Open Collections

BC Sessional Papers

Sixty-sixth Annual Report of the Public Health Services of British Columbia HEALTH BRANCH DEPARTMENT… British Columbia. Legislative Assembly [1963]

Item Metadata

Download

Media
bcsessional-1.0363984.pdf
Metadata
JSON: bcsessional-1.0363984.json
JSON-LD: bcsessional-1.0363984-ld.json
RDF/XML (Pretty): bcsessional-1.0363984-rdf.xml
RDF/JSON: bcsessional-1.0363984-rdf.json
Turtle: bcsessional-1.0363984-turtle.txt
N-Triples: bcsessional-1.0363984-rdf-ntriples.txt
Original Record: bcsessional-1.0363984-source.json
Full Text
bcsessional-1.0363984-fulltext.txt
Citation
bcsessional-1.0363984.ris

Full Text

 PROVINCE OF BRITISH COLUMBIA
Sixty-sixth Annual Report of the
Public Health Services
of British Columbia
HEALTH BRANCH
Department of Health Services and Hospital Insurance
YEAR ENDED DECEMBER 31
1962
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1963
  Office of the Minister of Health Services
and Hospital Insurance,
Victoria, B.C., January 24, 1963.
To Major-General the Honourable George Randolph Pearkes,
V.C., P.C., C.B., D.S.O., M.C.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Sixty-sixth Annual Report of the
Public Health Services of British Columbia for the year ended December 31, 1962.
ERIC MARTIN,
Minister of Health Services and Hospital Insurance.
 Department of Health Services and Hospital Insurance
(Health Branch),
Victoria, B.C., January 23, 1963.
The Honourable Eric Martin,
Minister of Health Services and Hospital Insurance,
Victoria, B.C.
Sir,—I have the honour to submit the Sixty-sixth Annual Report of the Public Health Services of British Columbia for the year ended December 31, 1962.
J. A. TAYLOR, B.A., M.D., D.P.H.,
Deputy Minister of Health.
 Q
Z
<
tn
S
83
i~
rt
ffi
rt
§
1
ffi
rt
O
oi
rt
H
!Z1
H
ffi
0-
W
Q
o
|
i
o
<
id
S
P
pa
O
•a
<
o'g
o-3§
a u.s
.2 ffi ra
.2 o 2
JO
o
rt
ffi
< cu
D
-£
UJ
pa
1|
5 8
>
■ft
w
s
t*3
C
O
3
z
rt
 The Department of Health Services and Hospital Insurance consists of
three branches—the Health Branch, the Branch of Mental Health Services, and
the British Columbia Hospital Insurance Service. Each of these is headed by a
Deputy Minister under the jurisdiction of the Minister of Health Services and
Hospital Insurance.
The chart on the other side of this page deals only with the Health Branch.
For convenience of administration, the Health Branch is divided into three
Bureaux. The Deputy Minister of Health and the Bureaux Directors form the
central policy-making and planning group. The divisions within the Bureaux
provide consultative and special services. The general aims of the Deputy
Minister with his headquarters staff are to foster the development of local health
services, to provide advice and guidance to those local health services, and to
provide special services which cannot, for economic or other reasons, be established on the local level. Included in these are the special services provided by
the Divisions of Tuberculosis Control, Venereal Disease Control, Laboratories,
Vital Statistics, Public Health Engineering, Public Health Education, etc.
Direct services to the people in their communities, homes, schools, and
places of business are provided by " local public health personnel." These fall
into two broad groups. In the metropolitan areas of Greater Vancouver and
Greater Victoria they are members of the city and municipal health departments, which, in these two cases, do not come under the direct jurisdiction of
the Health Branch. (However, they co-operate closely with the Health Branch
and, through it, receive substantial financial assistance with services from the
Provincial and Federal Governments.) Throughout the remainder of the Province the " local public health personnel " are members of the health units (local
health departments), which are under the jurisdiction of the Health Branch.
A health unit is defined as a modern local health department staffed by full-time
public health trained personnel serving one or more population centres and the
rural areas adjacent to them. Outside the two metropolitan areas mentioned
above, there are eighteen such health units covering the Province from the
International Boundary to the Prince Rupert-Peace River areas.
 TABLE OF CONTENTS
General Statement-
Bureau of Administration	
Division of Vital Statistics	
Division of Public Health Education.
Accounting Division	
Community Health Centres	
Bureau of Local Health Services-
Bureau of Special Preventive and Treatment Services-
Division of Tuberculosis Control	
Division of Venereal Disease Control-
Division of Laboratories	
Division of Occupational Health.
Page
9
11
16
26
29
30
35
64
77
88
91
99
Registry and Rehabilitation Services  102
  Sixty-sixth Annual Report
of the Public Health Services of British Columbia
HEALTH BRANCH
Department of Health Services and Hospital Insurance
YEAR ENDED DECEMBER 31,  1962
Twenty-one years as Provincial Health Officer ended for Dr. G. F. Amyot in
1962 when he retired from that position. In that period he had devoted himself to
building for this Province a public health programme founded upon the concept that
an adequate local health service was basic to efficient health administration. His
influence has been apparent in the development of the metropolitan health administrations in Vancouver and Victoria, in the organization of Provincial health units
for the rest of the Province, in the growth of the specialized health services, and,
indeed, in all the facets of preventive medicine and public health that have occurred
in that time. During his administration a change in Departmental status led to his
appointment as the first Deputy Minister of Health for this Province, in which position he served capably for the last fifteen years. There is little doubt that the people
of British Columbia have been enriched by his contributions to their welfare.
His plan for administration within the Health Branch has been such that upon
his retirement a transfer of administrative functions among his associates was possible with a minimum of change. The Deputy Provincial Health Officer succeeded
him in the position of Provincial Health Officer and Deputy Minister of Health, while
the former Assistant Provincial Health Officer was promoted to the vacant deputy
position. The Director of the Division of Health Units became the new Assistant
Provincial Health Officer, while the Director of the Bureau of Administration continued in the position held for the past several years. In this manner the senior
administrative tasks were absorbed without interruption.
THE PROVINCE AND ITS PEOPLE
More people, more marriages, more deaths, but fewer births influenced British
Columbia's health picture in 1962. The 366,000 square miles of the Province were
populated by 1,659,000 people, about 30,000 more residents than ever before. Of
course, they are not uniformly scattered throughout the Province, as approximately
49 per cent are congregated in the extreme south-west corner and Vancouver Island
areas. Nevertheless, whatever the place of residence, organized community health
services are available, as follows:—
Area Involved Population! per Cent
Health units  800,924 49.2
Metropolitan Vancouver and Victoria  794,312 48.8
Nursing districts2  (Ocean Falls, Howe Sound-
Squamish, Kitimat, Zeballos)   26,051 1.6
Others   6,913 0.4
Totals   1,628,200 100.0
1 Excluding Indians. 2 Nursing service only. 3 Not served.
Among that population, preliminary figures* would indicate marriages occurred
at a rate of 6.7 per 1,000 population, the same as the rate for last year.   The bulk
* The rates and figures for 1962 quoted in this Report should be considered as preliminary and subject to
adjustment.
9
 Y  10 PUBLIC HEALTH SERVICES REPORT, 1962
of the marriages occurred during the summer months, August being the most popular
one this year with June and September a very close second.
The birth rate was 23.0 per 1,000 population, somewhat below the 1961 rate
of 23.7 and a continuation of the trend of the last four years. It is well below the
high birth rates that were being recorded throughout the fifties. The influence of
the drug Thalidomide among infant births was important this year. Ten British
Columbia babies had birth deformities in which association with the drug was traced.
The stillbirth rate per 1,000 live births was 11.3, up from the 1961 figure of
10.6.   The maternal mortality rate was 0.3 per 1,000 live births.
The death rate of 9.0 was somewhat above the 1961 figure of 8.8. Heart disease continued to be the leading cause of death in the Province, the rate per 100,000
people having been 343.7, an increase over the 1961 figure of 335.9. Cancer, the
second leading cause, resulted in 152.6 deaths per 100,000 population, compared
with 151.2 in 1961, a large proportion of them, over 15 per cent, being cancer of
the respiratory apparatus. Ranking third as a creator of death statistics was that
commonly classed as a " stroke," which had a rate of 96.5 in 1962, compared with
95.2 last year. Accidental deaths continued to maintain fourth position as a death-
reaper, leaping ahead in their toll to attain a rate of 70.9 per 100,000 people, considerably above the previous year's rate of 64.7, the highest rate since 1956. Among
the causative factors, motor-vehicle accidents loomed largest, creating about a quarter of all the accidental deaths.
Communicable infections created more ill health last year than the previous
year. Infectious hepatitis caused jaundice in an even greater number of people,
1,886 persons, 200 more than in 1961.   Of this number, sixteen died.
After a complete absence for three years, one case of diphtheria was recorded
in 1961, which was followed by three cases in 1962. A significant feature is that
the patients were adults, who are prone to be most negligent to continue their immunization. The diphtheria was sufficiently serious to cause death for two of the
patients.
In spite of all precautions, food poisoning continued to occur—175 times due
to staphylococcal intoxication and 381 times from salmonella infection. The salmonella factor was, however, a decrease of slightly over 15 per cent from the average
of the last two years.
Similarly, dysentery from shigella bacteria was down about 40 per cent this
year from last year and by more than 64 per cent from 1960. In addition, there
were no deaths attributable to dysentery this year, in contrast to the two last year.
An increasingly rare condition in the form of leprosy was diagnosed in an
elderly Chinese, who is presumed to have acquired his infection in China.
A most encouraging trend toward a decrease in the amount of paralytic poliomyelitis was continued throughout the past year, during which only two cases were
reported, neither of them of a serious nature.
Streptococcal infections, which showed an upward trend last year, continued to
play a dominant role as a harbinger of transitory ill health. The majority of the 709
patients suffered little more than varying degrees of sore throat.
Venereal diseases, both gonorrhoea and primary syphilis, continued to be a
problem. Contact-tracing is occupying more and more time as efforts are devoted
to tracking down all sources of these infections.
In general, the people of British Columbia did not enjoy the same measure of
health in 1962 as in the previous year—more people were sick and more people died.
Efforts must be devoted toward a reversal of this situation.
 ADMINISTRATION
Y 11
REPORT OF THE BUREAU OF ADMINISTRATION
Although the Bureau of Administration encompasses specifically the general
offices in Health Branch headquarters, the Division of Vital Statistics, and the
Division of Public Health Education, its interests extend to all parts of the Health
Branch because all parts are involved in administration.
Separate reports concerning the Divisions of Vital Statistics and Public Health
Education appear elsewhere in this volume.
The central administrative offices are concerned with all phases of management, but the Bureau Director is particularly concerned with personnel management, accommodations, budget preparation, financial control, voluntary health
agencies, and the National Health Grants programme, which has a close bearing on
the budget and finances generally. (Particularly in matters relating to finances,
voluntary health agencies, and the National Health Grants, very close liaison is
maintained with the Deputy Provincial Health Officer and the Departmental Comptroller, who have major interests in these fields.)
ORGANIZATION AND STAFF
The chart at the front of this Annual Report shows the general organization
of the Health Branch. There have been some important changes during the year.
The Division of Epidemiology was transferred from the Bureau of Special Preventive and Treatment Services in Vancouver to the Bureau of Local Health Services
in Victoria because it is felt that epidemiology is more closely allied to local health
services. The Director, Dr. A. A. Larsen, in moving to Victoria, also assumed
responsibility for the emergency health services programme of the Health Branch
in close co-operation with the Provincial Civil Defence authorities.
Conversely, the Division of Occupational Health was transferred from the
Bureau of Local Health Services in Victoria to the Bureau of Special Preventive and
Treatment Services in Vancouver, where it is closer to the major industries. The
new Director, Dr. J. H. Smith, assumed, in addition, the direction of the Division
of Venereal Disease Control.
In Victoria the office of Mr. C. W. Burr, Provincial Health Supplies Officer of
the Civil Defence programme, was moved from the Civil Defence offices to Health
Branch headquarters. Although this did not change the basic administrative relationship, it permits closer liaison between him and Dr. Larsen.
Toward the end of the year Mr. W. J. Nichol, the administrator of Pearson
Tuberculosis Hospital and the adjoining Poliomyelitis Pavilion, resigned to accept
an appointment as hospital administrator in Kitimat. Mr. Nichol joined the Health
Branch in 1949 and received postgraduate training in hospital administration in
1950. It will be difficult to replace him, and, at the time of writing this report,
plans were being made to effect some reorganization in the Division of Tuberculosis
Control administrative structure to cope with the problem.
The following table lists the various parts (divisions, offices, clinics, etc.) of
the Health Branch and gives their location and the approximate number of persons
employed:—
Health Branch headquarters (Victoria), Legislative Buildings,
Victoria     39
Health Branch office (Vancouver), 828 West Tenth Avenue,
Vancouver     30
        69
 Y 12 PUBLIC HEALTH SERVICES REPORT,  1962
Division of Vital Statistics—
Headquarters and Victoria office, Legislative Buildings,
Victoria  61
Vancouver office, 828 West Tenth Avenue, Vancouver 16
Division of Tuberculosis Control—
Headquarters, 2647 Willow Street, Vancouver  13
Willow Chest Centre, 2647 Willow Street, Vancouver—- 115
Pearson Hospital, 700 West Fifty-seventh Avenue, Vancouver  178
Poliomyelitis Pavilion, 700 West Fifty-seventh Avenue,
Vancouver  59
Victoria and Island Chest Clinic, 1902 Fort Street, Victoria   11
New Westminster Stationary Clinic, Sixth and Cameron,
New Westminster  7
Travelling Clinics, 2647 Willow Street, Vancouver  13
Survey programme, 2647 Willow Street Vancouver       6
Division of Laboratories—
Headquarters   and   Vancouver   laboratory,   828   West
Tenth Avenue, Vancouver  60
Nelson branch laboratory, Kootenay Lake General Hospital  1
Victoria branch laboratory, Royal Jubilee Hospital1  	
Division of Venereal Disease Control—
Headquarters and Vancouver clinic, 828 West Tenth
Avenue, Vancouver  16
Victoria clinic  1
New Westminster clinic  1
Local Public Health Services (health units)—
East Kootenay, Cranbrook  19
Selkirk, Nelson  13
West Kootenay, Trail  16
North Okanagan, Vernon  18
South Okanagan, Kelowna  26
South Central, Kamloops  18
Upper Fraser Valley, Chilliwack  22
North Fraser, Mission  15
Boundary, Cloverdale  43
Simon Fraser, New Westminster  20
Gibsons-Howe Sound, Gibsons  6
Saanich and South Vancouver Island, 464 Gorge Road
East, Victoria  32
Central Vancouver Island, Nanaimo  41
Upper Island, Courtenay  22
Cariboo, Williams Lake  13
Skeena, Prince Rupert  14
Peace River, Dawson Creek  16
Northern Interior, Prince George  25
77
402
61
18
1 Services are purchased from the Royal Jubilee Hospital, which uses its own staff to perform the tests.
 ADMINISTRATION Y 13
Local Public Health Services (nursing districts)—
Kitimat	
Ocean Falls	
Telegraph Creek	
Tahsis 	
Stewart	
Cassiar 	
387
Total   1,014
As the table shows, there were slightly more than 1,000 full-time employees
on staff at the year's end. In addition, there were part-time employees in various
places.   These totalled the equivalent of approximately fifty full-time employees.
The Division of Tuberculosis Control had the largest number (just over 400)
and Local Public Health Services had the next largest number (somewhat less than
400). Comparisons with previous years reveal that the number in the Division of
Tuberculosis Control has been decreasing and the number in Local Public Health
Services has been increasing. The first trend is a result of the newer methods of
treatment of tuberculosis, which require less institutional care than formerly. The
second trend is related to the increasing population throughout the Province. There
have been no significant changes in the numbers of employees in the other offices
and divisions.
STAFF-TRAINING
Staff-training is a most important feature in an organization which depends
largely upon the professional and technical knowledge of its employees. During
1962 most of the training of individuals took the form of postgraduate work leading
to a diploma or a master's degree in one of the public health specialties. Funds
from National Health Grants were used to help defray the costs. Ten employees
completed such training and fifteen commenced their studies during 1962. The
following list shows how these were distributed according to university and type of
training: —
Completed training for Diploma in Public Health Nursing (University
of British Columbia)     6
Commenced training for Diploma in Public Health Nursing (University of British Columbia)  10
Completed training in Nursing Administration and Supervision (Mc-
Gill University)     2
Commenced training in Nursing Administration and Supervision (University of Toronto)     1
Completed training for degree of Master of Public Health (University
of Michigan)     1
Completed training for Diploma in Public Health (University of Toronto)     1
Commenced training for Diploma in Public Health (University of Toronto)     3
Commenced training for Diploma in Dental Public Health (University
of Toronto)     1
According to Health Branch policy, training such as the above is not granted
unless it is in the interests of the service. (Any personal benefit which accrues to
the individual is incidental.)   Further, each trainee is required to sign an agreement
 Y 14 PUBLIC HEALTH SERVICES REPORT,  1962
that he will return to work for the Health Branch for a specified period following
the completion of his course.
Using National Health Grants, the Health Branch and the Departments of
Continuing Medical Education and Preventive Medicine of the University of British
Columbia sponsored jointly a refresher course for health officers. Held on the
campus of the University, the course was attended by thirty-eight health officers
from the Health Branch, the two metropolitan health departments, and the Indian
Health Services.
The Department of Continuing Medical Education also conducted a series of
night classes in the Fraser Valley. Fifty-five nurses enrolled in this series, which
dealt with mental-health problems.
National Health Grants were also used to provide a course or working conference for public health nursing supervisors during the first week in December. The
principal lecturer was Miss Ruth Freeman, R.N., Ed.D., Associate Professor of
Public Health Administration, Johns Hopkins University School of Hygiene and
Public Health. This course of training was attended by thirty-one public health
nursing supervisors of the Health Branch staff, in addition to twenty-three supervisors from other agencies.
Training of the public health field staff was conducted at the Public Health
Institute which was held in Vancouver during the Easter season. The principal
speaker was Dr. S. J. Axelrod, Professor of Public Health Economics and Director
of the Bureau of Public Health Economics, School of Public Health, University of
Michigan. Dr. Axelrod's main theme was health care. Other lecturers, panelists,
and discussants were drawn from the Faculty of Medicine, University of British
Columbia, and the Health Branch staff.
Members of the Health Branch also participated in civil defence training.
More than thirty of the public health staff attended courses held either at the Civil
Defence College in Arnprior, Ont., or in Victoria or Chilliwack.
RECIPROCAL AGREEMENTS  (TUBERCULOSIS)
During 1962, reciprocal agreements for the care of tuberculosis patients were
continued with Alberta, Manitoba, and Ontario at a rate of $10 per diem and with
Saskatchewan and Quebec at a rate of $8 per diem.
For varying lengths of time during the year, ten British Columbia cases were
hospitalized in other Provinces. Three of these were still in hospital at the year's
end.   The distribution was as follows:—
Total for     At Year's
Year End
Alberta      4 1
Saskatchewan     2 1
Manitoba      3 1
Ontario      1
Quebec 	
Totals  10 3
The number from the other Provinces who received care in British Columbia
during the year totalled five. Only one of these was still in hospital at the year's
end.  The distribution was as follows:—■
 ADMINISTRATION
Y 15
Alberta          - „	
Total for
Year
       1
At Year's
End
Saskatchewan
       1
Manitoba     	
Ontario          	
     2
1
Quebec   	
     1
Totals    	
     5
1
 Y 16 PUBLIC HEALTH SERVICES REPORT,  1962
REPORT OF THE DIVISION OF VITAL STATISTICS
The Division of Vital Statistics has two major fields of responsibility in the
Health Branch. On the one hand, it administers the Province-wide vital statistics
registration system, and on the other hand it provides a centralized bio-statistical
service to all other divisions of the Health Branch, to the Mental Health Services
Branch, and to a number of voluntary health agencies.
Stemming from its civil registration duties, the Division administers in entirety
the Vital Statistics Act, the Marriage Act, and the Change of Name Act, and in
addition operates a registry of wills notices as required under the Wills Act. These
registration services are provided by a central office in Victoria and approximately
ninety district offices located in main population centres throughout the Province.
For registration purposes, the Province is divided into seventy-three vital statistics registration districts. In each of these districts there is a District Registrar
of Births, Deaths, and Marriages, and one or more Deputy District Registrars.
Approximately half of the District Registrar appointments are held by Government
Agents and another 25 per cent by members of the Royal Canadian Mounted Police.
In locations where Government Agents or Royal Canadian Mounted Police personnel are not available for this purpose, the District Registrar appointments are
held by municipal officials, other Governmental employees, or private individuals.
In addition, in order to facilitate registration of vital statistics events amongst the
native Indian population, all Indian Superintendents within the Province hold the
appointment of District Registrar of Births, Deaths, and Marriages for the area
encompassed by the Indian Agency.
In order to carry out its extensive bio-statistical duties, the Division has a staff
of trained bio-statisticians and statistical clerks and a modern mechanical tabulation
section complete with punching, verifying, sorting, collating, and tabulating equipment. While the main statistical resources of the Division are located at the central
office in the Parliament Buildings, Victoria, a statistical office is also maintained in
the Provincial Health Building in Vancouver in order to expedite the service given
to the other divisions and health agencies located in the Vancouver area and to make
available direct consultative service to those agencies.
REGISTRATION SERVICES
Administration of the Vital Statistics Act
The main registration duties of the Division devolve from the Vital Statistics
Act. This Act provides for the registration of all births, stillbirths, marriages, deaths,
adoptions, and divorces that occur within the Province. It also provides for the
issuance of certificates and other forms of certification from the registrations which
are on file. Registration of births, deaths, and marriages has always been mandatory
in British Columbia, and the Division has in its vault all original registrations ever
filed in the Province. The Division also maintains up-to-date microfilm copies of
all registrations and of all important subsidiary documentation.
All births, deaths, stillbirths, and marriages are required to be registered in the
vital statistics registration district in which the events occur. Registrations which
have been accepted by the District Registrars are forwarded to the central office on
a weekly basis. In order to facilitate the obtaining of certificates, District Registrars
are empowered to issue certifications from the registrations during the time that the
original registrations are in their custody. After that time, certificates may be obtained only from the central office in Victoria.
 VITAL STATISTICS Y 17
It has long been recognized that uniform requirements and procedures respecting the registration of vital events and the issuance of certifications therefrom would
be most advantageous to the public, and registration and legal officials across Canada have been working for some time to achieve this end. In 1948 a uniform Vital
Statistics Act was drafted by the Conference of Commissioners on Uniformity of
Legislation in Canada in co-operation with the Vital Statistics Council for Canada,
and this uniform Act was recommended to all Provinces for enactment. In 1962
British Columbia became the seventh Province to pass vital statistics legislation based
upon the uniform Act. The new Vital Statistics Act in this Province became effective on July 1, 1962. The British Columbia Act adheres closely to the uniform Act,
although it contains certain modifications and improvements which experience has
shown to be desirable.
One of the important features of the new Act is that it provides better safeguards
against the release of certificates and certified copies of registrations to persons not
properly entitled to receive them. Birth, marriage, and divorce certificates may now
be issued only to certain specifically enumerated categories of persons, although a
certificate of death may be released to any person who can supply the identifying
particulars. However, the Act expressly forbids the issuance of any form of death
certification which discloses the cause of death, except upon the special authorization
of the Deputy Minister of Health or the Judge of a Court. This provision is intended
to protect relatives from unnecessary embarrassment resulting from the disclosure
of the cause of death and to encourage accurate certification of cause of death by
the physician. The issuance of photostatic copies of registrations is also considerably restricted.
The new Act provides more positive control over the registration of deaths.
It is now mandatory for the funeral director to obtain a burial permit or a provisional burial permit before proceeding with the funeral or the disposition of a body.
A burial permit is issued by the District Registrar only upon receipt of the completed
death registration. The provisional permit is issued only upon certification by the
funeral director that it is impossible to obtain the physician's certification of cause
of death without unduly delaying the funeral, and that there is no reason to believe
that the death was due to other than natural causes. The new Act further provides
that where death occurs without medical attendance and under circumstances that
do not require an inquiry or inquest under the Coroners Act, the physician who
examines the body of the deceased may certify as to the cause of death. Formerly,
in this situation, the position of the physician called to make the examination was
not clear.
The new Act also gives positive direction with respect to the assignment of surnames on birth registrations. It requires that a legitimate child shall be registered
in the surname of the father, and that an illegitimate child shall be registered in the
surname of the mother, except in circumstances where the putative father acknowledges paternity.
The Act also recognizes the strong presumption at law that a child of a married
woman is legitimate. It requires that, except in only one specific circumstance, the
child of a married woman shall be registered showing the husband to be the father
of the child. The once exception is where the mother was living separate and apart
from her husband at the time of conception, and where, at the time of filing the
registration, she also files a statutory declaration to that effect. In this instance the
particulars of the father may be omitted, or if another man acknowledges paternity,
he may be shown on the registration as being the father.
Regulations under the new Act also became effective on July 1, 1962. These
regulations have further improved and clarified vital statistics registration procedures
 Y 18 PUBLIC HEALTH SERVICES REPORT,  1962
in a number of areas where positive statutory direction formerly was lacking. The
regulations also included a new and simplified fee schedule which replaced the separate 50-cent search and certificate fees formerly required in the purchase of certifications by a single fee of $ 1 per document.
