World Health Okganization Regional Office for South-East Asia

WORLD HEALTH OKGANIZATION REGIONAL OFFICE FOR SOUTH-EAST ASIA

I'I-FO'lI 4NNUAL KEPOR'I' ()F 'I'HE: KEGIONAL I)IRECrI'OH 'r0 THE KEGIONAL COMMITTEE FOR SOUTH-EAST ASIA

1 JULY 1971---30 JUNE 1972 SEA/RC25/2 Page iii

TABLE OF CONTENTS

Introduction vii

PART I - GENERAL WIEW OF ACTIVITIES

Public Health Administration 3 Planning and Strengthening of Health Services 3 National Health Planning 3 Organization of Basic Health Services 3 Operational Studies and Health Manpower 5 Family Health 7 Nursing 9 Environmental Health 11 Health Education 12 Nutrition 15 Mental Health 17 Dental Health 18 Occupational Health and Rehabilitation 18 Radiation Health 19 Cancer 20 Cardiovascular Diseases 21 Pharmacology and Toxicology 22 Quality Control of Pharmaceutical and Biological Products 22 Drug Dependence 22 Food Safety: Hazards to Man from Pesticides 22 Medical Stores Management 23

Communicable Diseases Malaria Tuberculosis Epidemiological Surveillance and Diseases Subject the International Health Regulations Smallpox Cholera Plague Bacterial Diseases Leprosy Venereal Diseases and Treponematoses Diphtheria, Tetanus and Pertussis Diarrhoea1 Diseases Virus Diseases Trachoma Poliomyelitis Dengue/Haemorrhagic Fever and Other Arboviruses Influenza and Other Respiratory Viruses Viral Hepatitis Parasitic Diseases SEA/RC25/2 Page iv

2.6.1 Filariasis 2.7 Veterinary Public Health 2.7.1 Rabies 2.8 Immunology

3. Health Laboiatory Services 4. Vaccine Production

5. Health Statistics

6. Education and Training 6.1 Medical Education 6.2 Paediatric and Obstetric Education 6.3 Teaching of Human Reproduction, Family Planning and Population Dynamics 6.4 Fellowships 6.5 The Regional Office Library

7. Technical Information and Reference Services

PART I1 - ORGANIZATIONAL AND ADMINISTRATIVE MATTERS

1. The Regional Committee

Administration General Organizational Structure Personnel Staffing Briefing Staff Training Employment Conditions Finance, Budget and Accounts The Regional Off ice Building

3. Procurement of Supplies and Equipment

Collaboration with Other Agencies United Nations United Nations Development Programme (UNDP) United Nations Children's Fund (UNICEF) United Nations Fund for Population Activities (UNFPA) World Food Programe (UP) Economic Commission for Asia and the Far East (ECAFE) International Atomic Energy Agency (IAEA) SEA/RC25/2 Page v

Office of United Nations High Commissioner for Refugees (UNHCR) Specialized Agencies Food and Agriculture Organization of the United Nations (FAO) International Labour Organisation (ILO) United Nations Educational, Scientific and Cultural Organization (UNESCO) International Bank for Reconstruction and Development (IBRD) on-governmental Organizations in Official Relations with WHO Inter-governmental and Bilateral Agencies National and Other Agencies

5. Public Information

PART 111 - ACTIVITIES UNDERTAKEN BY GOVERNMENTS WITH THE HELP OF WO

Project List

Burma Ceylon India Indonesia Maldives Mongolia Nepal Thailand Inter-country Inter-regional (Projects Within the Region) Inter-regional (Projects Outside the Region with Participants from the South-East Asia Region)

ANNEXES

1. Organizational Chart

2. Geographical Distribution of International Staff Assigned to the South-East Asia Region as of 30 June 1972

3. Meetings and Courses Organized by WHO and Held in the South-East Asia Region SEA/RC25/2 Page vi

4. Conferences and Meetings in the South-East Asia Region Called by the United Nations and Its Related Specialized Agencies at Which WHO was Represented

5. Conferences and Meetings of Governmental, Non-governmental and Other Organizations Held in the South-East Asia Region at Which WHO was Represented

6. Fellowship Tables

7. List of Technical Reports Issued by the Regional Office

GRAPHS

1. Population at Malaria Risk in the Areas Under Various Phases of the Malaria Eradication Progrme in the South-East Asia Region (1963-1972)

2. Fellowships Awarded by WHO, by Subject of Study and Country of Origin of the Fellow, South-East Asia Region

3. Fellowships,Awarded by WHO in the Last Five Years (1967-1971), South-East Asia Region SEA/RC25/2 Page vii

INTRODUCTION

At this time, when reporting on WHO'S activities in South-East Asia during the past year, I have the greatest pleasure in ~eZcominga neu Menber State to our Region. I refer, of course, to Bangladesh, which became a Member of KYO on 19 May 1972 and was assigned to the South-East Asia Region on 23 May. Irnediately, plans were made for assistance to the new Member country. Funds were allocated; a "task force"was constituted to study and make recornendations on a pZan of action, and I myself, with sme members of my ahinistrative staff, paid a visit to the country towards the end of the period under review.

All the countries in the Region wiZZ have reached the end of their current plan periods by 1975-76, and prepamtions for the next plans have alrea& been initiated. In India, a strategy paper on the Fifth Five-Year Plan, prepared by the Planning Comnission, has already been discussed at various levels, and in Indonesia active preparations for their next plan are in had. Along with these developments, clearer recognition that heaZth forms an integral part of economic and social development has Zed to more emphasis on the expansion and establishment of planning units in the national health acbninistrations. In Ceylon a planning unit was established with staff trained with WHO assistance, and the unit in !l'haiZand has been further expanded. Nevertheless, in spite of the fact that some of the countries in the Region can be counted amongst the world 's pioneers in national development planning, health administrations s till fall short of implementing plans dmed at providing adequate health services to meet the growing demands of expanding populations. !The Zack of clear policy and the failure to define specific pro- gmme objectives and to set quantifiable targets against which progress can be measured remain serious obstacles. Moreover, some ministries of health tend to work in isolation within the overall govemental strue ture and are unable to establish effective lines of comnication with other ministries and related bodies, with the result that the health aspects of industrial, agricultural and other development progrmes are neglected. Plan implementation is also hampered by fragmented responsibilities, inadequate co-ordination between stuff and line organizations, Zack of adequate infonation systems, overcentralization and economic constraints, which remain serious even though allocated funds are not aZways fully utilized.

In addition, health ministries face problems in establishing a rational personnel system and in improving management and adnrinistration suited to the needs and resources of the country. Above all, the shortage of trained manpower, inadequate training facilities, poor dktribution SEA/RC25/2 Page viii mzd utilization of avci lab le personnel, lack of mnployment opportunities and the exodus of qualified stuff, all hinder improvement. These weaknesses are recognized, and continuous efforts are being made to overcome them. In Bma the MCnistry of Health has been reorganized, and the dual system of Ministry and Directorate of HeaZth Services has been merged to form a unified authority. In order to improve personnel administration and training, ThaiZond has already cmried out a review of existing management concepts and practices, with WHO assistance.

To help meet the need for joint efforts in the planning and implementation of health services, WHO has been stressing the team approach and has constituted, at country and regional levets, interdisciplimq temns consisting of medical officers experienced in public health administmtion, pubZic health nurses, sanitarians, health educators and statistician. to work with national counterpart teams in the co-ordination of WIlO assistance into an integmted progranolle for the development of comprehensive health services. Such teams have been operating in Indonesia and NepaZ during the past year. A regular evaluation of their finctioning is being under taken, and I hope to report later in mre detail on this innovation and its effectiveness. Efforts to establish patterns for the effective exchange of ideas between different types and levels of health workers have also resulted in the organization of a nder of interdisciplinary group educational meetings sponsored both by WHO ond by national authorities. These, in turn, have stimulated institutions and individmk to organize simiZur meetings for the same purpose at local LeveZs, using modern methods of administration and rmnagement in health services. The two workshops on community medicine held in Indonesia, for eqle, have had an impact on the atti- tudes of arbninistrators and educators not only in that country but also in other countries which sent participants. Ceylon and Indonesia are carrying out cmprehensive health rmnpower studies to ascertain the present position of various levek of staff and likely BfutuFe needs. Subsystems in nursing and midifery have been the subject of special study in Indonesia, and the health mnpawer training system is currently being re-structured in Nepal, where a study of pattern in the delivery of basic health services is also being carried out. In India a study on the delivery of health services at the district level has entered its second phase, mzd a hospital utiZization study has been completed. In addition, preparations for conducting a comprehensive stu& for the strengthening of health services in the interrelated areas of health phning, the development and functioning of health services and of health infomtzon systems, to be carried out at the National Health Institute, Sumbaya, have been finalized jointly by WKO Headquarters and RegionaZ Office staff. SEA/RC25/2 Page ix

I am sure that these and other related studies which use modern techniques in system analysis and associated model building will tmte- riatly assist in the formulation and effective implementation of future p tans.

As I reported lust year, the Regional Cornnittee had asked me to approach the Director of the WHO Regional Office for the Western Pacific to explore uhether the countries of that Region would be interested in an association with the countries of South-East Asia in jointly promoting the Asian health charter for development. I have to inform you that in via, of the proposal to establish a "South-East Asian Medical and Health Organization" (SEAMHOI, which includes sevemZ member countries within the Western Pacific Region as well as Indonesia and Thailand from South- East Asia, it would not be possible to expect their participation in the promotion of the Asian health charter for development. A separate paper on this mtter is being presented to the Regional Conorrittee for discussion.

The introduction of 'rcountry progranmingN and the change from centripetal to centrifugal planning within the UNDP will, I hope, result in a concerted effort between the countries and WHG towards integrated progmmne planning ad improved implementation. However, I must express my concern at the diminishing funds for important health progrmes from this source, and again appeal to health ministries to ensure that greater emphasis is placed on health progrmes by the national planning atthori- ties.

Progress has been made to strengthen the offices of the WHO Representatives so that they are better equipped to help with the na, approach. Atso, folzowing a study by a systems analyst, changes have been mde in the responsibility of the senior technical staff within the Regional Office in order to ensure improved planning, co-ordination and management of country progrrmrmes based on country and regional need. and within the guidelines of WHO'S Fifth General Progranme of Work Covering a Specific Period (1973-77).

An important component of the Fifth General Progrme, in addition to the strengthening of health services, is the development of health mpmer. In this connection, as mentioned above, the Regional Office has continited to organize group educationaZ activities, a total of 37 of which were heZd in the period under review.

The training of multi-purpose health workers at the basic level, particularly in nursing and mihifew, has been encouraged. Ceylon, Indonesia, Nepal and Thailand have taken steps to revise the curricula of basic nursing schools and schools for auxiliary nursemicibives. Of particukr vaZue in the field of nursing education have been the short SEA/RCZS/Z Page x courses for doctors and nurses, organized to improve clinical patient cam and cmmnmication within the doctorpatient nurse team. In an attempt to provide more effective short training progmmnes, a neu educational technique, "the sequential learning activity", was developed, and a better method devised for the evaluation of the long-term impact of this progrme. Specialized training in selected areas of clinical nursing, e.g., orthopaedics, has also continued to receive attention.

The attention given earlier to tmining programmes for medical teachers has led to gratifying developments in the countries of the Region, with WHO assistance. Support has been given to the two medical faculties of Ceylon in examination methodology and student evaluation. In Bum, at the Institutes of Medicine, the examination systems and relevant educational problems have been studied with a view to promoting modern concepts. In Thailand there were individual consultations with all the medical faculties, follmed by a workshop for national staff in Bangkok. Large-scale projects in the education and training of health manpmer for possible UNDP assistance have been formulated for Bumna, Ceylon and Mongolia. In Nepal and Thailand, WHO has assisted in the planning for new erlucational institutions.

As part of a comprehensive and co-ordinated long-range training progmnme for teachers of medical and allied health sciences, medical education units have been established at the Faculties of Medicine, University of Ceylon, Peradeniya, and Chulalongkorn University, Bangkok. It is proposed to deveZop these units into regional teacher training centres in the future.

There has been a considerable expansion of education and training progmnrmes related to human reproduction, family planning and population dynamics in medical and nursing schools, especially for teaching stuff. A course was held for senior teachers of medical schools in India, Indonesia and Thailand. A model rmrriculuni in family health has been worked out with WHO assistance in India and will be introduced in medical colleges during the coming years. Related progrmes in health education, including the development of media, have been conducted during the year. An important development has been the expansion of studies in health behaviour patterns. In Indonesia, 70 national studies were revimed and 20 analysed in depth, and work started on four priority problems. SirniZar studies are being initiated in Ceylon in co-operation with the Univemity of Ceylon.

Disease prevention and control is another major objective in WHO'S General Prog~lr~neof Work. In spite of further adtwmces made in the control of conmunicable diseases, these still pose a major threat to the health of the people. Greater emphasis has been placed on the utilization SEA/RC25/2 Page xi of expanded health services, rather than on mi-purpose campaigns directed against specific diseases, and further efforts in all countries have been made towards the integration of these campaigns into the general health services.

I am glad to report that in this region continued progress has been made in the mkaria and smallpox eradication programmes. In Burma, India and Nepal there has been a substantial increase in the population now covered under the maintenance and consolidation phases of the malaria programme. In Ceylon the malaria epidemic is under control, and an assessment was mde by an international team under a national team leader. A revia, by a WHO/US AID team has been mde in Nepal to drm up a plan for the future strategy of the progrme in that country, and a similar revim was being started in Indonesia.

With regard to smallpor, Burma, Maldives, Mongolia and Thailand have not reported any cases during the past year; Ceylon notified one imported case, whilst in Indonesia no cases have been reported since February 1972. India has reported many more cases in 1972 than in the preceding period, but the increased nwnber of cases is due mostly to improvements in the notification system, and although much still remains to be done in Nepal, the substantial progress indicates the magnitude and efficiency of efforts being made by the countries in the Region. I hope that next year I shall be able to confirm the further decline in cases reported in this region.

In the fikariasis control campaigns, emphasis is being increasingly pkaced on vector control, and the experience in Burma and Ceylon has confirmed that this approach may be successfuZ for adaptation in other countries.

The trend of cholera in cozmtzies of the Region is mpredictable, but the awareness of the problem, iml~mvedreporting and the capacities developed for diagnosis and treatment, as well as the continued training progrmes for health staff, oil2 probably enable countries to meet unexpected situations pending successful long-tern measures related to improvements in the environment.

Observations indicate that viral hepatitis is ako endemic in this region, in some years reaching epidemic proportions. InfantiZe diarrhoea still remains one of the major causes of death in yowlg children, and the expansion of simple rehydration treatment facilities should assist in reducing the mortality. The only definite solution to these problems lies in urgent action for the improvement of environmental and personal hygiene and the promotion of health education programmes tmards this end.

At the last session of our Regional Conmrittee, attention was giuen to the resurgence of venereal diseases, and a regional symposim on this subject organized in Brmgkok in Decenber confinned that these diseases nm constituted a major problem of public health importance. !l'his problem, SEA/RC25/2 Page xii as well as the related social problems of drug dependence and alcoholism affecting the younger popuZation groups, is one which is rightly causing concern to governments. In this connection, I should like to mention the very large problem of treatment and rehabilitation of drug addicts which the United Nations has started in Thailand. lJHO is assisting here and in other countries in surveys of the situation and in the fomula- tion of preventive programnes.

Several other problems of public health importance requiring preventive action have emerged, and, as reported last year, the increased interest shown by governments in measures for the control of cardiovascular diseases, the streptococcal complex and malignant diseases resulted in my establishing in the Regional Office a unit for chronic and degenerative diseases. A beginning has now been made to help with progrmes related to some of these diseases.

A measure of the growing concern about these problems was the widespread observance of World Health Day 1972 on the theme "Your Heart is Your Health", which has also served to stimuZate further activities. I personally had the privilege of taking part in this observance by inaugurating the Institute of Cardiology in Madras. On this day, WHO also participated in the inauguration of "Heart Month" in New Delhi.

The cancer control pilot project established at the Arignar Anna Memorial Cancer Institute, Kancheepuram (India), and the preparations for the establishment of a State-wide cancer control programme in Tamit Nadu have been receiving continued WHO assistance.

In the field of nutrition, efforts are continuing in the provision of consultant services on a wide variety of problems and of training activities in the countries of the Region. Of special interest to research workers in many countries was the Symposiwn on Vesical Calculus organized in Thailand in January of this year.

All these efforts point to the urgent need for the establishment and strengthening of epidemioZogicaZ services as an integral part of health deparhents, and WHO will continue its assistance towards this end. There is a need for further strengthening health Laboratory services and their co-ordination with epidemiological services as an integral part of this pmgme, and plans to provide joint consuZtation services of specialists in epidemiological and laboratory sciences, as has been done in Thailand, will be pursued.

WHO'S programmes in the strengthening of laboratory services will continue to meet the objectives of acquiring competence in diagnostic and reference services, the production of vaccines of the required standard and potency, the development of a system of laboratory services at various administrative levels and the training of different categories of laboratoq staff, the fellowships awarded in this field being aimed SEA/RC25/2 Page xiii at establishing facilities for training professional and technical health labomtory staff within the cowltries of the Region.

A A .+

In the promotia of environmental. heatth, the fourth main objective of WHO'Y General Programme of Work, high priority has long been accorded to the provision of safe water supplies. It is satisfying to report that the UNDPassisted public water supply, dminage and sewemge project for the south-west coastal area in Ceylon was completed in July 1971, successfully accomplishing all its objectives, and has provided a detatled master plan for water supply, drainage and seuemge up to the year 2 000, the first phase of which is under implementation. Another project, started in Nepal in January 1971, has maintained satisfactory progress, with full support fmm the Government and UNDP.

A tmining course on preventive maintenance of water distribution systems (often as important as the construction of new systems) was orgnnized in Bonbay by the Centml Public Health Engineering Research Institute, Nagpur, with assistance from WHO and in coltaboration with the Bonbay Municipal Corporation.

Based on a report prepared early in 1972, in which the environmental health situation in six countries of the Region was revieued, it is hoped to fomlate proposals for the further improvement and expansion of community water supplies, severage and waste disposal and to explore sources of additional financial assistance required for their implementation from various sources. With the support of UNDP funds and geneml world interest as evinced by the recent Stockholm Conference on the Hwnan Environment, a major opportunity now exists to increase the tempo of development of basic sanitation facilities, especially in rum2 areas, in areas with growing semi-urban slwl and shanty-town populations, and in those with specific health prob lems, e. g., guinea-oorm infestation, the controt of which is subject to provision of adequate comnity water supplies.

The countries in the South-East Asia Region comprise one fifth of the world's population. In many of them a high birth rate, sometimes reaching a level of over 40 per I 000, varying with the size and structure of the population, has had serious repercussions on health conditions. Five countries - Ceylon, India, Indonesia, Nepal. and ThaiZand - have developed national programmes aimed at mising the quality of life through better health, and the support of such programmes has become an important part of WHO'S activities.

Through the allocation of funds by UNFPA and in co-operation with other United Nations agencies, WHO has assisted in this region with 42 pmjects covering a wide range of activities, including the education and training of health personnel at all levels, improvement of health care SEA/RC25/2 Page xLv through expansion of facilities and provision of equipment and supplies, health education and the strengthening of national and provincial health administrations. The funds avaiLabZe for these projects now represent approzimately 25 per cent of WHO'S regular budget in the Region, and this percentage is likely to increase. In addition, we are collaborating in large-scale family health progrmes in Ceylon, Indonesia and mailand for which substantial funds have been allocated by UNFPA. Family health pmgrmnmes on a national scale are atso being developedwith assistance fran the VorZd Bmk and other agencies. The development of plans of assistance for these and related programmes requiring concerted action on severaZ fronts has Zed to increasing and fmitful collaboration with the agencies concerned and especially between the WHO Representatives, the Resident Representatives of the United Nations Development Programme and with other agencies.

In all, WHO has, during the year under review, given assistance to 267 projects in the Region, of which 38 were inter-country projects, 223 country projects and 6 interregionaZ projects sponsored by WHO lieadquarters in which the Regional Office participated. The broad health fields covered by the projects were public health administration and basic health services (181, maternal and chiM health (291, nursing (27), environmental health and water supply (211, health education (131, nutrition (91, mental health (11, dental health (81, radiation health (151, quality mntml of drugs (51, mzlaria 1111, tuberculosis (9), smallpox (71, leprosy (51, other conununicab Ze diseases (22), health laboratory services and production of vaccines (161, health statistics 17), direct assistance to medical institutions 1161, and other activities (281. Brief descriptions of all these projects are given in part III of this report. During the same period 526 fellowships were awarded.

I have already mentioned the Zack of adequate enptoymcnt oppor tunities, and this is a special problem for those who have successfully completed their training. If these fellowship progrmes are to be fully successfuZ, the trained staff need to be provided with the necesoary supportive semrices and equipment in order to utilize their skilts effectively. I would once again urge Member Govermnents to pay attention to this need so that the heavy investments in training can pay proper divi- dends.

The total aid in medical supplies and equipment for the refugees in India channelled through WHO, including its own contribution, amounted to over $2.5 million. I should like to refer to the most impressive mmner in which the Govement of India handled this vast and complex problem. By taking prompt measures to control cholera and by successfully developing feeding progrmes for children, the authorities averted what could have developed into a mjor disaster. SEA/RC25/2 Page xu

In spite of the fact that WHO'S activities couM not help being adversely affected by the developments necessitating a state of emergency in Inhia tcwards the end of 1971, it is gratiflling to have been able to record steady progress in some fields of public health in the period wder review.

It gives me great satisfaction to report that the Regional Office building fonally became the property of the World Health Organization on 14 Septerrber 1971, when the sale and lease deeds were signed by representatives of the Government of India and WHO. In order to meet the demands for more office acconmodation, a new three-storey annex to World Health House has recently been constructed.

During the year wder review, as in previous years, I was able to visit most of the countries of our Region and to see for myself the development of heaZth activities. The reception accorded to me everywhere was eztremely cordial, and for this warm welcome I m deeply grateful. I am atso most gratefu2 to all our Meher Govemnts for their unstinted support and close co-operation, and am confident that, with this mutually beneficial relationship between MO and the governments in the Region, I shall have more and better progress to report next year.

V.T.H. Gunaratne, F.R.C.P., D.P.H., D.T.M. & H. Regional Director PART I

GENERAL REVIEW OF ACTIVITIES SEA/RC25/2 Page 3

1. PUBLIC HEALTH ADMINISTRATION

1.1 Planning and Strengthening of Health Services

In line with increasing awareness on the part of goverments of the desirability of planning for health as a component of overall socio- economic development, emphasis continued to be placed on the integration of curative and preventive services and of specialized programmes into the basic health services. Based on the realization that unless the infrastructure is strong,health programmes cannot be maintained or sustained, increasing stress was laid on the training of auxiliary health personnel and on their conversion from unipurpose to multi-purpose workers and absorption into the basic health services. In the various countries, high priority was given to collecting information and making inventories of existing resources, conducting studies of health manpower, preparing national health plans and master plans of operation for the strengthening of health services, and carrying out research in community health organization. WHO assisted with these activities at both national and regional levels.

1.1.1 National Health Planning

A major activity was the holding of the Third Regional Course in National Health Planning in collaboration with the United Nations Asian Institute for Econonic Development and Planning, Bangkok. In this course, which was held from 17 January to 7 April 1972, there were 17 participants, including one from the Eastern Mediterranean Region. (For more details, see SEAR0 0178 in Part 111.)

At the national level, a four-week course on development and health planning was held in Indonesia from 26 July to 20 August 1971, and was attended by 26 senior provincial health workers.

Assistance was provided to the Government of Ceylon in the development of its national health planning unit, and in training staff so as to make this unit an effective tool for carrying out a comprehensive health manpower study (see below), the results of which should be useful in planning the country's health services.

WHO also assisted the Government of Thailand in the establishment of its health planning unit.

1.1.2 Organization of Basic Health Services

The following was the position in individual countries of the Region:

A master plan of operation for strengthening the health services in Burma, envisaging integration of the curative and preventive services, the phased absorption of the specialized campaigns against couununicable SEA/RC25/2 Page 4 diseases into the general health services, improved health coverage of the entire population and expansion of the training programmes for health personnel, was signed by the Government.WH0 and UNICEF in February-March 1972.

In Ceylon, the emphasis was on strengthening the health planning unit as mentioned above, and in carrying out a comprehensive health manpower study (see section 1.1.3 below).

In India, two WHO staff members stationed in Chandigarh advised the Directorates of Health of Haryana and Punjab States on the development of basic health services and assisted in organizing a number of in-service training courses for auxiliary nurse-midwives, lady health visitors and nurses.

An annex to the master plan of operation for the strengthening of health services in Indonesia, establishing a plan of action for the years 1971 through 1974, was concluded and signed by WHO, UNICEF and the Govern- ment on 13 December. Team members in project Indonesia 0086 have provided short-term assistance with a broad range of activities for strengthening the basic health services, as reflected in (1) the development of job descriptions, (2) the strengthening and expansion of in-service training of supervisory and field staff of the National Training Centre, Bekasi, (3) the preparation of the first draft of a manual for conducting activity studies of midwives and a reference manual for health centre staff, and (4) the conduct of a workshop on community health, a workshop to assess the value of the recording and reporting system in the planning and design of household health services delivery and in demographic surveys and an eight-week upgrading course in teaching methods. A team of two staff members from the Regional Office and one consultant visited Indonesia in February-March to review the formulation of project Indonesia 0086 under the master plan mentioned above. Three educational activities - a health management course, a health management workshop and a course for the training of auxiliary health staff - were scheduled for mid-1972, and further assistance planned will consist of the assignment of a consultant to assist with the formulation of a preliminary outline for health in Indonesia's second five year development plan (1974-1979), and of another consultant to assist with the design of studies of health services delivery.

A WHO team consisting of a public health officer, a public health nurse educator-a malaria sanitarian, a general sanitarian and a laboratory technician is being built up in the Maldives, to help in the planning and strengthening of health services, control of communicable diseases and the organization, in Male, of a two-year course for auxiliary nurse-midwives and health assistants. Malaria, tuberculosis, leprosy and filariasis have received special attention by the health administration, assisted by WHO staff.

The WHO fellowship programme has supported the Mongolian health system by training health administrators. During the period under report, SEA/RC25/2 Page 5

five fellowships were awarded to physicians for orientation in various aspects of community health services. WHO was assisting in arrangements for the visit of a Mongolian team of two engineers, an architect and a physician, to hospitals and health centres in the USSR, Bulgaria and Hungary, with the purpose of preparing plans for a new maternity home with 200 beds and a new children's hospital with 600 beds in Ulan Bator.

In Nepal, where the guidelines provided in the country's Fourth Five-Year Plan (1970-75) serve as the basis for the strengthening of the basic health services, special attention was paid to the training of auxiliary health workers and to the introduction of a simple reporting and recording system for health posts. A master plan of operation for the development of comprehensive health services was signed by the Govern- ment, WHO and UNICEF, and two demonstration administrative areas, i.e., Kaski District of Gandaki Zone and Bara District of Naryani Zone, are being prepared for the implementation of integrated comprehensive health care services and to serve as an example of the organization of community health services. A plan of action for the Bara District pilot project was drawn up. A workshop for senior nurses at Bir Hospital, a training course for health aides, a short course in public health nursing and a 15-day training programe for peripheral health workers at Parwanipur in the Bara area were conducted. An orientation seminar for the senior health officials of Bara District was also held in connection with integration of specialized programmes.

In Thailand,as well, the development of integrated health services continued to receive high priority. A long-term WHO public health administrator was assigned to assist in national health planning and in health administration, on a broad basis, with primary emphasis on the phased integration of disease control and special programmes into the general health services, for the eventual development of a comprehensive health care service in the country. A study of the activities of health personnel working in health centres was carried out. It covers three categories of staff (doctors, health workers and nursing personnel) in six districts and is aimed at obtaining basic information needed for planning future health services in rural areas.

Medical Care

A regional seminar on the functional programing of hospital facilities, the first of its kind in the Region, was held in the Regional Office from 25 October to 5 November 1971, and was attended by 21 participants. Three consultants - a public health administrator, a public health nurse and an architect - assisted in conducting the seminar,which evoked keen interest among the participants. WHO provided a team of two consultant-architects for two months in 1972 to assist the Government of Nepal in the field of hospital design and planning.

1.1.3 Operational Studies and Health Manpower

The National Health Manpower Study in Ceylon, which was started in February 1971 in co-operation with WHO Headquarters, gained momentum SEA/RC25/2 Page 6 during the year. Eleven areas have been identified for the conduct of sub-studies, each of which is being planned,carried out and analysed in a phased manner. The collection of data was completed in some sub- studies, e.g., demographic characteristics, health needs and demands, census of doctors (pilot census), census of nurses and midwives (pilot census), and the data collected were under analysis. Data in respect of some of the other studies, namely, education of doctors, education of midwives and nurses, activities of rural health workers and utilization of doctors, were in various stages of collection and preparation Protocols for the remaining four sub-studies, on the staffing pattern. facilities and cost of health senrices, net demand, and Ayunredic practitioners, were being formulated. It was expected that interim reports on at least five sub-studies would be prepared during 1972.

The research project in district health administration in India (Rohtak District), undertaken by the National Institute of Health Administration and Education and assisted by WHO, continued to make progress. The study consists of two phases, the first being descriptive, and the second an "intervention" study, that is, in the first phase the baseline situation has to be described and measured, with respect to a large number of factors and variables, whereas, in the second, various combinations of modifications in the administration of services (i.e., delivery of health and medical care) are envisaged, with a view to improving their general effectiveness. The first phase was completed in December 1971, and the second is in progress. A staff member from WHO Headquarters assisted the Institute in the preparation of a scheme for introducing changes for the improvement of health services and criteria for measuring the effectiveness of these changes.

The three-year WHO Headquarters-assisted study carried out in Haryana and Punjab, which was aimed at establishing a method for analysing the underlying factors of hospital utilization and for planning hospital services on a scientific basis, was completed at the end of 1971. This study provided useful information for hospital planning.

In 1971, at the request of the Government of Indonesia, assistance was given in planning for the collection of up-to-date information concerning health manpower resources, health institutions and facilities, training schools and research institutions, in order to plan health programmes. A WHO consultant helped in drafting the record and report forms and conducted a two-week survey training course, attended by 12 participants.

With support from UNFPA, a long-term statistician is to be provided to Indonesia to assist in the development of a health manpower resources reporting system. The institution of an on-going record system through a permanent health resource information system is envisaged. Assistance was given in the establishment of a central data-processing unit. Six areas for operational research connected with the problems of ill health in the rural communities of Indonesia were identified. 'r y Wnv w4.,, ,,,, in impwing modief .&I- Ptcc~rw*how m clmr nI llrihffr mirtonk cat:ilan and rrainlng. &-- tctaivhg lrnlnilcg ror In the fijnl fir085 6' Qcrms If). J $wIrJl r>risr;tnl disprnsi~ifdru~snr Lhe run\ llrnltlt rcrtbr rrt Gpoaon B~Irm (I:, a grwp al nlsdlnt studtntr ~r~fl~wgtqprtweY 711d rrrriv)ng imtrrrztionn b ttlc i.vdside 11, 3 B tngoun hv* ill1 (3,. ~ndgcqbanl nufiing dcht.+ rindtrydnc pr-.rtf<.?l:fi! P.:*afip .>. ic Rapli.al ir Ilew Jdhi (41, 7 Tlia im,wrrbnct givsn ta th. lmp~etttd family :lw~ltband rtw! rvr rr~olf*trin Burwr (2) ;n(l in Irda~lu~~ (3). and lndlan mdrh~nJncinp pnnunrlrtl In ~rfnnf tcrhnqvrs al conrra~cplion,(.I:I. SEA/RC25/2 Page 7

1.2 Family Health

Maternal and child health

The WHO programme in maternal and child health was examined in detail at the twenty-fourth session of the Regional Committee. In this connection, after the Sub-cornittee on Programme and Budget had considered a report on the overall progress of family health programmes in the Region since 1965, it was noted with satisfaction that the Renional Office had allotted priority to this subject, but realized that, in view of the high incidence of morbidity and mortality among the pre-school age group, there was an acute need to provide greater support to the child care aspects of the family health programmes. The importance of better co-ordination between the on-going applied nutrition programmes and the child health services, especially in view of the close link between malnutrition and infection in the younger age group, was also stressed, as was the need for research on health practice, including studies related to the coverage and quality of maternal and child health and basic health services.

With technical guidance from the Regional Office, a substantial amount of UNICEF assistance was directed towards improving child care services and the training of health personnel in child health in the various countries.

In the field of neonatology, a consultant made an assessment of the benefits derived from previous courses in this subject held in the Region. and made recomnendations for the improvement of neonatal care.

WHO assistance was given in strengthening the teaching of child health in Burma, where, also, fellowships in paediatrics were awarded to medical officers (see also section 6.2).

A consultant made an assessment of progress since the WHO study of post-graduate paediatric education in India from July 1966 to February 1967 and assisted with a meeting on Post-graduate Education and Training in Paediatrics (see section 6.2).

In Mongolia, the first addendum to the master plan of operation of the maternal and child health services project helped in the further development of services, including referral services, and the trai~ing of health manpower in the field of maternal and child health.

Assistance to Thailand consisted mainly of the award of fellowships. In addition, during a visit to the country, the Regional Adviser on Maternal and Child Health held discussions on the development of maternal and child health programes.

Special programmes for the management of rehydration therapy and the production of rehydration fluids with respect to children are described in Chapter 4. SEA/RC25/2 Page 8

Maternity-centred approach to family planning

Substantial contributions from the United Nations Fund for Popu- lation Activities (UNFPA) made it possible for the Regional Office to meet an increased number of requests in the field of family health. For example, a WHO team assisted Ceylon (on the basis of the findings of the 1970 visit of the United Nations inter-agency mission) in drawing up country request submissions and, later, plans of operation for several family health projects. Assistance was also provided in formulating. in Thailand, plans of operation for the three UNFPA projects for which WHO will be the Executing Agency. At the beginning of 1972, there were 17 UNFPA-assisted projects in various aspects of family health in operation in the Region. The medical officer who has now been assigned to project Indonesia 0113, "~amilyHealth Services", is assisting in co-ordinating the WHO/UNFPA-assisted projects in that country. Also, in implementing these programmes every effort was made by WHO to co-ordinate its activities very closely with those of other United Nations agencies. In order to assist in co-ordination, an Assistant Director of Health Services in the Regional Office was made responsible for all UNFPA projects in the Region.

In India, efforts continued for the development of a project on integrating maternal and child health (including family planning) services into the general health services. Members of a World Bank Mission to India held discussions in the Regional Office before undertaking a reappraisal of the family pla~ingprogramme in the country.

With respect to further development of this approach in Indonesia, a combined report by a Headquarters staff member and a member of the Regional Office staff on their earlier visits to hospitals in Indonesia, under the Population Council's post-partum programme, was prepared and sent to the Government and other agencies concerned. The Regional Office also assisted in conducting an inter-regional seminar on the health aspects of human reproduction, family planning and population dynamics, held in Djakarta in October.

The national family planning and maternal and child health services in Nepal continued to receive assistance through the existing nursing and public health administration projects,in the way of fellowships and group educational activities. Preliminary steps were being taken to explore the possibility of helping the Government in the training of health manpower to meet the needs of the maternal and child health services and the accelerated development of the basic health services in support of maternal and child health/family planning activities.

Among the inter-country activities in family health during the year were (1) the Meeting on the Maternity-Centred (Post-partum) Approach to Family Planning, held in the Regional Office in August, and (2) a Symposium on the Role of the Paediatrician in a Family Planning Programme, which took place in Madras (India) in December. Details of these meetings are given in Part 111. SEA/RC25/2 Page 9

Two important national meetings organized with assistance from WHO were also held - a national seminar on the integration of maternal and child healthlfamily planning services into the basic health services, in Hua Hin, Thailand, in September, and, in Nepal, a national wrkshop on integrated maternal and child health/family planning services, which was organized in Kathmandu in December 1971.

With regard to research projects in family health, staff members from WHO Headquarters and consultants visited several medical research institutions in the Region to explore facilities for promoting studies in connection with the WHO Expanded Progrmme of Research Development and Research Training in Human Reproduction. A start was also made with the organization of the documentation centre for family planning materials in the Regional Office, described in last year's report (see also section 6.5).

With the arrival of a WHO team in Bangkok during the first quarter of 1972, the inter-regional research project for the Evaluation of Ferti- lity-Regulating Agents, established at the Faculty of Medicine. Chulalong- korn University, started its activities.

Social aspects of paediatrics and obstetrics

The Regional Office continued to provide technical assistance on health aspects of social welfare programmes to Burma, Ceylon, India, Indonesia and Thailand,in collaboration with the United Nations Department of Economic and Social Affairs and UNICEF.

1.3 Nursing

There has been a change in the volume and character of direct assistance to nursing and midwifery throughout the Region, brought about largely by the development of multi-disciplinary projects into which a number of nursing projects or posts have been absorbed. Indonesia 0086 is an example of such a multi-disciplinary project, and the fact that the nurses attached to a project on nursing services and education (Indonesia 0074) are now working with the multi-disciplinary project reflect the type of alteration which has occurred.

Planned studies in the fields of nursing and midwifery were also absorbed into comprehensive studies of health manpower and delivery of health services. Projects such as Ceylon 0101, "Study of the Activities of Public Health personnel", SEAR0 0212, "Assessment of Nursing Aspects of Maternal and Child Health and Family Planning as an Integral Part of Community Health Services", and Indonesia 0119. "Strengthening of Nursing/ Midwifery Education and Services, including Family Planning", are examples of such amalgamation.

Strenuous efforts were made to provide increased assistance to the strengthening of educational programmes for all levels of nursing and SEA/RC25/2 Page 10

midwifery personnel. In Ceylon, a large training programme under UNFPA funds was developed, and here, as well as in Mongolia and Nepal, continued assistance was provided to the basic education of nursing and midwifery personnel. In the Maldives, fellowships were awarded to prepare nurse- midwives at the basic level. Several new projects came into operation in India for the improvement of nursing practice in teaching hospitals and the education of auxiliary nurse-midwives. These projects relate to nursing in clinical specialties, the strengthening of the family planning aspects of nursing administration and the teaching of human reproduction.

Assistance to post-basic education for the preparation of nurse teachers, administrators, public health nurses and clinical specialties in nursing continued to be provided in India, Indonesia and Thailand. Short training courses emphasizing the improvement of direct patient care in hospitals were assisted in Burma,Ceylon, Mongolia and Nepal. The inter- country project SEXRO 0139, "Short Courses for Nurses and Other Health Personnel", also prwided assistance in this regard. (Details of these activities are given in Part 111 of this report.) There was increasing interest in participation in these courses, and requests have already been received for nine such courses in 1973.

The WHO-sponsored Training Centre for Nurses in Wellington, New Zealand, received enthusiastic support from the countries of the Region. Twelve nurses from five countries were enrolled in the 1972 programme. An evaluation tool for assessing the long-term impact of these courses on the quality of nursing service given by participants on return from the Centre was developed.

The need for national systems of nursing personnel and of education for these personnel remained an urgent problem in several countries of the Region. The trend towards increasing the levels of categories of health personnel to meet emergency health situations continued. The long- term effect of these increases on the overall health manpower system has been only partially felt. Problems relating to under-utilization and misuse of qualified nursing personnel continued to cause concern, as did the exodus of qualified national nurses to countries outside the Region.

In an attempt to provide more effective short training programmes, a new educational technique, "the sequential learning activity", was developed. Also, a tool was prepared for the evaluation of the long-term impact of this programme on the quality of health care provided by the participants. Both the technique and the tool vill be employed in the conduct of the short course on paediatric patient care, scheduled to be held in Ceylon in the last quarter of 1972.

WHO nurses have actively participated in a variety of joint efforts to develop concepts, programmes and projects relating to inter-disciplinary education for health personnel, health planning, programming for physical facilities for hospitals, etc. SEA/RC25/2 Page 11

Inter-agency activities in nursing have increased, as demonstrated by frequent and productive contacts with UNICEF, UNFPA, UNESCO and national and bilateral agencies such as nursing associations, the Canadian Univer- sity Service Overseas and US AID.

1.4 Environmental Health

In WHO-assisted environmental health programmes, community water supply and sanitation and the training of personnel have continued to receive emphasis.

A systematic survey of the existing situation of cornunity water supply and sanitation and of future needs in this regard has been carried out with the help of a consultant. The data thus collected will serve as a basis for the preparation of plans, in pursuance of a resolution of the Twenty-fourth World Health Assembly, for further WHO assistance to governments to accelerate the development and implementation of their community water supply progrmes, so as to meet national targets for the Second United Nations Development Decade. Along with this survey, an assessment of environmental health services has also been made in order to obtain information necessary for the formulation of proposals for possible WHO assistance in further improvement and expansion.

The UN1~~~/WH0-assistedrural water supply programmes under implementation in Ceylon, India, Indonesia, Nepal and Thailand continued as planned, with increasing technical and material assistance. A similar scheme was planned for Mongolia. An assessment was made of the village water supply programme being developed in several States in India with particular reference to design, construction, operation and maintenance. Thailand received assistance in the development of a well-drilling programe.

In Indonesia, WHO activities alao covered feasibility studies on the improvement of urban vater supplies and the preparation of a long- term plan.

Although the UNDP-assisted project for the preparation of a regional master plan for vater supply and sewerage in Ceylon was completed in July 1971, the training component was extended for three months in order to facilitate the development of training courses for the various levels of waterworks personnel. A proposal for UNDP assistance for a three-year training programme was under consideration by the Government. A similar project, which has been operating in Nepal since January 1971, continued as planned, and a panel of consultants made a mid-term evaluation of the progress of the project in April 1972. In India, the Govern- ment was considering a request for UNDP assistance with a programme for the investigation and control of water pollution in Maharashtra State. A consultant visited different cities in India during the last quarter of 1971 and provided technical advice on organizational, legislative and other matters related to the abatement and control of water pollution. SEA/RC25/2 Page 12

Preparation of the necessary documentation for WHO/UNDP assistance to the Maldives in the development of a master plan and detailed designs for water supply and sewage disposal schemes in Male was under way.

Governments have been increasingly concerned about environmental pollution, and steps have been initiated for engaging a consultant to assess the various aspects of this problem and to make recommendations for the formulation of proposals for WHO assistance. It is also proposed to hold a seminar on air pollution at the Central Public Health Engineer- ing Research Institute, Nagpur (India), towards the end of 1972, with participants from all countries of the Region.

With regard to training, WHO personnel assigned to the various countries, in addition to other activities, assisted in organizing and conducting in-service training programmes on the subjects related to their respective projects. Assistance to the Institute of Technology, Rangoon, in the development of a training programne in sanitary engineering was continued, and consultants were provided to Indonesia and Thailand to help with similar training. WHO also collaborated with the Central Public Health Engineering Research Institute, Nagpur, in conducting a training course on the preventive maintenance of water distribution systems, which was held in Bombay in January-February.

The research programme on handpumps sponsored by WHO in collaboration with the All-India Institute of Hygiene and Public Health, Calcutta, was extended in 1970 to cover also the testing of deep-well handpumps. A proposal to initiate a study on handpumps as part of the village water supply programme in India, with assistance from WHO and UNICEF, was under consideration. It was planned that this study would be closely co-ordinated with the one already under way.

1.5 Health Education

In 1971, addressing the Twenty-fourth World Health Assembly, the President of the Assembly stated that "improvement of health through the successful implementation of health projects depends ultimately on the consent and co-operation of individual people and communities. A process of education is urgently needed to remove lack of understanding, fear and apathy from the field of our endeavours". Towards this goa1,intensive health education activities have been undertaken in the Region and have been related to studies in health behaviour, assessment and strengthening of health education services, and training of health and allied personnel in health education. In all of them,emphasis was laid on the educational aspects of specific programnes like maternal and child health and family planning, control of communicable diseases and teaching of health in schools.

A large part of the programe of WHO assistance to health education during the year has been in the form of the provision of consultants. Twenty-one short-term and two long-term conaultanta, in addition to WHO is assisting Nepal in the planning, organization and implementation of a long-term comprehensive national programme of community water supply and waste disposal. Photos show construction work in progress on the modern water supply scheme which will replace the old system (above).

SEA/RC25/2 Page 13

31 national temporary advisers, were assigned. They assisted in (1) assessing the health education services in Ceylon, Indonesia and Mongolia, (2) reviewing and strengthening the health education curriculum in the pre- and in-service training programmes of health personnel in Ceylon and Indonesia, (3) starting studies in health education, health behaviour and related areas in Indonesia, (4) examining the present programmes of production and utilization of health education media in various countries, and (5) formulating guidelines for co-ordinated media production and in developing programmes of school health and family life education in Burma, India and Nepal. Reviews of health education activities and measures to be taken for improving these activities were carried out in the Maldives and Thailand.

Health education aims at inculcating desirable health behaviour into individuals and communities. It needs specialists who have knowledge of and experience in the behavioural sciences, in communication, in educational methods and media and in health. The urgent need is to develop such technical manpower in all the countries of the Region. Indonesia, with the assistance of WHO and US AID, started a health education manpower development project in October 1971. Fifteen candidates possessing the required qualifications and experience completed a six-month basic orientation course in health education and are now in the second phase of their programme of practical training in selected provinces. Those who successfully complete this training will be sent abroad for a post-graduate course. It is proposed to build up a nucleus of well-qualified and trained health education manpower within the current national plan period. In India, the third post-graduate training centre was started in July 1971 at the Central Health Education Bureau under the auspices of Delhi Univer- sity, and a WHO consultant assisted with this progranme. Twelve candidates completed the course in June 1972. The School of Public Health, Mahidol University. Thailand, is planning to develop the Bachelor's Degree Course into a Master's Degree Programme in Health Education from this year.

A significant development during the year was the establishment, in India, Indonesia and Thailand, of rural field practice areas to provide practical experience as part of the post-graduate health education 'course. As field training is an important component of these courses, action has been taken to pool the experiences and to provide guidelines for making such training more effective: also, an inter-country workshop is proposed to be held in October 1972. At WO's suggestion, national multi-disciplinary study groups have been set up in the various countries in order to examine critically their current field training programmes following the guidelines supplied. Plans are also under way to hold a meeting of a working group of health education faculty members in 1973, to develop local resource materials for the teaching of health education and relevant behavioural sciences.

Successful implementation of health education programmes depends on the health education specialist and the effectiveness of the health education tasks carried out by health and allied personnel. As almost all SEA/RC25/2 Page 14 the duties of the health worker in the field have an educational component, he needs to be trained, supported and supervised in recognizing and utilizing to the full the educational opportunities that he en- counters in his daily work. During the year assistance was given in the conduct of several in-service training programnes, in which the emphasis was on the training of the trainers and in the development of sound, practical and field-oriented courses. Appropriate teaching materials have also been supplied.

Training of teacher educators and teachers to enable them to plan and integrate the teaching of health into the school curriculum was undertaken in Burma, Ceylon, India and Nepal. As a follow-up of the inter-country workshop on school health and family life education which took place in 1970, national and local workshops were held in Burma, Ceylon, India. Nepal and Thailand. A number of the recommendations made by the inter-country workshop have been implemented by the education and health departments in almost all the countries of the Region. In fact, in Nepal the Education Department has established a School Health Educa- tion Unit to plan and guide the teaching of health in the school system. National joint committees on school health education with representatives from both education and health departments either are now working or are being established in all the countries. Resource materials to assist the teachers in teaching health have been developed, though there still remains a pressing need for good teaching aids. In Ceylon, India, Indonesia, Nepal and Thailand attention has been focussed on family life education/ population education as a part of total school health education, and the curriculum is in various stages of development. This approach to population education appears to be more acceptable than others in most countries.

Ceylon, Indonesia and Mongolia, with assistance from WHO, undertook critical reviews of their health education services, of activities undertaken at the local, provincial and national levels, and of those as an integral part of the national health programmes. The findings of the reviews were examined by national working groups, which developed plans for reorganizing and strengthening health education services. These plans and recommendations were, at the time of writing, under consideration by the respective ministries of health. Some of the recornendations were under implementation, and requests for additional WHO assistance had been received and were being considered. With regard to proposals related to mass communications and family life education aspects of family health programmes, action was taken to provide assistance jointly with UNESCO and the Development Support Communication Service of UNDP/UNICEF.

In India, assistance was given in a review of the functioning of the State Health Education Bureau of Tamil Nadu. The aim of the review was to find the most effective way of integrating the current health education programme with the educational aspects of maternal and child health and family planning. The Government of India has requested similar WHO assistance to seven more States during 1972. UNICEF continued SEA/RC~~/~ Page 15

co provide assistance to the State health education bureaux and district health education units in India and for the school health education projects in Nepal and Ceylon.

Thailand has developed a five-year plan for the integration of health education into all health progranrmes, specifically those of high priority such as maternal and child health and family planning, nutrition, comunicable-disease control and sanitation. A WHO consultant is being assigned to assist in working out details for the implementation of the plan. UNESCO and the Development Support Comunication Service were also expected to assist with those activities of the plan relating to their respective spheres,and US AID with the provision of equipment, materials and fellowships.

A sound programme of health education must, of course, take into account prevailing cultural, social, psychological, behavioural and related patterns of the community, and any appraisal of such efforts should be undertaken in the light of baseline data concerning these factors. During the year, studies in health behaviour were started in Indonesia. As the first step, as many as 70 studies conducted in the country which had implications for health and health education work were identified and 20 analysed. On the basis of this survey the National Health Research Council, Djakarta, approved 10 priority problems for study, and work on four of these was started in 1971. The study models prepared by WHO consultants were considered valuable for application. The progress of this work was again reviewed in the middle of 1972 and 6 additional studies were initiated. Studies in health behaviour are planned in Ceylon during the last quarter of 1972. The University of Ceylon has expressed interest in participating in these studies.

An important regional activity was the organization of a multi- disciplinary inter-country Workshop on Health Education Media, With Particular Reference to Family Health, which was held in the Regional Off ice in October. Twenty-five participants from different countries of the Region attended, in addition to representatives from the United Nations and other agencies. The workshop developed guidelines for a co-ordinated health education media programme and country plans. (For details, see SEARO 0213 in Part 111). The WHO consultant who conducted the workshop assisted Indonesia in taking follow-up action on the recommendations and guidelines of the workshop.

1.6 Nutrition

Activities in the field of nutrition during the year included the organization of meetings and assistance to training programmes.

A Regional Symposium on Vesical Calculus was organized in Bangkok fron 6 to 11 January. It was attended by 36 participants from 8 countries. Four hX0 consultants assisted in planning for and conducting the symposium. (For details, see SEARO 0195 in Part 111.) SEA/RC25/2 Page 16

A consultation meeting of experts on the prevention of xerophthalmia was held in March 1972 at the National Institute of Nutrition, Hyderabad (India). The report of the meeting, which was attended by 23 participants, was forwarded to WHO Headquarters for discussion with LWICEF.

A Headquarters-sponsored inter-regional course on the epidemiology and rreatment of protein-calorie malnutrition in young children was held in Chiengmai, Thailand, in November-December 1971. Sixteen of the 42 participants in the course were from countries in the South-East Asia Region, i.e., Ceylon, India, Indonesia, Nepal and Thailand.

Assistance continued to be given to both the degree course and the certificate course on nutrition at the National Institute of Nutri- tion, Hyderabad, India. Seven fellowships were awarded to enable attendance at the certificate course. Two guest lecturers were also made available by WHO. The 1972 degree course started in June. WHO providing a fellowship to one participant from Thailand.

The Regional Adviser on Nutrition made a study of the functioning of pilot nutritional rehabilitation centres in Rangoon. His findings confirmed that these centres constituted an effective means of preventing and treating moderate and severe forms of protein-calorie malnutrition. Transformation of the pilot model centres into less sophisticated units with minimum staff was suggested in order to reduce recurring costs.

In Ceylon, a consultant reviewed the work done in the field of nutritional anaemia and recommended the undertaking of prophylactic programmes among pregnant women and children. His report has been sent to the Government.

Goitre control programmes were continuing in Burma, India and Thailand. A consultant reviewed the programme in Burma and recommended the use of iodized oil in places where supplies of iodated salt could not be ensured. Iodized oil was supplied to the Burma Medical Research Institute, Rangoon, for use in the programme.

In India, WHO participated in a meeting of the Goitre Control Review Committee, held in New Delhi in October 1971. The meeting recommended (a) boosting the survey work in Assam State in order to speed up the initiation of the goitre control programme, (b) banning the entry of non-iodated salt in goitre endemic areas and exempting the salt intended for iodation from payment of cess, and (c) because of the need for strict quality control, prohibiting the supply of iodated salt by private traders in goitre endemic areas.

The report and recommendations of the consultant who visited West Irian in 1971 to carry out a feasibility study for starting a goitre control programme were sent to the Government of Indonesia (see also Indonesia 0088 in Part 111). SEA/RC25/2 Page 17

Applied nutrition programmes assisted by international agencies were in operation in India, Indonesia and Thailand. A WHO public health officer was assigned to the Indian programme in November 1971. A working group consisting of representatives of the Ministries of Health and Agriculture and of international agencies was set up by the Government of India to consider the report on an evaluation study of the programme.

During October 1971-January 1972, a consultant reviewed the applied nutrition programme in Indonesia and recommended guidelines for the conduct of nutrition surveys for collecting baseline data. His recommendations have been forwarded to the Government.

Another consultant reviewed the training in nutrition being given at the Faculty of Public Health, Bangkok, and his findings have been sent to the Government of Thailand.

The year saw the establishment of a National Food and Nutrition Institute in Thailand, responsible for all phases of food and nutrition programmes. The Institute is manned by personnel drawn from the Ministries of Education. Public Health and Agriculture and the Ramathibodi Faculty of Medicine.

Assistance was provided to the All India Institute of Medical Sciences, New Delhi, and to the Christian Medical College Hospital, Vellore (India) under WHO'S global programme of research for studies on nutritional anaemia. The Christian Medical College Hospital received further assistance in the testing of protein-rich food mixtures in human beings. Grants were also given for the conduct of studies on the interaction of malnutrition and infection (undertaken by the Indian Council of Medical Research in collaboration with Johns Hopkins Univer- sity) and to the Institute of Child Health, Bombay, for research on the domiciliary treatment of protein-calorie malnutrition.

1.7 Mental Health

Four senior psychiatrists - one each from Ceylon, India. Indonesia and Thailand - participated in the Seventh Seminar on Psychiatric Diagnosis, Classification and Statistics, held in Tokyo, in December 1971, on WHO fellowships.

In preparation for the Seminar on the Teaching of Psychiatry in Medical Colleges, to be held in Ceylon towards the end of 1972, questionnaires were sent to and completed by a high proportion of the medical schools in the Region. This will be the third such seminar to be held in the Region under WHO sponsorship, the first having been organized in Agra in 1968, and the second in New Delhi in 1970. The data extracted from the questionnaires will be used for comparison with the information collected and analysed in connection with the 1968 seminar. SEA/RC25/2 Page 18

1.8 Dental Health

WHO assistance to dental health programmes was related to training, preventive dentistry. organization of a dental workshop, stomatology and revision of dental curricula. In this connection, a dental mechanic tutor, five consultants, a temporary adviser and a Headquarters staff member were assigned to various countries during the year.

One of the consultants surveyed dental health activities in Burma and also assisted in the preparation of a government request for UNDP (SF) assistance for the training of personnel. In his report, which has been sent to the Government, he has stressed the need for more dental manpower. A Headquarters staff member also helped in redrafting the request. It is understood that the Government may seek bilateral aid in this connection.

In Ceylon, the training of dental students at the Dental School in Peradeniya continued to be assisted by the WHO dental mechanic tutor.

In January-February 1972 a consultant in preventive dentistry assisted the Dental College in Bangalore, India, and made a number of recowendations for improving the undergraduate and post-graduate training in community dental health/preventive dentistry. He stressed the need for having refresher courses for the dental profession. From August 1971 to January 1972, assistance was given to Indonesia in the organization and conduct of a national dental workshop. The WHO consultant assigned made recommendations on the planning of a national system of dental education, which have been forwarded to the Government.

The dental health situtation in the Maldives was being studied, in order to assess the nature of assistance required for promoting dental health amongst the population.

In Mongolia, WHO is assisting in the strengthening of dental education and services. In this connection, a consultant in stomatology is working at the Institute of Medicine in Ulan Bator.

Also,the Phyathai School of Dentistry in Bangkok has been given assistance in re-structuring the curriculum to meet the needs of the community. A consultant to review the training of dental auxiliaries is under recruitment.

1.9 Occu~ationalHealth and Rehabilitation

The strengthening of occupational health services, development of the specialty of medical rehabilitation and training of physiotherapists continued to receive the attention of WHO.

In addition to long-term staff, four consultants were provided to different countries during the year. SEA/RC25/2 Page 19

.4n expert in occupational health visited Buma in July 1971 for two weeks to prepare a report on the organization of occupational health services. He also helped to draft a government request to the UNDP for assistance in this field.

The draft request to the UNDP for the development of a Special Fund project in occupational health in Indonesia (mentioned in last year's report) was prepared in the light of comments received from other agencies concerned, and copies have been forwarded to the Government.

During March-May, the state of occupational and industrial health in Thailand was reviewed and assistance provided in determining the needs and priorities for the development of staff training programmes.

As regards medical rehabilitation, in India assistance continued to be given to the rehabilitation departments of the All-India Institute of Medical Sciences and Safdarjang Hospital, New Delhi. An expert in medical rehabilitation was also provided to Burma for three weeks during October-November, to follow up on the visits of previous consultants and to hold discussions on the further development of this specialty.

In the first quarter of 1972, a consultant visited Ceylon to assist in the development of medical rehabilitation services and to review the curricula relating to this subject in medical schools.

The training of physiotherapists at Baroda (India) continued to receive assistance. In Thailand, the concept of the prevention of disability by simple bedside measures was promoted, as an improvement of medical care in four of the thirteen hospitals in the populous north- eastern provinces. A beginning was made in the establishment of physiotherapy units in provincial hospitals.

1.10 Radiation Health

Activities in this field related mainly to the training of X-ray and electro-medical technicians, radiographers and medical physicists. Long-term WHO staff were assigned to these programmes.

WHO continued to assist with courses for X-ray and electro- medical technicians in Eurma, India, Indonesia and Mongolia. A new project, "Maintenance and Repair Workshop for Health Equipment", was started in Burma in September, with the assignment of a WHO engineer.

The training of radiographers and medical radiographers proceeded satisfactorily in India, Indonesia and Thailand.

Continued support was given to the training of medical physicists in Thailand. In India, a consultant was provided to the Bhabha Atomic Research Centre in Bombay to help with the Centre's regular course for SEA/RC25/2 Page 20

physicists, and another consultant was provided to the Radiation Medicine Centre, Bombay, in connection with radiorespirometry studies for the evaluation of various metabolic processes.

Two consultants were assigned to Ceylon to assist in the preparations for and conduct of a three-week course in radiation health, held in October-November in Colombo.

In connection with the fifth batch of the joint IAEA/WHO postal dose intercomparison studies, thermoluminescent tubes were sent to the institutions concerned in the Region. The results of the evaluation were communicated to the participating institutions.

1.11 Cancer

Though communicable diseases continue to receive priority consideration in the countries of the Region, governments are now showing concern about developing facilities for the prevention and treatment of degenerative diseases and for the rehabilitation of persons afflicted by them.

Thus in the cancer control programmes under way, increasing attention continued to be paid to the study of the epidemiology and early detection of the disease and to the organization of treatment facilities, with proper registration and follow-up systems. Stress was also being laid on health education and the training of health personnel in the management and prevention of cancer.

With a view to stimulating the training of oncologists for the development of control programmes and epidemiology services. WHO plans to provide assistance through consultants and the award of fellowships.

In India, the building for the Arignar Anna Memorial Cancer Insti- tute in Kancheepuram, near Madras, was completed, and laboratory facilities for the diagnosis of cancer were established. Four national staff members attached to the project - a cytopathologist, two cytotechnicians and a statistician - returned from abroad after training on WHO fellowships. A WHO consultant in statistics reviewed the epidemiological data and advised on the designing of forms and on the coding and analysis of the data. The Regional Director as well as other staff members from both WHO Headquarters and the Regional Office have visited the project on different occasions in order to hold discussions with the Government of Tamil Nadu on such subjects as treatment facilities for cancer cases detected in Kancheepuram and the proposal for a comprehensive control programne in the State. A decision has been taken on providing treatment facilities in Kancheepuram, and a State-wide programme will be developed in a phased manner during the current decade. SEA/RC25/2 Page 21

At the Fourth National Cancer Conference and International Seminar on the "Epidemiology of Oesophageal Cancer", in Bangalore in November, the Regional Director delivered a keynote address on cancer control. This meeting was attended by participants from all over India and abroad, among whom great interest in cancer control and in the development of special institutions for the management of this problem was discernible.

The Government of India has set up a committee to make recommendations for the establishment of regional centres for cancer treatment.

In Mongolia, which is receiving assistance in the development of an ontological dispensary and in the promotion of facilities for the early detection of cancer of the cervix, epidemiological studies in oesophageal and liver cancer will be undertaken.

It is also proposed to organize, late in 1972 or early in 1973, a regional meeting of experts to consider studies on the morbidity and mortality patterns of cancer and related matters in order to develop comprehensive control programmes within the existing public health delivery system.

1.12 Cardiovascular Diseases

The widespread observance of World Health Day 1972, on the theme "Your Heart is Your Health", served to focus attention in the various countries on the prevention of cardiovascular diseases, i.e., prevention of rheumatic fever and management of hypertension, ischaemic heart diseases and stroke.

Programmes for the control of rheumatic fever and ischaemic heart diseases were stimulated in India. In Madras, the Regional Director inaugurated a new Institute of Cardiology at the Madras General Hospital and Medical College on World Health Day and delivered an address on "Heart Patient - the Physician and Society" at a three-day symposium on cardiovascular diseases. The Institute is expected to become a centre for training, services and research on these diseases, and the Chief of the Cardiovascular Diseases Unit at WHO Headquarters visited Madras in February for discussions in this connection. Peripheral vascular occlusive disease, which is occurring with increasing frequency, will be one of the problems on which epidemiological studies will be undertaken at the Institute.

A number of urban hospitals in India are setting up coronary care units. WHO plans to assist in the training of the health team in the management of cardiovascular diseases and in the organization of cardiac and stroke registries in various countries.

Mongolia continued to receive assistance in its epidemiological studies on rheumatic fever and on the prevention of hypertension. SEA/RC25/2 Page 22

1.13 Pharmacoloay and Toxicolo~

1.13.1 Quality Control of Pharmaceutical and Biological Products

WO assistance continued to be provided for strengthening services in this field.

One consultant assisted the Government of Mongolia in connection with quality control and standardization of pharmaceutical and biological products, while, at the same time, another gave particular attention to the improvement and further expansion of the pharmaceutical industry in the country.

In Thailand, the WHO pharmaceutical chemist in the Department of Medical Sciences, Ministry of Public Health, continued to provide assistance in quality control as well as in the training of drug inspectors.

Work was continued on the finalization of a draft request from the Government of India to the LlNDP/Special Fund for assistance to a proposed project for strengthening drug quality control laboratories.

