FOREIGN QUARANTINE ACTIVITIES STATEMENTS OF DR. LOUIS JACOBS, CHIEF, DIVISION OF FOREIGN QUARANTINE; ACCOMPANIED BY RALPH E. RIGGS, DIVISION BUDGET OFFICER; DR. GARRUTH J. WAGNER, CHIEF, BUREAU OF MEDICAL SERVICES; HARRY L. DORAN, CHIEF FINANCE OFFICER AND JAMES F. KELLY, DEPARTMENT COMPTROLLER APPROPRIATION ESTIMATE "FOREIGN QUARANTINE ACTIVITIES "For carrying out the purposes of sections 361 to 369 of the Act, relating to preventing the introduction of communicable diseases from foreign countries, the medical examination of aliens in accordance with section 325 of the Act, and the care and treatment of quarantine detainees pursuant to section 322(e) of the Act in private or other public hospitals when facilities of the Public Health Service are not available, including insurance of official motor vehicles in foreign countries when required by law of such countries, [$7,311,000 $8,030,000. "[For an additional amount for 'Foreign quarantine activities', $125,000.]" Amounts available for obligation Transfer to "Office of Surgeon General, salaries and expenses" (42 U.S.C. 226) Total... Obligations by activity Transfer to "Office of Surgeon General, Salaries and expenses" (42 USC 226) - - 1966 total estimated obligations. 1967 estimated obligations___ Total change----. Mandatory: INCREASES 54, 000 6, 000 -1,000 7,653, 000 8, 030, 000 +377, 000 1. Additional cost of civil service employees within-grades, 71, 000 Examination of visa applicants in foreign countries___. Examination of aliens and quarantine inspection at 65, 000 3, 900 2, 100 9,000 2. Increased cost of social security amendments due to Public Examination of aliens, and quarantine inspection at Examination of visa applicants in foreign countries.. 3. Annualization due to civil service pay increase, Public Examination of aliens, and quarantine inspection at Examination of visa applicants in foreign countries.. 3, 100 5, 700 200 56, 000 53, 100 600 2,300 Mandatory-Contiuned Summary of changes-Continued INCREASES 4. Annualization due to military pay increase... Examination of aliens, and quarantine inspection at U.S. Examination of visa applicants in foreign countries... 5. Annualization of revision to Immigration and Nationality Act, Public Law 89-236---- Program: Examination of visa applicants in foreign countries_____. Subtotal, mandatory increases.. 1. Expanded contract program for medical examination of visa applicants (-11 positions). Gross increases_ DECREASES Reduction in 1967 of wage board increases funded in 1966_ Subtotal, decreases_ $6,000 2, 900 2, 800 300 70, 000 70,000 212, 000 216, 000 428, 000 -16, 000 -35, 000 -51, 000 +377, 000 Total net change requested___ EXPLANATION OF CHANGES Mandatory increases.-The requested increase will provide for $142,000 in mandatory increases for current personnel on duty and annualization of new positions added in 1966 due to revision to the Immigration and Nationality Act, Public Law 89-236, $70,000. Medical examination of visa applicants.—An increase of $216,000 is requested to improve visa medical examinations. The increase is requested to establish contractual arrangements with local physicians and clinics at Calgary, Canada; Guayaquil, Ecuador; Lima, Peru; Caracas, Venezuela; Oslo, Norway; Monterrey, Mexico; Berlin, Germany; Vancouver, B.C.; and Kingston, Jamaica. INTRODUCTION The Division of Foreign Quarantine guards the Nation against entry of disease from abroad in accordance with the quarantine regulations of the U.S. Public Health Service, and in accordance with other regulations applicable to immigrants to this country. The Division performs health inspections of international travelers, ships and airplanes, and certain imports at U.S. ports of entry. When necessary, the Division applies health controls to prevent the importation or spread of disease in the United States. To that end, the Division encourages the periodic vaccination of people most likely to come in contact with an infected traveler and informs travelers about health requirements for foreign travel. In addition, the Division conducts medical examinations of visa applicants at U.S. consulates abroad and medical inspections of aliens at ports of entry to detect diseases and conditions specified as excludable in immigration law. The speed and extent of international travel today are such that the factors of time and distance no longer act as protective barriers to the United States. Travelers (our own citizens as well as aliens) can enter the United States only a few hours after leaving countries where epidemic diseases are present. Up-tothe-minute information and knowledge of worldwide communicable disease conditions, together with constant vigilance, are employed in foreign quarantine activities to provide continuous protection of the United States. Smallpox is the principal quarantinable disease posing a threat both to the United States and to other countries from which this untreatable disease has been eradicated. Cholera now is spreading and occurring in most Asiatic countries from the Persian Gulf to the Philippines. The disease had been confined 60-302-66-55 mainly to India and East Pakistan for many years until 1961 when cholera el tor, previously confined to the Celebes Islands, spread to other islands of the Pacific. In respect to smallpox, a total of 43 nations reported 47,492 cases to the World Health Organization in 1964. The other quarantinable diseases of concern to international traffic are plague, yellow