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