1.13.2 Drup. Dependence

The problem of the control of drug abuse in the Region has been engaging the attention of the Organization. Studies on the epidemiology of this condition and on the organization of services for the treatment and rehabilitation of drug dependants will be undertaken in Burma. India and Thailand. The Chief of the Drug Dependence Unit from WO Headquarters visited Bangkok and New Delhi in April and held discussions on promoting programmes control. WHO fellowships have been offered to candidates from Burma, India and Thailand for training in activities related to the prevention of drug dependency and alcoholism.

1.13.3 Food Safety: Hazards to Man from Pesticides

In order to control and minimize hazards arising from the use of pesticides, plans are in hand for the provision of assistance in strengthening pesticides legislation, in promoting research on medical toxicology and in training the necessary staff.

The Government of Indonesia has been working on the problem for some time, and WHO is recruiting a consultant to advise on and assist in further strengthening national legislation related to pesticides. He will also help in establishing pesticide protection teams at the provincial level and in training staff.

In response to a request from the Government of Thailand, a consultant is also being provided to that country to advise on the analysis of pesticide residues in food. s~A/RC25/2 Page 23

Furthermore, a consultant will be assigned to the Industrial Toxi- cology Research Centre, Lucknow (India), to review laboratory procedures, assist in the organization and operation of an epidemiological unit, and help with specific problems and research related to medical toxicology.

1.14 Medical Stores Management

In the field of medical stores management, assistance has been requested by the Governments of Indonesia and Nepal.

Recruitment is under way for a consultant to advise on this subject as requested by the Government of Indonesia.

A medical stores management officer is being assigned to Nepal and is expected to be in position in the last quarter of 1972. Also, a six-month fellowship is being awarded to enable a national staff member to attend a course on pharmaceutical and medical stores management abroad.

2. COMMUNICABLE DISEASES

Just as in previous years, communicable diseases continued to be the main cause of human suffering in this region. Despite the increasing efforts made by governments and the assistance given by international and bilateral agencies, it has not been possible to eradicate smallpox nor to reduce the number of cases of other communicable diseases subject to the International Health Regulations. The complete eradication of these diseases is closely connected with human ecology and the availability of well developed basic and other levels of health services.

However, the efforts have resulted in several important achievements. An increase in the number of personnel trained to work in communicable-disease control has contributed to the reduction in case-fatality rates from these diseases and to better reporting. The systematic dissemi- nation of knowledge on cholera control, for example, has brought the treatment of cholera closer to the affected areas and to the patients, so that the case-fatality rate has fallen below 20%. and has been, for the whole of the Region, fluctuating between 12 and 14%. This is a considerable achievement when compared to previous years, when the rate ranged from 24 to 40% of the cases reported.

With the exception of Burma, human plague was not reported from any country having endemic foci of plague (i.e., from India, Indonesia and Nepal). The number of cases reported from Burma showed a slight increase, but this was parallel with the increase in the area covered by active surveillance of plague and is also due to better surveillance activities.

The plague project in Burma, which has been conducting epidemiological investigations and training courses/seminars for the past several SEA/RC25/2 Page 24 years~withWHO assistance, has come out with some interesting epidemiological observations: (a) that there are no indications which lead to the assumption of the existence of an endemic focus in Burma, (b) that the enzootic of plague does not kill all rodents and the persistence and perpetuation of plague among rodents results occasionally in human cases, and (c) that the appearance of human plague corresponds to an increase in the rate of Xenopsytta cheopis over X. astia among field and domestic rodents, which occurs during the epidemic season of the year. Careful surveillance of the resistance of fleas to insecticides has shown that fleas in all the countries mentioned as having endemic foci of plague (Burma, India, Indonesia and Nepal are resistant to DDT but not to BHC (benzene-hexachloride) or organophosphoric compounds. No resistance of Yersinia pestis to streptomycin or to other wide-spectrum antibiotics has yet been observed.

The governments in the Region have given attention to the surveillance of dengue/haemorrhagic fever. It is interesting to note that once the disease is established in an area, it continues to be a health problem, showing an increase in incidence every second year, with a rather high case-fatality at the beginning (5%).

Laboratory competence in respect of the arboviruses has been established in all the countries where these diseases constitute a problem.

The control of poliomyelitis and the monitoring of paralytic polio cases occupy an important place in the public health programmes of the Region. Immunizations are now given routinely as part of the services of the maternal and child health and family health centres, and the future aim is to be the coverage of the susceptible child population with vaccination or immunizations against tuberculosis, smallpox, polio, diphtheria, tetanus and pertussis. At the same time, in Burma, India, Indonesia and Thailand, action has been taken to increase the local production of the various vaccines to meet future needs.

Malaria and tuberculosis continue to be given high priority. Both programmes have registered successes as well as failures, but the areas under coverage are expanding, and efforts continue to consolidate the gains so far achieved.

The systematic activities directed towards the prevention and control of some communicable diseases contribute to the general improvement of the state of health of the population pari passu with socio- economic development. It is necessary both for governments and for other agencies to continue to give priority to the prevention of diseases by routine immunizations where possible, and to control epidemic outbreaks by all available means. s~A/RC25/2 Page 25

2.1 Malaria

The past year has been marked by both gains and losses. The number of persons in areas entering the consolidation phase has increased, as has the number brought under some form of malaria control. However, setbacks have been encountered, and the withdrawal of financial aid by assisting agencies will most certainly have a deleterious effect on the programmes in this region. This withdrawal of support has already started. Also, developments such as wars, civil disturbances and strikes have hampered progress; their future effects have yet to manifest themselves fully. lJHO assistance, in the circumstances, has been strained in order to maintain the gains made so far, but unless greater efforts are made by the countries concerned to increase their own expenditure, many of the campaigns will gradually become control programmes with no end.

The controversy concerning DDT has resulted in a general ban on its use in agriculture,but it is accepted for public health measures. It is hoped that representations made to DDT-manufacturing countries will result in a supply for at least the next ten years. The South-East Asia Region alone consumes 51% of the total global requirements.

It may be recalled that strategy reviews by governments assisted by international agencies have been carried out in India and Nepal. In countries with no official external assistance from other sources, e.g., Indonesia, the Maldives and Thailand, plans based on their own needs to cover operations for some years to come have been drawn up. In the meantime, plans of operation have been signed by Ceylon and the Maldives, and it is expected that Burma will follow suit. A further strategy review was made in Nepal. In passing, it should also be mentioned that the late arrival of DDT has resulted in spraying too late in the season or even in missing the first round. It is possible that this may put back the programmes concerned by as much as two to three years.

The following table shows the overall status of malaria eradication in the Region (June 1972 estimates): Millions Population in the Region 764.9 Population in originally malarious areas 730.5 Population in areas where eradication is claimed (maintenance phase) 319.0 Population in areas under malaria eradication 288.2 In consolidation phase 136.1 In attack phase 151.4 In preparatory phase 0.7 Population in areas under malaria control measures 83.5 Protected by extensive mosquito control measures 73.0 Where there is an organized effort for drug treatment 10.5 Population in areas with no specific anti- malaria measures SEA/RC25/2 Page 26

The table and the graph differ from those presented in past years. Previously,areas under control measures only were shown in the attack phase. Also, up to very recently, the figures of population increases had been only estimated; this time, the census in Indonesia in 1971 has been taken into consideration.

During the period under review, the number of WHO personnel working in malaria programmes was increased in Ceylon, Indonesia and the Maldives. The progress made throughout the Region is summarized below:

A plan of operation has been prepared and is under consideration by the Government of Burma. In Rangoon, a laboratory technician completed his assignment, and further assistance was given by WHO in the training of laboratory staff and inspectors in geographical reconnaissance. Changes in staining methods have been introduced. The malaria programne is being integrated by stages into the general health services. The headquarters of the Malaria Institute is in charge of the planning, technical direction, assessment, training and research, while peripheral institutions will be responsible for implementing the programme at township/rural health centre levels. The ultimate object is to have one malaria assistant and two malaria inspectors in each township, plus a malaria superviser and an adequate number of permanent spraymen assigned to each rural health centre. Figures show that there have been an increase in spraying operations and a considerable reduction in mortality rates from malaria. Malaria, which previously claimed the fourth highest mortality among the ten major causes of death, is no longer on this list at all. No long-term WHO staff have been with the programme since the beginning of 1972, and none are envisaged before 1973.

In Ceylon, the plan of operation has been signed. The epidemic which commenced at the end of 1967 and reached its peak at the end of 1969, has been showing a decline by lysis during the past two years. The figures have now attained a plateau at about 10 000 to 14 000 cases per month. Although the number of cases of P.vivuz continues to fall, the plateau has been maintained by the increase in the number of cases of P.faZciparm malaria. The Government is fully aware of this situatian and is taking vigorous measures to tackle it. However, the threat of a serious danger implied by an increase in cases will have to be considered. An assessment team under a national team leader and with WHO'S participation carried out an epidemiological and socio-economic survey early in 1912. The WHO team has been increased, particularly in respect of the National Malaria Eradication Training Centre. The present WHO strength at the Centre is one malariologist and one parasitologist; the Govern- ment has also assigned a malariologist and an entomologist to the Centre, and further assistance is given by other WHO malaria staff as well as external lecturers. Liberal supplies from WHO are helping in bringing about improvements at the Training Centre, which, it is hoped, will in due course become a malaria research centre. The decentralization of laboratories has now been completed and the backlog of slides cleared up. GRAPH 1 - POPULATION AT MALARIA RISK IN THE AREAS UNDER VARIOUS PHASES OF THE MALARIA ERADICATION PROGRAMME IN THE SOUTH-EAST ASIA REGION (1963-1972)

Population (in millions)

Population at Malaria Risk (in Millions) SEA/RC25/2 Page 27

In India,apart from difficulties caused by the emergency situation towards the end of 1971, the programme suffered seriously owing to the late arrival of DDT, and this delay, as mentioned earlier, may result in the steady increase of cases for the next two to three years. However, the necessity of changing the timing of residual insecticide spraying has been recognized, and the effects of this change will become clear as the new methods come into operation. There has been a considerable loss of experienced national malariologists due to death, retirement or transfer to other medical disciplines. WHO has considerably increased the supplies element and has also awarded a large number of fellowships for training at the Malaria Eradication Training Centre in Manila. The recommendations made by the strategy review team in 1970 are being implemented gradually. The usual annual independent assessment was carried out in January 1972. Furthermore, the problem of urban malaria is receiving attention, and a pilot project at Jodhpur (Rajasthan) using ultra-low-volume spraying techniques with a LECO machine is envisaged for the years 1972173. This will be a joint Government/WHO experiment.

In Indonesia, the WHO team has been considerably increased, with the result that there has been an extension of malaria control activities to the islands other than Java, particularly Sumatra, Kalimantan, Nusa Tanggara, Sulawesi and Molucca. The populations of these islands are now included in the table showing the total number of persons under malaria control measures. Field visits by WHO staff and their national counter- parts to these islands reveal varying degrees of intensity of malaria, from a negligible amount to hyperendemic proportions. Further investigations are necessary in order to divert DDT to those areas where it is most needed. The amount of DDT in Indonesia is far lower than what is required, but despite this fact, the number of cases shows a considerable decline. In West Irian, supplies have been ordered well ahead of time.

The activities in the Maldives continue to increase and improve with each passing year. A sanitarian has taken up his assignment with the malaria programme, which is being assisted in toto by WHO. The sole factor holding up rapid eradication is lack of sea transport.

Nepal has shown considerable progress, and 80% of the country is now in the consolidation phase. It is most unfortunate that at this particular stage financial aid from bilateral sources is to cease, as this withdrawal of support may reduce the tempo of operations. This possibility has been recognized, and a large team of national, WHO and US AID members has recently made a strategy review with the objective of making recommendations to consolidate the gains achieved.

In Thailand, it is intended to strengthen the epidemiological services for both malaria and other communicable diseases by the provision of a WHO epidemiologist/malariologist. The WHO sanitarians are being gradually withdrawn. In the meantime, research on the specific role played by A.ba2abacensi.s in malaria transmission has been continued. SEA/RC25/2 Page 28

The 1972 Burma-India-Pakistan Malaria Co-ordination Conference which had been planned could not be held.

Under the WHO Headquarters research programe, grants for research work on malaria were made to several institutes.

2.2 Tuberculosis

The year under review has been a fruitful one as regards activities in tuberculosis control in all the countries of the Region.

It is gratifying to note the continuing attention being given by governments to the development of tuberculosis control activities and to their operation within the general health services. It is hoped that in the future efforts will be made to increase the area of coverage and to intensify the various components such as case-finding, treatment, BCG vaccination, health education and training.

The assessment of the national tuberculosis control programme in Burma was completed, and the findings of the assessment team were used as a basis for discussion at the national seminar on tuberculosis control which vas held in October. A number of valuable papers were also presented by the national participants in this seminar, whose recommendations are expected to serve as guidelines for the future programme. Also in Burma, the national control programme and the National Tuberculosis Insti- tute have made preparations for carrying out, in 1972, a baseline tuberculosis survey, which will also include areas which have not yet been covered by the national programme. It is planned to provide WHO consultants to assist in this survey.

The tuberculosis baseline survey in Ceylon was completed, and the results, which have been analysed, indicate that the tuberculosis problem in the country is not of such a magnitude as expected and that the control activities have been effective.

In March-April 1972, a WHO medical officer assigned to an inter- country project and the laboratory technician with the Regional Tuber- culosis Training and Evaluation Team visited the Maldives in order to assess the tuberculosis control activities. Their findings show that the programme has been successful in the islands so far covered and has pinpointed the appearance of tuberculosis cases resistant to regular treatment by first-line anti-tuberculosis drugs.

Preparations have been made for an assessment of the tuberculosis programme in Mongolia, planned to take place later this year. A consultant is under recruitment. Meanwhile, the laboratory techniques related to mycobacteria were improved, with assistance from another WHO consultant.

In the report of the WHO consultant assigned to Indonesia from December 1970 to June 1971, recomendations have been made which SEA/RC25/2 Page 29 primarily stress the improvement of coverage by means of BCG vaccination. On the basis of the consultant's findings, an assessment of the programme is planned for 1973.

A WHO consultant was assigned to Nepal in June to assist the national tuberculosis control programme in that country.

Towards the end of 1971, a consultant was provided to Thailand to review the tuberculosis control activities and to make recommendations for future development.

The national programme in India continued to develop according to ~lan.As of September 1971, the total number of district tuberculosis control programmes was 215. At the National Tuberculosis Institute, Bangalore, which is the major training centre for tuberculosis workers, the regular courses for personnel of district programmes were conducted, and the Indian part of the international course on the epidemiology of tuberculosis was also held. Participants from outside India attended some of the courses on WHO fellowships. The WHO medical officer who assisted the project in the evaluation of the material of the longitudinal study (natural history of tuberculosis) completed his assignment in March 1972, after submitting a final report on the study.

Two consultants visited the Tuberculosis Chemotherapy Centre, Madras, early in 1972 to assist in evaluating the completed studies and in drawing up plans for future research activities.

Th? Regional Tuberculosis Training and Evaluation Team continued to assist in various aspects of national tuberculosis programmes.

Research activities regarding resistance of some tuberculosis cases to treatment by the first-line drugs will continue to be given attention, and it is hoped that the national control programmes, in their concurrent evaluation of operational activities and the epidemiological trend of tuberculosis, will study the magnitude of the problem of resistance to drugs and disease carefully before taking any decision which will change the policy.

2.3 Epidemiological Surveillance and Diseases Subject to the International Health Regulations

The International Health Regulations have now been in operation for more than one and a half years. It is still early to evaluate their usefulness, but it is felt that the Regulations, which are now based ,,more on national and international surveillance than on strict quaran- tine measures", have contributed to an improvement in the notification of the diseases which they cover, only three of which - cholera. smallpox and plague-occur in South-East Asia. Many areas in Burma and Indonesia which have not previously reported cholera have started notifying the disease, because of the improvement of surveillance activities and better diagnosis of a variety of clinical cases. DISEASES SUBJECT TO TKE INTERNATIONAL HEALTH REGULATIONS REPORTED BY COUNTRIES OF THE SOUTH-EAST ASIA REGION, 1969. 1970 AND 1971

(Sources: WorId Health Statistics Report, Vo1.24, No.4 and Weekly E~idemioloaicalRecord, 47, No. 14, 1972, and supplementary informtion as reported to WHO SU/RC25/2 Page 31

The table on page 30 gives the figures in respect of cholera, smallpox and plague for the years 1969, 1970 and 1971, as reported to the World Health Organization.

Two aspects of the surveillance programme are encouraging: first, the improvement in the reporting of cholera, which has not caused any hardship to international trade and traffic, and, second, the reduction in the case-fatality rate in reported cases of cholera, which can be interpreted as resulting from better detection and treatment and improved notification.

The microbiologist attached to the Regional Epidemiological Sur- veillance Team (now a project of wider scope which includes training) assisted the Government of Burma in the further development of epidemiological surveillance of cholera and salmonellosis, based on laboratory routine work and its support to field investigations.

The epidemiological surveillance programmes in countries cover all diseases subject to the International Health Regulations. In addition, the surveillance of denguelhaemorrhagic fever has been satisfactorily established in Thailand, Burma and Ceylon, based on co-ordinated epidemiological, clinical and laboratory work, and in Indonesia, based primarily on serological findings in patients in Djakarta and Bandung. The national epidemiological surveillance of other comunicable diseases is carried out in Ceylon, Burma, India, Indonesia and Mongolia. Nepal is concentrating mostly on diseases subject to the International Health Regulations, while the Maldives are devoting special attention to enteric fevers and other diarrhoea1 diseases.

The epidemiological services in all the countries have recorded further improvement. For example, in Mongolia, besides the central epidemiological unit, all 18 aimaks have set up such units. In Burma, in addition to the central epidemiological unit, six out of the nine divisional disease control teams have already been converted into divisional epidemiological units. In Thailand regional epidemiological units have been set up in the north-eastern and southern parts of the country. In Indonesia, as a result of intensive short courses organized by the Government with WHO assistance, the majority of the provinces are now covered by epidemiological surveillance programmes.

Of the eleven participants in the 1971 WHO-sponsored international (Prague/Delhi) training course in epidemiology, six were from South-East Asia (India 3, Indonesia 1 and Thailand 2). They received diplomas after the completion of their training.

2.3.1 Smallpox

The main achievement in smallpox eradication during the year has been the virtual interruption of transmission of smallpox in Indonesia. SEA/RC25/2 Page 32

During 1971, 2 158 cases were recorded in that country, as conpared with 10 081 cases recorded during the previous year. India (15 790 cases) and Nepal (215 cases) are now the major problem areas of the Region. Five countries remained free from smallpox - Burma, Ceylon (with the exception of one imported case), Maldives, Mongolia and Thailand.

A total of 18 073 cases were reported during 1971 as compared with the incidence of 22 585 during 1970.

In the southern States of India, only a few localized outbreaks have occurred (except in Mysore, with a higher incidence). In the west, with the exception of Mysore, in the States of Gujarat and Rajasthan, which had recorded the highest incidence of the disease in India in 1969 and 1970 respectively, the number of cases reported has fallen to a low level. The problem areas during the last year have been the northern States of Uttar Pradesh, Haryana and Bihar. The State of West Bengal has recorded increasing incidence, and it is feared that smallpox may likewise flare up in the other States of eastern India.

More cases have been reported in India (15 700) during 1971 than during the previous year (12 420). This increase in the number can be mostly attributed to better surveillance and improvement in the reporting of cases. The adoption throughout the country of a uniform reporting system, by which cases are now being recorded by the week of detection and not by the date of onset of the disease, is a great step forward. Furthermore, the reports are channelled to the Central Bureau of Health Intelligence through the State programne officers of the National Smallpox Eradication Programme instead of through the States' statistical units.

In Indonesia, in spite of an intensified search throughout Sumatra, no case has been detected in this island since September 1971. Similarly, the island of Java has remained free of smallpox since May 1971, with the exception of one localized outbreak which occurred in December 1971 in West Java. Sulawesi accounted for 296 of the 507 cases recorded in Indonesia during the year. No case has been recorded in Indonesia since January 1972. An active search for possible unreported cases is being carried out throughout the country, and pilot studies are being conducted in Java, in which freeze-dried smallpox and BCG vaccines are administered simultaneously. Should these studies prove successful, such combined vaccination will be carried out in all of Indonesia.

In Nepal, the programme was extended to an additional eight districts during the year. It is now in operation in 87% of the country (58 districts out of 75). The majority of outbreaks occurred in the Terai area and could be traced mostly to importation across the border. Frequent training courses for the local staff and better supervisory measures have helped to improve the routine vaccination, surveillance and reporting elements during the year. The WHO Headquarters-assisted Aedes Research Unit in Bangkok, Thailand, is continuing its work on finding improved methods for the control of Aedes mosquitoes, carriers of the dengue'haemorrhagic fever virus. Picture shows water storage jars, a favourite breeding place, being examined for the presence of the Aedes mosquito.

In Burma. the spraying of larvicides has resulted in a considerable reduction in the density of Culex Fatigam, the main vector of filariasis. Photos show spraying over a typical breeding place (left) and examination of a collection of utensils for possible breeding. With assistance from WHO, the malaria control activities in the Maldives are expected to cover all the inhabited islands by 1974. Shown in these pictures are insecticide-spraying and slide examination.

Smallpox is on the decline in the Region, thanks to the all-out efforts being made by governments. In this picture from Indonesia, a girl receives vaccination with the bifurcated needle. SEA/RC25/2 Page 33

The main emphasis in the activities undertaken with WHO assistance has been on the reporting, surveillance and containment elements of the programmes. Maximum efforts have been made, especially in India, to strengthen the smallpox eradication activities at both central and provincial levels.

WHO consultants assisted in assessing the programmes in many areas. Fellowships and grants for research in the fields of epidemiology and immunology were provided. Assistance was also given for the establishment of smallpox diagnostic laboratories. The local production and testing of freeze-dried vaccine were supported, and WHO supplied some countries with vaccine, either directly or through bilateral assistance (see also Chapter 3, Part 11).

2.3.2 Cholera

During the year 1971, cholera continued its spread westward, and many countries of Africa and Europe were affected. There have been times during the year when not only have more countries in Africa been involved but also more cases have been reported from that continent than from South-East Asia, the traditional home of cholera. A careful analysis of case-fatality rates, however, has shown that they are lower for both Africa and Asia (approximately 15%) - a decrease which,as earlier mentioned, could be interpreted as being due to better detection, treatment and reporting of various clinical types of cholera.

In South-East Asia, cholera was reported from Burma, India, Indo- nesia and Nepal, as in the previous year. The number of cases reported showed an increase in India and Indonesia (see table on page 30). The epidemiology, treatment and surveillance of cholera have been included in programmes of national training courses and seminars.

WHO continued to assist Indonesia in the study on the effect of the improvement of environmental conditions on the spread of cholera. In addition to a research grant, four consultants were provided at different periods of time for the study, which is being carried out in Makasar (Sulawesi).

One of the participants in an inter-regional training course on cholera organized in Malaysia and the Philippines was a WHO fellow from Indonesia.

WHO continued to assist the Government of India in studies for inproved (more immunogenic) cholera vaccines.

2.3.3 Plague

During the period under review, only from the plague endemic focus in Burma were cases of human plague reported, and no case was reported from Indonesia (Bojolali District focus) or from other countries S~A/Rc25/2 Page 34 suspected of having enzootic foci (India and Nepal). Information on the appearance of an outbreak among rodents in Coimbatore (South India) has not been confirmed, and no human cases have been reported.

A WHO consultant assisted the Government of Burma in further strengthening plague surveillance activities. The second inter-country training course in plague epidemiology and control was held in February in Mandalay,with nine participants from the countries of the Region. In addition to a WHO consultant and a temporary adviser, three WHO staff members assisted in the conduct of the course, which covered various aspects of plague control (rodent ecology, the fluorescent antibody technique, etc.).

The research project in the ecology of plague (mentioned last year) has started operations in the endemic focus in Indonesia (Bojolali District), with the aim of studying primarily the factors contributing to the persistence of plague foci in tropical countries. A WHO animal ecologist was assigned to the project at the beginning of 1972.

In Burma more (300) isolations of plague bacilli have been made from rodents than at any time in the past. This number of isolations and the fact that no marked increase in human cases has been reported confirm that the plague surveillance activities are well developed in that country.

2.4 Bacterial Diseases

2.4.1 Leprosy

Leprosy control continued to be accorded high priority in the activities of health services in the countries of the Region. During the year under review emphasis was placed on speeding up preparations for the integration of the control campaigns into the general health services in countries where such integration had not already started.

A WHO consultant assisted the Government of Thailand in the conduct of an epidemiological study of the prevalence of leprosy as well as in an operational assessment of the national leprosy control programme in selected provinces, in order to formulate guidelines for the future development of control activities within the integrated programme of health services in the country.

Preparations were made for an assessment of activities under the leprosy programme in Burma, covering the epidemiological as well as operational aspects. It is planned to hold a seminar on the epidemiology and control of leprosy at the end of the assessment, to consider future lines of action.

The WHO leprologist consultant in Ceylon continued to assist the Government in the further development of the control programme in that ccuntry. SEA/RC25/2 Page 35

The leprosy control programme in India developed according to plan. Towards the cnd of 1971, the second WHO leprologist completed his assignment and left the project.

A consultant is being provided to Nepal in Oztober:1972 to review the activities in that country.

Generally speaking, the national leprosy control programmes in the countries of the Region, which have been run for a long time as special campaigns, have been taken up for integration into the general health services. The caution with which governments are approaching integration promises that the achievements so far made will not be lost and that the trend of decline of leprosy as demonstrated by the reduction of the case detection rate will continue.

2.4.2 Venereal Diseases and Treponematoses

A first Regional Symposium on Venereal Diseases was held in Thailand in December 1971. The Symposium confirmed the disturbing reports of the increase in the incidence of venereal diseases in the countries of the Region and recommended various steps for increasing the surveillance and control of venereal diseases and for monitoring resistance to anti-venereal drugs. Two WHO c.onsultants and six temporary advisers assisted in the conduct of the Symposium, which was attended by eight participants from three countries.

WHO consultants were assigned to Burma and Thailand to review the national venereal-disease programmes. Subsequently, another consultant in the laboratory techniques of venereal diseases went to Burma. Two further consultants (a venereologist and a laboratory technician) are under recruitment for assignment to Thailand.

Towards the end of the period under review, a consultant was provided to Indonesia to assist with a review of the yaws programme in the country and to make recommendations for its future development and eventual integration into the health services.

2.4.3 Diphtheria, Tetanus and Pertussis

No epidemic outbreaks of any of these three diseases with large numbers of cases or high case-fatality were reported from any country during the year. IL has been found during multi-purpose serological surveys that natural immunization against diphtheria takes place reason- ably early, so that by the age of seven about 80 per cent of childrrn will show the antitoxin against diphtheria in their sera. It is presumed (but still not scientifically proved) that the infection and natural immunization take place through infected skin scratches.

Immunization against diphtheria, pertussis and tetanus has been successfully carried out in Mongolia,with a high coverage of the susceptible SEA/RC25/2 Page 36

population. Simultaneously, surveillance of diphtheria has been established on the basis of clinical, laboratory and epidemiological work. It is interesting to note that small outbreaks of diphtheria are sometimes recorded, and attempts are being made to elucidate the causes.

The Regional Adviser on Communicable Diseases, during a visit to the Maldives early in 1972, discussed with the national authorities plans for the introduction of DPT imunization in Male island and its subsequent gradual extension to the other inhabited islands.

2.4.4 Diarrhoea1 Diseases

An outbreak of diarrhoea in epidemic form was reported from Male island (Maldives) at the beginning of 1972. The Regional Adviser on Comniunicable Diseases, accompanied by a microbiologist, visited the Maldives to assist in the investigation and control of the outbreak. The totalnumbersof cases recorded during the outbreak period were 358 fever and 805 diarrhoea, with a low case-fatality rate (0.60%). Children up to the age of three were most affected, making up 72.77% of the number of recorded cases, and cases among adults were extremely rare. Assistance was given to the Government in undertaking the surveillance of diarrhoeal diseases and in strengthening preventive measures.

A surveillance prograrmne for the salmonelloses, based on epidemiological and laboratory investigation, has been started in Burma. Surveil- lance of diarrhoeal diseases in some areas of Rangoon City continued.

2.5 Virus Diseases

2.5.1 Trachoma

During the year there was no new scientific breakthrough related either to the vaccine to be used in trachoma control or to better drugs.

The national trachoma control programme in Burma is approaching the expansion level whereby it will cover all the eleven endemic areas. A WHO consultant visited the country to assist the national authorities in an evaluation of the effect of one or two courses of treatment of trachoma. It is expected that a decision on the eventual modification of the technical policy related to trachoma control will be taken after the completion of these carefully conducted studies.

In other countries where trachoma represents a public health problem, the activities have been integrated into the general health services. UNICEF continues its assistance with supplies of antibiotic drugs and other equipment, which are channelled through the health centres. SEA/RC25/2 Page 37

No epidemic outbreaks of poliomyelitis have been reported during the year under review. However, an increase in the incidence of paralytic polio cases has been observed in large cities (Djakarta, Bangkok, Rangoon), indicating that the disease will probably become a priority problem in the future.

Routine immunization against polio, with a high coverage of the susceptible population (more than 95%), has been carried out systemati- cally in Mongolia, through the maternal and child health centres, with the result that not a single case of paralytic polio has been reported for many years. The immunization carried out inMale (Maldives) in 1968 also resulted in the elimination of polio, but, in view of the increasing proportion of the younger generation which is susceptible, the Govern- ment is considering the possibility of introducing routine immunization before another outbreak occurs.

In Ceylon, a routine immunization programme has been in existence, but the reporting of cases of paralytic polio from various districts indicates that either the coverage has not been sufficiently high or, perhaps, some other factors connected with the tropical climate (including the handling of vaccine and interference phenomena) are playing a negative role. A study to elucidate these factors has been planned by the national epidemiological services.

Preparations were made for a Regional Seminar on Immunization Services, to be held in the Regional Office in July. The Seminar is expected to review the present stage of development of immunization programmes in all the countries. It is hoped that health services will devote greater attention to the organization and strengthening of routine immunizations, including immunization against poliomyelitis.

2.5.3 ~engue/Haemorrha~icFever and Other Arboviruses

Dengue/haemorrhagic fever continued to be reported in Thailand. Luricg the year 1971, a total of 11 494 cases were reported, representing the highest number of cases in any year. The number of deaths was 296, giving a case-fatality rate of 2.58%, also higher than during the previous three years (1968, 1969, 1970), when it had been below 1.70%. From past experience it is expected that 1972 will show a low case-fatality level.

In Burma, the incidence of dengue/haernorrhagic fever in Rangoon was lower during 1971 than in the previous year, the total number of cases being 685 and of deaths 34, giving a case-fatality rate of 4.96. The number of cases predictably showed an upward trend in February 1972, and 1972 is expected to be another epidemic year, showing the bi-annual peak typical for countries of South-East Asia. STA/RC25/2 Page 38

In addition, epidemiological surveillance of dengue/haemorrhagic fever is being carried out in Ceylon. Indonesia and in some parts of India (Vellore and Poona).

Following the visit of a WHO consultant to Rangoon in June 1971 to review the dengue/haemorrhagic fever position, arrangements were made for the testing of paired sera (collected during previous years) in Hawaii and Bangkok. Assistance was given to the National Health Laboratory in Rangoon in establishing competence in the serological testing of sera from dcngue/haemorrhagic fever patients as well as of specimens collected in surveys.

Preparations were made to combat any eventual epidemic which might show a high case-fatality rate - by abating adult Aedes mosquitoes, as well as by the measures to reduce breeding which were already being taken.

The Aedes Research Unit in Bangkok made further progress in improving methods of ultra-low-volume ground spraying of malathion, which is expected to be an important control measure.

2.5.4 Influenza and Other Respiratory Viruses

No large outbreaks of influenza were reported during the period under review. Epidemiological surveillance, based on laboratory follow- up of the circulation of influenza viruses, was continued as a routine in the inf luenza reference laboratories in Bombay ,Bangkok and Coonoor (India) . An outbreak of conjuctivitis in epidemic form, which was reported from Burma, India and Thailand, subsided,and the isolation of the adenoviruses was reported only from India. It is very likely that this epidemic was caused by adenoviruses in other countries as well.

The trial of measles vaccine planned to take place in Ulan Bator in 1971 was postponed to 1972, and the time for its conduct will depend on the epidemiological situation (i.e., it will be held durina a ~eriod free from outbreaks of respiratory infections).

2.5.5 Viral Hepatitis

No epidemic outbreaks were reported. The disease is receiving the attention of the health services in Mongolia, primarily from the point of view of treatment and prevention of complications. The disease is on the list of cowunicable diseases included in the national surveillance programme in Ceylon also, where it is being reported sporadi- cally from all the districts. 2.6 Parasitic Diseases 2.6.1 Filar iasis During the period under review, WHO-assisted filariasis control programmes in Burma and Ceylon continued to develop according to plan. SEA/RC25/2 Page 39

In Burma, the whole of Rangoon City has been covered by anti-larvi- cide spraying, and, in addition, action has been taken for cleaning the water drains - the main breeding places for Culex mosquitoes. The results achieved show that the density of these mosquitoes has been considerably reduced. The microfilaria surveys show a tendency towards reduced transmission; treatment of detected filariasis cases and microfilaria carriers was carried out by the health services. In Ceylon,activities with regard to microfilaria detection,treatment, spraying and health education were continued. Preparations have been made to convert the filariasis control campaign into a vector control programme in order to cover more areas as well as vectors other than hler fatigans. In the Maldives, blood smears are regularly being examined for microfilaria in Male. With effective action against vectors, which have practi- cally disappeared from the island, the detection rate of cases of microfilaria has also been low, i.e., about 1%,as against about 6% before the initiation of vector control measures. This shows clearly that,with the reduction in the density of mosquitoes, the transmission ceases and that detection and treatment of microfilaria cases lead to the ultimate control of the disease. Efforts were made to recruit a consultant for Indonesia, to review the filariasis problem and to assist in launching a control programme. In India,under the filariasis control prograrnme,surveillance covered the States of Andhra Pradesh, Assam, Gujarat, Kerala, Madhya Pradesh, Maha- rashtra, Mysore, Orissa, Uttar Pradesh and West Bengal. It consisted of checking the density of the vector and its infectivity index. Control operations were also carried out. 2.7 Veterinary Public Health In this ~phere~activitieswere directed towards training, rabies control measures and preparations for brucellosis vaccine production (in Mongolia). Information on anthrax in some of the countries (Burma, Indo- nesia and Thailand) was collected and confirmed that both animal and human anthrax was a problem in some areas. As regards training in veterinary public health, a WHO consultant assisted in improving the curriculum and teaching methods of the two-year Master's degree course being conducted at the All-India Institute of Hygiene and Public Health, Calcutta. Preparations were under way for the second Regional Seminar on Veterinary Public Health, to be held in Bangkok in 1973. 2.7.1 Rabies Rabies continued to be a problem of major public health importance. A WHO consultant visited Indonesia to study the situation with regard to rabies and make recommendations for its control. Rabies also is receiving special attention in Nepal, where a WHO-assisted project is being started with the aim of studying rabies epidemiology and control as well as the local production of vaccine. Another WHO consultant reviewed the production of rabies vaccine in Thailand, and has made recommendations for improving the quality and quantity of the vaccine. SEA/RC25/2 Page 40

2.8 Immunology

Efforts to increase competence in immunology in the countries of the Region have continued. Three WHO consultants studied the immunology of denguelhaemorrhagic fever in Thailand, and discussed their findings at a meeting held in Bangkok in February 1972. A number of fellowships were provided to candidates from the Region to attend the WHO training centres in Singapore and Lausanne (Switzerland), and plans are under way for a regional workshop in immunology, primarily of infectious diseases, to be held in Bangkok in August of this year.

Preparations are also being made for a WHOIIndian Council of Medical Research Centre for research and training in immunology to be established in New Delhi. It is expected that the centre will start functioning towards the end of 1972, when a meeting of immunologists on leprosy will be held.

3. HEALTH LABORATORY SERVICES

Recognizing the importance of the annual study on the utilization of laboratory services, which, under the sponsorship of WHO Headquarters, has been conducted since 1970 in selected countries, the Regional Office has proposed that Ceylon be chosen for such an assessment in 1974. The purpose of the study will be to assess the actual and potential efficiency and utilization of laboratories at intermediate and peripheral levels and to devise ways of bringing about improvements at minimal cost. In anti- cipation of this study, steps have been taken to improve the status of the rural laboratories in the various countries: as a follow-up of the inter- country Meeting of Administrators of Health Laboratory Services, held in 1970, national-level meetings were organized in India and Indonesia; a physical survey of rural laboratories is under way in India; courses for training technicians have been established at different levels in Burma, India, Indonesia and Thailand; with WHO assistance, in-service training of laboratory staff is being undertaken in six countries of the Region; manuals for field laboratories are under preparation in India and Indonesia, and with UNICEF assistance, the equipment for intermediate and field laboratories is being renovated in a number of countries, e.g., India, Indonesia, Thailand and Burma. It is hoped that the other countries will also take steps to seek UNICEF assistance for strengthening their laboratory systems.

A survey carried out by the Regional Office during the year has indicated that the training of laboratory staff is being accorded the highest priority. The table on page 40 summarizes the status of development of the training of technical staff and the resources available within the Region. Despite the efforts made so far in this connection, there is a continuing need for on-the-job training of a greater number of technicians; also, the demand for more skilled and specialized staff is far from being met. While a base for the training of technical staff has been developed in the Region, self-reliance in the training of professional

SEA/~c25/2 Page 42

workers has still to be attained. Diploma and master's degree courses in laboratory sciences are very few: however, a course leading to a diploma in bacteriology was started in Burma in 1971, and a master's degree course in laboratory technology is operating in India.

The survey of resources for the training of technicians (see table) has pointed up certain shortcomings: the level of training could be greatly improved by raising the entrance requirements for technicians. In view of the complexity of the technology involved in the surveillance of communicable diseases and the fact that supervision by senior staff is often lacking, greater reliance should be placed on the training of laboratory technicians, both in quantity and quality, and the category of laboratory assistants should be gradually abolished. By stabilizing the training courses through the appointment of full-time tutor technicians to the schools and by improving the tutor-trainee ratio, the standard of training, including practical instruction, could be greatly raised. The dearth of laboratory equipment in teaching laboratories is also a matter of great concern; UNICEF could be approached for substantial assistance. The salaries and service conditions of tutors should be revised in order to attract and retain more capable candidates.

In view of the vital role that national health laboratories and specialized laboratories are expected to play in the development of the health laboratory services in the countries of the Region, the Regional Office has, in its programmes of assistance, focussed attention on the establishment of such areas of excellence, encouragement of communication and exchange of information among the different countries, and a balanced development of competence and skill in laboratory technology. To this end, a number of activities were undertaken or are under way. They include an inter-country course on Immunohaematological Procedures in Blood Banking, which was held in Bombay in November 1971. Also, ten national laboratories in the Region are participating in the Headquarters/CDC(Atlanta)-sponsored scheme for collaboration in the quality control of laboratory tests on blood glucose and urea, and Ceylon, India and Thailand also participate in the CDC(At1anta)-sponsored proficiency test in syphilis serology. A streptococcus reference laboratory is bcing established in India. Support is being given to the establishment, strengthening and service of the national reference centres in Burma, Ceylon and India, and the exchange of information is encouraged between India and Burma on salmonella, cholera and streptococcus; diagnostic reagents, reference preparations and standards have been provided on request to leading virological laboratories in Burma, Ceylon and India, and literature and documents have been distributed when appropriate. With a view to securing a balanced development of competence in diagnostic services, encouragement is given to national laboratories to have their products confirmed by independent testing at the WHO Regional and International Reference Laboratories.

National courses in venereal-disease serology, public health microbiology and the laboratory diagnosis of rabies are being conducted in Burma, Ceylon and Indonesia. WHO and UNICEF co-operate with national health authorities in strengthening health laboratories as an integral part of the general health services. Shown here are technicians at work in Mongolia (I), Nepal (2). and Ceylon (3). With assistance from WHO, India's National Tuberculosis Institute in Bangalore is evolving a practical tuberculosis programme on a national scale. Using only limited funds, it is now possible to extend tuberculosis control measures to all of India's population. Photos show a patient being examined for tuberculosis (top) and another receiving drugs at a primary health centre. SU/RC25/2 Page 43

4. VACCINE PRODUCTION

The Regional Office has been pursuing its policy of establishing and maintaining, in the Region, the required capability for the manufacture and assay of essential vaccines, such es freeze-dried smallpox and freeze- dried BCG, DPT, polio, rabies and cholera vaccines, and of helping to ensure that they meet the minimum WHO requirements. The productivity capacity so established will, it is hoped, be adequate to meet the needs of immunization programmes during maintenance.

During the year, the following measures contributed to raising the overall status of production as compared with the previous year: (1) improving the use of the fermenter vessels in Kasauli, India, thus helping to step up the production of DPT vaccine from 4 million doses to over 5.6 million in 1971-72; (2) increasing the production of freeze- dried BCG vaccine in Madras, which was brought up to 15 million doses against 5 million in 1970-71; (3) achieving consistency in the quality of five consecutive batches of freeze-dried BCG vaccine produced by the Bio Farma Institute in Indonesia; (4) improving the potency of rabies vaccine and successfully freeze-drying a potent preparation in Burma, and (5) putting into operation the neurovirulence testing unit for polio vaccine in India (With the completion of control testing, the indigenous vaccine will be made available for the first time by the end of 1972.). Additional equipment procured by UNICEF for the expanded smallpox programme in India has been received and will be commissioned for production in 1972.

The following new developments are expected: the BruceZZa Rev.1 vaccine project in Mongolia has entered the implementation stage: a control bacteriology laboratory is being set up and arrangements are being made to order equipment in connection with the production and control of vaccine at the Central Veterinary Laboratory; Ceylon is considering plans to undertake sequential freeze-drying of smallpox and rabies vaccines; Thailand and Indonesia have expressed their interest in studying the feasibility of producing live rabies vaccine for animal use.

Events in India towards the end of 1971 have put vaccine-producing laboratories under an unprecedented strain. Although help was provided to the Central Research Institute, Kasauli, in replenishing its stock of essential requirements, a review of the whole question of immunization, in order to formulate long-term plans to meet the demands and future needs of on-going vaccination programmes, has been proposed to the Government. The proposal emphasizes (a) the importance of establishing focal points for mass production, and of using up-to-date methods commensurate with the volume of vaccine to be turned out, (b) the need for accelerating the organization of a national control laboratory, (c) the desirability of encouraging the supporting industries to improve the manufacture of expendables used in vaccine production in accordance with accepted standards of quality and purity, and (d) the establishment of a national institute of biologicals S~A/Rc25/2 Page 44 to undertake research and training in immunology in order to improve existing vaccines or to develop new ones.

With a view to enabling countries in the Region to achieve self- reliance in the quality control and assay of vaccines and sera, assistance was extended to the development of such competence as and when requested. In this connection, samples of the vaccines produced by the Burma Pharma- ceutical Industry, Rangoon, and the Bio Farma Institute, Bandung,Indonesia, were cross-assayed by the International Reference Centre at the Institut Pasteur, Paris, and a random sample of cholera vaccine which was marginal in potency was referred to a WHO reference laboratory for independent testing. Trial batches of freeze-dried BCG vaccine produced by Bio Farma were checked at Copenhagen and found satisfactory in meeting the requirements regarding count, viability and stability. Smallpox vaccine produced in Burma, India, Indonesia and Thailand continued to be tested periodically in the WHO International Reference Laboratory in the Nether- lands.

Rehydration Fluids

In Nepal, plans are in hand for assisting the hospitals at Birat- nagar, Buthwal, Birganj and Nepalganj to produce fluids in sufficient quantities to meet the needs of the respective areas. The minimum target is approximately 24 000 litres of different fluids per year, and it is expected that the project will help ease partially the perennial shortage of fluids which is experienced in the event of a cholera outbreak and which often necessitates emergency procurement of large quantities from abroad. In support of the Government's request for UNICEF assistance, technical guidance, including a comprehensive list of supplies, is being provided.

In Mongolia, following the recommendation of a WHO consultant, a five-year plan of action involving WHO assistance has been prepared. The project aims at enabling the country to become self-sufficient in the management of rehydration therapy, particularly for children. The Govern- ment will be seeking UNICEF assistance for the procurement of capital supplies and recurrent expendables on a long-term basis.

5. HEALTH STATISTICS

Increasing interest and activity in the field of health planning in the countries of the Region have brought with them a growing recognition of the need for statistical information.

In this connection, a noteworthy event during the year was the technical discussion on "Health Statistics Requirements for National Health Planning", held in Rangoon during the twenty-fourth session of the Regional Committee, in which the aim was to identify the requirements for demographic and health statistical data as a prerequisite for realistic SEA/RC25/2 Page 45 health planning and to define the nature and desirable form of collaboration between statisticians and health planners. A very important step in providing this basic information was the publication of the preliminary results of the 197011971 round of population censuses carried out in the majority of the countries of the Region.

Lay-outs of tables required for collecting basic statistical information for the quantification of health targets for the countries in the Region were prepared, and the available data on population, demographic characteristics, health manpower, health care establishments, morbidity and mortality, and socio-economic characteristics were being compiled.

Activities aimed at increasing the quantity and improving the quality of data available to health administrations have continued in the various countries,with support from WHO.

In India, paediatric departments of medical colleges were invited to take part in a trial use,in their training areas, of experimental maternal and child health cards designed by a WHO statistician.

A consultant assigned to Mongolia in April followed the broad outlines laid down in previous years in assisting with the further development and strengthening of health statistics services at the national and local levels. He also advised on the effective and wider use of data-processing equipment and showed ways of analysing and utilizing the data collected for the planning, monitoring and evaluation of health programmes.

In Nepal, a consultant on medical records gave assistance in the design and trial use of records and report forms for hospitals and health centres,to be introduced on a wider scale in the country. He continues this work on a long-term basis as a member of a multi-disciplinary team under the projcct "Development of Health Services" (Nepal 0021).

Assistance was given to the Government of Thailand in the matter of simplifying the present system of data collection and expediting their statistical processing in order to avoid delays in making these data available to health administrators and health planners. The consultant assigned for this purpose also advised on filling the gaps in the information available and on using the data effectively.

Efforts continued for the development and promotion of hospital statistics in the countries of the Region, emphasis being placed on the creation of effective reporting systems,on hospital resources and activities and on the improvement of skills required for providing the hospital morbidity data on a sampling basis,where advisable and feasible. In this connection, a statistician visited Indonesia, Burma and Nepal. SEA/RC25/2 Page 46

In order to provide assistance to the whole field of recording and reporting of health statistical services, two inter-country projects have been combined with one on "Reorganization of Rural Health Records and Reports" (SEARO 0050) to form a new project, "Collection and Uti- lization of Health Statistics, Records and Reports" (SEARO 0220).

To the health manpower study under way in Ceylon, advice and assistance on the statistical aspects have been given,mainly in respect of handling, processing and analysis of the data from the sub-studies of activities of health personnel working in rural areas, and from the censuses of doctors, nurses and midwives. Plans were being made to provide similar assistance, on a long-term basis, to Indonesia.

In the sphere of statistical training, a WHO-assisted Seminar on Statistical Methods in Medical Research was held in New Delhi from 24 November to 4 December. Twenty senior medical research workers from different research and teaching health institutions in India took part in the Seminar. Five health statisticians or health administrators - one each from Ceylon, India, Indonesia and Thailand and one from the Regional Office - participated in a three-week inter-regional Travelling Seminar on Health Statistics, held in the USSR and Finland.

Preparatory work was in hand in connection with the organization of a workshop on statistical methods in family planning programmes, to be held in Bangkok towards the end of 1972 for senior statisticians not necessarily involved in family planning programmes.

Arrangements were also initiated for convening a working group on the Ninth Decennial Revision of the International Classification of Diseases, in order to have the views of countries of the Region on the present utilization and usefulness of the ICD and on the proposed changes which they would like to see introduced in the next issue.

6. EDUCATION AND TRAINING

In Thailand, where,early in 1971, a "task force" from the Regional Office had held discussions on possible WHO assistance with development of a health sciences centre at Khon Kaen University and the establishment of a faculty of medicine at Prince of Songkhla University, a new faculty of nursing started functioning in 1971. WHO assistance to this faculty is to he provided within the framework of the existing programmes in nursing services and education. The establishment of the medical faculty is awaiting official sanction by the Government.

Another "task force" was established to explore ways of providing assistance to the proposed Institute of Medicine at Tribhuvan University in Nepal, which is to be established under the New Education Plan. After SEA/RC25/2 Page 47

preliminary discussions in the Regional Office and in Kathmandu, a basic document was drafted, and it is proposed to recruit a team of consultants to be available for advice to the Vice-Chancellor of Tribhuvan University and the ministries concerned.

In order to meet the increasing demands of the health services for trained personnel, the Government of Thailand is considering the introduction of a new category of health workers similar to the Russian "feldsher" or the health assistant functioning in several other countries. In this connection, WHO organized a study tour for eight senior public health administrators and educators from Thailand to visit the USSR, the USA, and countries in South America and Africa where this type of worker is being trained and utilized.

6.1 Medical Education

During the year, 40 short-term consultants assisted in implementing programmes in medical education in the various countries. This figure includes those assigned in connection with UNFPA-supported activities in medical schools.

Follow-up visits were made to medical colleges in Burma, Ceylon and India by consultants in teams of two or individually,in order to assess the changes made and to assist in implementing agreed plans. Long-term assistance by six WHO medical educators was continued in Burma and Indonesia.

The following group educational activities were organized:

(1) Seminar on Community Medicine for Medical Teachers, Surabaya, (Indonesia), (2) National Workshop on Teaching Methodology in Community Medicine, Surabaya (Indonesia), (3) Seminar on Tuberculosis of the Nervous System, Bombay, and (4) Training Course in Human Reproduction, Family Planning and Population Dynamics for Senior Teachers of Medical Schools, New Delhi, A total of 13 consultants served on the faculties for these meetings. (For details, see Part I11 of this report.)

Some of the activities can be summarized as follows:

High-level national meetings to discuss problems in medical education and to plan for further developments were held in Burma and Thailand. In Indonesia, special teams of the Consortium of Medical Sciences syste- matically visited the medical colleges in the country in order to hold short courses for the teaching staff in educational methodology.

A group of four medical educators, including a staff member from WHO Headquarters, visited Ceylon to study the system of post-graduate medical education and to develop plans for enlarging the existing programmes and introducing new ones,with a view to training post-graduates within the country. Early in 1972, the consultant who had, in 1970, SEA/RC25/2 Page 48 assisted in the design of a health manpower study helped to evolve the protocol for a sub-study on the utilization of doctors. Also,two consultants revisited the two medical faculties in Colombo and Peradeniya in order to follow up their previous work on examination methodology, and later went on to study the examination systems and relevant educational problems in the Institutes of Medicine in Burma.

In Thailand, individual consultations were held at all medical faculties, and a one-week workshop for national staff was organized in Bangkok. Advice was given to the Faculty of Graduate Studies on its post-graduate residency training programmes. Also, the Chief Medical Officer for Post-graduate Education from WHO Headquarters went to Thailand to discuss the establishment of a medical teachers' training centre in Bangkok. During his assignment to Ceylon he also covered this specific area.

Another staff member from Headquarters visited Burma and Mongolia to help the governments concerned in drafting requests for UNDP assistance to long-range programmes for the development of health manpower. In both countries, teams of WHO consultants had previously assessed the existing resources and determined requirements as a basis for project formulation. The final version of the project document for Burma was prepared by the Regional Adviser on Medical Education during a visit to Rangoon.

One of the participants in the Medical Teachers' Training Course held in New Delhi in July 1969 conducted a follow-up study of the course while on a WHO fellowship in the us~,workingfor a master's degree in education. Replies to a questionnaire relating to the various objectives of the course, sent to the former participants, indicated that, following the course, many changes had been introduced in departmental and even institutional programmes.

The Regional Director attended the annual conference of the Indian Association for the Advancement of Medical Education, held in Poona in February 1972, and delivered an address entitled "The Concept of the Health Team in Medical Education".

6.2 Paediatric and Obstetric Education

The Regional Office was represented at a meeting held in London to undertake a technical review of the UNICEF/WHO-sponsored Course ("the United Kingdom/Uganda/India course") for Senior Teachers of Child Health. The meeting discussed in detail the different aspects of the course, such as the co-ordination of the efforts with the objectives, the programme content and the methods used, and the role of the different institutions participating in the programme. The Director of the Course also visited the Regional Office for discussions.

In Indonesia, the WHO medical educator in obstetrics continued his activities in selected departments. SEA/RC25/2 Page 49

Further assistance in the development and conduct of post-graduate courses in paediatrics was given to Burma and Ceylon by the consultants in paediatrics previously assigned to these countries.

In India, a consultant in paediatrics on a follow-up assignment assessed the progress which had been made in the development of field training facilities since his last assignment in 1967 to the Medical College, Bangalore. Elsewhere, a consultant reviewed the progress made since the WHO study of post-graduate paediatric education which was conducted in 1966-1967. He also assisted with a meeting on Post-graduate Education and Training in Paediatrics in India, held at the Osmania Medical College, Hyderabad, in August 1971, where senior teachers in child health discussed measures required to strengthen post-graduate education and training in India and made some recommendations.

A course on rehydration therapy centres was held in Jaipur (India) in March 1972, with the participation of 19 senior paediatric teachers from medical faculties in India and one senior paediatrician from Nepal. A WHO consultant assisted in conducting the course (see also Chapter 4).

6.3 Teaching of Human Reproduction, Family Planning and Population Dynamics

In countries with national family planning programmes and WHO/ UNFPA-assisted projects for the teaching of human reproduction, family planning and population dynamics in medical schools, WHO has been promoting the concept that the components of these subjects should be taught by almost all departments of a medical school in a co-ordinated and continuous manner throughout the academic undergraduate training course. During the undergraduate and internship periods in the field training area, the students should be involved in practical demonstrations and applications of family planning problems, whether social, demographic or technical. Many medical colleges still lack staff with the appropriate skills in these fields, and field training areas vary greatly in their effectiveness as teaching situations.

Under an inter-country project, a training course in human reproduction, family planning and population dynamics for senior teachers of medical schools was held at the National Institute of Family Planning, New Delhi, early in 1972,with the full collaboration of the staff of the Institute. Teams of three from medical schools in India, Indonesia and Thailand participated. Detailed guidelines for the implementation of a strengthened curriculum in teaching human reproduction, family planning and population dynamics were drawn up, and a document containing these guidelines is under preparation. A notable feature of this course was the employment of 34 guest speakers from Indian institutions involved in various aspects of the subject.

A team of two consultants visited four medical colleges in India to study their facilities for teaching human reproduction, family planning SEA/RC25/2 Page 50

and population dynamics, and to assist in plans for introducing such teaching in medical colleges selected for the introduction of an improved curriculum in these subjects. In all, eight colleges have been selected for this purpose. Two further consultants will pay a follow-up visit later in 1972.

In Indonesia, a national workshop on the teaching of family and community health was held in Surabaya in December. Three WHO consultants, assisted by two members of the Rockefeller Foundation assigned to the Ramathibodi Medical College, Bangkok, helped in conducting this workshop (see also Indonesia 0114 in Part 111).

Plans are being made for providing assistance to the teaching of human reproduction, family planning and population dynamics in medical schools in Thailand,including the two new schools being set up, where the opportunity will be taken to build these subjects into the new curricula.

6.4 Fellowships

During the reporting period, 526 fellowships were awarded, 483 (92%) of which were new, 34 (6%) for a second year of study and 9 (2%) for a third or additional year necessary for the fellow concerned to complete specific programmes.

Of 167 fellowships in communicable-disease control, 37 (22%) were for malaria, 26 (16%) for tuberculosis, 40 (24%) for laboratory services, and 30 (18%) for entomology, immunology, plague, tropical medicine, venereal diseases and veterinary public health.

Fifty-eight fellowships were awarded in the sphere of public health administration, particularly in such subjects as national health planning and hospital administration. Assistance was provided to a group of eight candidates from Thailand to study the training and utilization of medical assistants in different countries.

Of the total number of awards for the period covered by this report, 64 (12%) were for training within the Region.

In all, 208 fellowships were awarded to doctors, engineers and nurses for one-year post-graduate courses leading to a degree or diploma; in addition, 70 were given for attendance at international courses, 205 for other types of training or experience, and 55 for study tours.

During the year, 93 fellows from outside South-East Asia visited the Region for periods varying from one week to 40 months. These fellows came from the following countries or territories: Afghanistan, Argentina, Bahrain, Botswana, Brunei, Chile, China, Costa Rica, Ethiopia, Hong Kong, Iran, Iraq, Japan, Korea, Kuwait, Laos, Liberia, Malaysia, Mauritius, New Zealand, Nigeria, the Philippines, Poland. Ryukus, Singapore, Syria, Sudan, Sweden, Turkey, Papua New Guinea, the United Arab Republic, Uganda, the USA and Viet-Nam. SEA/RC25/2 Page 51

Graph 2 and the accompanying table on page 52 show the number of fellowships by subject of study and country of origin of the fellow, from 1 July 1971 to 30 June 1972; Graph 3 and the table on page 53 show the number of awards over a five-year period.

It may be seen from the following figures that there has been a significant increase in the number of awards issued annually during the last five years:

1967 1968 1969 1970 1971

Budgetted 238 195 249 301 313

Awarded 212 296 384 537 553*

*includes extensions

Tables 1 to 4 in Annex 6 give,in respect to each country of the Region: (1) the distribution of the awards by sources of funds and type of fellowship; (2) distribution by subject of study and country of origin of the fellow; (3) the number of fellows from the Region going to other regions and vice versa, and (4) utilization of former WHO fellows.

Changes in the programe of study and last-minute cancellation of fellowships still cause problems and are the main source of difficulty in the administration of fellowships.

6.5 The Regional Office Library

The report on a survey of medical college libraries in the countries of South-East Asia which had been undertaken earlier was sent to governments, international agencies and all medical colleges in the Region. A modified version of this report has been accepted for publication in the IJNESCO Bulletin for Libraries.

During the year, the Library acquired 1995 new books, pamphlets and WHO publications. It now received 406 current periodicals (some on payment and others free or in exchange for WHO publications). In all, 1809 publications were issued on loan to Regional Office and field staff, 6139 pages of photocopies provided, and 535 articles of interest to WHO staff included in the Library NEWS.

A WHO consultant surveyed the facilities available in the Regional Office Library with a view to preparing plans for the establishment of the Regional Documentation Centre on Human Reproduction, Family Planning and Population Dynamics. A documentation officer is under recruitment. Fellowships Awarded by the WHO South-East Asia Region, By Subject of Study and Country of Origin of the Fellow

(1 July 1971 to 30 June 1972)

. Public health adminis-

2. Sanitation

laboratory services

7. Clinical medicine

8. Basic medical sciences 5 5 4 13 1 1 1 7 37 and education

TOTAL 46 51 139 7 0 7 35 4 3 135 526 * Graph 2-Fellowships awarded by WHO, By Subject of Study and Country of Origin of the Fellow (1 July 1971 to 30 June 1972), South East Asia Region

1. Public health administration 5. Other health services

2. Sanitation 6. Communicable diseases & laboratory services

3. Nursing a 7, clinical medicine 4. Maternal and child health / 8. Basic medical sciences and education

TOTAL

BURMA CEYLON

INDIA INDONESIA MALDIVES

MONGOLIA NEPAL THAILAND Graph 3-Fellowships Awarded by WHO in the last five years (1967-1971), South East Asia Region

Burma Ceylon India Indonesia Maldives Mongolia Nepal Thailand Annual Distribution of Fellowships by Country and by Tyve of Fellowships, 1967 to 1971 (Calendar Year), for Study Within and Outside the South-East Asia Region

Burma Ceylon India Indonesia Maldives Mongolia Nepal Thailand Total -

Year 3 3 3 3 3 3 i 3 3 3 rl i 3 rl 3 rl3 3 Grand I* Is '' I m ~m m I* m ~m m ~m m c uc c 2 2 uc c &G c uc c re e 1 2 Total 0 00 0 zg g $2 o kg 0 a,@ 0 a0 0 Gio 0 a,O 0 Gi 0 .A U.4 i U.4 ... 0.- ... U.3 ... U.3 d u.4 .3 U... .4 U .3 .3 U .i M GM M CM M c ffi CM M CM M cw M CM M CM M C M m ua, a, -a, "" -0 W CiW w a, a a a a 2 CL: a 2 ""a a a aZHWa a a - 2 2

1967 8 15 22 24 2 50 6 14 2 - 1 21 5 4 17 21 63 149 212

1968 6 30 8 27 1 58 7 26 5 - - 48 21 10 14 35 62 234 296

1969 12 39 14 35 4 54 15 40 8 - - 58 20 11 16 58 89 295 384

1970 7 41 16 51 8 133 14 67 10 2 - 42 19 25 14 88 88 449 537

1971 8 43 11 41 9 143 18 59 6 - - 51 20 20 12 112 84 469 553

TOTAL 41 168 71 178 24 438 60 206 31 2 1 220 85 70 73 314 386 1 596 1 982 SEA/RC25/2 Page 54

7. TECHNICAL INFORMATION AND REFERENCE SERVICES

WHO'S policy in South-East Asia to concentrate in its progranrne on short assignments of consultants and on more and more group educational activities such as seminars, training courses, etc., has brought with it an increasing problem of processing the many reports which result from these assignments and meetings. The number of reports issued by the Regional Office has quadrupled in ten years, and showed a further considerable increase in the period under review. Although every effort has been made to speed up the processing of these reports, the backlog continued to be substantial, mainly because: (1) the Editor who was appointed in March 1971 to fill one of the two editorial posts which the Regional Committee had recommended in 1969 resigned in March 1972, and the post had not yet been filled at the time of writing, and (2) the other post, viz., that of Editorial Assistant, continued to remain vacant. As an immediate solution to this problem, two temporary editors were engaged on a fee contract basis for about three months, and also the two assistants in the general service grade who were concerned with editing were asked to assume editorial responsibility of a higher level. As a result of these measures, the progress made in dealing with the backlog was gratifying. It is hoped that delays in issuing reports will be minimized when the vacant posts are filled.

During the year, approximately 250 staff members, including consultants, were briefed or debriefed concerning reporting procedures, documents, sales of publications and reference services.

Reports

During the period July 1971-June 1972, 217 reports were edited and issued. These consisted of 170 assignment reports, 14 reports of field visits by Regional Office and other staff, and 33 reports on seminars, courses, special studies, etc. Among the more important reports, four - those of the Conference of Deans and Principals of Medical Schools on the Teaching of Human Reproduction (held in December 1970), the Fourth Meeting of Directors or Representatives of Schools of Public Health (held in March 1971), the Medical Teachers' Training Course (held in November-December 1970) and the Assessment of the Malaria Eradication Programe in Ceylon (March 1972) - were issued under printed cover.

A "Bibliography on Family Planning", by Dr P. Robinson, and a selection of the speeches given by the Regional Director were also edited and brought out under printed cover.

