special circunst.net It del that the possibility of producing dried yeast on a large scale m countries in which abundant supplies of sugarcane molasses, or other chenp rourecs of fermentable carbohydrates, are available shouldl recerle careful consideration Cheap preparations of fish liver oil, e.g. shark liser oil, could be proluced in various parts of the workl and widely used to improve the health of children and of others who may need vitamin, and D". In India i small inilustry for the production of shark liter oil has niready been successfully developed The Conference also referred briefly to the control of the advertising of utamı anl fooil fireparations in general. "It is the responsibility of gorern- Inents to ensure that the constimer is not misled as to the content of fools, ritamın proxlucts, food extracts anil other preparntions derired from foodstuffs Regulations shouln be adopted to prorule for correct labelling and to insure that uunerical statements should not be such as to convey the impression that what are really negligible quantities of a nutrient make a significant contribution to human requirements". In conclusion, it may be remarked that the whole trend of the scction of the Conference report conermed with nutrition is to emphasise the growing re-ponsibility of pulilic health suthorities in this field. The movement for better nutrition", the report remarks. "must take place with the full collaboration of public health and agricultural authorities, and the former must ply a prominent part in its guidance" On this point an article* on the Conference written hy Thomas Parran, Surgeon-General, United States Public Teilth Service, may be quoted: * U. 8. Pablin Fisilth Reports, June II, 1943, Y. 24, pago 893. : * hno print for the Comet of lunger."

·IS 101 "Of greatest emancance to the ¡ublic intuito įrcie--jon va the respus- Elulty placed by the Conference of prod u litulihi authorities in the citainment of the world-wide fools touse dietild utntion is linbell on the re hand math public health, on the other with afru ulture It all stages from the recognation of the custolle of mutrition in a community to its tamination, knowledge of the be buri1 thic tiunian body essential. Because they possess and en outre show Inowledge, medical and health administrators bave n primary repabulata in putritual fields Any advance in health through lxctter nutnow!) lewand the full collaboration of public health and a ticultural authoritien 'l he turner will play an important role toth in determining nerds and in odmg the aswable for is tonards the fractical attainment of treedum from home for the picoples of the world". Coonoor, August 9th, 1943 APPENDIX RECOMMENDATIONS OF TIL CUS FERFLF CONCERNED WITH VUTRITION The final Plenary Se-sin ras held on June 3, 1943 As a result of the deliberations, is recorded in the minutes and reports of the respective Commuttees and Sections and of the Plenars Sessions, the United Nations Con. ference on Food and Agriculture aj proved the following declaration, resolution end recommendations 1 DECLARATION This Conference, meeting iu the midst of the greatest war ever wayed, and 10 full confidence of victory, has considered the world problems of food and wriculture and declares its belief that the goal of freedoin from want of food, suitable oil udequate to the health and streugth of all peoples, can be achieved 1 Tlie first task is to complete the wmning of the war and to deliver millons of people from tyranny unul from hunger. During the period of critical shortage in the aftermath of war, freedom from hunger can be aclueved only by urgent and concerted efforts to economize consumption, to increase supplies and distribute them to the best advantage. 2 Thereafter we must qully conuert our efforts to win and maintain frecrion from fear and freedom from want. The one , cannot be achieved mathout the other. 3 Tliere has never been enough food for the health of all pwople. This is justified methior by ignorance nor by the Larsliness of nature Procluction of fond must le frently exp inleil, we now have knowledge of the means by which this can be done It require's moginition and fir will on the part of cach government and people to male use or that knowledge 1. The first ennse of hunger and malnutrition is port rty. It is veeless to produce more fool unleas men and nations provide the markets to absorb There must lie an opinion of the whole worll conomy to provide the purchasing power suficient to maintain an silequite dirt for all With full employment in all countries enlarge industrial pimluction, the absence of cuplnitation, and increment flow of trude within und between countries, an orderly manopeinent ni dnr.1 -tic aml interrational investment and