Administration of the Marriage Act
The administration of the Marriage Act is also a responsibility of the Division
of Vital Statistics. This Act covers all phases of the Province's jurisdiction over the
solemnization of marriage. The main duties of the Division under this Act relate to
the issuance of marriage licences and to the vesting of individual ministers and clergymen with the authority to solemnize marriage in British Columbia. The Division
also supervises the Marriage Commissioners, who are appointed by Order in Council
to perform civil marriages, and the Issuers of Marriage Licences, who are also
appointed by Order in Council. In general, the appointments as Marriage Commissioners or as Issuers of Marriage Licences are vested only in District Registrars
or Deputy District Registrars of Births, Deaths, and Marriages, although occasionally other persons are appointed to meet special local needs.
Administration of Change of Name Act
The administration of the Change of Name Act is another major responsibility
of the Division. Under this Act, persons desiring to change either their Christian
names or their surnames must meet certain qualifications and must obtain an order
from the Director authorizing the change. The principal requirements for a legal
change of name are that the applicant be 21 years of age or over, a British subject,
and domiciled in this Province. A change of surname made by a married man automatically effects a change in the surname of his wife and of his unmarried minor
children. A notice of intention to apply for a change of name must be published
by the applicant in one issue of The British Columbia Gazette and one issue of a
newspaper circulating in the district in which the applicant resides. Changes in the
given names of children effected before the twelfth birthday and changes of name
brought about by marriage or by adoption are exempted from the provisions of the
Change of Name Act.
Registry of Wills Notices
A Registry of Wills Notices has been in operation in this Province since 1945,
and the Division of Vital Statistics has the responsibility for maintaining this Registry. The existence of the Registry enables a testator to file a notice with the Division stating the date and the location of his will. He may also file supplementary
notices showing changes of location of the will or indicating revocation of a will.
The filing of the wills notice is not mandatory, but the services of the Registry are
available to all persons who wish to ensure that information which will lead to the
discovery of their wills will be readily available upon their death. The Courts
require that a search be made of the wills notices on file in this Registry before they
will proceed with an application for probate of a will. By the end of 1962 over
77,094 wills notices were on file in the Division.
New regulations respecting the operation of the Registry of Wills Notices, which
were assented to in 1961, have now been in operation for over a year and have considerably strengthened the Registry. Under the new regulations sufficient identifying
information respecting the testator, such as date and place of birth, must be included
in the wills notice. Formerly, no such identifying particulars were mandatory,
although they were solicited by the Division on a voluntary basis.   The provision of
 VITAL STATISTICS Y 19
adequate identification of the testator greatly facilitates the subsequent searching of
notices on file at the time of probate.
Volume of Registrations and Certifications
There was a 6-per-cent increase in the volume of registrations filed during 1962
and a decline of 3 per cent in the volume of certifications issued. Revenue received
in the central office of the Division increased by approximately 15 per cent. This
increase was brought about by the adjustments in the fee schedule effected during the
last half of the year. Preliminary counts of the more important registration services
rendered by the Division in 1962 are as follows: —
Registrations accepted—
Birth registrations     40,010
Death registrations     15,495
Marriage registrations     11,632
Stillbirth registrations  430
Adoption orders       1,565
Divorce orders       1,498
Delayed registrations of birth  391
Wills notices       8,405
Legal changes of name  443
Legitimations of birth  133
Alterations of given name  230
Certifications issued—
Birth certificates     54,950
Death certificates        7,796
Marriage certificates       5,740
Baptismal certificates  33
Change of name certificates  643
Divorce certificates  326
Photographic copies of registrations     11,381
Searches of wills notices       7,508
Non-revenue searches for Government departments       7,218
Revenue received by the central office  $85,369
In previous Annual Reports, items have been included in the foregoing table
showing counts of total revenue searches and of total non-revenue searches. However, with the change in the fee schedule, which became effective on July 1, 1962,
the search and certificate fees are combined, and searches are not accounted for
separately, except in the relatively small number of cases where no registration is on
file. The new item included in the above table relating to searches of wills notices
was formerly included in the total for all revenue searches. Likewise, the new item
" non-revenue searches for Government departments " was previously included with
the total for all non-revenue searches.
BIO-STATISTICAL SERVICES
The bio-statistical services of the Division have been developed in order to
make readily available statistical information and analyses which are essential for
the efficient planning and operation of the many health facilities and public health
services of the Health Branch. The Division is therefore committed to providing
comprehensive statistical service to virtually all other divisions of the Health Branch
and to certain voluntary agencies receiving Governmental financial support.    In
 Y 20 PUBLIC HEALTH SERVICES REPORT,  1962
addition, it provides statistical service to the Mental Health Services Branch and to
the B.C. Government Employees Medical Services. The Division also compiles and
publishes detailed statistics on births, deaths, stillbirths, marriages, adoptions, and
divorces derived from the vital statistics registrations collected throughout the Province. Wide use is made of these vital statistics in connection with the statistical
analyses of health problems and of public health programmes. A detailed report
of vital statistics is published annually for public information. The extensive sets
of indexes which are required in connection with the registration and certification
responsibilities of the Division are all prepared in the Division's mechanical tabulation section.
Tuberculosis Statistics
Statistics relating to the tuberculosis-control programme in this Province have
been provided by the Division ever since the statistical section was organized over
twenty-five years ago. The Division is now responsible for the processing and compilation of data on all new tuberculosis cases reported, on admissions to and separations from tuberculosis sanatoria, on X-ray and tuberculin testing surveys, and on
other special studies relating to case-finding, treatment and follow-up of tuberculosis
cases in the Province. One of the major services provided to the Division of Tuberculosis Control is the maintaining of the tuberculosis known-case register. This
enables the central office of the Division of Tuberculosis Control to have up-to-date,
alphabetical, and numerical indexes of all known cases of tuberculosis and of certain
non-tuberculous chest conditions, while at the same time permitting the operation
of decentralized regional registries of active cases. The regional registries, which
were established several years ago, are part of an improved follow-up and control
system respecting active tuberculosis cases.
The large-scale tuberculin testing programme, which was continued during
1962, required the processing and analysis by the Division of over 100,000 tuberculin testing reports.
Special tabulations were prepared during the year from the statistical series
which has been maintained for a number of years respecting all tuberculosis cases
undergoing surgery. The study included an analysis of complications developing in
patients of various age-groups and at various stages of the disease, according to
the specific type of treatment given.
Personnel of this Division continued to serve on the medical records committee
of the Division of Tuberculosis Control and to participate in the preparation and
review of all printed forms used by that Division.
Monthly, quarterly, and annual reports respecting the tuberculosis-control programme were prepared routinely, and a number of special statistical studies were
undertaken upon request. The Division co-operated in setting up the statistical
aspects of a two-year study relating to patients converting from non-tuberculous to
tuberculous diagnoses.
Venereal Disease Statistics
Two major series of statistics are processed for the Division of Venereal Disease Control. One of these relates to the incidence of new venereal disease cases
reported in the Province, and the other to the epidemiological work of the Division
of Venereal Disease Control in case-finding and contact investigation. From these
two series, reports are prepared for the Division of Venereal Disease Control on a
monthly, quarterly, semi-annual, and annual basis. The reports include a number
of specially computed indices which indicate the effectiveness of the case-finding,
contact-tracing, and medical examination of contacts carried out by the Division of
Venereal Disease Control.
 VITAL STATISTICS Y 21
Public Health Nursing Statistics
The daily service reports of all public health nurses in the Provincial service
are routinely processed by the Division, and monthly and annual analyses are provided for administrative use. As a further aid in the administration of the public
health nursing programme, a time-study analysis relating to the work of the public
health nurse is carried out each year. This study is based on the work carried out in
four sample weeks during the year. The information accruing from this study is
used in a continuing evaluation of the utilization of public health nursing facilities
and of the use of clerical assistance in health units.
A comprehensive body of statistical data respecting the home-care programmes
throughout the Province is also compiled by the Division. For this purpose a
punch-card record is set up for each individual home-care visit made by the public
health nurses, and details of diagnosis, treatment, time expended, service given, and
other pertinent data are recorded. A special analytical report covering statistics of
the home-care programmes is prepared annually by the Division.
Dental Health Statistics
During the year the Division again collaborated with the Division of Preventive
Dentistry in the carrying-out of the annual community dental-health surveys in
selected areas of the Province. These surveys, which are designed to yield important
information respecting the dental-health status of the school population, are based on
statistical samples of the public school population in the various regions of the
Province. Each region is surveyed once every three years, since this periodicity is
considered sufficient to yield the type of data required. The selection of the samples
and the subsequent compilation and evaluation of the dental-examination reports are
the responsibility of the Division of Vital Statistics. The 1962 survey covered the
Greater Vancouver region, and the results were published in the special-reports
series of the Division.
From data collected in the 1961 survey of Vancouver Island, a special
study concerning the relationship between malocclusion and dental caries was
prepared in co-operation with the Division of Preventive Dentistry. Studies evaluating the effectiveness of topical applications of stannous fluoride were completed
in the Fraser Valley and Kootenay regions, and another study was initiated to assess
the effectiveness of topical application of fluoride phosphate. Surveys relating to
the fluoridation of community water-supplies were carried out in Kelowna and
Prince George, and the results of these surveys were compared with those of pre-
fiuoridation surveys completed some years ago.
Analyses were prepared from a special survey of dental needs and facilities in
the Province. For this purpose the Division processed returns submitted by dentists
throughout the Province. Assistance was also given to the Division of Preventive
Dentistry in the initiation of a study relating to the effect of penicillin therapy on
caries incidence among children.
Epidemiological Statistics
The Division has several continuing assignments in the field of epidemiological
statistics. The most important of these is the maintenance of the Province-wide
notifiable-disease reporting system, from which are compiled weekly, monthly, and
annual reports of notifiable diseases reported.
The Division also maintains a registry of all cases of cancer diagnosed in the
Province.    The purpose of this registry is to make available statistics which will
 Y 22 PUBLIC HEALTH SERVICES REPORT,  1962
help to indicate the course and magnitude of malignant disease in this Province.
A special statistical report on cancer morbidity and mortality is prepared annually
by the Division.
During 1962 the Division worked closely with the Director of Epidemiology
in connection with several aspects of the poliomyelitis immunization programme,
and in the follow-up and assessment of the cases occurring during 1960 in both vaccinated and unvaccinated persons.
Rheumatic Fever Prophylaxis Programme
During the year the Division assumed the responsibility for maintaining the
register of all cases on the rheumatic fever prophylaxis programme. Since the
Division has commenced the statistical processing of these records during the previous year, it was considered advantageous to make this change in the location and
operation of the register.
School Medical Examinations
In co-operation with the Director of Local Health Services, a statistical programme was designed to deal with the reports of medical examinations of schoolchildren under the new referral system. The recording and statistical arrangements
which have been made for this new system will reduce the amount of clerical work
required at the local level while at the same time making more readily available
statistical information which will be helpful in evaluating the programme. Toward
the end of the year the Division commenced processing the individual medical-
examination reports using mechanical tabulation equipment.
Infant and Peri-natal Mortality Statistics
Because infant mortality is still a problem of major concern to public health
officials, the Division has for a number of years engaged in a special analytical study
of all infant deaths occurring in the Province. In order that this analysis might
be as comprehensive and informative as possible, pertinent information respecting
each child who dies in infancy is obtained not only from the registration of death,
but also from the birth registration and from the physician's notice of birth. This
enables the study of the possible relationship between factors associated with the
birth of the child and with its subsequent death. During 1962 there appeared to be
an increased interest in the infant mortality problem on the part of a number of
public health and medical organizations, and considerable use was made of the data
available from this continuing study in this Province. Two special reports analysing
the infant mortality experience in British Columbia during a recent three-year period
were prepared and issued in the special-reports series of the Division.
The Division has also maintained a continuing series of statistics derived from
the physician's notice of live birth or stillbirth. Data obtained from this source
contain valuable information which is not available from the birth registrations, and
these data are especially important in connection with the infant mortality studies
just mentioned. In addition, they have useful applications in a number of other
problems being studied by public health and medical research workers. During the
year the feasibility of correlating information on file with the Registry of Handicapped Children and Adults with information contained on the birth records was
tested, and it appears that the integration of data from these two sources will yield
further valuable results.
 VITAL STATISTICS Y 23
Medical Care Statistics
An extensive statistical service is provided by this Division to the B.C. Government Employees Medical Service in the statistical processing of all claims reports
submitted for payment. Under an agreement with this Service, the Division compiles statistics relating to the illness experience of persons covered by the medical
care plan, and also prepares administrative statistics relating especially to volume
and types of services rendered and to cost analyses.
A special report containing statistics of the plan is issued each year in the
special-reports series of the Division. In the report covering the year 1961, an
expanded list of illness categories was shown in order to provide more detailed morbidity statistics. However, while a great deal of morbidity data are available from
the annual tabulations prepared by the Division, it is practical to include only a limited number of tables in the annual report. The additional data are available for
detailed study as required. Other special analyses are prepared from time to time
upon request from the directors of the plan.
Poison Control Statistics
The Division continued to receive reports of all accidental poisonings referred
to the various Poison Control Centres throughout the Province. Statistics relating
to the 1961 experience were compiled for Departmental use.
G. F. Strong Rehabilitation Centre Statistics
Statistical service was again provided to the G. F. Strong Rehabilitation Centre
during 1962 by the processing of all statistical records relating to patients treated at
the Centre. Administrative statistics, as well as statistics which are of special interest
in the field of rehabilitation, are provided by this system. The system also enables
special categories of patients to be identified and selected out for purposes of special
study or assessment.
Epilepsy Centre Statistics
The arrangement which was made in 1959 whereby this Division would provide a statistical service to the newly established Epilepsy Centre continued in effect
during 1962. As a result of the first two years' experience in this field, a number
of improvements were made in the recording system.
Mental Health Statistics
The provision of a full statistical service to the Mental Health Services Branch
of the Department of Health Services and Hospital Insurance is another major
responsibility of this Division. This includes the statistical processing of admission
and separation reports relating to all patients admitted to institutions of the Mental
Health Services Branch, and also the processing of the statistical records relating to
adult patients treated at the Mental Health Centre at Burnaby. At the end of each
fiscal year the Division compiles the detailed statistical tables which are required for
the annual report of the Mental Health Services Branch, as well as other detailed
tables required by that Branch for administrative purposes. The Division also provides consultative service to the Mental Health Services Branch, and during 1962
assisted in a number of special projects involving mental-health statistics.
The Division also compiles statistics based on the admission and separation
reports of patients treated in the psychiatric units of two large hospitals in the
Province.
 Y 24 PUBLIC HEALTH SERVICES REPORT,  1962
Registry for Handicapped Children and Adults
Although the Registry for Handicapped Children and Adults is administered
by the Director of Registry and Rehabilitation Services, the Division of Vital Statistics provides the day-to-day supervision of the Registry, and has the responsibility
of processing and analysing the statistics which stem from it. The Registry files
now contain statistical information respecting over 21,000 children who have been
reported as having disabilities and approximately 1,700 adults. The Division compiles extensive statistical tabulations from the records of the Registry, the more
important statistical data being summarized into the annual statistical report of the
Registry. In addition, mechanically tabulated indexes of all cases registered are
produced annually on both an alphabetic basis and on the basis of specific disability.
Separate alphabetic and disability indexes are prepared for each health unit in the
Province, showing all registered cases that are resident within the health unit area.
Although the Registry began accepting registrations of disabled adults commencing April 1, 1960, the number of disabled adults registered remains relatively
small. The majority of the registrations already on file respecting adults have originated with the G. F. Strong Rehabilitation Centre, or relate to persons who were
originally registered in the Children's Registry and have now reached the age of 21
years. During the year, arrangements were made for the registration of cases being
seen at the local rehabilitation councils under the welfare rehabilitation survey plan.
Arrangements were made during the year for the registration of children with
handicapping conditions who attend the Health Centre for Children in Vancouver.
Arrangements were also made with the Canadian Arthritis and Rheumatism Society
for the registration of disabled persons coming within the purview of that agency.
Reference was made in last year's report to the development of a Family Register within the Registry for Handicapped Children and Adults. This work was
continued during 1962 by the geneticist in the Department of Pediatrics at the University of British Columbia, who serves as a consultant to the Registry. By the end
of the year over 5,000 individual records had been reviewed with a view to determining familial linkages, and amongst these it was found that 372 families had more
than one member registered with a handicapping condition. These 372 families
accounted for over 800 registrations, or approximately 16 per cent of the group
reviewed.
Cytology Statistics
The statistical system which was developed for the Cytology Laboratory in
1957 and placed into operation in 1958 is functioning in a very satisfactory manner.
The individual examination reports from this programme are channelled through
the Division of Vital Statistics, and the relevant statistical information extracted on
to punch-cards. Analyses are produced which are designed to yield important information regarding the efficacy of the cytological screening procedure and the pathogenesis of uterine cancer. Although the volume of examinations increased over
fourfold from the 25,000 per year anticipated when the statistical processing began
to over 100,000 in 1962, the Division has continued to meet all of the statistical
requirements of the programme.
Special tabulations were prepared during the year in connection with the determination of incidence and prevalence of pre-invasive cervical cancer in the female
population of this Province. Since the pre-invasive stage of cervical carcinoma is
normally symptomless, the cytological screening programme provides the only source
of information for the estimation of incidence and prevalence rates. The statistical
data collected during the years 1958 to 1961, inclusive, were subjected to further
 VITAL STATISTICS Y 25
critical analysis during the year in connection with studies relating to the trend in
the incidence of invasive cervical carcinoma.
Britsh Columbia Cancer Institute Statistics
The Division collaborated with the British Columbia Cancer Institute in a
critical review of the statistical system which was set up at the Institute over ten
years ago. As a result of this review, an improved and simplified method of processing the basic statistical data required by the Institute was evolved and placed
into operation. An important feature of the new system is an arrangement whereby
the statistical abstract record of each case treated at the Institute will also serve as
the notification to the Health Branch of a malignant neoplasm required by regulations under the Health Act. Previously, the Institute initiated a separate report of
malignant neoplasm respecting each new case treated.
Obstetrical Discharge Statistics
The Division continued to provide a statistical service to another long-range
project in the health field designed to study maternal mortality, maternal morbidity,
and foetal wastage in British Columbia. This project, which is assisted by Federal
funds, is under the direction of the Department of Obstetrics, University of British
Columbia. The emphasis in this project to date has centred around analyses of the
detailed obstetrical discharge records of four Vancouver hospitals which are cooperating in the study.
A detailed review of the information being collected on the obstetrical discharge
records was made during the year by a special committee representing all participating hospitals, the Department of Obstetrics at the University, and this Division. As
a result of this study, a revised obstetrical discharge summary record was drafted
and approved for use commencing January 1, 1963. Statistics derived from this
improved summary of each case will yield additional information not previously
available.
Statistics for the Speech and Hearing Programme
The Health Branch and the Poliomyelitis and Rehabilitation Foundation of
British Columbia have set up a pilot plan for three years designed to provide speech
therapy in certain areas of the Province and to study the problem of speech-therapy
service throughout British Columbia. The Division of Vital Statistics participated
in the planning for this project and has arranged a method of recording the data on
individual children serviced under this programme which will enable the information
to be processed on to I.B.M. punch-cards.
Rehabilitation Statistics
A punch-card record is maintained of all disabled persons receiving training
under either the M or R Schedule of the Canadian Vocational Training Act. Statistics compiled during the year from this series were made available to the Rehabilitation Service and also to the Department of Social Welfare and the Department
of Education. These data have proved most valuable in assessing the effectiveness
of the training programme.
Other Statistical Assignments
The Division continued to provide a wide range of statistical information to
governmental and non-governmental agencies and to private individuals. Members
of the Division served on a number of special committees studying various health
problems and provided consultant service in bio-statistical matters to a large number
of health agencies and to personnel engaged in medical research.
 Y 26 PUBLIC HEALTH SERVICES REPORT,  1962
REPORT OF THE DIVISION OF PUBLIC HEALTH
EDUCATION
Plans to recruit a qualified teacher to specialize in school health education were
successfully completed in June with the employment of Mrs. Patricia Kahr, a former
public health nursing supervisor who is also a qualified elementary-school teacher.
Thus, during the year, the Division was able to extend its sphere of activity to
include one further important specialized service, the need for which has been discussed previously in these reports. In addition, Mr. Alex Buller was appointed
health-education trainee by the Greater Vancouver Metropolitan Health Service,
fiHing the vacancy created with the resignation last year of Mr. M. E. Palko, who
joined the staff of Information Services Division, Department of National Health
and Welfare.
SCHOOL HEALTH EDUCATION
This new programme is designed to support the existing curriculum as it
pertains to the teaching of health and is being developed through the provision of
specific services to (1) the Department of Education, (2) the teacher-training institutions at Victoria College and the University of British Columbia, and (3) to the
staff of local health departments who provide, as part of the school health services
programme, factual information concerning health to teachers in their area and
make available appropriate classroom teaching aids. Since her appointment in
June, the consultant in school health education has been involved with the teacher-
training institutions of this Province by organizing and giving a summer session in
health education at Victoria College, by participating in a one-day workshop in
health education sponsored jointly by Victoria College and the Victoria branch of
the Canadian Association for Health, Physical Education, and Recreation, and
through general continuing assistance to the staff of the Faculty of Education through
the provision of teaching aids and reference materials. Other projects specifically
referring to the teaching of health in the schools have included the development of
a programme of nutrition education for the elementary grades, to support and
suppplement the curriculum established by the Department of Education. It is
planned that this particular programme will be carried out in a few schools on an
experimental basis. Plans for 1963 include the development of similar programmes
for safety, smoking, and other subjects on which teachers have expressed a need and
desire for assistance. This need is being determined partly through a study currently
under way in conjunction with the staff of the Boundary Health Unit.
AUDIO-VISUAL AIDS AND WRITTEN MATERIALS
The Division continued to expand its facilities for the selection and distribution
of educational aids. Particular note is made with reference to the increased use of
films and the preparation of visual materials for displays. Some 6,000 film showings
were recorded during the year, which was a 35-per-cent increase over 1961. Confirmed film bookings increased to a total of over 3,700, more than double the number
completed only three years ago in 1959. This marked extension in the use of films
is attributable to, firstly, an increase in the number of classes for expectant parents
in the non-metropolitan areas, and more particularly to the demand emanating from
schools throughout the Province.
The central collection of slides and photographs depicting Provincial and local
health services was augmented during the year and proved again to be a valuable
 PUBLIC HEALTH EDUCATION Y 27
asset in preparing displays for several health centre openings; for the Departmental
exhibit at the Pacific National Exhibition; the public health section of the " Safeguarding Motherhood" display, also located at the Pacific National Exhibition,
sponsored by the British Columbia Division of the Canadian Medical Association;
and for a Departmental exhibit at the annual meeting of the British Columbia Dental
Association in Vancouver. In addition, slides were prepared specifically for talks
on emergency health services, prenatal instruction, and school health services. Too,
most of the photographs of the health centres appearing in a special section of this
Health Branch Annual Report were taken by the public health education assistant.
The preparation of informational materials was confined largely to those items
designed specifically for the oral poliomyelitis vaccine programme. The over-all
publicity plan developed by members of this Division included the preparation of
informational and promotional materials in the form of leaflets, press releases,
feature articles, posters, and bumper stickers. Specific reference should be made to
the considerable assistance, both financial and promotional, that was provided by the
Poliomyelitis and Rehabilitation Foundation of British Columbia and in health unit
areas by various Kinsmen groups.
At the conclusion of the year, three brochures were in draft form, scheduled
for publication early in 1963. One is a further revision of "Administration of the
Provincial Health Services," originally prepared for inclusion in the 1951 Annual
Report of the Health Branch. The second is a guide for health unit auxiliary workers, and outlines, step by step, procedures that are followed by volunteers to assist
professional health unit staff in the conduct of child health conferences, clinics, etc.
The third is a brochure written primarily for teachers and School Board members
describing current responsibilities of both the school and the health unit in the
provision of school health services.
IN-SERVICE TRAINING
Each year the Division organizes on behalf of the Director of Local Health
Services the annual Public Health Institute, at which time public health field staff
throughout the Province meet for a four-day period following Easter. This year's
meeting was held at the Hotel Georgia in Vancouver. The main topic was health
care and was covered largely by the four talks presented by Dr. S. J. Axelrod,
Director of the University of Michigan Bureau of Public Health Economics, who
discussed the general aspects of health care, including methods of financing and the
role of public health. The main theme was supplemented by lectures and panels
given by persons drawn from the University of British Columbia, voluntary health
agencies in the Greater Vancouver area, and from the staff of the Health Branch on
both the Provincial and the health unit level.
A departure from the usual practice of meeting at a hotel or school auditorium
is planned for 1963, when the Institute is to be convened at the University of
British Columbia, utilizing University residences for housing staff and classrooms
for the general and sectional meetings. Dr. J. R. Kidd, secretary-treasurer of the
Social Sciences Research Council, Ottawa, is scheduled to be the main guest speaker.
As representative of the Division on the Policy Manual Committee, the consultant in public health education devoted a considerable amount of time to not only
the production of the policy manual, but also the preparation of various sections.
Forty-six amendments were made, and nineteen new sections were added during
1962, including those pertaining to the revised school health services programme,
the dental programme, and emergency health services.   A further important step
 Y 28 PUBLIC HEALTH SERVICES REPORT,  1962
was the complete reorganization of the manual into four volumes covering administration, records, programmes, and agencies.
Library facilities for the Health Branch in Victoria and Vancouver were augmented by the addition of 173 and 20 titles respectively in addition to numerous
reference items outside the category of catalogued materials. Only three new titles
were purchased for distribution to each of the health unit libraries, as opposed to the
unusually large number of eighteen during 1961. However, the total number of
books now held in the two Health Branch and some seventy-five health unit libraries
is in excess of 4,000. Other in-service training functions, such as the publication of
the monthly staff bulletin, designed to keep Local Health Services staff informed
regarding developments in health and in Departmental activities, and involvement
with the preparation of various manuals, catalogues, and reports, continued throughout the year.