Documents and Other Publications

The reports and minutes of the twenty-fourth session of the Regional Committee, the report of the technical discussions on "Health statistical requirements for national health planning", held during the session, and the S~AlRC2512 Page 55 revised "Handbook of Resolutions and Decisions of the Regional Cornittee" were, as usual, compiled, edited and issued under printed cover.

Distribution

The Regional Office continued to make available technical information to governments as well as to health workers and others. In addition to the material mentioned above, various documents, reprints, articles, etc. received from Headquarters and other sources were given wide distribution. These included (a) A Bibliography on Education of Physicians and Auxiliary Personnel for Family Planning (prepared by the Wk10 Library, Geneva); (b) four documents entitled "Educational Programme", by Doaald F. Pochyly (WH0/EDU~/71.142), "Structure and work of the Central Institute for Advanced Medical Studies, Moscow, by Butrov et aZ (WHOIEDUCI~~.~~~~, ,, Advanced training of doctors in the USSR by two-part formal and correspondence courses", by Butrov et a2 (WHO/EDUC/71.143) and "Educational Objectives", by George E. Miller (WHOlEDUCl71.149); (c) Guide for collcc- tion and transport of virological specimens (VIRl71.4); (d) an article entitled "A comparison of various measures of sensitivity of M.tubercdZosi:. to pyrazinamide" by Tripathy et a2 (reprinted from Tubercle); (e) a document, "Comparative study of continuing education for physicians, study design" (ETl71.5); (f) NewsZetter No.13 of the WHO International Reference Centre for Community Water Supply; (g) Report on the Second WHO Conference on Medical Education in the Eastern Mediterranean, Tehran (EM/SCD.CONF.MED. EDUC.119); (h) Report of a PAHO Technical Group Meeting on Hypovitaminosis A in the Americas; (i) A sanitation manual for community health workers, issued by the Department of National Health and Welfare, Canada; (j) a number of issues of a TecririicaZ Digest issued by the Central Public Health Engineering Research Institute, Nagpur (India); (k) "Post-graduate education for medical personnel in the USSR" (WHO Public Health Papers No.39); (1) Reports of Working ~ro~pson the Role of Mobile Coronary Care Units and on Epidemiological Studies on Ischaemic Heart Disease, both issued by the WHO Regional Office for Europe, and (m) a large number of documents received from Headquarters, such as smallpox surveillance reports and reprints on subjects like malaria, tuberculosis and medical education. Wide distribution was also given to offprints from the Weekly EpidernioZog'~.cl R~cord,as well as to one from the WHO Official Records No.190 entitled 9, Cholera: present trends and problem, April 1971".

Documentation and reference services continued to be provided during meetings organized by WHO; document lists were compiled and requcsts for documents complied with.

Sales

In the sale of WHO publications, the important event of the year was the Organization's participation in the "World Book Fair. 1972", organized by the National Book Trust of India in New Delhi from 18 Plarch SEA/RC25/2 Page 56

to 4 April. The sales of WHO publications at the Fair amounted to Rs 3 000 (US$400)*, and it is expected that the impact of the promotional effort undertaken on the occasion will be felt on future sales.

The value of sales during the year 1971 amounted to $19 390 (subscriptions to $10 780 - 558 invoices - and retail sales to $8 610 - 1 234 invoices), and during the first six months of 1972 to $11 056.

Although there has been a slight drop in the total sales in 1971 when compared with 1970 ($19 598), there has been an increase in the number of subscriptions, from 524 in 1970 to 558 in 1971. The number of retail sales transactions has also shown an increase.

For sales promotion, a list of the contents of publications issued in 1968-1970 was prepared and widely distributed; two lists of new publications were circularized.

WHO publications were displayed during twenty meetings sponsored either by the Regional Office or by other agencies; these activities resulted in a number of orders and subscriptions.

Nine groups of nurses and health educators who visited World Health House during the period under review were briefed on WHO publications and their availability at concessional rates; some counter sales resulted from these visits.

As of 1 December 1971, the Regional Office Library was transferred from the Reports and Documents Unit to form part of the recently established Medical Education Task Force (see under Chapter 6, "Education and Training").

*All figures relating to sales are based on the net amount shown in the invoices, in most of which a 50% discount (40% in respect of subscriptions) and, in some cases, an additional 10% trade discount have been allowed. Therefore, the commercial value of the publications sold should be taken to be approximately double the figures given. SEA/RC25/2 Page 57

PART I1

ORGANIZATIONAL AND

ADMINISTRATIVE MATTERS s~A/RC25/2 Page 59

1. THE REGIONAL COMMITTEE

The twenty-fourth session of the Regional Committee for South- East Asia was held in Rangoon, Burma, from 28 September to 5 October. Representatives were present from all countries in the Region except the Maldives. In addition, the session was attended by a representative of the United Nations (who was also the representative of the United Nations High Commissioner for Refugees), and representatives of the United Nations Development Program, UNICEF and seven non-governmental organizations in official relations with WHO. An observer from the Colombo Plan also attended.

The session was inaugurated by Colonel Hla Han, Minister for Health, Education and Foreign Affairs of the Union of Burma. Addresses were also delivered by Dr Mahler, Assistant Director-General from WHO Headquarters, representing Dr Candau, Director-General of WHO, and by the Regional Director.

The Regional Comittee elected Lt Col Thein Aung (Burma) as Chairman and Dr G.S.L. Das (Nepal) as Vice-Chairman.

In its discussion on the Annual Report of the Regional Director, the Committee emphasized the need for active follow-up of the development of various studies on such topics as manpower needs and proper systems and cost-benefit analyses. In country programming, it was considered that overall planning should be undertaken by WHO at both regional and global levels.

Noting the increasing requests for assistance in family health, the Committee stressed the importance of co-ordinating the work of the numerous agencies involved in this programme which, it was thought, also should be widened in scope to ensure the practice of family health not only by the health services but in the broader aspect of social and economic development.

The satisfactory progress which had been made in the control of communicable diseases, particularly smallpox, and improvements in the exchange of epidemiological information among countries were noted, as were two problems being faced by the malaria programes - shortage of technical manpower and delays in the procurement of insecticides. The Committee underlined the value of DDT in public health programmes, which, it was considered, far outweighed the dangers of possible hazards.

WHO'S considerable efforts in training health manpower were welcomed, although it was agreed that much still remained to be done and that there was a necessity for orientating the training programmes of all members of the health team to the needs of the people. The Committee also stressed the importance of the teaching of community medicine to undergraduate medical students, as well as of preparing doctors more ade- quately for community work. Other subjects discussed included the SEA/RC25/2 Page 60 integration of specialized programmes into the general health services, the development of health laboratory services, water supply, waste disposal and environmental pollution, health education and health statistics. Eleven resolutions were adopted.

The Committee raised the subject of recruitment of WHO personnel. Methods of recruitment were discussed, and the Committee asked the Regional Director to take all necessary steps to expedite recruitment for the field programme, keeping in mind the availability of expertise in the countries of South-East Asia, and also the need to ensure that WHO staff was of a high quality.

A Sub-committee on Programme and Budget, consisting of representatives of all the governments, was established, and the Committee subsequently adopted its report and approved the proposed estimates for transmission to the Director-General. The Regional Director was asked to convey to the Director-General the Committee's strong conviction that additional funds were required for the Region, in view of the high density of its population, its limited financial resources and the continuing existence of major health problems.

Technical discussions were held on the subject of "Health Statis- tics Requirements for National Health Planning", and existing services as well as the kinds of health statistical data being collected were rtviewed. "Teaching of Community Medicine in undergraduate Medical Educa- tion" was chosen as the subject for the technical discussions to be held during the twenty-fifth session.

The Committee confirmed its decision to hold its twenty-fifth session in Ceylon (in September 1972), and decided that the twenty-sixth session should be convened in the Regional Office in 1973.

2. ADMINISTRATION

2.1 General

In May 1972, Bangladesh became a Member of the Organization, and at the request of the government was assigned to the South-East Asia Region. In June 1972 the Regional Director visited the country for administrative and technical discussions, and to prepare for the development of a programme of WHO assistance. During his visit, a WHO Basic Agreement was concluded with the Government. A WHO Representative was appointed and took up his functions.

During the year under review, the Regional Director also vis'ted Burma, Ceylon, Indonesia and Nepal, as well as various States in India. In Nepal, he took the opportunity of paying a courtesy call on His Majesty the King and of discussing with him WHO'S programme of assistance to the country. SEA/~c25/2 Page 61

The Regional Director was also invited to make a large number of addresses on WHO activities. While in Indonesia he delivered the inaugural address at the WHO-sponsored Inter-regional Seminar on Training and Services in Occupational Health for Developing Countries, held in Djakarta, and addressed participants in the Seminar on Community Medicine for Medical Teachers, which took place in Surabaya. In India, he gave an address at the 11th Annual Conference of the Indian Association for the Advancement of Medical Education in Poona, and also inaugurated the Second Course on Gross and Microscopic Photography and the Inter-country Course on Orthopaedic Patient Care (Nursing), both held in New Delhi.

The political situation late in 1971 had certain adverse repercussions on WHO activities. Travel in India was curtailed; the arrival of field staff was delayed, and several group educational activities had to be cancelled or postponed. However, conditions became normal within a fortnight.

The Director of Health Services paid a visit to Mongolia to discuss the assistance being given by WHO. He also went to Thailand to attend a Review Meeting of the Regional Course on National Health Planning in Bangkok, and later went to Indonesia to take part in a meeting on the development of the national institute of public health in Surabaya.

The development of the Programme Support and Co-ordination Unit within the Regional Office was assisted during Deceinber by a consultant on project and programme management, who reviewed the relationship between the Regional Office and the WHO Representatives in the countries in the Region.

hring the period under review a number of WHO-sponsored meetings, seminars and courses were held in the Region. A list is given in Annex 3.

2.2 Organizational Structure

The structure of the Regional Office as on 30 June 1972 is shown in Annex 1.

2.3 Personnel

2.3.1 Staffing

The distribution by nationality of professional staff in the Region on 30 June 1972 is shown in Annex 2; to complete the picture. a column showing the world-wide distribution by nationality of WHO staff has been included in the table.

The following table shows the number of posts in the professional category in the Region, and the number actually filled as on 30 June: SEAlRC2512 Page 62

Organizational Location Established Posts still

Field Pro~rammes 185 6 17 9 135 44(4'

TOTAL 242 10 232 lad5) 49

(1) i.c., at the request of governments (field programne posts) or because of changed requirements (Regional Office posts).

(2) selected candidate taking up post towards the end of July 1972.

(3) candidates for 3 of these posts being actively recruited and expected to be on duty before year-end; the fourth post will be filled in July 1972 upon return of the incumbent from study leave.

(4) candidates have been selccted for 39 of these 44 posts and active recruitment is under way - candidates are expected to be on duty bcfore year-end. Selection has yet to be made for the remaining 5 posts.

(5) the number includes 11 posts filled by consultants. SEA/RC25/2 Page 63

During 1971, for field programmes 204 consultants were employed for periods ranging from two weeks to eleven months.

From 1 January 1972 to 30 June 1972, 88 consultants were employed. Altogether about 300 consultants are expected to be appointed in 1972.

During 1971, 9 professional staff members and 4 general service staff members left the service of the Organization. During the first six months of 1972, 9 professional ad one general service staff left service.

2.3.2 Briefing

Steps were taken to improve the quality of the briefing given to newly recruited staff, and to ensure a regular feedback after they have sufficient experience in their assignments to enable them to evaluate the briefing reviewed as adequate preparation for their work. Measures adopted include providing detailed technical briefing on the project or the activity concerned before the candidates leave their home stations, and, on arrival at the Regional Office, thorough briefing on all the technical and administrative aspects of their work.

Greater emphasis is also being placed on the importance of de- briefing, by all concerned in the Regional Office, all departing staff, both individually and in groups. These sessions also help c~ntribute to an understanding of Member Governments' needs and desires for WHO assistance.

2.3.3 Staff Training

Two applications for study leave and one for refresher training for field staff in the Region were approved by the Director-General for the next year (197211973). During the year, one professional staff member from the Regional Office proceeded on study leave which had previously been approved.

Three general service staff members received training at Head- quarters relating to new functions in the Regional Office.

2.3.4 Emplovment Conditions

A comprehensive survey of the salaries and allowances of the general service staff in New Dclhi was conducted vith full participation of staff representatives and the salary scale was revised. The salaries and allowances of this category of staff in Indonesia were also revised.

A place-to-place professional cost-of-living survey was conducted in India in March 1972, with the assistance of a United Nations Consultant Statistician. SEA/RC25/2 Page 64

One professional and eight general service staff members were granted meritorious within-grade increases. In addition, one professional and 26 general service staff members received meritorious increases on completion of 20 years of service in the Organization. Two professional staff members received meritorious increases on completion of 25 years of service.

Several meetings were held between the Administration and representatives of the Staff Society to discuss matters of common interest, particularly those concerning conditions of service of the general service staff. The heads of the various agencies of the United 14ntions system in New Delhi continued their regular review of matters affccting staff posted in India.

2.4 Finance, Budget and Accounts

The total obligations incurred on field activities during the last five years, under the Regular budget, UNDP (TA and SF) funds, UNFPA, FUNDWI and "Funds-in-trust", were as follows :

Source of Funds

Regular UNDP UNFPA FUNDWI Funds- Total Year (including (TA and SF) in- malaria and trust smallpox eradication programmes)

us $ us $ us $ us $ us $ us $

1967 3 825 114 1 083 696 - - - 4 908 810

1968 4 686 760 1 486 619 - - - 6 173 379

1969 5 010 196 606 765 - - - 5 616 961

1970 5 885 225 1 178 234 36 978 23 707 20 542 7 144 686

1971 6 900 963 1 354 666 430 115 121 785 27 138 8 834 667

-- - SEA/RC25/2 Page 65

The obligations incurred under the Voluntary Fund for Health Promotion were as follows:

Special Account for

Year Smallpox Malaria Leprosy Yaws Miscellan- Total Eradication Eradication eous

us $ us $ us $ us $ us (5 us $

196 7 53 030 - 34 000 - 9 415 96 445

1958 88 41C. 14 738 30667 - 41 943 175 758

1969 38 489 - 30 023 3 686 3 750 75 948

19 70 10 778 ' - 34 897 1 140 - 46 815

19 71 25 447 - 5 000 - 135 293 165 740

-Note: In the above tables, figures in respect of Afghanistan have been excluded from the totals; hence the figures for 1967-1968 differ from the totals given in earlier reports.

2.5 The Regional Office Building

The sale deed relating to the Regional Office building, vesting the ownership of World Health House in WHO, and the lease deed in respect of the ground were signed on 14 September 1971 by the Government of India and the Organization.

In order to meet the additional requirements for office space, an annexe to World Health House was constructed, providing an additional 33 room.

3. PROCUREMENT OF SUPPLIES AND EQUIPMENT

During the period under review, supplies and equipment costing US $748 255 and covering 22 749 line items were procured. These included laboratory equipmcnt and chcmicals, hospital and surgical supplies, drugs, vaccir,es, biologicals, teaching equipment, vehicles and limited supplies SEA/RC25/2 Page 66 of office equipment and stationery. In addition, 8 657 medical books and periodicals costing $35 368 were procured.

Supplies provided by WHO to a number of research institutions receiving WHO research grants were cleared and sent to the institutions concerned. In addition,l 820 packages, a number of which were for WHO- assisted research activities, were received and despatched to the consignees.

Under the Revolving Fund for the procurenent of teaching and laboratory equipment for medical and paramedical education and training, seven new requests were received during the period and three requests processed. At the time of writing, some earlier requests were awaiting either clearance by governments or advance deposits from the institutions concerned.

The amounts of freeze-dried smallpox vaccine donated by Member Governments to countries in the Region were as follows:

Nepal .. 100 000 doses (from Thailand) Nepal .. 3 065 000 doses (from the USSR)

The Government of ceyion donated 30 000 doses of cholera vaccine to the WHO Voluntary Fund for Health Promotion.

In response to urgent requests for emergency supplies from various governments, action was immediately taken to procure and despatch the items requested.

On instructions from the Director-General, 40 tons of bleaching pm-der, urgently required by the authorities in Dacca for the chlorination of drinking water, were procured from Delhi and sent by road to Dacca.

Day-to-day liaison was maintained concerning the consignments of medical supplies sent through WHO from various sources for the East Pakistan refugees in India. Local markets were explored, and quotations were invited for such s~p?lies; the rates received were forwarded to Headquarters. Constant liaison was maintained with United Nations agencies and with the Government of India through the co-ordination committees and special sub- committees which had been set up by both the Government and the United Nations in Delhi.

4. COLLABORATION WITH OTKER AGENCIES

Collaboration with other agencies has been continuing satisfactorily and has been maintained through frequent meetings and informal contacts, at both Regional Office and country levels. SEA/RC25/2 Page 67

4.1 United Nations

There have been frequent consultations With the United Nations with respect to close co-ordination of the work being carried out by all the agencies of the United Nations system.

The draft of a brochure on United Nations activities in Ceylon was received for coments and review, and was sent back with suggested additions and alterations as appropriate.

In March, the WHO Representative in Kathmandu attended, as an observer, a meeting of the United Nations Advisory Panel for the Develop- ment of Lumbini.

4.1.1 United Nations Development Programme (UNDP)

Close co-operation was continued with the Resident Representatives of the UNDP in the various countries.

In Indonesia, the Deputy Resident Representative and the Executive Director of FUNDWI held discussions with the WHO Representative concerning international assistance to various projects. In July 1971, the WHO Representative attended a meeting of Heads of Missions for Country Pro- gramming, which was held in the office of the Resident Representative of the UNDP in Djakarta.

Country briefs on the health sub-sector were prepared by the WHO Representatives and a review of country programme proposals as prepared for some countries in the South-East Asia Region was undertaken in order to assist the Resident Representatives in preparing country programmes.

At the Regional Meeting of the Resident Representatives of the UNDP, held in Bangkok from 2 to 11 March 1972, the Regional Office was represented by an Assistant Director of Health Services and the Regional Planning Officer. This meeting provided an opportunity for further fruitful collaboration between WHO and UNDP at the national level.

A review was made of the country programmes, in order to ensure a balanced representation for health. During the last quarter of 1971, senior staff members of the Regional Office held a meeting with a high- level UNDP mission on inter-regional and inter-country progrming. The report of the mission was received and commented upon. Full co-operation was maintained with UNDP for the operation of the project in Nepal for water supply and sewerage in Greater Kathmandu and Bhaktapur, and the question of the need for feasibility studies planned for the second phase of the project was reviewed. SEAlRC2512 Page 68

4.1.2 United Nations Children's Fund (UNICEF)

The usual regular contacts and cc-ordination, both formal and informal, were maintained with the UNICEF regional offices in New Delhi and Bangkok. Staff members of both UNICEF and WHO took part in several joint discussions with governments concerning matters of mutual interest.

The group of senior teachers (participants in the United Kingdom1 UgandaIIndia Course for Senior Teachers of Child Health, sponsored by UNICEF), led by the UNICEF consultant for the course, held an exchange of views in the Regional Office, where they were received by the Regional Director and were provided with WHO documents/reports considered to be of interest. One of the Regional Advisers on Maternal and Child Health attended the Technical Review Meeting held in February in London in connection with this course.

At country level, regular contacts were maintained with UNICEF representatives, and the relations continued to be excellent.

4.1.3 United Nations Fund for Population Activities (UNFPA)

A thorough review of the earlier activities, supported by the United Nations Fund for Population Activities, was carried out during the last quarter of 1971, and has led to improvements in the programme for 1972. With assistance from WHO Headquarters, support was given in the preparation of country proposals for Ceylon and Thailand. With regard to the allocation of functions as regards these activities, discussions were held with the International Bank for Reconstruction and Development.

In November, discussions were held in the Regional Office with a visiting UNFPA Operations Officer in New York, concerning the proposed UNFPA-assisted family planning projects in Thailand.

During a visit paid to the Regional Office by the Associate Director of UNFPA, discussions were held on the status of UNFPA-assisted programmes in the Region and also on the implementation of those projects for which requests for UNFPA assistance had been forwarded to New York.

The delivery by WHO of UNFPA-assisted projects improved considerably as a result of building up the necessary supporting services in the Regional Office and securing technical advice at both regional and country levels.

4.1.4 World Food Programme (WFP)

Good co-operation and close personal relationships were maintained concerning the two WFP projects in Indonesia, viz., the Solo re- afforestation project and the planned hospital feeding scheme. Proposals for assistance by the WFP in India and Indonesia were commented upon and supported. A WFP Evaluation Mission visited India at the end of March and SEA/RC25/2 Page 69 the Organization participated in the meetings of the Mission on 12 and 13 April during which the WFP Project "Operation Flood" was discussed. The WHO Representative in Nepal maintained contacts with WFP in regard to a proposed WFP programme for the distribution of nutritional supplements.

4.1.5 Economic Commission for Asia and the Far East (ECAFE)

The WHO Liaison Officer with ECAFE participated in various meetings organized by ECAFE and continued to maintain good working relations with the ECAFE Secretariat. He represented WHO at the 28th session of ECAEE, which was held in Bangkok in March 1972. Some of the other ECAFE- sponsored meetings at which the Organization was represented were: the Meeting on Communication Research in Family Planning, the Second Meeting of the Preparatory Committee for the Second Asian Population Conference, the Twelfth Inter-agency Meeting on Rural and Community Development in Asia, the Sixth Regional Inter-agency Meeting on Social Development and the Third Inter-agency Meeting on Co-ordination of Regional Programmes in the Population Field.

The WHO economist at the Asian Institute for Economic Development and Planning attended the Conference of Asian Economic Planners, organized by ECAFE and held in Bangkok. Close co-operation was maintained with the United Nations Advisory Committee on the Application of Science and Tech- nology to Development in connection with the finalization of the chapter on health in the Asian plan of action.

4.1.6 International Atomic Energy Agency (IAEA)

The Regional Office was represented in an IAEA Amalgamated Siting Mission, which visited Thailand in March 1972 in connection with the siting of a nuclear reactor.

4.1.7 Office of United Nations High Commissioner for Refugees (UNHCR)

WHO continued to act as the UNHCR's focal point for the purchase of medical supplies and equipment, including a large number of vehicles, for use in the refugee camps in India. A senior staff member of the Regional Office had discussions in Geneva both at WHO Headquarters and with UNHCR staff concerning assistance to the refugees.

Further urgently needed medical supplies were procured and supplied by WHO with funds made available by the UNHCR. The "Operation Life Line", as drawn up by UNICEF for the children in refugee areas, was put into operation. Following an earlier visit by the Regional Director (described last year), the WHO Representative to India and one of the Regional Advisers on Communicable Diseases visited the refugee camps to assess the health problems and to make recommendations to the Health Sub-committee established by the Government of India. SEA/RC25/2 Page 70

4.2 Specialized Agencies

4.2.1 Food and Agriculture Organization of the United Nations (FAO)

The WHO Representative in Indonesia maintained close contact with the FA0 expert on the Applied Nutrition Programme.

A country-level co-ordination meeting convened in Kathmandu by FA0 was attended by the WHO Representative in Nepal. The meeting discussed FA0 projects having a direct or indirect bearing on health.

4.2.2 International Labour Organisation (ILO)

The ILO Regional Adviser on Population and Family Planning Educa- tion in Industry visited Delhi in August for discussions with the Government and with representatives of workers' organizations concerning the National Trade Union Seminar on Population and Family Planning Ques- tions sponsored by IU) and the Central Board of Workers' Education, Government of India, which took place in Bombay, in October 1971. The Rcgional Office staff participated in these discussions.

4.2.3 United Nations Educational, Scientific and Cultural Organization (UNESCO)

During a visit paid to India by the Deputy Director-General of UNESCO in August 1971, the Regional Director attended a meeting of all thc heads of United Nations agencies in New Delhi, called by the Resident Representative of the United Nations Development Programme, to review UXESCO's programme of co-operation with India.

4.2.4 International Bank for Reconstruction and Development (IBRD)

Orientation was given to a four-member World Bank Mission which came to India to nlake a reappraisal of the family planning programme, which visited the Regional Office in July and again in August 1971. The mission held discussions with the Regional Director and other senior staff, as wfll as with the WHO Representative in New Delhi.

A further three-member IBRD team visited the Regional Office in January 1972 for discussions on the nutritional component of the IBRD family planning project in India.

The Country Representative of the World Bank in Nepal, who had taken up his assignment in 1971, was briefed by the WHO Representative on the Kathmandu water supply and sewerage project. SEA/RC25/2 Page 71

4.3 Non-governmental Organizations in Official Relations with WHO

The presence of representatives from seven non-governmental organizations at the twenty-fourth session of the Regional Committee, in Rangoon, provided an opportunity for informal discussions and for the exchange of ideas.

As in the past, Regional Office staff maintained close contact with the national organizations affiliated to the world bodies in the various countries of the Region. WHO was represented in meetings sponsored by these organizations, which included the lndian Academy of Paediatrics, Indonesian Society of Obstetrics and Gynaecology, Indian Hospital Association, Indian Association for the Advancement of Medical Education, Indian Public Health Association, Indian Medical Association and Indian Cancer Society.

4.4 Inter-governmental and Bilateral Agencies

Close contacts continued to be maintained with inter-govern~ntal and bilateral agencies. Regional Office and field staff participated in various meetings, conferences or seminars organized by several of these bodies.

The WltO Representative's Office in Colombo was in contact with thc local Swiss Embassy concerning the planning of Swiss aid to Ceylon's health services. WHO participated in discussions which culminated in an agreement between the Governments of Switzerland and Indonesia for the supply of equipment by Switzerland to the Central Laboratory of the Ministry of Health.

In Nepal, WHO collaborated with US AID in carrying out, together with the Government, a review of the country's malaria eradication programme, with a view to determining the future strategy to be followed.

The WHO Representative in Indonesia maintained close contact with local US AID officials concerning the malaria, health education and community health programmes.

During a visit of the Chief Medical Officer of Australia's Department of Health to Indonesia, discussions took place on Australia's technical assistance to Indonesia and WHO'S programes in that country.

Discussions have been taking place between the WHO Representative in Nepal and the representative of the Swiss Association for Technical Assistance in Kathmandu on the Association's health programes.

4.5 National and Other Agencies

A large number of meetings sponsored by governments and national and voluntary agencies were attended. Two Regional Office staff members SEA/RC25/2 Page 72 participated in a function arranged by the Indian Council of Medical Research in New Delhi at which the new "ICMR Research Information Bulle- tin" was released. As usual, WHO staff members attended the annualmeet- ings of the Expert Groups/Advisory Committees of the Council held during the last quarter of 1971.

In August 1971, the Regional Director and one of the Regional Advisers on Community Health Services attended, at the All-India Insti- tute of Medical Sciences, New Delhi, the "Dr B.L. Kapur Oration of Hospit a1 Administration in a Developing Country", given by the Director- General of Health Services, Ministry of Health, Government of India. Discussions on medical education in India were held with the Director of the All-India Institute of Medical Sciences.

Some of the meetings attended by Regional Office and field staff were: a National Smallpox Eradication Programme Officers' Meeting, held in New Delhi on 30 and 31 July 1971; a Seminar on the Laboratory Diagnosis of Smallpox, held at the National Institute of Communicable Diseases in Delhi from 29 July to 2 August 1971, and preparatory meetings held in connection with (1) a workshop on health and population education at the Central Health Education Bureau, New Delhi, and (2) a seminar on behavioural research in health and medical care (at the Indian Council of Pledical Research, New Delhi). The Regional Office was also represented at a Seminar on Family Planning Policy and Administration, organized in New Delhi by the Indian Institute of Public Health Administration.

Close contact continued to be maintained with the Danish "Save thc Children Organization", Ermnaus Suisse, the Order of Malta and the Ikutsches Aussatzigen Hilfswerk, in connection with leprosy control programmes. The WO Representative in Djakarta participated in discussions concerning possible assistance from the Danish Save the Children Organi- zation to the leprosy programme in Indonesia.

5. PUBLIC INFORMATION

The most important activity in pub1f.c information each year remains assistance in the planning and organization of the observance of World Health Day in countries of the Region. The response of the governments to requests for celebrating the day and their participation with active public support have been growing steadily. World Health Day pro- vidcs m opportunity to all concerned to focus attention on a particular hcalth problem and, at the same time, to make a review of general health conditions.

World Health Day 1972 had a popular theme - "Your heart is your health" - a slogan which was picked up extensively by the press, radio and television in the Region. A number of public meetings were held, sponsored by local, state and national health services, medical associations, institutes of medicine, non-governmental organizations and medical and social welfare institutions. World Health Day 1972, which centred round a popular theme, "Your heart is your health", was celebrated extensively throughout the Region. Picture shows attendance at an exhibition arranged in New Delhi to mark the occasion.

The Regional Director at the laboratory of the Malaria Eradication Programme Headquarters in Dacca during his visit to Bangladesh in june 1972.

To meet the additional requirements for office space, a 33-room annexe to World Health House has been constructed. Photo shows work in progress earlier this year. A demonstration being given at the School of Medical Physicists in Bangkok. which receives WHO assistance for training in radiation health.

With WHO/UNICEF assistance,lndonesia has undertaken a wide range of activities for strengthening its basic health services. Photo shows a rural health centre in Java.

Since 1968 WHO has organized two semlnars on me teaching of psychiatry in medical colleges, and the third in the series is scheduled to be held in Ceylon Governments are taking steps to improve and streng- later this year. Picture shows a group of psychiatric then their programmes for the quality control of patients in a hospital in India. drugs, as illustrated by this picture from Thailand. SEA/RC25/2 Page 73

Taking advantage of this occasion, the All-India Heart Foundation sponsored the observance of a "Heart Montt~", which was inaugurated in New Delhi by the President of India. A large exhibition on the theme complemented the inaugural ceremonies.

As mentioned earlier, the Regional Director participated in the World Health Day celebrations in Madras, which coincided with the inauguration of an Institute of Cardiology in the Madras General Hospital. The participation by the Chief Minister of Tamil Nadu, the State Minister of Health and other local authorities contributed to the success of the occasion, which was widely reported by the various information media.

The Regional Office distributed 6 000 copies of a set of articles on the World Health Day theme prepared by WHO Headquarters. Arrangements were made for the translation of some of this material into Hindi and Tamil and for mailing it to newspapers and magazines in India. In addition, 300 gl-ossy prints were distributed for reproduction and exhibit purposes. The WHO Representatives in Burma, Indonesia and Mongolia werr assisted with translations of material into local languages. Films on the theme specially produced by Headquarters were supplied to several countries in the Region.

Regional Committee Meeting

There was excellent press and radio coverage of the twenty-fourth session of the Regional Committee, held in Rangoon, Burma, in September 1971. All the local newspapers, both English and Burmese, devoted ample space to the Committee, before, during and after the session, most of them carrying the news on the front page, illustrated with photographs. In addition, there were many specially written articles and editorials on the session as well as on general health topics. International wire services in Rangoon also picked up the news, for regional and global distribution. Radio coverage was also very good.

Collaboration with Headquarters

The Regional Office has assisted the Division of Public Informa- tion at WHO Headquarters in several matters.

Complete arrangements were made for the briefing and travel of a UNDPIWHO reporting team, consisting of two journalists representing leading newspapers in France and Sweden and a free-lance photographer from Switzerland, who visited countries in the Region to report on WLIO/UNDP- assisted projects. The write-ups were published in their own newspapers as well as in other European papers.

Six articles with photographs were prepared for publication in World Health. This material, which resulted from visits to prograuxnes in the field, covered topics such as environmental health, geriatrics and SEA/Rc25/2 Page 74 mental health in India and smallpox eradication and health laboratory services in Nepal.

Press and Radio

Close relations continued to be maintained with the press and radioltelevision in the Region. Press releases were regularly issued, and requests for background information on health topics were promptly filled. Personal contacts with representatives of the press and radio facilitated interviews with WHO staff, both in the Region and those from badquarters visiting South-East Asia.

Continuous attempts were made to interest the radio networks in the taped material produced by the Radio Unit at Headquarters. Although the radio stations received the tapes directly from Geneva, personal contacts helped to persuade the producers to make greater use of the material. At the same time, efforts were made to stimulate them to produce programmes of their own, focussing attention on health problems of special importance to this region, and the support of the United Nations Information Centre in the various countries was enlisted in this connection. The overall cojerage given by radio and television services to important events like World Health Day and the Regional Committee's session has been most encouraging.

Photography

Travel in the countries of the Region served to make valuable additions to the photo archives of the Regional Office as well as to the photo files as regards illustrative material on tuberculosis control, a cancer control pilot project and general aspects of health in India, smallpox eradication in Indonesia, and water supply and control of water pollution in Thailand. Photographs of most of the educational meetings taking place in New Delhi were obtained, and those of the participants were sent for distribution to the press in their respective home countries.

Hindi Edition of World Health

There was a break in the publication of the Hindi edition of WorLd Health. The venture was originally started with the assistance of an Indian industrial corporation, whose donation made it possible to pub- lish the first four issues of this quarterly magazine.

This support ceased after the first year of publication, but the publisher of the first four issues, a well-known establishment, continued to show interest in the venture, and this year the Regional Office agreed to buy a certain number of copies in order to subsidize the publisher. The first issue for the second year has now been published. The present contract covers four issues and it is hoped that the publisher uill be able to collect sufficient subscriptions to make the journal self-supporting and commercially viable. SEA/RC25/2 Page 75

Miscellaneous

In addition to producing material for the information of the public, the Regional Office has made continued efforts to stimulate the production of material by outside sources. Free-lance journalists were supplied with background texts and photographic material to assist them in writing about WHO and on general health conditions. A large number of valuable contributions resulted.

An indication of the interest of the public in WHO activities in the Region is the number of requests for information which are received from individuals: they average 300 to 500 a month.

Groups of nursing and medical students from institutions in Delhi and elsewhere continue to visit World Health House. They are briefed on WHO'S activities, provided with information material, and, in some instances, given technical talks by Regional Office staff members. SEA/RC25/2 Page 77

ACTIVITIES UNDERTAKEN BY GOVERNMENTS

WITH THE HELP OF WHO s~A/RC25/2 Page 79

PROJECT LIST

This part of the report contains a list of the projects for Aich WHO has given assistance during the whole or part of the period under review, listed by country. Inter-country and inter-regional projects are listed at the end.

In general, projects for which no active assistance, in the form of field staff, fellowships or supplies, was given during the period covered are not included. Also omitted from the list are projects for which technical advice from the Regional Office or Headquarters was the only assistance given, and projects assisted only by grants-in-aid.

In the first column (under "Project No.,Source of Funds, Co-operating Agencies") "R" means the Regular budget; "UNDP" the United Nations Development Programe; "UNFPA" the United Nations Fund for Population Activities; "FLINDWI" the Fund of the United Nations for the Development of West Irian; "UNICEF" the United Nations Children's Fund, and "US AID" the United States Agency for International Development. Names of co- operating agencies, except for UNICEF, whether or not they have contributed funds, are given in parentheses. Numbers given within brackets are those according to the proposed new numbering syster;?. In the second column, under the title of the project, the starting and, where relevant, finishing dates are shown within brackets.

The "Aim of the project" states the purpose for which it was undertaken by the Government concerned, and is not related to the form or extent of WHO'S assistance.

Projects entitled "Fellowships" list those which do not form part of assistance to a larger project; other fellowships are shown under the projects concerned.

It should also be noted that there are a number of projects not included in the list for which UNICEF is furnishing supplies and WHO technical advice only (with no special personnel being provided). SEA/RC25/2 Page 81

1. BURMA

PROJECT LIST

Project No. Source of Funds Co-operating Agencies Title

Burma 0006.2 (5101) Maternal and Child Health R (June - Aug. 1969; Aug. 1970; Oct. - Dec. 1970; Oct. 1971; Jan. 1972; March 1972; - )

Aim of the project. To strengthen the departments of paediatrics and obstetrics of major hospitals and to improve and expand maternal and child health services as part of the general health services.

Assistance provided by WHO during the year. (a) A seven-month fellowship (extension) for study in the United Kingdom, a six-month fellowship for studies in Sweden, the United Kingdom and the United States of America, and a one-week travel fellowship for study in the United Kingdom; (b) supplies and equipment.

Burma 0017 (1301) Leprosy Control R (A~ril. . 1960 - ) UNICEF

Aim of the project. To intensify the leprosy control programme, to extend it to cover all the endemic areas, and to train personnel.

Assistance provided by WHO during the year. (a) A leprologist; (b) three twelve- month fellowships - two for study in India and one for study in the United States of America; (c) supplies and equipment.

Work done during the year. The infrastructure of the leprosy control campaign, which now covers the entire country, has been strengthened. In all, 56 medical officers, 5 physiotherapists, 71 leprosy inspectors, 22 assistant leprosy inspectors, 463 junior leprosy workers, 47 laboratory assistants, 4 lady health visitors and 31 nurses are engaged in the leprosy control prograrmne. As of the end of 1971 a total of 19 303 new cases had been detected and brought under control. At the end of January 1972, out of a total of 233 587 registered cases, 224 909 patients were under treatment at various centres and/or hospitals. Out of those under treatment, only 2 886 cases (1.3%) were treated in hospitals and colonies.

Preparations were made for an assessment of the programe, to be carried out towards the end of 1972 and the beginning of 1973.

Assistance has been provided for conducting research on the best procedure for integrating the specialized leprosy services into the general health services. SEAIRC2512 Page 82

Burma 0028 (6201) Institute of Medicine I and School of UNDP Preventive and Tropical Medicine, Rangoon (Feb. 1955 - Feb. 1959; Feb. 1961; Sept. 1963; Aug. 1966 - Jan. 1967; Dec. 1967; July 1968 - )

Aim of the project. To assist the Institute of Medicine I in improving undergraduate teaching and to promote research in post-graduate study; to assist the School of Preventive and Tropical Medicine in developing a diploma course in academic and field training areas.

Assistance provided bv WHO during the vear. (a) A professor of epidemiology and a professor of public health administration, and assistance from the professor of sanitary engineering assigned under Buma 0089; three consultants; (b) a twelve- month fellowship for study in the United Kingdom; (c) supplies and equipment.

Work done during the vear. The WHO visiting professor of public health administration completed his assignment at the School of Preventive and Tropical Medicine in November 1971 and his duties have been taken over by his national counterpart, who has returned from study abroad on a WHO fellowship. The WHO professor of epidemiology continued in his long-term assignment. The WHO professor of sanitary engineering assigned to project Burma 0089 also assisted in the teaching of his subject, until his departure from Burma in February 1972. In May 1972, a consultant (professor of medical statistics) was assigned to help with the teaching of this subject.

During the past five academic years 46 post-graduate students have been awarded the Diploma of Preventive and Tropical Medicine. Emphasis has been placed on the field training of students in research projects and surveys, especially in the rural areas.

Early in 1972, the School of Preventive and Tropical Medicine was shifted from the Institute of Medicine I to its own premises, where more space and amenities for students and staff are available.

The WHO professors also assisted in the undergraduate teaching programmes at the Institute of Medicine I. The activities of the consultants in anatomy and paediatrics are described under project Burma 0079.

Burma 0031 (2001) Malaria Eradication R (May 1954 - )

Aim of the project. To eradicate malaria from the country in progressive stages.

Assistance provided by WHO during the year. (a) A laboratory technician and a short-term sanitarian; (b) travel expenses of national staff attending training courses; (c) supplies and equipment, including a transport vehicle.

Probable duration of assistance. A number of years.

Work done during the year. The malaria control programme continued to protect a population of 5.7 million by DDT spraying, 8.049 million by active case-detection, treatment and focal spraying, and 3.080 million by passive case-detection,treatment and remedial measures by the general health services.

In 1971, 5 702 positive blood slides were recorded, of which 3 876 (4 653 in 1970) were in the areas under DDT spraying, 1 652 (2 332) in areas under active SEAIRC2512 Page 83

case-detection and 174 (68) in areas under passive case-detection, showing a considerable reduction over 1970.

Pilot projects on integration into the general health services were carried out during the year 1971 and will continue in 1972.

Burma 0044.2 (1001) Strengthening of Health Services UNDP (Epidemiolog& (Feb. - May 1968; Jan. 1969 - )

Aim of the project. To strengthen the Epidemiological Unit in the Directorate of Health Services; to study the prevailing pattern of communicable diseases and to provide information for sound public health planning and control measures; also to develop public health laboratory services in support of the Epidemiological Unit.

Assistance provided by WHO during the year. (a) Three consultants; (b) supplies and equipment, including a transport vehicle.

Probable duration of assistance. Until 1977.

Work done during the year. A WHO consultant was assigned to advise the Government on the epidemiological surveillance of diseases subject to the International Health Regulations and of others which have been included in the national surveillance programme, such as viral diseases, salmonella and dengue-haemorrhagic fever.

Another WHO consultant assisted the Government in the introduction of laboratory methods for arbovirus serology in support of the surveillance of dengue1 haemorrhagic fever. During August-October 1971, a further consultant (venereologist) reviewed the national venereal-disease control programme. His proposals for the strengthening of the programe and for the intensification of venereal- disease control activities have been forwarded to the Government.

Burma 0056.2 (4401) Nursing Advisorv Services R (March 1959 - April 1966; June 1969; Oct. 1970 - Jan. 1971; May 1971 - )

Aim of the protect. To develop nursing and midwifery education and services.

Assistance provided bv WHO during the year. (a) Four nurse consultants; (b) two fellowships - one for ten months and one for eleven months - for study in the United Kingdom; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the year. During the period under review, three country-level courses were conducted under the project, i.e., a six-month course in "Neuro- logical and Neurosurgical Patient Care", with 31 participants; a five-week course on "Nursing of Patients with Eye, Ear, Nose and Throat Disorders", with 20 participants,and an eight-week course on the "Nursing Care of Surgical Patients", with 20 participants.

Interest continues to be shown in this type of assistance, and requests have been received for three courses in 1973. SEA/RC25/2 Page 84

Tuberculosis Control (Jan. 1964 - )

Aim of the proiect. To develop community-oriented tuberculosis control services.

Assistance provided by WHO during the year. (a) A medical officer; (b) a six- month fellowship for study in the United Kingdom.

Work done during the year. The WHO medical officer completed his assignment at the end of 1971. His report has been sent to the Government.

At the end of 1971, 15 BCG teams, in addition to two sub-teams, were operating in 13 administrative areas of the country. Out of 1 154 peripheral health centres functioning in Burma, 868 (75.2%) were involved in the consolidation phase of the BCG vaccination programme. Arrangements were made to strengthen the vaccination programme for infants and children of pre-school age at maternal and child health centres throughout the country.

Preparations were made for a tuberculosis baseline survey, to be carried out in the second part of 1972.

Burma 0066 (4501) Health Education R (Nov. 1966; May 1968; Aug. 1971; Nov. 1971 - Jan. 1972; June 1972 - )

Aim of the proiect. To develop health education services and to provide training in health education to teachers and those holding key posts in the school organization and in the general health services.

Assistance provided by WHO during the year. (a) Two consultants; (b) a two-month fellowship for study in Yugoslavia; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1976.

Work done during the vear. A WHO consultant was provided to the project from November 1971 to January 1972. He advised on strengthening the health education services and assisted in the planning and conduct of a national workshop on school health education, which took place from 3 to 15 January 1972. In his assignment report, which has been sent to the Government, the consultant has made a number of recomaendations regarding orientation and refresher courses to improve the effectiveness of health staff in discharging their health education responsibilities, and also with regard to school health education. The same consultant rcturned to the project in June 1972 for a further assignment.

Burma 0069 (1701) Trachoma Control R (March 1966; Sept. 1966; May 1967; Nov. 1967; UNICEF Feb. 1970; Aug. 1970: July 1971; June 1972; - )

Aim of the project. To continue the trachoma control programme.

Assistance provided by WHO during the vear. (a) A consultant; (b) a twelve-month fellowship (extension) for study in the United Kingdom; (c) supplies and equipment.

Probable duration of assistance. Some years.

Work done durina the year. Towards the end of the period under review, a WHO consultant visited Burma to review the progress of the trachoma control activities and to help in evolving guidelines for the future. SEA/RC25/2 Page 85

Burma 0074 (4201) Strengthening of Laboratory Services R (May - June 1967; April 1968; June 1968; Aug. - UNICEF Oct. 1968; April 1969; April 1970; Jan. 1971; Dec. 1971 - ) Aim of the project. To strengthen laboratory services and to promote their development at central and peripheral levels.

Assistance ~rovidedby WHO during the year. (a) A virology technologist, a consultant and assistance from the microbiologist provided under project Burma 0044.2; (b) two fellowships - one for twelve months and one for six months (extension) - for study in the United Kingdom, and a four-month fellowship for studies in India, Hungary and the Regional Office; (c) supplies and equipment.

Probable duration of assistance. Until 1977

Work done during the year. A consultant microbiologist (provided under Burma 0044) was assigned to the project from December 1971 to June 1972. A WHO virology technologist assumed her duties at the National Health Laboratory, Rangoon, from the last week of March 1972. A consultant serologist provided during December 1971-June 1972 assisted the laboratory in reorganizing the work of the Central Venereal Diseases Laboratory. He also helped in introducing and putting into use modern laboratory procedures in syphilis serology and venereal diseases: FTA 200, FTAIABS as well as the culture and identification of gono- cocci and testing of their sensitivity to antibiotics, preparation of serological reagents, etc. On the recommendation of this consultant, the VDRL testing has been decentralized and two in-service courses have been conducted for the training of laboratory technicians from the venereal-disease control programme in syphilis serology. In this connection,supplies, including seven sets of the laboratory manual, have been procured.

The Bacteriology Department, which has developed a high degree of competence, now functions as a national reference laboratory for salmonella and cholera. Phage-typing for cholera is done as a routine and phage-typing of salmonella typhi is being developed. Excellent collaboration is maintained with the WHO Inter- national Vibria Reference Laboratory, Calcutta, and with the Salmonella Reference Laboratory at the Central Research Institute, Kasauli, India. International and regional collaboration between the National Health Laboratory, Rangoon, and a specialized laboratory is being developed in order to exchange information on staphylococci, streptococci and phage-typing of salmonella other than salmonella typhi.

Burma 0077 (1002) Burma Pharmaceutical Industry (Production R of Biologicals) UNICEF (Feb. 1964; July 1964; AUK. 1968; Feb. 1969; July 1969; ~eb;1970; ~ept.1970 - March 1971; May 1971; Nov. 1971; - ) Aim of the ~rolect. To assist the Biological Division of the Burma Pharmaceutical Industry, Rangoon, in modernizing methods of production and assaying of bacterial and viral vaccines and anti-sera preparations, as well as in developing new vaccines.

Assistance provided by WHO during the year. (a) A three-month fellowship for studies in the United Kingdom and India; (b) supplies and equipment.

Probable duration of assistance. Until the end of 1977. SEAlRC2512 Page 86

Burma 0078 (1501) Plague Control R (Dec. 1966; June 1970; Sept. 1970; Nov. 1970; Dec. 1971 - March 1972; - )

Aim of the project. To identify the factors responsible for the persistence of foci of plague and to train personnel in the epidemiology and control of the disease.

Assistance provided bv WHO during the year. (a) A consultant; (b) two three-month fellowships for studies in the USSR, Iran and India; (c) supplies and equipment, including a transport vehicle.

Probable duration of assistance. Until the end of 1974.

Work done during the year. A WHO consultant assisted the programme in further field studies on the epidemiology of plague. The studies resulted in a number of isolations of Yersinia pestis in field rodents from various parts of the country, indicating a very wide circulation of plague bacilli.

During his assignment, the consultant also assisted in conducting a training course on plague epidemiology in Mandalay from 15 to 25 February (for details,see SEARO 0125).

Burma 0079 (6202) Medical Education R (Dec. 1964 - Peb. 1965; March 1966 - Jan. 1967; Dec. 1967 - )

Aim of the proiect. To improve undergraduate and post-graduate medical education, train teaching staff, develop curricula in keeping with modern concepts, and initiate and guide research at the Institutes of Medicine.

Assistance provided bv WHO during the year. (a) A professor of paediatrics and a consultant; (b) eight fellowships - one for twelve months (extension), one for seven months (extension), five for ten months and one for five months - for study in the United Kingdom and a twelve-month fellowship (extension) for study in Ireland; (c) supplies and equipment.

Work done during the year. A consultant in anatomy, during two assignments, assisted with the organization and execution of an M.Sc. course in this discipline.

Another consultant - in paediatrics - continued to give assistance to the diploma course in child health at the medical institutes at Mandalay and Rangoon.

Two consultants in medical education (assigned under project SEARO 0096) visited the three Institutes of Medicine in Burma in the last quarter of 1971 to advise on their examination systems and related educational problems.

Burma 0080 (1801) Smallpox Eradication (including Smallpox R Vaccine Production) UNICEF (Jan. 1967 - Dec. 1971)

Aim of the proiect. To assist the maintenance programme and, in particular, the surveillance component.

Assistance provided by WHO during the year. Supplies and equipment, including a transport vehicle. SEA/RC25/2 Page 87

Work done. This project began in 1967. At that time a low incidence of smallpox was being recorded in Burma, and since 1970, no cases at all have been reported. WHO'S aim was to assist in the eradication campaign and to establish a maintenance programme and a surveillance system. Throughout the period 1967- 1971, supplies, including freeze-dried vaccine, and equipment were provided. In 1969, a medical officer attached to the inter-country Smallpox Eradication and Epidemiological Advisory Team (SEARO 0030) visited Burma and reviewed various aspects of the programme with the authorities. The methodology of concurrent assessment was demonstrated, and a switch-over to vaccination by means of the bifurcated needle after a suitable pilot trial was recomended. In 1970 a joint GovernmentIWHO assessment was carried out.

In 1971, in addition to supplies and equipment, assistance was given in establishing a smallpox diagnostic laboratory. WHO will continue to provide facilities far this laboratory and will also assist with the testing of freeze- dried vaccine, which is being produced locally, WHO having provided technical assistance (under project SEARO 0038.2) and UNICEF providing supplies and equipment.

Evaluation

With the assistance of WHO and during the four years of implementation of this project, Burma has improved its smallpox surveillance programme, stren~- thened supervisory activities in this connection, introduced the multi-puncture technique of vaccination by means of the bifurcated needle, and initiated facilities for the laboratory diagnosis of smallpox.

Burma 0083 (5502) Education in Dentistrx UNDP (Jan. 1967; Nov. 1967 - Jan 1968; Jan. 1969; Sept. 1970; Sept. 1971; - )

Aim of the proiect. To strengthen dental education in the country.

Assistance provided by WHO during the year. A twelve-month fellowship (extension) for study in the United Kingdom.

Burma 0085 (4301) Traininn of Electro-medical Technicians R (March 1969; Sept. 1969; March - May 1970; UNICEF Aug. - Sept. 1970; Feb. - May 1971; - )

Aim of the proiect. To establish a school for the training of technicians for the maintenance and repair of X-ray and electro-medical equipment.

Assistance provided by WHO during the year. (a) Three three-month fellowships - two for study in India and one for study in Thailand; (b) supplies and equipment.

Burma 0086 (8501) Goitre Control R (March 1971; Dec. 1971 - Jan. 1972; - ) UNICEF

Aim of the proiect. To undertake the evaluation and surveillance of the goitre control programme.

Assistance provided by WHO during the year. (a) A consultant; (b) supplies and equipment. SEA/RC25/2 Page 88

Work done during the year. D1;ring December 1971-January 1972 a consultant was assigned to Burma to assist the Government in devising a methodology for the evaluation of the goitre control programme and to help the Burma Medical Research Institute in planning research in nutrition as applied to goitre control. His recommendations on the future development of the programmerwhich have been communicated to the Government, related to (a) use of iodized oil in areas where it was not practicable to supply iodated salt; (b) conduct of a nation-wide survey to determine whether iodine prophylaxis should be planned for the whole country; (c) dosage of iodized oil to be administered, and (d) programmes for the training of medical personnel for goitre surveys and in prophylactic treatment.

Iodized oil was supplied to the Burma Medical Research Institute for use in the programme.

Burma 0087 (2201) Filariasis Control R (Dec. 1969 - Jan. 1970; July 1970 - )

Aim of the proiect. To apply filariasis control methods.

Assistance provided by WHO during the vear. (a) An epidemiologist and a consultant; (b) supplies and equipment, including a transport vehicle.

Probable duration of assistance. Until the end of 1977.

Work done durina the vear. The anti-larval spraying operations of the filariasis control project, which showed satisfactory progress during the year, have covered almost the entire urban area of Rangoon. This coverage has resulted in a considerable reduction in the density of C.p.fatigan8. There has also been a reduction in micro-filaria in the population as compared with the previous findings, and this may be due to the interruption or reduction of transmission of filariasis resulting from the gross decrease in the number of adult Culex mosquitoes.

In April-May 1972, a WHO consultant reviewed the entomological aspects of the project and made recommendations, which have been forwarded to the Government.

Burma 0088 (4801) Rehabilitation of the Handicapped R (Oct. - Nov. 1969; July 1970; July 1971; Oct. - Nov. 1971; - )

Aim of the protect. To expand medical rehabilitation services at the central and peripheral levels and to improve workshop facilities for the manufacture of orthotic and prosthetic appliances.

Assistance provided by WO durinr the year. (a) A consultant-prosthetics tutor; (b) a twelve-month fellowship for study in the United Kingdom; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1977.

Work done during the year. A WHO prosthetic tutor was assigned to the project for three weeks in November 1971 for following up on the visits of previous consultants on medical rehabilitation and to hold discussions on the further development of medical rehabilitation in the country. SEA/RCZ5/2 Page 89

Burma 0089 (3001) Institute of Technoloev, Rangoon R (May 1969 - ) UNDP

Aim of the project, To teach sanitary engineering to undergraduate and graduate civil engineering students.

Assistance provided by WHO during the year. A professor of sanitary engineering and a consultant.

Probable duration of assistance. Until the end of 1973.

Work done durinn the year. At the Institute of Technology, Rangoon, where the teaching in sanitary engineering continued as planned, 104 students appeared for the final examinations in the 1970-71 academic year. Of the 103 successful candidates, three obtained distinction in sanitary engineering. Out of 127 fifth-year students, 126 passed and 8 received distinction. The final-year civil engineering students were the first group to receive the revised and extended syllabus of two years' training in the subject.

The first-term of the 1971-72 academic year was inaugurated on 1 September with 127 students in the final year and 122 in the fifth year. Courses on sanitary biology and on water distribution, both rural and urban, were given to fifth-year and final-year students respectively.

The WHO professor's first national counterpart returned from his 12-month fellowship on 1 September. With the arrival of equipment, plans were initiated for the construction of two pilot plants - one for the investigation of slow sand filtration and another for a water treatment plant to study the several stages in the treatment process.

Assistance was also given in the teaching of environmental health at the School of Preventive and Tropical Medicine, Rangoon.

The WHO professor left at the end of January; in order to ensure continuity of the training programme at the Institute, a consultant was assigned pending the selection of a long-term professor of sanitary engineering.

Burma 0090 (5501) Dental Health Services R (Aug. - Oct. 1971; Feb. 1972; - )

Aim of the projcct. To improve dental health and dental education in the country.

Assistance provided by WHO during the year. (a) A consultant and assistance from a staff member from Headquarters; (h) supplies and equipment.

Work done durinn the year. From August to October 1971, a consultant surveyed the dental health situation in Burma. In his report, which has been sent to the Government, he has stressed the need to train dental manpower. During his stay in Burma, he also assisted in the preparation of a request for UNDP assistance in the training of dental health personnel. Subsequently, a staff member from WHO Headquarters visited Burma to help in redrafting the request.

Burma 0091 (4701) Radiation Health R (June 1970; Jan. 1971; Dec. 1971; - )

Aim of the protect. To strengthen the radiation protection services in the health institutions, first by the development of film-badge monitoring services in Rangoon and gradually expanding the coverage to peripheral hospitals; to train staff. SEA/RC25/2 Page 90

Assistance provided by WHO durina the year. (a) A three-month fellowship (extension) for study in New Zealand; (b) supplies and equipment.

Probable duration of assistance. Until the end of 1975.

Burma 0092 (7401) Ouality Control of Drugs R (March 1970; May 1970; Aug. - Sept. 1970; Nov. - Dec. 1970: June 1971:. Seot.. 1971: May 1972; - )

Aim of the project. To formulate new legislation and develop laboratory competence in the field of quality control of pharmaceutical and biological preparations.

Assistance provided by WHO durin~the vear. (a) A six-month fellowship for studies in India, the United Kingdom, Denmark, the UAR and France, a six-month fellowship for study in India and a three-month fellowship for study in the USSR; (b) supplies and equipment.

Burma 0093 (5601) Nutrition Services R (May 1972; - )

Aim of the proiect. To strengthen nutrition work through the health services by organizing in-service orientation courses for medical personnel and by giving specialist training to key personnel.

Assistance provided by WHO during the year. Supplies and equipment.

Probable duration of assistance. Until 1975. liurma 0094 (4001) Strengthening of Health Services R (May - Aug. 1969; Jan. - March 1970; UNICEF Nov. 1970; May 1972; - )

Aim of the project. To strengthen health services, with particular emphasis on the development of a comprehensive health care service; to implement a national health plan, and also to train health personnel for basic health services, particularly auxiliary personnel.

Assistance provided by WHO during the year. Supplies and equipment.

Probable duration of assistance. A number of years.

Burma Medical Research Institute (Jan. 1972; - )

Aim of the project. To strengthen the units of the Medical Research Institute.

Assistance provided by WHO during the year. A three-month fellowship for study in Singapore. SEA/RC25/2 Page 91

Burma 0097 (4302) Maintenance and Repair Workshop R for Health Equipment UNICEF (Sept. 1971 - )

Aim of the proiecl. To establish workshops and train staff in the maintenance and repair of equipment used in health institutions.

Assistance provided by WHO during the year. (a) An electro-medical engineer; (b) supplies and equipment.

Probable duration of assistance. Until 1975.

Work done durin~the year. The WHO electro-medical engineer took up his assignment on 1 September 1971.

He visited various hospitals in Rangoon to determine the types of equipment which were out of order, to conduct fault-finding tests and to identify the spare parts that would be required. Many items of equipment were repaired and put into service.

At the Rangoon General Hospital, it is planned to develop a simple type dental chair suitable for district-level dental clinics.

Five students are attending the course for electro-medical technicians, and it is being arranged to take two more, possibly from the Dental College, Rangoon, since it was felt that there was a need for technicians in the maintenance and repair of dental equipment.

The WHO electro-medical engineer assisted, in co-operation with the Colombo Plan, in thc design and types of equipment required in the Dental College and suggested the tools and supplies for the repair and maintenance of dental equipment.

A department for the repair of optical equipment, including microscopes, ophthalmoscopes, etc., is being set up.

In the workshop at Rangoon General Hospital, manufacture of cylinder trolleys has been undertaken with very good results.

Burma 0101 (4202) Clinical Pathology, Institute of UNDP Medicine, Mandalay (Dec. 1971; - )

Aim of the proiect. To raise the standards and widen the scope of laboratory services offered by the Department of Clinical Pathology at the Institute of Medicine, Mandalay.

~Issistanceprovided by WHO during the year. Supplies and equipment, including two tissue dryers,two ultra-low temperature cabinets, a cryostat and a spectronic system.

Burma 0200 (6641) Fellowships R

1.aboratory services. A four-month fellowship for studies in Hungary and the United Kingdom. SEA/RC25/2 Page 92

Management of plasma production. A two-month fellowship for studies in Hungary and the United Kingdom.

Technoloav of plasma production and framnentation. A six-month fellowship for studies in Hungary and the United Kingdom. SEAIKC~~IL Page 93

2. CEYLON

PROJECT LIST

Project No. Source of Funds Co-operating Agencies Title

Ceylon 0005.2 (1101) Venereal-Disease Control R (Sept. 1964; Sept. 1966; Oct. - Uec. 1967; July 1968; March - May 1969; Sept. - Oct. 1969; Aug. 1970; Dec. 1970; July 1971; - )

Aim of the project. To develop laboratory diagnostic facilities for the national venereal-disease control programe.

Assistance provided by WHO during the year. (a) A one-month fellowship for study in the United States of America; (b) supplies and equipment.

Ceylon 0026.2 (1301) Leprosy Control R (Oct. - Nov. 1967; Uec. 1968 - Aug. 1959; Nov. 1969 - Sept. 1970; Jan. 1971 - )

Aim of the project. To assess the extent of leprosy, develop an integrated control programme, and to train staff.

Assistance provided by WHO during the year. (a) ,\ consultant leprologist; (b) a three-month fellowship for study in India and two two-month fellowships for studies in the Philippines, Burma and India; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1973.

Work done during the year. The WHO consultant leprologist continued to assist the leprosy programme and its control activities, with emphasis on school surveys

He carried out house-to-house surveys in some places in the country and, at the time of writing, was preparing a special report on the prevalence rate avong the population examined.

Ceylon 0037 (5401) Mental Health R (Nov. 1955 - Jan. 1956; Aug. 1960; Nov. - Dec. 1961; Jan. - May 1963; June - July 1966; March 1967; Sept. 1969; Nov. 1969; Aug. 1970; Oct. - Dec. 1970; Feb. 1971; - )

Aim of the project. To develop mental health care within the framework of comprehensive health services, to strengthen the teaching of mental health in the undergraduate medical curriculum and to train various categories of health perscnnel.

Assistance provided by WHO during the year. Supplies and equipment.

Probable duration of assistance. A number of years. SEAIRC2512 Page 94

Ceylon 0047 (6201) Medical Education R (June - Aug. 1959; Nov. 1963 - April 1964; Oct. 1964 - Dec. 1965:, Seot.. 1966: Nov. 1967: Sept. 1968 - Aug. 1969; Jan. - March 1970; May 1970; Aug. 1970 - March 1971; May 1971; Oct. - Dec. 1971; Feb. - April 1972; - )

Aim of the project. To develop further undergraduate and post-graduate teaching programmes and to assist teacher training at the two Faculties of Medicine in Ceylon.

Assistance provided by WHO during the year. (a) Four consultants; (b) filur fellowships - two for twelve months and two for six months - for study in the United Kingdom, a four-month fellowship for studies in Nigeria, Malawi and Zambia, and a 15-day fellowship for a study tour of Switzerland, Hungary and Bulgaria; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the year. In October-November 1971, a consultant in surgery was assigned to the Faculty of Medicine, Peradeniya, to advise on the teaching of this subject at undergraduate and post-graduate levels. Among his recommendations were proposals for the improvement of out-patient facilities to enable better utilization of clinical material for teaching and suggestions for the integration and synchronization of teaching by several departments. His report has been sent to the Government .

A consultant paediatrician paid a follow-up visit to the Faculty of Medicine, Colombo, during the last quarter of 1971. In his report, which has been forwarded to the Government, he has stated that the DCH course is well designed, bearing in mind that the training of doctors should be geared to the needs of the country.

A third consultant also visited Ceylon during the same period to advise on the development of anaesthesiology and on post-graduate training in this field. The report containing his recommendations has been submitted to the authorities.

A consultant in medical sociology revisited Ceylon early in 1972 to finalize the protocol for the sub-study on utilization of physicians, which is a part of the comprehensive health manpower study under way at present.

