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