SURVEYS AND RESEARCH
The Division entered a further phase of its programme development late in the
year with the initiation of plans for the design of a methodology for the collection
and analysis of base-line data on public knowledge, attitudes and behaviour with
respect to commonly recommended health practices. This methodology is to be
applied initially to the field of dental-health education, the resulting information
serving to enable health unit staff in the particular regions surveyed to determine
those areas of dental health requiring particular educational emphasis, and to provide
base-line data for future evaluation of educational activities.
 ACCOUNTING DIVISION
Y 29
REPORT OF THE ACCOUNTING DIVISION
For the Period April 1, 1961, to March 31, 1962
The functions of the Accounting Division are to control expenditure, process
accounts for payment, account for revenue, forecast expenditures, and prepare the
Departmental estimates of revenue and expenditure in their final form. In addition,
the Division is responsible for the inspection and control of expenditures for Departmental cars.
The table shown at the end of the report gives a comparison of gross expenditures and percentage of expenditure related to various services within Public Health
Services for the fiscal years 1959/60 to 1961/62, inclusive. In comparing the gross
expenditure for the Department for the fiscal year 1961/62 with the previous fiscal
year 1960/61, there is a decrease of $50,345.
The Division of Tuberculosis Control expenditures have decreased in the fiscal
years shown (1959/60 to 1961/62) by $252,281 or 10.8 per cent. During this
period the patient-days have decreased by 26,734.
Local Health Services expenditures continue to increase as a percentage of
expenditure of the total Public Health Services budget. The increase within the
three-year period amounts to $526,828 or 21.8 per cent. The increase is largely
due to the expansion of the home care programme, which has increased from an
expenditure in 1959/60 of $11,165 to the 1961/62 expenditure of $192,126.
A further reason for the increased expenditure is the salary increases granted in 1960.
The items of cancer, arthritis, rehabilitation, research, etc., are grants to voluntary agencies, and over the recorded three-year period this section has increased by
$161,084.
The poliomyelitis section of expenditure for 1961/62 shows a decrease both
absolutely and as a percentage of the Departmental gross expenditure from the previous fiscal year. This section of expenditure covers the Poliomyelitis Pavilion at
Pearson Hospital, situated in Vancouver, and the poliomyelitis vaccine programme.
The decrease in expenditure is due to the changes, perhaps temporary, in the vaccination programme.
The Accounting Division continues to operate an inspection of motor-vehicles
throughout the Province, and during the fiscal year 1961/62 the fleet of vehicles
was increased by thirty-two cars. The additional vehicles were required for the
operation of the home nursing-care programme. There were 195 Government-
owned vehicles operated by the Health Branch as of March 31, 1962.
Comparison Table of Public Health Services Gross Expenditure for the
Fiscal Years 1959/60 to 1961/62
Service
Gross Expenditure
Percentage of Gross
Expenditure
1959/60
1960/61
1961/62
1959/60
1960/61
1961/62
Division of Tuberculosis Control 	
$2,342,565
2,417,767
1,208,520
413,249
405,688
376,785
312,200
99,145
$2,265,614
2,692,908
1,379,975
478,009
412,442
379,134
308,802
93,422
$2,090,284
2,944,595
1,369,604
365,482
408,752
376,234
310,176
94,834
30.9
31.9
16.0
5.5
5.4
5.0
4.1
1.3
28.3
33.6
17.3
6.0
5.1
4.7
3.9
1.2
26.3
37 0
Cancer, arthritis, rehabilitation, research, etc.1
17.2
4.6
General administration and consultative ser-
5.1
4.7
3.9
1.2
Totals        	
$7,575,919
$8,010,306
$7,959,961
100.0
moo   i   loo.o
1 Previous Annual Reports have shown this service under two items, " cancer, arthritis control, rehabilitation,
etc." and " research, training, etc." Because a certain amount of overlapping is developing between these two,
they are being shown as one.   The previous two years have been adjusted accordingly.
 Y 30 PUBLIC HEALTH SERVICES REPORT,  1962
COMMUNITY HEALTH CENTRES
The official opening of the Comox Community Health Centre on October 23rd
by the Honourable Eric Martin, Minister of Health Services and Hospital Insurance,
marked the sixty-second health centre to be completed in British Columbia since
the plan of combined assistance from the Federal and Provincial Governments was
introduced in 1951.
In all, there were four ceremonies during the year. The main office of the
Upper Fraser Valley Health Unit was moved to its new building, the Chilliwack
Health Centre, in May; in July, Campbell River celebrated the opening of its community health centre; and August saw the Minister officiating at the opening of the
health centre at Nelson, main office of the Selkirk Health Unit.
" Health centres " are truly named. A few years ago, health departments in
many communities of the Province were housed in inadequate and incommodious
quarters, frequently requiring mothers with infants to climb long flights of stairs to
attend clinics. The modern health centres are evidence of a changing concept. They
are buildings of functional design, with emphasis on the practical and economic
aspects of a building planned to render important public services. Convenience of
location and accessibility are now prime considerations, but perhaps most outstanding is the inclusive nature of these buildings—inclusive in that they serve as a community health headquarters; here are brought together all preventive and rehabilitative health services rendered not only by the public health staff, but also by voluntary agencies such as the Red Cross, the British Columbia Division of the Canadian
Cancer Society, the British Columbia Tuberculosis Society, and others. The resulting co-ordination of effort embraces also the travelling consultative clinics, which
make intermittent visits throughout the year to render specialized services in connection with tuberculosis, mental health, cancer, and paediatrics.
Community residents feel a pride of personal possession in the newer type of
health centre. This is fostered by the Medical Health Officer and his staff, who, by
their identification and integration with community life, gain a keener awareness of
the people's needs and an increased ability to serve them better. Citizens respond
by taking an active interest in the work of the health unit, many of them participating as health unit volunteers, or through other avenues of personal endeavour which
attest to their sense of being a part of the community's public health effort.
The " community " aspect of these projects has remained paramount from the
inception of the programme in 1951, in that the sponsorship, planning, and fund-
raising for a health centre originates either with the municipal authorities or with a
service club. Much of the credit for the achievements recorded under the plan goes
to the municipal representatives and the service clubs concerned, who accept complete financial responsibility. In most cases the new health centres have been sponsored by service clubs such as Kinsmen, Kiwanis, Rotary, Lions Club, and others.
It can truly be said that the majority of the new centres owe their existence to the
enthusiasm and spirit of the service club members, who adopt these projects as their
own and then, with energy and determination, follow them through to completion.
It is on the basis of this initial commitment that the senior governments make
substantial contributions to the cost by way of National and Provincial health grants.
To date the total Federal share has been almost $650,000, with the Provincial contribution amounting to approximately $730,000.
In addition to the financial support provided by the two senior governments and
the municipalities concerned, funds needed to bring the total to the amount required
for the whole project are often made up by voluntary agencies such as the British
 COMMUNITY HEALTH CENTRES Y 31
Columbia Tuberculosis Society, the British Columbia Division of the Canadian
Cancer Society, the Poliomyelitis and Rehabilitation Foundation, and others. Taking
into consideration contributions from all sources, the total cost of health centre
construction during the past eleven years has amounted to more than $3,350,000.
The municipality (which in most cases donates the land) accepts ownership of the
completed building and assumes all responsibility for maintenance, insurance, and
redecoration as required, charging the Provincial Government a nominal rental of
$1 per year. The Government meets all operating expenses, including heat, light,
water, and janitorial services.
 Greenwood Health Centre.
 Langley Health Centre.
Penticton Health Centre.
 Revelstoke Health Centre.
White Rock Health Centre.
 LOCAL HEALTH SERVICES Y 35
REPORT OF THE BUREAU OF LOCAL HEALTH SERVICES
The over-all function of the Health Branch is primarily to promote and maintain the community health. Within these terms of reference, this Bureau specifically
seeks to establish and maintain an adequate full-time local health service rendered
by public health trained personnel, to provide supervision of, and consultative services to, these local health services and, finally, to endeavour to co-ordinate the channelling of special services which, for economic or other reasons, cannot be developed
at the local level. The staff of the local health unit endeavour to integrate and
identify as closely as possible with their local community that they may assess community needs the more accurately and thereby offer health services of maximum
benefit to the residents.
The Bureau of Local Health Services includes the Divisions of Public Health
Nursing, Preventive Dentistry, Epidemiology, and Public Health Engineering, and
the Nutrition Service. This report summarizes the work of these individual divisions, but since, in practice, the common objective is to co-ordinate and balance the
services provided to health units, it is reasonable that this summary of the year's
work should be presented as far as possible with no such clear-cut division of
service but as the work of a closely knit and interdependent group.
COMMUNITY MENTAL HEALTH
With the expansion of community mental-health programmes, service is being
extended to include all age-groups in prevention, diagnosis, treatment, and rehabilitation at the community level. This year, as a result of close co-operative planning
between Mental Health Services and this Health Branch, the first regional mental-
health service was started in the Okanagan Valley, with headquarters in the South
Okanagan Health Unit at Kelowna. Treatment is being encouraged locally, with
hospital admission as one phase only in the total treatment programme, while emphasis is directed toward continuity of care as the patient returns to the community
from hospital. Community mental-health services are gradually being extended to
replace the travelling clinics, whose services were limited to child guidance with
intermittent visits precluding adequate follow-up. This community-developed approach finds the psychiatric team based in the community at the local health unit
headquarters serving adjacent health unit areas. The three Okanagan health units
receive service from Kelowna, while psychiatric-treatment beds are utilized in the
local hospital.
Similar regional development of service is proposed for the Kootenay and
Vancouver Island areas in the near future, and in the meantime improved facilities
are gradually becoming available in other parts of the Province while health unit
staff participation in mental-health services continues to increase rapidly. Within a
regionalized service, the family doctor represents the pivot of the clinical service,
the Medical Health Officer acts as administrator and facilitates communication,
while the psychiatrist is consultant both to individual patients and to the clinical
group on clinical-social problems. The efficiency of this type of programme is
dependent upon the closest co-operation of the local professional workers to include
the family physician, Medical Health Officer, public health nurse, social worker,
Probation Officer, school counsellor, and others. A patient may be referred from
any of these resource personnel, but the family doctor is always involved. With the
patient's or parents' consent, a social history is taken, and the family doctor receives
a copy of this social history and, when possible, preliminary consultations are held
 Y 36 PUBLIC HEALTH SERVICES REPORT,  1962
between him, the public health nurse, the social worker, and the Medical Health
Officer. Such consultations serve as a screening mechanism to try to avoid the need
to refer every patient to the specialist psychiatric team. Local branches of the
Mental Health Association are encouraged to participate and can assist greatly in
the rehabilitation aspect by stimulating the development of recreational facilities,
etc., in the local area.
It is obvious that rehabilitation, to include vocational training and job placement, will play a major part in these programmes. It is interesting to note the
increasing involvement of public health nurses in mental-health work, so that during
the past year their visits in association with this programme increased by some 20
per cent, to total approximately 9,000. Mental-health teaching is a recognized part
of family health counselling, and, therefore, the time spent within this programme
does not represent the total extent of participation in this very broad and complex
field.
SCHOOL HEALTH PROGRAMME
Although the school health programme is referred to as an entity, the health
of the school-child is influenced by many factors which lie outside his immediate
school experience. Prenatal teaching, care during infancy and the pre-school years,
community preventive dental programmes, control of communicable disease, improved sanitation, and many other facets of a community health programme will
have an influence on his health. The school health programme per se is merely a
small part, albeit an important one, and due consideration must be given to the
other services recorded elsewhere in this section of the Report. The past year has
been one of active study of the school health programme. The School Health
Services Committee, formed in 1961 as a sub-committee of the Health Officers'
Council, continued its studies, and early in the year drafted a recommended school
health programme for use in other than metropolitan areas. Meetings were held
with representatives from the Department of Education, who made valuable contributions in the preparation of the final programme.
In April the School Health Programme (1962) was distributed jointly by the
Health Branch and the Department of Education to Health Unit Directors and District Superintendents of Schools, with the recommendation that it be interpreted to
Boards of School Trustees and health and education personnel before being put into
effect on September 1st. Following discussions with representatives of the metropolitan health services in Vancouver and Victoria, they advised that their respective
school health programmes were under continued study, and that certain modifications might be anticipated but that no changes would be effected at this time.
Although the School Health Programme (1962) does not constitute a radical
change, it does recognize certain practices which have developed almost spontaneously in many areas of the Province. These practices stem from the day-to-day
experience of those closest to, and therefore most aware of, the child and the manner
in which his needs can best be met through the medium of this programme within the
framework of the total community health service. It defines in general terms, and
for the first time, the roles of health and education personnel, with the aim of having
each member seek the best interests of the child by giving every possible assistance
to the other while respecting their individual areas of professional responsibility.
An attempt is made to ensure the effective use of time by replacing certain routine
procedures with a more selective type of service, giving recognition to parental
responsibility and to the need for continuing care by the family physician.
The programme lays emphasis on the method by which pupils are selected for
special supervision and follow-up.  These include teacher-nurse conferences, school
 LOCAL HEALTH SERVICES Y 37
liaison committee meetings, and vision, hearing, and tuberculin tests. The more
routine type of medical examination has been superseded by the referral examination
of pupils demonstrating the need for special care because of physical, emotional, or
mental problems. The home visit is stressed as a basic part of the service. The role
of the nurse and of the teacher is outlined in respect to health education, accidents
or illness, absenteeism, and participation in physical activities, and provision is made
for the nurse to notify teachers regarding pupils with special disabilities. Procedures
are outlined for giving service to kindergartens and schools for retarded children,
and for reporting annually to Boards of School Trustees.
The programme of health education as conducted in schools is receiving considerable study, and it is hoped that something can be done to equip children of
school age with a better knowledge of themselves as human beings and of how they
should relate, as members of the animal kingdom, to their environment and particularly in this day and age to society in general.
A time study conducted in February showed that the school health programme
utilizes about 36 per cent of the time of each public health nurse, to include home-
visiting, which is a most important part of the follow-up of the school services provided, to the extent that this year 49,081 visits were made, to represent a 30-percent increase over last year.
It is felt that a more detailed description of the programme should await the
results of studies which are currently being conducted by health units, and which
will be completed in the summer of 1964. It is anticipated that some modification
of the present programme will take place at that time. Fifteen separate aspects of
the programme are presently under study, with all health units participating in one
or more. These aspects were suggested for study by individual health unit staffs,
and with their interested co-operation and assistance the details of approach and
scope of each area of study were worked out. The following areas were selected:
Tuberculin testing; hearing testing; health-education teaching; vision testing; reading smallpox revaccinations; health programme in kindergartens; health programme
in private schools; physical-education programme; school construction, environment, to include school lighting; examination of school beginners by the family
physician; selection of pupils in liaison committees in secondary schools; the health
programme in schools for the mentally retarded; accident prevention and first aid in
schools; annual report to Boards of School Trustees.
A special study of referral examinations is also being conducted by all health
units to obtain information on methods of pupil selection, results of examination, and
follow-up. It is anticipated that the special consideration being given to these aspects
of the programme by the persons who are most intimately concerned will result in
sound recommendations to ensure the ultimate provision of a programme which will
not only prove of maximum benefit to the child, but allow this to be obtained with a
minimum of non-productive effort.
To modify any health programme, a method must be devised whereby the
over-all health status can be assessed, and, over the years, various systems have
been adopted for reporting on the health status of children of school age in this
Province. In the school-year 1941/42 a system was devised for reporting the
health of school-children who were given routine examinations. Rating was done in
three broad categories—A, B, and C—and these categories were qualified by " d "
for a physical defect and " e " for an unsatisfactory environmental factor. In
1955/56 this method was replaced by the P-E-M rating, which graded pupils according to their physical, emotional, and mental status. The P, E, and M categories
were given a number from one to four to indicate the magnitude of the respective
 Y 38 PUBLIC HEALTH SERVICES REPORT, 1962
defect. Reports of the A-B-C ratings are therefore available for fourteen years, and
reports of the P-E-M ratings for seven years. Throughout these twenty-one years,
pupils with no defect or minor defect only, accounted for some 80 to 90 per cent of
those examined.
In 1941, when ratings first began, 50.4 per cent of pupils were given a routine
physical examination. By the school-year 1961/62 this percentage had decreased to
9.6 per cent, due in part to the increasing emphasis on referral examinations. In
keeping with the current philosophy of channelling school health services to those
pupils whose need is greatest, further modification of the programme has now been
made to place a still greater emphasis on referral examinations. This will therefore
be the last year in which the health status of school-children will be presented on the
basis of results of routine medical examination. Instead, it will be presumed, from
the experience of the past twenty-one years, that some 85 per cent of the children
attending school in this Province will have no significant health problem and future
reports will be concerned primarily with the remaining 15 per cent.
SPEECH AND HEARING PROGRAMME
During the year, field services have been consolidated. This programme is
under the direction of a joint planning committee, with representatives from the
Poliomyelitis and Rehabilitation Foundation of British Columbia, the Vancouver
General Hospital, and the Health Branch, being financed by these organizations and
by National Health Grants. The supervisor was able to reorganize existing facilities,
so that the best possible use is now being made of the available resources. One
full-time therapist is serving in the Victoria area, one is located in Nanaimo for the
remainder of Vancouver Island, and there is another in each of the Simon Fraser
and Boundary Health Units. A Provincial survey is presently under way to determine the needs in those areas of the Province where no therapists are presently
available. During the year an assessment survey was conducted in the North Fraser
and Kootenay Health Unit areas, and in the coming year the four northern and the
remaining health units in the Interior will be studied. Local health unit staffs have
been active in referring children and adults needing diagnosis, treatment, and follow-
up, and have been able to assist greatly in this programme. It is hoped that in the
near future it will be possible to have more regional speech therapists to work in
close co-operation with these health unit staffs.
PATTERNS OF DISEASE
Morbidity and mortality figures represent a crude yardstick by which a health
department may attempt to assess the success of its programmes. If these rates are
studied and compared on a ten- or fifteen-year basis, then the change in the pattern
of disease may be shown quite dramatically, for example in such diseases as diphtheria, typhoid fever, and tuberculosis, even here in British Columbia. On the
other hand it is extremely important to be able to identify specific areas of a disease
picture in which more immediate improvement is required, and to do so the more
refined tools of detailed survey and research must be utilized.
The significant features in the list of reported diseases during the past year
show that after three years without a reported case of diphtheria (1957 to 1959,
inclusive), one case occurred in 1961 and three this year, all in adults, of whom
two died. This parallels the experience in other parts of Canada where more diphtheria in adults is being reported. A suggestion has been made that this increase
is due to the recent wave of immigration from areas where diphtheria is more preva-
 LOCAL HEALTH SERVICES Y 39
lent. This may or may not be a factor, but what is important is that diphtheria is
now making itself apparent among adults who, we know, do not as a group have
either the sub-clinically acquired active immunity that they used to have or the necessary level of artificially acquired active immunity following immunization. Preliminary plans have been made in conjunction with the Connaught Medical Laboratories to carry out a field trial of the effectiveness of quarter-strength diphtheria
toxoid. In conjunction with this, another trial is planned of a product new to Canada but long used elsewhere—namely, alum precipitated toxoid.
The number of cases of dysentery due to shigella or undetermined organisms
has decreased over 40 per cent this year from the 806 cases reported last year and
by more than 64 per cent from the 1,511 similar cases reported in 1960. In addition, there were no deaths attributed to dysentery during the year, in contrast to two
last year. At the moment there is no obvious reason for this apparently spontaneous decline in the incidence of dysentery, and this may only represent a yearly
variation, although it may be part of a true secular cycle.
There are two organisms primarily responsible for outbreaks of food poisoning
in this Province—staphylococci and salmonella. During the year 175 cases of
staphylococcal intoxication were reported, most of these coming from two or three
outbreaks of the typical " banquet " or " church supper " variety. This type of food
poisoning can readily be prevented if due care is taken in the preparation of food.
Further education and enforcement measures are required in this regard. Food poisoning due to salmonella infection was reported 381 times, representing a decrease
of just over 15 per cent from the average of the last two years. More basic research
is required before the solution to this problem is found, and a working party of the
Health Officers' Sub-committee on Communicable Disease Control, assisted financially by National Health Grants, has been carrying out studies directed toward
determining the reservoirs of salmonella in British Columbia, the methods of spread
of this disease, and to suggest methods of control. In addition to Health Branch
members, representatives from the Federal Food and Drug Directorate, the University Faculty of Agriculture, and the Greater Vancouver Metropolitan Health Department have been added to the committee to take advantage of all available facilities
in the Province for studies of this type. This working party hopes that by extensive
study reservoirs of infection may be identified and modes of transmission of the salmonella organism determined.
The highest number of cases of infectious hepatitis ever recorded in British
Columbia were reported during the year—a total of 1,886 cases, 200 more than in
1961. Of this number, sixteen died. Again, this condition requires a tremendous
amount of basic research into the modes of transmission and methods of prevention.
Gamma globulin is the only specific preventive measure presently available, but its
use is limited by relative scarcity and cost. These two factors have made it imperative that the smallest possible effective dose be used. For this reason, a study to
determine the lowest effective dose is being carried out in four of our health units.
This study involves an analysis of the results of the use of gamma globulin in 1,500
to 2,000 close contacts of the infection. There have been no widespread outbreaks
of the disease, but, rather, cases appeared here and there throughout the Province,
particularly in family groups and in the North. Only a few minor institutional outbreaks were reported.
It is of interest that one case of leprosy was reported in a Chinese, age 57, who
had lived in Canada for the past fifty years, with the exception of a one year's stay
in China a year ago. It is presumed that he acquired his disease at that time. There
is no evidence that his family or other contacts have been infected, and he is presently
receiving active treatment with an entirely favourable prognosis.
 Y 40 PUBLIC HEALTH SERVICES REPORT, 1962
Following the major outbreaks of paralytic poliomyelitis experienced in 1959
(132 cases) and in 1960 (165 cases), last year saw only seven cases, and this year
a further decrease has occurred, so that only two cases of paralytic poliomyelitis
have been reported, neither of them of a serious nature. Wild polio virus (Type I)
was isolated from seven other patients suffering from aseptic meningitis, and this is
indicative of the fact that this virus is prevalent in the Province, although not causing
paralytic disease. This points up the need for continuing immunization against
poliomyelitis. Such immunization may be carried out using Salk vaccine, and in
this connection it was felt desirable to determine the degree of protection given to
the pre-school and school population in British Columbia following the various Salk
vaccine immunization programmes carried out during the past few years. Blood
samples were taken from about 500 children selected at random approximately one
year after their third injection immediately prior to a fourth (or booster) dose.
These blood specimens have been titrated at the Connaught Medical Laboratories
in Toronto to determine antibody levels and thereby the precise effect of this vaccine
as administered under the recommended dosage schedule for this Province. The
second vaccine used to combat poliomyelitis is Sabin's oral vaccine, and it is intended
that a field trial will be conducted in the Victoria metropolitan area in the near future
to test the value of an improved version of this trivalent vaccine using 100 volunteer
children in the Grades I to VII level.
Early in the year Sabin's oral vaccine, effective against all three types of poliomyelitis, was licensed for use in Canada. It was decided to offer one dose of this
vaccine to everyone in British Columbia in order to reinforce the immunity gained
from the previous Salk vaccine programme. In May and June this vaccine was
offered at school and public clinics in the Interior and northern parts of the Province.
Two hundred and seventy-four thousand doses were given, representing an acceptance rate of just over 68 per cent. It had been planned to conduct similar clinics
in the Lower Mainland and on Vancouver Island in October, but technical difficulties in the production of the vaccine have made it necessary to delay further use of
the vaccine at least until 1963.
The sudden increase in the number of reported streptococcal throat infections
appearing in 1959 has been maintained, with 709 cases reported this year. Clinically
most of these cases are not too severe. The British Columbia Hospital Insurance
Service is preparing figures on the number of cases of rheumatic fever admitted to
hospital in this Province during the years 1957 to 1962, inclusive. Since rheumatic
fever is commonly associated with a prior streptococcal infection, it will be of interest
in relation to the rheumatic fever programme to see if the number of cases of this
disease show a parallel increase.
In 1961 an outbreak of trichinosis (twenty-three cases) was reported, and it is
gratifying to note that only two cases have occurred this year. This may well be due
to the increased vigilance being exercised by the Federal and Provincial Departments
of Agriculture in their inspection of animals and to the efforts of the public health
sanitary inspectors in Vancouver and the Lower Fraser Valley, where most of last
year's cases occurred.
The incidence of typhoid and paratyphoid fever again show a substantial decrease, with only four and seven cases respectively reported during the year.
Although the activities of the Division of Venereal Disease Control are reported
elsewhere, mention should be made of the fact that the incidence of gonorrhoea,
which began to rise again in 1956 after a spectacular post-war decline, has again
increased substantially, with 3,975 cases being reported. In addition, a continuing
and most disconcerting increase in infectious syphilis (primary, secondary, and early
 LOCAL HEALTH SERVICES
Y 41
latent) is again apparent. For the first time in a number of years the majority of
these infectious cases are being spread by heterosexual rather than homosexual contacts. In order to try to keep this increase to a minimum, public health personnel in
the field are being asked to give high priority toward the identification and treatment
of named contacts.
Again, the Division of Tuberculosis Control reports on its year's activities elsewhere, but within the framework of our communicable-disease control programme
it is interesting to note the amount of work that control of this infection alone means
to the health unit staffs throughout the Province. This year, for example, the public
health nurses made 14,313 visits to patients suffering from this disease and their
contacts, which, incidentally, represented a 13-per-cent increase over last year.