Ceylon 0053 (4401) Nursing Advisory Services R (July 1960 - Feb. 1966; Aug. - Oct. 1966; Sept. - Dec. 1967; Dec. 1969; Feb. 1970; May 1970; July 1970; Sept. 1970; Feb. - June 1971; Feb. 1972 - )

Aim of the proiect. To develop nursing and midwifery education and services.

Assistance provided by WHO during the year. (a) A consultant; (b) four fellowships - two for six months, one for eight months and one for twelve months - for study in the United Kingdom, a twelve-month fellowship for study in New Zealand and a twelve-month fellowship for study in India; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1974.

Work done during the vear. During the period under review, two country-level courses were conducted under this project, with assistance from project SEAR0 0139: SEA/RCZ~/Z Page 95

one on "Clinical Teaching in Schools of Nursing", with 16 nurse participants, of one month's duration; the second on "Administration of Nursing Services". with 28 nurseldoctor participants. This course was of five weeks' duration.

The nurse educator who assisted with the courses later helped with the preparation of comprehensive lists of equipment required for nurse training. This entailed visits to all the nurse training schools in the country.

Plans are well ahead for the application of a new educational technique, scheduled to start in Ceylon shortly. This will provide a sequential learning activity in "paediatric patient care", the purpose of which is to demonstrate a methodology which may be ultimately adopted to develop "areas of excellence" in all clinical fields in a country,thereby strengthening the delivery of health services. Much time has been spent in the development and testing of an assessment tool for use in this activity, by which an attempt will be made to measure the effectiveness of the programe. It is planned to have an element of follow up in each of the three sequential phases of this progrannoe.

A nurse consultant was assigned for six months from February 1972 in order to advise and assist with the development of training courses in midwifery for qualified nurses. She also helped with the planning for the introduction of midwifery training into the basic curriculum for nurses and the two-year curriculum to he used for the more comprehensive preparation of the public health midwife (auxiliary nurse-midwife).

Ceylon 0056 (2201) Filariasis Control UNDP (Dec. 1959; April - July 1961; Sept. 1961; Aug. - Sept. 1963; June 1965 - )

Aim of the project. To control filariasis.

Assistance provided by IbXO during the sear. (a) An epidemiologist/parasitologist and an entomologist; (b) supplies and equipment.

Work done during the year. The activities of the project, which continued as planned, consisted of vector control and detection of microfilaria carriers in areas in the filaria belt and in adjoining places. Preparations were made to expand the scope of the project to cover vectors other than C.p.fatigans. The WHO epidemiologist and the WHO entomologist continued to provide assistance.

Some special entc~ologicalsurveys were conducted outside the endemic belt and in areas of pilgrim congregations. A number of C.p.fatigans were collected from various places for dissection. None was found positive.

Mring the year, 1 254 566 persons were examined, out of whom 6 906 were found positive, with a microfilaria rate of 0.55%. Proposals were made for an effective sanitation programme in order to achieve good results in mosquito control in the country.

Cevlon 0058 (2001) Malaria Eradication R (Aug. 1960 - )

Aim of the project. To eradicate malaria.

Assistance provided bv WHO during the year. (a) Two malariologists, an entomologist, a parasitologist, a sanitary engineer, a sanitarian, a clerk-stenographer, SEA/RC25/2 Page 96

and a consultant; (b) two fellowships - one for two months and one for one month - for study in the Philippines; (c) supplies and equipment; (d) payment of subsidy.

Probable duration of assistance. A number of years.

Work done during the year. The plan of operation was signed by the Government and WHO in February 1972. A population of 4.7 million was protected by DDT spraying at 1 gram/m2 monthly intervals, three spray cycles a year. In P.faZci- parm areas DDT spraying at 1 gram/m2 at two-monthly intervals was undertaken, protecting a population of 1.10 million.

There was a significant reduction in the incidence of malaria, the fall having started in June 1970, when the spraying operations and case-detection were stabilized. The total number of positives recorded in 1971 was 145 368 as compared with 468 199 in 1970 and 539 193 in 1969.

The National Malaria Eradication Training Centre was assisted by WHO staff. Supplies and equipment were also provided. Three courses for medical officers of health and five courses for public health inspectors have been completed.

Supervision appears to be the major problem in the implementation of anti- malaria activities, as the number of supervisory personnel is not adequate.

The programme has been integrated into the general health services in 15 health divisions and 102 MOH areas.

In March-April 1972, a comprehensive assessment of the programme was carried out by a team consisting of a national leader and two WHO consultants (see also SEAR0 0007).

Cevlon 0063.2 (4801) Medical Rehabilitation R (Nov. 1968 - Feb. 1969; Feb. - June 1970; Jan. - March 1972; - )

Aim of the project. To assist the medical rehabilitation services and to train staff.

Assistance provided by WHO during the year. A consultant (medical rehabilitation specialist).

Probable duration of assistance. Until the end of 1975.

Work done during the vear. A consultant in medical rehabilitation was assigned for three months in early 1972 to assist in the development of medical rehabilitation services and to review the curricula in this subject in medical schools. His report was under study.

Ceylon 0064 (3001) Community Water Supply and Sanitation R (Oct. 1963 - ) UNICEF

Aim of the protect. To develop programmes of community water supply, sewage disposal storni-watcr drainage and general sanitation, and to train personnel.

Assistance provided by WHO durin~the year. (a) A sanitary engineer; (b) a three- month fellowship (extension)for study in the United Kingdom and a twelve-month iellorjship for study in the Netherlands; (c) supplies and equipment. SEA/RC25/2 Page 97

Probable duration of assistance. Until the end of 1978.

Work done durin~the year. The tripartite plan of operation for the WHOIUNICEF- assisted community water supply programe was signed in December 1971, and the Government took effective action to start the implementation of the project in accordance with the work plan incorporated in the plan of operation.

The WHO sanitary engineer continued to provide advisory services to the Government in the development of the project.

Steps were taken to prepare lists of equipment and materials for investigations and water supplies, and the procurement of most of the items was initiated by UNICEF. Index cards and cabinets ordered by UNICEF were received. Work on the preparation of a national plan continued as planned.

Detailed surveys and investigations were completed in respect of all communities listed in the first group.

A new materials management system, evolved by the WHO sanitary engineer, was accepted by the Government and put into practice.

Ceylon 0060.3 (4201) Strengthening of ~aboratoryServices R (Aug. 1966 - March 1969; Oct. 1969; Dec. 1969; May 1970; Aug. - Sept. 1970; Nov. 1970; April 1971; July 1971; Oct. 1971; Dec. 1971; Feb. 1972; - )

Aim of the proieit. To develop further specialized diagnostic and reference functions in support of communicable-disease control and prevention, and to train staff.

Assistance provided by WHO during the year. (a) A twelve-month fellowship and a three-month fellowship (extension) for study in the United Kingdom, a three-month fellowship (extension) for studies in the United Kingdom and Denmark, and a seven- month fellowship for studies in the Vnited Kingdom and the Regional Office; (b) supplies and equipment.

Probable duration of assistance. Until 1977.

Ceylon 0071 (4701) Radiation Health R (Nov. Dec. 1966; Aug. - Sept. 1969; Aug. - Sept. 1970; April 1971; Oct.- Nov. 1971; - )

Aim of the project. To strengthen radiation protection services and to train staff.

Assistance provided by WHO durlng the=. (a) 'Two consultants; (b) supplies and equipment.

Probable duration of assistance. Until 1975.

Work done during the year. Two consultants were assigned from 20 October to 20 November 1971 to assist in the preparation and conduct of a three-week course in radiation health for student radiographers. The course was held at the Radiographers' Training School, General Hospital, Colombo, from 26 October to 11 November. The report of the consultants, containing recomendations,was forwarded to the Government. SEA/RC25/2 Page 98

Cevlon 0072 (4501) Development of Health Education R (Nov. 1966 - Feb. 1967; Feb. - May 1969; Sept. 1969; June 1970; Dec. 1970; Jan. 1971; March 1971; July - Sept. 1971; - )

Aim of the project. To strengthen health education services, including school health education, and to evaluate health education activities; to strengthen health education teaching in medical colleges, teacher training institutions and in other training centres.

Assistance provided by WHO durinn the vear. (a) A consultant; (b) supplies and equipment.

Probable duration of assistance. Until the end of 1975.

Work done during the vesr. A WHO consultant was provided to the project from July to September 1971. He assisted in planning, conducting and evaluating a national workshop on school health education, including family life education, which took place from 26 to 31 August. Thirty-three participants, who were paid stipends by UNICEF, attended the workshop. The recommendations of the workshop mainly concerned (i) strengthening the health education section of the Ministry of Health with a school health education specialist; (ii) entrusting school health education work in the Education Ministry to a qualified and senior officer; and (iii) making health education a compulsory subject in the teacher training college, providing in-service and pre-service training to teacher educators and teachers.

The report of the consultant has been sent to the Government.

A WHO health education specialist is under recruitment.

Cevlon 0075 (1201) Tuberculosis Control R (Jan. 1966 - ) UNICEF

Aim of the project. To control tuberculosis through a comunity-oriented programme.

Assistance provided bv WHO during the year. (a) A medical officer and a statistician-consultant; (b) supplies and equipment.

Probable duration of assistance. Until 1973.

Work done durinn the vear. A tuberculosis baseline survey was carried out with the assistance of the Regional Tuberculosis Training and Evaluation Team, and, during the year, a WHO statistician helped with the analysis of the data. The survey was shown that the problem of tuberculosis in Ceylon is not of such magnitude as in other countries of the Region, but nevertheless is accorded importance in the country's public health programme. The WHO-sponsored international (Prague- Bangalore) training course in tuberculosis was conducted for one week in Ceylon as a part of the national tuberculosis control programme.

The WHO medical officer completed his assignment in August and submitted a report, which has been sent to the Government. SEA/RC25/2 Page 99

Ceylon 0077 (7401) Quality Control of Biological and Pharmaceutical Products (March 1966; Sept. 1966; Dec. 1967; Jan. - April 1971; April 1972; - )

Aim of the project. To strengthen the quality control of pharmaceutical and biological preparations and to train staff.

Assistance provided by WHO during the year. (a) A six-month fellowship for study in the United Kingdom; (b) supplies and equipment.

Probable duration of assistance. A number of years.

Ceylon 0078 (1001) Strengthening of Epidemiological Services R (July - Oct. 1967; Dec. 1970; Sept. 1971; - )

Aim of the proiect. To strengthen the epidemiological services and to train personnel.

Assistance provided by WHO during the year. (a) A twelve-month fellowship for study in the United Kingdom; (b) supplies and equipment.

Probable duration of assistance. Until 1976.

Cevlon 0083 (2901) Port Health Services R (Sept. 1969; Sept. 1970; - )

Aim of the proiect. To strengthen port health services.

Assistance provided by WHO during the year, Supplies and equipment.

Ceylon 0084 (5101) Maternal and Child Health Services R (Dec. 1968 - March 1969; June 1970; Sept. 1971; Dec. 1971; - )

Aim of the project. To improve the administration and reorientation of the preventive and curative maternal and child health services, including family planning, and to conduct a series of courses on maternal and child health For nursing and medical personnel at all levels.

Assistance provided by WHO during the year. Three twelve-month Fellowships for studies in the United Kingdom and the United States of America, and a Wo-month fellowship for studies in Yugoslavia, Finland, Sweden, the Netherlands and the United Kingdom.

Cevlon 0085 (5601) Public Health Nutrition* R (Dec. 1969 - Jan 1970; Dec. 1971 - Jan. 1972; - )

Aim of the project. To carry out a pilot project for the control of nutritional anaemia.

Assistance provided by WHO during the year. (a) A consultant; (b) supplies and equipment.

"Previous title: control of Nutritional Anaemia. s~A/~C25/2 Page 100

Probable duration of assistance. Until the end of 1975.

Work done during the vear. During December 1971-January 1972, a consultant assisted in drawing up plans for initiating a nation-wide prophylactic programme against nutritional anaemia and has recommended investigations based on iron and folic acid therapy as prophylaxis. A summary of his recommendations has been sent to the Government.

(Aug. 1967 - Det

Aim of the proiect. To plan, develop and extend public water supply, surface drainage and sanitary sewerage facilities in the south-west coastal area.

Assistance provided bv WHO durinr the year. (a) A project manager; (b) a twelve- month fellowship for study in the United Kingdom; (c) supplies and equipment, including a vacuum chlorimeter.

Work done. The plan of operation for this UNDP-assisted project was signed in March 1969, with WHO as the executing agency. The UNDP Administrator authorized commencement of operations in May 1969. Soon after, the WHO project manager assumed duties and the sub-contractors started work in July 1969.

In the implementation of the project, the work schedule was adhered to as much as possible. A panel of expert consultants reviewed the progress during 1970 and again in 1971 and made recommendations and suggestions for improvement.

Field work by the consulting engineers came to a close officially in July 1971, although some draft reports were submitted in 1972. The final printing of the reports is in progress.

At the request of the Government, before che project was completed in July 1971, the services of the sub-contractors' consultant who was assisting the project in training, were retained for a further three months in order to assist the Government in setting up a chlorinator repair facility, in training technicians, in initiating courses in pipe-laying and repairs, in helping to organize training courses in water treatment and chlorination, and in the further development of the training centre. He was also expected to make recommendations in regard to additional subjects for training. All this work has been accomplished.

Copies of the Agency Terminal Report were submitted to WHO Headquarters in February 1972 for transmission to UNDP.

Evaluation

In summary, the project was a success. The Government of Ceylon will soon have a comprehensive plan for the development of water supply, sewerage and drainage for the south-west coastal area, a recommended plan for the organization and operation of a water and sewerage board, and a well established organization for the training of personnel.

Ceylon 0087 (5501) R

Aim of the project. To develop further teaching and training programmes for dental personnel and to expand integrated dental health services as part of the general health services. SEA/RC25/2 Page 101

Assistance ~rovidedby WHO during the year. (a) A consultant in dental prosthetics; (b) an eleven-month fellowship for studies in Denmark, Norway and Sweden, and a twelve-month fellowship for study in the United Kingdom; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1975.

Work done during the year. The WHO dental mechanic tutor continued to assist the project. He helped in teaching dental prosthetics, in providing instruction to post-graduate dental surgeons in advanced dental technology, and in the training of dental technicians at the Dental Faculty, University of Ceylon, Peradeniya.

National Health Planning (June - Aug. 1970; Sept. - Dec. 1971; June 1972 - )

Aim af the project. To establish and strengthen a health planning unit in the Ministry of Health and to train staff.

Assistance provided by WHO during the year. (a) A medical officer and a consultant; (b) supplies and equipment.

Probable duration of assistance. Until 1975.

Work done during the year. Assistance was provided to the Government of Ceylon by the assignment of a consultant (public health administrator) to advise on and assist in the further development of the Health Planning Unit in the Ministry of Health, to advise on the introduction of health measures into development projects and to assist the Unit in the comprehensive health manpower study. His report has been sent to the Government.

In June 1972, a long-term medical officer was assigned in order to assist the Government in the development of the Health Planning Unit by advising on its organization, administration, objectives and functions, and to help with the training and preparation of staff for the Unit. He is also helping with the national health manpower study.

Ceylon 0093 (2801) Veterinary Public Health Services R (Zoonoses Control) (March 1972; - )

Aim of the project. To develop zoonoses control services.

Assistance provided by WHO during the year. A three-month fellowship for study in the United States of America.

Probable duration of assistance. Some years.

Ceylon 0099 (4502) Assessment and Strengthening of Health LJNFPA Education in Family Planning (July - Oct. 1971; - )

Aim of the project. 'To evaluate the health education programes and to strengthen health education services, training, communication media and studies.

Assistance provided by WHO during the year. Two consultants. SEAlRC2512 Page 102

Work done during the year. During July-October 1971, two consultants were provided to the project to assist in assessing and strengthening health education services in family health. Their report has been sent to the Government, and the main recomnendations included (i) reorganization of the Health Education Division, re-designating it as "Health Education Bureau" and placing it directly under the Deputy Director, Public Health Services, with an Assistant Director (Health Education) in charge; (ii) designation of a health education specialist at the level of Superintendent of Health Services as "Health Education Officer", with responsibility for the planning, implementation and evaluation of the health education activities undertaken by all health workers in the Division, and (iii) recruitment and training of health education specialists from amongst medical doctors, graduate teachers and social scientists.

A follow-up visit by the Regional Adviser on Health Education was made in February 1972.

Since the beginning of 1972, the activities have been merged with project Ceylon 0104, "Health Education in Family Health".

Cevlon 0101 (4102) Health Manpower Study* UNFPA (Feb. - April 1971; Oct. - Nov. 1971; April 1972 - )

Aim of the project. To undertake a study of the activities of personnel employed by the Ministry of Health in rural areas and delivering health care to the community in the context of family health services; to conduct a health manpower study.

Assistance provided by WHO during the vear. (a) Two nurse consultants (one provided under project SEAR0 0178) and temporary assistance from staff assigned to other projects; (b) supplies and equipment, including two vehicles and an electronic scanner.

Probable duration of assistance. Until the end of 1973.

Work done during the vear. Assistance was given in carrying out the national health manpower study by the temporary assignment of a medical officer, a nurse administrator and a statistician provided to inter-country projects.

Four major operational areas were identified - population characteristics, health manpower, educational process and health care - and eleven sub-studies were being planned covering these areas (See also Section 1.1.3, "Operational Studies and Health Manpower", in Part I).

In April, two nurse consultants were assigned to assist with the collecting and coding of data from the field for the various phases of the study of the activities of public health personnel.

Cevlon 0104 (4503) Health Education in Family Health UNFPA (March 1972 - June 1972; - )

Aim of the proiect. To promote family health through health education.

Assistance provided by WHO during the vear. A consultant.

*Previous title: Studies of the Activities of Public Health Personnel. S€.A/RC25/2 Page 103

Probable duration of assistance. Until the end of 1981.

Work done during the year. A WHO consultant was provided to the project for four months from March 1972. She reviewed the training programe of health workers in health education and assisted in planning and conducting the training of the trainers. Assistance was also provided in the conduct of a seminar for the faculties of the training centres to revise the curriculum in health education.

The Regional Adviser on Health Education visited the project in February 1972 to study the problems and programmes connected with the development of health education in family health.

It is proposed to initiate studies in health behaviour and health education as related to family health in the last quarter of 1972.

Ceylon 0105 (5102) Family Health UNFPA (Nov. - Dec. 1971; Feb. 1972 - )

Aim of the project. To promote family health as an integral part of the general health services.

Assistance provided by WHO during the year. (a) Four consultants and assistance from a Headquarters consultant and from the medical officer and statistician attached to the Regional Team on Family Health (SEAR0 0192); (b) two ten-month fellowships for study in Australia.

Probable duration of assistance. Until the end of 1976.

Work done during the year. Two consultants visited Ceylon in November 1971 to collect data for the formulation of a plan of operation for a family health programme to be carried out with assistance from the United Nations Fund for Population Activities. During the same period a third consultant prepared a list of audio-visual teaching aids required in the medical schools in Colombo and Peradeniya for the teaching of human reproduction, family planning and family health.

The medical officer and the statistician of the Regional Team on Family Health (SEAR0 0192),together with a nurse consultant, helped with the preparation of a request for UNFPA assistance for the project, and the formulation of the plan of operation.

A consultant in paediatrics visited Ceylon in June 1972 to advise on paediatric services, with special reference to domiciliary care, home nursing and the integration of hospital and cornunity health services.

The regular staff of the project (medical officer, statistician and nurse) are being recruited and are expected to be in position in the third quarter of 1972.

Ceylon 0106 (4402) Strengthening of Nursing/Midwiferp UNFPA Education (Feb. 1972; - )

Aim of the project. To strengthen the nursingfmidwifery education offered in the eight basic schools of nursing, the Mulleriyawa affiliation school and the Post- basic School of Nursing, Colombo, with emphasis on public health, midwifery and child care. SEA/RC25/2 Page 104

Assistance provided by WHO during the year. Temporary assistance from one of the Regional Nursing Advisers.

Probable duration of assistance. Until 1974.

Work done during the year. During her visit to Ceylon in February, one of the Regional Nursing Advisers, working with national and WHO staff in the country, completed a revised draft submission for the development of this project. A UNESCO team of architects assisted in drawing up estimates for essential repairs and renovations to the eight basic nursing schools, the Post-basic School of Nursing, Colombo, and the Affiliation Training Centre, Mulleriyawa. Equipment and supply lists for all schools participating in the project were completed. Plans were in an advanced stage for the recruitment of both national and international staff. It is expected that the WHO nurse educator will be in position in the third quarter of 1972.

Ceylon 0200 (6641) Fellowshi~s R

Diploma in public health. A ten-month fellowship for study in the United Kingdom.

Diploma in public health and leprosy control. A twelve-month fellowship for studies in the United Kingdom, India, Thailand, Malaysia and Indonesia.

Public health administration (diploma in tropical public healthl. A twelve-month fellowship for studies in the United Kingdom, Yugoslavia, Burma and India.

Sanitary engineering. A twelve-month fellowship for study in the Netherlands.

Ceylon 0201 (6641) Fellowships UNDP

Medical education. A thirteen-month fellowship for studies in India, Iran, Turkey, Israel, Yugoslavia, the United Kingdom, Canada, the United States of America, Australia, New Zealand, Malaysia and Thailand. SEA/RC25/2 Page 105

3. INDIA

PROJECT LIST

Agencies -Title

India 0053 (1201) Tuberculosis Chemotheravv Centre, Madras UNDP (Dec. 1955 - ) (BMRC) (Im)

Aim of the project. To undertake controlled trials to find simple, effective and inexpensive methods of tuberculosis control through domiciliary and ambulatory chemotherapy, and to carry out related research.

Assistance provided by WHO during the year. (a) Two consultants; (b) supplies and equipment.

Probable duration of assistance. Until 1975.

Work done during the vear. Two WHO consultants visited the project for a week in February in order to review the results of the controlled field trials so far completed as well as to prepare protocols for future studies. Their report has been submitted to the Government.

Keeping in view the very important studies being carried out at the Tuber- culosis Chemotherapy Centre, Madras, arrangements were made for the Director of the Centre to participate in the XXI International Tuberculosis Conference, held in Moscow in July 1971, and to present the studies. On his way back to India, he held discussions on the activities of the Centre with the British Medical Research Council in London and at WHO Headquarters in Geneva.

India 0081 (1301) Leprosy Control (National Programme) R (Jan. 1961 - ) UNICEF

Aim of the project. To develop a programe for leprosy control, to provide technical direction for a control project supported by the Danish "Save the Children" Organization, and to train staff.

Assistance provided bv WHO durinn the vear. (a) A leprologist; (b) a twelve-month fellowship for studies in the United States of America, the Philippines, Malaysia, Thailand and Burma.

Probable duration of assistance. Until 1974.

Work done durinn the vear. The WHO leprologist left the project at the end of 1971 on completion of his assignment. His report has been sent to the Government. The Government has decided to merge the activities carried out in Aska and Pogiri into the respective State programmes of the national leprosy control programe, with continued assistance from UNICEF for the supply of drugs. SEAlRC2512 Page 106

In the second half of 1971, 3 530 schools out of a total of 3 607 in the project area were surveyed, and 274 515 students out of the total enrolled strength of 312 774 were examined. In addition, a large number of patients were given education in the prevention of secondary disabilities.

India 0103 (1202) National Tuberculosis Yroarame UNDP (Oct. 1956 - ) UNICEF

Aim of the project. To develop a national tuberculosis control progranme by providing technical guidance, based on model tuberculosis control programes, epidemiological findings and operational research; to train sufficient public health workers of various categories for the tuberculosis control centres at district and State levels, and to develop methods and procedures for assessment of the programme.

Assistance provided by WHO during the vear. (a) A medical officer and an X-ray technician; (b) a four-and-a-half-month fellowship for studies in Kenya, Czecho- slovakia, Denmark, Noway, the Netherlands, the United Kingdom and the United States of America, a five-and-a-half-month fellowship for studies in the United Kingdom, Denmark and France, a six-month fellowship (extension) for studies in the United States of America, the United Kingdom, the Netherlands and Denmark, two four-and-a-quarter-month fellowships for study in Czechoslovakia and Ceylon, a four-month fellowship for study in Czechoslovakia, a six-month fellowship for studies in France, the Netherlands, Denmark, Norway, Czechoslovakia and Kenya, and a two-month fellowship for studies in Kenya, Denmark, Norway, Czechoslovakia, the United Kingdom and the USSR; (c) supplies and equipment.

Probable duration of assistance. Until 1974.

Work done during the vear. The activities of the national tuberculosis programe developed according to plan, and covered the control, operational research and training aspects. Raining was provided not only to workers of the national control programe but also to the participants in the WHO-sponsored combined (PraguelBangalore) training course on the epidemiology of tuberculosis.

A final report on the evaluation of materials from a five-year follow-up of a population of about 60 000 persons in an area where anti-tuberculosis epidemiological measurements had not been provided, has been prepared.

The WHO laboratory technician and the WHO medical officer left the project in March and April 1972 respectively on completion of their assignments.

India 0108 (4501) Health Education: Assistance to States* UNDP (Oct. 1971 - Jan. 1972; - )

Aim of the project. To establish and develop State health education bureaux; to integrate - co-ordinate health education activities of the general health services with those of the family planning programme at different levels of the health administration.

Assistance provided by WHO during the year. (a) A consultant; (b) two fellowships - one for twelve months and one for three months - for study in the United States of America, and a three-month fellowship for studies in the United States of America and the Philippines.

*Under this project, which started in March 1958, assistance has been given to the States of Maharashtra, Uttar Pradesh, Bihar, Orissa and Gujarat. SEA/RC25/2 Page 107

Probable duration of assistance. Some years.

Work done during the year. A WHO consultant was assigned to the State of Tamil Nadu from October 1971 to January 1972 to assist in reviewing the current status and functions of the State Health Education Bureau and to suggest measures for further development. He has reconnnended (i) the strengthening of district health organizations by providing them with health education units which will operate hand in hand with the environmental sanitation programme in rural areas, and (ii) the formation of a school health education comnittee with representation from both the education and health directorates.

Two WHO health education specialists and five short-term consultants are under recruitment.

India 0110 (4401) Nursing Advisers to States UNDP (Dec. 1967 - Dec. 1968; Dec. 1969; Aug. - Sept. 1970; Jan. 1971; July 1971)

Aim of the project. To organize and expand nursing education and nursing services and to ro-ordinate supervisory services so as to ensure uniformly high standards of nursing and midwifery in the health programmes.

Assistance provided by WtlO durinR the year. Three four-month fellowships for studies in Canada and the United States of America.

India 0111 (6201) Medical Education R (Dec. 1958 - Sept. 1961; Nov. - Dec. 1965; Aug. 1966 - )

Aim of the project. To improve the teaching, service and research in medical colleges.

Assistance provided by WHO durinz the year. (a) Two consultants; (b) six fellowships, four for twelve months and two for six months,for study in the United Kingdom, three fellowships - one for twelve months, one for ten months and one for five months - for study in the United States of America, a six-month fellowship for study in Canada, a twelve-month fellowship for studies in the United Kingdom and the United States of America, a six-month fellowship for studies in the United Kingdom, Norway, Sweden and France, a five-month fellowship for studies in the United Kingdom and the Federal Republic of Germany, and a twelve-month fellowship for studies in Switzerland, France, the Federal Republic of Germany, the Nether- lands, Denmark, Sweden, the United Kingdom, the United States of America and Japan; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1974.

Work done duringthe year. During August-September 1971 a consultant in paediatrics and community health was assigned to Bangalore Medical College as a follov- up of a previous assignment four years ago. His report has been sent to the Government.

A planned visit of two consultants to twelve medical colleges in India where 21 former participants in the medical teacher training course held in New Delhi in 1969 were located could not take place. SEAlRC2512 Page 108

A consultant in psychiatry was assigned to Goa Medical College to assist in the teaching of psychiatry and to advise on its place in the undergraduate curriculum.

India 0114 (5101) Paediatric Education R (Aug. 1958 - ) UNICEF

Aim of the proiect. To expand and improve undergraduate and post-graduate teaching of paediatrics in medical colleges and to develop courses for various categories of personnel in paediatric departments.

Assistance provided bv WHO during the year. (a) A consultant and 14 temporary advisers; (b) supplies and equipment; (c) secretarial assistance.

Probable duration of assistance. Until the end of 1977.

Work done during the year. The comments of the Government of India on the draft plan of operation for the project were received and were being examined.

The Indian Medical Council, under new regulations published in February 1971, recommended that undergraduate training should include a clinical clerkship of not less than three months, and that Part I (Medicine) of the third professional examination should include paediatrics.

The Government of India agreed to select two medical colleges (one in Ahmeda- bad and one in Calicut) for a trial of the undergraduate paediatric curriculum prepared by the Ad hoe Committee sponsored by WHO in 1969-70. Because of difficulties in recruiting suitable consultants, the trial could not be implemented in 1971.

It is now planned to try out the curriculum in the Medical College, Ahmedabad, in 1972 and a consultant is under recruitment. As regards the trial at the Medical College in Calicut, certain inadequacies in the vay of equipment, including teaching aids, need to be overcome with the assistance of UNICEF. It is planned to provide a consultant to this college in 1973.

As part of the development of training and services in paediatrics and obstetrics in India, a consultant, assigned during July-August 1971, reviewed the progress made in establishing a system of post-graduate training in paediatrics. His report has been sent to the Government. He also conducted a meeting on "Post- graduate Education and Training in Paediatrics", which was held at Osmania Medical College, Hyderabad, frw 9 to 11 August. Fourteen medical educators, invited as temporary advisers to the Regional Director, attended the meeting. The Regional Office provided secretarial assistance. The report on the meeting has been sent to the Government.

Technical approval was given for UNICEF assistance to the undergraduate paediatric, post-graduate paediatric and obstetrics departments of some medical colleges.

India 0114.7 (5101) Paediatric Education. Raiasthan R (Feb. 1971 - ) UNICEF

Aim of the project. To expand and improve undergraduate and post-graduate teaching of paediatrics in medical colleges and to develop courses for various categories of personnel in paediatric departments. SEA/RC25/2 Page 109

Assistance provided by WHO during the year. A nurse educator.

Probable duration of assistance. Until the end of 1977.

Work done during the year. It was necessary to suspend assistance to this project for several months. The WHO nurse educator in maternal and child health was temporarily assigned to New Delhi, where she assisted with a short course on paediatric patient care (under project SEARO 0139, "Short Courses for Nurses and other Health Personnel"). A paediatrician and two nurses from S.P. Nedical College Hospital, Bikaner, attended the course.

As of 1 January 1972 the nurse educator was transferred to project India 0269, "Nursing in Clinical Specialties", but continued to carry out the same functions as before.

India 0114.8 (5101) Paediatric Education, New Delhi R (Nov. 1971 - ) UNICEF

Aim of the project. To expand and improve undergraduate and post-graduate teaching of paediatrics in medical colleges and to develop courses for various categories of personnel in paediatric departments.

Assistance provided by WHO during the year. A nurse educator.

Probable duration of assistance. Until the end of 1977

Work done duriny the ycar. From August to December 1971 the LWO nurse educator in maternal and child health under this project in Bikaner was temporarily assigned to New Delhi in connection with a short course on "Paediatric Patient Care" under project SEARO 0139, "Short Courses for Nurses and other Health Personnel". On 22 November the WHO Paediatric Nurse Educator was assigned to the Paediatris Surgical Unit, All India Institute of Medical Sciences, New Delhi and, as of 1 January 1972, was transferred to project India 0269, "Kursing in Clinical Specialties".

India 0121 (4901) Indian Council of Medical Research (Statistics) R (Aug. 1962 - Feb. 1963; Dec. 1963 - June 1965; Aug. 1966 - July 1967; Sept. 1967 - May 1968; Oct. 1968 - Jan. 1969; Aug. - Dec. 1969; Nov. - Dec. 1970; July 1971; Sept. 1971; Nov. - Dec. 1971; - )

Aim of the project. To assist the Indian Council of Medical Research in strengthening its statistical unit, and in training staff for medical research.

Assistance provided by WHO during the year. (a) A consultant and two temporary advisers; (b) a three-month fellowship for studies in the United Kingdom and at WHO Headquarters, and a ten-day fellowship for a study tour of Switzerland, the United Kingdom and France; (c) cost of attendance of participants.

Probable duration of assistance. Until the end of 1975.

Work done during the year. A Seminar on Statistical Methods in Medical Research was held at the Indian Council of Medical Research, New Delhi, from 24 November to 4 December 1971 with the participation of 20 senior medical research workers from SEA/RC25/2 Page 110

various States of India. A WHO consultant and two temporary advisers to the Regional Director assisted in organizing, conducting and evaluating the Seminar. The aim of the Seminar was to familiarize the participants with basic principles of statistical methods applied in epidemiology and population studies, in order to facilitate them to deal efficiently with biostatistical problems. The report on the Seminar has been forwarded to the Government.

Preparations are under way for organizing a three-week training course on statistical methods in medicine and public health, to be held at the Indian Council of Medical Research in November/December 1972 for 20 biostatisticians from India. Action is in hand for the recruitment of a consultant in this connection. It is proposed to engage a few temporary advisers to the Regional Director and one more consultant to give lectures on specific subjects.

India 0136 (4402) Post-basic Nursing Education: Assistance R to States*

India 0136.1 (4402) Post-basic Nursing Education. Uttar Pradesh R (Jan. - Nov. 1962; March 1972 - )

Aim of the project. To expand post-basic nursing education, with initial emphasis on post-basic degree programmes usually offering professional specialization in teaching, administration, public health or one of the clinical specialties.

Assistance provided by WHO during the vear. A nurse educator.

Probable duration of assistance. Until the end of 1974.

Work done during the vear. The project began with the arrival of a WHO nurse educator in March 1972. Assistance has been given to the establishment at Kanpur of a college of nursing with a post-basic programme leading to the B.Sc. degree.

A national nurse completed the master's degree programe at the College of Nursing, New Delhi, and was expected to return to Kanpur soon as the first member of the faculty of the College. Work was started on the development of a syllabus and the curriculum for the programme.

The WHO senior nurse educator at Chandigarh (project India 0136.3) was to be transferred to this project in August.

India 0136.2 (4492) Post-basic Nursing Education, Gujarat R (Jan. 1963 - Dec. 1966; Dec. 1967; Jan. 1968 - )

*The project started in January 1962 and is expected to continue until the end of 1977. During the year four fellowships were awarded for study in the United States of America - one for twelve months for a candidate from West Bengal (extension), one for twenty-four months for a candidate from Andhra Pradesh, one for six months for a candidate from Mysore, and one for twenty-one months for a candidate from Madhya Pradesh. S~A/~c25/2 Page 111

Assistance provided by WHO during the year. (a) Two nurse educators and a consultant; (b) a twelve-month fellowship for study in the United States of America; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1974.

Work done during the year. The College celebrated its third Annual College Day on 8 July 1971 and in conjunction with this published its first alumni magazine. Seven students received the B.Sc. (Nursing) degree. Delhi University gave official recognition to the college programme. An extension of affiliation to Gujarat University was given up to June 1973. Full affiliation is dependent upon several factors, including the provision of a college building and the appointment of a librarian.

Revisions in the two courses, comprehensive nursing and public health nursing, were incorporated into the curriculum. Three units, therapeutic communications and psycho-social aspects of disease, a more concise nutrition and a unified unit in child growth and development, were taught as the basic content for both the public health and comprehensive nursing courses.

The second-year students had a successful experience in team nursing on paediatric wards of the New Civil Hospital, Ahmedabad, and visited intensive care units in some Bombay hospitals.

Four graduates of the College were deputed for further studies by the Govern- ment and admitted to the M.Sc. (Nursing) programme at Delhi University.

A WHO consultant in psychiatric nursing returned for a second assignment and conducted a three-week course on "Orientation to Psychiatric Nursing1' for 24 tutors in government hospitals of Gujarat. She also held sessions with students of the College. Her report has been sent to the Government.

India 0136.3 (4402) Post-basic Nursing Education, Punjab R (March 1964 - June 1972; - )

Assistance provided by WHO during the year. (a) A nurse educator; (b) a six- month fellowship for study in the United States of America (extension).

Probable duration of assistance. Until the end of 1974.

Work done during the year. Thirty-three students were admitted to the College, an increase of four over the previous year. The student evaluation form was revised, using the behavioural objectives as the criteria for evaluation. The syllabus, revised in line with the new curriculum, was implemented.

The introduction of a basic degree programme has been postponed until the number of nursing staff at Nehru Hospital is substantially increased.

Two new nursing faculty members joined the College of Nursing, one of them after completing a Master's degree programme on a WHO fellowship. One nursing lecturer's post is still vacant, and one clinical instructor resigned. The WHO senior nurse educator completed her assignment towards the end of June. No further long-term assistance by WHO nurse educators will be required. SEA/RC25/2 Page 112

A total of 27 nurses completed one of the two short courses on paediatric nursing.

India 0136.5 (4402) Post-basic Nursing Education, Madras R (June 1964 - )

Aim of the Droject. To expand post-basic nursing education, with initial emphasis on post-basic degree programmes usually offering professional specialization in teaching, administration, public health or one of the clinical specialties.

Assistance provided by WHO during the year. (a) Two nurse educators; (b) two fellowships - one for twenty-four months and one for twelve months (extension) - for study in the United States of America; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1973.

Work done during the year. Ten general service candidates and a WHO fellow from Nepal were admitted to the College. The revised curriculum for the B.Sc. progrannne was passed by the Medical Board of Studies and the Syndicate of the Uni- versity and is to be implemented with the next group of students. It involves many changes, including elimination of the specialty areas.

The Principal resigned to accept employment abroad. Two national faculty members were on WHO fellowships; one of them completed an MPH programe and the second the first year of a two-year Master's degree study. A complete turnover of the nurses temporarily deputed to teach at the College has made it difficult to develop the progranme.

The WHO senior nurse educator left at the end of the period under review upon completion of her two-year assignment. The nurse educator in medical- surgical nursing left in December, but returned to the project in May.

India 0136.7 (4402) Post-basic Nursing Education, New Delhi R (Nov. 1969 - )

Assistance provided by WHO during the vear. (a) Two consultants in nursing education; (b) two fellowships - one for six months and one for eleven weeks - for study in the United Kingdom and a twelve-month fellowship for study in the United States of America; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1974.

Work done during the year. 'ho WHO nurse educator consultants returned and completed their assipments at the College of Nursing, New Delhi, during the period under review. This continuity of personnel was helpful in reinforcing and expanding the progress made in 1969 and 1970. Assistance was given in several areas, including (i) the development of courses, particularly the public health nursing component of the three programmes, (ii) student research activities in the post- graduate programme, and (iii) revision and allocation of space within the new college buildings under construction. The administrative block, classrooms, laboratories and hostel for 270 students on the new campus are scheduled for completion by September 1972. SEA/RC25/2 Page 113

Selected topical areas in public health nursing administration, education and research were taught to the Master's degree candidates. Various aspects of the curriculum were revised and organizational changes of the urban and rural field teaching centres were instituted. In strengthening the public health content, greater and better use was made of various educational resources Out- side the College.

Assistance was given to a workshop on "!Gays of Bringing Schools of Nursing Within the System of Higher Education", which was conducted at the College by the Ministry of Health for principals of colleges of nursing and State nursing superintendents, with financial support from the Ninistry of Health and LNICEF.

One WHO nurse participated in planning for a regional workshop in health education at the Central Health Education Bureau and assisted the nurse faculty of the National Institute of Health Administration and Education in planning sessions on nursing for a seminar on hospital administration.

Three WHO fellowships were awarded to the faculty - one for 24 months of post-Master's study, one for 18 months in a Master's degree programme in medical- surgical nursing, and the third for a six-month study tour in nursing administration in colleges of nursing.

India 0136.8 (4402) Post-basic Nursing Education, Bombay R (Nov. 1970 - )

Assistance provided by WHO during the year. (a) A nurse educator; (b) a twelve- month fellowship for study in the United Kingdom.

Probable duratian of assistance. Until the end of 1974.

Work done during the year. The Basic B.Sc. (Nursing) Programme at the College ended in May 1972, when the last class of five students completed their studies. This will enable the faculty to concentrate their efforts on further development of the Post-Basic B.Sc. (Nursing) Programme in the year ahead. The total enrolment will be 62 students in the two-year programme for the 1972-1973 acadc- mic year.

The College has continued its teaching programmes in temporary quarters. A Board of Nursing Studies in the Faculty of Medicine, Bombay University, was initiated in January 1972. The nursing faculty have taken interim steps for converting the organization of the curriculum to the semester system in June 1974.

India 0153 (2001) Malaria Eradication R (Aug. 1958 - ) US AID

Aim of the ~roiect. To eradicate malaria.

Assistance provided by IJHO durin): the year. (a) Two epideniologists; (b) two three-and-a-half-month frllr~stipsfor studies in the Philippines and Thailand and a three-week fellowship f;r study in Japan; (c) supplies and equipment, including an insecticide ap~li-ator; (d) subsidy. SEAIRC2512 Page 114

Probable duration of assistance. Some years.

Work done during the vear. The Government of India continued to give high priority to the programme. In 1971172, a population of 130 million (24%) was in the attack phase, 93 million (17%) in consolidation and 322 million (59%) in maintenance. There were setbacks, particularly in areas in the maintenance phase under the responsibility of the general health services. Problems in attack phase areas were confined to the States of Gujarat, Madhya Pradesh, Maharashtra and Rajasthan, where 82.3% of the total cases were found. Other States mainly affected in the maintenance phase were Punjab, Haryana and Mysore.

The total number of positive cases recorded for 1971 was 1 092 224, compared with 694 647 in 1970 and 348 647 in 1969.

The Government has accepted most of the recommendations of the strategy review team. Difficulties involving procurement of DDT in time have been solved for 1972 and 1973. Spraying will now be timed prior to the actual transmission season. The epidemiological section at the central level has been strengthened and an urban malaria unit has been established. Plans for a trial using ultra low-volume application of malathion for the control of urban malaria in Jodhpur have been finalized. One of the WHO epidemiologists left in December.

India 0174 (1801) Production of Freeze-dried Small~oxVaccine R (Sept. - Oct. 1564; June 1955 - March 1966; LRJICEF Feb. 1967 - Jan. 1970; - )

Aim of the project. To become self-sufficient in the production of freeze-dried smallpox vaccine of standard quality.

Assistance provided bv WHO during the vear. Supplies and equipment.

Probable duration of assistance. A number OF years.

Work done durina the year. The ninth addendum ts the plan of operation of this project is being submitted to the Government for signature. The addendum provides for technical and organizational considerations regulacing the responsibilities of the State Governments concerned vis-a-vis the assistance provided bv the Government of India, UNICEF and WHO for increasing the production of freeze- dried smallpox vaccine to the target of 10.4 million ampoules (of .25 ml each) by 1974. The equipment provided by UNICEF has been installed at Patwadangar, Hydera- bad and Madras, and changes in the building, including the installation of a chilling plant and the construction of a poultry farm, are being made at Belgaum. A physical survey of damaged equipment was conducted and the parts that need replacement are being procured by UNICEF. The local engineers from the four production centres have been trained on the engineering and servicing aspects of the equipment provided by UNICEF.

Special arrangements are being made by the Government of India to provide a regular supply of gas for the operation of the ampoule-sc~ling macllines at Patwadangar and Belgaum. Sealing and printing machines are being procured by UNICEF for all the four vaccine-producing centres. Both the vaccine and diluent ampoules used for the programe are manufactured in India frcm indigenous material in accordance with specifications approved by the Indian Standards Institution.

The vaccine, which is tested regularly at the National Smallpox Laboratory at the National Institute of Communicable Diseases, Delhi, is also sent to the SEA/RC25/2 Page 115

WHO International Laboratory for reference checking, and meets the WHO requirements regarding potency, stability and bacterial count. The results of the national test have been fairly consistent with those of the WHO reference laboratory.

India 0176 (3001) Central Public Health Engineering Research R Institute, Nagpur (Feb. 1961 - ) Aim of the protect. To develop the Institute as a major research and training centre for environmental sanitation problems; to co-ordinate research programmes.

Assistance provided by WHO during the vear. (a) Two consultants; (b) two twelve- month fellowships - one for study in Sweden and one for study in the United States of Anerica, a three-month fellowship for studies in the United Kingdom, the Nether- lands and the Federal Republic of Germany, and a six-week fellowship for studies in the United Kingdom, the Netherlands and Switzerland.

Probable duration of assistance. Until 1977.

Work done durinx the year. At the request of the Institute, technical assistance and guidance were provided in the organization of a training course on preventive maintenance of water distribution systems in Bombay. The services of two experts, a sanitary engineer and a biologist, were obtained through the Water Research Association (WRA), England, with whom WHO signed a contract for this purpose. In addition, training equipment was also supplied through WRA.

The course, which took place from 31 January to 18 February 1972, was attended by eighteen participants. Three volumes of a technical manual were prepared and distributed to the participants. Excellent co-operation was extended by the counterpart personnel of the CPHERI Zonal Centre in Bombay as well as the Bombay Municipal Corporation in the conduct of the course.

It is felt that CPHERI is in a position to conduct similar courses in the future for participants in this region without external technical guidance.

India 0181 (5601) Applied Nutrition Programmr. R (Oct. 196h - ) UNICEF

Aim of the proiect. To expand and improve the health component of the Applied Nutrition Programme assisted by FAO, UNICEF and WHO.

Assistance provided by WHO durinn the year. A public health officer.

Probable duration of assistance. Until the end of 1974.

Work done during the year. A WHO public health officer has been assigned to the programme since November 1971.

The reports on the evaluation of the Applied Nutrition Programme, carried out by the Indian Institute of Management, Ahmedabad, and of the Evaluation Committee on the Applied Nutrition Progranme in Maharashtra were under consideration by the Central and State Governments. StA/KC25/2 Page 116

A Working Group consisting, among others, of the representatives of the Ministries of Agriculture and Health and of the Planning Commission of the Government of India, FAO, WHO and UNICEF,held a number of meetings to examine the recommendations and suggestions made in the evaluation report for the improvement of the prograonoe. The Group will continue to meet in order to prepare specific proposals in this regard.

India 0182 (1001) Strenntheninn of Health Services UNDP (E~idemiolo~v) (March 1963 - )

Aim of the project. To establish or improve health intelligence units in State health directorates; to train staff in epidemiology, health statistics, microbiology and communicable-disease control, and to develop the National Institute of Communicable Diseases (NICD) , Delhi.

A5Sistance provided by WHO during the year. (a) A virologist; (b) three six- month fellowships for study in Czechoslovakia and India, and a nine-month fellowship for study in the United States of America; (c) supplies and equipment.

Probable duration of assistance. Until 1974.

work done during the vear. The WHO virologist continued to assist the project and contributed to the further improvement of the enterovirological laboratory. The laboratory has developed a method for monitoring the circulation of polio viruses in the environment. Two papers on poliomyelitis were prepared for publication.

A number of cases of poliomyelitis were reported by several hospitals in Delhi during April-June 1971 and, as a result, the WHO virologist was busy during most of the period under review studying seroconversion following immunization. The main objective of the study was to determine the pre-immunization status of the selected age-group with regard to antibody level against different polio- viruses and excretion of these viruses before and after immunization.

Steps were taken to recruit a WHO consultant in immunochemistry.

India 0185.213 (4001) strengthen in^ of Health Services, R Puniab and Haryana UNICEF (Jan. 1967 - )

Aim of the proiect. To strengthen national health services at State, district and local levels, with emphasis on training programmes for health staff, particularly medical officers and assistant nurse/midwives, supervision of auxiliaries by professional staff, and operational studies.

Assistance provided by WHO during the vear. (a) A public health officer and a public health nurse; (b) three three-month fellowships - two for study in the United Kingdom and one for studies in the USSR, Sweden, the United Kingdom and Czechoslovakia; (c) supplies and equipment.

Probable duration of assistance. Until 1973.

Work done during the year. The project staff advised the Directorates of Health in Haryana and Punjab States on the development of basic health services and assisted in the organization of a number of in-service training courses for SEA/RC25/2 Page 117

auxiliary nurse-midwives, lady health visitors and nurses. The WHO Headquarters- assisted hospital utilization study, carried out in the two States for establishing a method for analysing the factors underlying hospital utilization and for planning hospital services on a scientific basis, was completed towards the end of 1971. The study has provided some useful data in this regard.

India 0187 (4301) Traininp. of Radioaraohers R (March 1967 - )

Aim of the project. To establish a degree-level training programme for radiographers at the Institute of Post-graduate Medical Education and Research, Chandigarh.

Assistance provided by WHO during the vear. (a) A radiography tutor; (b) a twelve-month fellowship for study in the United Kingdom.

Probable duration of assistance. Until the end of 1974.

Work done during the vear. The training and teaching programme for the B.Sc. in Medical Technology (Radiography) continued satisfactorily.

Applications for the first M.Sc. course were received and processed. Two candidates were selected and commenced their studies.

The national counterpart of the WHO technical officer (radiology), who had gone to London on a twelve-month WHO fellowship, returned at the end of December 1971 and resumed his duties. Another national staff member left for the United Kingdom in the first quarter of 1972 on six-month fellowship.

A new full-time hospital physicist joined the Department of Radiotherapy and took over the teaching of radiation physics. The assistant physicist also received a regular appointment.

A model X-ray unit provided by WHO for demonstration purposes in connection with the function of the apparatus and the physical principles involved in the production of X-rays was received, as were an overhead projector and several textbooks.

India 0188 (4201) Stren~theningof Laboratory Services R (Feb. 1965 - )

Aim of the project. To strengthen health laboratory services in India.

Assistance provided by WHO during the vear. (a) A laboratory technician; (b) a twenty-five-month fellowship (extension)for studies in the United Kingdom and the Regional- Office, a twelve-month fellows hi^ for studies in the United Kinedom- and the Regional Office, a twelve-month fellowship (extension) for study in Ceylon and three twelve-month fellowships (one of which was an extension) for study in the United Kingdom; (c) supplies and equipment.

Probable duration of assistance. Some years.

Work done during the vear. The project has continued to make good progress in its advanced stage of development. During the academic year 1971-72, 38 students (1st and 2nd year) attended the B.Sc. course, including one candidate from Nepal. SEA/RC25/2 Page 118

Twelve students attended the M.Sc. course. Since the start of the project in 1965, 28 students have graduated and another 21 arc to take their final examination in August 1972. Ibe first group of post-graduate students will receive their Master's degree in 1973. The fourth six-week training course was conducted in November 1971 for seven malaria microscopists from Punjab. The course, which aims at diversifying their skill in laboratory technology, has thus trained 30 microscopists so far. Apart from surveillance in malaria, the competence of microscopists so trained will he utilized to man rural laboratories.

The M.Sc. students also made satisfactory progress in their respective disciplines. In order that students qualify for their final M.Sc. degree, it is proposed that they present a dissertation on a laboratory discipline in consultation with the head of the department, with emphasis on the research side.

Altogether, the four tutor technicians from Chandigarh have been awarded one-year WHO fellowships in advanced technology in the subjects of their speciality, i.e., histopathology, haematology, chemistry and bacteriology. They will be learning teaching methodology, principles of pedagogy, teaching psycho- logy and the use of teaching aids for training technicians.

UNICEF has agreed to provide, during the remaining period of the Fourth Five-Year Plan, equipment to several eligible regional laboratories provided they met the minimum requirements agreed upon. In 1972, technical concurrence was given to the Government's request for such assistance to the Regional Public Health Laboratory, Poona, and the State health laboratories at Chandigarh and Ernakulam.

The streptococcus disease laboratory at the Lady Hardinge Medical College, New Delhi, is coming up as a national reference laboratory with the assistance of the Government Of India and the Indian Cpuncil of Medical Research. A draft plan of operation involving UNICEF assistance has been drawn up.

Startlng from 1973, the project will be involved in field operations. As an imnediate objective, it is proposed to reorganize the health laboratory services in the State of Maharashtra. This will involve the realignment of microbiology in the field of health, to support the surveillance of epidemic communicable diseases; the linking of laboratories at different echelons through the establishment of a referral service,and the comprehensive training of the laboratory manpower. A team of one microbiologist and one technician is being recruited, and a physical and functional survey of health laboratory services is being undertaken in Maharashtra. A consultant will help finalize the addendum to the plan of operation with the Government of Maharashtra.

India 0190 (4502) Training in Health Education R (Sept. 1968; June 1969; April 1970; July 1970; NOV. 1970; ~~ril- May 1971; Aug. 1971; Nov. - Dec. 1971; - )

Aim of the proiect. To establish and develop three post-graduate health education training centres with rural and urban field practice areas.

Assistance provided by WHO during the vear. (a) A consultant; (b) three fellowships - one for four months (extension), one for four-and-a-half months (extension) and one for twelve months - for study in the United States of America; (c) supplies SEA/RC25/2 Page 119

Probable duration of assistance. Until 1977.

Work done during the year. A WHO consultant was assigned to the Central Health Education Bureau, New Delhi, for six weeks during November-December to assist the Bureau in establishing its post-graduate health education training course, to help with the teaching and to demonstrate the application of the latest educational methodology.

In her report, which has been sent to the Government, she has recommended (i) grouping the sessions of each paper into educational units in order to go deep into the subject matter; (ii) devoting at least two weeks towards the end of the academic course for reviewing certain aspects of the programme; (iii) providing individual counselling to the subjects; (iv) relating theory to the research papers produced by the Central Health Education Bureau; (v) designing a unit to introduce public health and health education, and (vi) providing continuing education to the faculty.

A further consultant is under recruitment.

India 0192 (4701) Radiation Medicine Centre, Bombay R (Jan. - Feb. 1963; March 1967 - )

Aim of the project. To strengthen the Radiation Medicine Centre, Bombay.

Assistance provided bv WHO during the year. (a) A consultant; (b) two twelve- month fellowships for study in the United States oi Amcrica (one of them an extension) and a two-week fellowship for studv in the United Kingdom: (c) sun~lies and equipment.

Probable duration of assistance. Until 1977

Work done during the year. During October-December, a Idti0 ccnsultant assisted the Radiation Medicine Centre, Bombay, with radiorespirumetry studies for the evaluation of various metabolic processes. His assignment report has been forwarded to the Government.

India 0194 (4801) Medical Rehabilitation R (Nov. 1963 - Feb. 1964; April - June 1967; UNICEF Feb. - June 2969; Oct. 1969; June 1970 - )

Aim of the project. To expand medical rehabilitation services and to establish training schools in the various disciplines.

Assistance provided by WHO during the year. (a) A prosthetics tutor; (b) a twelve- month fellowship for studies in the United Kingdom and the Unites States of America; (c) supplies and equipment.

Probable duration of assistance. Some years.

Work done durina the year. The WHO prosthetic tutor continued to assist the Rehabilitation Departments of the All India Institute of Medical Sciences and Safdarjang Hospital, New Delhi.

The production programme at the Institute continued satisfactorily. The development of mass-produced components continued, with new designs under test and four others under preparation. SEA/RC25/2 Page 120

The semice programme at Safdarjang Hospital was started.

The WHO prosthetic tutor visited the Department of Orthopaedic Surgery, MGM Medical College, Lucknow, to advise on the establishment of a rehabilitation and artificial limb centre. He was away in November 1971 on an assignment to another country in the Region.

India 0195 (4703) Course in Radiological Physics, Bombax R (April 1962 - Sept. 1967; July 1971)

Aim of the proiect. To strengthen the training of radiological physicists.

Assistance provided by WHO during the year. A four-week fellowship (extension) for study in the United States of America.

India 0199 (4302) School for Training of Technicians UNDP (Dec. 1967 - )

Aim of the project. To train technicians in the installation, maintenance and repair of electrical and mechanical equipment available in health institutions.

Assistance provided by WHO during the year. (a) An electro-medical engineer; (b) a six-month fellowship for studies in the Netherlands and the Federal Republic of Gerrrany; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1977.

Work done during the year. The seventh course, which had commenced on 15 January 1971 with twelve students, concluded on 15 July.

The WHO technical officer left the project in September on re-assignment. His report has been sent to the Government. A replacement was under recruitment and was expected to he in position by the end of June 1972.

India 0200 (6641) Fellowships R

Cardiology. A six-month fellowship for study in the United Kingdom.

Communitv water supply. A six-month fellowship for study in the United States of America.

Psychiatry and mental health. A twelve-month fellowship for study in the United States of America.

Psychiatric nursin~. A four-month fellowship for study in the United Kingdom.

Tuberculosis and allied subjects. A three-month fellowship for studies in Hong Kong, Singapore, Czechoslovakia and the United Kingdom.

India 0208 (5501) Improvement of Dental Education UNDP (July - Dec. 1966; Sept. 1967 - )

Aim of the proiect. To improve and strengthen dental education. SEA/RC25/2 Page 121

Assistance provided by WHO durinp. the year. (a) A consultant; (b) two fellowships - one for ten months and one for twelve months - for study in the United States of America, and a twleve-month fellowship for study in the United Kingdom.

Probable duration of assistance. Until the end of 1977.

Work done during the year. A consultant (specialist in preventive and social dentistry) was assigned to the Government Dental College, Bangalore, during January-February. In his report, he has recommended involvement of the undergraduates during their training in preventive dental care at comnunity level for the rural and urban populations, improvement of facilities for clinical training in dental faculties, research training for post-graduate dental students, organization of short courses for continuing education of the dental profession, establishment of a maintenance and repair workshop, research studies in epidemiological aspects of dental health problems, training of faculty members, promotion of the teaching of oral biology,and use of auxiliaries through the provision of consultancy services. A sumary of his recommendations has been sent to the Government.

India 0212 (4403) Nursing Administration*

India 0212.1 (4403) Nursing Administration, Chandizarh (Jan. 1968 - )

Aim of the proiect. To develop nursing administration in teaching hospitals and to promote in-service training and co-ordination of nursing services.

Assistance provided by WHO during the year. A nurse administrator.

Probable duration of assistance. Until the end of 1973.

Work done during the vear. As a part of the planning for the eventual disconti- nuation of the hospital school of nursing and establishment of a basic collegiate programme, the number of hospital nurses has been increased on a phased basis. A plan for reorganization of the senior nursing staff was prepared and accepted in principle.

An orientation programme was held for six newly appointed ward sisters. Two ward sisters' courses were conducted for a total of eleven senior ward sisters.

The midwifery course and parts of the general nursing course were revised to help ensure better supervision of students in the clinical areas.

A new gynaecology and obstetric demonstration ward, with elements of progressive patient care, was established. The all-India post-partum family planning programme was implemented and most of the additional staff authorized under the project, including nursing staff, were appointed.

*The project started in January 1968 and is expected to continue until the end of 1973. During the year thrce fellowships were awarded - a twelve-month fellowship for study in New Zealand, a six-month fellowship for studies in the United Kingdom, Canada end the United States of America, and a twelvr-month fellowship for studies in Yugoslavia, the United Kingdom, Canada and the United States of America. SEA/RC25/2 Page 122

India 0212.2 (4403) Nursing Administration, Guiarat R (July 1968 - )

Aim of the prolect. To develop nursing administration in teaching hospitals and to promote in-service training and co-ordination of nursing services.

Assistance provided bv WHO during the vear. (a) A nurse administrator; (b) supplies and equipment.

Probable duration of assistance. Until the end of 1973.

Work done during the vear. At New Civil Hospital, Ahmedabad, considerable progress was made. Additional administrative nursing staff and an increase in staff nurses facilitated the improvement of hospital nursing service. On-going in-service educational programmes were established and several nurses were deputed for short courses in clinical specialties. The Hospital Committee of Management and the Nursing Service Committee worked effectively.

The hospital environment continued to improve. Efforts were directed towards providing better nursing facilities by experimenting with new ward lay-outs and equipment. A new injection centre in the out-patient department enhanced the service to patients and permitted safe practice.

In co-operation with the tutors of the school of nursing steps were taken to develop an educationally sound programme for student nurses. The new laundry and twenty-four family quarters for graduate nurses were completed.

The WHO nurse administrator paid a visit to S.S.G. Hospital, Baroda. Efforts have been made to obtain sanction for an appropriate number of nursing staff for the Intensive Care Unit, the Central Supply Department and a proposed special nursing home. There have been many problems created by the expansion of services without sufficient increase in nurses to staff these services.

The nursing tutors were assisted in preparing a school calendar and in revising the student programme for the preliminary training period.

India 0214 (1901) Virological Techniques R (Sept. 1968; Nov. 1969; Aug. 1971; - )

Aim of the proiect. To develop the laboratory capacity for the diagnosis and surveillance of virus diseases, and to establish competence in the production and testing of live poliomyelitis vaccine.

Assistance provided by WHO during the year. (a) A twelve-month fellowship for. study in the USSR; (b) supplies and equipment.

Probable duration of assistance. Until the end of 1977.

India 0218 (4101) National. Institute of Health Administration R and Education (NIHAE) UNICEF (Sept. 1965 - May 1967; March 1968; Dec. 1968 - Jan. 1971; Nov. 1971; - )

Aim of the proiect. To conduct studies in district health administration at Rohtak (Haryana) .IS a prelude to the promotion and planning of comprehensive health care services at the district Level; to formulate research and teaching SEA/~c25/2 Page 123

programmes pertaining to health administration, and to undertake teaching programmes, studies and research in the field of hospital administration.

Assistance provided by WHO during the year. A four-month fellowship for studies in Sweden, the United Kingdom, the United States of America, Hong Kong and Singapore.

Probable duration of assistance. Until 1974.

India 0221 (6202) Seminars and Workshops on ?:edical Education R (Dec. 1965 - May 1966; Jan. 1967 - )

Aim of the project. To strengthen further medical teaching.

Assistance provided by WHO during the year. (a) Four temporary advisers and assistance from the Regional Adviser on Medical Education; (b) cost of attendance of participants; (c) secretarial assistance.

Probable duration of assistance. A number of years.

Work done during the year. A Symposium on "Tuberculosis of the Nervous System" was held at the Grant Medical College, Bombay, from 2 to 5 February 1972 in collaboration with the Indian Academy of Hedical Sciences. Twenty-eight participants attended. The faculty consisted of four temporary advisers to the Regional Director, together with the Regional Adviser on Medical Education. The Regional Office provided secretarial assistance. Assistance was given for the publication of the papers delivered at the Symposium in a special number of the "Annals of the Indian Academy of Medical Sciences".

India 0222 (7401) Drug Laboratory Techniques and Biological R Standardization (June 1967: Oct. - Dec. 1967:, Aur.- 1968: July - Aug. 1969; Nov. 1969 - Jan. 1970; Sept. 1970 - Feb. 1971; Dec. 1971; - )

Aim of the project. To develop services concerned with quality control of pharmaceutical and biological preparations, and to train staff.

Assistance provided by WHO during the vear. (a) A twelve-month fellowship for studies in Sweden and the United Kingdom; (b) supplies and equipment.

Probable duration of assistance. Until 1975.

India 0225 Freeze-dried BCG Vaccine Production R (May - June 1968; June - Sept. 1970; - ) UNICEF

Aim of the proiect. To produce freeze-dried BCG vaccine of standard quality.

Assistance provided by WHO during the year. Supplies and equipment.

Probable duration of assistance. Until 1975.