currenri-s, and sustained internal an international clonic equilibrium, the form which is pmiluced can be made available to all people 5. The primary nyunsibility lies with pichration for Reina that 113 people liave the ind rouled for 1:'n masih 1.1. inition Tiut pan natin an 11'lacl are its coal crir til it ·in 102 7. The first steps toward freedom from want of food must not await the final solution of all other problenis. Each advance made in one field will strengthen and quicken advance m all others. Work already begun must be continued. Once the war has been non decisive steps cau be taken. We must make ready now. II INTERIJI ASU PERMANENT COMMISSIONS FOR CARRYING OUT THE RECOVYCNDITIONS OP THE UNITED NATIONS CONFERENCE ON FOOD AND AGRICULTURC. IT hereas 1 Freedom froin want is diffcult to achieve without concerted action amon; all like-minded nations to expand and improve production, to increase employ. ment, to raise levels of consumption, and to establish greater freedom international con merce, 2 The successful carrying out of the recommendations of the Conference in the field of production, distribution, and consumption of food and other agricultural products in the post-war period will be the most important pre-requisite for the achievement of freedom from want, and requnes the creation by the governments and authorities here represented of a permanent organization in the field of food and agriculture, therefore, The United Nations Conference on Food and Agnculture recommends 1 That the governments and authorities here represented recognize and embody in a torinal declaration or agreement the obligation to their respective peoples and to one another, henceforth to collaborate in raising levels of nutrition and standards of living of their peoples, and to report to one another on the progress achieved, 2 That the governments and authorities here represented establish a permanent Operation in the field of fond anıl agriculture, and resolves 1 That moules that, evy practicable step mos be taken to attain these and the other ppropriate objectives set forth m the declaration and specific recommendations of the Conference, an Interim Commission for carrying out the recommendations of the United Nations Conference on Food and Igriculture be established. 2. That buch of the struments and authorities bere representeil be entitled to designate a lepresentatusu on the Interim Commission, and that the Interion Commission be installed in Washington not later than July 15, 1913, 3. That the Interim Conmission perform its work with due regard to the exigencies of the war, through such form of organization and personnel ng it mans deen appropriate, and formulate regulations covering its expenditures and fubmit to the member governments and authorities a builget and allocation of quota contributions; 4 That the functions of the Interim Commission be to forinulnte and recommend for consuleration by each meinber government or nuthor.ty; (a) A specific plan for a perinnent orgamzation in the field of food and Agriculture: (b) The formal declaration or agreement referred to in the first recommendotion, in which cach participant shall recognize its obligation; (i) To raisr the levels of nutrition and standards of living of its own people; (11) To improve the efficiency of agricultural production and distrihution; (1:1) To co-operate, so for as may be possible, with other nations for the achievement of these ds; (iv) To undertake to submit periodicalls to the other participants, through the f«nne nt organization, riports on the action taken and tho achined forarils these ands () Such proposals er reports as are necessary to give elect to the recommenilntions o? the Conference; progress ·2 JUS 5 luat u the preparativa of a lua fu: the permisot org luzation the stern Cowws100 gle full coulderatiu iu the following (a) The relation of the permaliebt 07.12.2stiou tu. is Bethods of 8850- wating it with, other wstitutious, uationui International, bub already exist or winch unas Werefter ble etablished, in the field of food and agriculture and 111 related butih, tuuline muu utb : fields. 