Streptomycin injections were down by 30 per cent, but still amounted to some 6,141.
Reported Communicable Diseases in British Columbia, 1958—62
(Including Indians)
(Rate per 100,000 po
pulation.
)
1958
1959
1960
1961
1962
Reported Disease
Numbei
Number
Number
Number
Number
of
Rate
of
Rate
of
Rate
of
Rate
of
Rate
Cases
Cases
Cases
Cases
Cases
1
0.1
9
0.6
Brucellosis 	
2
0.1
6
0.4
3
0.2
2
0.1
2
0.1
Cancer	
3,238
210.5
3,758
239.8
4,073
254.2
4,324
265.4
4,208
253.6
Diarrhoea of the newborn.	
(!)
C1)
53
3.4
24
1.5
35
2.1
19
1.1
1
0.1
3
0.2
6
0.4
1
0.1
2
0.1
2
0.1
1
0.1
Bacillary  	
936
60.9
336
21.4
1,192
74.4
307
18.9
152
9.2
Unspecified	
(!)
(!)
62
3.9
319
19.9
499
30.6
336
20.3
Food poisoning—
238
14.9
3
0.2
175
10.5
Staphylococcal   intoxica
tion 	
(l)
C1)
8
0.5
238
14.9
3
0.2
175
10.5
Salmonella infections	
292
19.0
355
22.6
434
27.1
475
29.2
357
21.5
Unspecified	
C1)
(!)
3
0.2
52
3.2
46
2.8
24
1.4
Hepatitis, infectious	
558
36.3
907
57.9
924
57.7
1,677
103.0
1,889
113.9
1
0.1
2
0.1
3
0.2
1
0.1
Meningitis, viral or aseptic—
C1)
C1)
3
0.2
137
8.6
3
0.2
1
0.1
C1)
C1)
23
1.4
36
2.2
10
0.6
Due to ECHO virus
(!)
(!)
1
0.1
Other and unspecified	
t1)
f1)
56
3.6
83
5.2
87
5.3
42
2.5
Meningococcal infections	
25
1.6
31
2.0
16
1.0
15
0.9
13
0.8
1
0.1
C1)
C1)
3
0.2
5
0.3
12
0.7
1,427
92.8
680
43.4
962
60.1
212
13.0
456
27.5
Poliomyelitis, paralytic. ... .
12
0.8
132
8.4
165
10.3
6
0.4
2
0.1
1,098
71.4
3,839
245.0
1,576
98.4
1,081
66.4
573
34.5
Streptococcal sore throat	
172
11.2
724
46.2
633
39.5
987
60.6
681
41.1
1
0.1
3
0.2
2
0.1
3
0.2
2
0.1
2
0.1
7
0.4
23
1.4
2
0.1
Tuberculosis	
1,128
73.3
1,200
76.6
1,173
73.2
968
59.4
865
52.1
Typhoid fever	
8
0.5
4
0.3
5
0.3
7
0.4
7
0.4
22
1.4
12
0.8
20
1.2
21
1.3
3
0.2
2
0.1
2
0 1
Venereal disease-
3,420
222.4
3,360
214.4
3,546
221.4
3,670
225 3
4,013
241 9
Syphilis—
Primary and secondary
28
1.8
55
3.5
56
3.5
64
3.9
173
10.4
Other  	
227
14.8
216
13.8
191
11.9
148
9.1
134
8.1
3
0.2
6
0.4
2
0.1
	
Non-gonorrhceal urethri-
308
20.0
281
17.9
352
22.0
297
18.2
308
18.6
Totals	
12,916
839.8
16,118
1,028.6
16,232
1,013.2
14,997
920.6
14,444
870.6
1 Not reportable prior to 1959.
3
L
 Y 42 PUBLIC HEALTH SERVICES REPORT, 1962
For all communicable diseases, prophylactic (as opposed to treatment) injections increased by 24 per cent to number 6,343. The over-all immunization programme continues to involve a considerable amount of time as it is applied to all
age-groups, and during the year just over 1,000,000 individual doses were given to
residents of this Province to protect them against various communicable diseases,
while, in addition, 23,000 tuberculin tests and approximately 1,700 other tests were
administered by health unit staffs.
The rheumatic fever prophylaxis programme was introduced in 1958 after a
number of carefully conducted trials had shown that it is possible to prevent recurrences of rheumatic fever through the use of small daily doses of antibiotics. Since
the consequences of such recurrences are frequently very serious, free medication
has been distributed to all children in this Province who have had rheumatic fever.
By the end of this year there were 1,058 children receiving antibiotics under this
programme. Detailed reports on the progress of the children participating in this
programme have been collected for the past three years, and it is now planned to
tabulate the data which have been collected in order to assess precisely the value of
this programme to the children of British Columbia.
Another rather specialized programme is the poison-control programme, and
it is perhaps a little horrifying to realize that there are at least 1,000 cases of accidental poisoning every year in British Columbia, of which over 500 are serious
enough to warrant admission to hospital. For this reason, the Health Branch has
undertaken to continue the work of the now disbanded British Columbia Poison
Control Council. Major poison-control information centres have been located at
the Vancouver General Hospital and Victoria's Royal Jubilee Hospital, and other
centres have been located in thirty-five hospitals throughout the Province. These
centres provide information on the poisonous ingredients of the swallowed substances and on the proper method of treatment to physicians, and in emergency to
the general public. Up-to-date information on new products is received from the
Federal Food and Drug Directorate, and steps are being taken to enlist the aid of
the British Columbia Pharmaceutical Association in an educational campaign to
warn the public about the hazards inherent in many common household substances.
The results associated with the use of the drug Thalidomide in the early months
of pregnancy showed up in this Province as well as elsewhere across Canada and
in Europe. With the assistance of the Division of Vital Statistics, the records of
babies born with a deformity which might possible have been associated with the
maternal intake of Thalidomide were located, their histories examined, and over
thirty live or stillborn babies were identified. Of these, the deformities of ten were
felt to be directly attributable to the taking of this drug. Complete details about
each of these deformed babies have been obtained from the family physician, and
this information will be used on a National basis to assess the problem across Canada
and on a more local basis to determine how assistance may best be offered to these
unfortunate children. Occurrences of this type highlight the tremendous need for
further information on factors that may affect the developing foetus in the early
months, and a period of almost equal importance obtains perinatally where high
morbidity and mortality rates continue to occur. In this regard, methods of analysis
require further refinement before such factors can be recognized, and several members of this Department, together with representatives from the Faculty of Medicine
of the University of British Columbia and the larger Vancouver hospitals, have met
monthly during the year to devise a monthly obstetrical discharge summary form
which is now in use in four large hospitals, and which will be useful to any hospital
wishing to review its own experience in this field.
 LOCAL HEALTH SERVICES Y 43
Another area requiring intensive analysis in which morbidity and mortality
might weU be considered disastrous is that of motor-vehicle accidents. In conjunction with representatives from the Motor-vehicle Branch, plans have been completed
for a study of the relationship between motor-vehicle accidents and medical defects
of the driver. A medical-examination form and a guide for its use have been written
and distributed, and all reported medical defects will shortly be added to each
motorist's individual I.B.M. punch-card for correlation with his accident history.
So that all medical reports with positive findings might be checked, various members
of the Health Branch staff have acted as medical referee for the Motor-vehicle
Branch to advise on the restrictions that should be placed on drivers with medical
defects.
Although perhaps concerned with less dramatic areas of interest, certain other
surveys are being conducted throughout the Province by local health unit personnel
—surveys which will again assist in determining more precisely how best the over-all
health of the residents of this Province can be improved. In this connection the field
of preventive dentistry presents a major challenge. The therapeutic tools available in
dentistry are very limited, and the comparative scarcity of dentists suggests that the
battle against dental disease can only be won by using the weapons of prevention.
Research, therefore, continues to play a major role in the work of the Division of
Preventive Dentistry, and basic to all surveys in the field of dental-disease prevention
lies the methodology of the British Columbia dental-health survey as established
in 1955 and tested in 1956 and 1957. During the years 1958 to 1960 random
samples of over 97 per cent of the school population of all areas of the Province were
examined. This established a base-line of the dental-health status of the children
of British Columbia at that time. A further series of surveys is now planned for
the years 1961 to 1965. Children of the Vancouver Island health units were reexamined early in 1961, and certain highlights of the 1962 survey in Greater Vancouver will be mentioned later. Plans are now completed for the second survey of
the Kootenay region early in 1963, while the Okanagan and Fraser Valley regions
will be resurveyed in 1964, and the northern health units and the Greater Victoria
School District in 1965. As a by-product of these surveys, a statistical analysis has
been prepared demonstrating a significant correlation between dental caries and
malocclusion, an association not previously demonstrated elsewhere.
Last year the anticariogenic effectiveness of a single topical application of a
stannous fluoride solution was studied in the Victoria schools, and data from a further
study are now being analysed to evaluate the effectiveness of this technique when
utilized by a group of general dental practitioners in the perhaps less ideal circumstances of a busy dental practice. Reports have been received of a successful pilot
study utilizing a single topical application of a fluoride-phosphate solution, and it is
suggested that this is perhaps twice as effective as stannous fluoride. For this reason,
a research project has now commenced in the Chilliwack area incorporating more
than 500 Grade I children (with parental consent) to determine and confirm the
reported value of this rather complex solution which is being prepared by the Faculty
of Pharmacy of the University of British Columbia. Acknowledgment is made of
their assistance, of the co-operation of the Board of Trustees of School District No.
33, and of the assistance of the ten dentists in Chillwack who will extend their services to the local preventive dental programme so that this research becomes possible.
In Sweden it has been suggested that supervised tooth-brushing in classrooms
nine times in two years with a 1-per-cent sodium fluoride solution has significantly
reduced the incidence of dental decay. Utilizing in the same way the fluoride-
phosphate solution mentioned above, it may perhaps produce results of even greater
 Y 44
PUBLIC HEALTH SERVICES REPORT,  1962
significance. Again, this hypothesis is being studied within the elementary schools of
the Central and Upper Vancouver Island Health Unit areas. Supervised tooth-
brushing will be carried out five times in the school-year, and the increase in dental
caries in these children will be compared with that of children brushing with distilled
water, and also with children not benefiting from any such supervised tooth-brushing
instruction.
An interesting study has been suggested by the Director and dental consultant
in the Northern Interior Health Unit, Prince George, who are to investigate whether
or not the children who are caries-immune in that city may perhaps have ingested a
greater quantity of water and thereby of fluoride from the community water supply
than those children suffering rampant dental caries. The Prince George water supply
was first fluoridated in September, 1955. It is therefore hoped that of the Grade I
pupils of this city's schools in 1962 there are at least 200 who have received fluoridated water since birth, with their mothers drinking it, in addition, during pregnancy.
By investigating the fluid intake of these children at this time and interviewing the
mothers, it is hoped to be able to estimate the approximate comparative level of their
fluoride intake over the years and compare this with their dental-decay experience
during the same period.
During the past year a survey which commenced almost two years ago was
completed. This survey was designed to eliminate unnecessary radiation hazards
from the various dental X-ray units of this Province. As at January 1, 1962, there
were 671 dentists licensed to practise in British Columbia, to include those in administrative appointments. At the close of the survey, 437 dental X-ray units had
been monitored by the use of film badges kindly supplied and especially interpreted
by the Radiation Protection Division of the Department of National Health and
Welfare.
A substantial amount of the communicable-disease experience in the Province
is rather naturally encountered among children of pre-school and school age.
HEALTH OF THE SCHOOL-AGE CHILD
As mentioned previously, this is the last year in which the health of the school-
child will be reported using the P-E-M rating system, but the following tables and
comments summarize the general health and immunization status of school-age
children during the past year.
Table I.—Summary of Health Status of Pupils in All Grades in All Schools
in British Columbia, 1957 to 1962
1957/58      1958/59      1959/60      1960/61       1961/2
Total pupils enrolled in grades examined .
Total pupils examined 	
Percentage of enrolled pupils examined
Percentage examined with minor or no physical, emotional, or mental defects __ — 	
Percentage examined having specified type and degree of
defect—
Physical 2
Emotional 2.
Mental 2	
Physical 3 —
Emotional 3._
Mental 3	
Physical 4—
Emotional 4.
Mental 4 	
272,499
42,947
15.8
85.8
11.5
3.4
1.5
0.7
0.2
0.3
0.1
C1)
0.2
279,040
309,993
328,497
38,174
37,175
38,434
13.7
12.0
11.7
84.5
84.5
84.8
10.9
10.8
11.2
3.8
3.7
3.0
1.8
1.8
1.8
0.8
0.8
0.6
0.2
0.2
0.2
0.3
0.4
0.2
0.1
C1)
0.2
0.1
(!)
(!)
0.2
0.4
0.1 |
342,925
32,832
9.6
84.4
10.3
3.9
2.0
0.7
0.6
0.3
0.3
0.1
0.4
1 Incidence of less than 0.1 per cent.
 LOCAL HEALTH SERVICES
Y 45
Although the number of pupils enrolled increased by 14,428 from the preceding year, the number of pupils given routine examinations decreased by 5,602. This
figure represents 9.6 per cent of the total enrolment, compared with 11.7 per cent
in the previous year, which is consistent with the decrease which has been shown
throughout the past two decades.
The percentage of pupils with minor or no defects has remained remarkably
constant, with a variation of only 1.4 per cent over the past five years.
Table II.—Health Status of Individual Grades of Total Schools, Including
Greater Vancouver Metropolitan Health Area, 1961/62
Item
All
Schools
Grade
I
Grade
II
Grade
III
Grade
IV
Grade
V
Grade
VI
Grade
VII
Total pupils enrolled in grades
342,925
32,832
9.6
84.4
10.3
3.9
2.0
0.7
0.6
0.3
0.3
0.1
0.4
37,457
24,346
65.0
85.8
9.9
3.9
1.6
0.4
0.5
0.1
0.2
C1)
0.1
35,298
1,252
3.5
74.4
12.2
3.9
2.0
1.0
0.7
0.2
0.2
33,675
896
2.7
81.5
12.5
4.2
1.9
0.8
0.9
0.2
0.3
0.2
32,034
862
2.7
81.3
12.5
3.0
1.4
0.8
0.6
0.1
0.6
30,341
680
2.2
81.3
10.3
3.4
1.5
1.6
1.2
0.1
1.9
0.1
29,584
659
2.2
80.0
12.9
2.7
3.0
1.2
1.4
0.5
0.6
30,328
Total pupils examined	
Percentage   of   enrolled   pupils
examined          	
Percentage examined with minor
or no physical, emotional, or
863
2.8
84.9
Percentage     examined     having
specified type and degree of
defect—
Physical 2	
Emotional 2	
10.0
2.5
1.4
Physical 3 	
2.0
Emotional 3	
Mental 3	
0.2
0.2
Physical 4	
Emotional 4	
05
Item
Grade
VIII
Grade
IX
Grade
X
Grade
XI
Grade
XII
Senior
Matric.
Special
Classes
Kindergarten
Total pupils enrolled in grades
examined 	
29,211
553
1.2
82.8
9.6
3.3
1.3
1.6
0.7
0.5
0.2
0.2
27,486
671
2.4
84.1
12.5
3.0
0.9
3.0
0.1
0.1
21,982
683
3.1
91.4
9.4
1.8
1.0
0.1
0.1
16,485
496
3.0
94.4
4.4
2.2
0.2
1.0
0.2
13,199
343
2.6
96.2
4.4
1.2
0.3
1,855
53
2.9
96.2
3.8
3,990
475
11.9
32.2
22.5
17.3
32.2
6.1
5.9
11.8
2.3
1.9
22.3
5.035
1,785
Percentage   of   enrolled   pupils
35 5
Percentage examined with minor
or no physical, emotional, or
80.9
Percentage    examined    having
specified type and degree of
defect—
Physical 2	
11.2
8.0
3 0
Physical 3.—	
0.7
2 8
0 3
Physical 4 	
0.1
02
Mental 4.. —	
0.8
1 Incidence of less than 0.1 per cent.
Sixty-five per cent of Grade I children were routinely examined this year, a
decrease of 6.5 per cent from last year. The percentage examined in other grades is
fairly consistent with previous years, with special classes and kindergartens showing
the highest percentages (11.9 and 35.5 per cent respectively). Once again children
in special classes are shown to have a high incidence of physical and emotional
defects in combination with mental defects, such that, of the 3,990 pupils enrolled,
 Y 46
PUBLIC HEALTH SERVICES REPORT,  1962
66.3 per cent had a significant mental defect, 30.9 per cent a physical defect, and
25.1 per cent an emotional defect. These figures indicate the need to concentrate
school health services on this group of children.
Table III.—Health Status by Individual Grades of Total Schools, Greater
Vancouver Metropolitan Health Area, 1961/62
Item
AH
Grade
Grade
Grade
Grade
Grade
Grade
Grade
Schools
I
II
III
IV
V
VI
VII
Total pupils enrolled in grades
examined    .
118,843
12,087
11,545
11,285
10,978
10.406
10.094
10,475
15,650
11,156
579
530
436
418
404
418
Percentage   of   enrolled   pupils
13.2
92.3
5.0
4.7
4 0
4.0
4.0
4.0
Percentage examined with minor
or no physical, emotional, or
86.6
87.1
84.8
87.0
91.3
87.3
86.6
88.3
Percentage     examined     having
specified type and degree of
defect—
Physical 2	
7.8
7.5
9.8
6.6
6.4
7.2
7.7
7.4
Emotional 2 	
4.7
5.1
4.0
4.9
2.5
3.8
2.7
2.2
Mental 2 	
1.6
1.4
1.7
0.9
0.9
0.5
3.2
1.0
Physical 3  	
0.3
0.2
0.5
0.4
0.7
0.2
1.0
Emotional 3 	
1.0
0.9
1.2
0.9
0.2
1.2
2.0
0.2
Mental 3    	
0.3
0.2
0.2
0.2
0.2
0.7
0.2
Physical 4   —   ..
0.4
0.4
0.5
1.7
1.0
Emotional 4     	
0.1
0.1
Mental 4..   ..   	
0.7
0.2
0.2
	
0.2
Item
Grade
Grade
Grade
Grade
Grade
Senior
Special
Kinder
VIII
IX
X
XI
XII
Matric.
Classes
garten
Total pupils enrolled in grades
examined 	
10,197
9,706
8,192
6,320
5,530
558
1,470
4,462
386
388
295
220
154
13
253
1,760
Percentage   of   enrolled   pupils
examined  	
3.8
4.0
3.6
3.5
2.8
2.3
17.2
39.4
Percentage examined with minor
or no physical, emotional, or
90.2
89.4
86.1
90.0
94.8
84.6
41.9
80.5
Percentage     examined     having
specified type and degree of
defect—
Physical 2       .
6.2
8.5
11.2
7.3
3.2
15.4
20.2
11.3
Emotional 2...   ...
2.3
1.5
2.7
2.7
1.9
15.8
7.9
Mental 2      	
1.3
0.8
0.5
17.8
3.0
0.3
0.8
0.7
0.9
2.0
0.7
Emotional 3 —	
1.0
0.3
5.5
2.1
Mental 3    ...
6.7
0.3
Physical 4 	
0.8
1.2
0.1
Emotional 4    ...   	
0.3
2.4
0.2
Mental 4.	
0.3
	
	
34.4
0.8
In the Greater Vancouver area the percentage of pupils routinely examined has
decreased slightly from 13.7 per cent last year to 13.2 per cent this year; however,
the percentage of Grade I children examined shows a slight increase from 91.4 to
92.3 per cent. In special classes the percentage of children examined remains higher
than average at 17.2 per cent.
The percentage of children examined in kindergartens has shown an increase
this year, from 35.0 to 39.4 per cent, indicating a desirable trend toward increased
service for this age-group. Kindergartens shown in this report are those operated
by Boards of School Trustees. As in previous years, the percentage of children
with a minor or no defect is higher than in other areas of the Province, with an
average of 86.6 per cent for all grades, compared with 82.4 per cent for the rest
 LOCAL HEALTH SERVICES
Y 47
of the Province.   This percentage is lowest in special classes (41.9 per cent) and
can be seen to increase to 90 per cent or over in the more senior grades.
Table IV.—Health Status of Individual Grades of Total Schools, Excluding
Greater Vancouver Metropolitan Health Area, 1961/62
Item
All
Schools
Grade
I
Grade
II
Grade
III
Grade
IV
Grade
V
Grade
VI
Grade
VII
Total pupils enrolled in grades
224,082
17,182
7.7
32.4
12.5
3.1
2.4
1.1
0.3
0.4
0.2
C1)
0.1
25,370
13,190
52.0
84.7
11.9
2.8
1.8
0.6
0.1
0.1
0.1
C1)
C1)
23,753
673
2.8
65.4
14.3
3.9
2.2
1.5
0.3
0.3
22,390
366
1.6
73.5
21.0
3.3
3.3
1.4
0.8
0.5
0.8
0.3
21,056
426
2.0
71.1
18.8
3.5
1.9
0.9
0.9
0.7
19,935
262
1.3
71.8
15.3
2.7
3.1
3.8
1.1
2.3
19,490
255
1.3
69.4
21.2
2.7
2.7
3.1
0.4
1.6
19,853
445
Percentage   of   enrolled   pupils
examined     .
Percentage examined with minor
or no physical, emotional, or
2.2
81.8
Percentage     examined     having
specified type and degree of
defect—
12.4
2.9
Mental 2	
1.8
2.9
0.2
Mental 3-   	
0.2
Item
Grade
VIII
Grade
IX
Grade
X
Grade
XI
Grade
XII
Senior
Matric.
Special
Classes
Kindergarten
Total pupils enrolled in grades
examined  	
19,014
167
0.9
65.9
17.4
5.4
1.2
4.8
17,780
283
1.6
76.7
18.0
4.9
1.1
6.0
0.4
0.4
13,790
388
2.8
95.4
8.0
1.0
1.3
0.3
10,165
276
2.7
97.8
2.2
1.8
1.1
0.4
7,669
189
2.5
97.4
5.3
0.5
0.5
1,297
40
3.1
95.0
5.0
2,520
222
8.8
21.2
25.2
18.9
48.6
10.8
6.3
17.6
3.6
1.4
8.6
573
25
Percentage   of   enrolled   pupils
4.4
Percentage examined with minor
or no physical, emotional, or
92.6
Percentage     examined     having
specified type and degree of
defect—
4.0
Emotional 2 	
Mental 2              .	
12.0
Emotional 3 	
Mental 3 	
Mental 4	
i Incidence of less than 0.1 per cent.
The percentage of pupils routinely examined in areas of the Province other than
Greater Vancouver has decreased this year from 10.6 to 7.7 per cent. The number
with minor or no defects remains essentially the same, at 82.4 per cent, with special
classes giving a particularly low percentage of 21.2.
 Y 48
PUBLIC HEALTH SERVICES REPORT,  1962
Table V.—Immunization Status of Total Pupils Enrolled, According to
School Grade, 1961/62
Total
Pupils
Enrolled
by Grades
Smallpox
Diphtheria
Tetanus
Poliomyelitis
Grade
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
Total, all grades	
nrarte I
342,925
37,457
35,298
33,675
32,034
30,341
29,584
30,328
29,211
27,486
21,982
16,485
13,199
1,855
3,990
5,035
267,941
30,739
29,452
27,590
25,352
24,267
25,361
23,807
20,901
21,488
16,488
10,290
8,347
1,096
2,763
2,586
78.1
82.1
83.4
81.9
79.1
80.0
85.7
78.5
71.6
78.2
75.0
62.4
63.2
59.1
69.3
51.4
283,411
33,478
31,828
30,084
27,617
25,125
26,039
24,981
22,736
22,329
16,935
10,137
8,209
1,057
2,856
3,675
82.7
89.4
90.2
89.3
86.2
82.8
88.0
82.4
77.8
81.2
77.0
61.5
62.2
57.0
71.6
73.0
267,785
33,402
31,675
29,904
27,494
24,995
25,866
24,261
21,318
19,026
12,788
7,792
5,766
791
2,707
3,669
78.1
89.2
89.7
88.8
85.8
82.4
87.5
80.0
73.0
69.2
58.2
47.3
43.7
42.6
67.9
72.9
306,593
33,585
31,932
30,201
28,780
27,558
27,510
26,741
24,788
24,684
19,684
14,580
11,738
1,539
3,273
3,447
89.4
89.7
Grade II	
Grade III    ...
90.5
89.7
Grade IV        	
89.8
Grade V	
90.8
Grade VI	
93.0
Grade VII	
88.2
r,rarte VTTI
84.9
Grade IX   ..
89.8
Grade X.	
89.6
Grade XI.	
88.4
Grade XII    	
88.9
Senior Matriculation.....
83.0
82.0
68.5
The total immunization status for the Province as a whole is higher this year for
smallpox, diphtheria, and tetanus. A very slight drop is shown for poliomyelitis.
The figure for tetanus immunization increases each year, and this year has reached
78.1 per cent, the same as for smallpox. The figures for poliomyelitis immunization
remain fairly constant throughout all grades, but for the other three diseases the
immunization status drops considerably after Grade X. The percentage immunized
in special classes and kindergartens is markedly lower than average. The figure of
51.4 per cent of kindergarten children protected against smallpox is regrettably low,
although showing an increase over the 1961 figure of 45.3 per cent.