Work done during the year. The Institute has implemented the recommendations made by the WHO consultants provided during 1969 and 1970: asepsis measures have been reinforced in the vaccine production area, an increasing number of batches of the SEA/RC25/2 Page 124

vaccine are being tested for quality control, the construction of an animal house is under way, and greater use is being made of the freeze-drying equipment. As a result of these measures, the target of 15 million doses of freeze-dried BCG vaccine is expected to be reached during the year 1971-72. As the operation picks up momentum, it is also expected that the entire production of 27 million doses will be freeze-dried in 1973. There are plans for the replacement of the existing equipment by a modern plant of larger capacity, and if these materialize, will result in a substantial reduction in the cost of quality control.

As a result of the sustained efforts made over the past few years, suitable glass ampoules manufactured in accordance with the specifications provided by WHO consultants are being turned out in India from indigenous material. UNICEF has agreed to provide an automatic sealing machine, and the Institute is making arrangements to meet the pre-requisites linked with its procurement.

India 0226 (3101) Prevention and Control of Water Pollution R (Oct. - Nov. 1969; April 1971; Oct. - Dec. 1971; - )

Aim of the proiect. To provide technical advice on organizational and other matters related to the abatement and control of water pollution.

Assistance provided by WHO during the year. A sanitary engineering consultant.

Probable duration of assistance. A number of years.

Work done during the vear. Consultant services were provided to the Government in the last quarter of 1971 to study water pollution problems in India and to review and advise on organizational, legislative and other matters related to the abatement and control of such pollution. The consultant visited some parts of the country where the problem was acute, and submitted his findings and recommendations for promoting improved programes of pollution control.

India 0227 (3201) Rural Water Supplies (Nov. 1971 - Jan. 1972; - )

Aim of the protect. To study and analyse data on rural water supply projects being developed with assistance from WHO and UNICEF in order to find the most suitable methods of extending the coverage throughout the country.

Assistance ~rovidedby WHO durin~the year. Two sanitary engineering consultants.

Work done during the year. Arrangements were made for a three-day discussion, scheduled to take place in Delhi during December 1971, with the chief public health engineers and other officials directly involved in the planning and execution of rural wafer supply schemes in the States of India. In conjunction with this meeting, a demonstration of drilling equipment was arranged by UNICEF at Hyderabad for the participants.

Two consultqnts were recruited to assist in the preparation and conduct of the meeting. One of the consultants was also to assist in the collection of data and in evaluating the progress of the rural water supply programme in the various States in order So make recornendations for improvement. The report of this consultant was sent to the Government.

The demonstration at Hyderabad, which preceded the expected meeting, was conducted successfully but, at the request of the Government, the three-day discussion was called off owing to the national emergency just before the scheduled date. SEA/RC25/2 Page 125

India 0228 (6203) Registry of Pathology R (Nov. 1966 - March 1967; April 1969; Dec. 1970; - )

Aim of the proiect. To assist the Indian Registry of Pathology in organizing a peripheral centre at Grant Medical College, Bombay.

Assistance provided by WHO during the year. Supplies and equipment.

India 0233 (1802) Small~oxEradication (Oct. 1967 - )

Aim of the project. To develop the smallpox eradication programme.

Assistance provided by WHO during the year. (a) Four medical officers, three consultants and temporary assistance from three Headquarters staff members; (b) supplies and equipment, including 31 transport vehicles.

Probable duration of assistance. Uncil 1975.

Work done during the year. Thc number ot cases recorded in India during 1971 was 15 700, as against 12 426 reported during the previous year. This increase can be attributed mostly to improved reporting. In the five southern States (population 190 million), with the exception of Mysore, only small localized outbreaks were reported, the majority being the result of introduction from endemic areas in the north. In Mysore, an important outbreak involving 1 300 cases occurred and spread to the adjoining districts of Andhra Pradesh.

Considerable progress has been made in the previously heavily infected States of Rajasthan and Gujarat in Western India. Efforts are now concentrated on the problem areas, i.e., in the north-western States of Uttar Pradesh and Haryana and the eastern State of West Bengal and the bordering districts of Bihar.

The reporting element in the programme has improved, although notification of cases is still delayed and incomplete. A uniform reporting system, by which cases are now being recorded by the week of detection rather than by the date of onset of the disease, was adopted throughout the country and has shown promising results. Reporting charts and forms were drawn up and distributed by WHO to all the States and Union Territories.

Surveillance activities and containment measures have been inproved in most of the States. However, much still remains to be done to strengthen the programme at the national and State levels. Emphasis was laid on the training of national staff, and a WHO training course was conducted in Delhi for the staff of selected States in the northern region.

WHO consultants assessed and assisted the prograwe in the States of Kerala, Maharashtra, Madhya Pradesh, Gujarat, Uttar Pradesh and Haryana. The Chief of the Smallpox Eradication Unit from WHO Headquarters also assessed the prograwes in Rajasthan, Madhya Pradesh and West Bengal. Two new WHO medical officers were assigned to the project during the second half of 1971.

India 0234 (6204) Training of Medical Educators* UNDP (May 1968; July 1968; Sept. 1968; Nov. 1971; Dec. 1971; - )

Aim of the project. To provide further training to national medical educators.

*Previous title: Medical Education (All India Institute of Medical Sciences, Xew Delhi) SEA/RC25/2 Page 126

Assistance provided by WHO durinK the vear. A six-month fellowship for studies in the United States of America, Canada and the United Kingdom, a twelve-month fellowship for studies in Norway, Sweden, the United Kingdom and the United States of America, a three-month fellowship for studies in the USSR, Turkey and the United Kingdom, and a three-month fellowship for studies in the USSR, the Federal Republic of Germany, France and the United Kingdom.

Probable duration of assistance. Some years.

India 0236 (1101) Penicillin Production R (June 1970; - )

Aim of the prolect. To produce penicillin.

Assistance provided by WHO during the year. Supplies and equipment.

India 0238 (8101) Cancer Control Pilot Proiect, Tamil Nadu (July 1968 - )

Aim of the prolect. To start and develop a pilot project for the early diagnosis and control of oropharyngeal and cervical cancer and to establish a training centre in Kancheepuram (Tamil Nadu).

Assistance provided bv WHO during the year. (a) A medical officer (epidemiologist), a consultant and temporary assistance from a Headquarters staff member; (b) two six-month fellowships for study in Australia; (c) supplies and equipment, including a cryostat.

Probable duration of assistance. A number of years.

Work done durina the vear. During the year, attention was directed towards health education, a social survey, training of national staff, detection of cancer of the cervix in the population, treatment of cases detected, and the organization of the recording and filing system. A consultant in statistics visited the project during August-September 1971 to review the progress made and to advise on setting up the recording and filing system for statistical analysis of the epidemiological data. The computerized pre-study results brought by the national statistician from Man- chester were reviewed by the WHO consultant, who took 306 statistical tables to Paris for analysis at her Institute. The form for the cervical cancer study has been revised to enable better coding for analysis.

The Regional Director visited the project at the Arignar Anna Memorial Hospi- tal, Kancheepuram, and held discussions with the Chief Minister, the Health Minister and Government officials of Tamil Nadu regarding the provision of treatment facilities for cancer patients detected in Kancheepuram and the State's plan for a comprehensive cancer control prograwe within the framework of the existing public health services.

A total of 6 971 households were visited by the field staff and 7 829 eligible couples were exposed to cancer health education. A schedule for the first visit of all households in Kancheepuram town was drawn up and the enumeration register was updated.

Health education meetings were conducted and an exhibition in cancer education was also arranged. SEA/RC25/2 Page 127

A manual on the new recording and filing system was prepared, and the new system has been in operation since 1 January 1972. A follow-up system was also planned to be introduced from early 1973.

The pathologists and two cytotechnicians returned to Kancheepuram after completing their training in Australia.

The Institute's building has been provided with water and power supply, and the construction will be completed in all respects in the near future. The Chief of the Cancer Unit, WHO Headquarters, visited Kancheepuram towards the end of March 1972 and held discussions vith the Health Minister and other officials of Tamil Nadu.

The second meeting of the Advisory and Guidance Comittee for the project was held on 21 February under the Chairmanship of the Minister of Health; representatives of all national and international agencies participating in the project were present. The Committee felt that treatment facilities should be established in Kancheepuram. It was also decided to provide advisory services to the project; the Directors of the Barnard Institute of Radiology, the upgraded Institute of Obstetrics and Gynaecology, the Dental Faculty and the Professor of Medicine from Madras Medical College would be consulted and involved in the development of treatment facilities in Kancheepuram.

India 0244 (2801) Traininn in Veterinarv Public Health R (Aug. 1969; March 1970; May - July 1971; - )

Aim of the project. To develop further a post-graduate (Master's degree) course in veterinary public health at the All-India Institute of Hygiene and Public Health, Calcutta, and the Indian Veterinary Research Institute, Izatnagar.

Assistance provided by WHO during the year. (a) A twelve-month fellowship for study in the United States of America; (b) supplies and equipment.

Probable duration of assistance. A number of years.

Work done durin~the vear. A WHO consultant (provided under an inter-country project) visited Calcutta in February to assist in the conduct of the two-year master's degree course in veterinary public health at the All-India Institute of Wygiene and Public Health (see alrio SEAR0 0168). The report of the consultant who had visited the Institute during May-July 1971 on a similar assignment was sent to the Government.

India 0247 (4503) Central Health Education Bureau R (May 1969; March 1971; - )

Aim of the ~roiect. To assist the Central Health Education Bureau in strengthening various aspects of its work.

Assistance provided by WHO duriw the vear. Supplies and equipment.

Probable duration of assistance. Until 1975.

India 0250 (5102) Intenration of Maternal and Child Health R Services into the General IJealth Services (Sept. 1967; Nov. - Dec. 1967; June - July 1968; June 1970; Nov. 1970 - Feb. 1971; May 1971; July - Aug. 1971; - )

Aim of the ~roiect. To integrate maternal and child health services, including family planning, into the general health services in selected States. SEA/RC25/2 Page 128

Assistance provided by WHO during the year. Two twelve-month fellowships - one for study in the United States of America and one for studies in the United States of America, Japan, Republic of Korea, Taiwan, Hong Kong, Singapore and Malaysia.

India 0251 (3202) Ground-vater Traininn Course R (Feb. - Hay 1970; July 1970; June 1971; - ) UNICEF

Aim of the proiect. To train staff in the development and utilization of ground- Water for cornunity water supplies.

Assistance provided by WHO during the year. Two four-month fellowships for studies in the United States of America and Australia.

Probable duration of assistance. Until 1974.

India 0255 (4902) Strengtheninn of Health Statistics Services R (July - Oct. 1970; - )

Aim of the proiect. To develop and strengthen health intelligence units in State health departments and to train national statistical staff.

Assistance provided by WBO during the vear. Supplies and equipment.

Probable duration of assistance. Some years.

India 0257 (4802) Physical Therapy School, Baroda* R (May 1968; March 1969 - April 1972; - )

Aim of the vroiect. To train physiotherapists to degree standard (Bachelor of Physiotherapy) at the Physiotherapy School in S.S.G. Rospital, Baroda, over a three-year period.

Assistance provided bv Mi0 during the year. (a) A physiotherapy tutor; (b) supplies and equipment.

Work done during the vear. For the degree course in physiotherapy there were 14 students in the first year, eight in the second year and three in the third year, i.e., during the 1971-1972 session.

The first group of students for the three-year degree course in physiotherapy completed their studies in the month of May.

A questionnaire prepared by the WHO tutor and sent to all the units in the hospital earlier in 1971 shoved that the existing mmnber of physiotherapists was considerably less than the number needed.

One of the national physiotherapists returned in November after a year's WHO fellowship in the United Kingdom.

The School premises were enlarged and the library facilities extended.

The Director of the Physiotherapy School and the counterpart to the WHO physiotherapy tutor were appointed on a temporary basis.

*Previous title: Physiotherapy School, Baroda. SEA/RC25/2 Page 129

The WHO physiotherapy tutor completed her assignment at the end of April. Her recommendations were forwarded to the Government.

A replacement for the tutor was recruited and was expected to be in posi- cion shortly.

India 0259 (1002) National Institute of Conmrunicable Diseases R (Feb. 1972; - )

Aim of the proiect. To assist the National Institute of Comunicable Diseases in strengthening its faculty in order to improve further the field training of epidemiologists.

Assistance provided by WHO during the year. A consultant.

Frobable duration of assistance. Some years.

Work done during the year. WHO continued to provide tunds to the National Insti- tute of Communicable Diseases to assist in the conduct of the Delhi part of the international course in epidemiology. A WHO consultant visited the Institute in February and helped with the final examinations of the participants.

India 0267 (5603) Nutrition Training R (Dec. 1970; May 1971; - )

Aim of the project. To support the National Institute of Nutrition, Hyderabad.

Assistance provided by WHO during the year. Supplies and equipment, including an enlarger and a freeze-drier.

Probable duration of assistance. Some years.

India 0268 (3203) Village Water Su~ply R (May 1971 - ) UNICEF

Aim of the project. To plan and co-ordinate the development of community water supplies in rural areas, including the well-drilling programme in areas where hard rocks present special problems and in those where water is scarce; to train professional and drilling staff.

Assistance provided 5y WHO during the year. A sanitary engineer.

Probable duration of assistance. Until the end of 1974.

Work done during the year. The WHO/UNICEF-assisted village water supply programme in the various States maintained steady progress. The WHO sanitary engineer, who is stationed in Bangalore, visited project areas in several States and gave advice on technical problems.

In Andhra Pradesh, a total of 1 298 handpumps were installed; piping network to lI, villages as well as an elevated balancing reservoir of 200 000-gallon capacity were completed. In Kerala, a WHO/lJNICEF-assisted piped water supply system was inaugurated in the Poovar-Karichal area. In Mysore, assistance was given to the committee of officials of various departments constituted by the SEA/RC25/2 Page 130

Government to review the progress of WHO/tJNICEF-assisted rural water supply and sanitation schemes, in the preparation of a memorandum defining the duties and responsibilities of each department. Departmental estimates for the second stage of the well-drilling programme were approved and steps were taken to launch the scheme. Infiltration wells were sunk in the North Pennar river bed and water was pumped into overhead tanks for distribution to public standposts. An additional vehicle was supplied by UNICEF to the project in Mysore to meet the increasing official needs of the WHO sanitary engineer.

With the constitution of a Water and Drainage Board in Tamil Nadu, the responsibility for the implementation of this programme was transferred from the Department of Highways and Rural Works to the Board. The Board appointed six geologists for geophysical exploration. The well drilling programme was progres- sing satisfactorily.

India 0269 (4404) Nursing in Clinical Specialties R

India 0269.1 (4404) Nursing in Clinical Specialties, New Delhi R (Jan. 1972 - )

Aim of the proiect. To improve clinical practice in selected specialties.

Assistance provided by WHO durina the vear. A nurse educator in orthopaedic nursing.

Probable duration of assistance. A number of years.

Work done during the vear. The project began on 11 January 1972 with the arrival of the WHO nurse educator in orthopaedic nursing for an ll-month assignment at the Institute of Orthopaedics, Safdarjang Hospital. New Delhi. Her counterpart had recently completed a WHO fellowship in this clinical specialty at the hospital where the WHO nurse had been employed.

Some in-service education was started for the nursing staff of the Institute. Planning was done for a short all-India course for nurses, to be held later in 1972.

The WHO nurse participated in an inter-country course on "The Care of Ortho- paedic Patient'' (under project SEAR0 0139, "Short Courses for Nurses and other Health Personnel").

India 0269.2 (4404) Nursing in Clinical Specialties. Raiasthan R (Feb. 1972 - )

Aim of the proiect. To improve clinical practice in selected specialties.

Assistance provided by WHO duriw the vear. A maternal and child health nurse educator.

Probable duration of assistance. A number of years.

Work done during the vear. The WHO maternal and child health nurse educator was transferred from project India 0114 and returned on 28 February 1972 to the S.P. Medical College Hospital after a ten-month absence. The paediatric medical ward SEA/RC25/2 Page 131

has been moved to a newly constmcted area, facilitating more effective and safer patient care. Several procedures instituted during the WHO nurse's previous assignment have been maintained. Particular attention was given to improving the care of the premature.

Owing to shortage of nursing staff a full-time counterpart has not been appointed, but two staff nurses on the medical paediatric ward, who attended the WHO-sponsored inter-country course on "Paediatric Patient Care", have assisted on a part-time basis.

India 0269.3 (4404) Nursing in Clinical Specialties, New Delhi R (Jan. 1972 - )

Aim of the project. To improve clinical practice in selected specialties.

Assistance provided by WHO during the year. A paediatric nurse educator.

Probable duration of assistance. A number of years.

Work done during the year. The WHO paediatric nurse educator in project India 0114, "Paediatric Education", was transferred to this project on 1 January 1972 and continued to carry out the same responsibilities at the All India Institute of Medical Sciences, New Delhi.

Regular monthly meetings of the Control of Infection Comittee have led to a plan for improving patient care by establishing policies and uniform practices for all procedures. Work was started on the compilation of a manual for the Intensive Care Unit (Nursery) and the main section of the Paediatric Surgical Unit.

India 0274 (4504) Health Education in Schools. Including UNFPA Family Life Education (July - Aug. 1971; - )

Aim of the proiect. To integrate family life education in school, college and teacher-training curricula, establish and develop a health education programme in the educational system, prepare teachers in health education, and develop teaching aids required for primary, secondary, collegiate and teacher-training institutions.

Assistance provided by WHO during the year. (a) A consultant; (b) a twenty-four- month fellovship for studies in the United States of America, Japan, the Philippines and Thailand; (c) supplies and equipment.

Probable duration of assistance. Five years.

Work done during the year. A national workshop on health and population education in schools was held in New Delhi from 23 August to 4 September. Forty-one key personnel from health and education ministries from the different States participated in the workshop, which was assisted by a WHO consultant.

The recommendations of the workshop included defining the objectives of health and population education at all levels of school education; integrating and articulating health and population education with the core curriculum in schools; preparing suitable instructional nraterials for teachers, students and parents; providing in- and pre-service traininglorientation to teacher educators, teachers and educational supervisors, and co-ordinating health and population education activities at different levels of the administration. Action was taken to recruit a WHO health educator for assignment to the project and to assist in conducting eight follow-up seminars in different States.

India 0275 (6206) Strengthening of the Teaching of Human UNFPA Reproduction. Family Planning and POPU- lation Dvnamics in Medical Colleges (May - Sept. 1971; Dec. 1971; - ) Aim of the proiect. To strengthen the service, teaching and research functions of the departments involved in the teaching of human reproduction, family planning and population dynamics in medical colleges.

Assistance provided by WHO during the vear. Four twelve-month fellowships for study in the United States of America and a nine-month fellowship for studies in the united Kingdom, Uganda and India.

Probable duration of assistance. Some years.

Work done during the vear. Preparations were under way to assist four additional medical colleges (Banaras, Baroda, Calcutta. Cuttack) in the introduction of a longitudinal integrated teaching progranme.

The plan of operation for the project, drafted in 1971 by two consultants in collaboration with temporary advisers at a special meeting, was under review by the Government.

India 0276 (4405) Strengthening of Family Planning Aspects UNFPA of Nursing Administration (March 1972 - ) Aim of the proiect. To strengthen the nursing and midwifery components of health care in the maternity cycle.

Assistance provided by WHO during the year. A nurse-midwife educator consultant.

Work done during the vear. This project became operational with the arrival on 22 March 1972 of a WHO nurse-midwife consultant for 11 months. She was assigned to the Government Erskine Hospital attached to Madurai Medical College, Madurai, to advise on and assist with strengthening the midwifery and obstetrical nursing education and services at the hospital and basic school of nursing, with particular attention to the family planning aspects.

India 0277 (4406) Strenathening of the reaclllng of Human UNFPA Reproduction. Population Dvnamics and

-Family -- Planning on Nursing and Midwiferx Education (March 1972 - )

Aim of the project. To improve the maternal and child health and family planning components of auxiliary nurse-midwife training and to strengthen the domiciliary midwifery and public health nursing experience of nursing students in hospital schools of nursing; to strengthen the teaching of human reproduction, family planning and population dynamics at teaching institutions for nursing personnel.

Assistance provided by WHO during the year. (a) A nurse educator; (b) supplies and equipment. SEA/RC25/2 Page 133

Probable duration of assistance. A number of years.

Work done during the year. This is the first WHO-sponsored nursing project in India to be financed under UNFPA. A WHO nurse educator arrived on 3 March 1972 and has been assigned to Patna to assist in the further development of the training of auxiliary nurse-midwives of Bihar State.

The WHO nurse from project SEAR0 0192, "Regional Team on Family Health", was seconded in April to assist with similar training in the State of Uttar Pradesh. The WHO nurses conducted a three-month orientation course for 15 nursing personnel assigned to teaching jobs at some of the auxiliary nurse- midwife schools in the two States.

This project is closely co-ordinated with UNICEF assistance to the training of auxiliary nurse-midwives in the States of Bihar and Uttar Pradesh.

India 0278 (5103) Intearation of Maternal and Child Health, UNFPA Including Family Planning Services,into the General Health Services (May 1971 - )

Aim of the proirct. To plan, organize, operate and evaluate the family health programmes as an integral part of the general health services.

Assistance provided by WHO during the vear. A twelve-month fellowship for studies in the United Kingdom and Canada.

Probable duration of assistance. Some years.

Work done during the vear. The draft plan of operation for the project, which had been formulated by a meeting of temporary advisers from 21 to 26 June 1971, was forwarded to the Government of India for comments.

The report on the Workshop on the Integration of Maternal and Child Health and Family Planning in Rural Areas, held from 17 to 22 May 1971, and that on the Workshop on Operational Studies Related to the Integration of Maternal and Child Health and Family Planning in the Overall Context of General Health Services, held from 28 June to 3 July 1971, have been sent to the Government.

Plans were being made for holding a workshop on the inethodology of in-service training for integration of maternal and child heatlh services (including family planning services) into the general health services in the Regional Office in December 1972. sEA/RC25/2 Page 135

4. INDONESIA

PROJECT LIST

Proiect No. Source of Funds Co-operating Agencies

Indonesia 0032 (2001) Malaria Eradication R (May 1955 - )

Aim of the project. To reduce malaria endemicity to the lowest possible level with the ultimate goal of malaria eradication.

Assistance provided by WHO during the year. (a) Three malariologists,an entomologist and a translator-typist; (b) two fellowships - one for three months and one for two months - for study in the Philippines, a three-month fellowship for study in Japan, and a three-and-a-half-month fellowship for studies in the Philippines and India; (c) supplies and equipment; (d) subsidy.

Probable duration of assistance. A number of years.

Work done during the vear. The malaria control programme is now covering a population of 76.170 million in Java and Bali and a population of about 35 million in the other islands. The activities are carried out only in priority areas of socio- economic importance.

The problem of availability of insecticides in adequate quantity and on time continued, resulting in delayed spray cycles during the year.

As funds become available, spraying operations will be expanded to the other islands. Sumatra has a malaria control programme in 7 out of 18 provinces in 19i2.

There has been a decrease in incidence from 117 056 cases in 1970 to 72 829 in 1971.

The monitoring of the susceptibility status of A.aconitus continued and it is planned to undertake another study in an area with a population of 55 000 in Magiton, Java, in 1972.

Indonesia 0036 (5101) Paediatric and Obstetric Education and Services UNDP (Oct. 1956 - Dec. 1957; May 1967 - June 1969; UNICEF Sept. 1969; Nov. 1970; July 1971; - )

Aim of the project. To expand and improve paediatric and obstetric services and the teaching of medical and nurse students in maternal and child health in a number of medical schools.

Assistance provided by WHO during the vear. A twelvemonth fellowship for study in the United States of America. SEA/RC25/2 Page 136

Indonesia 0050 (1201) Tuberculosis Control R (July 1961 - ) UNICEF

Aim of the nrolect. To integrate BCG vaccination without prior tuberculosis testing into the work of the maternal and child health clinics and regency polyclinics; to train staff engaged in case-finding by microscopic sputum examination, and to provide ambulatory treatment.

Assistance provided by WHO during the year. Four three-week fellowships for studies in the Republic of Korea, Taiwan and India.

Probable duration of assistance. Until the end of 1974.

Indonesia 0060 (4201) Laboratory Services R (June 1967; June - Aug. 1968; June 1969; UNICEF June 1970 - )

Aim of the project. To strengthen health laboratory services.

Assistance provided by WHO during the year. (a) A microbiologist, a virologist and a laboratory technician; (b) a twelve-month fellowship (extension) for study in the United States of America, a three-month fellowship for study in Singapore, a three-month fellowship for studies in the United Kingdom and the Regional Office, and a twelve-month fellowship for study in Thailand; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1977.

Work done during the year. In collaboration with the Director, Directorate of Health Laboratory Services, CDC, Djakarta, a plan of action has been prepared to cover the project's activities in 1972. During the year, the project progressed as planned. The Central Public Health Laboratory, Djakarta, has been provided with staff and equipment and will start functioning as soon as water and parer connections are installed. A substantial amount of the project's effort has been focussed on the rehabilitation of rural laboratories. The Public Health Labora- tory at Ampenan and the kabupaten laboratories in Bali, Madura, Lambok, South- east Sulewesi, Central Sulewesi and Central Kalimantan have been surveyed and the eligible ones have been recommended for UNICEF assistance; work continues on the preparation of a manual for use by kabupaten laboratories; also, a chapter on laboratory procedures is being contributed to a manual for the use of health centres which is under preparation.

The WHO virologist assessed the competence of various laboratories in virus work in Medan, Surabaya, Bandung and Sulewesi. Rabies, smallpox and dengue/ haemorrhagic fever are no doubt important problems, and support to the surveillance progranme of these diseases will have to be based on a referral service operating from the Central Public Health Laboratory, Djakarta. Meanwhile, competence in viral work needs to be developed, and exchange of information between different laboratories should be encouraged.

The project continued to help in specialized fields to support the connrmni- cable diseases programme. In this connection, the following activities were undertaken: the field laboratory in Bojolali has been established for ecological study in plague, a protocol for plague bacteriology and plague serology procedures was prepared; at the Central Public Health Laboratory, Djakarta, the smallpox laboratory is well established and serum and infectious materials were collected SEA/RC25/2 Page 137

from West Java and North Sumatra; material assistance was extended to the cholera laboratory, Makassar, in maintaining its work uninterrupted; the microbiologist gave lectures in the laboratory diagnosis of vaccines at a cholera workshop organized in Jogjakarta; a protocol covering laboratory aspects has been prepared for a venereal disease survey in Djakarta; a course will be held in October 1972 in the laboratory diagnosis of rabies; contacts are being made with the Bogor Zoo- logical Museum and the Soil Research Institute, with a view to establishing co- operation in plague mamology.

Manpower training also received attention. The project staff participated in the following activities: a 10-day workshop on the microbiology of comunicable diseases for directors of provincial health laboratories and an eight-day training course for 30 technical officers from the kabupaten laboratories which have been upgraded through assistance from UNICEF. A syllabus for the two-year in- service training for four bacteriologists from the Central Public Health Labora- tory, Djakarta, has been prepared, and the technical staff from the Provincial Health Laboratory at Jogjakarta have received bench training.

Indonesia 0061 (3001) Training in Sanitary Engineering R (Feb. - March 1968; Sept. 1968; May 1969; Aug. - Sept. 1969; July 1970 - )

Aim of the proiect. To train sanitary engineers at the Institute of Technology, Bandung.

Assistance provided by WHO durinz the year. (a) A visiting professor of sanitary engineering; (b) a six-week fellowship for study in Australia and two fellowships - one for eight-and-a-half months (extension) and one for ten months - for study in the United States of America; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the year. A consultant (visiting professor of sanitary engineering), assigned to the Institute in October 1970 to assist in reorganizing and strengthening the teaching and training programme in sanitary engineering, left in September 1971. Following his recommendations, steps were taken to supply an incubator to the laboratory and some machine tools to the students' workshop. The report of the consultant was sent to the Government.

The fourth addendum to the plan of operation was concluded covering the assignment of a consultant for three months and of a sanitary engineer for two years. The sanitary engineer is expected to join the project in August 1972 to assist the Institute in the further development and expansion of the training progr-e. This assignment will follow that of the consultant who will study the requirements for sanitation personnel and survey and assess the available training facilities in the country with a view to making specific recommendations for their further improvement.

Indonesia 0062 (6201) Medical Education R (May 1964 - )

Aim of the project. To develop the teaching programmes of the medical faculties in keeping with national needs and the progress of educational sciences.

Assistance provided by WHO durin~the year. (a) Three professors - one of public health administration, one of pharmacology and one of histology and embryology; SEh/RC25/2 Page 138

(b) four twelve-month fellowships - two for study in the United States of America, one for study in Australia and one for study in Thailand, a two-month fellowship (extension) for study in Australia, and a five-month fellowship for studies in India, Turkey, Federal Republic of Germany, Denmark, the Netherlands, the United Kingdom, Canada and the United States of America; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the year. The WHO professor of pharmacology assigned to the Faculty of Medicine, Sumatera Utara University, Medan, continued to introduce the students to practical classes, using simple and partly improvized equipment. He also organized scientific meetings for the staff and has been studying the pattern of examination results with a view to using his findings as a feedback for improving the course. The WHO professor of histology and embryology completed his assignment at Gadjah Mada University, Jogjakarta, in October. A WHO professor of public health (reassigned from another country) took up his position at Airlangga University, Surabaya, in the same month. A WHO professor of microbiology was under recruitment for Medan, and recruihnent of three short- term consultants - in physiology, clinical pathology and medical statistics - was under way.

Indonesia 0066 (3201) Improvement of Urban Water Supplies, FUNDWI Province of West Irian (Jan. - April 1972; - )

Aim of the project. To improve urban water supplies.

Assistance provided bv WHO during the vear. A sanitary engineering consultant.

Work done during the year. A consultant was assigned from January to April 1972 to undertake feasibility studies on the improvement of urban water supplies, to advise on the alteration of design or modification of water supply systems, and to assist in the development of a phased programme in this field. On his way to Indonesia, the consultant visited Manila for two days to hold technical discussions with the Asian Development Bank in viw of the Bank's keen interest in the project in terms of providing financial assistance for the improvement of urban water supplies in West Irian.

Indonesia 0069 (4301) Training of X-.:av and Electro-medical R Technicians (March 1966 - i

Aim of the project. To train technicians and radiographers in the use, maintenance and repair of electro-medical equipment.

Assistance provided by WHO during the year. (a) A radiography tutor and an electro- medical engineer; (b) a thirteen-week fellowship for study in Italy and a twelve- month fellowship for study in the United Kingdom; (c) supplies and equipment, including a modular pulse generator system, a didactix, a portable vacuum pumping trolley and a signal generator.

Probable duration of assistance. A number of years.

Work done duriw the year. The training of radiographers continued satisfactorily. The end-of-year examinations were held in December 1971. The final group of SEA/RC25/2 Page 139

students trained under the "old system" were examined and 13 graduated. Out of 36 students moving from the second to the third year of studies, 22 passed, and out of 48 first-year students 21 were successful. The new session started on 1 February 1972.

The third refresher course for the upgrading of practising radiographers was successfully held in Semarang from 2 to 20 October 1971. There were 27 participants from all parts of Indonesia.

The progress of the training programme at the School of Electro-medical Technicians was also satisfactory.

The WHO specialist in electro-medical techniques attended the Ninth Inter- national Conference on Medical and Biological Engineering, held in Melbourne, Australia, and visited the intensive care unit at St. Vincent's Hospital, Melbourne, which has links with the intensive care faculty at R.S. Tjipto Man- gunkusumo, Djakarta.

The national staff aember who had gone to Italy to attend a three-month course on the maintenance of radioisotope equipment resumed his duties. It was planned that he should work full time in the electro-medical workshop and later, after acquiring more experience, he should be appointed as an instructor in the Academy and give lectures.

The new workshop building at Biro V. Kebajoran was completed and became available for use as classroom and for office accommodation. ATRO, along with two other academies, moved into the new premises and the lectures commenced.

Indonesia 0071 (3002) National Community Water Supply and Sanitation R (March 1969; June 1969 - ) n:ICCF

Aim of the protect. To plan community water supply, sewerage and storm-water drainage systems, water pollution control and general sanitation work, and to train staff.

Assistznce provided by WHO during the year. (a) A sanitary engineer and a consultant; (b) supplies and equipment.

Probxble duration of assistance. Some years.

Work done during the pear. The report of the consultant assigned during April- July 1971 (briefly mentioned last year), containing recommendations for the further development and expansion of the training programme for personnel required for the implementation of the rural water supply scheme, was submitted to the Government. Another consultant, also recruited in April 1971 under an inter- country project, assisted the Government in the improvement of the existing municipal water supplies and in the development of a long-term programme in this field.

A demonstration on the use, joining and laying of WC pipes and fittings was conducted at the PVC Factory in Djakarta for six officers of the Central Direc- torate. Twenty sanitarians and assistant sanitarians were imparted in-service training in East Java. In addition, a central level in-service training course was organized at the Institute of Technology, Bandung, from 22 September to 10 October 1971 for fifteen health controllers, two sanitarians and one technician. SEA/RC25/2 Page 140

Supplies and equipment, including eleven vehicles as well as PVC pipes, for five water supply schemes and for five community water supply projects were received from UNICEF and sent to the sites. In addition, a tentative list of UNICEF supplies for twenty-five water supply projects, for the programme of sanitary wells with handpumps and for two mechanical well-drilling rigs, was prepared and submitted to UNICEF.

Installation of tubewells with handpumps in seventeen provinces continued as scheduled; this programme was completed in five provinces. Construction work in 19 piped-water supply schemes with material assistance from UNICEF maintained good progress. The lay-out drawings and the preliminary hydraulic designs for 29 piped distribution systems for 1972-73 were completed.

A survey of about 60 contiguous villages with approximately half a million people in the Kabupaten of Sukabumi in West Java was started in order to prepare a proposal for a water supply package project. A proposal was also worked out for pilot areas of work in water supply and excreta disposal within the vicinity of the National Health Training Centre, Bekasi.

A consultant was assigned in March 1972 for three months to assist in the improvement of urban water supply schemes and to prepare a long-term programme. He was also assisting the consulting engineering firm engaged by the Government to conduct feasibility studies on water supply systems in six cities.

Another consultant was being recruited under an inter-country project to assist the Government in programmes and techniques of effective sewage and waste disposal.

Indonesia 0072 (4002) Establishment of Health Centres, FUNDWI Province of West Irian (Jan. - April 1970; May 1972 - )

Aim of the project. To develop integrated services in West Irian on a pattern consistent with the facilities and resources available, to co-ordinate projects in West Irian in the health sector, and to advise on the health aspects of other projects.

Assistance provided by WHO during the year. A public health officer.

Work done durina the year. A WHO public health officer took up a two-year assignment with the project towards the end of May 1972. He will advise the Government on the organization and development of health services in West Irian and will also assist in training the necessary staff.

Indonesia 0074 (4401) Nursing and Midwifery Education R (June 1967; Aug. 1967; Jan. - Dec. 1969; April 1970 - )

Aim of the project. To strengthen and further develop nursing and midwifery education.

Assistance provided by WHO during the year. (a) A nurse educator; (b) two twelve- month fellowships for study in New Zealand; (c) supplies and equipment.

Probable duration of assistance. Until 1976. SEA/RC25/2 Page 141

Work done during the year. Enphasis was placed on assisting the national authorities in developing and implementing plans for the establishment of a rational nursing/midwifery personnel system. Assistance was provided in the collection of data regarding existing categories and levels of nursinglmidwifery personnel and the training prograwes which prepare these personnel, the preparation of working papers and of draft short and long-range plans for the introduction of the system. The system proposed recommends two levels of nursing personnel, i.e., (1) the auxiliary nurse-midwife and (2) the nurse-midwife. The former progrme would be two years and the latter four years in length. Existing auxiliary nurse-midwife and nurse-midwife programmes would be phased gradually into the new system. Supplemental education would be given to qualified personnel in order to provide them with knowledge and skills not included in the curriculum when they were trained.

Assistance was given to the teacher training programme throughout Java and particularly to the new one-year programmes which were started at the UNICEF- assisted schools.

The WHO nurse educator participated in a number of short training courses. The third quarter of 1971 was devoted largely to the preparation and conduct of a four-week course on "The Integration of Public Health Aspects in the Curriculum". Twenty-three teachers from nursing and midwifery schcols attended the course.

Indonesia 0075 (4901) Hospital Statistics R (Nov. 1968; May 1969; July 1969; May 1970; Aug. 1970; July 1971; Dec. 1971; - )

Aim of the project. To train medical record officers and hospital statisticians.

Assistance provided by WHO during the year. A three-month fellowship for studies in the United Kingdom and at WHO Headquarters, and an eight-month fellowship for studies in Australia and India.

Indonesia 0076 (2002) Malaria Control, Province of West Irian FUNDWI (Jan. 1970 - )

Aim of the proiect. To control malaria in West Irian.

Assistance provided by W0 during the year. Supplies and equipment, including two transport vehicles.

Probable duration of assistance. Until 1973.

Indonesia 0079 (5501) Dental Health UNDP (Jan. - April 1968; July 1969; Aug. 1970 - Feb. 1971; Aug. 1971 - Jan. 1972; - )

Aim of the proiect. To develop further teaching and training programmes for professional and auxiliary dental personnel, to expand dental health services within the framework of comprehensive health services, and to explore the feasibility of establishing water fluoridation schemes.

Assistance provided by WHO durina the year. (a) A consultant; (b) part payment of cost of attendance of participants; (c) supplies and equipment.

Probable duration of assistance. Some years. sEA/RC25/2 Page 142

Work done during the year. A WHO consultant to advise on the planning of a national system of dental education was assigned between August 1971 and January 1972. With a view to meeting the needs of dental health services in Indonesia, the consultant recommended the training of the senior staff in the Directorate of Dental Health Services and of selected dental health personnel at the district and regency levels in leadership skills, planning, administration and related operational activities. The gradual development of a need-based common curriculum for all dental schools, continuing education for existing dental health personnel and a correspondence course were considered important for the promotion of dental manpower resources. The report of the consultant has been sent to the Government.

During his stay in Indonesia, the consultant also assisted in the organization and conduct of a five-day national dental workshop in January 1972 for 15 participants from dental faculties and officials with experience of dental public health. The workshop reviewed the teaching and training in dental schools and recommended changes in the dental education system. It also outlined steps for the planning of a national system of dental education based on modern concepts.

Indonesia 0081 (1801) Smallpox Eradication R (Dec. 1967 - )

Aim of the project. To eradicate smallpox.

Assistance provided by WHO during the vear. (a) Two medical officers, an operations officer and a consultant; (b) two six-month fellowships - one for study in Thailand and one for study in the United Kingdom; (c) supplies and equipment; (d) subsidy.

Probable duration of assistance. A number of years.

Work done during the vear. No case of smallpox has been recorded in Indonesia since January 1972. In the islands of Sumatra and Sulawesi the last reported outbreaks occurred in September and November 1971 respectively. Since l:ay 1971 smallpox transmission in Java appeared to have been interrupted; however, an undetected focus of infection was found in December 1971 in West Java and 163 cases occurred before it was contained. An intensive nation-wide search for possible additional foci has been in progress and as yet no further outbreaks have been detected.

Two thousand and one hundred cases were recorded in the country during 1971, as compared with 10 081 during 1970. A WHO-assisted seminar on smallpox was held in October in Sumatra. Following the decisions taken at the Seminar, an active search for cases throughout the country was carried out and pilot studies of combined smallpox-BCG vaccine field trials were conducted. If these trials give satisfactory results, a similar vaccination programme will be implemented throughout Java and Bali.

During July and August 1971 a WHO consultant assisted the programe in the problem areas in Sumatra and Sulawesi and also assessed the situation in Java. A medical officer of the inter-country team (SEARO 0030) visited the country in February 1972 and held discussions with national and WHO staff on the future activities of the project. SEA/RC~~/~ Page 143

Indonesia 0083 (1002) Vaccine and Sera Production UNDP (Dec. 1968; Jan. 1969; March 1970; UNICEF Oct. - Dec. 1970; Nov. 1971; - )

Aim of the project. To improve methods of producing bacterial and viral vaccines, anti-toxins and toxoids; also to develop capability for the quality control of vaccines and sera.

Assistance provided by kWO during the year. (a) Two consultants; (b) supplies and equipment.

Probable duration of assistance. Some years.

Work done during the year. A WHO consultant who visited the project in November 1971 assembled, tested and commissioned the refrigerated centrifuge procured through UNICEF. His report has been sent to the Government. In May 1972,another consultant, a vaccine engineer, reviewed the technical aspects and helped in stepping up the yield of the continuous culture fermentor "Bilthoven Unit", which has been cormoissioned for the production of DPT vaccine. The commissioning of the Bilthoven Unit and the refrigerated centrifuge should enable Bio Fama to streamline its process for the manufacture of DPT vaccine, as it has changed over production from small to large batches.

Indonesia 0084 (4402) Nursing Education and Traininn, FUNDWI Province of West Irian (Jan. - March 1970; April 1971 - )

Aim of the proicct. To strengthen and develop mrsing/midwifery services and education in West Irian.

Assistance ~rwidedby FHO during the year. (a) A nurse educator/administrator; (b) a twelve-month fellowship for study in Sew Zealand; (c) supplies and equipment, including a transport vehicle.

Probable duration of assistance. Some years.

Work done durin~the year. The work of the WHO nurse educator and associated national staff was concerned largely with the conduct of a nursing manpower survey and the development of revised syllabi for the training of health personnel.

The collection of accurate information relating to health manpower in general and nurse-midwife manpower in particular and to the various institutions providing clinical and public health experience for nursing midwifery students involved extensive travel and correspondence. The material is now relatively complete and the data have been organized and presented in tabular form. They will now be used for the preparation of both short and long-term plans for the further developnent of nursing midwifery services and education.

Translation of all. syllabi being used in nursing and midwifery education in West Irian was completed, and the syllabi were revised subsequently.

Efforts were made to collect reliable information concerning the curricula in primary and secondary schools in order to be able to do more effective planning for curricula which would prepare health workers. SEA/RC25/2 Page 144

The WHO nurse assisted with the planning and conduct of a number of in- service and short-course training programmes, including public health orientation courses for newly graduated midwives. Plans were made for a three-month course in nursing education, to be conducted in Djajapura.

The WHO nurse educator travelled extensively throughout the Province, visiting schools of nursing and midwifery and associated health establishments.

Indonesia 0086 (4001) strengthening of National Health Services R (Feb. - March 1969; May 1969 - ) UNICEF

Aim of the project. To progrme, co-ordinate and integrate health services; to standardize and intensify training activities for health staff, and to promote reviews of public health practice and organization intended to lead to the optimum delivery of health care.

Assistance provided by WHO during the year. (a) A public health administrator; a medical officer, a nurse administrator, a statistician, a health educator, a nurse educator, a sanitarian, a secretarial assistant and a consultant; (b) two twelve-month fellowships - one for studies in the United Kingdom, India and Thai- land and one for studies in Belgium, Federal Republic of Germany, Noway, the Netherlands and the United Kingdom, a ten-month fellowship for study in the United Kingdom, and a one-month fellowship for a study tour of Switzerland, the Nether- lands, Denmark, the United Kingdom and India; (c) supplies and equipment.

Probable duration of assistance. Some years

Work done during the year. Assistance was given to the development of job descriptions and to the strengthening of supervision and in-service training of supervisory and field staff of the National Training Centre, Bekasi. Help was also provided in the preparation of the first draft of the manual for the conduct of activity studies on midwives in Indonesia on the basis of the design of the Bekasi study, which had been well received by the Government.

A reference manual for health centre staff, aimed at achieving maximum efficiency, was prepared.

A workshop on community health, with the aim of providing job-oriented medical education, was conducted from 6 to 11 December 1971 in Surabaya (see Indonesia 0114).

A programme for providing additional training to medical, paramedical and auxiliary staff was developed for the financial year 1972-73.

A workshop to evaluate the results of a recording and reporting system, carried out during the past one year on a trial basis in selected health centres, was held in Djakarta from 13 to 17 March 1972; it was attended by national staff from 23 provinces and 25 regencies.

An outline for the establishment of a central data processing unit was prepared, and plans were made and the design drawn up for a proposed household, health and demographic survey. An eight-week up-grading course in teaching methods was organized and was attended by 21 participants representing eighteen provinces.

A ten-year draft plan for the development of a nursing education system was prepared. SEA/RC25/2 Page 145

A national health planning course, attended by 26 senior provincial staff, was conducted with the assistance of a WHO consultant. Plans were made for a similar course, to be held in 1972. It was planned to assign a consultant to review the Government's five-year health plan.

Steps were taken to plan a series of three educational activities, viz., a health management course, a health management workshop, and a course for the training of auxiliary health staff, to be held in mid-1972.

In June 1972, a WHO consultant took up a two-month assignment with the project to assist with the preparation of the study protocol of research projects in public health practice, to be undertaken by the Government.

Indonesia 0087 (4303) Rehabilitation of Hospitals and Polyclinics, FUNDW I Province of West Irian (Dec. 1970; July 1971; - )

Aim of the project. To survey existing facilities in hospitals and polyclinics; to train national staff in hospital administration and in selected fields of cornunity health services; to provide supplies and equipment for the upgrading of hospitals and polyclinics.

Assistance provided by WHO during the year. (a) A ten-month fellowship for study in Belgium; (b) supplies and equipment, including a transport vehicle.

Indonesia 0088 (8501) Goitre Control. Province of West Irian FUNDW I (Jan. - March 1971; - )

Aim of the proiect. To prevent goitre.

Work done during the year. The report of the consultant assigned to the project from January to March 1971 to advise on the planning of a goitre control programme in the Province of West Irian, was forwarded to the Government. He has, among other things, recommended the starting of a pilot project in the Bilorai Valley to investigate the duration of action of intramuscular viscous iodized oil and orally administered iodized oil, estimation of iodine in specimens of urine from patients receiving the treatment, adequate measures to protect the population of the central highlands against tuberculosis prophylactic treatment against malaria, and food supply to the population migrating from the highlands to the coastal areas,

Indonesia 0089 (4202) Public Health Laboratory. Province FLINDWI of West Irian (April - May 1971; Oct. 1971; - )

Aim of the project. To organize the Public Health Laboratory at Djajapura and to train laboratory personnel.

Assistance provided by WHO during the year. A twelve-month fellowship for study in Australia.

Indonesia 0091 (1001) Strengthening of Epideniological Services R (June 1969 - )

Aim of the proiect. To develop epidemiological units at both central and intermediate levels and to train staff. SEA/ RC2512 Page 146

Assistance provided bv WHO during the year. (a) A medical officer and two consultants; (b) a twelve-month fellowship for study in the United States of America, a nine-month fellmship for studies in Czechoslovakia and India, a five-month fellowship for studies in the Netherlands, Switzerland, Thailand and Malaysia, a three-and-a-half-month fellowship for studies in the Netherlands and Switzerland, a ten-month fellowship for study in the United Kingdom, and a two-week fellowship for studies in the USSR, Iran and Thailand; (c) supplies and equipment,including a transport vehicle.

Probable duration of assistance. Some years.

Work done during the vear. The WHO medical officer left the project in January 1972 on completion of his assignment.

A WHO consultant visited the country during January-February to assist the Government in the conduct of a national seminar on epidemiological services. He also visited various areas in which epidemiological surveillance had already been established, to observe as to how the knowledge acquired at the annual training courses were being put to use. His report has been sent to the Government.

Another consultant visited the country in April to advise the Governnent on the clinical aspects of denguelhaemorrhagic fever surveillance and the role of hospitals in this regard.

Indonesia 0097 (6401) Post-graduate Education in Public Health R (Jan. - Feb. 1972; - ) Aim of the project. To develop further the teaching and training programmes conducted by the School of Public Health, University of Indsnesia.

Assistance provided by WHO during the vear. Two consultants (provided under SEARO 0096.2)

Probable duration of assistance. Until 1977.

Work done during the year. Two consultants assigned during January-February under project SEARO 0096.2 assisted the School of Public Health of the University of Indonesia in Djakarta with the development of teaching and research programmes. The report containing their recommendations has been forwarded to the Government.

A consultant has been recruited and is expected to be in position in July. He will assist in the formulation and implementation of the plans being developed by the national authorities on the basis of the recornendations of the consultants mentioned above.

Indonesia 0099 (1501) R (Nov. 1969 - Feb. 1970; March 1971; Jan. 1972 - )

Aim of the project. To study factors responsible for the persistence of plague.

Assistance provided by WHO during the year. (a) A scientist (animal ecologist); (b) a four-month fellowship (extension) for study in Malaysia, and two one-week fellowships - one for study in Iran and one for study in Thailand; (c) supplies and equipment. SEA/RC25/2 Page 147

Work done during the year. The WHO scientist (animal ecologist) joined the project in January 1972. A medical officer from the Bacterial Diseases Unit from WHO Headquarters also visited the project to discuss the selection of study areas and to finalize the protocols in order to establish a research project to study the endemic foci of plague in Indonesia.

Indonesia 0100 (2801) Veterinary Public Health R (Nov. 1971 - Jan. 1972; - )

Aim of the proiect. To study major zoonoses and to train veterinary public health officers.

Assistance provided by WHO during the year. A consultant.

Probable duration of assistance. A number of years.

Work done during the year. A WHO consultant visited the country during November 1971-January 1972 to advise the Government on the control of rabies, a major problem of public health importance. His assignment report has been sent to the Government.

Indonesia 0107 (4203) Establishment of Cytolony Services and Training UNFPA (Sept. - Nov. 1970; Dec. 1971; - )

Aim of the project. To establish laboratory services for cytology as part of the national family planning programme and initially at each of the principal medical schools.

Assistance provided by WHO during the year. (a) A twelve-month fellowship for study in Australia; (b) supplies and equipment.

Probable duration of assistance. Until 1975.

Indonesia 0113 (5104) Family Health Services UNFPA (Aug. - Oct. 1970; May 1971; Dec. 1971; April 1972 - )

Aim of the project. To plan, organize and manage maternal and child health and family planning activities as a regular function of the health services.

Assistance provided by WHO during the vear. (a) A medical officer; (b) a nine- month fellowship for studies in the United Kingdom, Uganda and India; (c) supplies and equipment, including a transport vehicle.

Work done during the vear. The report of the WHO consultant assigned to Indonesia in May 1971 (briefly mentioned in the last report), which reviews WHO-assisted projects in Indonesia related to the National Family Planning Prograwe and the external assistance being given in order to help in determining the future role of WHO, was sent to the Government. A WHO medical officer on a regular basis has been assigned to the project since April 1972. SEAIRC2512 Page 148

Aim of the project. To strengthen the services provided and the teaching carried out by the departments responsible for the teaching of human reproduction, family planning and population dynamics in medical schools, and to stimulate research on these subjects.

Assistance provided bv WHO during the year. (a) Three medical educators; for the workshop (see below), four consultants and assistance from the professors of public health and of obstetrics/gynaecology assigned to project Indonesia 0062; (b) five fellowships - four for twenty-two months and one for twelve months - for study in Thailand, and a twelve-month fellowship for study in Australia; (c) supplies and equipment, including two transport vehicles; (d) cost of attendance of participants.

Probable duration of assistance. Until the end of 1974.

Work done during the vear. The WHO medical educator in paediatrics who had been assigned to Padjadjaran University, Bandung, completed his work at the end of November. During his stay in Indonesia he also visited four Faculties of Medicine in Java and Bali. The WHO visiting professor in obstetrics and gynaecology assisted the Medical Faculty in Bandung and also paid visits to other medical colleges to advise on the development of integrated courses in human reproduction, family planning and population dynamics in the medical curriculum. In May 1972 he moved from Bandung to Medan to work at the Faculty of Medicine, Sumatera Utara University.

A national workshop on the "Teaching of Family anll Community Hedlth" was held in Surabaya from 6 to 11 December. Three consultants, one from the Netherlands and two from the Ramathibodi Hospital Medical School, Bangkok, together with two professors from the Rockefeller Foundation unit at the medical school, formed the faculty. This workshop followed an inter-country seminar on "Cornunity Medicine for Medical Teachers" (under project SEAR0 0096). also held in Surabaya; several participants in the inter-country seminar and four of the faculty joined the national workshop and utilized this experience for the benefit of a larger group of national participants.

A WHO visiting professor in educational planning was assigned to assist the Cunsirrtium of Medical Sciences in the overall review and revision of the educational system which are being carried out with the aim of better preparation of doctors and other health personnel for the actual needs of the country.

I i ., 01 15 (6501) Assistance to Libraries for Health Personnel* lMFPA (June - Sept. 1971; - )

Aim of the project. To establish lending and reference libraries for medical students on subjects related to family health.

Assistance provided by WHO durin~the vear. Two consultants.

Probable duration of assistance. Until 1975.

-- - *l'rcv~uus tr tlc: L~braryBanks in Medical Schools. SEA/RC25/2 Page 149

Work done during the year. The tvo consultants assigned in June 1971 (mentioned in the last report) to assist the Ministry of Education and the Ministry of Health to make an assessment of library facilities and advise on intermediate and long- range development of these facilities, completed their work in September. A sumary of the recowendations was fowarded to the Government.

Indonesia 0116 (4701) Radiation Health R (June 1972; - )

Aim of the project. To develop a film badge monitoring service.

Assistance provided by WHO during the year. Supplies and equipment.

Inlonesia 0119 (4101) Resources for Family Health UNFPA (July - Sept. 1971; - )

Aim of the proiect. To take a census of health manpower, to make an inventory of health and training facilities, and to develop and bring up to date a records system.

Assistance provided by WHO durinp. the year. (a) Two consultants (provided under project SEARO 0178); (b) supplies and equipment, including a transport vehicle.

Work done during the year. Assistance was given in the establishment of the health manpower resources reporting system by the assignment of two consultants (provided under an inter-country project). One of them drafted the record and report form and conducted a two-week survey training course for 20 participants - 12 from the Ministry and Directorates-General and 8 from the provincial health offices. For an account of the work of the other consultant, see SEARO 0178.

Steps were taken to recruit a long-term statistician to assist in the development of the health manpower resources reporting system.

Indonesia 0120 (4502) Health Education (Behavioural Studies1 UNFPA (July - Sept. 1971; - )

Aim of the proiect. To promote family health through behavioural changes.

Assistance provided by WHO during the year. Four consultants.

Work done during the year. During July-September 1971, two WHO consultants assisted in initiating studies related to the behavioural and educational aspects of the family health programme. The consultants identified 70 studies undertaken so far in Indonesia and analysed some of them. They also presented a paper for consideration at a meeting of the National Research Council, which selected ten priority studies and approved the suggested models. Out of these ten, four studies have been started with WHO assistance and the remaining six may be started soon.

At the Government's request, the same consultants have been assigned in June 1972 to assist in undertaking these studies. SEA/RC25/2 Page 150

Indonesia 0121 (4502) Development of Health Education in WPA Family Health (Aug. - Nov. 1971; - )

Aim of the proiect. To strengthen the health education component of family health.

Assistance provided by WHO during the year. A consultant.

Probable duration of assistance. Until 1977.

Work done during the vear. A WHO consultant assisted in the assessment and strengthening of health education services in family planning during August-November 1971. As a part of the project, a meeting of a working group of key national health,health education and other experts was held in November, and its recornendations included upgrading of the Health Education Division in the Ministry of Health, strengthening of the Division by the addition of more trained and qualified staff, and follow up of the Five-Year Development Plan formulated by the group for national heatlh education services. The WHO consultant participated in this meeting.

The assignment report of the consultant has been sent to the Cavernment, which has requested WHO assistance for implementing the provincial health education programme recommended by the consultant.

Indonesia 0122 (4502) Health Education in Family Planning UNFPA Teaching Proxranrme (Aug. - Dec. 1971; - )*

Aim of the proiect. To strengthen the health education component in teaching family health.

Assistance provided by WHO during the vear. A consultant and temporary assistance from the health education specialist attached to the Regional Team on Family Health.

Work done during the vear. A consultant was provided to the project from August to December 1971 to assist in reviewing the teaching of health education in the training of health personnel for the family health programme. A national working group, with the help of the consultant, prepared plans and a curriculum for further strengthening the training of health personnel in health education.

The WHO health education specialist under project SEAR0 0192. Regional Team on Family Health, assisted the project in planning the practical training of the students undergoing the basic orientation course. This work was undertaken from January to March 1972 as a part of the WHO-US AID-Government of Indonesia Health Education Manpower Development project. Since April 1972, the health education specialist has been working with this project.

Indonesia 0124 (5105) Development of Maternity-centred Family UNFPA Planninp. Services (Sept. - Oct. 197.1 - )

Aim of the proiect. To strengthen institutional maternity services in order to promote maternity-centred approach to family planning.

*Since the beginning of 1972, the activities have been continued under project Indonesia 0120. SEA/RC25/2 Page 151

Assistance provided by WHO during the year. Temporary assistance froa a Head- quarters consultant and from one of the Regional Advisers on Maternal a-d Child Health.

Work done during the year. A WHO Headquarters consultant and one of the Regional Advisers on Maternal and Child Health visisted 16 hospitals in Sumatra, Java and BaIi for two weeks in September 1971 to explore the possibility of assimilating the hospitals at present in the Population Council's programme into the WHO proposal to UNFPA for expanding the maternity-centred approach to family planning. They also collected information relevant to the integration of existing and proposed family planning projects within the basic health services and the training of medical and allied health personnel. Their report has been sent to the Government.

Indonesia 0125 (5601) Applied Nutrition Programme R (Oct. 1971 - Jan. 1972; - )

Aim of the proiect. To assist in the planning of nutrition surveys in the context of the Applied Nutrition Programme.

Assistance provided by WHO during the year. A consultant.

Work done during the year. From October 1971 to January 1972 a consultant assisted the Government in planning a nutrition survey. Based on his findings, he has recommended co-ordination of the activities of the Departments of Agriculture and Health in the production of food, nutrition education and development of pisc'~culture. He has also suggested that nutrition surveys should include the qualirative aspects of food. His other recornendations related to the collection of base-line data; environmental sanitation, treatment and prevention of parasitic infestation as essential measures for the promotion of better nutrition among the population, and inclusion in nutrition training programmes of administrators, superviscrs, teachers in all educational institutions, cornunity leaders and specialists in communication media. The recommendations of the consultant have been forwarded to the Government. SEA/RC25/2 Page 153

5. MALDIVES

PROJECT LIST

Project No. Source of Funds Co-operating Agencies

Maldives 0005 (4001) Public Health Administration R (Oct. 1959 - )

Aim of the proiect. To develop comprehensive health services, to train personnel, and to strengthen the medical care services.

Assistance provided by WHO during the vear. (a) A sanitarian, a laboratory technician, a consultant and a temporary adviser; (b) two fellowships - one for three months and one for six months - for study in India, a four-month fellowship for studies in Western Samoa and Malaysia, and four twelve-month fellowships(exrension) for study in India; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the vear. A WHO team consisting of a public health officer, a public health nurse educator, a malaria sanitarian, a general sanitarian and a laboratory technician,has been built up to assist in the planning and strengthening of health services, in the control of communicable diseases, and in the organization in Male of the two-year course for auxiliary nurse-midwives and health assistants. The curriculum for the training of health assistants was revised for better coverage of the health needs of the community. Malaria,tuberculosis, leprosy and filaria received the special attention of the health administration, assisted by WHO staff.

Beginning April 1972, the malaria control programme has been placed under a new project (see Maldives 0010).

Assistance was also provided by the assignment of a consultant to assess the situation with regard to leprosy and to advise on an effective control programme covering all the atolls. He also gave assistance with practical training for the national staff.

In May 1972, a WHO temporary adviser visited Male to hold discussions with the national authorities on the nature of assistance required for promoting dental health among the population.

Maldives 0007 (3001) Water Supply and Sanitation R (April 1971 - )

Aim of the project. To develop water supply and sewage disposal systems for Male and an environmental sanitation programme; to train staff.

Assistance provided by WHO during the vear. (a) Temporary assistance from a sanitary engineer assigned to another country; (b) supplies and equipment. SEA/RC25/2 Page 154

Probable duration of assistance. Until the end of 1976.

Work done during the year. The WHO sanitary engineer in Ceylon continued to assist with this project and submitted three reports. Following the Government's acceptance of the recommendations, a draft project document and a draft project description were prepared.

Under a contractual service agreement concluded with the Survey Department of Ceylon, a team of surveyors visited Male twice in 1972 for the execution of a close contour survey and the preparation of a contour map of Male. Assistance was given by the British Government in undertaking an aerial photography of this as well as Hulule Island, where an additional source of water for Male would be explored.

Water-level recorders, which were urgently required, were ordered and a detailed list of supplies and equipment was being worked out.

Maldives 0009 (6101) Training of Auxiliary Health Personnel UNDP (Nov. 1971; - )

Aim of the project. To establish a school for the training of auxiliary health personnel.

Assistance provided by WHO during the vear. Supplies and equipment.

Probable duration of assistance. A number of years.

Maldives 0010 (2001) Malaria Control (Jan. 1972 - )

Aim of the project. To eliminate malaria in progressive stages and to prevent its recurrence, and to develop and integrate malaria eradication programmes within the general health services.

Assistance provided by WHO during the vear. (a) A sanitarian; (b) supplies and equipment; (c) subsidy.

Probable duration of assistance. Some years.

Work done during the year. The plan of operation for malaria control in the Maldives was signed in April 1972. The plan envisages complete spraying of all inhabited islands by 1974, after which a review will be made for the further phasing of the programe. A WHO sanitarian was assigned to the project in April. Since 1966, nine atolls have been sprayed once with 2 grams DDT/~~.Two other atolls will be sprayed in 1972, thus bringing the entire population in atolls north of Male under insecticide protection.

During 1971, a total of 349 positive cases (343 in 1970) were detected, of which 271 were from Male Island, 32 from Kaaf Atoll and 46 from the other sprayed atolls. The majority of the positive cases (323) were imported from the unsprayed atolls. There were, however, 23 indigenous cases detected in Kashidoo Island in November 1971. Kashidoo Island, sprayed in 1966, remained free of anophelines until October 1971, when A. tesselatus was detected in experimental pits dug by the Food and Agriculture Organization for determining the salinity of the pit water for agricultural purposes. SEA/RC25/2 Page 155

Anophelines reappeared in three islands of Baa Atoll (sprayed in 1969) and two islands of Laviyani Atoll (sprayed in 1968). No active transmission has been reported in any of these islands, indicating the need for speeding up the introduction of spray operation in all inhabited islands so as to maintain the freedom from malaria.

The problem of the availability of sea-going transport remains, but this is likely to be solved in 1972,hen tvo engines will be provided for the "Golden Ray" SEA/RC25/2 Page 157

6. MONGOLIA

PROJECT LIST

Project No. Source of Funds Co-operat inK Agencies Title

Mongolia 0001 (1001) Strengthening of Health Services (Epidemiologyl R (July 1963 - )

Aim of the proiect. To undertake epidemiological surveys of prevailing cormnuni- cable diseases in order to plan practical control measures; to advise on the use of epidemiological methods, and to train personnel.

Assistance provided by WHO during the year. (a) An epidemiologist and a laboratory technician; (b) three eight-month fellowships for studies in Czechoslovakia, the USSR and Bulgaria; (c) supplies and equipment, including a transport vehicle.

