OFFICIAL RECORDS OF THE WORLD HEALTH ORGANIZATION No. 94 FIRST REPORT ON THE WORLD HEALTH SITUATION 1954 -1956 WORLD HEALTH ORGANIZATION PALAIS DES NATIONS GENEVA May 1959 NOTE The Ninth World Health Assembly in May 1956 invited Members of WHO to prepare, as a step towards the fulfilment of their obligations under Article 61 of the Constitution, a report covering as far as possible the period 1954 to the end of 1956.1At the same time the Assembly requested the Director -General to prepare for the Eleventh World Health Assembly the first report on the world health situation, summarizing those reports. In June 1958 the Eleventh World Health Assembly discussed the report prepared by the Director- General, thanked the Member governments for their assistance in providing material and invited them to submit amendments for the final report.2 The " general survey" presented as Part I of this volume contains a synthesis, under broad subject headings, of the reports received from Member States.The reports themselves, with the amendments submitted by the governments, are reproduced in Part II. 1 Resolution WHA9.27: Off: Rec. Wld Hith Org. 71, 27 2 Resolution WHA11.38: Off: Rec. Wld Hlth Org. 87, 34 PRINTED IN SWITZERLAND CONTENTS Page Preface vII Introduction 1 PART I - GENERAL SURVEY Chapter 1.Influences affecting the health of the peoples 7 1.Climate and other geographical conditions 7 2.Environmental conditions 8 3.General influences 10 Chapter 2.The state of the public health 14 1.The measurement of health 14 2.Sources of statistical information 15 3.Trends in the state of health of various countries in the course of development 18 4. Development in physical and mental health.Nutritional standards 23 Chapter 3.Administration of health services and activities 26 1. The role of various government departments 26 2. The role and structure of health administrations 29 Chapter 4.The distribution of functions in the health services 33 1.Medical care, including hospital, clinic, rehabilitation and home services 33 2.Maternal and child health 35 3.Mental health 38 4.Occupational health 42 5.Health education 45 6.Dental care 47 7.Nutrition 49 8.Veterinary public health 51 9.Health and the environment 52 10. The control of communicable disease 57 11.Chronic and degenerative disorders and aging 61 Chapter 5.Institutions and field establishments 65 1.National health institutes, including public health laboratories 65 2.Hospitals, out -patient departments, health centres, rural health units, etc. 67 3.Statistical services 72 4.Domiciliary health services 74 5.Institutions for the production and control of drugs, biological preparations, and foodstuffs 76 Page Chapter 6.Education and training 81 1.Medical education 81 2.Nursing education, including training in public health nursing 85 3.Auxiliary personnel in the health services 87 Chapter 7.Future developments 89 1.Trends in health promotion 89 2. Developments in administration 90 3.Long -range planning 91 4.Short -term independent programmes 91 5. Communicable disease control 92 6.Rural health development 92 7.Supply of medical manpower 92 8.Improvement of living and working environment 93 9.Plans for community development 93 10.Health aspects of radiation 93 11.Field research and investigation 94 12.International collaboration 95 PART II- COUNTRY REVIEWS Page Page African Region African Region (continued) Angola 101 Seychelles 138 Basutoland 102 Sierra Leone 139 Bechuanaland Protectorate 104 Swaziland 141 Belgian Congo 105 Tanganyika 142 British Somaliland Protectorate 107 Autonomous Republic of Togo 144 Cape Verde 109 Uganda 145 Comoro Archipelago 110 Union of South Africa. 148 French Equatorial Africa 111 Zanzibar 150 French West Africa 113 Gambia (Colony and Protectorate) 115 Ghana 118 Region of the Americas Kenya (Colony and Protectorate) 120 Alaska 155 Liberia 122 American Virgin Islands 156 Madagascar 124 Argentina 157 Mauritius and Dependencies 126 Bahama Islands 159 Mozambique 127 Barbados 159 Federation of Nigeria 128 Bermuda 161 Portuguese Guinea 131 Bolivia 162 Réunion 132 Brazil 164 Federation of Rhodesia and Nyasaland 133 British Guiana 166 Ruanda -Urundi 135 British Honduras 167 St Helena and Dependencies 136 Canada 168 Sao Tomé and Principe 137 Chile 173 - Iv - Page Page Region of the Americas (continued) European Region (continued) Colombia 174 Federal Republic of Germany 255 Costa Rica 176 Gibraltar 258 Cuba 177 Greece 259 Dominican Republic 178 Hungary 261 Ecuador 180 Iceland 265 El Salvador 181 Ireland 267 French Departments in America 182 Italy 271 Guatemala 183 Luxembourg 275 Haiti 184 Monaco 276 Hawaii 186 Morocco 277 Honduras 187 Netherlands 278 Jamaica 187 Norway 282 Leeward Islands 189 Poland 285 Mexico 191 Portugal 288 Netherlands Antilles 193 Romania 290 Nicaragua 194 Spain 294 Panama 195 Sweden 296 Panama Canal Zone 196 Switzerland 298 Paraguay 197 Turkey 300 Peru 198 Union of Soviet Socialist Republics 304 Puerto Rico 200 United Kingdom of Great Britain and Northern Ire - Surinam 201 land 307 Trinidad and Tobago 202 Yugoslavia 313 United States of America 203 Uruguay 206 Eastern Mediterranean Region