Table VI.—Immunization Status of Total Pupils Enrolled, According to School
Grade, Greater Vancouver Metropolitan Health Area, 1961/62
Total
Pupils
Enrolled
by
Grades
Smallpox
Diphtheria
Tetanus
Poliomyelitis
Grade
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
118,843
12,087
11,545
11,285
10,978
10,406
10,094
10,475
10,197
9,706
8,192
6,320
5,530
558
1,470
4,462
87,025
9,711
9,233
8,835
8,323
6,867
8,608
8,207
7,615
6,935
5,619
2,893
2,893
260
1,026
2,197
73.2
80.3
80.0
78.3
75.8
66.0
85.3
78.4
74.7
71.5
68.6
45.8
52.3
46.6
69.8
49.3
91,140
10,328
10,088
9,861
9,183
7,188
8,562
8,500
8,094
7,371
5,652
2,449
2,637
242
985
3,224
76.7
85.5
87.4
87.4
83.7
69.1
84.8
81.2
79.4
75.9
69.0
38.8
47.7
43.4
67.0
72.3
80,769
10,267
9,975
9,734
9,086
7,091
8,430
8,003
7,108
5,205
2,774
1,061
1,068
105
862
3,201
68.0
84.9
86.4
86.3
82.8
68.1
83.5
76.4
69.7
53.6
33.9
16.8
19.3
18.8
58.6
71.8
103,861
10,418
10,142
9,703
9,457
9,047
9,314
9,332
8,573
8,483
7,302
5,533
4,871
491
1,195
2,973
87.4
Grade I      	
86.2
Grade II     	
87.9
Grade III   	
86.0
Grade IV        	
86.2
Grade V.            	
86.9
Grade VI   .
Grade VII          	
92.3
89.1
Grade VIII    	
84.1
Grade IX   	
87.4
Grade X        	
89.1
Grade XI    	
87.6
Grade XII    ..
88.1
88.1
Special classes  	
Kindergarten	
81.3
66.7
 LOCAL HEALTH SERVICES
Y 49
Table VII.—Immunization Status of Total Pupils Enrolled, Excluding Greater
Vancouver Metropolitan Health Area, According to School Grade, 1961/62
Total
Pupils
Enrolled
by
Grades
Smallpox
Diphtheria
Tetanus
Poliomyelitis
Grade
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
Number
Per
Cent
Total, all grades  	
Grade I  	
Grade II_.   _
Grade III	
224,082
25,370
24,753
22,390
21,056
19,935
19,490
19,853
19,014
17,780
13,790
10,165
7,669
1,297
2,520
573
180,916
21,028
20,219
18,755
17,029
17,400
16,753
15,600
13,286
14,553
10,869
7,397
5,454
836
1,737
389
80.7
82.9
81.7
83.8
80.9
87.3
86.0
78.6
69.9
81.9
78.8
72.8
71.1
64.5
68.9
67.9
192,271
23,150
21,740
20,223
18,434
17,937
17,477
16,481
14,642
14,958
11,283
7,688
5,572
815
1,871
451
85.8
91.2
87.8
90.3
87.5
90.0
89.7
83.0
77.0
84.1
81.8
75.6
72.7
62.8
74.2
78.7
187,016
23,135
21,700
20,170
18,408
17,904
17,436
16,258
14,210
13,821
10,014
6,731
4,698
686
1,845
468
83.5
91.2
87.7
90.1
87.4
89.8
89.5
81.9
74.7
77.7
72.6
66.2
61.3
52.9
73.2
81.7
203,732
23,167
21,790
20,498 |
19,323
18,511
18,196
17,409
16,215
16,201
12,382
9,047
6,867
1,048
2,078
474
90.9
91.3
88.0
91.5
Grade IV	
91.8
Grade V  „
Grade VI	
92.9
93.4
Grade VII 	
87.7
Grade VIII   	
85.3
Grade IX	
91.1
Grade X	
89.8
Grade XI	
89.0
Grade XII	
Senior Matriculation	
89.5
80.8
82.5
82.7
Tables VI and VII show in general a fairly high immunization status in the
early grades, with a marked reduction in the higher grades for smallpox, diphtheria,
and tetanus, particularly in the Greater Vancouver area. The figures for smallpox
are generally lower than for other immunizations, indicating a need for greater
emphasis on smallpox vaccination. The particularly low figure for kindergartens
points out the special need in the infant and pre-school groups. The figures for
Senior Matriculation are considerably below average, and this serves to endorse the
recently instituted policy of giving reinforcing doses in Grade XII.
ADMINISTRATIVE CONSIDERATIONS
All public health services and programmes as operated by the field staff have
been established on the basic framework of a public health administration, which,
until this year, consisted of seventeen health units distributed throughout the Province. During the year, one of these was divided to create an eighteenth health unit
area. This is an example of the way in which such a framework lends itself to the
provision of additional services as required by the industrial and population growth
of the Province and by the changing pattern of the health needs of the community.
Again, special mention is made of the tremendous assistance received toward expansion and extension of existing health services through the National Health Grants
programme.
On July 1st the former Cariboo Health Unit, with main office in Prince George,
was divided to create an additional health unit area comprising School Districts No.
28 (Quesnel), No. 27 (Williams Lake), and No. 82 (Anahim Lake Area), with main
office at Williams Lake and bearing the name of Cariboo Health Unit. The northern
half of the original unit area was renamed the Northern Interior Health Unit, to
include School Districts No. 55 (Burns Lake), No. 56 (Vanderhoof), No. 57
(Prince George), and No. 58 (McBride), with main office in Prince George. This
served to overcome many administrative problems previously experienced due to the
very large area and compounded by the increasing population and severe winter
conditions. During the summer the Director of the Northern Interior Health Unit
was active in stimulating the formation of a Union Board of Health in association
with each of these health units.   At this time, only the Peace River Health Unit lacks
 Y 50 PUBLIC HEALTH SERVICES REPORT,  1962
a Union Board of Health, which is composed of representatives from local municipal
authorities and Boards of School Trustees, and proves a most valuable means,
through their representation, of keeping these bodies informed of the public health
services available in the area, while allowing the individual representatives to draw
attention to the health needs of their respective communities as seen by them in their
capacity of community leaders. Once again, the value of the active participation
and interest of local residents in public health services cannot be overstressed. Without community identification, standards of service deteriorate and job satisfaction
will diminish correspondingly.
In the Peace River area, formal recognition was given by Order in Council
to the services already being offered by the staff of the Peace River Health Unit to
School District No. 81 (Fort Nelson), School District No. 83 (Portage Mountain),
and the various communities located on the Alaska Highway northwards to include
Cassiar.
On August 1st the boundaries of the Upper Island Health Unit, with main office
in Courtenay, were officially extended to include School Districts No. 73 (Alert Bay)
and No. 74 (Quatsino). This extension followed discussion with the Boards of
School Trustees in these areas together with further requests from individual communities and the local practising physicians. The combined population of these
two areas amounts to some 10,000 persons, distributed over the northern end of
Vancouver Island itself, adjacent small islands, and the nearby mainland area. To
provide service to these areas, two public health nurses have been located in Port
Hardy and an additional sanitary inspector appointed to the Campbell River area.
Considerable problems were encountered with regard to the provision of accommodation and office facilities for these nurses, but, thanks to the co-operation of local
residents and their Boards of School Trustees, these problems were successfully overcome. With the incorporation of this area into the Upper Island Health Unit, only
a few communities in the Province are not organized within a health unit area.
In these communities a nursing service is provided wherever possible, and, in general,
proves capable of meeting the demands placed upon it.
An extremely close and happy relationship continues with the Indian Health
Services of this Province. During the year, public health nursing service was
extended to a number of Indian reserves under a special arrangement with the Department of National Health and Welfare. The reserves included Tseycum, Tsartlip,
Tsawont, D'Arcy, Devine, Squamish, Pauchquachin, Cassiar, Good Hope, and
Metlakatla. Approximately 8,000 Indians, or 25 per cent of the Indian population
within the Province, now receive public health nursing service from the official Provincial health agency. It is hoped that this trend to provide the same public health
nursing service to Indian and white will continue. It is noteworthy that this development has not taken place to the same extent in any other Province. It seems reasonable that the Indian should receive the same preventive health services as the white,
and under these arrangements much unnecessary duplication of service is avoided.
In the same vein, discussions are presently nearing finalization with the Division of
Medical Services of the Department of National Health and Welfare whereby the
services of dental externs may be extended to include the treatment of groups of
Indian children within the framework of the preventive dental programme.
During the year the public health engineers were formally appointed as regional
consultants to specific areas of the Province, each engineer becoming responsible for
four or more health unit areas. It is hoped that this arrangement will serve to improve liaison and co-operation with health unit staffs, particularly the sanitary
inspectors.   This parallels the arrangement whereby the nursing consultants, work-
 LOCAL HEALTH SERVICES Y 51
ing under the Director of Public Health Nursing, are each responsible for three or
more health units.
The development of the Greater Victoria Metropolitan Health Service was discussed in some detail in last year's Annual Report. This has now been in operation
for one year and has resulted in considerable improvement in the standard of service
offered to the residents of the area.
The programme of health centre construction is dealt with in considerable detail
elsewhere in this Report. During the year new health centres were completed at
Ganges, Comox, Chilliwack, Campbell River, and Nelson. The Kelowna Health
Centre underwent major alterations and extension to incorporate facilities for the
Regional Mental Health Clinic, and the Victoria and Island Chest Centre was completed on the grounds of the Royal Jubilee Hospital in Victoria. Further health
centres are presently under construction, to include the main office for the Saanich
and South Vancouver Island Health Unit on the outskirts of Victoria, Castlegar,
Newton, and an extension in Revelstoke, with a continuing programme of construction already scheduled for 1963/64.
Under the grant-in-aid programme, physicians are encouraged to take up
residence in remote communities and to provide service on a periodic schedule of
visits to neighbouring communities which are not sufficiently large in themselves to
support a physician.   Eighteen physicians are presently in receipt of these grants.
PERSONNEL
With continued growth in the complexity and volume of public health services,
it seemed timely and opportune to carry out certain personnel appointments and
transfers within the central office administration. These included the transfer of the
Director, Division of Occupational Health from Victoria to Vancouver to work
within the Bureau of Special and Preventive Treatment Services and become located
in closer proximity to the major industrial complex of this Province, situated, as it is,
in the Vancouver and Lower Mainland area. At the same time the Director, Division of Epidemiology, was transferred from Vancouver to Victoria, where the Division became part of the Bureau of Local Health Services and its Director assumed
additional responsibilities in the field of emergency health services. Much of the
work in both these fields involves local health unit personnel. Somewhat later in
the year a duly qualified pharmacist was transferred from Civil Defence headquarters
to the Health Branch central office as Emergency Health Supplies Officer for the
Province. These changes have served to place the administration of emergency
health services on a much sounder footing, and considerable progress in planning
and training has been achieved during the year.
In 1944, when the position of Chief Sanitary Inspector was created, there were
only six sanitary inspectors employed in the health units of the Province. Since then
the number of sanitary inspectors has increased to fifty in order to keep pace with
population increase and the needs of a programme which becomes steadily more
diverse and complex. During this same period no additional senior positions had
been created in central office, and it became evident during the year that a second
senior sanitary inspector must be appointed to Health Branch headquarters if adequate supervisory and consultative services to the field were to be maintained. In
addition, the role of the sanitary inspector is interrelated with that of the public
health engineer, and it was felt that both should operate within the same division.
For this reason it was decided that the Division of Public Health Engineering would
be divided into two sections—a Public Health Engineering Section and a Sanitary
Inspection Section—both being responsible directly to the Director, Division of
 Y 52 PUBLIC HEALTH SERVICES REPORT,  1962
Public Health Engineering. In late summer the position of Consultant in Sanitary
Inspection was assumed by the senior sanitary inspector of the Boundary Health
Unit, this selection being in keeping with Departmental policy to have senior appointments filled by individuals experienced in field administration. Since taking up his
duties, the Consultant has been engaged in receiving a general orientation throughout
the Province and in studying the various health unit sanitation programmes and
activities. At this time new policy, procedure, and technical manuals are under
preparation. His appointment has also permitted the Chief Sanitary Inspector to
devote more time to other fields which have long needed more attention, such as
pollution control, shellfish control, industrial camps, radiation services, occupational
health, and others.
At the health unit level, the inevitable turnover to be found in association with
any large organization prevailed, and the usual number of resignations and transfers
took place to present some acute problems in regard to recruitment, primarily of
health officers, but also to some extent of public health nurses and sanitary inspectors.
Changes in the employment of public health physicians occurred in the Central
Vancouver Island, North Fraser, Upper Fraser Valley, Cariboo, East Kootenay, and
West Kootenay Health Units. Continuing vacancies in the ranks of health officers
exist in three health units, and due to lack of applicants it has not been possible to
fill these positions at year's end.
Among the public health nurses it was possible to add eleven full-time and
four part-time public health nursing positions in local health units to provide better
service to certain communities needing additional nurses. During the year eighty-
seven nurses were recruited to fill existing full-time vacancies, and thirty-four transferred to new districts. Seven of these full-time positions were financed under
National Health Grants and were allocated to the following health units: North
Okanagan at Vernon, North Fraser at Mission, Boundary at Cloverdale, Cariboo at
Williams Lake, Peace River at the new branch office in Fort Nelson, Upper Island
Health Unit at Port Hardy (two nurses for the new branch office serving School
Districts No. 73 and No. 74). Four public health nurses were added to assist in
developing the home care programme in new areas—three in the Simon Fraser
Health Unit at Coquitlam and one in the Central Vancouver Island Health Unit at
Ladysmith. The part-time nursing additions were made for the general service in
the Howe Sound nursing district at Pemberton, at Stewart in the Skeena Health Unit,
at Fernie in the East Kootenay Health Unit, and a half-time nurse was added in
the North Okanagan Health Unit at Revelstoke to assist in the home care programme. Provision was also made for the employment of the first full-time physiotherapist and the first practical nurse to assist with the home care programme in the
Saanich and South Vancouver Island Health Unit.
During the year 88 per cent of the nursing staff were fully qualified public
health nurses. In addition, approximately 21 per cent of these nurses have university degrees in nursing. The nurses who do not have full public health nursing
training are taken on staff as public health nursing trainees and given an opportunity to demonstrate their suitability for the public health nursing field. If satisfactory they may qualify for National Health Grant training bursaries. During the
year six nurses returned from educational leave of absence, having completed their
required university programme, and were placed in districts to which it is usually
difficult to attract public health nurses. Ten more are currently attending the University of British Columbia under a similar educational plan. In all about 20 per
cent of the present field staff have been trained under National Health Grants.
 LOCAL HEALTH SERVICES Y 53
A total of fifty sanitary inspectors, to include six trainees, is employed in the
local health units of the Province, and during the year it has not been possible to
fill the demand for new sanitary inspectors, so that at year's end three positions
remain vacant, at Terrace, Port Alberni, and Kimberley. To try to overcome the
existing shortage of sanitary inspectors, a sanitary inspector training programme
is in operation whereby a number of trainees are taken on staff on a temporary basis
and stationed in various health units for training purposes. Five such individuals
sat for the examinations for certification in sanitary inspection and were successful
in obtaining their certificates in June of this year, after which they were immediately
posted as sanitary inspectors in various districts throughout British Columbia.
Further vacancies necessitated the enrolment of six trainees in September, and it is
expected that these persons will be ready to qualify for appointment to permanent
positions in June of next year.
Where a large number of highly trained professional staff are employed and
are engaged in giving service within a field as complex and rapidly changing as public health, the need for continued in-service education and training becomes obvious.
During the year a very successful refresher course for health officers was held
on the campus of the University of British Columbia, sponsored jointly by the
Departments of Continuing Medical Education and Preventive Medicine of the
University and by this Health Branch, being financed under National Health Grants.
A total of thirty-eight health officers attended, with representation from the metropolitan health services of Greater Victoria and Greater Vancouver, from the Indian
Health Services, and from the Health Branch. It is hoped that similar courses may
be conducted every two to three years to keep health officers abreast of the more
recent advances and changing emphasis not only in public health, but in medicine
as a whole, since their job entails very close co-operation with the physician in
private practice in their local areas. During the year one physician completed the
D.P.H. course at the University of Toronto, and two others proceeded on course to
obtain this degree. In adition, one regional dental consultant proceeded to the
University of Toronto to obtain the Diploma in Dental Public Health, the four other
regional dental consultants serving in the field having already completed their
graduate training. This training programme is supported by bursaries under the
National Health Grants programme.
Similarly, senior public health nursing staff require additional preparation for
their responsibilities, and two senior nurses returned from McGill University, where
they completed their degree programme in public health nursing supervision and
administration, and another from the University of Michigan, where she received
the Master of Public Health degree. These nurses were able to take on responsible
positions as public health nursing supervisors on their return. One nurse is currently at the University of Toronto on a similar course.
Considerable in-service education is provided by staff meetings at the local
health unit level, but, in addition, certain more specialized courses have to be conducted, and, as an example, fifty-five nurses enrolled in a series of night classes held
in the Fraser Valley on mental-health problems, conducted by the Department of
Continuing Medical Education of the University of British Columbia. This was
designed to help them prepare to take on additional responsibilities in the field of
mental health, which, as noted previously, tends to demand an increasing amount of
the time of the public health nurse. Late in the year and using National Health
Grant funds, it was possible to bring to Vancouver Miss Ruth Freeman, Professor of
Public Health Administration from the Johns Hopkins University School of Hygiene
in Public Health, to conduct a one-week intensive educational programme in public
L
 Y 54 PUBLIC HEALTH SERVICES REPORT,  1962
health nursing supervision. Some fifty-seven public health nurses participated from
the Provincial and metropolitan health units of Greater Vancouver and Victoria,
as well as representatives of the University of British Columbia and the Victorian
Order of Nurses. This course proved to be extremely useful, especially since university postgraduate training of this kind is not available in British Columbia. It has
long been felt that senior health unit staff could benefit by a more intensive education in staff supervision and personnel management, and it is hoped that in the
future there will be a more unform approach to staff development and quality of
service by the nurses providing public health nursing supervision and also by physicians employed as health unit directors.
As a sort of lend-lease contribution, the public health nurses in the field provide educational field training to nurses completing university postgraduate courses
and to undergraduate nursing students completing their nurse's training. During
the year, one-month field placements were supervised for thirty-two students from
the University of British Columbia and two students from the University of Alberta,
while 142 students from the following hospital schools of nursing had one-week
field observation in Provincial health units adjacent to their schools of nursing:
Boundary and Simon Fraser Health Units for the Royal Columbian School of Nursing, the South Central Health Unit for the Royal Inland Hospital, and the Saanich
and South Vancouver Island Health Unit for the two schools of nursing in Victoria—■
namely, St. Joseph's and the Royal Jubilee. Students from the Vancouver General
and St. Paul's Hospitals in Vancouver continue, under a special arrangement, to
utilize health units throughout the Province. It is believed that the public health
service is making a good contribtuion toward the general education of student nurses,
and at the same time promoting a better understanding of the work of an official
health agency. In addition, twenty-four practical-nurse students completing vocational training have had periods of field experience in New Westminster and in the
Central Vancouver Island Health Unit.
The cold war continues, and having experienced the extreme frigidity of the
recent Cuban episode, many people will be inclined to view the work of civil defence
with considerably enhanced approbation. Within the over-all framework of the
Provincial civil defence organization, this Health Branch is responsible for the
development of emergency health services planning, the distribution of emergency
health service supplies, and the training of selected individuals throughout the
Province. In the past few years considerable attention has been paid to such
planning, so that at this time the original emergency health services plan has been
subjected to further revision and will be ready for implementation early in the
coming year. Most of the Medical Health Officers have been trained in their role
of zone or area health adviser, and during the year thirty-one public health staff
attended courses held either at the Civil Defence College in Arnprior, Ont., or in
Victoria or Chilliwack. Among these were physicians, nurses, dentists, public health
engineers, and sanitary inspectors, while a further sixty-six individuals engaged in
private medical or dental practice and in other fields of medical or nursing practice
in this Province also attended these courses. Recently two new courses tailored
to the needs of public health personnel have developed at Arnprior—" Emergency
Public Health " and " Health Operations and Administration." The emergency
health services programme is discussed in more detail later in this Report.
SERVICES AND PROGRAMMES
Personnel are recruited and trained, as discussed above, so that they may offer
the services and operate the programmes which follow.   These personnel work out
 LOCAL HEALTH SERVICES Y 55
of individual health units and comprise the professional staff (physicians, nurses,
dental consultants, and sanitary inspectors) and the non-professional (the clerical
workers). For the purposes of presentation, it is necessary to place certain programmes under nursing or sanitary inspection services, but it should be recognized
that the health unit staff work as a group, each having a close interest and taking
some measure of responsibility for the work of his colleagues. The public health
nurse must know the basic elements of the sanitation programme, while the sanitary
inspector can do much to assist the nurse in her daily routine. In this way a balanced health unit programme can be achieved and, when offered to the residents of
the community concerned, ensures that they receive the highest possible standard
of health care.
PUBLIC HEALTH NURSING*
This service is designed on a generalized basis to meet the health needs of all
members of the family, while certain of its programmes are directed toward specific
age-groups or conditions where special health problems are known to exist. Family
service begins with health instruction to expectant parents, on a group or individual
basis, and during the year approximately fifty-five centres offered classes for expectant parents, with a total attendance of 23,043. This represented a 20-per-cent
increase in attendance over 1960, and it is estimated that approximately 10 per cent
of all expectant mothers take advantage of these classes. Public health nurses
visited 20,000 (over 90 per cent) of all newborn infants. In addition, they made
36,000 infant and 39,500 pre-school visits to give guidance and health instruction
to parents to help them recognize the physical and emotional needs of their child.
During the year the special organized home nursing programme continued to
expand, and thirty-seven communities, acounting for forty-seven per cent of the
population, now provide home care and rehabilitation nursing as part of the basic
public health nursing service. When the home nursing service provided by the Victorian Order of Nurses in larger urban areas is added, a total of 80 per cent of the
population of the Province have home nursing service available to them. Regular
scheduled visits are being made by public health nurses to local hospitals in communities where the home nursing programme is in effect, in order to provide liaison
with the hospital and to arrange for continuity of nursing care for those patients who
can be discharged home. Public health nurses have been active in follow-up
of patients from " activation units " in certain hospitals—namely, the Kelowna General, the Prince George Regional, and the Gorge Road Hospital, Victoria. During
the year there was a 63-per-cent increase in nursing-care visits to total 34,432.
In addition, 4,356 nursing-care visits were made as part of the general programme.
Health-teaching is carried out in the homes to assist the family and the patient
to obtain the maximum return to normal living. In the Saanich home care area a
practical nurse was employed for the first time to do simple nursing procedures under
the supervision of the public health nurse, thus permitting the public health nurse
increased time in which to provide service for which she alone is qualified. Also
in the Saanich area a physiotherapist has been taken on staff to provide consultative
help to the public health nurses in assessing the need for physical rehabilitation and
to assist in supervising the care and progress of selected patients.
The latest statistical analysis of the nursing-care programme was completed
during the year, and the results were published in the Division of Vital Statistics
Special Report No. 66, "Nursing Care Statistics, British Columbia, 1961," which,
* The statistics in this section concern the services provided by public health nurses under the jurisdiction
of the Provincial Health Branch and do not include services provided by Greater Vancouver, Victoria, Esquimalt,
Oak Bay, and New Westminster.
 Y 56 PUBLIC HEALTH SERVICES REPORT,  1962
together with the previous two reports, has given valuable data on the trend and
importance of this programme. A 22-per-cent increase since 1960 has taken place
in the number of patients receiving care, representing a total of 1,177 patients, and,
as in the 1960 analysis, the majority of these patients (71 per cent) were in the
age-group 60 years and over and received 80 per cent of the home visits. Of the
types of service involved, 53 per cent consisted of injections, but general care and
nursing supervision have increased slightly over last year to represent 26 per cent
of the total service. The remaining 21 per cent of the visits was for treatment, such
as rehabilitation exercises, irrigations, dressings, etc. Some 56 per cent of the
patients were suffering from diseases of the heart and circulatory system, from
diseases of the nervous system, or from anemia.
Of the patients treated at home, some 30 per cent were discharged from hospital to home care, and this is important since these people will generally be happier
at home and therefore tend to recover more rapidly. Furthermore, this results in
a reduction in the number of additional hospital beds needed in any given community. Although such " institutional " days are not always saved, it was estimated
that 1,900 bed-days were saved in 1961, of which approximately 16 per cent were
acute, 68 per cent chronic, and 16 per cent represented savings in bed care in other
types of institution.
Over all, this represents a 60-per-cent increase in the savings of acute-hospital
bed-days, and with the very approximate estimate that bed-day care in an acute
bed costs $20, in a chronic bed some $12, and approximately $7 in other types of
institution, it is obvious that care at home is going to save the Province a considerable sum of money.
In areas where committees of the Joint Rehabilitation Project (sometimes called
the Welfare Case Finding Programme) have been set up—namely, Nanaimo, Chilliwack, and Prince George—the public health nursing staff are in a position to fulfil
an active role in the follow-up of certain individuals referred to this committee for
assistance. To this date, Prince George is the only area which conducts a home
care programme in association with the Joint Rehabilitation Project, and it is hoped
that the additional resources—for example, vocational training and placement services made available through this committee—can be used to assist some of the
patients receiving home care. The Health Branch has continued to work closely with
the Victorian Order of Nurses, particularly with the development of rehabilitation
nursing services, through the provision of funds for additional employees for the
programme, to include the physiotherapist mentioned above and some public health
nursing staff. The need for more organized homemaker services is being stressed
to encourage the development of better home care in the community. This programme has gone forward with two excellent homemaker services in the South
Okanagan Health Unit at Kelowna and Penticton, the Red Cross Homemaker service in Chilliwack, and with the addition of a new service this year in the North
Okanagan Health Unit at Vernon.