Probable duration of assistance. Until the end of 1972.

Work done during the year. The WHO laboratory technician continued his activities and assisted the national staff in further strengthening the laboratory components of the epidemiological services. A WHO consultant visited the country early during the period under report and reviewed the epidemiological surveillance activities. He has submitted recommendations for the strengthening and further development of the epidemiological surveillance services in the country. His report has been forwarded to the Government.

The WHO medical officer left the project in August 1971.

Mongolia 0002 (4201) Public Health Laboratory Services UMlP (May - Aug. 1964; Dec. 1964; Aug. 1965; UNICEF 0ct. 1966 - Sept. 1968; Jan. 1969; May 1969; Sept. - Oct. 1969; Feb. 1970 - )

Aim of the project. To strengthen health laboratory services and to train personnel in medical laboratory technology.

Assistance provided by WHO during the year. (a) A microbiologist and a laboratory technician; (b) a twelve-month fellowship for studies in the USSR and Poland; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the year. With the active involvement of the Laboratory Council, the reorganization of laboratories in Ulan Bator is taking shape: the Central Clinical and Biochemical Laboratory, the counterpart of the Central Bacteriology Laboratory (CBL), has been established on the premises of the First Republic Clinical Hospital; the different bacteriology units at the Institute of Hygiene, Epidemiology and Microbiology (IHW), as well as clinical and chemical laboratories, have been unified under the respective chiefs; the CBL continues to provide diagnostic services to the polyclinics and hospitals and has been strengthened by the appointment of two microbiologists. In 1971,it provided 365 different types of tests and was involved in the processing of 77 449 samples. For the first SEA/RC25/2 Page 158

time, leptospira and meningococcus have been isolated from clinical cases. Service and reference assistance is being provided in specialized fields. The culture of tubercle bacilli is well under way and the Tuberculosis Laboratory has made further progress; sensitivity test has been introduced as a routine; a survey of staphylo- coccus carriers in maternal hospitals was made and 30 strains of Neissera Meningo- coccus were isolated from meningitis cases at Nalaich laboratory.

Special efforts continue to be made to step up the work at aimak laboratories. In this connection, the laboratories at Nalaich, Arvaicher, Chujurt, Charcharin and Tshitsherleg were visited, the work reviewed and guidance provided in the day- to-day work; laboratory notes in chemistry and microbiology are being distributed by the IHEM and similar notes are being prepared in syphilis serology; minimum criteria are bein8 spelled out and the need for equipment is being surveyed. A refresher course for bacteriological laborants at the IHEN has been organized.

The timetable and the syllabus of the Medical Technicum have been revised. As a result, the duration of the course has been reduced to two years and practical training has been given emphasis. Six physicians from aimak laboratories have completed specialized training in clinical chemistry and two courses of two months each were conducted in Ulan Bator for medical officers - one for 28 medical officers in clinical pathology at the CCBL and the other for 24 bacteriologists at the CBL.

Mongolia 0003 (1201) Tuberculosis Control UNDP (Dec. 1963 - Jan. 1964; Aug. 1965 - )

Aim of the project. To study the epidemiology of tuberculosis and to organize a national control programme.

Assistance provided by WHO during the vear. A consultant.

Probable duration of assistance. Until 1972.

Work done during the year. A WHO consultant, specialist in tuberculosis microbiology, visited the country in January-April 1972 to evaluate the microbiological aspects of the tuberculosis control programme. He has made recomendations for further strengthening and improving the laboratory work. His report was under study.

Mon~olia0004 (5101) Maternal and Child Health Services UNDP (June - Sept. 1965; Nov. 1966; July 1967 - ) UNICEF

Aim of the project. To develop maternal and child health services and to establish referral services.

Assistance provided bv WHO during the vear. (a) A maternal and child health officer; (b) four six-month fellowships - one for studies in the USSR. Bulgaria, and Czechoslovakia, one for studies in the USSR and Poland, one for studies in the USSR and Yugoslavia, and one for studies in the USSR, Bulgaria and Romania.

Probable duration of assistance. Until the end of 1980.

Work done during the year. The present activities and future developments related to maternal and child health were discussed at the annual meeting of the heads of the health services at aimak level. SEA/RC25/2 Page 159

The Second Children's Hospital in Ulan Bator with 50 beds, to serve as a teaching hospital for the nursing school, started functioning.

With the objective of training physicians in child health, training courses were conducted.

UNICEF provided supplies and equipment.

Mongolia 0005 (3201) Environmental Health (Cornunity Water Supply) UM)P (June 1966 - May 1968; Sept. 1968; Sept. 1969 - Jan. 1970; March 1972 - )

Aim of the proiect. To assist in the development of water supply and sanitation, particularly in rural areas.

Assistance provided by WHO during the year. (a) A consultant; (b) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the year. Pending the arrival of a regular WHO sanitary engineer, a consultant was assigned from March to May 1972 to assist in the preparation of designs of the modified project, including the sewerage system for principal buildings, lists of materials and equipment, and estimates of costs. The report containing the consultant's findings and recommendations was being processed for submission to the Government.

Efforts continued to recruit a WHO sanitary engineer for the project; he was likely to be in position by September 1972.

Mongolia 0006 (6201) Medical Education R (April - May 1970; Sept. 1970; Dec. 1970 - Jan. 1971; May 1971; July 1971; Dec. 1971; - )

Aim of the project. To develop further and improve medical education.

Assistance provided bv WHO during the year. (a) A ten-month fellowship for studies in the USSR, Federal Republic of Germany, Czechoslovakia and Poland, a six-month fellowship for study in the USSR, and a five-month fellowship (extension) for studies in the USSR and Hungary; (b) supplies and equipment.

Probable duration of assistance. A number of years.

Work done durin~the year. A staff meaber from WHO Headquarters visited the country to draft a government request for a large-scale UNDP project for the education and training of health personnel. This request has been submitted to the UNDP. Recruitment of a project co-ordinator was initiated, and a consultant in microbiology to assist in the teaching of the subject at the Institute of Medicine, Ulan Bator, has been selected.

Mongolia 0007 (4901) Health Statistics R (Aug. - Sept. 1967; Sept. 1968; Jan. - Sept. 1969; Jan. 1970; April - July 1971; April 1972 - )

Aim of the prolect. To develop health statistical services and to train personnel. SEA/RC25/2 Page 160

Assistance provided by WHO during the vear. (a) A consultant; (b) supplies and equipment.

Probable duration of assistance. Until 1975.

Work done during the vear. The main recowendations of the consultant provided in 1971 were directed towards strengthening the Health Statistics Unit in the Ministry of Public Health, establishing ways of co-ordination of statistical activities carried on by different health institutions at the central level, as well as improving the work of the Data Processing Unit at the Ministry of Public Health. The consultant's report has been forwarded to the Government.

The same consultant was recruited again in 1972 for a three-month assignment from April to assist in the further development and strengthening of the Health Statistics Unit in the Ministry of Public Health and the health statistics services at the intermediate and local levels. He was also helping in the revision of the data collection system in order to meet the requirements for statistical information for health planning, monitoring and evaluation of health programmes. In addition, assistance is being provided in the training of statisticians and health administrators at the national and local levels in healthhedical statistics.

Efforts were being made to locate a second consultant for a three-month assignment to assist the Data Processing Unit in the maintenance of statistical equipment and in training the staff.

Spare parts needed for the statistical equipment available in the Data Processing Unit were provided.

Mongolia 0008 (4401) Nursing Services and Education R (Dec. 1966; June 1968 - ) Aim of the project. To develop schools of nursing; to strengthen existing training programmes for nursing personnel, and to improve nursing services.

Assistance provided bv WHO during the vear. (a) Two nurse educators; (b) four twelve-month fellowships for study in Poland; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1977.

Work done during the vear. Emphasis continued to be placed on assistance to the training of nursing personnel of all levels. Both WHO nurses, until the departure in December on study leave of the senior nurse educator, continued to provide direct help in the development of the educational programme at the nursing school in Ulan Bator. Direct and indirect assistance was also given to the conduct of a number of short training courses for a wide range of qualified health personnel employed in the health services. These courses, which were conducted both in the capital and in aimak centres throughout the country, were directed mainly at increasing knowledge and skills in clinical patient care and the management of nursing services. Seminars for teachers(fe1dshers and tutor-nurses)were organized.

At the request of the Health Ministry assistance was given to the organization of nursing services at the new hospital at Horen. SEA/RC25/2 Page 161

Mongolia 0010 (8201) Cardiovascular Diseases R (May - June 1967; July - Nov. 1969; July 1970; ~ept.1970; March - April 1971; Oct. - Nov. 1971; - )

Aim of the Droiect. To study the epidemiology of certain cardiovascular conditions and to advise further on prevention and treatment with particular emphasis on streptococcal and hypertensive and ischaemic heart disease.

Assistance provided by WHO during the year. (a) Two six-month fellowships - one for studies in the USSR and Poland and one for studies in the USSR and Bulgaria; (b) supplies and equipment.

Probable duration of assistance. A number of years.

Mongolia 0011 (8101) Cancer R (May 1968; March - Aug. 1969; Aug. - Sept. 1970; Nov. 1970 - April 1971; March -April 1972; - )

Aim of the project. To study and advise on the epidemiology, early detection and treatment of cancer.

Assistance provided by WHO during the year. Two six-month fellowships for studies in the USSR and Bulgaria.

Probable duration of assistance. A number of years.

Mongolia 0012 (4301) Strengtheninp, of Radiological Services R (Nov. 1968 - Feb. 1969; April 1971 - )

Aim of the project. To train technicians to undertake the repair and maintenance of electro-medical equipment; to promote radiation protection practices in health institutions.

Assistance provided by WHO during the year. (a) A technical officer (electro- medical techniques); (b) two six-month fellowships - one for study in the USSR and one for studies in the USSR and Bulgaria.

Probable duration of assistance. Until the end of 1976.

Work done during the vear. A draft plan for the development of a workshop for electro-medical technical services was prepared.

A programme for the short intensive course for technicians working in the aimaks, prepared by the WHO electro-medical engineer, was accepted by the Ministry of Public Health.

The WHO technician also assisted in the development of a general plan for the installation of deep therapy Cobalt 60 equipment and for the construction of a beton pillbox.

The elctro-medical engineer, together with national staff, remounted a number of items of electro-medical equipment at the Workshop for the Maintenance and Repair of Medical Apparatus, as practical demonstration. At the Medical Technicum, he also gave lectures to the students of the third course to prepare them for better performance in the exploration of electro-medical apparatus, on some simple remounts and maintenance, and on diagnosing defects in cases of difficult remounts. SEAlRC2512 Page 162

He held discussions with the concerned officials of the Ministry of Public Health on the problem of safety in connection with the exploration of medical equipment. and made several suggestions in this regard. Draft rules and regulations concerning protection from radiation hazards were drawn up.

Discussions were held with Mongolian organizations on the problem of supervision of autoclaves and the safety of the electronic and electrical equipment in hospitals.

The counterpart of the WHO electro-medical engineer left for the USSR in the first quarter of 1972 on a WHO fellowship.

Mongolia 0013 (2801) Brucella Vaccine Production UNDP (May - July 1970; June 1972 - )

Aim of the project. To produce freeze-dried BruceZZa vaccine and establish laboratory facilities for its testing.

Assistance provided by WHO during the year. (a) A consultant; (b) supplies and equipment, including a transport vehicle and a centrifugal freeze-drier.

Probable duration of assistance. Until 1977.

Work done during the year. Pending his assignment as the project manager, an epizootiologist took up a short-term consultantship in June to assist the Govern- ment in drawing ip a plan of operation for the project, consisting of (1) the production of live Rev.1 EruceZZa melitensis vaccine, (2) quality control, (3) livestock immunization programme, (4) epizootiological studies, including tuberculosis, and (5) a fellowship programme for the training of national staff in the production and control of the vaccine.

A WHO microbiologist has been recruited and is expected to be in position shortly. He will assist the consultant in the planning and layout of the vaccine production laboratory and the central vaccine laboratory; he will also look aftcr the organization of the diagnostic laboratory and will assist in finalizing the list of supplies needed for the project.

Mongolia 0014 (4501) Health Education R (Nov. 1970; March 1971; Sept. 1971 - Jan. 1972; - )

Aim of the proiect. To develop and implement a health education programme.

Assistance provided by IJHO during the vear. (a) A consultant; (b) three two- month fellowships for studies in the USSR and Bulgaria.

Probable duration of assistance. Until the end of 1980.

Work done durinx the gear. During October 1971-January 1972, a consultant reviewed the existing health education services at the various levels of the health administration and in institutions and formulated short and long-range plans for improving these services, including training programmes. His main recornendations included developing a health education plan for the years 1971-1975; involving various Government departments such as those concerned with health, education, culture, internal affairs, home trade and public and nutrition, as well as communication media such as radio, television, cinema, newspapers and magazines, and also the Red SEA/RC25/2 Page 163

Cross, trade unions and youth organizations, in the health education programne. He has also suggested the operation of a project for creating model sanitary facilities.

The consultaot's report has been sent to the Government.

Mongolia 0015 (5501) Dental Health Services R (May - June 1970; Feb. 1972 - )

Aim of the proiect. To strengthen dental health services, particularly the paediatric stomatology services, train dental health personnel and study the feasibility of having a fluoridation programme.

Assistance provided by WHO duringthe year. (a) A consultant; (b) a four-month fellowship for studies in the USSR and Bulgaria.

Probable duration of assistance. A number of years.

Work done during the vear. In March 1972, a consultant took up a six-month assignment to advise on the organization and development of teaching and research in the new stomatological department at the Medical Institute, Ulan Bator.

Efforts to recruit a consultant in orthopaedic stomatology were made.

Mongolia 0016 (7401) Quality Control of Druas R (Feb. 1971; Sept. - Oct. 1971; - )

Aim of the proiect. To develop further the manufacture of pharmaceutical products and upgrade the services associated with their quality control, including the training of staff .

Assistance provided by WHO durin~the year. Two consultants.

Probable duration of assistance. Some years.

Work done during the year. Two consultants were assigned in September-October 1971 to advise the Government on methods of quality control and standardization of pharmaceutical and biological products and on improvement and further expansion of the pharmaceutical industry in Mongolia.

The reports containing the recommendations of the consultants were sent to the Government.

Integrated Maternal and Child Health Services (Sept. - Oct. 1971; - 1

Aim of the project. To develop integrated maternal and child health services and to establish referral facilities.

Assistance provided by WHO during the year. Two two-month fellowships for studies in the USSR and Bulgaria. SEAlRC2512 Page 164

Mongolia 0018 (2901) Epidemiological Services and Surveillance R (Jan. 1972; - )

Aim of the project. To develop further epidemiological surveillance of diseases representing major public health problems.

Assistance provided by WHO during the year. Supplies and equipment.

Probable duration of assistance. Some years.

Mongolia 0200 (6641) Fellowships R

Artificial circulation of blood. A six-week fellowship for study in Bulgaria.

Haemtolofiy. A four-month fellowship for studies in the USSR and Czechoslovakia.

Paediatrics. A four-month fellowship for studies in the USSR and Hungary.

Public health administration. Five fellowships - four for nine months and one for two months - for study in the USSR.

Sanitary engineering. A nine-month fellowship for study in Poland. SEA/RC25/2 Page 165

7. NEPAL

PROJECT LIST

Proiect No. Source of Funds Co-operatin?. Agencies

Nepal 0001 (2001) Malaria Eradication R (June 1954 - )

Aim of the project. To eradicate malaria.

Assistance provided by WHO during the year. (a) A malariologist, an epidemiologist, an entomologist, three sanitarians, a laboratory technician, an administrative assistant, a transport assistant and a clerk-stenographer; (b) a three- week fellowship for study in Japan and four one-month fellowships for study in the Philippines; (c) supplies and equipment, including three transport vehicles.

Probable duration of assistance. A number of years.

Work done during the year. The programme has progressed as planned. About 80% of the population is now in the consolidation phase. Two pilot projects on the integration of malaria within the general health services have been initiated, one in Kaski and one. in Bara.

Two independent reviews of the programme have been carried out so far, the first, which was a strategy review, in 1970, and the second in May 1972, the aim of which was to assist the Government with a suitable plan to maintain the gains already achieved in view of the reduced budget brought about by the termination of US AID assistance in 1972. This assistance had contributed a great portion of the malaria budget - 62% in 1970 and 56% in 1971.

In 1971, 2 778 positive cases were detected, compared with 2 090 in 1970; 561 of these were from consolidation (390 in 1970) and 2 217 (1 706 in 1970) from attack phase areas.

Spraying operations were improved in the hard-core areas and passive case- detection was developed through voluntary collaborators.

Nepal 0002 (4401) Nursing Education and Services UNDP (Nov. 1954 - ) UNICEF

Aim of the proiect. To assist the Directorate of Health Services in co-ordinating nursing activities; to set up a basic nursing school, organize courses for assistant nurse-midwives. upgrade nursing services in Bir Hospital; to improve clinical facilities for student nurses, and develop public health nursing services which will provide practice fields for nursing and assistant nurse-idvife students.

Assistance provided by WO during the year. (a) A nurse adviser and two nurse educators; (b) supplies and equipment.

Probable duration of assistance. Until 1974. SEAIRC2512 Page 166

Work done during the vear. Direct assistance continued to be provided to the following: (1) the nursing section in the Directorate of Health Services, (2) the School of Nursing, Kathmandu, (3) the auxiliary nurse-midwife training programes at Biratnagar, Bharatpur and Nepalganj, and (4) the development of public health nursing services, particularly where these services provide practice fields for nursing and auxiliary nursing students.

The work of the nursing section increased with more correspondence coming directly to the unit and more authority being delegated regarding nursing and midwifery services and personnel. An on-going record system of all nurses and auxiliary nurse-midwives in Nepal was established, as were similar records regarding Nepali nurses with post-basic preparation. The national nurse assigned to the section was awarded a WHO fellowship for advanced study in nursing at the degree level.

The educational programme at WG School of Nursing was improved with revision of course outlines in nutrition and diet therapy and better planning for and implementation of the programme for both faculty and curriculum development. An extensive recruitment tour of Narayani and Janakpur Zones was undertaken by the Superintendent of the School accompanied by the WHO nurse adviser. It is anticipated that the interest stimulated among high school students will result in better recruitment for future classes at the school. There was a steady improvement of the experience provided in the public health and clinical practice fields.

Problems continued to persist regarding the provision of adequate midwifery experience for the students from the Assistant Nurse-Midwife Schools located at Bharatpur and Nepalganj. It is hoped that this experience can shortly be provided at the home hospitals rather than in Kathmandu.

Recruitment of the WHO nurse who will fill the vacant post in the project and will assist directly the three ANN schools was completed. This nurse should be in position by August 1972.

Nepal 0008 (5101) Maternal and Child Health Services R (Dec. 1963 - Jan. 1968: Julv 1968:. May. - UNICEF 'sept. 1969; April - D~C.1970; - )

Aim of the project. To develop maternal and child health, including family planning services, to establish referral facilities and to conduct refresher and orientation courses for nurses and medical personnel at all levels.

Assistance provided by WHO during the vear. Supplies and equipment.

Nepal 0009 (1801) Smallpox Eradication* R (Feb. 1962 - Dec. 1963; Aug. 1966 - ) UNICEF

Aim of the project. To assist in the national smallpox eradication programme.

*Previous title: Smallpox Eradication and Control of Other Communicable Diseases. SEA/RC25/2 Page 167

Assistance provided by WHO during the year. (a) A public health officer, two operations officers, and assistance from a Headquarters consultant; (b) a three-

month~~ ~~ fellows hi^~. for studies in India. Indonesia. Ethiopia,. . Kenya and Tanzania; (c) supplies and equipment, including two transport vehicles; (d) subsidy.

Probable duration of assistance. Until 1975.

Work done during the year. Two hundred and fifteen smallpox cases were recorded in Nepal from 1 January to 31 December 1971. Since January 1972, all outbreaks have occurred in the two western zones of Seti and Bheri, where the eradication progranme was only initiated in December 1971. A vaccination programme and surveillance activities have been gradually extended throughout the country during the past three years. The programme has now been implemented in 87% of the country (58 districts out of 75) and 10 million persons have been vaccinated. The programme is now active in all districts except those in the northern, sparsely settled maintenance region. The surveillance aspect is gradually being strengthened. The reporting system has been improved, weekly smallpox reports now being received from the districts in addition to the telegraphic reports on the cases detected. A new system of active surveillance by senior vaccinators has been implemented in all districts covered by the progranme, and personnel working in the hospitals, health centres and malaria unit offices are now co- operating in reporting suspect cases. Pilot projects on the integration of health services in two districts of Gandaki and Narayani Zones are being conducted by the staff of the malaria eradication programme. This staff is carrying out smallpox vaccination and scar surveys, whilst the investigation and containment of reported outbreaks remain the responsibility of the SEP personnel.

An additional WHO operations officer was assigned to the project in May 1972 and is stationed in Kathmandu to supervise the Eastern Zone, while the other operations officer is now assigned to Lumbini Zone to assist the programme in the western region of the country. A WHO consultant visited the country in October 1971 to assess the programme, and the medical officer under the inter- country team (SEAR0 0030) also visited the project in 1972 and reviewed local problems with the national and WHO staff of the programme.

Plans were drawn up for implementing the necessary measures required for the better co-ordination of the Indian and Nepalese smallpox eradication programmes.

Nepal 0010 (4201) Health Laboratory Services R (May 1967 - ) UNICEF

Aim of the project. To develop health laboratory services, to support an epidemiological unit, and to train personnel.

Assistance provided by WHO during the year. (a) A microbiologist and a laboratory technician; (b) two fellowships - one for seven months (extension) and one for twelve months - for study in the United Kingdom and a six-month fellowship for study in India; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1979.

Work done during the year. The WHO microbiologist left the project in October 1971 after completing a four-year assignment, and his responsibilities have been taken over by the national counterpart. In his report, which has been sent to the Government, the microbiologist has emphasized the integration of all laboratories in Nepal into a national service and the need for establishing a minimum SEA/RC25/2 Page 168

of full-time professional and technical staff for the larger hospitals in Kath- mandu and in the selected zones. He has also stressed the importance of manpower training and the need to provide facilities in the country for the further basic and additional training of all laboratory technical staff.

The WHO technician has continued to conduct the courses for laboratory assistants at the Central Health Laboratory (CHL), Kathmandu. Since 1969, 26 laboratory assistants have completed training and have been posted in the main hospitals; 23 more trainees are at present attending the two-year course: 12 students in the first year and 11 in the second year. With a view to securing a good standard of work at the CHL and maintaining good performance in the course for technicians, four national technicians from the CHL have been awarded WHO fellowships in advanced laboratory technology and tutor training.

The CHL has extended community services in support of communicable-disease prevention, epidemiology and environmental health. In this connection, specimens of water are being checked for bacteriological and chemical quality; the investigation of the cholera outbreaks at Sagarmatha, Rajbiraj and Surasari areas has resulted in the isolation and identification of Vibrio choZera; the laboratory has assisted in a survey of the incidence of diphtheria in school children and in the processing of stool specimens received from the Infectious Diseases Unit of Bir Hospital for specific pathogens, including cholera. Arrangements are being made with the national malaria eradication programme for the training of malaria microscopists in laboratory technology.

The supply of rehydration fluids to cholera-stricken areas in the event of an outbreak continues to be a problem. In this regard, plans are in hand to establish, with UNICEF assistance, facilities for the production of rehydration fluid in four selected zonal hospitals. A consultant is being recruited to survey the facilities and advise on the implementation of the project and on the equipment required.

Nepal 0013 (1301) Leprosv Control R (March 1967; Dec. 1968; Sept. 1969; July 1970; May 1971; - )

Aim of the project. To develop leprosy control services and to train health personnel.

Assistance provided by WHO during the vear. A twelve-month fellowship for studies in the United States of America, Ceylon, India and Burma.

Probable duration of assistance. Some years.

Nepal 0016 (1201) Tuberculosis Control R (March 1965 - Sept. 1970; April - UNICEF May 1971; Feb. 1972; June 1972 - )

Aim of the project. To develop a tuberculosis control programme as part of the basic health services, and to train personnel.

Assistance provided by WHO during the vear. (a) A consultant; (b) a three-month fellowship for study in India, a three-week fellowship for studies in the Republic of Korea, Taiwan and India, and a seventeen-week fellowship for studies in Czechoslovakia. India and Ceylon; (c) supplies and equipment.

Probable duration of assistance. Some years. SEA/RC25/2 Page 169

Work done during the year. A WHO consultant was assigned to the project in June 1972 for about ten weeks to review the national tuberculosis control programme and to assist the Government in drawing up a plan to expand the programme from Kathmandu Valley to the rest of the country as an integral part of the general health services.

Health Education (May - Aug. 1967; Sept. 1968; Nov. 1968 - UNICEF Feb. 1969; Sept. 1969; April - May 1970; Julv 1970: Dec. 1970 - Jan. 1971: May 1971:

Aim of the ~rolect. To plan health education in the basic health services and special projects, and to strengthen health education in schools and teacher training institutions.

Assistance provided by WHO during the year. (a) A consultant; (b) a five-month fellowship for studies in India and the United Kingdom and a four-and-a-half- month fellowship (extension) for study in the United States of America; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1977.

Work done during the vear. A WHO consultant was provided to the project from July to September 1971. He worked closely with the health, education and panchayat ministries and undertook several important school health education activities. His main recornendations included a training programme for those who will be teaching health in accordance with the new curriculum at the National Vocational Training Centre and the College of Education; preparation of teachers to teach health during the 1972-1973 school year in Pokhara and Chitwan; designation by the Government of a health education specialist to serve in the Department of Education (Curriculum Development Section), and utilization of the curriculum developed for teachers and health workers. The report of the consultant has been sent to the Government.

Action was initiated for the assignment of the same consultant for a period of three months in 1972.

Nepal 0021 (4001) Development of Health Services R (Sept. - Nov. 1968; Jan. 1970 - )

Aim of the ~roiect. To strengthen the development of the basic health services in conformity with the development plans of the Government, placing particular emphasis on the training of all categories of health workers and eventually leading to the establishment of an integrated comprehensive health care service; to conduct health surveys, health manpower surveys and relevant studies; to co-ordinate associated projects operating in the country.

Assistance provided bv WHO during the vear. (a) Two medical officers, a public health nurse, a medical record officer and a consultant; (b) six fellowships - one for eight months for study in the United Kingdom, one for four months for study in India, one for twelve months for study in the United States of America, one for two months for studies in Indonesia, Malaysia, the Philippines and Thai- land, one for three months for studies in the United Kingdom, Yugoslavia and Israel, and one for six weeks for studies in India, Ceylon and Singapore. SEA/RC25/2 Page 170

Probable duration of assistance. A number of years.

Work done during the vear. The scope of the project was extensively broadened during the year in order to enable it to play the role of the central co-ordinating project for WHO assistance to Nepal.

A team consisting of a public health administrator, a public health officer, a medical record officer and a public health nurse has been assisting in the organization.and strengthening of the basic health services on the basis of the guidelines provided in the Fourth Plan (1970-75). A master plan of operation for comprehensive health services development in Nepal was signed by the Govern- ment, WHO and UNICEF. The project staff visited health offices, hospitals and health posts in Eastern, Western and Central Nepal to study the existing situation regarding available health facilities and to advise on their improvement. A simple reporting and recording system for health posts was developed. Two demonstration administrative areas, i.e., (1) Kaski District of Gandaki Zone, where the implementation of basic health services is being attempted through the utilization of malaria posts, and (2) Bara District of Naryani Zone, where basic health services are being developed through the already established health posts centred round the district hospital at Kalaiya, are being developed for the implementation of integrated comprehensive health care services and to serve as examples in the organization of cowunity health services. A plan of action for the Bara District pilot project was prepared. A survey of Bara District was carried out in order to assess the physical facilities available and to take an inventory of health posts and the Kalaiya hospital. Assistance was given in conducting a workshop for senior nurses at Bir Hospital, a health aides training course for staff working in the maternal and child healthlfamily planning programmes, a short course in public health nursing for nurses working in different community health areas, and a 15-day training programme for peripheral health workers at Parwanipur in Bara (attended by 90 workers of the malaria, family planning and smallpox programmes who are being converted into junior auxiliary health workers, as well as by 11 auxiliary health workers and 11 senior auxiliary health workers). Two manuals for junior auxiliary health workers were prepared and distributed to the participants in the Parwanipur course. An orientation seminar for the senior health personnel of Bara District was also held in connection with the integration of activities. Help was provided in the integration of maternal and child health and family planning activities in the health posts of Kathmandu Valley. A team of two consultant-architects (provided under SEAR0 0104) was assigned in May 1972 for a period of two months to assist the Government in the field of hospital design and planning.

Nepal 0025 (3001) Water Su~plyand Sewera~e in Greater UNDP Kathmandu and Bhaktapur (July 1969; Nov. 1970 - )

Aim of the Droiect. To prepare a plan for the development of water supply and sewerage in Greater Kathmandu and Bhaktapur.

Assistance Provided bv WHO during the vear. (a) A sanitary engineer for the review meeting (see below), a consultant and assistance from Headquarters. Regional Office and field staff; secretarial assistance; (b) two twelve-month fellowships - one for study in the Netherlands and one for study in the United Kingdom, and a six-month fellowship for study in Israel; (c) supplies and equipment.

Probable duration of assistance. Until 1973. SEA/RC25/2 Page 171

Work done during the year. The project,started in January 1971, maintained sufficiently good progress with full support from the Government and UNDP. The UNDP approved an additional expenditure in connection with two supplementary agreements concluded between the consulting firm and WHO - one in October for engaging a driller, and the other in December to cover additional mapping requirements.

hring the period under report, the activities were related to the investigation of groundwater sources - five holes were drilled and tested. The field studies of surface water were almost complete and routine flow and meteorologi- cal measurements were continued. The work on sector study was 80% complete, and in that connection field visits to thirteen centres were made. In regard to the master plan for water, draft reports of demand projections and construction costs were prepared. A preliminary study of possible schemes was under way, and the master plan (water) studies were 70% complete. The work on the master plan (sewerage) continued as planned. The prograrmne on "Immediate Works" maintained satisfactory progress, and a draft preliminary engineering report for Lalitpur, as well as the surface water possibilities for Bhaktapur, was drawn up. The survey of the distribution system continued as scheduled and most of the field work was completed.

The Government's views on the sub-contractor's interim report were received reflecting its acceptance in principle of the establishment of an autonomous organization to deal with water supply and sewerage facilities in Kathmandu Valley on a trial basis.

A mid-term review meeting was held in Kathmandu in April to make a periodic evaluation of the overall development of the project. Representatives from the World Bank and UNDP also participated in the meeting. From the discussions it appeared that there might not be any need for the feasibility studies which had been planned for the second phase of the project, and that it would be possible to switch over to the preparation of the final engineering designs for the whole project area. The World Bank displayed keen interest in the project. A detailed report on the mid-term review was being processed in collaboration with UNDP, for submission to the Government in due course.

Equipment ordered for the project was received and put to use. Requirements for additional equipment were assessed, and procurement action was initiated.

Nepal 0026 (1001) Strengthening of E~idemioloaicalServices R (April - July 1970; Feb. -May 1972; - )

Aim of the proiect. To establish an epidemiological unit in the Directorate of Health Services and to train personnel in epidemiology.

Assistance provided bv WHO durinn the vear. (a) A consultant; (b) supplies and equipment, including a transport vehicle.

Probable duration of assistance. Until 1972.

Work done during the vear. Early in 1972, a WHO consultant reviewed the development of epidemiological services in the country as well as epidemiological problems of public health importance. His report has been submitted to the Government. SEAIRC2512 Page 172

Nepal 0029 (3002) National Community Water Supply and Sanitation R (Jan. 1971 - ) UNICEF

Aim of the protect. To plan, organize and administer a national environmental health programe and, more specifically, to provide technical guidance in the strengthening of the Sanitary Engineering Bureau of the Department of Irriga- tion and Water Supply of the Ministry of Irrigation and Power; to assist the government agencies concerned in the planning, organization and implementation of a long-term comprehensive national programme of cormunity water supply and waste disposal.

Assistance provided bv WHO during the vear. (a) A sanitary engineer; (b) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the vear. The plan of operation of the project was signed in August, and the programme proposals and budget estimates for the years 1971, 1972 and 1973 were prepared and approved.

The WHO sanitary engineer, assigned to the project since January 1971,visited five of the seven sites selected for water supplies to reassess the situation and to assist in the preparation of plans for local construction. With the transfer of the community water supply programme to the Department of Local Development. Ministry of Home and Panchayat, three regional headquarters were set up - at Birat- nagar, Butwal and Nepalganj. These are manned by engineers who, in addition to the overall community water supply programe, will be responsible for the construction activities carried out by the Department of Local Development. Construction work on all the seven schemes started, and 18 volunteers from various agencies were on active duty.

Under Phase 11, more than 60 per cent of the newly proposed sites were re- surveyed and estimated. A list of supplies and equipment, covering 30 schemes and 80 hand wells, was prepared and submitted to UNICEF.

The PVC pipes ordered by UNICEF for the water supply schemes arrived in Kathmandu.

Nepal 0200 (6641) Fellowships

Biochemistry. An eighteen-month fellowship for study in India.

Nursing. Two twelve-month fellowships for study in New Zealand.

Nursing administration. Two twenty-fourmonth fellowships for study in India. SEA/RC25/2 Page 173

8. THAILAND

PROJECT LIST

Proiect No. Source of Funds Co-operatin?. -Title

Thailand 0002.2 (4001) Strengthening of Health Services (Integration UNDP of Specialized Programesl

UNICEF (Jan.. 1964 - Dec. 1968:~ ~ Feb. 1969: Julv - Sept. 1970; June 1971; Dec. 1971 - )

Aim of the proiect. To promote the integration of specialized communicable- disease control progranmes into the general health services.

Assistance provided by WHO during the vear. (a) A consultant; (b) a two-month fellowship for studies in Denmark, Norway, the Netherlands, the United Kingdom Czechoslovakia, Yugoslavia, Turkey and India, a three-month fellowship for study in the United Kingdom, and two three-week fellowships for studies in the Republic of Korea, Taiwan and India.

Work done during the year. A WHO consultant took up a six-month assignment in December 1971 to assist the Government in reviewing the national tuberculosis control programme and to make recommendations for the further development of the activities within the integrated prograorme of the general health services in the country.

Thailand 0030 (1301) Leprosy Control R (Oct. 1955 - ) UNICEF

Aim of the project. To expand and intensify the leprosy control programme to cover all endemic areas; to train personnel.

Assistance provided by WHO during the vear. A leprosy control officer.

Work done during the year. The WHO leprosy control officer left the project in October 1971 on completion of his assignment. The activities have been integrated into the project Thailand 0098, Health Planning Administration.

A WHO consultant (leprologist) was assigned in March 1972 (under project Thailand 0059) to review the leprosy control activities in certain areas and to make recornendations for the integration of the control programe into the general health services.

Thailand 0037 (4901) Vital and Health Statistics R (Aug. 1957 - July 1959; Oct. 1959 - April 1960; Nov. 1968 - Jan. 1969: Feb. - Oct. 1971; Dec. 1971; - )

Aim of the project. To develop a co-ordinated health statistics system and to train the staff required for this purpose and for the development of medical records. SEA/RC25/2 Page 174

Assistance provided by WHO during the year. (a) A consultant; (b) a twelve-month fellowship for study in Australia.

Probable duration of assistance. Until the end of 1974

Work done during the year. The consultant (statistician) assigned to the project in February 1971 (mentioned in the last report) left in October. He studied the availability, degree of completeness and reliability of the existing statistical data and the system of obtaining them. In this report, which has been sent to the Government, he has made many useful recommendations aiming at simplification of the existing system of medical recording and reporting, especially in rural health centres.

Steps were being taken to recruit a statistician to assist and advise on the collection and use of health statistical data for health planning and monitoring of health programmes, as well as on the application of modern statistical techniques to the planning and evaluation of public health programmes.

Thailand 0038.2 (6402) School of Public Health. Bangkok R (Dec. 1966 - Jan. 1967; June - Sept. 1967; Dec. 1967 - March 1968; June 1970; Dec. 1971)

Aim of the project. To plan, study and advise on the various courses in the School.

Assistance provided by WHO during the year. A twelve-month fellowship (extension) for study in the United States of America.

Thailand 0057 (6301) Faculty of Tropical Medicine R (Aug. - Sept. 1959; June - Aug. 1961; June 1962; June - July 1963; Jan. - Dec. 1964; Jan. 1967; Aug. 1967; July 1968; June - Dec. 1969; May 1970; July - Sept. 1970; Dec. 1970; March - June 1971; Dec. 1971; - )

Aim of the proiect. To continue to strengthen the Faculty of Tropical Medicine of Mahidol University.

Assistance provided by WHO durine the year. A twelve-month fellowship (extension) for study in the United Kingdom.

Probable duration of assistance. Until the end of 1973.

Work done during the year. A consultant in clinical chemistry was under recruitment for the Faculty of Tropical Medicine, Mahidol University, Bangkok.

Thailand 0059 (1001) Epidemiology R (Oct. 1966; Dec. 1966 - Aug. 1967; July 1968; UNDP Aug. 1969; May - June 1970; June - Sept. 1971; Nov. 1971; Jan. 1972; March 1972 - )

Aim of the proiect. To organize and strengthen a national epidemiological service, undertake studies of specific health problems,and train personnel.

Assistance provided by WHO during the vear. (a) Five consultants; (b) a six-month fellowship for studies in the USSR and India, and a three-month fellowship for study in India. SEA/RC25/2 Page 175

Probable duration of assistance. A number of years.

Work done during the year. A WHO consultant (epidemiologist) visited the project twice - in January and June 1972 - to advise the Government on the further development of epidemiological services according to the plan of action. The report on his first visit has been sent to the Government.

Another consultant visited the country in August-September 1971 and again in May-June 1972 and assisted the Government in cholera carrier studies and surveys of diarrhoea1 diseases carried out so far.

A third WHO consultant, recruited under this project, was helping with the Integration of leprosy control programmes into the general health services (see also Thailand 0098).

Thailand 0065 (2001) Malaria Eradication R (Jan. 1962 - )

Aim of the project. To eradicate malaria.

Assistance provided by WHO during the year. (a) A malariologist, an entomologist, a scientist (technical officer), three sanitarians and a translator-typist; (b) twenty fellowships - ten for two weeks, eight for three weeks and two for two months - for study in the Philippines; (c) supplies and equipment; (d) subsidy.

Probable duration of assistance. A number of years.

Work done during the year. The Government's plan of action for the period 1970- 1977 is being implemented as planned. Withdrawal of spraying, based on the recommendation of a national team in 1972, has resulted in the following phasing: attack phase 10.018 million, and consolidation phase 26.167 million.

In areas of low transmission the responsibility for case-detection has been gradually taken over by the general health services. Spraying in problem areas has been augmented by multi-purpose teams assigned to look for and spray struc- tures in remote and forested areas.

The study on A. 1iciLubiiucnsis in Wangtong District continues and the area will be sprayed in 1972.

The malaria case incidence is on the increase. The reported number of positive cases in 1971 was 133 999, compared with 85 664 in 1970. Most of the positive cases were from areas in the attack phase.

The training centre at Prabudhabat is being strengthened by the provision, by WHO, of adequate training material and transport. It is envisaged that this centre will train all the national malaria workers as well as those in the integrated health services.

A number of senior national supervisory posts are vacant owing to resigna- tions, transfers or retirement.

Thailand 0066 (3601) Food Control Administration R (Aug. - Oct. 1964; Feb. - April 1971; Oct. 1971; - )

Aim of the project. To assist the Department of Medical Sciences, Ministry of Public Health, in establishing a national food control administration and in training staff in food control. SEAlRC2512 Page 176

Assistance provided by WHO during the year. A seven-month fellowship for study in the United Kingdom.

Probable duration of assistance. Until 1976.

Thailand 0067 (4701) Radiation Protection Services R (April - May 1963; Feb. - March 1965; Nov. - Dec. 1965; Dec. 1966 - Feb. 1967; Nov. 1967 - Feb. 1968; Feb. - May 1969; July 1969; Sept. - Dec. 1969; April - June 1970; Sept. 1970; July 1971; - )

Aim of the project. To establish a radiation protection service in the Department of Medical Sciences, Ministry of Public Health, and to train staff.

Assistance provided by WHO durinp, the year. (a) A two-month fellowship (extension) for study in the United Kingdom; (b) supplies and equipment.

Thailand 0070 (1002) Vector-Borne Disease Control R (June 1963; June 1964; March - May 1965; June 1967; Dec. 1968; Feb. 1970; Sept. 1971; - )

Aim of the proiect. To assist the Department of Medical Sciences in training staff in medical entomology and vector-borne disease control.

Assistance provided by WHO during the year. A three-month fellowship for study in the United Kingdom.

Thailand 0071 (4301) School for Medical Radiography UNDP (Jan. 1965 - )

Aim of the proiect. To train radiographers.

Assistance provided hv WHO during the year. (a) A radiography tutor; (b) a twelve- month fellowship for study in the United Kingdom; (c) supplies and equipment.

Probable duration of assistance. Until 1972.

Work done during the year. In the training programme at the School of Medical Radiography, Ramathibodi Hospital, Bangkok, which continued satisfactorily, the academic year for the first and second-year students ended with examinations for all students undergoing the course. During the year 38 radiographers graduated, and all of them found suitable employment. Thirty-three trainees were in the second year and 42 in the first year of training. Twenty-six candidates trained in diagnostic radiography and five in radiotherapy and nuclear medicine met the required standards. A total of 31 candidates formally graduated in 1972.

For the fourth course of training, 40 candidates were admitted in June 1972, and out of them 25 were selected from the provinces for eventual service there.

A two-year diploma course was started in September 1971 at Siriraj Hospital with an initial intake of 25 students for training in radiography.

The tutor-Principal of the School returned to his duties in late September after one year's training in post-graduate teaching at the Middlesex Hospital, London, thus further augmenting the teaching and supervisory strength of the School. SEA/RC25/2 Page 177

Two members of the teaching staff acquired the diploma qualification from the Society of Radiographers of the United Kingdom.

Additional X-ray equipment was put into commission in the Department of Radiodiagnosis, bringing the number of units available for the students' practical training to ten.

The technical operation of the Department of Radiodiagnosis, which provides the bulk of the training in practical radiography at the School, was reviewed, modified and reorganized to meet an ever-expanding workload. The post-graduate training and experience which the superintendent radiographer gained overseas on a WHO fellowship has proved invaluable in this task. The theoretical and practical training activities of the School continue to benefit from the increasing utilization of new teaching aids and methods.

Information regarding radiographer training, staffing patterns and the possibilities of formal registration of radiographers in Thailand was compiled and submitted to the Government for consideration. Preliminary steps were taken for the formation of a Society of Radiographers in Thailand.

Thailand 0075 (4201) Strengthening of Laboratory Services R (April - May 1968; March 1969; Sept. 1969; UNICEF Oec. 1969: March 1970; Oct. - Dec. 1970; May 1971; Aug. 1971; Oct. 1971; June 1972; -

Aim of the project. To organize national health laboratory services; to strengthen the teaching of laboratory sciences and the training of medical laboratory technology.

Assistance provided by WHO during the year. (a) A consultant and a temporary adviser; (b) a twelve-month fellowship for study jn the United Kingdom.

Probable duration of assistance. Until 1977.

Work done during the vear. A WHO ten'porary adviser who visited the project in October 1971 conducted a survey of the need for small laboratory animals and studied the feasibility of establishing a national breeding centre for mice, rats, hamsters, guinea pigs and rabbits. He has suggested that the land available at Saraya, Mahidol University, could be used for establishing this centre. On the basis of the adviser's recommendations, the Government has requested UNDP assistance for the implementation of the project. The adviser's report has been sent to the Government.

A consultant visited the project in June 1972 to prepare the plan of action for the development of national health laboratory services in Thailand. Efforts were being made to recruit a microbiologist to asslst with the long-term implementation of thc project.

Fellowships were awarded to four candidates in different subjects: imunology and immunochemistry, enterobacteriology, blood banking and clinical chemistry.

Thailand 0079 (7401) Quality Control of Pharmaceutical Preparations R (May 1970; Sept. 1970 - )

Aim of the project. To strengthen legislation and laboratory competence in the quality control of pharmaceutical preparations and train drug analysts and drug inspectors. SEAlRC2512 Page 178

Assistance provided by WHO durinp, the vear. (a) A pharmaceutical chemist; (b) a three-month fellowship for studies in Switzerland, the United States of America and Hong Kong; (c) supplies and equipment.

Probable duration of assistance.Unti1 the end of 1976.

Work done during the vear. Extensive notes were prepared on assay design and calculation procedures in connection with the strengthening and development of the pharmaceutical laboratories of the Department of Medical Sciences (Division of Drug Analysis). These notes are intended for use in the laboratories now and also for teaching purposes in the analysts' training courses.

Inspectors were assigned to work with the WHO pharmaceutical chemist for the development of procedures for factory inspection. This team visited a number of factories and developed inspection guidelines which are in use now.

The procedure of fact-finding visits to factories was replaced by a fact- finding questionnaire which was sent to the various factories.

A Seminar on the Code of Good Manufacturing Practice was held from 20 to 25 September 1971; it was sponsored by the Druggists Association and intended for factory owners and pharmacists. The second seminar on the subject was held from 6 to 11 March 1972, attended by 122 participants from 72 companies.

On product registration, in the absence of any guidelines issued by WHO, a proposal was made at the second Seminar on the Code of Good Manufacturing Prac- tice that the Druggists Association should set up its own guidelines as part of the code of professional practice. The application of such a voluntary code would ease the task of the registration section and enable it to deal more efficiently with applications for licences.

Supplies and equipment provided by WHO were received.

Thailand 0081 (3004) Water Pollution R (Dec. 1966 - Jan. 1967; Oct. 1967; Sept. - Oct. 1968; Jan. 1969; May 1969; Aug. 1969; Oct. 1969; Jan. - Feb. 1970; April 1970; June 1970; Nov. 1970; Jan. 1971; Sept. - Oct. 1971; - )

Aim of the protect. To provide technical advice on organizational and othez problems related to the prevention and control of water pollution.

Assistance provided bv WHO during the vear. A nine-month fellowship (extension) for study in the United Kingdom and a six-month fellowship (extension) for study in the United States of America.

Thailand 0082 (1101) Venereal-Disease Control R (Feb. - Aug. 1967; Oct. - Dec. 1967; May 1969; Aug. 1969; Jan. 1970; Nov. 1970; July 1971; Nov. 1971 - Jan. 1972; April 1972; - )

Aim of the project. To control venereal diseases and to train staff in the clinical and laboratory aspects. SEA/RC25/2 Page 179

Assistance provided by WHO during the year. (a) A consultant; (b) a four-week fellowship for study in the United States of America and a six-month fellowship for studies in the United Kingdom and Denmark.

Probable duration of assistance. Until 1974.

Work done during the year. During November 1971-January 1972 a WHO consultant reviewed the national venereal-disease control programme and made recommendations for further strengthening the activities in order to meet the danger of the spread of venereal diseases. On the basis of the consultant's findings steps were taken to provide a further consultant (venereologist) and a laboratory technician to assist in the improvement of laboratory methods in diagnosis. The consultant's report has been sent to the Government.

Thailand 0086 (5501) Dental Health R (Jan. 1967; Nov. 1967 - April 1968; April 1969; Aun. 1969 - July 1970; Feb. 1971; April 1971;

Aim of the project. To improve dental services anti to train dental health personnel.

Assistance provided by WHO during the year. Five one-week fellowships for study in Malaysia.

Probable duration of assistance. Until the end of 1974.

Thailand 0089 (4401) Nursing Education and Services R (Jan. 1968 - )

Aim of the ~roiect. To study nursing needs and resources; to strengthen nursing services and education; to develop university-level courses for nurses, and to organize and conduct studies related to nursing services and education.

Assistance provided by WHO during the year. (a) A nursing adviser, a public health nurse and an adviser in psychiatric nursing; (b) five twelve-month fellowships for study in New Zealand and three fellowships - one for twenty-four months and two for twelve months (one of which was an extension) - Lor study in the United States of America; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the year. The WHO nurse adviser, the WHO public health nurse and the WHO nurse educator (psychiatric nursing) all completed their assignments during the year under review. The second WHO nurse educator proceeded on study leave. Thus there were no WHO staff in the project after January 1972.

Before the departure of the WHO staff work was completed on the draft of the report on the "Study of the Activities of Health Personnel in Health Centres in Thailand". This repor t was being processed.

The Department of Nursing, Faculty of Education, Chulalongkorn University, enrolled thirty-two students in the post-basic degree programme. The WHO nurse educator (psychiatric nursing) continued to give assistance to this school until her departure in early January 1972. She also continued to assist in the upgrading of nursing services and education at the Somdet Chao Phraya Hospital. SEA/RC25/2 Page 180

Regional Office staff participated with WHO and national staff in Thailand in planning for the future operation of the project. It was agreed that priority in assistance should be directed towards the development of the educational programmes for nurses at the Faculty of Nursing, Khon Kaen University, and the Department of Nursing Education, Chulalongkorn University. Other elements providing assistance to special programmes such as central sterile supply units would be developed within the project as the need arose. An agreement was completed between the Government and the Canadian University Services Dverseas for the assignment of four CUSO nurses to participate with WHO and national staff in the implementation of the project.

It is expected that the two full-time WHO staff who will assist with the revised project will be in position in the latter half of 1972.

Thailand 0090 (3001) 1 UNDP Sewerage and Pollution Control UNICEF (Jan. 1969 - )

Aim of the project. To plan, organize and administer a national environmental health programme and, more specifically, to provide technical advice and guidance for the expansion of the national community water supply and other environmental health programmes.

Assistance provided by WHO during the year. (a) A sanitary engineer and two consultants; (b) two twelve-month fellowships - one for studies in the Nether- lands and one for studies in the United States of America; (c) supplies and equipment.

Probable duration of assistance. Until the end of 1976.

Work done during the vear. Since the start of the programme, 269 water systems have been completed in various parts of the country. Plans were dram up for the construction of a total of 46 schemes during the fiscal year which started in October 1971. The five-year plan for the community water supply programme was approved. The WHO personnel of the project assisted a World Bank team in its sector study on the community water supply programmes in Thailand.

A consultant was assigned during November-December 1971 to assist in the operation and maintenance of water supply schemes. His report has been sent to the Government. Another consultant, who had been provided in May 1971 (mentioned ill the last report) to assist with the conhnunity water supply programme,compLeted his assignment at the end of June 1972.

The working regions of the Division of Sanitary Engineering were increased from four to seven - two in the north, two in the north-east, two in the centre and one in the south. Nine waterworks in Khon Kaen and Kalasin Provinces were selected for the establishment of a pilot project for preventive maintenance of water supply systems. UNICEF agreed to include the necessary spare parts for the maintenance of water schemes in their 1973 assistance programme.

Pipes and chlorinators received from UNICEF were despatched to the project site. About 70% of the sewerage work connected with the Khon Kaen Hospital was completed.

A pilot well-drilling project for jetting small-bore deep wells was approved and incorporated into the programme for rural school water supplies of the Community Health Development Division of the Department of Health. Funds were made available for the materials for three jet rigs and for fabrication of the drill rigs at the mechnical workshop in Korat. SEA/RC25/2 Page 181

Assistance was given to the Provincial Water Supply Division of the Depart- ment of Public and Municipal Works in conducting a feasibility study on the Khon Kaen sewerage system.

An interim programme, dram up for the village well pump maintenance, envisaged the replacement of worn cups and broken parts on well pumps in five selected provinces. In the long-term prograrmne, the pumps would be serviced annually in every province. A study was being made to explore a viable substi- tute for the present Thai standard, gear actuated "Korat" pump.

The Cho Buri Health Training Centre was assisted in designing a sewage system in which sewer lines would collect the waste water and deliver it to the stabilization ponds for treatment.

Thailand 0093 (4801) Medical Rehabilitation R (Oct. 1968 - )

Aim of the project. To develop rehabilitation services in selected hospitals in the provinces and in Bangkok, and to train staff.

Assistance provided by WHO during the year. (a) A physiotherapy tutor; (b) two fellowships - one for six months (extension) and one for twelve months - for study in the United Kingdom, and two one-week fellowships for a study tour of Singapore.

Probable duration of assistance. Until the end of 1973.

Work done during the year. The WHO physiotherapy tutor undertook a tour of 13 hospitals in the populous north-eastern provinces. The concept of the prevention of disability by simple bed-side measures was promoted and the equipment and layout of prospective physical treatment departments in four major hospitals discussed

In Bangkok, at the Lerdsin General Hospital, the physical treatment of patients in the hospital wards has continued to increase. The top floor of the physical treatment building was cleared and an occupational therapy unit was established.

Difficulties were experienced in recruiting physiotherapists for hospital posts outside Bangkok.

Physiotherapy units were established at several provincial hospitals in Thailand.

From the students due to graduate in April 1972, 7 have expressed willing- ness to work in pro~incialhospitals.

Thailand 0095 (6401) Education in Public Health R (Dec. 1968 - Jan. 1969; Oct. - Nov. 1969; Jan. 1970: Nov. 1970: Dec. 1971 - Jan. 1972; March - May 1972; - )

Aim of the proiect. To assist the Faculty of Public Health, Mahidol University, in further developing its teaching and training programmes.

Assistance provided by WHO during the year. (a) Two consultants; (b) three five- month fellowships (extensions) for study in Israel.

Probable duration of assistance. Some years. SEA/RC25/2 Page 182

Work done during the vear. In December-January, a consultant reviewed the nutrition training courses at the Faculty of Public Health, Bangkok, and recommended that the institutions engaged in the training of medical and paramedical personnel in nutrition should define the role of the health services in the improvement of the nutritional status of the community. The experience and organizational network needed for the integration of nutrition into the cornunity health services, field experience in nutrition training integrated with other public health activities, and exchange of information with the other nutrition programmes in the country are to be examined by these institutions. The type of personnel to be trained at various levels to undertake responsibility for training is to be decided upon. Field training, exchange of information and co-ordination in research were recommended as essential for a successful nutrition training programme in Thailand. The report of the consultant has been sent to the Government.

Another consultant was assigned for a period of two months in 1972 to review the existing state of occupational and industrial health and to assist the Ministry of Public Health and the Faculty of Public Health in determining the needs and priorities for staff training and programme development.

Thailand 0097 (6201) Medical Education and Training R (May 1971 - )

Aim of the project. To develop further the teaching and training programes of the existing four medical faculties at Chiengmai, Chulalongkorn and Mahidol Universities, including the Faculty of Post-graduate Studies of the latter, and to plan the Faculty of Medicine at Prince of Songkhla University.

Assistance provided bv WHO durinR the vear. (a) Three consultants; (b) three fellowships - two for twelve months and one for three months - for study in the United Kingdom, two fellowships - one for twelve months and one for three months - for study in the United States of America, a two-month fellowship for studies in Taiwan, the Philippines, Singapore and Malaysia, a three-month fellowship for szudies in Denmark, the United Kingdom and the United States of America, a three- month fellowship for studies in the United Kingdom, Federal Republic of Germany and France, a three-month fellowship for studies in Singapore, Malaysia, the Philippines, Taiwan and Korea, a five-week fellowship for studies in Taiwan and the Philippines, a four-month fellowship for study in Japan, a two-month fellowship for studies in Taiwan, Singapore and Malaysia, and a two-month fellowship for studies in the Netherlands and the United Kingdom.

Probable duration of assistance. Some years.

Work done during the year. During July-August 1971, a consultant was assigned to the Faculty of Graduate Studies, Mahidol University, to advise on residency training programnes. His report has been sent to the Government.

A team of two consultants was provided to the Faculty of Medicine and Siriraj Hospital, Mahidol University, to advise on the further development of undergraduate medical education. In the course of their assignment, which lasted from December 1971 to January 1972, the consultants also visited the other three medical schools in the country and held a one-week workshop on educational methodology, which was attended by teachers from all medical schools. The report containing the consultants' recommendations has been forwarded to the Government.

A consultant in virology was expected to take up his assignment at the Faculty of Medicine, Chiengmai University, early in July. SEAIRC2512 Page 183

Thailand 0098 (4101) Health Planning sdAdministration R (Oct. 1970 -

Aim of the proiect. 1'0 assist in national health planning and in health administration, on a broad basis, with primary emphasis on the phased integration of disease-control and special health programmes, eventually leading to the development of a comprehensive health care service in the country.

Assistance provided by WHO during the year. (a) A public health administrator; (b) nine six-week fellowships for studies in the United States of America, Venezuela, Brazil, Ethiopia, the USSR, India, WHO Headquarters and the Regional Office, a four-month fellowship for study in the United States of America, a three-month fellowship for study in the United Kingdom, a twelve-month fellowship for study in the United States of America (extension), a twelve-month fellowship for study in Israel and a five-month fellowship for studies in the United Kingdom, Czechoslovakia, India and Ceylon; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done durina the year. A long-term WHO public health administrator was assigned in December to assist in national health planning and health administration, with primary emphasis on the phased integration of disease-control and special programmes, eventually leading to the development of a comprehensive health care service in the country. The consultant provided under project Thailand 0059 was also assisting with integration, with particular reference to leprosy control activities.

Assistance was given in a study of the activities of health personnel working in health centres covering three categories of personnel (doctors, health workers and nursing personnel) in six districts with a view to obtaining basic information needed for planning future health services in rural areas.

Thailand 0105 (7701) Production of Biolo~icals R (June 1971; April 1972; - )

Aim of the project. To assist the Department of Medical Sciences and the Govern- ment Pharmaceutical Organization in (i) building up capacity in the production of vaccines and sera, (ii) testing the sera and vaccines, and (iii) preparing national standards and reference reagents for vaccines and sera.

Assistance provided by WHO during the year. Two six-month fellowships - one for study in the United Kingdom and one for studies in India and Denmark.

Thailand 0106 (4302) Improvement of Anaesthesiology R (July 1971 - )

Aim of the proiect. To assist the University of Maltidol in developing training programmes in anaesthesiology.

Assistance provided by WHO during the year. (a) Two consultants; (b) a four-week fellowship for studies in Denmark and the United Kingdom; (c) supplies and equipment.

Probable duration of assistance. Until 1973.

Work done during the year. Two WHO consultants in anaesthesiology were assigned - one in the last quarter of 1971 and the other early in 1972 - to the Faculty of SEA/RC25/2 Page 184

Medicine, Siriraj Hospital, Mahidol University, to assist in developing a national training centre in anaesthesiology. The report of the first consultant was sent to the Government, and that of the other consultant was under study.

These sequential assignments, which will continue, are part of a long-range plan drawn up in collaboration with the WHO-supported Anaesthesiology Centre, Copenhagen, where a number of national staff have been trained since 1950. The plan was developed after the visit of a consultant team in 1969 under an inter- regional project (IR 283).

Thailand 0107 (8301) National Institute of Dermatology R (Feb. - March 1972; - ) Aim of the project. To establish a national institute of dermatology which will provide facilities for diagnosis, treatment, research and training.

Assistance provided bv WHO durinn the year. A consultant.

Probable duration of assistance. Until 1975.

Work done during the vear. A WHO consultant was assigned to the project in February-March to assist in the planning of the National Institute of Dermatology, Bangkok. The consultant reviewed the current problems in dermatology and helped in the formulation of a research programme. His assignment report has been sent to the Government.

Thailand 0108 (5502) Phvathai School of Dentistry R (March 1971; Sept. - Oct. 1971; - ) Aim of the project. To establish a new School of Dentistry as part of Mahidol University and to train staff of the Chiengmai Medical College.

Assistance provided by WHO during the year. (a) A consultant; (b) a twelve-month fellowship for study in the United States of America.

Probable duration of assistance. Until the end of 1974.

Work done during the vear. During September-October 1971, a consultant advised the Government on planning a curriculum in dental education and on the teaching methodology to be adopted at the newly established Phyathai School of Dentistry. His main recommendations concerned the setting up a division of dental health in the Ministry of Public Health, the holding of pre-admission tests for entrance to dental colleges, introduction of a community-oriented curriculum for training of dental health personnel, and improvements to the Phyathai School of Dentistry. The report containing these and other recommendations has been sent to the Govern- ment.

Thailand 0109 (4702) School for Medical Phvsicists UNDP (Jan. 1971 - ) Aim of the proiect. To teach and train medical physicists.

Assistance provided by WHO during the vear. (a) A medical physicist; (b) supplies and equipment, including a radiological densitometer.

Probable duration of assistance. Until the end of 1974. SEA/RC25/2 Page 185

Work done during the year. The first one-year diploma course, which had started in May 1971. concluded on 12 May 1972. A two-year B.Sc. (Medical Physics) course was instituted in May 1972 under the joint auspices of the Faculty of Medical Sciences and the Faculty of Medicine, and has been approved by the National Educa- tional Council. The first group of B.Sc. (Medical Physics) students will graduate in 1974, when they will be eligible for admission to the proposed M.Sc. degree course. Arrangements are being made to integrate the students into a special course in nuclear electronics that is being planned by IAEA in association with the Thai Atomic Energy Commission and Chulalongkorn University. A part of this one-year course is proposed to be devoted to the study of medical electronics and instrumentation for the special benefit of medical physics students. Detailed lecture programmes were prepared for each lecturer to co-ordinate his work with those of others for the course.

The senior hospital physicist of the Department returned to duty in October 1971 after successfully completing the M.Sc. degree course in radiological physics at the Royal Marsden Hospital, London, on a WHO fellowship.

Arrangements were being made to award a fellowship to a staff member in the Department of Nuclear Medicine to undertake a two-year study in the United Kingdom. During the fellowship, which was expected to commence in June 1972, he will undertake special studies in the radioassay of hormones.

The necessary budget was approved for an extension to the Department of Radiotherapy to accomnodate the School, and it was expected that the extension would be completed before the next intake of students.

The Department of Radiotherapy and Nuclear Medicine has installed modern equipment and instrumentation for medical diagnostic and therapeutic purposes, which are available for the on-the-job training of students.

A secondary Standards Dosimetry Laboratory for the Region will be established at Ramathibodi Hospital and will be jointly assisted by WHO Headquarters and the International Atomic Energy Agency.

The WHO physicist participated in a meeting of an IAEA Siting Mission to Thailand, held in Bangkok from 26 to 31 May 1972.

Thailand 0111 (5101) National Seminar on Urban and Rural Integrated ITNFPA Services (MCHIFamily Health) (Sept. 1971)

Aim of the project. To provide opportunities for senior public health administrators in urban and rural areas to discuss integrated maternal and child health and family planning services, including in-service training of personnel.

Assistance provided by WHO during the year. A consultant and a temporary adviser.

Work done. A national seminar on integrated (maternal and child health and family planning) services was held from 13 to 17 September 1971 at Hua Hin, Thailand. A consultant was recruited for three weeks to assist with the Seminar, which was used as an opportunity for discussing the proposals to the UNFPA for an accelerated and expanded maternity-centred approach to family planning in four north-eastern provinces of Thailand. The Seminar, which was attended by 42 participants from Thailand, was the first of its kind to be held in Thailand on this topic. Among the subjects discussed were the role of males in family planning, inclusion of "post-contraceptive services" in family planning, and acceleration of the general health services. SEA/RC25/2 Page 186

Thailand 0115 (6202) Teaching of Human Reproduction. Family Planning UNFPA and Population Dynamics in Medical Schools (Nov. - Dec. 1970; Aug. - Oct. 1971; Feb. 1972; - ) Aim of the project. To strengthen the teaching, research and service functions in departments of paediatrics, obstetrics and gynaecology, preventive and social medicine and in other departments involved in the teaching of human reproduction.

