HEALTH AND WELFARE IN PLANTATIONS. 411
place of the medical officer, the dispensary contains a minimum of drugs,
whilst the so-called hospital accommodation is uninviting. Indeed our
nspections lead us to believe that in some cases it ig in fact never
used. In certain other gardens no medical provision of any kind is
made.
Central Hospitals.
We believe that, given a certain amount of organisation, these
disparities should disappear. It is more economical and more advanta-
geous to the sick to concentrate treatment in a large hospital than to
provide on individual gardens a series of smaller institutions. For a
group of plantations there are great advantages in having a large central-
ly situated hospital of the type we saw in the Labac district of the Surma
Valley, which serves a group of 18 gardens under different managements.
This hospital has a nursing staff, separate wards for men, and for women
and children, an infectious diseases block, an operating theatre and a
sentral store for the issue of supplies to the outlying dispensaries. These
dispensaries deal with all sick persons in the first place, but the organi-
sation provides for the speedy transfer to the hospital of all serious cases.
Attached to the hospital is a laboratory where all routine laboratory
examinations are made under the guidance and control of the chief
medical officer, whose residence is in close proximity to the hospital.
There are many features in this scheme which we believe are capable
of adoption elsewhere. Similar organisations have also proved successful
In the Anamalais plantations.
Need of Co-ordination.

Where no central hospital exists, the medical officer of a group
has to travel long distances in Visiting serious cases of illness, and their
sreatment must frequently be a cause for anxiety in the absence of a
trained nursing staff and suitable nursing facilities. In a central hospital
both would be available. In every plantation area in India ample
scope exists for a wide extension of this medical group organisation, and
we believe that the improved facilities which are so necessary in the smaller
and less developed plantations, andin areas like the Nilgiris, will only
be obtained by co-ordinated effort of this kind. We propose later machi-
nery by which this co-ordination should be secured. }

Women Doctors.

Owing to the general reluctance of Indian women to consult
a male doctor, the women on the plantations have made less use than
the men of the available medical facilities and have so far failed to receive
all the medical attention that is desirable. The employment of women
doctors seems to us to be the most satisfactory method of correcting this
deficiency, especially as the women and children constitute a large pro-
portion of the population in these areas. If the medical group organisa-
bion we have suggested employed a woman doctor, her services would be
of the greatest value in the management of all confinements in hospital
and for the training and supervision of midwives and dais working in