Each District Health Office is directed by a District Medical Officer of Health, responsible for the performance of all health services rendered directly by his Office and for the supervision and coordina tion of those provided by other agencies in the district. He is assisted by a Deputy who usually also acts as epidemiologist of the Office, by other Medical Officers of Health, the Chief Public Health Nursing Supervisor, a district pharmacist, a sanitary engineer, a chief sani tarian, a chief malariologist, a district administrator, and a staff of doctors and public health nurses, mostly employed in mother-andchild health services. The Sub-District Offices are staffed on similar lines, but there is only one Medical Officer of Health in each. It is the Sub-District Offices which carry out the work in the field. Activities on the District Office level include environmental sanitation, mother-and-child health, anti-malarial work, epidemiology of communicable and non-infectious diseases, the follow-up of the chronically ill and rehabilitation, mental health, health aspects of town planning, health education, supervision of non-governmental hospi tals, quarantine, and control of drugs, medicines and poisonous substances. One of the most important duties is cooperation with, and coordina tion of, the operations of other Ministries or agencies concerned with health, such as the Ministry of Agriculture (meat control, animal diseases, pesticides), the Ministry of the Interior, local authority serv ices (registration of births and deaths), the Ministry of Social Wel fare, the Ministry of Commerce and Industry (food control), the Ministry of Education and Culture (school health services), and voluntary health agencies. In every district, mother-and-child health centres are maintained. mainly by the Ministry. Of late, the emphasis has been shifting from the care of mother and child to the care of the family, including its working members, the chronically ill and aged people, and also to mental health counselling. The maintenance by the Ministry of mother-and-child health serv ices, including school health services, school dental health services and health education, is thought of as a transient situation. The ultimate goal is the gradual transfer of these services to local government. The Ministry's function will then be supervision and guidance. Some problems of a particular character were dealt with jointly by the Regional Health Services and the units for mother-and-child health and epidemiology. One was the campaign against trachoma. which, as in other Oriental countries, was a serious danger to health. especially in the pre-State period. But, while energetic action in the Jewish community reduced the incidence to sporadic cases, occurring. usually, among newcomers from eastern countries, pockets of the disease remained in the rural Arab population, chiefly in the norther district. In 1963, a physician was trained ad hoc and sent to work through out that district, to examine and treat the Arab inhabitants systema tically, village by village. This work went on intensively till the end of 1964, when its continuation could be left to routine case detection and treatment by the existing school health services. At the end of 1964. trachoma was thought to be well under control. A very important step towards improving the quality of the work carried out in the units of the Regional Services Administration, has been the intensification of in-service training for all categories of workers in all branches of public health. The training takes the form of lectures and one-day seminars, and informal visits of workers from one unit to another. Several in-service training seminars have been organized by the workers themselves. Since 1962, the services provided for the chronically ill and the aged, as well as for mental patients, are progressively integrated into the existing Regional Health Services on the sub-district level, just as are mother-in-child health services. New staff has been taken on for this purpose. The services for the improvement of environmental sanitation are becoming ever more important. While the familiar tasks of wastedisposal, water, food and pest control are far from being effectively tackled, new problems, like the control of air pollution and radiation, have arisen. The Ministry's policy is that the actual work in most branches of environmental health should be carried out by the personnel of the local authorities, but supervision and advice remain in the hands of the Ministry's specialists. The expertise of the local staff had, therefore, to be improved constantly. In 1964, the Nutrition Unit was created. Its duty is to advise the Director General and departments of the Ministry itself on nutrition policy, to organize in-service training in nutrition for health personnel, to help in giving that training and to initiate research. One of the most serious health problems, becoming more acute with each passing year, is the very high number of road accidents. As it was believed that the human factor played a very important part in the causation of the accidents, a thorough examination of drivers, mental is well as physical, became paramount, and the Traffic Department of he Ministry of Transport and Communications asked for the help of the Ministry of Health in putting an end to death on the highways. The Ministry, in its District Offies, had already been carrying out, for years, examinations of applicants for driving licenses, but they were mostly confined to tests of acuity of vision. In 1962, a Medical Road Safety Institute was established by the Ministry. |