In conjunction with the work of the public health nurses in the mental health,
school health, speech and hearing, rheumatic fever, and poison-control programmes,
the above can only be considered as a very brief review of the nursing services
offered. In conclusion, a statistical summary showing the volume of public health
nursing services during the year 1962 may be of some interest:—
 LOCAL HEALTH SERVICES Y 57
Service Number
Prenatal—
Home and office visits  3,533
Expectant parents' classes—
Attendance   11,049
Exercises  8,598
Infant—
Child health conference attendances  59,220
Infant home and office visits  36,108
New infants, home and office  20,107
Phone consultations  12,123
Pre-school—
Child health conference attendance  64,104
Home and office visits  39,446
Phone consultations   12,123
School service—
Assistance with doctors' examinations  14,349
Service by nurse  132,707
Teacher-nurse conferences (classroom)  5,655
Consultations—staff members  78,561
Meetings   673
Home and office visits  49,081
Meetings with parents  3,448
Phone consultations  35,209
Adult-
Services rendered at home and office  117,336
Phone consultations  46,594
Tuberculosis—
Home and office cases and other  14,313
Streptomycin injections  6,141
Mental health  8,935
Venereal disease—Examination, treatment, and other  1,769
Nursing care—
Injections and other, general programme  4,356
Special programme   34,432
Prophylactic injections for communicable disease  6,342
Total homes visited  108,738
Immunization series completed for protection against—
Pertussis  47,001
Diphtheria   79,376
Tetanus  81,821
Poliomyelitis   82,997
Oral poliomyelitis  269,620
Typhoid  959
Smallpox   76,077
Total number of individual doses (injections)   216,586
Total doses including oral polio   586,206
Tuberculin tests  22,741
Other tests  1,622
Other immunizations   2,069
 Y 58 PUBLIC HEALTH SERVICES REPORT,  1962
NUTRITION
A satisfactory standard of health can only be maintained when the intake of
food is adequate and its content can be considered satisfactory. The Nutrition Consultant is interested in the food eaten by all age-groups, from the pregnant mother
to the old-age pensioner, and for this reason her work demands good liaison with
many different agencies and departments of Government. As in past years, the Nutrition Consultant carried out periodic visits to institutions, to include Government-
operated hospitals and general hospitals, and at the request of the British Columbia
Hospital Insurance Service she extended these visits to a number of private hospitals.
Consultative service was also given to other organizations and departments of Government, such as the Department of Social Welfare, the Home Economics Division
of the Department of Education, and to the Provincial Civil defence organization.
In co-operation with the British Columbia Dietetic Association, a hospital cooks'
refresher course was conducted at Penticton. To assist the public health nurses in
the field, the Nutrition Consultant prepared a leaflet on low-cost meals and worked
with a nutrition group to provide reference material on the use and misuse of dietary
supplements and the addition of vitamins, minerals, and proteins to food.
The Vancouver Metropolitan Health Services employs two nutrition consultants, and in conjunction with them an effort is being made to interpret the regulations regarding the food service of licensed boarding homes under the Welfare
Institutions Licensing Act. A check list to assist those involved with inspection is
almost completed, and a manual for the use of operators has been started.
PREVENTIVE DENTISTRY
Despite continued shortage of dental practitioners in the Province it is encouraging to note that the work of the Division of Preventive Dentistry has been able to
fill the breach to the extent that during the past six years the dental-health status of
close to half the child population of British Columbia has improved, and to a degree
that can be readily accepted as statistically significant. Results of surveys carried
out in the Greater Vancouver area in 1956 and 1962 show, for example, that the
percentage of children (7 to 15 years) who have never experienced dental decay of
their permanent teeth has increased from 8.1 per cent to the present level of 12 per
cent. The 15-year-olds have averaged during this period 1.5 per cent fewer permanent teeth decayed, missing, or filled. The percentage of children having lost
one or more of their permanent teeth has decreased by close to one-third to 13.3
per cent.
During the past year an independent Canadian study was reported, and this
study attempted to ascertain the attitude and habits of the public in regard to dental
health to include frequency of visits to the dentist, acceptance of topical fluoride
applications and water fluoridation, and dental-health education as carried out by
family dentists. The conclusion to this study included the statement, " The most
outstanding fact to be observed is the advantage British Columbia has over the other
regions in dental-health practices."
Community preventive dental programmes continued to operate in all eighteen
health unit areas during the past school-year. Over ninety-one separately and locally
sponsored programmes of this type operated in sixty-nine of the seventy-six school
districts included within the health unit areas. A total of 134 general dental practitioners of this Province generously provided part-time clinical and educational
services to these programmes. In return these dentists received nominal honoraria
and the warm appreciation of their respective communities for their public service.
 LOCAL HEALTH SERVICES Y 59
There is, of course, an acute shortage of dentists in the rural areas of the Province,
as is true across Canada, and many smaller communities are without a resident
dentist. So that those areas may also benefit by these preventive dental programmes,
this past summer five recently graduated dentists were successfully recruited to serve
as dental public health externs, each for approximately twelve months. These dentists are not employed by the Health Branch, but successively by the local agencies
sponsoring these programmes. Applications are currently being received for five
similar appointments to commence in the summer of 1963. Techniques are at this
time being discussed whereby supervision of the externs' clinical services by the
regional dental consultants may be strengthened. To facilitate the clinical services
of the externs, each has now been issued a high-speed air rotor dental unit purchased
through the National Health Grants programme.
As at January 1, 1962, nine communities within the Province were benefiting
from a water supply with a controlled concentration of fluoride considered adequate
to reduce dental caries by approximately two-thirds. Population of these communities represents only 3.5 per cent of the total population, and no community in
British Columbia with a population of significant size has a water supply wherein
natural fluoride is present in adequate concentratilon. In December, 1961, the City
of Kamloops, by plebiscite, voted in favour of this preventive measure, but the
necessary equipment has not yet been installed. In December, 1962, three further
communities held fluoridation referenda, which failed in Revelstoke and Delta but
obtained the necessary three-fifths majority vote in favour in Fort St. John. Post-
fluoridation surveys were carried out in Kelowna in 1961 and in Prince George in
1962 respectively, five and six and a half years after fluoridation commenced.
A definite reduction in dental caries prevalence rates was observed in the children
of both these communities.
The ratio of dentists to population in this Province stands at 1:2,406, and is
thereby better than in any other Province of Canada. However, the present demand
for dental treatment in British Columbia was evidenced by a survey of all practising
dentists in this Province carried out in September, 1962, in co-operation with the
British Columbia Dental Association. One result revealed that 25 per cent of dentists reported that they were " too busy to treat all patients requesting appointments."
In the past ten years the population of Briish Columbia has increased by 40 per
cent, but the number of dentists has increased by only 23 per cent during the corresponding period. The Union Boards of Health in many of the health unit areas
have for some years been recommending most strongly that a Faculty of Dentistry
at the University of British Columbia be established. It is therefore with very
considerable pleasure that it is possible to report that this past year the final steps
were taken and a Dean of a Faculty of Dentistry was appointed. He has since
announced plans whereby it is hoped that the first undergraduate dental students at
the University of British Columbia will be enrolled during 1964.
Considerable time has necessarily been expended by the Director of the Division of Preventive Dentistry in relation to the preparation of dental legislation, and
at the 1962 Session of the Legislative Assembly of British Columbia were enacted
an "Act to Amend the Dentistry Act" and an "Act to Amend the Dental Technicians Act."
As mentioned previously, considerable attention is being paid to the possibilities of unsuspected radiological hazard existing in the offices of members of the
dental profession. Discussions are being held with the Division of Occupational
Health with the hope of extending the programme whereby a radiological technician
will visit and advise any dentist in this regard.   To date, forty dental X-ray units
 Y 60
PUBLIC HEALTH SERVICES REPORT,  1962
have been appraised.   It is at present considered that such a service might be completed in a three-year period for the Province as a whole.
The British Columbia Dental Association has, as a public service, commenced
a pilot project whereby, at no cost to players, protective mouth-pieces have been
provided to football teams of two Vancouver high schools. Initial reaction to this
project some three years ago on the part of the Vancouver Inter-high Athletic Association was reported as being very cold, but currently the Dental Association states
that it is being swamped with requests from other football teams, from many parents,
and from some hockey teams.
Table VIII.—Full-time Preventive Dental Treatment Services in British Columbia,
Shown by Local Health Agency, School-years 1956/57 to 1961/62
Grade I Pupils
•o
OT3
•="3
«
School-year
Wo
S3
c
•o-9
o
Z
w^
■otJ p
Sou
3.2
za
lis
Pal
Sis
PL, "0 0
si
[Otl
rift o
(1)
a»  s
C g   .5
3scE
erg j> a
(2)
a
^—3j
SB a
<tt,Q
(3)
o c c
_ C ri
5—  -
fog
1956/57  	
14
2,022
13,761
3,726
5,106
3,271
12,103
318
1957/58	
9
2,213
13,715
3,204
5,587
3,208
11,999
481
1958/59  	
8
2,538
14,091
3,617
5,952
3,508
13,077
178
1959/60	
6
2,459
2,603
14,134
3,631
3,804
6,406
6,548
3,510
2,969
13,547
13,321
148
1960/61 	
6
14,353
155
1961/62—
Greater Vancouver Metropoli
tan Health Committee	
5
2,577
11,876
3,567
5,418
2,212
11,197
142
Greater Victoria School Dis
trict...	
1
1
2,240
2
1,409
598
2,009
3
Totals	
6
2,578
14,116
3,569
6,827
2,810
13,206
145
At the Grade I level, 99.8 per cent were examined and some 4,000 of their
parents individually counselled. Of those examined, 48.4 per cent did not appear
to be in need of dental treatment, a further 19.9 per cent were subsequently treated
by their family dentists, and 25.3 per cent by the school dental clinics—a total of
93.6 per cent of the total Grade I enrolment.
Table IX.—Part-time Preventive Dental Treatment Services (Community Preventive
Dental Programmes) in British Columbia, School-years 1957/58 to 1961/62
School-year
l-P.B
Era ra
3 V "
zs<
CL.O
L.C
-2 3
Ep
£«
CO
41
.a 1'cj
t3 E u
225
ber of
ramme
h
ated
s£o
Num
Prog
Whic
Oper
§e'£
ZOo.
i5*
Os u
Pm-SU
4
"3^ «
Cfl
a
o^<
,?   •a
M 2 3
«SE
m6S
on M
OfiU
11,214
4,999
12,948
5,981
13,403
6,079
10,340
4,426
10,406
!
3,897
,     ,    B.HH
ofiO-n
0 -_-S
ri « Ow
h D,e5w
1957/58..
1958/59.
1959/60-
1960/61..
1961/62-
17
17
17
17
18
53
59
67
66
69
80
114
93
126
97
134
95
130
91
134
2,277
2,760
2,797
3,701
4,122
8,793
10,212
10,130
9,045
8,974
The continuing trend toward increased attention to the pre-school children will
be noted from Table IX. For the first time during the past school-year, more preschool children than Grade I pupils benefited directly by these programmes.
 LOCAL HEALTH SERVICES Y 61
PUBLIC HEALTH ENGINEERING
Through its staff of public health engineers and sanitary inspectors in the field,
the Division of Public Health Engineering is concerned with the entire field of
environmental sanitation to include community water supplies, community sewerage
and sewage disposal, stream pollution and the work of the Pollution-control Board,
the conduct of sanitary surveys and various consultative services both to local
health unit personnel and to municipalities and their consultant engineers.
During 1962 there were fifty-six approvals or provisional approvals given in
connection with waterworks construction. Watersheds from which public water
supplies are obtained are in the Division's sphere of interest, and in this regard the
Director, as chairman of a committee of the Pacific Northwest Pollution Control
Council, assisted in the preparation of a comprehensive pamphlet dealing with
watershed control. Chlorination remains a recommended treatment for water
necessary to create an acceptable bacteriological standard. Between 80 and 85
per cent of the population of the Province used water protected by chlorination.
Some of the communities in the Province obtain water from major rivers which
drain thousands of square miles, and it is just not possible to prevent all contamination of such rivers. As industries that produce large volumes of waste water increase
in number, there will be great difficulty in maintaining at their original quality the
water supplies drawn from these rivers. With the discharge of industrial waste,
even though treated to a fairly high degree, and with the discharge of sewage containing quantities of the newer synthetic chemicals, it is possible that within the
next few years a number of municipalities now obtaining water from large rivers
may have to build extra water-treatment facilities. Adequate pollution-control
measures will delay this trend but may not be able to prevent it entirely. With no
water-borne epidemics resulting from the use of public water supplies, the record
of the past several years was maintained. To achieve this, constant vigilance is
required on the part of the waterworks personnel, local health authorities, and the
engineers of this Division, and an important part is played by the excellent consultative services provided by private consulting engineers in the Province.
In considering sewage disposal it should be borne in mind that only 55 to 60
per cent of the total population of the Province is served by common sewers, most
of the remainder relying on septic tanks for sewage-disposal purposes. As well as
extensions to existing sewerage systems in the larger communities, more and more
of the smaller municipalities are requiring sewerage systems. A field that is developing rapidly in sewerage construction work is the sewering of district municipalities
that are becoming urban in character. There were ninety-three approvals given
during the year in connection with sewerage works. A considerable volume of work
was done in the Greater Vancouver area by the Greater Vancouver Sewerage and
Drainage District so that the Iona Island sewage plant will be opened in 1963.
This will result in diversion to the Iona Island plant of the sewage presently being
discharged into English Bay, thus removing a major contamination load from the
beaches of Greater Vancouver. Of the sewage by-laws passed during the year in the
Province, perhaps the most notable was one for $9,800,000 in the District of North
Vancouver. During the next ten years this will enable the municipality to complete
its sewerage collection and disposal system.
A new type of sewage treatment introduced in British Columbia during the year
was the oxidation ditch. Plans for two of these installations were approved, but
none was in operation by year's end. This type of plant is suitable for small communities.   There is still a great need for research into methods of sewage and indus-
 Y 62 PUBLIC HEALTH SERVICES REPORT,  1962
trial-waste treatment. Some of the newer household chemicals, such as synthetic
detergents, are not sufficiently treated by present-day sewage-treatment plants.
The Pollution-control Board was set up late in 1956 to control the discharge
of waste into the lower Fraser Basin. This area was extended considerably in April,
1961, by the inclusion of all the Columbia Drainage Basin within British Columbia,
and a further extension took place in December, 1962, when the areas covered by
the Board were increased to include the entire Fraser Basin as well as the entire
Columbia Basin in Canada, plus the eastern side of Vancouver Island. The Director
of this Division is secretary and executive engineer of the Board and also serves as
technical adviser. The local health units assist the Board considerably by collection of water samples, a very extensive series being collected during the year from
the Kootenay and Columbia Rivers. The results of this sampling will guide the
Board on its activities in this area for the next few years. Another result of the
health units' sampling activities has been seen in a review during 1962 of the data
collected to date on the Fraser River, followed by adoption by the Board of water-
quality objectives for the lower Fraser River.
Air pollution is not a matter that comes under the authority of the Pollution-
control Board, but there are increasing signs of a public demand for a Provincial air-
pollution control programme. Studies are planned for next year to see whether or
not the Pollution-control Board should become involved in this problem.
In the enforcement of the Shellfish Regulations, inspection of shucking plants
and handling procedures now come under the jurisdiction of the local health units.
There are six health units that have one or more shucking plants in their area. The
situation reported last year wherein the commercial oyster industry was engaged in
the harvesting of wild oysters in the Strait of Georgia continued throughout 1962.
This again had an adverse effect on the high degree of control previously possible
when all oysters were grown in areas controlled by lease. Shellfish toxicity which
was encountered in the Strait of Georgia in 1957 has improved to the point where
it was possible in 1962 to declare all of British Columbia open for the harvesting of
clams, after four seasons in which varying restrictions were in effect. It is not possible to predict if and when shellfish toxicity will return, and for this reason continuous sampling was carried on throughout 1962. This sampling programme will
have to be sustained on a permanent basis to ensure protection against this form
of toxicity.
The demand for sanitary inspection services continues to increase steadily,
compounded by growing populations which call for extension of services in connection with water supplies, sewage and garbage disposal, and the inspection of
milk and meat.
In 1961 the report of the Committee on the Problem of Indiscriminate Disposal
of Refuse was released by the Department of Municipal Affairs. Since that time
an endeavour has been made to stimulate quasi-corporate collection arrangements
or disposal sites by the establishment of local areas under the Local Services Act.
No local areas were established during the year, but in many instances considerable
interest has been displayed by such organizations as Women's Institutes and Farmers'
Institutes, and a large volume of investigational work has been done by sanitary
inspectors.
Meat inspection by-laws were passed by the City of Victoria, the Municipalities
of Esquimalt and Oak Bay, and the Villages of Sidney and North Kamloops. In
addition, several other municipalities were discussing the adoption of such a by-law.
Indications of the increasing interest in meat inspection were seen in the resolutions
from a number of Union Boards of Health embodying requests for the provision of
meat inspection on a Province-wide basis.
 LOCAL HEALTH SERVICES Y 63
In the field of milk control, an evaluation of the laboratory inspection of milk
samples reveals that in 1962, as in the previous eleven years, an improvement has
been registered over the preceding twelve-month period. The improvement was very
slight, chiefly because of the high standard which has gradually been attained over
the years.
An evaluation of the inspection reports on fifty-eight summer camps reveals
that seventy-three per cent were classified as " good," with only one camp receiving
a " poor " classification. There were no outstanding problems indicated in the
over-all picture of these camp inspections, and a decrease in the correspondence on
this subject indicates the trend toward better standards of camp operation and
management. In each case the original of the inspection report is sent to the
Welfare Institutions Licensing Board, where it may be used as a factor in the granting
of the annual licence.
EMERGENCY HEALTH SERVICES
As mentioned previously, the Health Branch has accepted the responsibility
for planning, organizing, and, in an emergency, directing the British Columbia emergency health service, and members of the Heatlh Branch staff have been designated
to carry out the required planning and organization at the Provincial and regional
levels. During the past year the Provincial Emergency Health Services Plan has
been completely revised, and draft regulations under the authority of the Civil
Defence Act have been formulated to allow this revised plan to be put into operation
in the event of an emergency. Close liaison has been established with the Medical
Health Officers of the Vancouver and Victoria target areas, and plans are being
devised as to how the medical services from these two areas might best be fitted into
the Provincial plan. Liaison has also been established with the Army target area
co-ordinators in order to integrate the civilian emergency health service plan with
the Army re-entry plan. An emergency health service identification card, which will
be issued to all Health Branch personnel and all volunteers, has been produced and
will soon be distributed.
It was hoped that medical supplies would have been released from the Federal
stockpile at Chilliwack before the end of the year for pre-positioning in strategic
spots throughout the Province. This has not yet occurred, but should take place
early in 1963.
In the event of an emergency, everyone in the Province with any skill in the
health field will be required to operate the emergency health services. A list of the
professions and occupations that will be involved has been drawn up and distributed
so that these people will not be drafted into other services. Most of the members
of the Health Branch staff concerned with planning in this field attended a one-week
training course in this speciality at the Canadian Civil Defence College at Arnprior
during the year. In addition and again as mentioned previously, a number of training exercises, demonstrations, and courses were held within the Province. These
included participation in Exercise Tocsin B, a Physicians' and Pharmacists' Indoctrination Course, several advanced treatment centre demonstrations and lecturing
to the students.
Although a fairly complete Provincial plan has now been developed, planning
at the zone or operational level needs much more attention; particularly volunteers
for all phases of emergency heatlh service work will have to be recruited, trained,
and exercised so that there will be someone ready to operate the emergency medical
facilities that are being planned.
 Y 64 PUBLIC HEALTH SERVICES REPORT,  1962
REPORT OF THE BUREAU OF SPECIAL PREVENTIVE AND
TREATMENT SERVICES
The general operation of this Bureau has not changed appreciably during 1962,
but a number of developments and changes are worthy of note. The main components of the organization are now the Divisions of Tuberculosis Control, Venereal
Disease Control, Laboratories, Occupational Health, and the Registry and Rehabilitation Services. There are now some 511 staff positions in the Bureau and its
various services, an over-all reduction of about 11 per cent over a two-year period,
principally due to the decrease in tuberculosis in-patient care service.
Early in the year the locations of the Epidemiology and Occupational Health
Services were reversed, with Epidemiology moving from Vancouver to Victoria and
Occupational Health Services from Victoria to Vancouver. This relocation produced a different functional grouping in Vancouver, in that the Director of Occupational Health, newly appointed during the year, also assumed the responsibilities
of the Division of Venereal Disease Control.
The Division of Venereal Disease Control, in order to maintain full-time direct
supervision and to establish better co-ordination between its various sections, appointed a qualified public health nurse to the administrative function of Assistant
Director. It is also interesting to note in the report for this Division that an alarming increase in early infectious syphilis occurred during 1962.
On the other hand the largest of the Bureau components, the Division of
Tuberculosis Control, reported a slightly reduced operation during 1962 in its inpatient care programme. In this field, during the latter part of the year, the hospital
administrator at Pearson Hospital resigned, and his duties were temporarily assumed
by the Bureau administrator. The volume of out-patient activity, however, remained
high with the completion of a most extensive case-finding survey in the northern
part of the Province and the opening of the new and modern Victoria and Island
Chest Clinic in Victoria. Statistics for the Division show continued success in the
fight against the disease, but also show that the disease is far from being wiped out.
The Division of Laboratories further developed its services with the completion
of plans for the opening of a virus laboratory early in 1963. The Division continued
to provide a comprehensive public health laboratory service throughout the Province, through the central laboratories in Vancouver and the branch laboratories in
Victoria and Nelson.
VOLUNTARY HEALTH AGENCIES
During 1962 the Bureau continued in its liaison function with the voluntary
health agencies in the Province, and the valuable contributions of these agencies to
the operation and development of their respective public health services continued
and advanced during the year. The major activities of those agencies which received
direct financial support through the Health Branch are outlined in their reports,
which follow.
British Columbia Cancer Foundation
The British Columbia Cancer Foundation has continued in its operation of the
British Columbia Cancer Institute with its attached 56 beds, the Victoria Cancer
Clinic in Victoria, and the thirteen consultative cancer clinics at centres throughout
the Province.
In 1949 the British Columbia Cancer Foundation was designated by the Provincial Government as the agency for the diagnosis and treatment of cancer in British
 SPECIAL PREVENTIVE AND TREATMENT SERVICES Y 65
Columbia. The operational expenses are met by the Cancer Control Grant and by
a matching grant from the Government of the Province of British Columbia, together
with fees from private patients.
The British Columbia Cancer Institute has installed its third cobalt unit, to
complete the building programme commenced in 1961.
The new Victoria Cancer Clinic at the Royal lubilee Hospital is expected to
be opened in May, 1963.
The consultative cancer services have been expanded, and now a member of
the staff of the British Columbia Cancer Institute makes a weekly visit to the Royal
Columbian Hospital in New Westminster to consult on patients admitted to that
hospital with malignant disease.
British Columbia Medical Research Foundation
The British Columbia Medical Research Foundation is a voluntary society
which provides financial support for those aspects of medical research in British
Columbia which are not adequately covered by research-granting bodies operated
by the Federal Government and by the national voluntary health agencies. About
half of the Foundation's annual income is provided by a Provincial Government
grant, and the remainder is obtained from private sources, including an allocation
from the Community Chest of the Greater Vancouver area.
Applications for financial assistance may be submitted by physicians and other
medical scientists working on any type of medical research project in any institution
in the Province. The Foundation makes a special effort to avoid undue emphasis on
any one disease or in any particular field of medical science, but all applications are
carefully screened by the Medical Board to ensure that grants are made only to
projects which have been carefully planned and which are conducted by competent
investigators.
Since the Foundation provides less than 5 per cent of the money which is made
available to medical research workers in British Columbia by local and National
research agencies, projects whose requirements can be covered fully by the large
National bodies are not usually supported, although supplementary grants are often
made to projects which receive partial support from such sources. Experience has
shown, however, that an efficient local organization can act with great speed and
flexibility to meet unforeseen needs as they arise, and this has enabled the Foundation to make a contribution to the over-all effectiveness of medical research in the
Province, which is out of all proportion to the actual amount of money involved.
G. F. Strong Rehabilitation Centre
The G. F. Strong Rehabilitation Centre is a non-profit community organization,
registered under the Societies Act and the Hospital Act of British Columbia.
Its primary purpose is to assist in the rehabilitation of disabled children and
adults, on an in-patient and out-patient basis, through an integrated programme of
medical, psychological, social, educational, and vocational evaluation and services
under competent professional supervision. The major portion of such evaluation
and services is furnished within the Centre, and all medical and related health services are prescribed by and under the supervision of physicians employed by the
Centre, who are licensed to practise medicine in British Columbia.
In fulfilling its purpose, the Centre has developed a co-operative working relationship with other community organizations in order to bring the maximum resources possible to bear on the problems experienced by disabled individuals in
the Province.
 Y 66 PUBLIC HEALTH SERVICES REPORT,  1962
The admission policy requires that patients must be physician-referred, and
only those patients will be admitted who, in the opinion of the medical director,
will benefit from the services offered.
No one is refused admission because of inability to pay. In-patients are
covered under the provisions and regulations of British Columbia Hospital Insurance
Service, subject to the co-insurance charge of $1 a day. Items such as wheelchairs,
braces, artificial limbs, and self-help devices are not covered by the British Columbia
Hospital Insurance Service, nor are out-patient services.
Grants received from the Provincial Department of Health Services and Hospital Insurance make it possible to reduce substantially the amount of the fee for
out-patient care. On verification of their financial status, patients who are unable
to pay the co-insurance charge or out-patient fee, or who are unable to pay for
prescribed appliances, will have the cost of their requirements reviewed by the sponsorship social worker for possible referral to an appropriate voluntary or Government agency for sponsorship.