Assistance provided by WHO during the year. Two fellowships - one for two months and one for six months - for study in India, two fellowships - one for four months and one for five months - for study in the United States of America, a three-and- a-half-month fellowship for study in Australia, a six-month fellowship for studies in the United Kingdom and Sweden, a twelve-month fellowship for study in the United Kingdom, and a ten-week fellowship for studies in Indonesia, Australia,the United Kingdom, Federal Republic of Germany and Sweden.

Probable duration of assistance. Some years.

Thailand 0120 (3002) Bio-environmental Engineering UNDP (Oct. 1971 - )

Aim of the proiect. To assist the Sanitary Engineering Department, Faculty of Engineering, Chulalongkorn University, in carrying out a review and study of the current curriculum and the existing teaching and laboratory facilities with a view to recommending improvements in teaching and research in bio-environmental engineering.

Assistance provided by WHO during the vear. A consultant.

Probable duration of assistance. Until 1972.

Work done during the vear. A consultant was assigned towards the end of Octobcr for six months to review and study the current curriculum of the Sanitary Engineer- ing Department, Faculty of Engineering, Chulalongkorn University, and the existing teaching and laboratory facilities with a view to recommending improvements in teaching and research in bio-environmental engineering and also to assisting in the establishment of facilities for engineering students who wished to specialize in a broader field of public health engineering.

At the request of the Government, the assignment of the consultant was further extended by three months under an inter-country project in order to enablc him to complete the work.

In addition to some WHO publications, technical books were provided to the project.

Thailand 0200 (6641) Fellowships R

Biochemistry of the thyroid hormones. A twelve-month fellowship for study in the United Kingdom (extension).

Clinical chemistry. A twelve-month fellowship for studies in the United Kingdom. Denmark and the Regional Office. SEA/RC25/2 Page 187

Clinical patholo=. A twelve-month fellowship for study in the United Kingdom.

Drug addiction. A seven-week fellowship for study in the United States of America.

Rehabilitation of narcotic druz addicts. A three-month fellowship for study in Hong Kong.

Sanitary chemistry. A twelve-month fellowship for study in the United Kingdom. SEA/RC25/2 Page 189

PROJECT LIST

Project No. Source of Funds Co-operating Agencies Title

SEARO 0007 (2001) Assessment Team on Malaria Eradication R (May 1959 - Dec. 1961; Nov. 1963 - )

Aim of the project. To make an independent assessment of malaria eradication programmes, including any special aspects, in countries of the Region.

Assistance provided bv WHO during the year. Eight consultants and a temporary adviser.

Probable duration of assistance. A number of years

Work done during the year. Independent assessment teams were formed to determine, in some countries, the readiness of areas for the withdrawal of spraying and their phasing from consolidation to maintenance. A strategy review was carried out in one country in order to recommend a plan of action based on available local resources.

A consultant was assigned to Burma for three months from November 1971 to follow up the plan of action which he had prepared in 1969. His report has been sent to the Government.

In Nepal, a team of two consultants assisted with the re-phasing of the programme. The team recommended areas with a population of 94 000 for withdrawal of spraying; thus, 80% of the country is now under the consolidation phase.

Two further consultants were also provided to Nepal to assist the Government in drawing up a revised plan of action capable of maintaining the gains already achieved, following the withdrawal of US AID assistance in 1972.

In Ceylon, a team of two consultants and a temporary adviser to the Regional Director made a comprehensive review and assessment of the malaria programme in regard to the epidemiological, operational and socio-economic aspects. The recommendations of the team have been sent to the Government.

In June 1972, a consultant was assigned to Indonesia in connection with an independent assessment of the control programme in that country, to be carried out in collaboration with US AID.

SEARO 0030 (1801) Smallpox Eradication and Epidemiological R Advisory Team (Oct. 1962 - )

Aim of the project. To assist in the smallpox eradication programmes, in the development of epidemiological services, and in training.

*This list includes some meetings, seminars, etc., with participation from other regions but for which the Regional Office had the main administrative and financial responsibility. SEA/RC25/2 Page 190

Assistance provided by WHO during the vear. (a) Two epidemiologists, a consultant and a clerk-stenoprapher; (b) supplies and equipment, including a photocopier.

Probable duration of assistance. Several years.

Work done during the year. The medical officer of the team visited Indonesia, Nepal and the State of Uttar Pradesh in India to review the smallpox eradication programmes and discuss current problems with national and WHO project staff. In July 1971, she helped with the conduct of a WHO-assisted training course at Delhi for State programme officers and district medical officers of selected States in northern India. She also participated in the annual meeting of State Smallpox Eradication Programme Officers and in the seminar on laboratory diagnosis of smallpox, held at the National Institute of Communicable Diseases, Delhi, for the doctors of the smallpox diagnostic laboratories in India.

In November, a consultant visited the six laboratories designated as the regional laboratories for the diagnosis of smallpox in India, in order to assess their suitability for this purpose and to make recommendations on measures to be taken to strengthen their functioning. His report has been sent to the Govern- ment of India. Another consultant (provided under SEAR0 0038.2, see below) was sent to Ceylon to assist the Government in planning the future production of freeze-dried smallpox and rabies vaccines, as up till now only liquid vaccine was being used for routine vaccination; WHO provided one million doses of freeze- dried smallpox vaccine to Ceylon and plans were drawn up for the continued provision of vaccine until the locally produced freeze-dried vaccine is available.

Tens of thousands of smallpox recognition cards, reporting material and other training aids overprinted in 23 different languages were distributed by WHO to health centres in the Region.

SEAR0 0038.2 (1802) Production of Freeze-dried Smallpox Vaccine R (Nov. - Dec. 1.967; Nov. - Dec. 1968; Dec. 1969 - UNICEF Jan. 1970; Dec. 1970 - Jan. 1971; Dec. 1971; - )

Aim of the project. To assist with the production of freeze-dried smallpox vaccine.

Assistance provided by WHO during the vear. A consultant.

Probable duration of assistance. Until 1974.

Work done during the year. A WHO consultant visited Ceylon in December 1971 to assist the Government in the elaboration of a draft plan of operation for project Ceylon 0089, "Freeze-dried Smallpox Vaccine Production", and to identify and to phase over a number of years the commitments of the Government, WHO and UNICEF in order to enable Ceylon to become self-reliant in the production of freeze-dried smallpox and rabies vaccines conforming to WHO standards. He also held discussions on the freeze-drying of smallpox and rabies vaccines to help the authorities decide on the type of equipment that will best meet their requirements. The report of the consultant was sent to the Government, whose comments have been received. A draft plan of operation has been prepared, incorporating the recommendations of consultant, and sent to UNICEF for comments.

SEAR0 0042.2 (4701) Radiation Protection R (Sept. - Dec. 1968; April 1969; Sept. 1969 - Jan. 1970; Nov. - Dec. 1971; - )

Aim of the protect. To train personnel concerned with the use of ionizing sources of radiation and promote the development of radiation protection practices in health institutions by improved measures to guard against the harmful effects of radiation. SEA/RC25/2 Page 191

Assistance provided by WHO during the year. A consultant.

Probable duration of assistance. Until the end of 1977.

Work done during the year. A consultant was assigned to Nepal from 24 November to 15 December 1971 to assist the Government in the establishment of a radiotherapy unit at Bir Hospital, Kathmandu, and to advise on the purchase of equipment for the purpose. His report has been forwarded to the Government.

Community Water Supply and Sanitation* (April 1965 - )

Aim of the project. To assist countries of the Region in developing urban and rural community water supplies and sanitation programmes.

Assistance provided by hllO during the "ear. (a) lltree sanitary engineers, a sanitary engineerin,: Ioniu1L;rnr and LWO (.1eri(-sLe~l~gr:lphtrrr; (h) ;I ~wo-w,:t?k fellowship for a candidate from Thailand for study in India; (c) supplies and equipment.

Probable duration of assistance. Some years

Work done during the year. The senior sanitary engineer visited Indonesia in July 1971 to study the urban water supply programe and to discuss further WHO assistance in this field. He also visited the WHO Regional Office for the Western Pacific in August for discussions in connection with the proposed UNDP project in environmental health in the Lower Mekong Basin. In the third week of October, he left on reassignment to Headquarters.

Another sanitary cngincer, stat~oned in Bangkok, made visits from time to time to Burma and Indonesia to provide further assistance in the development of rural water supply schemes in these countries. In Burma, he visited the WHO/ UNICEF-assisted rural water supply project in Hlegu and the piped water supply schemes for Aung Mingalar, Pyi Daw Tha, and Thar Tha Na Yeik communities. Some UNICEF material and equipment for this project arrived. Preliminary surveys, investigations and final designs for the Pyi Daw Tha system were completed and a list of supplies and equipment was submitted to UNICEF. While in Thailand, the engineer lssisted thc Provincial Water Supply Division of the Department of Public and Municipal Works in the well-drilling programme. In this connection, he visited twelve co~mlinitiesin Chainat, Singburi and Angthong provinces in order to carry out z preliminary assessment. Besides, he helped with the pre- paratioa and conduct of a five-week groundwater training course for thirty well drillers. Assistance was also provided in the formulation of a draft proposal for the UNDP environrrental health project in the Lower Mekong Basin, mentioned above.

Two sanitary engineers were assigned to the project in February (one of them as replacement for the sanitary engineer who left in October). A consultant was assigned to Thailand on a contractual basis to help with the develooment of water supply schemes.

The team leader assisted the Regional Adviser on Environmental Health in matters relating to programmes for training and education in enviranmental health in the Region and in other related aspects. The other sanitary engineer helped

*Previous title: Development of Conmunity Water Supply Programme. SEAlRC2512 Page 192

in reviewing the reports of the UNDP-assisted project, Ceylon 0086, and in the preparations for the mid-term review of the UNDP project in Nepal in April. He visited Bangladesh in May-June 1972 to assess the immediate or emergency measures to be taken for the rehabilitation of existing water supply systems and the improvement oE wastes disposal and also to assess possible WHO assistance in the development of a long-term programme for cormnunity water supply and sanitation.

A consultant was recruited for four months to carry out a survey of the community water supply and sanitation situation and to study environmental health services in the countries of the Region. He took up this job in April and has been visiting the different countries.

SEAR0 0066 (3201) Community Water Supply Special Account (March 1971 - ) for Community Water Supply

Aim of the project. To assist countries in the Region in the managerial, financial and design aspects of community water supply programmes.

Assistance provided bv WHO during the year. A consultant.

Work done during the year. The consultant provided to Indonesia under this project in April 1971 (mentioned in last year's report) completed his assignment in December. During this period, he surveyed the existing unfinished municipal water supply schemes in order to make recomnendations for their early completion, assisted in reviewing and revising the designs for urban water supply systems, and advised on the development of a long-term programme for municipal water supplies.

External Cross-Checking of Blood Films (Sept. 1968 - )

Aim of the project. To develop facilities in the countries of the Region for independent cross-checking of blood fjlms from malaria programmes.

Assistance provided by WHO during the year. (a) A laboratory specialist; (b) su.-:.lies and equipment.

Probable duration of assistance. Until the end of 1977.

Work done during the year. In Ceylon, the WHO laboratory specialist participated in the organization of the National Training Centre and also in the training of microscopists. The result of cross-checking blood slides in 1971 showed an error rate of 0.97% as compared with a rate of 2.5% in 1970, showing a significant improvement.

He visited Burma late in 1971 to assist in training microscopists and in improving the cross-checking centre at Rangoon; his report has been sent to the Government. Giemsa staining replaced JSB staining of thick blood smears.

The WHO laboratory specialist has been in Indonesia since April 1972 to assist the Government in strengthening the laboratory aspects of the malaria programme. Microscopists have been trained at the regency level and cross-checking centres at the provincial level have been set up. SEA/RC25/2 Page 193

Medical Education (March 1969 - ) Aim of the protect. To develop medical education at all levels; to adjust teaching and training pogrammes to the needs of the countries in the Region and to the progress of educational science; to train medical educators,with particular emphasis on educational science, and to promote inter-country exchange of experience in educational matters.

Assistance provided by WHO during the year. (a) Sixteen consultants and assistance from a Headquarters staff member and from the Regional Adviser on Medical Education; (b) two fellowships for study in the United States of America - one for four months for a candidate from Ceylon and one for three months for a candidate from Thailand - and a six-month fellowship for a candidate from Thai- land for studies in the United States of America and Canada; (c) cost of attendance of participants; (d) supplies for Indonesia.

Probable duration of assistance. A number of years.

Work done during the year. A team of three consultants, accompanied by an expert in post-graduate education from WHO Headquarters, visited Ceylon for two weeks in September to advise on the development of medical education with special emphasis on post-graduate education. The report containing their recommendations has been sent to the Government of Ceylon.

The staff member from Headquarters mentioned above also visited Thailand to extend the discussions initiated earlier by one of the Regional Advisers on Medical Education on the establishment of a regional medical teacher training centre.

An inter-country seminar on "Community Medicine for Medical Teachers" was held in Surabaya. Indonesia, from 29 November to 4 December. The 27 participants came from Burma (4). Ceylon (41, Indonesia (15) and Thailand (4). The faculty consisted of two medical educators and a team of six from the Department of Community Medicine of the Ramathibodi Hospital Medical School, Bangkok, which has developed a non-traditional teaching programme in community health. The Regional Adviser on Medical Education and the WHO professors of public health administration and of obstetrics and gynaecology assigned to Indonesia also participated. In addition, two professors of the Rockefeller Foundation unit at Ramathibodi were members of the faculty.

Two consultants jointly visited Indonesia early in 1972 to assist in the development of the School of Public Health of the University of Indonesia in Djakarta. Their report has been sent to the Government.

Earlier, in November-December 1971, a team of two consultants was assigned to Burma to advise the Institutes of Medicine on improvements in their examination systems. They also visited Ceylon.

In June 1972, a consultant took up a one-month assignment in Thailand to advise on the teaching of psychiatry to undergraduates and post-graduates at the medical schools in Bangkok and Chiengmai.

SEAR0 0097 (5601) Nutrition Training and Advisory Services R (Dec. 1963 - ) UNICEF

Aim of the proiect. To assist with the training of health personnel in nutrition and to advise on public health measures in nutrition. SEA/RC25/2 Page 194

Assistance provided by WHO during the vear. (a) Two guest lecturers and a consultant; for the meeting (see below), eight temporary advisers and assistance from a Headquarters staff member, a staff member from the Regional Office for the Americas and from a field staff member assigned to a project in India; (b) five three-month fellowships for candidates from Ceylon (1) and Thailand (4) for participation in the certificate course in nutrition and a twelve-month fellowship for a candidate from Thailand for study in the United States of America; (c) part payment of cost of attendance of participants; (d) secretarial assistance.

Probable duration of assistance. Until the end of 1974.

Work done during the vear. The fourth nine-month degree course and the ninth three-month certificate course in nutrition at the National Institute of Nutrition, Hyderabad, India, ended in February. Two WHO guest lecturers assisted with the conduct of the courses for two weeks. There were five participants from India on UNICEF stipends in the degree course. The certificate course had seven participants on WHO fellowships - 1 from Ceylon, 2 from Indonesia, 3 from Thailand and 1 from Iraq. The 10 Indian participants were given stipends by UNICEF. The fifth degree course in nutrition started in June with one participant from Thailand on a WHO fellowship.

A Consultation Meeting of Experts on the Prevention of Xerophthalmia was held at the National Institute of Nutrition, Hyderabad, from 27 to 29 March. The participants included two from Ceylon, three from Indonesia and one from the Philippines (financed by UNICEF), one from Thailand, two from India, one from Switzerland (cost of attendance being borne by the participants), and two UNICEF officials. WHO was represented by a medical officer from the Nutrition unit in Geneva, a medical officer from the WHO Regional Office for the Americas, the WHO public health officer with the Applied Nutrition Programme in India, and eight WHO temporary advisers to the Regional Director. The group recognized that the most rational method for the prevention of xerophthalmia was improvement in the diet, although in most developing countries it would take considerable time to improve the situation. It recommended, as an immediate short-term measure, oral administration at periodic intervals of large doses of vitamin A once every six months. The group also recommended undertaking of control studies on a pilot basis to determine the effect of different forms of vitamin A. Studies for exploring the possibility of identifying either less toxic derivatives of vitamin A or identifying drugs which could offset the toxi- city, were also considered essential.

Assistance in the form of publications was provided for an orientation course for nutrition officers of the newly established Nutrition Monitoring Bureau in India, held at the National Institue of Nutrition.

SEAR0 0102 ((4101) Asian Institute for Economic Development R and Plannin~,Bangkok UNDP (Jan. 1964 - ) ECAFE UNICEF

Aim of the project. To assist the faculty of the Asian Institute for Economic Development and Planning with the health component of training courses and research.

Assistance provided bv WHO during the vear. (a) A public health administrator and an economist; (b) supplies and equipment, including a copying machine and an offset printing machine.

Probable duration of assistance. Until 1973. SEAlRC2512 Page 195

Work done during the year. The two WHO staff members continued to assist with the general programme of work of the Institute, including the regular training courses. They were responsible for the organization and conduct of the Third Regional Course on National Health Planning (see under SEARO 0178, "National Health Planning and Manpower Studies"). The Faculty of the Institute conducted special courses during 1971 and, in collaboration with UNICEF, also a Regional Course on Social Development and Planning during March 1972.

The project staff took part in a meeting held in Bangkok in July 1971 between WHO and the Asian Institute to review the Second Regional Course on National Health Planning and, in the light of the experience gained, to plan for the third course. The WHO public health administrator and the technical officer (economist) helped in organizing a country course in Indonesia from 9 to 16 August 1971. They provided help to the WHO Regional Office for the Western Pacific in the organization of their Fourth Regional Course on National Health Planning in September 1971 and to the WHO Regional Office for the Eastern Mediterranean in an inter-country Course in Health and Manpower Planning, which took place in December.

Continuous contact was maintained with the Public Health Administration Group of the Faculty of Public Health, Mahidol University, Bangkok.

Lhring the year, the WHO public health administrator participated in various ECAFE-sponsored meetings, including the Regional Seminar on Population Change and Development (11-20 January 1972). The WHO economist attended the Conference of Asian Economic Planners (22 November-1 December) in Malaysia. Both participated in the ECAFE-sponsored Expert Group Meeting on Socio-Economic Returns of Family Planning Programmes, which was held in Bangkok from 19 to 30 June 1972.

It is planned to move the WHO staff from thc Asian Institute to the Faculty of Public Health in Bangkok during the latter half of 1972. They will, however, continue to participate in the Institute's activities.

SEARO 0104 (4301) Organization and Administration of Hospital R and Medical Care Services (Aua.- - Oct. 1968: Dec. 1963: Feb. 1969: Julv 1970 - Jan. 1971; Sept.-- Dec. 1971; Feb. 1975; ~a;1972 - ) Aim of the project. To assist in the development of regionalized health services, in the organization of systems of medical care, and in hospital administration, including the planning and development of facilities for the diagnosis, treatment, care and rehabilitation of the sick.

Assistance provided by WHO during the vear. (a) Six consultants; (b) a three- week fellowship for a candidate from Ceylon for study in India and a three-month fellowship for a candidate from Thailand for studies in India and the United Kingdom; (c) cost of attendance of participants; (d) supplies for the Seminar.

Probable duration of assistance. A number of years.

Work done during the year. A regional Seminar on Functional Programming of Hospital Facilities was held in the Regional Office from 25 October to 5 November 1971. Its objectives were (1) to enable the participants to become acquainted with the concept of functional programming of hospital facilities, using a nursing unit as an example and developing functional programming for individual departments of a hospital, and (2) to determine ways in which functional programing could be developed in the countries of South-East Asia. SI:A/RC25/2 Page 196

The Seminar was attended by 21 participants - three from Ceylon, five from India, six from Indonesia, two from Nepal and five from Thailand. Three consultants - a public health administrator, a public health nurse and an architect - assisted in conducting the Seminar. The report of the Seminar has been distributed.

A WHO consultant was assigned to Thailand in February to assist the Govern- ment in connection with plans for the rehabilitation of heroin and opium-dependent persons. In his report, which has been submitted to the Covernment,the consultant has expressed his agreement with the general programe as envisaged in the Five- year Plan of the Ministry of Public Health, and has suggested its implementation at the Thanyarak rehabilitation centre and in other government installations. He has also recommended a rehabilitation programne as an independent entity, follow- up, training of personnel of various categories, promotion of research, laboratory facilities to identify psycho-active drugs in urine, and establishment of a low- profile experimental project in a highland valley area.

A team of two consultant-architects was assigned to Nepal in May to assist the Government in the field of hospital design and planning.

SEAR0 0113 (1201) Tuberculosis train in^ and Evaluation Team R (Dec. 1967 - )

Aim of the project. To provide training in tuberculosis control; to assist with operational research related to the assessment and evaluation of integrated tuberculosis control programmes in the Region and to give practical assistance to national tuberculosis programmes.

Assistance provided by WHO during the vear. (a) A medical offjcer, s statistician, a laboratory technician and a public health nurse; (b) supplies and equipment, including two transport vehicles.

Probable duration of assistance. Until the end of 1977.

Work done durinp, the year. The Team conducted an assessment of the national tuberculosis control programme in Burma. On the basis of the findings of the assessment, a national seminar on the programme was organized to discuss the strategy for future tuberculosis control activities.

Preparations were made for conducting a similar assessment of the control programme in Mongolia, to be followed by a national seminar, later in 1972. A WHO consultant has been recruited for this purpose.

The WHO medical officer (team leader) left the project. late in 1971 and efforts were being made to recruit a replacement.

Inter--Country Nllrsing Me"_t&& (Aug. - Scpr. j.9:i; No..:. 1959; Nov. - Dec. 1971; - )

Aim of the project. To hold trr,..,%al meetings for the purpose of studying problems in nursing that are of interest to all countries of the Region.

Assistdnce provided bv WHO during the vear. (a) Three consultants; (b) supplies.

Probable duration of assistance. Until 1977. SWL/KC25/2 Page 197

Work done during the year. Three consultants were recruited and details of thc agenda, programme, working papers, etc., to be used to conduct the meeting were completed. Participants were selected and travel arrangements made. Oving to the state of emrrgency in India in December 1971 the consultants, staff and most participants were unable to makc the journey to Bangkok, where the meeting was scheduled to be held. As a result, the meeting was postponed until the last quarter of 1972.

~iphtheria/Pertussis/Tetanus Vaccine Production (July 1968; Feb. 1970; June 1972; - ) UNICEF

Aim of the project. To assist in the production ot diphtherialpertussisltctanus vaccine consistent with WHO minimum requirements.

Assistance provided by WHO during the. (a) A consultant; (b) supplies and equipment for India.

Probable duration of assistance. Until the end of 1977.

Work done durinp. the vear. A WHO consultant visited the Central Research Insti- tute, Kasauii, for a werk in June 1972 to advise on the introduction of the necessary technical changcs in the current netliod of production of DPT vaccine in order to improve the yield of toxin and bacteria harvcst per unit volume of medium. He vas also expected to assess the Institute's potential for stepping up the production of vaccine along the continuous culture technique.

SEAR0 0125 (1501) Plague Epidamiology R (May 1968 - )

Aim of the proiect. To follow up plague surv~illanceactivities and assist in the training of national workers participating in surveillance, with particular emphasis on the persistence of infectivc rodents.

Assistance provided by WHO during the year. (a) A consultant and assistancc from a Hcadquartcrs staff member; (b) cost of attendance of participants; (c) sccrr- tarial assistance; (d) supplies of plaaue vaccine to India.

Probable duration of assistance. Until 1972.

Work done during the vear. The second inter-country Training Course on Plaguc Epidemiology and Control was held in Mandalay from 15 to 25 February. The aim of thc course, which was attended hy nine participants (From Rurma, India, Indonesia and Thailand), was to increase the comprtcnce of workers engaged in the surveillance and control OF plague.

The report of Lhu trait:-li: rourse was bcinp, processed in the Regional Officc.

SEAR0 0139 (4402) Short Courses for Nurses and Other R Health Personnel UNICEF (Jan. 1967 - )

Aim of the project. To assist in conducting short courses for nurses and other health personnel in order to develop new concepts and skills with particular reference to patient care and family health; to assist in preparing reference SU/RC25/2 Page 198

and teaching materials; to develop new educational techniques useful to the implementation and evaluation of short courses; also to participate in studies of nursing services and education.

Assistance provided by WHO during the vear. (a) Four nurse educators, five consultants and assistance from a nurse provided to a project in India; (b) two clerk-stenographers; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the vear. During the period under review, four inter-country courses were conducted under the project, the subjects being "Neurological Patient Care and Rehabilitation", "Paediatric Patient Care", "Hospital House- keeping", and "Orthopaedic Patient Care". Ninety-seven nurseldoctor participants have attended these courses from Ceylon, India, Indonesia, Mongolia, Nepal and Thailand.

Assistance was also provided to six country-level courses, in a variety of subjects; three of these were conducted by staff from the project, and the others by short-term consultants.

The team leader visited Burma to discuss the planning of forthcoming short courses, and one of the nurse educators assisted in the preparation of comprehensive lists of equipment for the nurse training schools in Ceylon.

Plans are well ahead for the development of a new educational technique which will provide a sequential learning activity for nurses and other health personnel. The purpose of this activity is to demonstrate a methodology by which n country may develop areas of excellence, and strengthen the delivery of its health services. There is a built-in element of assessment and follow- up which will opcrate throughout the activity. A tool for the assessment of paediatric care has been developed in the project and will be tested in the field shortly. It is planned that this tool will provide data by which the effectiveness of the first sequential learning activity in paediatric patient care can be measured.

Assistance continues to be provided in the identification and provision of retercnce material for various WHO and national programmes.

Rehydration Therapy (Feb. - March 1967; March 1970; March 1971 - )

Aim of the project. To assist in producing rehydration fluid and in establishing rehydration centres in children's hospitals and at peripheral centres, and to train staff.

Assistance provided by I.MO duriny the year. (a) Two consultants, a temporary adviser and assistance from one of the Regional Advisers on Maternal and Child Health; (b) cost of attendance of participants; (c) secretarial assistance.

Probable duration of assistance. Until the end of 1977.

Work done during the year. An inter-country Course on Rehydration Therapy Centres was held at the Medical College, Jaipur (India), from 6 to 17 March 1972. Nineteen participants from India and one from Nepal attended the course. SEA/RC25/2 Page 199

The faculty consisted of a WHO consultant and a temporary adviser to the Regional Director. The Regional Adviser on Maternal and Child Health also joined the faculty at the time of formulation of the report of the course. The participants arrived at several important conclusions and recommendations, among which was the emphasis placed on the importance of rehydration therapy in the treatment of diarrhoea1 diseases in children. The participants also concluded that oral rehydration therapy had a definite place in the rehydration programme and should therefore be given serious consideration for widespread use in India. The report of the course was being processed in the Regional Off ice.

A consultant visited Mongolia in May-August 1971 to study the feasibility of centralizing the production of rehydration fluids in Ulan Bator. He has stated that the production could be undertaken by the Institute of Hygiene, Epidemiology and Microbiology. Until better facilities could be made available in the national control laboratory, the testing of the parenteral fluids should be undertaken by the Institute of Hygiene, Epidemiology and Microbiology. The report of the consultant has been sent to the Government.

Following his recommendations, a team of two consultants, a pharmacist and a paediatrician, will be visiting Mongolia to assist in drawing up a five-year plan of action for the production of different types of infusion fluids and their quality control as well as in training staff.

Strengthening and Development of Health Services (June 1970 - )

Aim of the project. To constitute a resource group and field arm for the Pro- gramme Support and Co-ordination Unit of the Regional Office, which will (1) assist in the analysis of WHO-assisted health projects and programmes; (2) help to identify areas in which operational and cost-benefit studies are needed; (3) participate in the design, conduct and evaluation of such studies, and (4) assist in co-ordinating all operational studies undertaken by the Regional Office.

Assistance provided by WHO during the year. (a) Two medical officers, a statistician, a nurse administrator and six consultants; (b) two clerk-stenographers; (c) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the year. The team leader of the project participated in the Sixth Scientific Meeting of the International Epidemiological Association held at Primosten, Yugoslavia, from 29 August to 3 September 1971. He also attended the WHO-sponsored Seminar on Statistics in Medical Research held in New Delhi in November. The nurse administrator participated in a seminar at the National Institute of Health Administration and Education, New Delhi, related to health practice research, and conducted sessions on health manpower studies with emphasis on the nursing aspects. The team was involved in the preparation for the first meeting on the Role of Operational Research in Health Services and Education for these Services (which has since been postponed until 1972). A beginning was made towards developing a monitoring system for projects having an element of operational research. SEA/RC25/2 Page 200

The efforts of the team have been concentrated on assistance to the National Health Manpower Study in Ceylon. The nurse administrator of the project, together with the statistician from the Regional Team on Family Health (SEAR0 0192),visited Ceylon in August 1971 to discuss with the authorities the protocols prepared for some of the sub-studies of the National Health Manpower Study. During the visit the groundwork for the implementation of six of these sub-studies was prepared, the most important aspect being the formation of national working groups and the appointment of chief researchers for each sub-study. The team visited Ceylon in October-November 1971 to discuss the progress of the sub-studies with the national study director, the officials of the Health Planning Unit, the WHO Representative to Ceylon and the WHO consultant assigned (under project Ceylon 0092) to assist the Health Planning Unit in establishing the scope and nature of the planning activities. Preparations were made for other sub-studies within the framework of the National Health Manpower Study.

The team leader stayed in Ceylon from January to May 1972 and the nurse administrator visited the country in January-February and again in April and May 1972. It is envisaged that the findings of the Study will be utilized for developing a planning methodology based on the principles of operations research.

There are now eleven sub-studies, of which eight are under way. The sub- study "G", relating to the activities of health personnel working in rural areas, was launched in April 1972 and collection of field data is in progress. Two WHO consultants are assisting national investigators with the collection of data. A WHO consultant(medica1 sociologist) provided under another project, spent one month early in 1972 helping wfth the preparation of the protocol for the sub-study on the utilization of doctors. The testing of the instruments developed is pro- ceeding, and it is expected that the consultant will return later in 1972 to provide further assistance.

Statistical support received from project SEARO 0220 has made a substantial contribution. Further assistance is being provided by a consultant-statistician recruited to take charge of the computor programming aspects of the study.

The statistician leEt the Region in September 1971 on reassignment and the team leader was reassigned to project Ceylon 0092, National Health Planning, in June. Recruitment is under way for replacements.

In addition to the activities mentioned above, three consultants were assigned under this project to assist with various prograrmnes. In July 1971, a consultant visited Burma to help the Government in finalizing a request to the UNDP for assistance with a project on occupational health. A scientist in operational research was assigned to Indonesia in February-March to study the management of the project "Strengthening of National Health Services" (Indonesia 0086) and its co-ordination with other allied projects in that country. A consultant (economist) spent three weeks in the Regional Office during January to advise on economic planning relating to health.

Education and Training of Environmental Health Personnel* (Sept. 1970 - April 1971; -

Aim of the project. To assist in the training and utilization of engineers and other personnel in various aspects of environmental health requiring urgent attention.

*Previous title: Seminars and Training Courses in Sanitary Engineering. SEA/RC~~/~ Page 201

Assistance provided by WHO during the year. Supplies and equipment for Burma.

Probable duration of assistance. A number of years.

SEAR0 0153 (9201) train in^ in immunology R (Oct. - Dec. 1969; Nov. 1970; Feb. - March 1972; - )

Aim of the project. To reviev progress in immunology, particularly as related to comunicable diseases; to strengthen training in this specialty.

Assistance provided by WHO during the year. Eight fellowships - four for ten weeks for candidates from India and four for twelve weeks for candidates from India (I), Indonesia (1) and Thailand (2) - for study in Singapore.

Probable duration of assistance. Some years.

SEARO 0161 (4902) Hospital Statistics and Medical Records R (Jan. 1969 - Dec. 1971)

Aim of the proiect. To assist governments of the Region: (i) in urganizing an efficient system for the maintenance and flow of records in selected hospitals, (ii) in the collection, processing al:d presentation of hospital statistical data, and (iii) in training medical records and hospital statistics personnel.

Assistance Provided by WHO during the vear. (a) A statistician and a clerk-stenographer; (b) supplies and equipment for Burma and Indonesia.

Kork done. During the period June to December 1971, the WHO statistician visited Burma, Indonesia and Nepal for brief periods. In Burma, he assisted with the development of a recording and reporting system in the out-patient clinics of government hospitals and health centres and also helped in the establishment of routine statistics in respect of heaLth personnel in the hospitals. In Indonesia, he proposed simplification of the reporting system on the utilization of hospital resources and activities as well as :lospital in-patient morbidity.

A one-month trial of a new reporting system for hospitals was carried out in two provinces to check the feasibility and efficiency of this system.

During the visit to Nepal, the .;tatistician reviewed Lhc existing svstem oi recording and reporting in hospitals, hcalth posts and health centres and, together with the statistical consultant assigned to project Nepal 0021, discussed its further development.

The statistician altended a Travelling Scncinar from 4 to 25 August 1971 on ltealth Statistics in Lhc USSII and Finland. The main purpose of the Seminar was to study the organixation and operiition of health statistical services in those countries, especially tltr utiiizatioi~of statistical data for national health planning.

Since 1 January 1972, the activities of this project and those of SEARO 0050, "Reorganization of Rural Health Records and Reports", have been amalgamated to form a new project, "Collection and Utilization of Health Statistics Records and Reports" (SEARO 0220). SEAlRC2512 Page 202

SEAR0 0168 (2801) Training in Veterinary Public Health and R Promotion of Veterinary Public Health Services* (Aug. - Sept. 1968; March - June 1969; March - May 1970; Feb. - March 1972; May 1972; - ) Aim of the ~rolect. To assist in training veterinary public health officers.

Assistance orovided by WHO during the vear. (a) A consultant; (b) a twelve- month fellowship for a candidate from Thailand for study in India.

Probable duration of assistance. A number of years.

Work done durinp, the vear. Early in 1972, a WHO consultant visited Calcutta to assist in the conduct of the two-year master's degree course in veterinary public health at the All-India Institute of Hygiene and Public Health. The same consultant also visited Thailand to advise on the problem of rabies as well as on the production of rabies vaccine in that country.

It was planned for the same consultant to visit Thailand again towards the end of 1972 to draw up a programme for the development of veterinary public health services.

SEARO 0170 (5102) Short Courses on Neonatologl! R (Jan. - Feb. 1970; Dec. 1971 - Feb. 1972; - ) Aim of the orolect. To review modern practice and teaching in neonatology for paediatricians in medical schools.

Assistance provided by WHO during the year. A consultant.

Work done during the year. During December 1971-February 1972 a consultant visited medical colleges in Burma, Ceylon, India, Indonesia and Thailand which had sent participants to attend the orientation courses in neonatology organized by WHO so far, in order to review the progress made in the practice and teaching of neonatology. The assessment involved visiting the area of the hospital concerned with neonatology, discussion of technical details and inspection of equipment. Sample cases were reviewed to discuss individual management of clinical problems. The report of the consultant has been issued.

SEAR0 0176 (4202) Courses on Health Laboratory Techniques R (April 1969; Sept. - Oct. 1970; Oct. - Nov. 1971; - ) Aim of the oroiect. To assist with courses in health laboratory techniques.

Assistance provided by WHO during the year. (a) Two consultants and ten temporary advisers; (b) cost of attendance of participants; (c) supplies for the course (see below); (d) secretarial assistance.

Probable duration of assistance. A number of years.

Work done during the year. An inter-country Course on Immuno-haematological Pro- cedures in Blood Banking was held in Bombay from 1 to 10 November. Fourteen participants from Ceylon, India, Indonesia, Nepal and Thailand participated in

*Previous title: Training in Veterinary Public Health SEAIRC2512 Page 203

the Course, which was conducted by two WHO consultants and ten temporary advisers (nine from India and one from Ceylon). The Course was also attended by the Regional Adviser on Health Laboratory Services; the Regional Office provided secretarial assistance.

The holding of this course in this region, where blood-banking services are sparsely located and call for immediate national and international attention, was greatly welcomed. The consultants and the temporary advisers, who acted as resource persons in addition to giving prepared lectures, succeeded in creating in the participants the necessary interest and zeal in blood-banking.

As a follow-up of this activity, two consultants are being recruited to formulate minimum requirements for blood banks. They will also pay follow-up visits to different countries to meet the participants in the above course.

SEAR0 0178 (4102) National Health Planning and Manpower Studies UNDP (March 1969; July - Sept. 1969; Nov. 1969 - Feb. 1970; June 1970 - ) Aim of the project. To develop further national health planning in the countries of the Region through regional and national training courses, meetings and study groups and consultants to formulate national health plans, to delineate the health aspects of development plans, and to strengthen health planning units.

Assistance provided by WHO durine, the year. (a) Eleven consultants and two temporary advisers; (b) Fifteen three-month fellowships for candidates from India (4), Indonesia (5) and Thailand (6) to follow the Third Regional Course on National Health Planning in Bangkok; (c) supplies and equipment for the course; (d) cost of attendance of participants.

Probable duration of assistance. Until 1977.

Work done during the year. The highlight oE activities during the year was the holding of the Third Regional Course on National Health Planning, which took place at the Asian Institute for Economic Development and Planning. Bangkok, from 17 January to 7 April 1972. (Owing to the state of emergency in India in Decanber, the first part of the Course, which was to have taken place in New Delhi, was cancelled.) The WHO public health administrator and the WHO economist assigned to the Asian Institute were responsible for the organization and conduct of the Course, and four consultants and a temporary adviser (a statistician, a public health administrator, a mathematician, a health planner and an economist) assisted with the various sessions.

The objective of the Course was to teach senior health officials the theory and practice of socio-economic and health planning with particular emphasis on new, different and innovative approaches, ideas and techniques, multi-disciplinary planning, group analyses and exercises. Of the seventeen participants, 15 were from South-East Asia (4 from India, 5 from Indonesia and 6 from Thailand). The main method of teaching was by informal seminars around a table, and the subjects taught included health planning, economic and development planning, demography and statistics, sociology, accounting and budgeting, general educational planning and regional planning, comparative health planning methodology, operational research, and general review and analysis of results.

During the period under review, a number of WHO consultants were assigned under this project, as follows: SEA/RC25/2 Page 204

A consultant and a temporary adviser assisted the meeting held in Bangkok in July 1971 to review the Second Regional Course on National Health Planning and plan for the third course.

Two consultants were provided to Indonesia during July-September 1971 - one to organize a country-level course on national health planning and the other to assist the Government in the establishment of a sound "health resources reporting system" (see also Indonesia 0119).

A WHO temporary adviser assisted the Government of Mongolia in the conduct of a national conference on health economics, held in April 1972.

In May 1972, a consultant took up a two-week assignment in Bangkok to advise the Regional Director on the optimum organization of training in health planning, on the further development of regional training programmes in this field and on the development of curricula for various national courses for health personnel at different levels. He worked in collaboration with the WHO staff at the Asian Institute for Economic Development and Planning.

Assistance is being provided to the Government of Ceylon in the collection of field data for the various phases of the study of health personnel working in the rural areas of the country. The consultant assigned ror the purpose has been in position since May (see also Ceylon 0101).

A consultant has been assisting the Regional Office since June to develop a preliminary systems model of health services development, including manpower training capacities, financial and other relevant indicators for long-term development which can serve both Governments and WHO as a frame for country programming for health.

SEARO 0192 (5104) Regional Team on Family Health UNFPA (Aug. 1970 - )

Aim of the proiect. To support country and inter-country activities in family health with regard to services, training, evaluation and research embracing family health.

Assistance provided bv WHO during the year. (a) A medical officer, a health educator, a statistician and a nurse; (b) supplies and equipment.

Probable duration of assistance. Until 1972.

Work done during the year. The members of the team assisted with the preparation and conduct of a number of training courses, in addition to attending a staff training course in Geneva from 18 to 30 October 1971. The medical officer helped with a national training course on the health aspects of human reproduction in Indonesia, and in the planning of two inter-country courses, viz. "Medical Educa- tion in Human Reproduction, Family Planning and Population Dynamics" (SEARO 0206) and "Health Planning for Maternal and Child Health/Family Planning Administrators". (The latter two courses were postponed.) He also conducted a national seminar on integrated maternal and child health/family planning services in Thailand.

The health educator and the nurse participated in the inter-country Symposium on Maternity-Centred (Post-partum) Approach to Family Planning, held in the Regional Office from 26 to 28 July. The health educator, in addition, assisted with a number of national projects in Ceylon, India and Indonesia. The nurse took part in the "Consultation on the Teaching of Human Reproduction, Family Planning and Population Dynamics in Nursing and Midwifery Education Programmes", held in Geneva in October 1971. SE~fRC25f2 Page 205

The statistician was involved in drafting and finalizing protocols for sub- studies of the Comprehensive Health Manpower Study in Ceylon.

In Novemher-December 1971 the medical officer and the nurse conducted a national workshop on integrated maternal and child healthffamily planning services in Rampur, Nepal. Wring this period, the health educator assisted national workshops in Indonesia.

In early 1972, the medical officer and the statistician assisted in the preparation of a request for submission to the United Nations Fund for Popula- tion Activities and a plan of operation for the family health project in Ceylon. Similar help was provided in respect of other UNFPA projects in Ceylon. The health educator was involved in the conduct of a basic orientation course in health education in Indonesia. The nurse has been working in support of another UNFPA project in India. An evaluation of two courses on the health aspects of human reproduction, held in Indonesia in 1971, was undertaken.

SEAR0 0193 (2903) Epidemiological Surveillance and Trainin%* R (Sept. 1966 - )

Aim of the project. To assist in strengthening epidemiological surveillance programmes directed towards priority diseases, in introducing epidemiological surveillance activities into the functions of local health services, and in training staff.

Assistance provided by WHO durinn the year. (a) A bacteriologist, a consultant and a stenographer; (h) supplies and equipment.

Probable duration of assistance. A number of years.

Work done during the year. Efforts were being made to recruit a replacement for the WHO epidemiologist (team leader), who left early during the year under review. The bacteriologist continued to provide assistance to various countries in strengthening their epidemiological services. He visited institutes in Maharashtra State (India) to discuss with the respective staff plans for strengthening epidemiological surveillance. He paid a visit to Burma to assist the Government in further strengthening the surveillance of enteric infections.

A WHO consultant recruited under this project reviewed the situation with regard to venereal diseases in Burma and made recomnendations for further improvement. As a result of this visit, the control activities are being strengthened. The report containing his findings has been forwarded to the Government (see also Burma 0044.2).

SEAR0 0194 (4403) WHO-sponsored Training Centre for Nurses R IWellington. New Zealand) (.Jan. 1970 - )

Aim of the project. To provide a training programme for nurses from the Region who cannot obtain admission to other post-basic courses because of lack of the secondary education and/or the language skills required for admission.

Assistance provided by WHO duriny the year. A nurse instructor.

*Previous title: Regional Epidemiological Surveillance Team SEz1/RC25/2 Page 206

Work done durinp, the vear. WHO fellows from three countries of the Region completed their course work in December 1971. Twelve nurses were enrolled in the 1972 programme: 1 from Ceylon, 1 from India, 3 from Indonesia, 2 from Nepal and 5 from Thailand.

The staff and students of the Centre continued to co-operate in curriculum development. Work schedules directed at meeting the needs of individual students were developed. Selected hospitals, public health and other comnity agencies throughout New Zealand worked with the Centre to provide effective lear~ing experiences for the students. A brochure concerning the Centre was prepared.

Work progressed on the development and use of tools for evaluating the effectiveness of the progrme. National and WHO personnel in Nepal, Thailand and Indonesia participated in the application of the evaluation techniques.

The health of the fellows continued to give concern. Methods for better physical assessment of candidates are being investigated.

The countries of the Region have responded well to requests for early submission of particulars regarding fellows for the 1973 programme. Five applications wcrc already being processed in the Regional Office.

A second New Zealand Nurse tutor is being assigned full time to the Centre, and is expected to be in position in September 1972.

One of the Regional Nursing Advisers visited the Centre in August 1971.

SEAR0 0195 (5602) Symposium on Vesical Calculus R (Feb. - March 1971; Dec. 1971 - Jan. 1972; - )

Aim of the project. To review current knowledge on vesical calculus and explore means of preventing the disease.

Assistance provided by WHO durinp, the vear. (a) Four consultants and four temporary advisers; (b) payment of part of the cost of attendance of participants.

Work done during the year. A Symposium on Vesical Calculus, held in Bangkok from 6 to 11 January 1972 to review the existing knowledge on the prevalence and distribution of bladderstone disease, considered the various possible aetiological factors and the mechanism of urinary calculus formation and proposed further research to determine the cause of vesical calculus and measures for its prevention.

It was attended by 29 participants, of whom 13 were from South-East Asia - four from India, two from Indonesia and seven from Thailand. Four WHO consultants and four temporary advisers assisted with the conduct of the symposium.

The report of the symposium was under preparation.

Seminar on Health Aspects of Care of Normal Children in Day Centres and Institutions (June 1972; - )

Aim of the project. To assist in improving the health care of normal children in day-care centres and other similar institutions; to organize and conduct health educational activities. SEA/RC25/2 Page 207

Assistance provided by WHO during the year. (a) Three consultants, three temporary advisers and assistance from the Regional Adviser on MaternaI and Child Health; (b) cost of attendance of participants; (c) secretarial assistance.

Probable duration of assistance. Until 1973.

Work done during the year. The Seminar on Health Aspects of Care of Normal Children in Day Centres and Institutions was held from 19 to 24 June 1972 at the Faculty of Medicine, Chiengmai. Thailand. It was attended by participants from Ceylon, India, Indonesia, Nepal and Thailand. The objective of the Seminar was to provide an opportunity for senior health officials and representatives of interested specialized agencies and UNICEF to (i) review the nature and extent of the health needs of normal children in day-care centres and institutions, and (ii) to outline general principles for the guidance of the countries of the Region in the development and strengthening of health care programmes for such children in accordance with local situations and requirements.

WHO provided three consultants and three temporary advisers. The Regional Adviser on Maternal and Child Health also participated.

SEAR0 0198 (6501) Regional Centre for Documentation on Human Repro- UNFPA duction. Family Planning and Population Dynamics (Jan. 1971 - )

Aim of the project. To set up, in the Regional Office, a regional centre to re- produce basic reports and documentation on various aspects of human reproduction, family planning and population dynamics for wide distribution, particularly to schools for professional and auxiliary health workers, to the health services, to the main health institutions in the Region and to international documentation centres.

Assistance provided by WHO during the year. (a) A consultant; (b) supplies and equipment, including a microfiche printer, a microfiche processor, a developer, a jacket filler and a magnaprint.

Probable duration of assistance. Some years.

Work done durina the year. A consultant visited the Regional Office in October- November and made proposals for the establishment of a documentation centre. He also went to see other documentation centres in New Delhi, Bangkok and Stockholm.

A contractual service agreement was concluded with a professor of paediatrics to review recent literature and to compile "An Aid to the Teaching of Human Repro- duction, Family Planning and Population Dynamics" covering all related disciplines. The "Aid" is being printed in loose-leaf form so that the information can be updated from time to time.

SEAR0 0199 (6301) Group Education in Service, Teaching and UNFPA Research As~ectsof Human Reproduction, Family Planning and Population Dynamics (July 1971; Nov. - Dec. 1971; - )

Aim of the project. To assist in the development of education and studies in human reproduction, family planning and population dynamics. SEA/RC25/2 Page 208

Assistance provided by WHO during the vear. (a) Five consultants, one temporary adviser and assistance from two Headquarters staff members and from one of the Regional Advisers on Maternal and Child Health; (b) cost of attendance of participants; (c) secretarial assistance; (d) supplies for the symposium.

Probable duration of assistance. A number of years.

Work done during the vear. A Meeting on Maternity-centred (post-partum) Approach to Family Planning was held in the Regional Office from 26 to 28 July 1971 with 17 participants from India, Indonesia, Nepal and Thailand. The meeting, which was assisted by a WHO consultant, strongly recomended that the maternity-centred approach to family planning should be adopted within existing maternal and child health services.

A Symposium on the Use of Oral Contraceptives in National Family Planning Programmes was held in the Regional Office from 24 to 26 November with 21 participants from Ceylon, India, Indonesia, Nepal and Thailand. Two WHO consultants assisted in planning and conducting the symposium. The report on the meeting has been distributed.

A further meeting held during the period under review was the Symposium on the Role of the Paediatrician in a Family Planning Programe, which took place at the Institute of Child Health, Madras, from 6 to 8 December, with 11 participants from Ceylon, India and Indonesia. This symposium provided an opportunity to leading paediatricians to exchange views on the contribution of family planning to the improvement of child health, and proposed methods for promoting family planning concepts through child health services, education and research. The report on this symposium has also been issued.

In October, a WHO consultant visited Indonesia to take part in the WHO- sponsored Seminar on Clinical and Public Health Aspects of Human Reproduction, Family Planning and Population Dynamics, held in Djakarta from 4 to 6 October. He also attended the Fifth Asian Congress of Obstetrics and Gynaecology, which took place from 8 to 15 October in that city.

SEAR0 0206 (6203) Medical Education in Human Reproduction, UNFPA Familv Planning and Po~ulationDynamics (March 1972 - ) Aim of the project. To assist in the planning, preparation, conduct and evaluation of short training courses for senior medical teachers in order to improve further the teaching of human reproduction, family planning and population dynamics in medical schools of the Region.

Assistance provided by WHO during the year. (a) Three consultants and a temporary adviser; (b) supplies and equipment.

Probable duration of assistance. Some years.

Work done during the vear. A regional course on the teaching of human reproduction, family planning and population dynamics in medical colleges was held at the National Institute of Family Planning, New Delhi, from 3 April to 2 May. There were eighteen participants - senior teachers of preventive and social medicine, obstetrics and gynaecology and paediatrics - and they came from India, Indonesia and Thailand. Two consultants and a temporary adviser prepared and conducted the course, assisted by a faculty of 34 guest lecturers. The contributions to be made SEA/RC25/2 Page 209

by the various departments of a medical school throughout the entire undergraduate period (including the internship period) were examined in detail with regard to timing, teaching methodology, course content, machinery for implementation and evaluation, etc. Luring a field visit to the Rural Health Research Centre, Narangwal, the participants studied the service framework for a rural field practice area and evolved guidelines for a three-month internship training programme.

SEAR0 0211 (4002) Public Health Advisory Services, Mekong FT Committee (Sept. 1968 - ) Aim of the project. To provide technical advice to the Co-ordinating Committee for the kvelopment of Lower Mekong River Basin; to advise on the prevention of comnunicable diseases resulting from the changes in environment due to man-made lakes and other irrigation works.

Assistance provided by WHO during the year. A sanitary engineer. Probable duration of assistance. Until the end of 1973.

Work done during the year. The sanitary engineer continued to render advice and assistance to the Division of Economic Studies of the Mekong Committee Secreta- riat. He has undertaken special studies on the effect of impoundment of water on the mosquito vectors and malaria incidence in the resettlement areas on the Mekong river projects. A detailed report on "Malaria in the Lower Mekong Basin" has been prepared. Entomological observations in the tributary project areas of North Thailand are being carried out by a team of the Thai malaria eradication programme. An offer of financial assistance for carrying out, during the next three years, entomological work in the Lower Mekong Basin, particularly in the Nam Phrom and Nam Pong water resources areas, has been received from a commercial source.

SEAR0 0213 (4502) Health Education Materials and Communications UNFPA Media with Particular Reference to Family Planning (Aug. - Nov. 1971; - ) Aim of the project. To assist in developing and in improving the quality of informational, educational and teaching materials used in educational activities, and in planning for more effective utilization of various communication media for the education of the public and for preparation of staff in health education.

Assistance provided by WHO during the year. (a) A consultant, six temporary advisers and assistance from Regional Office and field staff; (b) cost of attendance of participants; (c) secretarial assistance.

Probable duration of assistance. Until the end of 1975.

Work done during the year. A consultant assisted in planning the inter-country Workshop on Development of Health Education Media with Particular Reference to Family Health. He visited Ceylon, In,ionesia and Thailand and assisted the country study groups in collecting the required information.

The Workshop was held in the Regional Office from 12 to 20 October. Twenty- five participants from Ceylon (2) , India (6). Indonesia (7), Mongolia (2) , SEA/RC25/2 Page 210

Nepal (4) and Thailand (4) attended the workshop, which was conducted by a consultant and six temporary advisers. UNESCO, UNDP, ECAFE and FA0 were also represented. In addition, representatives from US AID, the Population Council, IPPF and the Ford Foundation attended the workshop. A guideline for the production, utilization and evaluation of health education media, including mass communication, was prepared by the workshop, which also drew up country plans. Subsequent to the workshop the WHO consultant, at the request of the Government of Indonesia, visited that country in order to assist in finalizing the country follow-up plans and schedule of activities. The report on the workshop has been distributed.

It is planned to provide a consultant in 1972 to assist the various countries to take effective follow-up action on the recommendations and country plans.

SEAR0 0214 (1101) Symposium on Epidemiolo~y and Control R of Venereal Diseases (Nov. - Dec. 1971)

Aim of the project. To organize a Symposium on the Epidemiology and Control of Venereal Diseases in the Region, and to revlew the control measures undertaken, with special emphasis on the organization and administration of venereal-disease control programmes.

Assistance provided by WHO during the year. (a) Two consultants and six temporary advisers; (b) a one-week fellowship for a candidate from India for study in Thailand; (c) cost of attendance of participants.

Work done. The Symposium was held from 14 to 17 December 1971 at Bangrak Hospital, Bangkok (Thailand). It was attended by eight participants from three countries (Ceylon, Indonesia and Thailand) and 14 observers from Thailand. (Participants from India and Nepal could not attend.) Two WHO consultants, in addition to six temporary advisers from Thailand, formed the WHO faculty and assisted in the conduct of the Symposium.

The Symposium dealt at length with the problem of venereal disease and the factors which contributed to its growth in the countries of this region, and made positive recommendations for controlling the spread of venereal diseases. The report on the Symposium has been distributed.

Development of Elaternity-cenLred Aspects of Family Health Services (Jan. 1972 - )

Aim of the project. To support country and inter-country activities in family health with particular emphasis on the maternity-centred approach.

Assistance provided by WHO during the vear. A medical officer and a consultant.

Probable duration of assistance. Some years.

Work done during the vear. The project started in January 1972 with the assignment of a consultant. He visited several institutions in Ceylon, India, Nepal and Thailand concerned with the maternity-centred approach to family health services. After completion of his assignment, the same consultant was appointed SEA/RC25/2 Page 211

as medical officer in the project on a regular basis. Steps are being taken to recruit a further medical officer.

Collection and Utilization of Health Statistics. Records and Reports (Jan. 1972 - )

Aim of the proiect. To assist in developing consistent systems of record keeping and reporting for health centres and hospitals, in the collection, processing and presentation of statistical data arising from these systems, and in training staff required at various levels of their operation.

Assistance provided by WHO durina the year. A statistician and a clerk- stenographer .

Probable duration of assistance. A number of years.

Work done during the year. This project came into existence on 1 January 1972 by the amalgamation of projects SEARO 0161, "Hospital Statistics and Medical Records", and SEARO 0050, "Reorganization of Rural Health Records and Reports". The statistician of SEARO 0161 was transferred to this project.

The statistician assisted the National Health Manpower Study under project Ceylon 0101 for a period of nearly five months (January to May). He revised and formulated the data processing plan for some of the sub-studies, e.g., "Census of Doctors", "Census of Nurses and Midwives", "Study of Activities of Rural Health Personnel'' and "Education of Doctors" and advised on other statistical aspects of the work concerning the study.

He proceeded to Indonesia in June to assist the Government in the analysis of results of a trial which was carried out in two provinces to find out a simple and effective routine hospital reporting system. He was also to help with the organization of medical records systems in two hospitals in order to suggest the most suitable system to be adopted by other hospitals in the country.

Initial preparations were made to convene a working group on the Ninth Decennial Revision of the International Classification of Diseases (ICD) in order to get the views of countries of the Region on the present utilization and usefulness of the ICD and on the proposed changes which they would like to be introduced in the next issue. SEA/RC25/2 Page 213

10. INTER-REGIONAL (PROJECTS WITHIN THE REGION)*

PROJECT LIST

Proiect No. Source of Funds Co-operating 4encies Title

Inter-regional 0188 Economic Comission for Asia and the R Far East (July 1970 - )

Aim of the ~rcject. To carry out liaison functions with ECAFE.

Assistance ~rovidedby WHO during the year. (a) A liaison officer; (b) supplies and equipment.

Probable duration of assistance. Sonle years.

Work done during the year The liaison officer attended numerous meetings of ECAFE, including its 28th Session in March 1972 as well as the meetings of the Mekong Secretariat and Committee on behalf of WHO, presenting the Organization's policies and views. He continued to promote exchanges of views and co-ordination of activities of mutual interest, and advised on the health aspects of jointly-assisted projects. He worked in close co-ordination with the WHO sanitary engineer assigned to the project, "Public Health Advisory Services, Mekong Committee" (SEAR0 0211).

Inter-regional 0190 Leprosy/BCG Trial Team. Burma R (April 1964 - )

Aim of the project. To continue the field trial in Burma to determine the value of BCG vaccination in the prevention of leprosy and to obtain information on the epidemiology, therapy and bacteriology of the disease and on its clinical patterns.

Assistance provided by WHO during the year. A medical officer and a statistician.

Probable duration of assistance. Until 1974.

Work done during the year. The programme activities continued as planned. Regular re-examination of the children included in the BCG/leprosy trial contributed further information relevant to the main objective of the project. The Chief of the Leprosy Unit from WHO Headquarters visited the project to review the results and guide the team members regarding future action.

*This list includes meetings and seminars held within the Region for which the main responsibility was that of WHO Headquarters. However, assistance in their organization has often been given by the Regional Office, which also has sometimes financed its own participation. Meetings of this nature for which the Regional Office has the main responsibility are listed in Section 9. SEAIRC2512 Page 214

Inter-regional 0306 Aedes Research Unit (Bangkok) Special Account (April 1966 - ) for Medical Research

Aim of the proiect. To study the ecology, behaviour and distribution of Aedes; to carry out research and field trials on the control of A. aegypti, using insecticides and biological procedures at present being developed.

Assistance provided by WHO during the year. A medical officer and an entomologist.

Work done during the year. The Aedes Research Unit continued its research activities related to the ecology and population dynamics of the Aedes mosquito, vector of denguelhaemorrhagic fever. Various ways of reducing the density of adult mosquitoes have been under trial in order to develop the most suitable and economical method which would eventually result in the control of outbreaks of dengue and denguelhaemorrhagic fever.

Preparations were being made for the gradual transfer of the unit to Indo- nesia. The transfer is expected to take place as soon as the investigation programmes already initiated in Thailand are completed and the results analysed.

Inter-regional 0445 Inter-regional and Regional Cholera Teams UNDP (Aug. 1970 - )

Aim of the proiect. To assist in organizing epidemiological and other studies of cholera, and to advise the health authorities of countries where the disease is prevalent on the application of control measures and on new techniques of diagnosis and treatment.

Assistance provided by WHO during the year. A consultant.

Work done during the year. A WHO short-term consultant, accompanied by a staff member from WHO Headquarters, visited Indonesia in April 1972 to assess the progress of the WHO-assisted study on the influence of improvements in the environment on the spread of cholera. The activities, which were initiated last year, have continued to be carried out in Sulawesi (Indonesia), considered to be the home of cholera El Tor.

Inter-regional 0529 Research on the Genetic Control of Culicine Special Account Mosquitoes (India) for Medical (Oct. 1969 - ) Research

Aim of the proiect. To conduct research into the feasibility of controlling CuZex fatigans, Aedes aegypti and Anopheles stephensi on an operational scale by genetic manipulation.

Assisrancc proviJed by hWU during theyear. A n~edlcalofficer, an rnLomologist, an ecoloyisr, two consultants, an administrative assisrant, a senior assistant and four assistants.

Work done during the year. The activities of the project were further expanded, and preparations have been made for a split up of field trials in the genetic control of mosquitoes, involving the use of the cytoplasmic incompatible strain of C. fafatiguns. SEA/RC25/ 2 Page 215

The work has been reviewed at regular intervals by staff and consultants from WHO Headquarters, the staff of the project, and the counterpart staff from India.

Inter-regional 0575 Research Team on Evaluation of Fertility UNFPA Regulating &ents.Ban~kok (April 1972 - )

Aim of the Droiect. To evaluate the health impact of fertility control methods by direct field studies, by assisting in national clinical trials, and by short- term training programmes in clinical trial methodology.

Assistance ~rovidedby WHO during the year. A pharmacologist, a gynaecologist, an administrative officer, and a consultant.

Probable duration of assistance. Four years.

Work done during the year. A meeting of a consultant group was held from 17 to 21 April 1972 to identify suitable research proposals and also advise on the functioning of the WHO Research Team on Clinical Evaluation of Fertility Regu- lating Agents, established at Chulalongkorn University, Bangkok.

