HEALTH AND WELFARE.

257
Anti-malarial Work.

Our remarks as to the action to be taken by municipal and other
local bodies apply with equal force to railway authorities and to those
responsible for the control of health in the mining areas. In both cases
a great improvement in the health of the workers could be effected with
the inauguration of more vigorous anti-malarial work. The Bengal
Nagpur Railway management has found it an economic proposition
to employ a full-time malariologist for purposes of research and to ad-
vise its engineers on the carrying out of anti-malarial measures. We
recommend this policy for general adoption by railway companies, as
in many centres malaria causes a great deal of unnecessary suffering
and illness among the staffs, in addition to detracting heavily from
their efficiency. Some railway authorities stated that they would be
willing to carry out anti-malarial activities in their areas if and when
the local municipal councils became similarly active. We believe this
negative attitude to be largely responsible for the lack of progress in
preventive work of great urgency, and we suggest that railway
administrations should be ready to give a lead in this connection. In
the mining areas the Boards of Health and Welfare would find it of
similar advantage to extend their preventive work to include malaria.
For this purpose the medical staff of each Board should include an
officer with expert knowledge of the disease and its prevention.

Existing Medical Facilities.

In India the provision of hospitals, dispensaries and medical
treatment has been made mainly by the State, although a number of
municipalities and industrial concerns have their own medical institu-
tions, the former aided by lump-sum grants from Government. In
addition a number of small hospitals are maintained by religious and
charitable bodies. Only recently has there been any considerable
body of independent medical practitioners, but these tend to be
concentrated in the populous centres. With the development of industry
in different parts of the country, a new situation has gradually arisen
Which has three different aspects requiring consideration. The first
1s where industry has grown up by degrees in the centre of a large
town, the numbers employed inthe industry being only a fraction
of the whole population. In such cases workers are accustomed
to utilise the medical facilities already available to the general
Population. In Bombay, for example, the employers, with few
exceptions, have considered it unnecessary to provide additional
facilities for the treatment of sick employees. At the same time it was
Made clear to us that the existing number of hospital beds is quite
Inadequate to meet the city’s needs. The second is where industry
hag developed in a particular area to such an extent that
the industrial workers constitute the bulk of the population. In
Many such cases the local hospital, originally intended to meet a far
Smaller need, has not attempted to cope with the steadily increasing
Population. The third case is where a new industrial concern is started
In a rural area remote from any existing medical institution capable