Venezuela 207 Aden (Colony and Protectorate) Windward Islands 209 319 Cyprus 320 Egypt 323 South -East Asia Region Ethiopia 326 Afghanistan 215 French Somaliland 327 Burma 216 Iran 328 Ceylon 218 Iraq 329 India 220 Israel 331 Indonesia 222 Hashemite Kingdom of Jordan 333 Nepal 225 Lebanon 334 Portuguese India 226 United Kingdom of Libya 335 Thailand 227 Pakistan 337 Saudi Arabia 339 European Region Sudan 340 Syria 342 Austria 233 Tunisia 343 Belgium 235 Yemen 344 Bulgaria 238 Czechoslovakia 240 Denmark 242 Western Pacific Region Finland 247 American Samoa 347 France 251 Australia 347 - V - Page Page Western Pacific Region (continued) Western Pacific Region (continued) British Solomon Islands Protectorate 350 New Caledonia and Dependencies 371 Brunei 351 New Hebrides 372 Cambodia 352 New Zealand 373 Republic of China 353 Niue Island 374 Cook Islands 355 North Borneo 375 Fiji 356 Pacific Islands 376 French Polynesia 357 Papua and New Guinea 377 Gilbert and Ellice Islands 358 Republic of the Philippines 378 Guam 359 Portuguese Timor 381 Hong Kong 360 Sarawak 381 Japan 362 Singapore 382 Republic of Korea 364 Tokelau Islands 384 Laos 366 Tonga 385 Macao 367 Viet Nam 386 Federation of Malaya 368 Western Samoa 387 Netherlands New Guinea 370 Index of countries 391 FIGURES Fig. 1. Climatic regions facing 8 Fig.2.Density of the population facing 9 Fig.3.Notification of smallpox cases, by continents, 1948 -57 58 Fig.4. Reduction of cholera prevalence, 1948 -57 60 Fig.5. Regression of typhus: cases of louse -borne typhus reported from 1945 to 1957 60 Fig.6.African Region 100 Fig.7. Region of the Americas 154 Fig.8.South -East Asia Region 214 Fig.9.European Region 232 Fig, 10.Eastern Mediterranean Region 318 Fig. 11.Western Pacific Region 346 - VI - PREFACE THE present review, covering the period 1954 -56, is the first report on the world health situation. The Annual Reports of the Director -General have dealt with the work of WHO year by year, and a comprehensive account of the Organization's achievements in various countries has been presented in this way.This Annual Report has deservedly become an essential feature of the functions of WHO, and the accumulated experience derived from ten years' activity has made a genuine contribution to international history.Nevertheless, for various reasons, the obligation accepted by Member States in Article 61 of the Constitution of WHO to report on the progress achieved towards the improvement of health has remained in abeyance during these early years.This fact has been recognized by the World Health Assembly and led it recently to reaffirm'. the responsibility of the World Health Organization to review the health situation in the world and to confirm that this is another essential function of the Organization. The services that WHO was privileged to give to many nations in such matters as education and training of personnel, the control of communicable diseases, and public health administration have been documented in a number of publications, including the Bulletin of the World Health Organization and the Technical Report Series ; but deeper analysis shows how important it is also for each country to have an opportunity of telling its own story about its health situation.As countries differ so much in size, population, and resources, it is essential that each account of the progress of the health services should be illuminated against a background of reality.It would be absurd to expect a small, sparsely populated country to have the same design for health as a highly industrialized state of enormous dimensions; yet its story of overcoming difficulties might be well understood by and become a source of great encouragement to other countries on the same path of progress. For an international organization like WHO one of the methods of serving Member States is to present faithfully in clear, simple outline a picture of the state of health of each country and territory, based on the information at present available, and to focus a spotlight with the correct degree of intensity on new developments.By this means each country would keep the world informed of its proposals and undertakings, and so all the peoples would become more familiar with one another's problems in an intelligible relation to resources of personnel, money, and equipment.Furthermore, the world would discover what is being done in the great endeavour to improve health on a global scale. I would ask the national health authorities, therefore, in reading this report, to direct their attention especially to the efforts which are being made, often against mighty odds, to promote the health and welfare of peoples who were previously little known to them.That is the reason why the description of the health services of each country is preceded by a brief, very simple, background of reference and allusion which can readily be followed by all.National health authorities have, of course, a detailed knowledge of their own situation and services, and they may well feel -in the larger countries especially - that some of the information is too obvious for serious presentation.