WHO provided the services of consultants and a staff member. SEA/RC25/2 Page 217

11. INTER-REGIONAL (PROJECTS OUTSIDE THE REGION WITH PARTICIPANTS FROM THE SOUTH-EAST ASIA REGION)

Project No. and Number of Source of Funds Title Participants

Inter-regional 0113 Eleventh International Training Course 6 (3 from India,* UNDP on the Epidemiology and Control of 1 from Indonesia, Tuberculosis, Czechoslovakia/India 1 from Nepal & (5 April - 9 August 1972) 1 from Thailand*) Inter-regional 0120 Eighth Refresher Course in Anaes- 2 from Thailand Voluntary Fund thesiology, Copenhagen for Health (5-25 September 1971) Promotion

Inter-reeional 0120 Twenty-second Training Course in 3 (1 from India, Voluntary Fund Anaesthesiology, Copenhagen 1 from Nepal 6 for Health (16 January - 9 December 1972) 1 from Thailand) Promotion

Inter-regional 0120 Ninth Refresher Course in Anaes- 1 from Thailand Voluntary Fund thesiology, Copenhagen for Health (1-24 June 1972) Promotion

Inter-regional 0228 Training Course on Cholera Control, 4 (2 from India, UNDP Malaysia, Singapore and Philippines 1 from Indonesia & (9-23 October 1971) 1 from Thailand)

Inter-regional 0228 Training Course on Cholera, Accra 1 from Indonesia UNDP (Ghana) (7-25 February 1972)

Inter-regional 0439 Inter-regional Seminar on Health and 1 from Thailand Regular Manpower Planning,Yugoslavia and Turkey (6 September - 1 November 1971)

Inter-regional 0453 Training Course on Modern Trends in 2 from India UNDP the Care of Psychiatric Patients with S~ecialEmuhasis on Psvchiatric Nursing Care, Denmark (4 September - 16 October 1971)

Inter-regional 0455 Training Course for Immunology 6 (1 from Ceylon, Voluntary Fund Teachers, Copenhagen 2 from India, for Health (9-29 April 1972) 1 from Indonesia & Promotion 2 from Thailand)

Inter-regional 0495 Training Course on the Quality Control 3 (1 from Indonesia & Voluntary Fund of Drugs, Copenhagen 2 from Thailand) for Health (10 April - 6 May 1972) Promotion

*from SEAR funds SEA/RC25/2 Page 218

Protect No. and Number of Source of Funds Participants

Inter-regional 0524 Inter-regional Training Course on 1 from Indonesia UNDP Radiation Protection, Supervision and Inspection, Holte, Denmark (2-28 August 1971)

Inter-regional 0538 Seminar on the Structure and Synthesis 6 (1 from Ceylon, UNDP of Antibodies, Moscow 2 from India, (4-16 October 1971) 1 from Indonesia 6 2 from Thailand)

Inter-regional 0571 Training Course on the Methodology 4 (2 from Indonesia & UNFPA of Clinical Trials with Fertility 2 from Thailand) Regulating Agents, Tehran (11-20 December 1971)

Inter-regional 0594 Inter-regional Travelling Seminar on 4 (1 from Ceylon,* Regular Health Statistics, USSR and Finland 1 from India, (4-25 August 1971) 1 from Indonesia* & 1 from Thailand*) lntcr-regional 0594 Second Inter-regional Travelling 1 from Thailand Regular Seminar on Health Statistics, USSR and Finland (5-24 June 1972)

Inter-regional 0620 Sixth Course in Child Dental Health, 2 (1 from India & UNDP Aarhus, Denmark 1 from Indonesia) (20 September - 26 November 1971)

Inter-renional 0637 WHO/IAEA Seminar on the Training of 1 from India Regular Radiographers and other Technical Staff in the Medical Use of Ionizing Radiation and Radioisotopes, Tehran (4-15 December 1971)

Inter-regional 0638 Seminar on Teacher Training for Schools 2 from Thailand Regular of Medicine and Allied Health Sciences, Chicago (USA) (18-28 October 1971)

Inter-regional 0640 Training Course on Diagnostic Techniques 3 (2 from India & Regular for Chromosome Aberrations, Sweden 1 from Thailand) (23 August - 4 September 1971)

Inter-regional 0707 Seminar on Public Health Aspects of 2 (1 from India & Regular Water Pollution, Zurich (Switzerland) 1 from Thailand) (22-27 November 1971)

Inter-regional 0718 WHOIIAEA Seminar on Training and 1 from Thailand Regular Education in Medical Physics, Kiel (Federal Republic of Germany) (10-22 April 1972)

*from SEAR funds SEA/RC25/2 Page 219

ANNEXES I REGI0SA.L DIBECTOR I

I DIRECTUR, HEALTH SERVICES 1 I

...... ASSISTILVT DIRECTOR ASSISTANT DIRECTOR ASSISTAXI DIRECTOR ASSISIANI DIRECIOR I !

&L------EDUCATION AND TRALSINC

4, 4, 8, 128 8 BUDGET 6 FINMICE FELLOUSHIPS LIBRARY REGIOXAL ADVISERS

PERSONNEL chronic 6 Degenerative nalaria Direares Macema1 and Child Healrh iomuricable Diaeares (Family Heslrhl corsnuniry Health services ~edicalEducation MEDICAL SUPPLIES ~nvironnental~ealrh Sursing Health Education ~urrition malfh ~abo~aroryServices Pvhlie Healrh Health SlaLisfiCB Smallpox

...... FIELD PROGRAMME ...... , SEA/RC25/2 Page 222 Annex 2

GEOGRAPHICAL DISTRIBUTION OF INTERNATIONAL STAFF ASSIGNED TO THE SOUTH-EAST ASIA REGION AS OF 30 JUNE 1972

SOUTH-EAST ASIA REGION WHO (global) Country Total Regional Regional Field Total June 1972 Off ice Advisers Staff - Afghanistan - - 1 1 4 Australia - - 4 4 33 Belgium - - 2 2 36 Bolivia - - 1 1 5 Brazil - - 1 1 19 Bulgaria 1 - - 1 5 Hiu"ina - i - 1 4 Canada - 1 6 7 61 Cpy Zon 1 1 6 8 15 Czechoslovakia - - 2 2 29 Denmark - - 2 2 23 Ecuador - - 1 1 8 Egypt - 2 6 8 4 1 Finland - - I 1 7 France 1 - 4 5 130 Germany, Federal Republic of - 3 - 3 54 Greece - - 1 1 14 Guatemala - - 1 1 4 India 2 3 5 10 58 lndoncsia - 1 3 4 6 Ireland - - 2 2 16 Tt.11~ 2 - 1 3 47 Jamaica 1 - 1 2 7 Japan - - 1 1 20 Korea. Republic of 1 - - 1 14 Mexico - 1 1 2 10 h<~paZ - 1 2 3 5 Netherlands 1 1 4 6 32 New Zealand - - 1 1 15 Philippines - 1 1 2 22 Poland - 2 3 5 28 Sweden 1 - 1 2 27 Switzerland - - 1 1 47 Tanzania - - 1 1 I, Ti!ai Land - 2 - 2 4 Union of Soviet Socialist Republics - - 5 5 4$ United Kingdom 6 4 24 34 165 United States of America 3 1 22 26 203 Viet-Nam - - 1 1 4 Yugoslavia 1 1 6 S 39 Other countries - - - - 4:s

Grand Total 21 26 125 172 1 714

Not included: (1) Staff on study leave (2) Staff on leave without pay (3) Staff on leave under insurance cover (4) Staff who have left the Region but whose posts are not yet formally vacated (5) Staff assigned to projects SEARO 0188 (Liaison with ECAFE) and SEARO 0211 (Mekong Cornittee) SEA/RC~~/~ Page 223 Annex 3

MEETINGS AND COURSES ORGANIZED BY WHO AND HELD IN THE SOUTH-EAST ASIA REGION* (1 July 1971 - 30 June 1972)

5 July - Course on Neurological Patient Care and Rehabili- Bangkok 6 August tation (SEARO 0139)

26-28 July Symposium on Maternity-Centred (Past-Partum) New Delhi Approach to Family Planning (SEARO 0199)

9-11 August Meeting on Post-graduate Paediatrlc Education Hyderabad (India 0114) (India)

23 August - Workshop on Health and Population Education in New Delhi 4 September Schools (India 0274)

13-17 September National Seminar on Integration 01 Maternal and Hua Hin Child Health and Family Planning (Thailand 0111) (Thailand)

4-29 October Course on Administration of Schools of Nursing Djakarta (SEARO 0139)

12-20 October Workshop on Development of Health Education Media New Delhi with Particular Reference to Family Health (SEARO 0213)

18-23 October National Seminar on Tuberculosis (SEARO 0113) Rangoon

19 October - Course on Paediatric Patient Care (SEAR0 0139) New Delhi 19 November

25 October - Seminar on Functional Programming of Hospital New Delhi 5 November Facilities (SEARO 0104)

26 October - Course in Radiation Protection (Ceylon 0071) Colombo 11 November

1-10 November Course on Immuno-haematological Procedures in Bombay Blood Banking (SEARO 0176)

1 November - Course on Nursing of Patients with Eye, Ear, Nose Rangoon 11 December and Throat Conditions (Burma 0056)

3-29 November Course on Clinical Teaching in Schools of Nursing Kurunegala (SEARO 0139) (Ceylon)

15 November - Course on Hospital Housekeeping (SEARO 0139) Bangalore 10 December (India)

22 November - Refresher Course in Entomology (Inter-regional Prabhudhabat 10 December 0079) (Thailand)

*Including national courses or meetings for which WHO assistance consisted of more than the provision of consultants. SEA/RC25/2 Page 224 Annex 3

24-26 November Symposium on the Use of Oral Contraceptives in New Delhi National Family Planning Programme (SEARO 0199)

6-10 December National Seminar on Integration of Maternal and Rampur Child Health and Family Planning (Nepal 0034) (Nepal)

29 November - Seminar on Conmunity Medicine for Medical Surabaya 4 December Teachers (SEARO 0096.2) (Indonesia)

25 November - Seminar on Statistical Methods in Medical New Delhi 4 December Research (India 0121)

29 November - Seminar on Training and Services in Occupational Djakarta 11 December Health for Developing Countries (Inter-regional 0708)

1-11 December Seminar on Epidemiology, Prevention and Treatment Chiengmai of Malnutrition in Young Children (Inter-regional (Thailand) 0622)

6-8 December Symposium on the Role of the Paediatrician in a Madras Family Planning Programe (SEARO 0199) (India)

6-11 December Workshop on Teaching of Family and Community Surabaya Health (Indonesia 0114) (Indonesia)

14-18 December Regional Symposium on the Epidemiology and Chi engmai Control of Venereal Diseases (SEAR0 0214) (Thailand) 1972

6-11 January Symposium on Vesical Calculus (SEARO 0195) Bangkok

13-19 January Dental Workshop (Indonesia 0079) Djakarta

17 January - Third Regional Course on National Health Planning Bangkok 7 April (SEARO 0178)

2-5 February Seminar on Tuberculosis of the Nervous System Bombay (India 0221)

14 February - Nursing Care of Surgical Patients (Burma 0056) Rangoon 7 April

15-25 February Training Course on Plague Epidemiology and Mandalay Control (SEARO 0125) (Burma)

24 February - Administration of Nursing Services (Ceylon 0053) Colombo 24 March

6-17 March Course in Rehydration Therapy (SEARO 0144) Jaipur (India)

27 March - Orthopaedic Patient Care (Nursing) (SEARO 0139) New Delhi 28 April SEA/RC25/2 Page 225 Annex 3

27-29 March Meeting on Prevention of Xerophthalmia (SEAR0 0097) Hyderabad (India)

3 April - Training Course in Human Reproduction, Family Nev Delhi 2 May Planning and Population Dynamics For Senior Teachers of Medical Schools (SEAR0 0206)

19-24 June Seminar on Health Aspects of Care of Normal Children Clliengmai in Day Centres and Institutions (SEAR0 0197) (Thailand) SEAlRC2512 Page 226 Annex 4

CONFERENCES AND MEETINGS IN THE SOUTH-EAST ASIA REGION CALLED BY THE UNITED NATIONS AND ITS RELATED SPECIALIZED AGENCIES AT WHICH WHO WAS REPRESENTED (1 July 1971 - 30 June 1972)

30 June - EWE: Third Inter-agency Meeting on Co-ordination Bangkok 1 July of Regional Programmes in the Population Field

17-23 August ECAFE: Seminar on Development and Environment Bangkok 25 August - ECAFE: Regional Seminar on Ecological Implications Bangkok 3 September of Rural and Urban Population Growth

25-27 October ECAFE: Advisory Committee on the Application of Bangkok Science and Technology to Development - Seventh Meeting of the Regional Group for Asia 22 November - ECAFE: Conference of Asian Economic Planners Bangkok 1 December

13-17 December FAOJIAEA: Study Group Meeting on Food Irradiation Bangkok

2-11 March United Nations Development Programme: Meeting of Bangkok Resident Representatives

8-14 May EWE: Meeting of Experts on Contribution of Bangkok Social Sciences to Development Planning

16-17 May ECAFE: Eighth Regional Inter-Agency Meeting on Bangkok Social Development

19-23 June UNICEF: Preview Meeting New Delhi

19-30 June ECAFE: Expert Group Meeting on Socio-economic Bangkok Returns of Family Planning Programmes SEA/RC25/2 Page 227 Annex 5

CONFERENCES AND MEETINGS OF GOVERNMENTAL, NON-GOVEREMEXTAL AND OTHER ORGANIZATIONS HELD IN THE SOUTH-EAST ASIA REGIUN AT WHICH WHO WAS REPRESENTED (1 July 1971 - 30 June 1972)

5-7 July National Institute of Health Administration and New Delhi Education: Conference on Social Science-based Researches in Health and Family Planning

24-25 July Indian Academy of Paediatrics: Workshop on Bombay Protein-calorie Malnutrition for Paediatricians

13-17 September Indian National Science Academy and National New Delhi Academy of Sciences, USA: Workshop on Water in Man's Life in India

8 October Indian Council of Medical Research: Annual New Delhi Meeting of the Expert Committee on Kesearch in Medical Education

8-15 October Asian Federation of Obstetrics and Gynaecology Djakarta and Indonesian Society of Obstetrics and Gynaecology: Fifth Asian Congress of Obstetrics and Gynaecology

12-13 October Government of India: Seventeenth Meeting of the Jaipur Central Council of Health (India)

23-24 October Indian llospital Association: Seminar on Hospital New Delhi Materials Management

28-30 October Indian College of Allergy and Applied Immunology: Jaipur Fifth National Convention on Allergy and Applied (India) Im~unology

3-5 November Indian Cancer Society: Fourth National Cancer Bangalore Conference (India)

13 Sovember - Indian Social Institute: All-India Seminar on New Delhi 2 December thc Indian Family in the Change and Challenge of the 1970s

20-22 February International Institute for Population Studies, Bombay Bombay: All-India Seminar on Family Planning Problems in India

24-26 February Indian Association for the Advancement of Medical Poona Education: Eleventh Annual Conference (India)

26 February - Indian Association of Occupational Health: Ootacarmnd 1 liarci. XYI I Annual Conference SW/RC25/2 Page 228 Annex 5

10-12 March All India Institute of Medical Sciences, New Delhi: New Delhi Sixteenth All-India Obstetrics and Gynaecological Course

12-16 March Indian Medical Association: International New Delhi Conference on Family Planning

17-19 March Indian Public Health Association: Sixteenth Ahmedabad Annual Conference (India)

24-26 March Indian Academy of Paediatrics: Ninth Conference

7-9 April Institute of Cardiology, Madras: Symposium on Madras Cardiovascular Diseases (India)

4-5 May Government of India: First Indo-Bangladesh Anti- Shiilong Malaria Co-ordination Conference (India)

3 June Indian Public health Association: Symposium on Calcutta Community Health

19-23 June Central Co-ordinating Board, SEAMEO/Mahidol UniversitvIGovernment, of ThailandIAssociation of Industrial Medicine of Thailand: Workshop on Ergonomics SEAIRC1512 Page 229 Annex 6

FELLOWSHIP TABLES

Table 1. Fellowsliips harded,by Sources of Funds. Type of Fellowship and Country of Origin of the Fellow (1 July 1971 - 30 June 1972)

I Country of period1 Regular UNDP LINFPA Total Regional Inter- Origin Funds Funds Funds rr~ional

1971 34 3 - 37 7 30 Burma 1972 9 - - 9 1 b Total 43 3 - 46 8 36

1971 40 2 - 42 2 -10 Ceylon 1972 7 - 2 9 1 8 Total 47 2 2 51 3 43

1971 76 19 8 103 1 1'1; India 1972 21 14 1 36 6 >O

Grand Total

1 The fisurrs for the reporting year are broken down into two parts: for t'le periods from 1 July to 31 December 1971 and from 1 January to 30 June 1972. S~A/~c25/2 Page 230 Annex 6

Table 2. Fellowships Awarded by the WHO South-East Asia Region, by Subject of Study and Country of Origin of the Fellow (1 July 1971 - 30 June 1972)

m .rl LO m "a Group LO m .d C Subject m 2.2: Total NO. .E:.rlommm.rl IrXW-Jd 0. m auec g F P2UuHsZh

1 Public Health Administration

Hospital administration -16- - - - 3 10 National health planning - -45- - - 6 15 Public health administration -234.56424 Training of medical assistants ------9 9 .. - Total - 313 9 - 5 622 58 -

2 Sanitation -3134 -13 630 -

3 Nursin~ 2 8 22 4 2 4 11 13 66 -

4 Maternal and Child Health 4 610 6 - 7 -12 45 - 5 -Others Dental health 133- -1-614 Drug control I 1 ------2 Health education 1-10- -14-16 Health statistics - -32-1-1 7 Mental health 1-4- -1-3 9 Medical rehabilitation - -2- - - - - 2 Nutrition 11 1 - - - - 8 11 Narcotic addiction and treatment ------3 3 Occupational health 1 ------6 7

Total 6 523 2 - 4 427 71 SEA/RC25/2 Page 231 Annex 6

Table 2 (continued)

s .i 10 m v a 'A C Group c $ Subject .Z .i: Total NO. ..,22.; rz"2gE10cc

6 Communicable Diseaaes and Laboratory

Malaria -233- - 9 20 37 Communicable diseases - - -2- - - - 2

Laboratory techniques Leprosy control Plague epidemiology Smallpox eradication Tropical medicine Tuberculosis control Vaccine production Venereal-disease control Veterinary public health

Clinical Medicine

Anaes thesiology

Medical technology Ophthalmology Oto-rhino-laryngology Plastic surgery Diabetes mellitus

Radiation physics

Therapeutics Urology and transplanta- tion of kidney SEA/RC25/2 Page 232 Annex 6 Table 2 (continued) - rl*ma -3 m Group Subject No.

8 Basic Medical Sciences and Education

Medical education 3538- -1424 Neurophysiology - - -1- - - - 1 Pathology - -12- - - 1 4 Pharmacology 1 ------1 2 Physiology 1 - -2-1-1 5 Undergraduate medical education - - - -1- - - 1

Total 55413111737

Grand total 46 51 139 70 7 35 43 135 526 SEA/RC25/2 Page 233 Annex 6

Table 3. Fellowships Awarded by the WHO South-East Asia Region for Study in Other Regions and Vice Versa (1 July 1971 - 30 June 1972)

African Region European Eastern Western Total Region of the Region Mediter- Pacific Americas ranean Region Region

From the South-East Asia Region to: 7 102 126 7 139 381

To the South-East Asia Region from: 23 4 5 18 43 93 SEA/RC25/2 Page 234 Annex 6

TaLle 4. Utilization of Former WHO Fellows by Country (Analy~isof 126 reports received from 1 July 1971 to 30 June 1972)

Number of Fellows

Total

0, Utilization m M .rl (O m 5 N (O w .3 U e a > 3 $ mordc.rlo,43 : $ 222S.a.rl n *o "HEi~~~~Z~E?$$a '3

Utilization reports received 9 20 37 13 - 4 10 33 126 -

Employed in the subject of their fellowship 9 19 34 13 - 4 10 31 120 95

Assumed greater responsibilities in their former fields of activity 9 13 31 11 - 3 6 26 99 79

Began new activities in keeping with their fellowship studies 9 929 9 - 2 523 8668

Introduced new methods 9 10 30 9 - 3 9 28 98 78

Established new services 9 930 6 - 2 523 8467

Imparted the knowledge gaincd :o others by means of conferences and by articles in medical journals 9 12 33 11 - 2 6 28 101 80

Engaged in training activities 9 14 35 7 - 4 7 28 104 83

Engaged in research 9 10 29 6 - 3 3 16 76 60

Maintained some degree of contact with other fellows and officials whom they rame to know during their studies 2 816 b - 2 215 5140

Had been on international assignments - -7- - - - 3 10 79 I SEA/RC25/2 Page 235 Annex 7

LIST OF TECHNICAL REPORTS ISSUED BY THE REGIONAL OFFICE (1 July 1971 - 30 June 1972)

Document Title Author

Addiction-Producing Druus

SEA/APD/2 Assignment report on control of Dr M.H. Seevers narcotic drugs in Thailand (rehabilitation of heroin and opium-dependant persons) (Thailand 0068) 6-16 February 1972

Anaesthetics

SEAIAnaesthlZ See SEA/Med.Educ./l75

Cardiovascular Diseases

SEA/CVD/S Assignment report on cardiovascular Prof. I.T. Chumbur diseases (arterial hypertension) (Mongolia 0010) 29 March - 23 April 1971

SEAlCMl6 Report on a visit to the Institute of Dr 7.. Fejfar Cardiology, Government General Hospital, Madras, Tamil Nadu (India), 5-18 February 1972

Cancer

SEA/Cancer/B Assignment report on organization of Dr S. Balmuhanov ontological services (radiotherapy), (Mongolia 0011), 4-18 April 1971

SEAICancerllO Assignment report on cancer control Mrs H. Mouriesse pilot project, Kancheepuram, Tamil Nadu (India 0238), 5 August - 15 September 1971

Cholera

SEA/Cholera/22 Assignment report on production of Mr V. Vesely rehydration fluid in Mongolia (SEARO 0144), May-August 1971

SEA/Cholera/23 Report on a course on rehydration Dr R. Bradley Sack therapy centres, held in the S.M.S. Medical College, Jaipur (India), (SEARO 0144), 6-17 March 1972 SEA/RC25/2 Page 236 Annex 7

r Document Title Author

Communicable Diseases

SEA/CD/34 Field visit report on leptospirosis Dr Soemiatno control in Ceylon (SEAR0 01931, 21 September - 20 October 1971 SEA/CD/35 Assignment report on problems and Prof. C.D. Calnan training in dermatology and establishment of a national institute of dermatology (Thailand 0107). February - March 1972

Dental Health

SEA/DH/20 Assignment report on dental health, Prof. I.J. Mdller Indonesia (Indonesia 0079), 29 August 1970 - 6 February 1971 SEAIDHI21 Assignment report on organization, Dr J.V. Olson curriculum and teaching methods, Phyathai School of Dentistry, Mahidol University, Bangkok (Thailand 0108), September - October 1971

SEA/DH/22 Assignment report on dental health, Dr E.M. Mdrch Indonesia (Indonesia 0079), August 1971 - January 1972 SEA/DH/23 Assignment report on dental diseases, Sir Robert Bradlaw dental health services and dental education in Burma (Burma 0090). August - October 1971 SEA/DH/24 Assignment report on improvement of Dr P.D. Barnard dental education, India (India 0208). December 1971 - February 1972 Diarrhoea1 Diseases

SEA/MCH/7 5 See SEAlMCHl75 SEA/DD/2

SEA/Drugs19 Assignment report on improvement and Dr Tomicek further development of the manufacture of pharmaceuticals in Mongolia (Mongolia 0016), September 1971 SEA/RC25/2 Page 237 Annex 7 - Document Title Author

SEA/Drugs/lO Assignment report on quality control Dr Josef Hubic and standardization of pharmaceutical and biological products, Mongolia (Mongolia 0016), 1-30 September 1971

Education

SEA/Educ/l3 Assignment report on school for the Mr C. Hutchinson training of electro-medical technicians, India (India 01991, December 1967 - September 1971 Environmental Health

SEA/Env.San./99 Assignment report on education and Mr I.J. Silverstone training in sanitary engineering (Khon Kaen Sewerage) (SEAR0 0150), 16 September - 15 December 1970 SEA/Env.San./lo0 Assignment report on national commu- Mr Z.J. Buzo nity water supply programme, Thailand (SEARO 0064lThailand 0090), March 1968 - February 1970

SEA/Env.San./lOl Kcport on the short-term development Mr B.J. Kukielka progrnmme for water supply and sewage disposal systems in Male (Maldives 0007). 12-16 January 1971

SEA/Env.San./lOl -do- -do- Add. 1

SEA/Env.San. 1101 -do- -do- Add.2

SEA/Env.San./lOZ Assignment report on short course on Dr V.L. Keyes environmental health, Rangoon (SEARO 0150). 31 January - 25 March 1971

SLA/Env.San./l03 Assignment report on development of Mr A.J. Moller community water supply programmes (ground water sources, Thailand) (SEARO 0064), January - March 1971 SEA/Env.San./l04 Assignment report on the training and Mr I.W. Beaton utilization of sanitarians in rural water supply construction, Indonesia (Indonesia 00711, 21 April - 19 July 1971 SEA/RC25/2 Page 238 Annex 7

Document Title Author

SEA/Env.San./105 Field visit report on environmental Mr Z.J. Buzo health and community water supplies in Mongolia, 29 August - 11 September 1971 SEA/Env.San./lO6 Assignment report on water supply Mr Alberto Jacome systems operation and maintenance in Thailand (Thailand 0090), 27 October - 27 December 1971

SEAIEnv.San./lO8 Second report on public water supply, WHO Consultant Panel sewerage and drainage for the South- Dr A.E. Berry & west Coastal Area (Ceylon), (Ceylon Dr D.H. Rohde 0086). 24 April - 9 June 1971 SEA/Env.San./l09 Assignment report on rural water supply Mr Robert P. Morfitt in India (India 0227). 16 November 1971 - 9 January 1972 Epidemiology

SEA/Epid/39 and Assignment report on strengthening of Dr T.C. Eickhoff Corr.1 health services (epidemiology),India (India 0182). 23 February - 19 March 1971

SEA/Epid/40 Assignment report on strengthening of Dr S.B. Halstead health services (epidemiology), Thalland (Thailand 0059). 2-29 June 1971

SEA/Epid/40 Add.1 Follow up on assignment report on Dr S.B. Halstead strengthening of health services (epidemiology), Thailand (Thailand 0059), 1-15 January 1972

SEA/Epid/41 Assignment report on strengthening of Dr Z. Jezek health services (epidemiology) Mongolia (Mongolia 0001), May - July 1971 SEAIEpidl42 Assignment report on epidemiological Dr Z. Bencic scrvices (reporting and study of gastro-intestinal diseases), Thailand (Thailand 0059), 5 August - 27 September 1971

SEA/Epid/43 Assignment report on strengthening of Dr M.B. Crcgg epidemiological services, Indonesia (Indonesia 0091), 28 January - 28 February 1972 . SW/RC25/2 Page 239 Annex 7

Document Title Author

SEAIEpidl44 Assignment report on strengthening Dr J.J. Cervenka of epidemiological services, Nepal (Nepal 0026), 24 January - 3 May 1972

Filariasis

SEA/Fil/ll Assignment report on the Culex pipens Mr J.E. Graham fatiguns control programme (filariasis control, Burma) (Burma 0087), 8 April - 28 May 1972

Haemorrha~icFever

SEA/Haem.Fever/9 Assignment report on haemorrhagic Dr S.B. Halstead fevers, Burma, (SEARO 0099). 21-26 June 1971

Health Education

SEA/HE/43 Report on an inter-country workshop Regional Office on health education in schools held in Bangkok (SEARO 0130), 16-27 November 1970

SEA/HE/43 Add.1 Guidelines for developing health Regional Off ice education in schools

SEA/HE/44 Assignment report on school health Dr W.C. Sutton education, Ceylon (Ceylon 00721, 7 July - 3 September 1971

SEA/HE/45 Assignment report on assessment and Dr H.J. Park strengthening of national health education services, Indonesia (Indonesia 0121), 7 August - 26 November 1971

SEA/HE/46 Report on an inter-country workshop Dr B.S. Sehgal on development of health education media with particular reference to family healtll (SEAR0 0213) 12-20 October 1971

SEA/HE/47 Assignment report on health education Dr John T. Fodor in Nepal (Nepal 0019), 6 July - b September 1971

SEA/HE/48 Assignment report on heaith education, Dr Victoria Garcia India (diploma course in health education of the Central Healch Education Kureau, New Delhi) (India 0190), 10 November - 18 December 1971 SEA/RC25/2 Page 240 Annex 7

1 I Document Title Author

SEA/HE/49 Assignment report on assessment and Dr L.H. Glase strengthening of health education in Dr Wirjawan 6, family health, Ceylon (Ceylon 0099), Dr Djojosu~ito July-October 1971

SEA/HEI50 Assignment report on health education Mr N. Scotney in Burma (with particular reference to school health education) (Burma 0066). 21 November 1971 - 31 January 1972

STA/HE/51 Assignment report on health education Dr Simmons 6 (behavioural studies), Indonesia Dr G.U. Krishnamurty (Indonesia 0120). 25 June - 24 September 1971

SEA/HE/52 Assignment report on health education Dr N. Korostelev in Mongolia (Mongolia 0014). November 1971 - January 1972

Health Laboratory Methods

SI.A/IILM155 Assignment report on strengthening of Dr J. Sramek laboratory services, ("Streptococcus Laboratory") , (India 0188.03). 4 January - 24 April 1971

SEA/HLM/~~Add.1 Standardized laboratory procedures Dr J. Sramek for laboratory diagnosis of streptococcus infection

SEA/HLM/~~ I Assignment report on production of / Mr W.H. Thomas and demand for infusion fluid, Burma, I (SEARO 0144). 21 April - 5 July 1971

SEA/HLM/57 Corr.1 Assignment report on healtn labora- Dr R.E. Modica and ~brr.2 tory services, Irian Barat (West Irian) (Indonesia 0089). April - May 1971

SEAIHLEII 58 Report on the feasibility of establish- Dr Stian Erichsen ment of a breeding centre for small laboratory animals in Thailand (Thalland 0075). 3-27 October 1971 1

SEA/HLM/59 Assignment report on the establish- Dr V. Teply ment of serum banking activities. Ceylon (SEARO 0191), March 1971

SEA/HLM/60 Assignment report on the establish- Dr V. Teply ment of serum banking activities, India (SEARO 01911, March 1971

L > SEA/RC25/2 Page 241 Annex 7

Document Ti tle Author

SEA/HLM/61 Assignment report on the establish- Dr V. Teply ment of serum banking activities, Thailand (SEAR0 0191). March 1971

SEA/HLM/62 Report on the inter-country course Regional Office on immuno-hoematological procedures in Blood Banking, Bombay (SEARO 0176). 1-10 November 1971

SEA/HLM/63 Assignment report on health labora- Dr B.B.G. Nehaul tory services, Nepal (Nepal 0010). November 1967 - October 1971

SEA/HLM/64 Assignment report on smallpox diagnos- Dr K.R. Dumbell tic laboratories in India (SEARO 0030). 30 October - 26 November 1971

1.eprosy

SEA/Lep/48 Assignment report on leprosy and its Dr F.M. Noussitou control in Maldives (Maldives 00051, 29 August - 23 September 1971

SEA/Lep/49 Assignment report on leprosy control, Dr E.A. Blum and Corr.1 India (India 0081). May 1969 - Guttierrez Deccmber 1971

Malaria

SEA/Mal/82 Report on a visit to the States of Dr G.L. Adan Tamil Nadu and Kerala (India), 21 April - 30 April 1971

SEAIMall83 Assignment report on malaria eradi- Dr S.W. Wenzel cation programme in Ceylon (Ceylon 00581, March 1968 - September 1971

SEA/Ma1/84 Assignment report on malaria eradi- Dr R. Baidya cation prograrmne in India (India 01531, 13 November 1965 - 11 May 1971

SEA/Mal/85 Assignment report on malaria eradi- Mr William Rooney cation (laboratory services) Indonesia (SEARO 0094). May - June 1971

SEA/Ma1/86 Assignment report on malaria eradi- Dr D.N. Popovic cation, India (India 0153). June 1969 - October 1971 SEA/RC25/2 Page 242 Annex 7

Document Title Author

SEA/Ma1/87 Assignment report on malaria cradi- Mr William Rooney cation, (laboratory services) Burma (SEARO 0094), 11 October - 20 November 1971

SEA/Ma1/88 Assignment report on malaria eradi- Mr S.G. Guerrero cation, Burma (Burma 0031), 4 October 1970 - 31 December 1971 SEA/Mal/89 Assignment report on malaria eradi- Dr R. Sloof cation in Ceylon (Ceylon 0058). April 1970 - December 1971

SEA/M31/90 Assignment report on the malaria Dr A.R. Cilroy control programme in Burma (SEARO 0007). 10 November 1971 - 3 February 1972

SEA/Mal/91 Assignment report on malaria cradi- Dr B. Bisscru cation, Ceylon (training aspects) (Ceylon 0058). 15 October 1971 - 10 January 1972

Maternal and Child Health

SEA/Nurs/El3 See SEA/Nurs/Zl3 SEA/MCH/70

SEA/MCH/71 Assignment report on maternal and Dr H.P. Tait child health services in Burma (Burma 0006). 6 October - 15 December 1970

SEA/MCH/72 Report on the Seminar on School Dr P. Henderson Health, Rangoon, (SEAR0 0184), Mr P.P. Shrestha 6 8-13 February 1971 Miss D. Basco

SEA/MCH/73 Assignment report on paediatric Dr F.J.W. Miller education, India (India 0114). 11 July - 18 August 1971

SEA/MCH/74 Report on a meeting on post-graduate Regional Office education and training in paediatrics, held in the Osnania Institute of Medical Sciences, Hyderabad (India 0114), 9-11 August 1971

SEA/MCH/75 Assignment report on rehydration Dr N.F. Pierce SEA/DD/2 practices and training in the management of infantile diarrhoea and cholera, Indonesia (SEAR0 0144), - March - April 1971 SEA/~c25/2 Page 243 Annex 7

Document Title Author - SEAIMCH176 Report on visits to medical colleges Dr Beryl D. Corner as a follow up of neonatology courses held in 1968, 1969 and 1970, India (SEARO 0170). December 1971 and February 1972

SEA/MCH/77 Report on visits to medical colleges Dr Beryl D. Corner as a follow up of neonatology courses held in 1968, 1969 and 1970, Ceylon (SEARO 0170). 1-9 January 1972

SEA/MCH/~~ Report on visits to medical colleges Dr Beryl D. Corner as a follow up of neonatology courses held in 1968, 1969 and 1970, Thailand (SEARO 0170), 9-18 January 1972

SEA/MCH/79 Report on visits to medical colleges Dr Beryl D. Corner as a follow up of neonatology courses held in 1968, 1969 and 1970. Burma (SEARO 01701, 18 January - 3 February 1972

SEA/MCH/80 Report on visits to medical colleges Dr Beryl D. Corner as a follow up of neonatology courses held in 1968, 1969 and 1970, Indonesia (SEARO 0170). 3-15 February 1972

Maternal and Child Health and Family Planning

SEA/MCH/FP/lO Assignment report on teaching of Dr J. Houstek SEAIMed. Educ. /I56 human reproduction, family planning Dr A. Klopper and population dynamics in medical Dr D. Llewellyn schools, Indonesia (Indonesia 0114). Jones & February - March 1971 Dr J. Villarreal

SEA/MCH/FP/~~ Report on the workshop on operational Regional Office studies related to integration of maternal and child health and family planning in the overall context of general health services, New Delhi, 28 June - 3 July 1971

SEA/MCH/FP/lZ Assignment report on strengthening of Dr P. Robinson & teaching of human reproduction, family Dr T.E.C. Barns planning and population dynamics in medical colleges, India (India 0275), May - August 1971

SEA/MCH/FP/12 Add.1 Report on visits to Madurai and Dr T.E.C. Barns Osmania Medical Colleges, India, June - July 1971 SEA/RC25/2 Page 244 Annex 7 . Document Title Author

SEA/MCH/FP/13 Assignment report on WHO-assisted Dr L. Engstrom projects in Indonesia related to the national family planning programme (Indonesia 0113), 7 May - 3 June 1971

SEA/MCH/FP/14 Report on a visit to hospitals Dr L. Engstrom & included in the post-partum family Dr P. Huntingford planning programme of the Population Council in Indonesia, 18 September - 1 October 1971

SEA/MCH/FP/15 Report on the meeting on maternity- Dr Rosenfield centred (post-partum) approach to family planning, New Delhi, 26-28 July 1971

SEA/MCH/FP/16 Report on the Symposium on the use Dr S.L. Romney & of Contraceptives in National Family Dr F.E. Szontagh Planning Programme, New Delhi (SEARO 01991, 24-26 November 1971

SEAIMCHJ FPI17 Report of a workshop on the integra- Dr H.B.L. Russell tion of maternal and child health and family planning services in the rural areas of India, New Delhi (SEARO 02781, 17-22 May 1971

SEA/MCH/FP/18 Assignment report on family health, Dr C.H. Gurd Ceylon (Ceylon 0105), 11 November - 15 December 1971

SEA/MCH/FP/18 Add.1 Assignment report on family health, Dr Y.J.A. Gueguen Ceylon (Ceylon 0105). 5-17 November 1971

SEA/MCH/FP/18 Add.2 Assignment report on family health, Dr G.I. Zatuchni (maternity-centred family planning programme) , Ceylon (Ceylon 0105). 11 November - 15 December 1971

SEA/McH/FP/19 Report on the Symposium on the Role Regional Office of the Paediatrician in Family Plan- ning Programmes, Madras (SEARO 0199). 6-8 December 1971

Medical Education

SEA/Med.Educ. /I55 Report on the Fourth Meeting of Regional Off ice Directors or Representatives of Schools of Public Health, New Delhi, 24-29 March 1971 SEAlRC2512 Page 245 Annex 7

* Document Title Author

SEAIMCHIFPI~O See SEA/MCH/FP/lO SEAIMed .Educ .I156

SEAIMed.Educ.1157 Assignment report on medical education Dr C.C.C.O'Morchoe (physiology), Sawai Man Singh (S.M.S.) Medical College. Jaipur (India Olll), 23 February - 6 April 1971

SEA/Med.Educ.1158 Assignment report on medical education Dr J.D. Maynard (surgical pathology), All-India Institute of Medical Sciences, New Delhi (India 0111), 4 January - 9 February 1971

SEA/Med.Educ.1159 Report on the Second Regional Seminar Regional Office SEAlMent.118 on the Teaching of Psychiatry, New Delhi (SEAR0 0172) ,17-19 September 1970

SEAIMed .Educ. /l60 Assignment report on medical education Dr P.N. Meenan (microbiology), Bangalore Medical College (India 0111). 22 January - 1 March 1971

SEA/Med.Educ./l61 Assignment report on medical education Dr Beni Horvath (clinical pathology), Institute of Medicine 11, Mingaladon, Rangoon (Burma 0079), 19 July - 10 September 1970

SEAIMed.Educ.1162 Assignment report on medical education Dr A. Trzebski (Physiology), Gadjah Mada University, Jogjakarta (Indonesia 0062). 16 July - 17 September 1970

SEA/Med.Educ.1163 Regional teacher training centre for Dr T. FiilSp health personnel - Report on a visit to Thailand, 25-30 August 1971

SEAIMed.Educ. 1164 Assignment report on post-graduate Dr G .A. Smart training and residency programmes in the Faculty of Medicine and Siriraj Hospital, Thailand (Thailand 0097), 14 July - 17 August 1971

SEAIMed .Educ./165 Assignment report on post-graduate Dr G. Velazquez Palau medical education in Ceylon (SEARO Dr J.O.F. Davies 0096), 27 August - 13 September 1971 Dr B. Richter & Dr T. FilSp SEA/RC25/2 Page 246 Annex 7

I Document Title Author

SEA/Med.Educ./l66 Assignment report on medical education, Dr J.T. Aitken India (India 0111). January - Dr W.A. Gillespie & February 1971 Dr H.W. Rodger8

SEA/Med.Educ./166 Assignment report on medical education Dr J.T. Aitken Add. 1 (anatomy), Sarojini Naidu Medical College, Agra (India Olll), January - February 1971

SEAfMed. Educ. 1166 Assignment report on medical education Dr W.A. Gillespie Add. 2 (microbiology and pathology), Sarojini Naidu Medical College, Agra (India 0111), January - February 1971

SEA/Med.Educ./l66 Assignment report on medical education Dr H.W. Kodgers Add.3 (surgery), Sarojini Naidu Medical College, Agra (India 0111). January - February 1971

SEA/Med. Educ. 1167 Assignment report on medical education Or E. 1,lewellyn (pharmacology), Ceylon (Ceylon 0047), Thomas 16 October 1970 - 31 March 1971

SEA/Med.Educ. 1168 Assignment report on medical education Dr N.H. Keswani (anatomy), Burma (Burma 0079). 18 May - 24 August 1971

SEA/Med.Educ./l69 Assignment report on the teaching of Dr H.M. Gilles clinical tropical medicine and preventive medicine, Mahidol University, Thailand (Thailand 0057), 4 April - 16 May 1971

SEA/VHS/129 See SEA/VHS/129 SEA/Med.Educ./l70

SEA/Med.Educ./l71 Assignment report on medical education Dr M.J. Waas (physiology), Indonesia (Indonesia 0062). 1 May 1967 - 31 October 1971 SEAIMed. Educ. 1172 Assignment report on School of Preven- Dr Z.J. Sestak tive and Tropical Medicine, Institute of Medicine I, Rangoon (Burma 0075 and I 0028), February 1967 - October 1971 SEA/Med.Educ./l73 Report on the Seminar on Rheumatic Dr E.B. French Heart Disease: Epidemiology, Dr S.L. Morrison 6 Prophylaxis and Clinical Management, Miss E. Shearman All-India Institute of Medical Sciences, New Delhi (India 0221) 22-25 February 1971 SEAlRC2512 Page 247 Annex 7

a - Dacument Title Author SEAIMed.Educ.1174 Assignment report on medical education Dr Michael Hobsley (surgery), University of Ceylon, Peradeniya (Ceylon 0047), 1 October - 29 November 1971

SEA/Med.Educ.1175 Report on improvement of anaesthesio- Dr J.C. Rosen SEA/Anaesth./Z logy in Thailand (Thailand 0106). 15 October 1971 - 15 January 1972

SEAIMed.Educ.1176 Report on medical teachers' training Dr S. Abrahamson course, Peradeniya, Ceylon (SEAR0 Dr J. Foster 0096), 14 November - 2 December 1970 Dr W.A. ~illard6 Dr R.E. Tranquada

SEA/Med.Educ.I177 Assignment report oc medical education Dr R.H. Jackson in paediatrics, Ceylon (Ceylon 0047), October - December 1971

SEAIMed.Educ.1178 Assignment report on medical education Dr David G. Fish (development of a protocol for the study of the utilization of doctors in Ceylon) (Ceylon 0047), 29 February - 31 March 1972

SEAIMed.Educ.1179 Assignment report OIL the development Dr J.M. Last 6 of the Faculty of P~~blicHealth, Dr John Pemberton Djakarta, and on thr: curriculum in preventive and social medicine and public health in six state medical schools in Indonesia (SEARO 0096), 2 January - 10 February 1972

SEAIMed. Educ .I180 Assignment report on medical education Dr F.M. Katz 6 (faculties of medicine) in Thailand Dr W.H. McCarthy (Thailand 0097). 14 December 1971 - 31 January 1972

SEAIMed.Educ.1181 Assignment report on assistance in Dr V. Dyrberg organization of post-graduate training in anaesthesiology in Ceylon (Ceylon 0047), 25 October - 4 December 1971

SEAIMed. Educ .I182 Assignment report 0.1 Bangalore Medical Dr John H. Read College, India (paediatrics and preventive and social medicine) (India Olll), 23 August - 26 September 1971

SEA/Med.Educ.1183 Final condensed report on assistance The Faculty of to medical education in Gujarat, India Medicine, University (Baroda Medical College) (India 0183), of Edichurgh 1963-1969 - SEA/RC25/2 Page 248 Annex 7

Document Title Author

SEA/Med.Educ./184 Assignment report on medical education Dr W.E.S. Kiernan (psychiatry), India (Medical College, Goa) (India Olll), March - April 1972

Mental Health

SFA/Med.Educ./159 See SEA/Med.Educ./l59 SEA/Ment./lB

SEA/Ment./l9 Report on a Seminar on the Organiza- Regional Office and Corr.1 tion and Future Needs of Mental Health Services, New Delhi, 1-5 February 1971

Nursing

SEA/Nurs/Zl3 Assignment report on paediatric and Miss Barbara E. Walsh SEA/MCH/70 obstetric training and services. Kerala State (India 0114), March 1970 - February 1971

SEA/Nurs/215 Report on a visit to the WHO-sponsored Miss Ruth W. Dean and Corr .l Training Centre for Nurses, Wellington, New Zealand, 2-7 August 1971

SEA/Nurs/Zlh Report on a meeting of WHO nurses Regional Off ice stationed in India, New Delhi, 2-4 March 1971

SEA/Nurs/217 Information on short course on Miss E. Gillespie guidance and counselling in schools of nursing, held at the post-basic school of nursing, Colombo (SEARO 0139), 12 March - 7 April 1971

SEA/Nurs/218 Information on short course on adminis- Miss Rachel Ask tration of schools of nursing, held in Djakarta (SEARO 0139), 20 September - 15 October 1971

SEA/Nurs/219 Assignment report on post-basic nurs- Mrs A.T. Howard ing education, Chandigarh (India 0136). 28 August 1970 - 16 July 1971

SEA/Nurs/ZEO Assignment report on nursing services Miss R. Joseph and education, Maldives (Maldives 0005 and 0008). June 1968 - March 1971

SEA/Nurs/221 Assignment report on post-basic nurs- Dr A.M. Maglacas ing education, College of Nursing, New Delhi (India 0136), February - June 1971 - SEA/RC25/2 Page 249 Annex 7

Document Title Author

SEA/Nurs/222 Assignment report on nursiog advisory Miss M.G. McPhedran services, Ceylon (Ceylon 0053). 15 February - 22 June 1971

SEAINurs/223 Assignment report on psychiatric nurs- Miss A. Klimeoko ing course to nursing tutors in Gujarat and integration of psychiatric nursing at the College of Nursing. Ahmedabad (India 0136). 5 July 1971 - 4 August 1971

SEA/Nurs/224 Report on the short course on neuro- Miss I. Bjorkroth logical patient care and rehabilita- Mr J.R. Hughes 6 tion, held at Chulalongkorn Hospital, Dr T.R. Fisher Bangkok, Thailand (SEAR0 0139) 5 July - 6 August 1971

SEAl~urs/225 Assignment report on nursing education Miss M.M. Higgins and services, Nepal (Nepal 0002) , May 1969 - August 1971

SEA/Nurs/226 Assignment report on nursing education Miss G. Richardson and services, Thailand (Thailand 0089), 1 July 1967 - 31 July 1971

SEAINursl227 Assignment report on public health Miss M.S. Lochore nursing component of projects - strengthening of health services,Pitsanuloke Province (Thailand 0002),and nursing education and services (Thailand 00891, March 1966 - July 1971

SEA/~urs/228 Report on a short coarse on clinical Miss Mary Powell teaching orthopaedic nursing, held at Post-basic Nursing School, Rangoon (Burma 0056), 16 November 1970 - 18 January 1971

SEA/Nurs/229 Report on a short course on neuro- Miss J. Hope logical and neurosurgical patient care, held in General Hospital, Rangoon (Llurma 0056), 1 June - 27 November 1971

SEA/Nurs/230 Assignment report on post-basic nurs- Miss B. Guerrieri ing education, Madras (India 0136). June 1969 - December 1971

SEA/Nurs/231 Report on short course on paediatric Miss B.E. Walsh patient care, held at the All-India Miss G. Clement 6 Institute of Medical Sciences, New Mr Kirkland Delhi (SEAFLl 0139). 19 October - 19 November 1971 SEAIRC2512 Page 250 Annex 7

Document Title Author

SEAINurs1232 Assignment report on psychiatric Mrs L.S. Morrill nursing education and services in Thailand (Thailand 0017 and 0089), August 1968 - December 1971

SEA/Nurs/233 Report on short course on hospital Mr A. Roy Bubb housekeeping, held in Bangalore, India (SEARO 0139), 15 November - 10 December 1971

SEAtNurs1234 Information on short course on clini- Miss Margaret M. cal teaching in schools of nursing, Higgins held in Kurunegala, Ceylon (SEARO 01391, 3-29 November 1971

SEA/Nurs/235 Report on a short course on clinical MKS T. Miller teaching of paediatric surgical nurs- Miss M.N. Clements 6 ing, held at the Institute of Child Mr I.S. Kirkland Health and Hospital for Children, Egmore, Madras, India (SEARO 0139) 13 July - 14 August 1970

SEAINurs1236 Assignment report on nursing services Miss I. Szarkowska and education, Mongolia (Mongolia 0008), March 1968 - December 1971

SEAlNurs1237 Assignment report on post-basic nursing Dr Charlotte Seyffer education, India (India 0136), 1 October 1971 - 29 April 1972

SEA/Nurs/237 Add.1 Assignment report on post-basic nurs- Dr A. Mangay Maglacas ing education, India (India 0136), 6 January - 24 April 1972

Nutrition

SEA/Nut/34 Interim report on the pilot nutri- Dr W.D. Keller tional rehabilitation centres, Rangoon (Burma 0093) (based on field visits paid during the period February - August 1971)

SEA/Nut/35 Report on a Meeting on Prevention of Regional Office Xerophthalmia, held at the National Institute of Nutrition, Hyderabad, India (SEARO 0097), 27-29 March 1972

SEA/Nut/36 Assignment report on public health edu- Dr R. Buzina cation, Thailand (nutrition training at the Faculty of Public Health, Mahidol University, Bangkok) (Thailand 0095). 11 December 1971 - 23 January 1972 SEAIRC2512 Page 251 Annex 7

, . Document Title Author SEAINut137 Assignment report on control of nutri- Dr S.K. Sood tional anaemia in pregnancy, Ceylon (Ceylon 0085). 31 December 1971 - 31 January 1972

SEAlNut138 Assignment report on goitre control, Dr Van Rhijn Province of West Irian (Indonesia 0088). 19 January - 26 March 1971

Occupational Health

~~A/Occ.~lth/7 Assignment report on occupational Dr M.A. El Batawi health in Burma (SEARO 0148), 11-24 July 1971

SEA/Occ.Hlth/8 Assignment report on occupational Dr M.H. Nowcir he~lthand industrial hygi,nr scrviccs, Indonesia (Indonesia 0105), 14 September 1970 - 29 January 1971

Pharmacolo~y

SEAIPharmacologyl6 Assignment report on pharmaceutical Dr James Chilton education in Ceylon (Ceylon 0077), January - March 1971

SEA/Plague/lO Assignment report on epidemiology and Dr M. Bahmanyar control of plague in Burma (Burma 0078), 16 December 1971 - 25 February 1972

Public Health Administration

SEA/PHA/92 Report of the team on assesso~entof Dr A. Leslie Banks the health services developed in Pitsanuloke project, Thailand (Thailand 0002), July - September 1970

SEAlPHAl96 Assignment report on strengthening of Dr W.H. Coates health services, Nepal (Nepal 0003), January - December 1970

SEA/PHA/97 Assignment report on food control Dr Robert S. Roe administration, Thailand (Thailand 0066), 26 February - 26 April 1971

SEA/PHA/~~ Assignment report on national health Mr M. Wheeler planning and manpower studies in Indonesia (SEARO 0178lIndonesia 0119), 6 July - 28 September 1971 1 SEA/RC25/2 Page 252 Annex 7

* Document Title Author

SEA/PHA/~~ Assignment report on national health Dr W.L. Barton planning, Indonesia (SEARO 0178), 9 July - 19 September 1971

SEA/PHA/ 100 Assignment report on public health Dr K.S. Seal administration, Thailand (Thailand 0098), October 1970 - December 1971

SEA/PHAI~OL Assignment report on national health Dr D.J.M. Mackenzie and Corr .l planning in Ceylon (Ceylon 0092), September - December 1971

SEA/PHA/lOL Report on the Seminar on Functional Miss N. Lyslo Programming of Hospital Facilities, Mr G. Entwistle & (SEARO 0104), New Dclhi, 25 October - Dr J. Andress 5 November 1971

Rabies SEA/Habics/2 See SEAlVaccinel47 SEA/Vaccine/47 Sfi.'A/Rabies/3 Assignment report on rabies epidemio- Dr C.T. Caraway logy and control, Indonesia (Indonesia 0100), 15 November 1971 - 29 January 1972

Radiation S&\/R;ld/58 Assignment report on radiation health Dr C.A. Greatorex h in Ceylon (Ceylon 0071) 20 October - Mr G. Subrahmanian 19 November 1971

St:A/Rnd/59 Assignment report on radiation protec- Dr F. Edsmyr tion in Nepal (SEAKO 0042). 24 November - 19 December 1971

SEA/R~~/~O Assignment report on Radiation Dr W.W. Shreeve Medicine Centre, Bombay (India 0192), November - December 1971

Rehabilitation SEA/Rehab/l2 Assignment report on rehabilitation of Prof. Marian Weiss handicapped children, (SFARO 0174), 10 March - 30 April 1971

SEA/Rehab/lZ Add.1 Assignment report on rehabilitation of Prof. Marian Weiss handicapped children, ~eylon(SEAR0 0174). 17-27 March 1971

SEA/Rchab/l2 Add.2 Assignment report on rehabilitation of Prof. Marian Weiss handicapped children, Indonesia (SEAR0 0174). 29 March - 6 April 1971 SEA/RC25/2 Page 253 Ancex 7

1 Document Title Author

SEA/Rehab/l2 Add.3 Assignment report on rehabilication of Prof. Marian WeiSs handicapped children, Thailand (SEAR0 0174). 9-17 April 1971

SEAIRehabll2 Add.4 Assignment report on rehabilitation of Prof. Marian Weiss handicapped children, Burma (SEAR0 0174), 19-24 April 1971

SEAIRehabll3 Assignment report on rehabilitation of Mr J.A.E. Gleave the ~h~sicallyhandicapped in Burma (Burma 0088), 30 October - 21 November 1971

SEAIRehabll4 Assignment report on development of Miss E.M. Stanley Physiotherapy School and services, Baroda (India 0257), 1 July 1970 - 31 January 1972

Smallpox

SEA/Smallpox/49 Report on a visit to the smallpox Dr N.C. Grasset eradication programme in Mysore State (India 0233), 16-26 June 1971

SEA/Smallpox/50 Assignment report on smallpox eradica- Dr R. Wasito tion and control of other comunicable diseases, Nepal (Nepal 0009), 8 January 1968 - 31 October 1970

SFA/Smallpox/51 Report on a visit to the smallpox Dr D.A. Henderson eradication programes in Rajasthan and Uttar Pradesh, India (India 0233). 5-20 April 1971

SEA/Smallpox/52 Assignment report on smallpox eradica- Dr R.R. Lindner ation, Indonesia (Indonesia 0081), January 1969 - June 1971

SEA/Smallpox/53 Report on a visit to Rajasthan, India Dr I. Arita h / (India 0233). 9 March - 1 April 1971 Dr A. Monnier ~E~/~mallpox/54 I Assignment report on smallpox eradica- Mr M.J. O'Regan tion, Indonesia (Indonesia OORl), 8 May - 14 July 1971

SEA/Smallpox/55 Assignment report on smallpox eradica- Dr P.F. Wehrle tion, Indonesia (Indonesia 0081), 1-31 July 1971

SEA/Smallpox/56 Report on a visit to Gujarat, India Dr I. Arita (India 0233), 16 October - 8 November 1971 SEA/RC25/2 Page 254 Annex 7

Document Title Author

SEA/Smallpox/57 Assignment report on an assessment of Dr J.G. Breman the smallpox eradication programme in Madhya Pradesh, India (India 0233), 25 September - 31 October 1971

SEA/Smallpox/58 Assignment report on an assessment of Dr J.G. Breman the smallpox eradication programe in Maharashtra, India (India 0233), 31 October - 8 November 1971

SEA/Smallpox/59 Report on a visit to the smallpox Dr D.A. Henderson eradication programme, India (India 0233), 10-28 March 1972

Tuberculosis

SEA/TB/113 Assignment report on tuberculosis Dr R. Hanak control, Mongolia (Mongolia 0003), 23 August 1965 - 15 August 1970

SEA/TB/114 Rev.1 Assignment report on tuberculosis Dr K. Toman control, Indonesia (Indonesia 0050), December 1970 - June 1971

SEA/TB/115 Report on the Seminar on Tuberculosis Dr R. Krzysko control, held in Colombo, Ceylon (SEAR0 0113), 22-28 February 1970

SEA/TB/116 Assignment report on tuberculosis Dr G. Kann control in Burma (Burma 0065), October 1968 - December 1971

SEAITBI117 Assignment report on tuberculosis Dr Eung Soo Han control, Ceylon (Ceylon 0075). August 1968 - August 1971

S!iA/TB/118 Assignment report on Tuberculosis Dr Wallace Fox & Chemotherapy Centre, Madras (India Prof. D.A. Mitchison 0053), 10-18 February 1972

SEA/TB/119 Assignment report on the tuberculosis Dr J. Radkovsky control programme in Ceylon (Ceylon 0075), September 1971 - February 1972

SEA/TB/lZO Field visit report on tuberculosis Dr L.A. Simeonov 6 control in Maldives, March - April 1972 Mr A.G. Beer

k SEA/RC25/2 Page 253 Annex 7

Document Title Author

SFA/Rehab/l2 Add.3 Assignment report on rehabilication of Prof. Marian Weiss handicapped children, Thailand (SEAR0 0174), 9-17 April 1971

SEA/Rehab/l2 Add.4 Assignment report on rehabilitation of Prof. Marian Weiss handicapped children, Burma (SEAR0 0174), 19-24 April 1971

SEA/Rehab/l3 Assignment report on rehabilitation of Mr J.A.E. Gleave the physically handicapped in Burma (Burma 0088), 30 October - 21 November 1971

SEA/Rehab/l4 Assignment report on development of Miss E.M. Stanley Physiotherapy School and services, Baroda (India 0257). 1 July 1970 - 31 January 1972

Small~ox

SEA/Smallpox/49 Report on a visit to the smallpox Dr N.C. Grasset eradication programme in Mysore State (India 0233). 16-26 June 1971

SEA/Smallpox/SO Assignment report on smallpox eradica- Dr R. Wasito tion and control of other comunicable diseases, Nepal (Nepal 0009), 8 January 1968 - 31 October 1970

SEA/Smallpox/51 Report on a visit to the smallpox Dr D.A. Henderson eradication programes in Rajasthan and Uttar Pradesh, India (India 0233), 5-20 April 1971

SEA/Smallpox/5Z Assignment report on smallpox eradica- Dr R.R. Lindner ation, Indonesia (Indonesia 0081) , January 1969 - June 1971

SEA/Smallpox/53 Report on a visit to Rajasthan, India Dr I. Arita & 1 (India 0233), 9 March - 1 April 1971 Dr A. Monnier

SEA/Smallpox/ 54 Assignment report on smallpox eradica- Mr M.J. O'Regan tion, Indonesia (Indonesia 0081), 8 May - 14 July 1971

SEA/Smallpox/55 Assignment report on smallpox eradica- Dr P.F. Wehrle tion, Indonesia (Indonesia 0081), 1-31 July 1971

SEA/Smallpox/56 Report on a visit to Gujarat, India Dr I. Arita (India 0233), 16 October - 8 November 1971 C SEA/RC25/2 Page 254 Annex 7

Document Title Author

SE~/Smallpox/S7 Assignment report on an assessment of Dr J.G. Breman the smallpox eradication programme in Madhya Pradesh, India (India 0233), 25 September - 31 October 1971

sEA/Smallpox/S8 Assignment report on an assessment of Dr J.G. Breman the smallpox eradication progrannne in Maharashtra, India (India 0233), 31 October - 8 November 1971

sE~/~mallpox/59 Report on a visit to the smallpox Dr D.A. Henderson eradication programme, India (India 0233), 10-28 March 1972

Tuberculosis

SEA/TB/113 Assignment r2port on tubcr~ulosis Dr R. Hanak control, Mongolia (Mongolia 0003), 23 August 1965 - 15 August 1970

s~A/TB/114 Rev. 1 Assignment report on tuberculosis Dr K. Toman control, Indonesia (Indonesia OOSO), December 1970 - June 1971

sE~/TB/115 Report on the Seminar on Tuberculosis Dr R. Krzysko control, held in Colombo, Ceylon (SEAR0 0113), 22-28 February 1970

~Ek/TB/116 Assignment report on tuberculosis Dr G. Kann control in Burma (Burma 0065), October 1968 - December 1971

SEA/TB/117 Assignment report on tuberculosis Dr Eung Soo Han control, Ceylon (Ceylon 0075), August 1968 - August 1971

SEA/TB/118 Assignment report on Tuberculosis Dr Wallace Fox 6 Chemotherapy Centre, Madras (India Prof. D.A. Mitchison 0053), 10-18 February 1972

SEA/TB/119 Assignment report on the tuberculosis Dr J. Radkovsky control programme in Ceylon (Ceylon 0075), September 1971 - February 1972

SEA/TB/120 Field visit report on tuberculosis Dr L.A. Sfmeonov 6 control in Maldives, March - April 1972 Mr A.G. Beer SEA/RC25/2 Page 255 Annex 7

Document Title Author

Vaccines

SEA/Vaccine/47 Assignment report on production of Dr P. Atanasiu SEA/Rabies/Z rabies vaccine and laboratory diagnosis of rabies, Bulma (Burma 0077), 10-20 March 1971

SEA/Vaccine/48 Assignment report on production of Dr C. Kaplan freeze-dried smallpox vaccine, Ceylon (SWRO 0038). 13-21 December 1971

SEA/Vaccine/49 Report on engineering aspects of Mr Hans H. Stock vaccine and sera :)reduction, Bio Farma, Bandung (Indonesia 0083) ,1-30 November 1971

Venereal Diseases and Treponematosis

SEA/MT/17 Assignment report on venereal-disease Dr A.A. Lozano control, Burma (Burma 0044), 7 August - 25 October 1971

SE4/VDT/18 Report on the Regional Symposium on Dr R.S. Morton 6 Venereal Diseases, held at Bangrak Dr L.A. Juhlin Hospital, Bangkok (Thailand) (SEARO 0214, 14-17 December 1971

SEA/VDT/19 Assignment report on venereal-disease Dr A. King control, Thailand (Thailand 0082). 7 November 1971 - 10 January 1972

Veterinary Public Health

SEA/VPH/IO Assignment report on post-graduate Dr W.C. Beran training in veterinary public health, India (India 0244), May - July 1971

Vital and Health Statistics

SEAIVHSI124 Assignment report on health statistics, Dr D.B. Shestov Mongolia (Mongolia 0007), 13 Aprl 1 - 14 July 1971

SEA/VHS/125 Hospital statistjcs and medical records Dr Morihiro Ishida in Thailand - Report on a visit (SEARO 0161). 15 May - 4 June 1971

SEA/VHS/126 Report on a visit to Burma on hospital Dr Morihiro Ishida and Corr.1 statistics and medical records (SEAR0 0161). 9 June - 1 July 1971 sEA/RC25/2 Page 256 Annex 7 - Document Title Author

SEAIVHSf127 Hospital statistics and medical Dr Morihiro Ishida records - report on a visit to Indonesia (SEARO 01611, 19 September - 15 October 1471

SEAIVHSf128 Health statistics requirements for Regional Office national health planning - report on the technical discussions held during the twenty-fourth session of the WHO Regional Committee for South-East Asia (28 September - 5 October 19711, Rangoon

SEA/VHS/129 Assignment report on medical education Dr Chaiyan SEA/Med.Educ.f170 (statistics) in Indonesia (Indonesia 00621, 25 December 1970 - 24 March 1971

SEAIVHSI130 Assignment report on vital and health Dr E.L. Huppert statistics, Thailand (Thailand 0037), February - October 1971

SEA/WS/130 Add.1 Discussion on the recommendations, Dr E.L. Huppert addendum to the report on vital health statistics, Thailand 0037

SEA/VHS/131 Field visit report on hospital statis- DK Horihiro Ishida tics and medical records in Nepal (SEARO 0161), 3-30 December 1971

sEAIVHSI132 Field visit report on hospital statis- Dr Morihiro Ishida tics and medical records in Burma (SEARO 0161), 4 November - 3 December 1971

sEAfVHSf133 Report on a Seminar on Statistical Dr J.A. Heady Methods in Medical Research, held at the Indian Council of Medlcal Research, New Delhi (India 0121), 24 November - 4 December 1971