1b) l'rovisiou for memburship in the met tul!!Z.stiva dut course.. of governments not repreneurd on the Tutorius Lumis-10n 6 That in considering the tunet1011- le duties tu he assigned to the permanent organization the futurum omnibyou tube vitu aciunt (a) The firomotion of scientific tohutud sixt!, and Lulullc research, (b) The collection and lowermatou i infissation und provision for the eschauge of services, (6) The submissiou ty member useruluents und uuthorities of recommendations for action with regard to the tulbully (1) Nutrition, Standurds of consumption vi fuod iud uthe ugricultural products. (...) Agricultural produe tion, di-tributius, Jud conseriatiou, (iv) Statistics and economic in the held of agriculture and food. including the study of the relation of oriculture to world economy, () Lducation and estension work in the field of food and agriculture; (v) Agru ultural credit, (51) Prolsen af ? Kurul population and farm labour, That the Interin. In-sion further consider the desirability of assign ing to the permanent or imzation functions in the field of (a) Development of aircultural resources and orientation of production, where necessary (1) Igricultural commodity irrungen.ents, (c) Agricultural co-operative movements, (a) Land tenure; (a) Other subjects on hiel: recommendations have been made by the Conference; 8. That thic Interim Commission also consider the initiation of preliminary statistical investigations and research into the prolilems with which the perma. nent organization will deul, 9 That the Interim Commission be deemed to bave been dissolved wben the permanent organization lias been established; 10. Tlint the Governinent of the Umted States of America be invited to take thatever preliminary action my lie necessary for the establishment of the Interim Commission after the United Nations Conference on Food and Agricul. turc lins completed its work. III Isrrov ST OL XATIONAL DICTS The l'uted Sations Conference on food and Agriculture Ilaring review the informat nu fullizmitted lit, th:• several delerations og consumption. deficients and the 14 of fail to lealth throue out the world and bmz dee pils, umazanel lit the l'ut pile played to slepuste fool in the reductin or riel!: de st's rsies uit. msintese health declares: 1. Thnt the first anseo?? al ! ..:: ***KAI:*! all inen of these pri re rectes bior} :) or team from disease, and for the 411111""! Oi!. 1., That the nicest fup!'. ! ! *****!: ! should be placed within the map of x'! :*** *** 3" Isa! #homers possible time;

·104 3. That ample evidence has been presented revealiug the existence of malnutrition in every country with its ineritable consequences of preventable ill health; and Tecommends. 1. That the governments and authorities here represented: (a) Immediately undeztake the task of increasing the food resources and improving the diets of their people in accordance with the principles and objectives outlined in the findings of the Conference, and declare to their res. pective peoples and to other gosernments and authorities here represented their intention of so doing, (b) Undertake periodtcally to report to one another through the permanent organization recommended in Resolution II on the state of their national nutrition and on the steps being taken for its importement IV DIETS OF TUL, ER ADLI GROUPS Il hereas 1 There are special needs of sulnerable groups, such as pregnant and nursing women, infants, pre-school and school children, adolescents, workers, and individuals receiving low incomes; 2 Families with numerous children in loir-lacome groups are particularly vulnerable, 3 Social, economic, and health measures of various kinds are or should be provided for these groups, 4 Wide experience has shown that direot measures to supplement iñadequute diets have been economical and fruitful, The United Nations Conference on Food and Agriculture recommends : That the serveral governments and autliorities here represented, undertako positive measures for the iniprovement of the drets of the vulnerable groups enumerated above. V MALNUTRITION AND DISEASE Whereas. 1. Malnutrition is responsible for despread impairment of human effi ciency and for an enormous amount of all health and disease, reduces the Tesistance of the body to tuberculosis, and enuances the general incidence and seventy of familiar diseases; 2. Mortality rates in infants, children, and mothers are higher in ill-fed thao in well-fed populations,* 3. l'ood consumption at a level inerels sufficient to present maloutrition is not enough to promote health and well-being, The United Nations Conference on Food and Agriculture recommends. 1. That the governments rod authorities here represented (a) Initiate or continue the study of the relationship between malnutrition and impaired bodily health and vegour; and, in particular, investigate the role of nadequate food consuinption in the causation of, and mortality from, all those diseases which constitute their most serious health problems; (b) Direct their attention to the study of health and well-being and of the nutritionul and related factors which are necessary to secure and maintain thern; (c) Consider the most effective means of disseminatiog kaon ledse of correct leeding among all sections of the population * Obviously this is impossible for porernraents whose territory is entirely or partly occurated by entpay forces.