It has not been possible to compile the statistics for 1962 at the time of preparing this report. However, it is expected, based on eleven months of actual
experience, that the extent of services provided by the Centre in 1962 will reflect
a slight increase over that provided in 1961.
While detailed statistics cannot be included in this report for 1962, the statistics
available for 1961 will be of interest and generally will reflect the Centre's operating
experience for 1962. As the Centre for several years has been over-utilizing the
designed capacity of its physical facilities, no major change can be expected in the
extent of services provided despite a consistent waiting list for in-patient care.
In the following statistical summary the figures in parentheses provide a comparison with the previous year's figures. In 1961, 537 (527) patients were admitted
to a programme or seen in consultation, exclusive of 133 (124) patients on a programme of rehabilitation services who were carried over from the previous year.
Twenty-eight (34) per cent of this group of 537 patients were 19 years of age
or under, 23 (25) per cent were between 20 and 39 years of age, 29 (24) per cent
were between 40 and 59 years of age, and 20 (17) per cent were 60 years of age
and older. This reflects a moderate decrease in the number of patients admitted
who were 39 years of age or under and a moderate increase in patients over 39 years
of age.
In addition, 326 (299) children were provided services in the cerebral palsy
out-patient clinic, aggregating 8,249 (9,236) visits. This approximate 10-per-cent
drop in the number of visits, in contrast to an increase in patient load, results mainly
from a shortage of physiotherapists. This clinic is operated co-operatively with the
Cerebral Palsy Association of Greater Vancouver.
The Centre continues to provide space and facilities for the treatment services
of the Canadian Arthritis and Rheumatism Society. Meeting facilities also are regularly provided for about twenty-seven voluntary and professional organizations, and
the large gymnasium is allocated to handicapped groups for evening social and recreational activities.
Monthly staff education meetings have maintained a high standard in furthering
staff knowledge of new and advanced techniques and of developments taking place
in ancillary services in the community. The Centre was the site for the last refresher
course given to the health unit directors of the Provincial Department of Health.
The visit of these physicians to the Centre, supported by a rehabilitation theme to
their programme, was thought to be helpful in reinforcing their role to the Centre.
 SPECIAL PREVENTIVE AND TREATMENT SERVICES Y 67
The Centre's professional training programme provides teaching services for
medical students, internships for physiotherapists and occupational therapists, and
field placements for social workers. In 1963 the Centre will provide internships for
the first class of rehabilitation therapists being trained at the University of British
Columbia. Orientation courses are regularly arranged for student social workers
and physical education instructors. Many of the teaching hours contributed by
Centre personnel are allocated to student health nurses, public health nurses, psedi-
atric and other graduate nurses who are exposed, by a practical demonstration of
the Centre's programme, to the scope of the residual effects of disease and injury
treated. The Centre's community public relations programme continued during the
year at an increased level through the provision of tours for interested lay and professional groups.
Multiple Sclerosis Society of British Columbia
This Society, established to provide assistance to those suffering from multiple
sclerosis, has, in its first year, concentrated much of its effort on locating patients
outside the city centres of the Province. Exclusive of the Vancouver, Victoria, and
New Westminster metropolitan areas, the Society has registered 149 patients since
its opening and has been made aware that this number may represent only one-half
of the cases. As knowledge of the Society spreads, registration increases, and it is
planned, in the coming year, to continue efforts towards having every multiple
sclerosis patient in the Province registered with the Society.
Direct aid is provided for needy patients in the form of wheelchairs, orthopaedic
appliances, drugs, and physical and occupational therapy, and these services have
been provided in fifteen different centres in the Province during the year. The
heaviest concentration of patients is, naturally, in the Lower Mainland, but assistance
has been given to patients in such widely separated areas as 100 Mile House,
Kelowna, Creston, Kamloops, Notch Hill, Ocean Falls, and on Vancouver Island.
Again, it is hoped that, as patients and physicians become aware of the purpose of
the Society, more areas will benefit.
The Society endeavours to keep its patients and members informed on the latest
discoveries and developments in connection with the disease by means of newsletters
distributed from its headquarters. In addition, a supply of literature is kept on hand
to answer requests for information.
During the year, branches were formed at Ocean Falls and Powell River, and
it is planned to establish further branches in the coming year.
Canadian Arthritis and Rheumatism Society
The aim of the Canadian Arthritis and Rheumatism Society is to prevent disablement in those who have only a minimal functional disability and to reclaim, as
far as possible, those already disabled. More than 50 per cent of the patients are
already disabled upon referral.
During 1962 between 4,000 and 5,000 patients were treated, of whom approximately 82 per cent showed improvement on discharge.
The services of the Canadian Arthritis and Rheumatism Society to the community fall into four areas of endeavour.
Service to patients includes in-patient treatment, out-patient clinics, and
medical social casework in the Vancouver area and medical treatment and consultation service and liaison with social workers in the field. Physiotherapy and
occupational-therapy treatment centres, vocational testing and training with job
placement through community resources, government schemes, or volunteers are also
 Y 68 PUBLIC HEALTH SERVICES REPORT,  1962
provided. A system of measuring the functional disabilities of disabled patients has
been developed, together with the statistical recording of status and improvement of
these patients. The Society continued to provide, maintain, and ensure equipment
for physiotherapy rooms and mobile units. Social gatherings, arts and crafts instruction, and cultural events were provided by the Women's Auxiliary.
In the field of education, instruction was given regularly by Canadian Arthritis
and Rheumatism Society's doctors to nurses, social workers, physiotherapy and
occupational-therapy students, and clinical instruction to medical students. Postgraduate and in-training lectures and tours were given for student public health
nurses and student nurses of the Vancouver hospitals. A refresher course was
sponsored for Canadian Arthritis and Rheumatism Society's physiotherapy and
occupational-therapy staff. The educational programme is completed by the distribution of medical pamphlets and literature on arthritis to doctors and other interested
groups and through the media of radio, press, television, films, and lectures to the
general public.
The research programme for the Canadian Arthritis and Rheumatism Society
for the year 1962 involved basic investigations, a clinical study of children and adults
with rheumatoid arthritis, and an epidemiological study of arthritis in the Haida
Indians.
In the field of community planning, advice was given to general hospitals in the
planning of physiotherapy departments, with architectural drawings and designs
being supplied. Model plans and specifications have been drawn up, in collaboration
with Community Chest committees, for the housing of disabled persons. In connection with personnel, an interest was taken in the preparation of potential physiotherapy students through lectures, pamphlets, job-study prizes, and interviews, together with the provision of bursaries to assist students in their training.
British Columbia Epilepsy Society
Basically the epilepsy programme for 1962 was divided into three parts, as
follows:—
(1) Public education, directed toward the building of an informed society in
which the controlled epileptic may find acceptance and understanding,
together with the dissemination of factual information re modern methods
of treatment and the availability of specialized services in British
Columbia.
(2) The maintenance of a centre to provide direct service to the epileptic
and his family. This centre, known as the " Vancouver Epilepsy Centre,"
is under the direct control and supervision of the society's Vancouver
branch.
(3) The establishment of branches of the Society at various points in the
Province to provide information outlets and stimulate interest in the
epilepsy programme at the local level.
The Society's programme has increased in scope and general activity during
1962, and during the eleven months under review activities have included 1,095
motion-picture showings of one or the other of its films, " Modern Concepts of
Epilepsy " and " The Dark Wave." A special speaker was provided on most of
these occasions, and some 1,500 newsletters were also distributed. During the year
the Provincial Society paid the expenses involved in sending the executive director
of the Vancouver Epilepsy Centre and a Provincial Board member to the Western
Institute on Epilepsy held in San Francisco during November.
 SPECIAL PREVENTIVE AND TREATMENT SERVICES Y 69
In Nanaimo extensive assistance was provided to a group with the view to
forming a branch of the Society in that city. This is expected to be fully operative
early in 1963.
In its direct-service programme, the Vancouver Epilepsy Centre, which accepts
patients on the basis of physician's referral only, reported that the rate of new
referrals had increased from less than two per month in 1961 to one per week in
1962. Services here provided relationship therapy to patients and their families,
to assist them with personal adjustment, marital, parent-child, adolescent, health,
vocational, and other problems. The Centre undertook the preparation of fully
documented reports and referrals to the National Employment Service, Rehabilitation Service, and other agencies. The registered case load at the Centre was reduced
to thirty-five because of limited staffing.
The Centre conducted weekly group therapy programmes for selected adult
patients. With guidance and direct participation of the Centre's psychiatric consultant and caseworker, group members approached programmes of a personal and
interpersonal nature affecting their satisfactory social adjustment and, indirectly,
their seizure control. A socialization programme for adult patients was undertaken
jointly by the Centre and a special committee of the Vancouver Board of Parks and
Public Recreation. Other social activities were arranged for both children and
adult patients.
British Columbia Heart Foundation
The year 1962 proved very successful for the British Columbia Heart Foundation, resulting in major expansion of research and education programmes. A major
factor was the increase in heart volunteers to a number in excess of 5,000.
Eighteen research grants were awarded in addition to support of a National
fellowship programme, at a cost of approximately $100,000. The Annual Cardiac
Symposium attracted a large number of physicians and cardiologists from all over
the Province, wh'le the public education programme was responsible for the distribution of 338,000 pieces of educational literature and provided speakers and films
for 123 meetings. In co-operation with Provincial health units, a large amount of
professional and lay material on rheumatic fever—prevention and diagnosis—was
distributed.
NATIONAL HEALTH GRANTS
In August officials of the Department of National Health and Welfare met with
members of the Health Branch, the British Columbia Hospital Insurance Service, and
the Mental Health Services Branch to discuss the reorganization in management of
the National Health Grants and the National Hospital Insurance Agreement. A close
review was made of all grants in an attempt to assess the actual funds required for the
current fiscal year and to estimate the requirements for the National Health Grants
and National Hospital Insurance Agreement programmes for next year.
Professional Training Grant
Commencing April 1, 1962, all short-term postgraduate training requests for
hospital personnel were financed through the British Columbia Hospital Insurance
Service under the National Hospital Insurance Agreement between the Department
of National Health and Welfare and this Province. However, such requests are still
submitted to the Health Branch and approval is sought from the British Columbia
Hospital Insurance Service.
Assistance was provided under this Agreement for hospital personnel toward
the extension courses sponsored by the Canadian Hospital Association in hospital
L
 Y 70 PUBLIC HEALTH SERVICES REPORT,  1962
administration, medical records, and nursing unit administration training. Assistance was also provided under the National Health Grants toward personnel of the
Mental Health Services Branch and the Health Branch for these courses. It is gratifying to note that all trainees who participated in the new course in nursing unit
administration training were successful.
Short-term postgraduate training requests were supported under the grants to
staff of the Faculty of Medicine of the University of British Columbia, the Greater
Victoria Metropolitan Board of Health, the Victorian Order of Nurses, the Health
Branch, and to the Royal Inland Hospital for the fifth annual postgraduate course
for medical laboratory technologists held in Kamloops.
Funds were made available to the training of radiotherapy technicians at the
British Columbia Cancer Institute in order to meet the increasing cancer services.
Assistance was also provided for a cytology technician to be trained at the cytology
laboratory of the Vancouver General Hospital. The British Columbia and Yukon
Division of the Canadian Cancer Society shared in the cost of these training
programmes.
Support to undertake university training was given to registered nurses of the
Health Branch and general hospitals, psychiatrists of the Department of Psychiatry of
the University of British Columbia, and the Mental Health Services Branch, the Victorian Order of Nurses, and the Greater Vancouver Metropolitan Board of Health.
Other personnel on the staff of the Mental Health Services Branch also received
assistance.
The Department of Continuing Medical Education, Faculty of Medicine, University of British Columbia, continued to receive assistance for its programme to
improve community health through a health-care team consisting of the physicians
and the professional and technical workers in the health field.
Hospital Construction Grant
A total of $1,619,781 was committed for hospital construction, utilizing almost
92 per cent of the total funds allocated to this grant. The health centre construction
commitment amounted to $132,375.
Mental Health Grant
The use of the Mental Health Grant continues along the lines described in
previous reports.
Of the nineteen active projects in 1962, nine provided assistance to the programme of the Mental Health Services Branch of the Province. At the University
of British Columbia there were four research projects supported, including a new
one under the aegis of the Department of Psychiatry devoted to epidemiologic studies
of hospitalized psychiatric illness.
The graduate programme of the Department of Psychiatry at the University
continued to receive support for various clinical supervisors together with some
secretarial assistance. The psychiatric out-patient department of the Vancouver
General Hospital, which is associated with the University Department of Psychiatry
in its teaching programme, continued to receive support in the payment of salaries
of selected professional and clerical members of the staff.
The mental-hygiene programme of the Metropolitan Health Committee of
Greater Vancouver continued along previous lines without any significant change.
A new project was approved this year to permit the establishment of a mental-
hygiene programme for the Greater Victoria Metropolitan Board of Health. This
is now getting well under way.
 SPECIAL PREVENTIVE AND TREATMENT SERVICES Y 71
The study of the combined course in psychiatric and general nursing which was
conducted under the segis of the Mental Health Services Branch was concluded, and
the final report was prepared and submitted to the Department of National Health
and Welfare.
The British Columbia Epilepsy Society received funds to assist in defraying the
salaries required to operate its clinical service. The Children's Foundation received
a grant to assist in the payment of salaries to two professional members of its staff.
Tuberculosis Control Grant
The Division of Tuberculosis Control received the largest portion of this grant,
since the Province is responsible for the majority of the tuberculosis services. Details
of the programme appear in a later section of this Health Branch Report.
Funds were provided for continuation of payment to general hospitals for X-ray
films on admission of patients, purchase of X-ray equipment for health units and
general hospitals, antimicrobial therapy, and special out-patient investigations in
general hospitals. The tuberculosis services provided by the Greater Vancouver
Metropolitan Board of Health and the Sunny Hill Hospital (Princess Margaret
Children's Village) were assisted through this grant.
Public Health Research Grant
The study conducted by the Department of Geology and Geography, University
of British Columbia, into trace elements in some limestones and related sediments
and their possible relationship to the distribution of multiple sclerosis was completed.
The Departments of Pathology and Surgery, Faculty of Medicine, University of
British Columbia, concluded their research studies of connective tissue disorders
and heart surgery respectively.
The frequency compression speech system project conducted by the Health
Centre for Children conjointly with the Department of Electrical Engineering, University of British Columbia, was also completed.
The following projects were continued through various departments of the
Faculty of Medicine, University of British Columbia, in co-operation with the G. F.
Strong Laboratory for Medical Research:—
(1) Study of epidemiology and control of infection caused by staphylococci in
patients in a general hospital.
(2) Investigations of arthritis and rheumatism.
(3) A study of methods of total cardiac by-pass in the small animal. The
Health Centre for Children continued its study entitled "Auditory Disorders in Children of Pre-school Age in British Columbia ". The research
project enttiled " Epidemiological Study of Arthritis in Haida Indians "
was continued by the Canadian Arthritis and Rheumatism Society. The
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, continued its project on the understanding of
endocrine disturbances associated with obstetrical complications.
The following new projects were commenced:—
(1) British Columbia Research Council: Gas chromatographic techniques
for the identification of low concentrations of atmospheric pollutants.
(2) British Columbia Research Council: Investigation of improved methods
for controlling schistosome dermatitis in British Columbia lakes.
(3) Department of Surgery, in co-operation with the G. F. Strong Laboratory
for Medical Research: Development of surgical relief of tricuspid valve
atresia by right atrial-pulmonary artery shunt.
 Y 72 PUBLIC HEALTH SERVICES REPORT,  1962
(4) Department of Surgery (Ophthalmology): Establishment of a glaucoma
unit for clinical and basic research.
(5) Health Centre for Children, in co-operation with the Vancouver General
Hospital: Bleeding tendencies in the newborn and correlation with a
micro test of blood coagulation.
(6) Health Centre for Children, in co-operation with the Vancouver General
Hospital and the Department of Paediatrics: Evaluation of serum hormonal iodine levels in early infancy.
(7) St. Joseph's Hospital, Victoria: Tonography and water-drinking tests for
detecting glaucoma among hospital patients.
(8) Division of Laboratories, Health Branch: Salmonella problem—search
for reservoirs and vehicles of human infection.
(9) Department of Surgery (Ophthalmology): Pilot study initiating a retina
service and clinical study of neovascularization in diabetic retinopathy.
(10) Department of Paediatrics, with assistance from the Mental Health Services
Branch: Chromosome studies in some individuals with mental defect.
(11) Division of Preventive Dentistry, Health Branch:   Dental-caries control.
General Public Health Grant
The general public health programme of the local health services continued
to receive assistance, and detailed information has been outlined earlier in this
Health Branch Report.
The Greater Vancouver Board of Health and the Greater Victoria Board of
Health continued to receive assistance toward their operations.
The venereal disease control programme received the total funds available for
its services, which is on a Provincial matching basis. The report of the Division of
Venereal Disease Control appears in a later section of the Health Branch Report.
The rheumatic fever prophylaxis programme now covers just over 1,050 children and young people up to the age of 18 years and appears to be functioning in a
satisfactory manner. A very real effort is being made to see that the diagnosis
of rheumatic fever has been accurately made before accepting anyone on the
programme.
It is planned to assess the value of this programme very carefully in the coming
year with a view to making any modifications that appear necessary. To this end
the co-operation of the British Columbia Hospital Insurance Service is being sought
in order to determine whether fewer people are being admitted to hospital with
recurrence of this disease.
In May and June everyone in the Interior and northern parts of the Province
was offered trivalent Sabin vaccine at school and community clinics sponsored by
local health services.
Just over 270,000 people accepted the vaccine, which constitutes an over-all
acceptance rate of about 69 per cent.
The Salk vaccine programme was continued through the use of quadruple vaccine containing Salk vaccine in infants receiving their primary immunization and
through the use of a triple vaccine also containing Salk vaccine in the school immunization programme.
By this method every child will have had five doses of vaccine before he is
exposed to the increased risk of poliomyelitis on entering school. The vaccine in
the form of tetanus toxoid and poliomyelitis vaccine (combined) was made freely
available to all adults, but no special clinics were held.
 SPECIAL PREVENTIVE AND TREATMENT SERVICES Y 73
The hospital-utilization study being conducted by the Department of Preventive
Medicine, Faculty of Medicine, University of British Columbia, under the direction
of the Metropolitan Hospital Planning Council was continued. Two reports were
finalized—namely, a study of the emergency departments in hospitals in the metropolitan area of the Lower Mainland of British Columbia and a pilot study of professional utilization of the White Rock District Hospital and the Surrey Memorial
Hospital.
Funds were provided to the Canadian Council on Hospital Accreditation to
assist it in its efforts to ensure the best possible care to patients in Canadian hospitals
and to give leadership to improve the quality of that care.
The programme for placing medical-student interns in the Health Branch divisions continued to provide excellent assistance to the Provincial Local Health
Services and at the same time orientated the students to the various health services
conducted by the Health Branch.
Laboratory Services
The Laboratory Advisory Council made a thorough study of the laboratory
facilities in the hospitals in the Prince Rupert-Terrace-Kitimat district and recommended that the area have the full-time services of a pathologist. Approval for this
appointment was given, and it is anticipated that a suitable candidate will be available early in 1963. The establishment of a regional pathology service in this area
will increase the number in the Province to six.
The other five regional laboratories continued to improve the standard of work
by stressing quality control. The increased work load was an indication of the
utilization of these services, and in one instance the pathologist was unable to give
adequate assistance to all the laboratories in the area. As a result, the physicians
and hospital administrators in the Northern Interior Health Unit asked assistance in
the formation of a North Central regional pathology service emanating from the
Prince George regional hospital. Active study of this request was commenced during
the latter part of the year.
Training facilities of medical laboratory technologists entailed considerable
planning. The didactic part of training for all technologists in British Columbia will
take place in the Institute of Technology, which is expected to be in operation in
January, 1964. The plans were drawn up for a classroom to accommodate eighty
students. Many of the details necessary for the operation of this school were worked
out, and a large proportion of the equipment required was ordered.
Two postgraduate courses were given. The haematologist at the Vancouver
General Hospital arranged a week's course in advanced hematology. Senior technologists from seventeen hospitals were invited. The attendance at the fifth annual
postgraduate course in Kamloops was an indication of the interest in advanced
training. Ninety-five technologists attended, as compared with fifty-one the previous
year. The pathologist who directs this course invited five senior technologists to act
on an advisory committee to assist with next year's programme. The technical supervisor is chairman of this committee.
Other forms of postgraduate training were discussed with the Department of
Continuing Medical Education, University of British Columbia, and consideration
was given to initiate a correspondence course which could be of benefit to all the
technologists in the Province.
One sub-committee of the Laboratory Advisory Council reviewed the plans for
laboratories for the new hospitals, and recommendations on request for grants for
new diagnostic equipment were given by the technical sub-committee of the Laboratory Advisory Council.
 Y 74 PUBLIC HEALTH SERVICES REPORT,  1962
Radiological Services
The Radiological Section of the Bureau underwent some modifications and
consolidation during the past year. The Division of Occupational Health moved
from Victoria to the Vancouver office. The Director is the Provincial health
authority for radiation under the National Atomic Energy Control Act, with the
radiation inspection technician and the technical adviser acting as radiation inspectors. This has resulted in an improved service to those seeking direction and advice
in matters pertaining to radiation as most of the commercial, industrial, and research
installations are centred on the Lower Mainland.
The files and records covering all phases of radiation have been consolidated
in the Vancouver office, which has greatly reduced the paper work and resulted in
a faster service to the people requesting it. A system is at present being developed
for the users of the film-badge monitoring service to be able to give them a quarterly, annual, and lifetime total of their accumulated radiation exposure, which, on
request, they can have when changing employment. This system, though often
talked about, is not available anywhere else in Canada or, it is believed, in North
America. It is also designed to reduce recording time and will completely eliminate
the present filing system, thus saving considerable space.
Radiation surveys and inspections were increased this year. This was made
possible by the appointment of a radiation technician. The areas covered were
the Peace River District, Central and Upper Vancouver Island Health Units, South
Okanagan, and Howe Sound and Sechelt Peninsula. One hundred and seventy-seven
inspections were done in these areas.
A well-developed working liaison has been established with those who are
responsible for the planning and installation of X-ray equipment in public and
private institutions through the architects and their consultants and the X-ray supply
houses. This has resulted in a considerable saving in time and money to the owner.
The technical adviser has conferred with them on six health unit buildings, seventy-
five reviews of hospital plans, and twenty reviews of private installations, besides
160 telephone calls concerning these and other installations.
Forty dentists' offices were surveyed throughout the Province during the inspection tours, with the main radiation problem being the lack of lead diaphragms
and aluminum filters to restrict and reduce the amount of radiation being given the
patient and scattered to adjoining areas. The dentist, in some instances, was not
aware that he was standing in a potentially dangerous spot while the X-rays were
being taken.
The X-ray operators' refresher courses proved to be successful again in the
spring of 1962, with fifty-one attending from all parts of the Province. Plans are
already well advanced for two courses in 1963.
In 1962 the Radiological Services developed and conducted the first one-week
refresher course for industrial radiographers in Canada, with instructors from the
Canadian Specification Board, Ottawa, and the Pacific Naval Laboratories. Fifty-
nine attended the course from British Columbia and Alberta. Following the course
twenty wrote examinations for their junior radiographer certification. As a result of
this course, British Columbia had the highest percentage of passes of any group
in Canada.
The British Columbia Dental Association has requested assistance in developing a short X-ray course for dental assistants with special emphasis on radiation
protection, to be held some time early in the new year. It is estimated that 250
dental assistants will attend.
 SPECIAL PREVENTIVE AND TREATMENT SERVICES Y 75
Progress with the central training programme for X-ray operators in the
Province is showing concrete results. The building for the Institute of Technology,
which will carry the training programme as one of many faculties, will open in 1964.
Committees have met to recommend purchase of equipment and layout of the
allotted floor space.
The Equipment Committee of the Radiological Advisory Council, at the
request of the British Columbia Hospital Insurance Service, reviewed forty-three
applications for grants toward the purchase of X-ray equipment. Approved for
grant assistance was equipment with a total value of $198,109.96.
With increased concern shown by the various Provincial law-enforcement
bodies and the Provincial Fire Marshal's office in the road movement of radioisotopes and the probable consequence of an accident, it has been recommended,
until legislation makes it compulsory, that all vehicles travelling on the roads in
British Columbia be conspicuously marked with the approved radiation warning
signs and that their movements and destination be pre-indicated, either by letter
or phone, to the Provincial health authority.
All technical surveys that involve radiation or radiation equipment, either
X-rays or radioisotopes, and requested by either the Radiological Advisory Council,
British Columbia Hospital Insurance Service, Radiation Protection Division of the
Department of National Health and Welfare, Ottawa, or the Occupational Health
Division and Workmen's Compensation Board, are handled through the office of
the technical adviser, which has simplified procedure and cut down on duplication of
man-power. There are over 100 telephone calls a month on technical or planning
problems received from the various professions and trades, with every indication
that the field is still expanding.
Cancer Control Grant
The funds from this grant, which are matched by Provincial funds, are mainly
used for the operations of the British Columbia Cancer Foundation. Details of the
programme of the Foundation are outlined earlier in this Health Branch Report.
The cytological diagnostic laboratory, which is operated under the direction of
the Director, Department of Pathology, Vancouver General Hospital, received the
balance of available funds. Due to the continuing increase in the operations of the
laboratory, and in order to employ increased staff, additional funds were supplied
through the British Columbia and Yukon Division of the Canadian Cancer Society.
