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SECTION 28: PREVENTION OF ILLNESS, CARE AND AFTER-CARE
TUBERCULOSIS.
The statistics relating to notified cases of tuberculosis are given in an earlier
section.
Although there has been some further decrease in the incidence of this disease there
still remains much scope for improvement. Much has been achieved through the earlier diagnosis
of tuberculosis by means of mass radiography and improved contact tracing. The majority of the
early and some of the more advanced cases now have a greatly improved chance of ^recovery with
the new drugs that are available and the improved surgical techniques which are being developed.
In spite of all this there remain problems which are pressing - the question of the elderly
undiagnosed and infective cases of so-called "bronchitis" or the open chronic tuberculous
patient who has failed to respond to medical and surgical treatment. The latter is not of
such danger, as his disability is known and he has been advised as to how he should conduct
himself. The former, on the other hand, is a menace and increasing detection of this class
can be brought about by the continued efforts of the general practitioner, the Mass Radiography
service, by Health Education of the community and by thorough contact tracing until every avenue
has been explored.
A further weapon Is B.C.G. vaccination among the school leaving population in an
effort to prevent the disaster of a young and promising career being ruined by some chance
infection of the teenager or young adult from a fellow employee, or at the dance hall or
Community Centre. Not only will it be possible to give these young people some protection
against the disease but by means of the preliminary tests and x-ray of tuberculin positive
children, early cases would be brought to light.
Another factor which requires urgent consideration in regard to the prevention of
tuberculosis or the deterioration of the tuberculous case is the question of housing. It
is realised that this is an extremely difficult problem especially as local authorities are
beset by the difficulty of rehousing people from clearance areas and overcrowded accommodation,
of old people, handicapped persons and so on. Nevertheless, unsatisfactory housing conditions
and especially overcrowding are an important factor and everything possible needs to be done
to avoid the deterioration of the case who has been discharged from hospital, who has perhaps
spent months in hospital or sanatorium and upon whom much time and trouble in addition to
money have been expended. In the long run it would probably be more profitable to the country
as a whole to provide new homes for these cases wherever necessary.
The close co-operation between the Chest Clinic and Health Department has continued.
The Senior members of the Health Department and the Chest Physician meet for monthly
conferences and close working liaison has been maintained.
The library service for tuberculous cases has continued to serve a most useful purpose
and regular additions have been made to the stock of books. The Tuberculosis Voluntary Aftercare
Committee has continued its good work in providing for the needs of patients and their
relatives which cannot be met from public funds. In addition, an Occupational Therapist was
appointed and started a domiciliary service which included tuberculous patients, and also
held weekly classes for such eases at the Chest Clinic. Although this service has had small
beginnings it is hoped that in due course it will be expanded to a larger centre where
group therapy for tuberculous eases can be reinforced by social activities and where
Productive work can be carried out under sheltered conditions.
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