fever, louse borne typhus, and louse borne relapsing fever. This estimate provides funds for the maintenance of foreign quarantine defenses at almost 400 ports of entry under U.S. jurisdiction; for the medical examination of visa applicants abroad and the medical inspection of aliens at ports of entry in accordance with immigration law; and for the necessary headquarters activities. The funds requested for 1967 by the Division of Foreign Quarantine for its domestic operation will be used to maintain a level of operation that will protect the United States against the introduction of disease from abroad. Within the framework of the domestic operation, the Division expects expanded workload and will continue to function to the best of its ability in meeting its program requirements. These are: (1) quarantine inspection of persons at ports of entry; (2) application of measure to prevent the introduction into the country of dangerous communicable diseases and their vectors from abroad; (3) medical inspection of aliens to prevent entrance into this country of any alien with a disease or medical condition excludable by law, and (4) epidemiological communication operations with the collection, analysis, and dissemination of information on epidemic disease areas throughout the world to quarantine stations and appropriate agencies. These elements involve a broad span of complex operations, such as the application of an epidemiological communication operations to direct health procedures on persons at the ports of entry and a sophisticated network for notification, surveillance, and quarantine of those persons suspected of having a dangerous communicable disease. These operations are carried out in cooperation with international, national, State, and local health organizations through a continuous program of intercommunication. The strength of this program lies in its potential to meet its obligations for immediate action under all conditions and circumstances. The program will attempt to maintain its peak level of operation in spite of new ports of entry which will be established and in the face of increased size and speed of aircraft and ever increasing numbers of travelers. In order to determine the most effective methods of operation of the U.S. Quarantine Station, Miami, Fla., a Division review was made in mid-1965 to ascertain the future requirements for the retention of Government-owned property. The results of the review indicated that the current location and the retention of the quarantine operation on Fisher Island was not in the best interests of property managements, or the economical use of funds or personnel. Thus, action has been taken to relocate the station from Fisher Island to Governmentleased space on Dodge Island, effective July 1, 1966. Such action will result in the station being more conveniently located to the main area of operation of maritime traffic and the elimination of five maintenance positions. The savings resulting from this relocation will be utilized for the quarantine inspector training program. The estimate for this subactivity provides funds for the continuation of quarantine functions at almost 400 continental and insular locations in the United States and its possessions. The following table reflects selected major workloads at U.S. ports of entry: 1 Includes inspections performed by DFQ, immigration, customs, and agriculture at the Mexican border under the joint primary inspection program. The estimate for this subactivity provides funds for medical examinations of immigrants and certain other nonimmigrant visa applicants, in accordance with the provisions of the Immigration and Nationality Act and the Public Health Service Act. Immigrants and certain other visa applicants are required to submit to a medical examination as a step in the legal procedure for obtaining a visa. About 40 percent of these examinations are now being conducted by panels of local private physicians who are designated by consular offices of the Department of State. These physicians, who are not responsible to the Public Health Service, perform medical examinations of certain visa applicants and are paid by the applicant for the examination. In certain localities, and to the extent possible, the consular officers and the local physicians are given advice and consultation by Public Health Service physicians. The Public Health Service and the Bureau of Security and Consular Affairs, Department of State, have recognized the need for increased participation of the Division of Foreign Quarantine in the medical examinations of visa applicants. As a result of this recognition, a Department of State airgram was sent to all visa issuing posts on December 31, 1963, outlining the following basic policy objectives agreed to by the Department of State and the Public Health Service: 1. Public Health Service American physicians abroad will serve primarily in a supervisory and consultative capacity on a regional basis, rather than in the routine medical examination of applicants. 2. Insofar as practicable and consistent with efficiency of the total operation, panel physicians will be replaced gradually by contract location doctors supervised by regional Public Health Service physicians. 3. Until panel physicians can be replaced by contract location physicians or where for some reason the Public Health Service or the chief of the mission considers it advisable not to replace them, the Public Health Service regional |