·105 11 DEFICIENCY 1992455 Thereas: 1. The progressive improvement of diets will result in better health and erentually in the elimination of specific deficiency diseases, and a frent deal of unnecessary suffering could be avoided if an iminediate and concerted attack were made upon them, 2 Progress in our knowledge of nutrition nahrs it possible to seek out, treat successfully, and prerent the recurrence of the common diseases resulting froin specific deficiencies in the diet, The United Nations Conference on l'ood and igneinture recommends. That the several governments and authorities here represented undertake immediately (a) To ascertain the prevalence of specific defic.ency diseases among their respective peoples, (b) To deal with them is suitable dietar: and therapeutic measures; (c) To take appropriate steps to prevent their recurrence VII XATIONAL AUTRITION ORGANIZATIONS Thereas 1 A sound food and nutrition policy must be adopted by each government if national diets are to be progressively improved, specific deficiency diseases eliminated, and good health achieved; 2 Such a policy requires the guidance of a central authority with special competence and responsibility to interpret the science of nutrition in the light of national conditions and to propose to the appropriate authorities practical means for extending its benefits to all sections of society: The United Natrons Conference on Food and Agriculture recommends · 1 That the governments and authorities here represented: (a) Undertake to establish national nutrition organization, if such do not now exist, entrusted with the responsibility of ascertaining food-consumption habits and the nutritional status of different sections of the population; such organizations to be composed of authorities in health, nutntion, economics, and agriculture, together with administrators and consumers representatives, etc., to be provided with adequate funds and facilities for the efficient conduct of their work, and to have the authority to bring their recommendations to the attention of the public and to those Agencies of government hicb deal with Agriculture and the framing of economic and social polics; (5) Re-examine and, if necessary, reorganize existing agencies and review legislation concerned with health, ngriculture, and nutrition to the end that food and nutrition policies may be efficientis carried out VIII IxCANOE OP INFORVATION AND EXPERIENCE. Thercar: 1. Experience has shown that national nutrition nrganizations receive corsi. derable benefit froin periodic exchanges of viens and information on methods employed, obstacles encountered, and progress achieved: Governments partisipating in a common undertaking will wish to colls. borate so that levels of fool consumption may become trore equitable not only among the different sectisns of the population in a firea country but among the several nations of the world as well; The United Nations Conference on Food and Agriculture recommende: 1. That the several national nutntion romanestias exchange inlomatis and experience and pride mutual assistance, to sth d.rec:!r. Leo ng! and through the permanent operiralina rammezle! in Tirant.in II. which thes should submit geriale tenets or te reizes c! their creating into national dietary shits and nutrital status, sle: the sames 2! in raising the lerel of fixed.core:m::: thozha:t the popula;

·104 3. That umple evidence has been presented revealing the existence of malnutrition in every country with its inevitable consequences of presentable ill health, and Tecommend :: 1. That the governments and authorities here represented. () Immediately undertake *the task of increasing the food re-ources and improving the diets of their people in accordance with the principles and objectives outlined in the findings of the Conference, and declare to their res. pective peoples and to other governments and authorities here represented their intention of so doing; (b) Undertake periodically to report to one another through the permanent organization recommended in Resolution II on the state of their national nutrition and on the steps being taken for its importement. IV DIETS OF TELNERABLE GROUPS. Tlhereas: 1. There are special needs of vulnerable groups, such as pregnant and nursing women, infants, pre-school and school children, adolescents, trorhers, and individuals receiving low incomes; 2. Families with numerous children in low-iacome groups are particularly vulnerable; 3. Social, economic, and health measures of various kinds are or should be provided for these groups; 4. Wile experience has shown that direot measures to supplement inadequnte diets have been economical and fruitful; The United Nationg Conference on Food and Agriculture recommends That the several governments and authorities here represented, undertako positive measures for the improrement of the diets of the vulperable groups enumerated above. V MALNUTRITION AND DISEASE Thereas: 1. Malnutrition is respovsible for widespread impairment of human efticiency and for un enormous amount of all health and disease, reduces the resistance of the body to tuberculosis, and enhances the general incidence and severity of farnılar diseases; 2 Mortality rates in infants, children, and mothers are higher in all-fed than in well-fed populations,* 9 Tood consuinption at a level merels sufficient to prerent maloutrition is not enough to promote health and well-being; The United Nations Conference on l'ood and Agnculture recommends. 1. That the goveruments and authorities here represented : (11) Initiate or continue the study of the relationship between maloutrition and mpircil bolily health and vigour, and, in particular, insestigate the role of inadequnte food consumption in the causation of, and mortality froni, all thoso discases which constitute their most serious health problems; () Direct their attention to the study of health anit well-being and of the nutrition al and related factors which are necessary to secure and maintnin them; (c) Consider the most effective means of disseminatiog knon ledge of correct leeding itong all sections of the population • Obviously thu so wapossible for gorerameats whose territory u catirely or partly accuratel by energy forces.

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