It is estimated that two-thirds of the practising physicians in the Province avail
themselves of the services of the laboratory. Although the number of specimens has
continued to increase substantially each year, the actual cost per specimen has decreased from $1.52 in 1957/58 to $1.04 in 1962/63. The average number of
specimens per month for the past ten-year period has ranged from 544 in 1952 to
5,306 in 1960, with an estimated average of 7,858 for the nine-month period in
1962. From October, 1960, to September, 1961, 81,985 examinations were carried out.
The lay educational programme was carried out by the British Columbia and
Yukon Division of the Canadian Cancer Society.
Medical Rehabilitation and Crippled Children Grant
This is a matching Federal-Provincial grant.
The Cerebral Palsy Association of British Columbia and the G. F. Strong
Rehabilitation Centre continued to receive support. Provision was made toward
the medical rehabilitation services supplied by the British Columbia Division of the
 Y 76 PUBLIC HEALTH SERVICES REPORT,  1962
Canadian Arthritis and Rheumatism Society. The home care programme of the
local health services also received matching funds.
The speech and hearing programme, under the direction of the Health Centre
for Children and the Poliomyelitis and Rehabilitation Foundation of British Columbia, continued to receive assistance for staff and travel, with support also being
received from the Foundation. This project was formerly under the General Public
Health Grant.
Provision was supplied to the Registry for Handicapped Children and Adults.
Details of the programme appear in a later section of this Health Branch Report.
Child and Maternal Health Grant
Partial assistance was provided toward the purchase of equipment for the
research department of the Health Centre for Children, together with payment
toward staff and purchase of supplies.
Projection equipment was purchased for the prenatal programme of the Greater
Vancouver Metropolitan Board of Health.
The British Columbia Co-ordinating Council for Child Care continued to carry
out its study on child care and facilities in the Province. Support was sponsored
through this grant and the Poliomyelitis and Rehabilitation Foundation of British
Columbia.
The maternal mortality, maternal morbidity, and certain aspects of foetal-
wastage study continued under the direction of the Department of Obstetrics and
Gynaecology, Faculty of Medicine, University of British Columbia. Supervision of
this project was provided through the Division of Vital Statistics of the Health
Branch.
The one-year research project carried out by the Health Centre for Children
on infections as an important cause of death in the neonatal period and its early
detection and treatment to reduce neonatal mortality was completed.
The following studies were continued by the Health Centre for Children:—
(1) Neurological development of the newborn infant in relation to earlier
detection of cerebral palsy and mental retardation.
(2) Methods of respiratory function testing in the newborn infant—design,
standardization, and clinical application.
(3) Investigation of metabolic disturbances in children with mental retardation and nervous disorders.
(4) Correction of experimental neonatal atelectasis.
 TUBERCULOSIS CONTROL Y 77
REPORT OF THE DIVISION OF TUBERCULOSIS CONTROL
This is the twenty-eighth year of operation of the Division of Tuberculosis
Control. It is only within the last decade that rapid strides toward control have
been possible because of the discovery and widespread use of drugs that are effective
against the germ that causes tuberculosis. It is mostly in this period that the basic
concepts of control of tuberculosis have altered to any degree as the nature of the
tuberculosis problem changes. However, in this latter period changes have taken
place.
This Division is chiefly concerned with treatment, supervision of known cases,
and the finding of new cases of tuberculosis. At a result of the success achieved in
treatment, as shown by the marked reduction in deaths and in the number of sanatorium beds in operation, our resources have been redirected to strengthen the programme of the supervision of known cases and the finding of unknown cases. Both
of these functions are carried out by the clinics of the Division—the diagnostic
clinics, both stationary and travelling, for the supervision of known cases, and the
survey clinics, both stationary and travelling, for case-finding. In both of these
services new techniques have been developed and new practices have been put into
effect to meet the changing problems and to improve efficiency.
DIAGNOSTIC CLINICS
The chief purpose of the diagnostic clinics is to provide a specialized consultant service in tuberculosis and chest diseases throughout the Province. In the
heavily populated areas of the Lower Mainland and Lower Vancouver Island permanent clinics have been set up—namely, in Vancouver, New Westminster, and
Victoria. All other areas of the Province are provided with this service through
travelling clinics. All of these clinics work in conjunction with local public health
field staff and the practising physicians to provide supervision for all the known
cases and advice regarding their progress. Reports are sent to the local field health
staff and the private physicians who are see'ng these patients in their homes. There
are almost 22,000 people who are known to have had tuberculosis in British
Columbia, of whom approximately 4,800 are Indian. Those Indians not of white
status are looked after by the Indian Health Service, Department of National Health
and Welfare. The following data, therefore, relate in most cases to the non-Indian
population.
While the prime responsibility for the known cases in their homes is that of the
local public health service, the Division of Tuberculosis Control has a responsibility
to ensure that satisfactory follow-up is being carried out. This is made possible by a
special case register that is maintained by each of the clinics. In this register is
recorded all the pertinent information on those cases in whom the disease is active or
who are considered to be a high-risk group. This group includes active cases of
tuberculosis, cases that are inactive less than two years, suspects, quiescent cases,
and cases under treatment with antituberculous drugs; in other words, cases that
are still under close supervision. About 2,600 cases are so classified so that they may
receive special attention.
Over 1,250 cases are being treated with tuberculosis antimicrobials as outpatients as an extension of sanatorium care, and this is only possible because of the
close supervision that can be provided by local health services and tuberculosis
clinics.
 Y 78
PUBLIC HEALTH SERVICES REPORT, 1962
The activities of the clinics of the Division of Tuberculosis Control are directed
toward the discovery of the active case of tuberculosis. The majority of the active
cases each year will be new active cases, and the number discovered in 1962
amounted to 500, including Indians. However, a significant number of these new
active cases will be amongst persons who have been followed because of conditions
considered to be non-tuberculous, but known to be sometimes associated with tuberculosis. In the past year 123 of the new active cases of tuberculosis were discovered
in this group. Each year a significant number of active cases of tuberculosis come
from the known cases of tuberculosis which have been inactive. Approximately
19,000 of the known cases in British Columbia are classified as inactive, and in
1962, eighty-six cases of active tuberculosis occurred in this group. In other words,
less than 1 per cent of the known cases reactivated, which represented 15 per cent
of the total cases that were found to be active in 1962. The number of active tuberculosis cases among the total population found in 1962, including new active cases
and reactivations, was 586.
Tuberculosis being an infectious disease, the logical place to look for unknown
cases of tuberculosis is amongst those people who are in contact with active cases
of tuberculosis. The persons most likely to develop tuberculosis from this source
are those who live in the same household, those who have close association with
tuberculous cases outside of the home, and those who have casual but significant
contact with tuberculosis in some other manner.
The following is an analysis of the results of tracing contacts of the new active
cases found during 1961, the latest year for which this is available:
Contact-tracing, 1961
(Excluding Indians,
Source
(Index)
Cases
Contacts Examined
New
Active
Examined by-
Information
Complete
Unsuccessful
Follow-up
Total
Tuberculosis
Cases
Found
Willow Chest Centre.,.  	
191
106
40
89
888
622
202
331
82
5
10
970
627
212
331
7
21
Victoria and Island Chest Clinic-	
12
Totals       -
426
2.043         1               97
2,140
40
TYPE OF CONTACT EXAMINED
Type
Contacts
Examined
New Active Tuberculosis
Cases Found
Number
Per Cent
910
753
477
20
20
2.2
2.7
Totals   -               .
2,140
40                    1.8
DIAGNOSIS OF SOURCE
CASE
Diagnosis
Contacts
Examined
New Active Tuberculosis
Cases Found
Number
Per Cent
1,842
298
39
1
2 1
0 3
2,140
40
1.8
 TUBERCULOSIS CONTROL Y 79
From these figures it will be seen that from 426 new active cases of tuberculosis
2,140 contacts were traced. This is approximately five contacts from every new
case discovered, representing a 96-per-cent successful follow-up. This is, indeed,
a very commendable effort, considering the difficulties of contact-tracing in the slums
of our larger cities and in the outlying districts of the Province. For this all credit
must go to the public health nursing field staff, whose responsibility it is to persuade
these people to come to the clinics for examination.
From the contacts examined, forty new cases of active tuberculosis were
found, indicating a rate of active tuberculosis of 1.8 per cent in contacts examined,
or one new active case of tuberculosis in every fifty-two contact examinations. This
can be compared with one new active case of tuberculosis in 2,076 persons examined
in our community surveys. In all, forty-three new cases of tuberculosis were found
by contact-tracing. However, three of these cases were considered to be inactive.
Here emerges a most important finding, that the proportion of cases proven
active from contact examination is considerably greater than that found by any other
means. In fact, approximately half the cases found by other than contact examination will be inactive.
These figures also show that practically all the cases of tuberculosis found were
contacts of pulmonary tuberculosis rather than non-pulmonary types of disease.
They also show that the examination of non-household contacts is of equal importance with the examination of household contacts, in that 2.8 per cent of the non-
household contacts were found to have active tuberculosis while 2.2 per cent of
the household contacts were found to have active tuberculosis. The results also
indicate that casual contacts of tuberculosis are not an important source of tuberculosis, and in this study no cases were found amongst 477 casual contacts examined.
Proportion of Cases of Active Tuberculosis Reported as a Result of Examination by
Clinics of the Division of Tuberculosis Control, 1962
Source of initial referral— Per cent
Physician referral  50.8
Combined X-ray and tuberculin survey   12.7
Contact investigation  10.5
Obligatory X-rays  10.5
Self-referral      7.9
Routine general hospital admission X-ray     2.9
Organized tuberculin survey     2.6
Organized X-ray survey     1.8
Notified on death     0.3
Original X-ray taken by—
Clinics of Division of Tuberculosis Control  26.3
Mobile survey units  15.1
General hospitals—
In-patients   21.3
Out-patients   13.2
Survey units, Metropolitan Vancouver     5.4
Other-
Mental Health Services     3.1
Department of Veterans' Affairs     0.3
Private radiologist     3.1
Non-pulmonary with negative chest film     3.8
Ex-province, including immigration     4.2
Other     4.2
  18.7
 Y 80 PUBLIC HEALTH SERVICES REPORT,  1962
In an analysis of the new active cases of tuberculosis found in the clinics of the
Division, the source of the first referral for examination and the facility to which
these people were referred for their original X-ray examination leading to the diagnosis of tuberculosis is of interest and of considerable importance. In all cases the
confirmation of the diagnosis was made at the clinics of the Division. The chief
source of referral is, as might be expected, the private physician, and the proportion
of people referred through this source (50.8 per cent) indicates a high index of
suspicion of tuberculosis on the part of physicians and their close co-operation in
the programme of tuberculosis-control. Another important source of referral was
through contact investigation, and 10.5 per cent came from this source. Obligatory
X-rays, such as those required for immigration purposes, employment examinations,
routine examination of hospital employees, and those working in dusty occupations,
also proved to be the source of 10.5 per cent of the new active cases found. It is
interesting to note that 7.9 per cent of new active cases were self-referrals, and this
reflects the widespread educational campaign that is carried out to enlighten the
public in matters pertaining to tuberculosis.
An analysis of the facility used to provide the first X-ray examination leading
to the diagnosis of tuberculosis shows that the diagnostic clinics of the Division of
Tuberculosis Control first examined 26.3 per cent of these cases, whereas the mobile
units of the Division examined 15.1 per cent. Examinations through the facilities of
general hospitals led to the discovery of 34.5 per cent of all cases found, and it is significant that of these almost two-thirds were found among in-patients in hospitals,
indicating that there is a considerable volume of tuberculosis amongst patients admitted to general hospitals for other conditions. Various other individuals and
institutions provide facilities for the diagnosis of tuberculosis, and they consistently
contribute to the numbers discovered, and in total 18.7 per cent of all cases were
found through these agencies.
TRAVELLING DIAGNOSTIC CLINICS
Divisional policy for travelling clinics remained unchanged during the year,
but some limited changes are planned for 1963. No over-all change in operation is
planned, and in general it has been found that any variation in the operation of the
different clinics has grown out of necessity and is usually the procedure best suited
to the area concerned. Changes are made to suit the circumstances under which
each clinic operates, chiefly with relation to staff and geographic location. Considering the effectiveness of current antimicrobial therapy in treating tuberculosis and
reducing the number of reactivations, the frequency of routine re-examination of
inactive cases can gradually be decreased, thus reducing the average clinic load.
Physician attendance at clinics is considered desirable. Where long distances
are involved in travelling and more than two centres are to be visited, it is not possible to arrange clinics in such a way that the physician be present only when cases
he needs to see are attending. The separate consultation clinic arrangement, where
the physician visits after the nurse has X-rayed the patients, so that he may see
selected patients, was designed to avoid this problem, but it is necessary to have a
good attendance to make this procedure worth while. This year's experience in the
Kootenay area indicates that the volume of work in many centres does not justify the
expense of consultation clinics in some centres. As a result, beginning in July, 1963,
the Kootenay Travelling Clinic will change to the type of clinic presently held by the
other travelling groups; that is, the physician in attendance at the film-taking clinic.
It has been possible to arrange this without increasing the amount of time the
clinician spends on the road.
 TUBERCULOSIS CONTROL
Y 81
The loss of two clinicians (one transfer and one death) has led to some staff
changes and rearrangement of area coverage. The Alert Bay area has been taken
from the Coast Travelling Clinic and put under the Island Travelling Clinic. With
this reduction in work, the Interior, Coast, and Kootenay Clinics are now staffed
with three full-time and one half-time clinician instead of four full time.
Approximately 32,000 films were read during 1962 in the travelling clinics.
In terms of work done, this figure shows only a slight variation from previous years'
experience.
This Division, through its travelling clinics, continues to provide an anuual
chest X-ray survey service to the Mental Health Branch at Tranquille, Dellview
Hospital, and Skeenaview Hospital, and also to Marpole Infirmary. The nurse-
technician with the Kootenay Travelling Clinic has continued with tuberculin testing
of schools through the East and West Kootenays. More tuberculin testing is scheduled for the first half of 1963. This will practically complete the school surveys in
these areas.
Our relationship with health units remains cordial, and their co-operation is
appreciated. In general, attendance at clinics is largely dependent on the interest
and drive of health unit personnel. The increase in the number of other travelling
teams in recent years has put a considerable strain on health unit accommodations
and on their staffs, and the continued pleasant co-operation of health unit staff is
enjoyed by all travelling clinic personnel.
TUBERCULOSIS SURVEYS
During the period under review the tuberculosis survey team had a most successful year. While the total number of persons examined was slightly less than in
the previous year, 139,615 persons were provided with an examination for tuberculosis by the survey team. The area covered greatly exceeded anything previously
done and involved much travelling, with many surveys held in sparsely populated
areas well off the main highways.
During a five-month period from May to October, the survey team was on the
road continuously and conducted community surveys in the northern parts of the
Province from Prince Rupert to Vanderhoof, including Kitimat and Kemano,
throughout the Peace River area as far north as Fort Nelson, and throughout the
Cariboo. During the surveys of these areas 73,590 persons were examined for
tuberculosis. Prior to the northern survey, large-scale surveys were held in Burnaby
and Coquitlam and in the South Okanagan Health Unit area, including Kelowna
and district. At the end of the year the survey team was working in the slum area
of Vancouver, and a survey of the New Westminster Penitentiary was also carried
out.
Besides this the survey units revisited areas where surveys had been held the
previous year to re-X-ray those persons who had been found to have a positive
tuberculin reaction. The centres visited and numbers of persons examined were:
Alberni, 2,457; New Westminster, 2,274; Vernon, 1,143; Lumby, 126; Armstrong, 202; Enderby, 174; Salmon Arm, 512; Sicamous, 101; and Revelstoke,
604. The names of all the positive tuberculin reactors had been recorded from the
previous survey, and they were sent individual notices by the Division of Tuberculosis Control reminding them of the impending visit of the mobile X-ray unit and
the need for re-examination. The response to this recommendation for re-examination was considered excellent, with about 75 per cent of the people notified presenting themselves for re-examination.
 Y 82 PUBLIC HEALTH SERVICES REPORT,  1962
The community surveys, as in the past, have been a combined effort of the
British Columbia Tuberculosis Society and the Division of Tuberculosis Control,
the Society providing the organizing and educational facilities and the Division of
Tuberculosis Control doing the examinations and reporting. As has been the policy
for some time now, all surveys are organized so that through volunteer canvassers
each person is solicited individually to present himself for examination, and examinations are so arranged in each community that facilities for the examination are
strategically located so that each person only has to go a block or two to avail himself of the service.
For the survey throughout the northern part of the Province, this area being
heavily populated with native Indians, a combined effort with the Indian Health
Services was carried out so that all persons in the area would be examined. The
Indian Health Services provided two full-time nurses and an X-ray machine with
operator to assist in the work, and as a result a good coverage was obtained of the
total population in these areas. Skeena Health Unit area has always been known
as a high-incidence area for tuberculosis, and it was not surprising that the incidence
of tuberculosis found during the northern surveys was considerably higher than has
been the experience elsewhere, except in the depressed sections of Vancouver and
Victoria.
As a result of several years of community surveys, all of the Interior of the
Province, except the East and West Kootenays, has now been surveyed on the basis
of a combined tuberculin testing and X-ray examination. So far we have been concentrating on the areas of higher incidence, and the Kootenay area is known from
previous surveys to have a low incidence of tuberculosis.
The tuberculin test for the discovery of tuberculosis is now widely accepted by
the people of the Province as a result of a widespread educational programme to
familiarize the people with this test. It still remains the objective of the Division of
Tuberculosis Control to identify all those persons in the Province who have a positive tuberculin reaction so that they may be followed as potential cases in the future.
TREATMENT SERVICES
There is little change to report either in the number of beds in operation or the
scope of the service provided. However, only thirty-six major lung operations were
done in 1962, as compared with fifty-five in 1961 and 285 in 1956. It will be seen
that the need for lung surgery has diminished considerably, and as a result a smaller
proportion come to lung surgery of the total treated. This can be accounted for by
the fact that as a result of more experience with the drugs that are specific against
tuberculosis, it is possible to use them more effectively in achieving the desired result
of healing the disease. Moreover, experience has also led to better selection of cases
for surgery, and there are fewer cases who need " salvage " operations as a result
of extensive lung destruction that occurred before the days when the specific drugs
were available.
During the past year there were thirty-seven cases admitted to sanatorium for
the treatment of non-pulmonary tuberculous conditions, other than pleurisy. This
amounted to 7.6 per cent of the total admissions, excluding review cases and transfers. A high proportion of these cases must be treated surgically, and this resulted
in an appreciable number of surgical procedures being carried out on this group.
Thirty-four cystoscopies were done, as well as eight major genito-urinary operations.
Ten major operations were also done for tuberculosis of the bones and joints and
eight major abdominal operations for non-tuberculous conditions.
 TUBERCULOSIS CONTROL
Y 83
At the end of the year there were 265 beds, not all occupied, operated by the
Division of Tuberculosis Control—172 at Pearson Tuberculosis Hospital and 93 at
Willow Chest Centre.   This is a reduction of 35 beds during the year.
In 1962 the cases admitted to these institutions, excluding review cases and
transfers, totalled 486, of which 338 were first admissions and 148 were readmissions. This compares with 420 admissions in 1961, of which 311 or 74 per cent
were first admissions and 109 were readmissions. By comparison, in 1956 there
were 924 admissions, of which 35 per cent were readmissions.
Age Distribution in Sanatoria
Date
Total
Sanatorium
Population
50 Years of
Age and
Over
Per Cent 50
Years of Age
and Over
November, 1952  _
838
615
448
332
331
294
244
230
276
251
217
189
161
169
128
126
32.9
November, 1955. ...	
40.8
48.4
November, 1958    . 	
56.9
November, 1959          ....   .
48.6
November, 1960    	
57.4
November. 1961  _                       _.
52.5
November. 1962       	
54.8
The above-noted figures will indicate that the trend toward a reduction in the
number of tuberculosis patients needing sanatorium care has decelerated, and while,
on the average, from 1952 to 1961 there was a 15-per-cent reduction in beds each
year, in 1962 there was only a minor decrease in beds needed, amounting to about
6 per cent.   This was a reduction of fourteen patients in the past twelve months.
The percentage of patients 50 years of age and over in sanatorium is still very
high and represents 55 per cent of the patient population. However, this is mostly
due to the problem of males 50 years of age and over, who represent 47 per cent of
the total sanatorium population and 64 per cent of the male sanatorium population.
This situation is reversed in the female 50 years of age and over, and this group
represents only 30 per cent of the female sanatorium population and only 8 per cent
of the total sanatorium population. This again confirms the fact that tuberculosis
in the elderly person, particularly the elderly male, is one of the most serious and
indicates that the ones that are dying are being replaced by other older persons who
are newly discovered and enter sanatorium each year as a result of the case-finding
programme. The ratio of males to females in the sanatorium population is almost
2.8 to 1.
After the spectacular decreases in the number of patients needing sanatorium
care that occurred in the early years of the present decade and led to the closing of
Tranquille Sanatorium in 1958, it is now evident that during the past four years this
trend has markedly slackened and almost levelled off. It appears likely that further
decreases will occur rather slowly. It is noted that during 1961 there were 501
patients admitted to the sanatoria of the Division, in which there were 300 beds
available, while in 1952 there were 989 patients admitted to 838 beds in operation.
From this it will be seen that at the present time there is a more rapid turnover of
patients than there was ten years ago.
TUBERCULOSIS AND MENTAL ILLNESS
A large-scale programme of tuberculosis control is continuing at the Provincial
Mental Hospital and other mental institutions as a combined effort of the Division
 Y 84 PUBLIC HEALTH SERVICES REPORT,  1962
of Tuberculosis Control and the Mental Health Services. The work at Essondale
is supervised by specially trained tuberculosis workers provided through the Division
and permanently assigned to Essondale. Chest X-ray surveys in the other mental
hospitals are carried out by the travelling clinics.
An active-treatment programme is maintained in the North Lawn Building,
where there are 140 cases of tuberculosis presently cared for. During the first eleven
months of the year there were ninety-five patients admitted to North Lawn and seventy discharged. There were also twenty-two deaths, mostly from non-tuberculous
conditions associated with the tuberculosis. In addition, there were 228 inactive
cases of tuberculosis who are closely supervised and frequently examined in other
parts of the Provincial Mental Hospital.
A considerable volume of work is entailed in the supervision of the patients
and staff of such a large institution as the Provincial Mental Hospital. This is seen
by the fact that about 17,000 chest X-rays are taken annually, 3,368 tuberculin tests
were done, and 158 persons were given B.C.G. vaccination against tuberculosis.
The results of this programme in the Provincial Mental Hospital over the years have
proven most gratifying in reducing the incidence of tuberculosis and controlling this
disease in such a difficult group of patients. All those concerned with the programme have been most co-operative, and any administrative difficulties that have
arisen have been readily adjusted.
POLIOMYELITIS PAVILION
In 1955 the Provincial Government undertook to provide care and treatment
for chronic poliomyelitis patients who were accumulating in general hospitals. This
group represented those cases that had been left with severe residual paralysis and
could not be taken care of outside of hospital. Almost all had chest paralysis as
well as paralysis of their limbs and were in respirators. It was decided that they
could be best cared for by those who had experience in the treatment of lung diseases, so a programme was set up under the Division of Tuberculosis Control and
a Poliomyelitis Pavilion was built at Pearson to accommodate these people.
On the average, thirty-five to forty patients have been under treatment in the
Poliomyelitis Pavilion, and they have proved a great challenge to the staff. Because
at the outset the field of endeavour had not been well developed, most emphasis was
placed on the custodial aspects of care. However, the objective has always been to
help these patients do more for themselves and to make them as independent as
possible. With this goal in mind, a great deal has been accomplished and much
achieved that previously would have been thought to be impossible. This has been
brought about by the dedication and ingenuity of the staff of the Poliomyelitis
Pavilion. Through these efforts a well-developed programme of physical and vocational rehabilitation has been developed. During the past eighteen months the Provincial Rehabilitation Service has helped considerably by providing splints and other
prosthetics for these patients.
The medical staff consists of one full-time doctor, who is a tuberculosis specialist with special training and interests in rehabilitation, together with part-time
consultants in paediatrics, ear, nose, and throat, internal medicine, and orthopaedics.
Besides this there is a special liaison with the G. F. Strong Rehabilitation Centre by
which a consultant visits the patients to advise on physical rehabilitation and to
arrange transfer of the patients to the Rehabilitation Centre when they are able to
benefit from the facilities that are available there.
In treating chronic poliomyelitis, one needs an excellent staff of all types who
must be well trained and highly dedicated and with a sympathetic understanding of
 TUBERCULOSIS CONTROL Y 85
the problems of these patients. Such a staff has been assembled at the Pearson
Poliomyelitis Pavilion. The nurses, nurses' aides, and orderlies who provide the
bedside care for these patients are, for the most part, regularly assigned to the
Pavilion; however, many of the staff of the tuberculosis wards have been trained
and can be called on to relieve in the Poliomyelitis Pavilion. Physiotherapy plays
a very important part in the rehabilitation of the poliomyelitis patients, and a staff
of three qualified therapists has contributed greatly to the success of the programme.
Every effort is made to develop any capability that the patient may possess so that
he may become less dependent on help from others. Occupational therapy also
plays a large part in the rehabilitation of these patients, and this is encouraged to
stimulate them to greater effort. Possibly the greatest example of the application of
this and the determination of the patients is shown in art therapy, in which field
several patients have produced excellent paintings although they have been almost
completely paralysed. These paintings have been done by holding the brush in
the mouth. One patient has almost reached the stage of being self-supporting
through the sale of his paintings.
While most of the patients in the Poliomyelitis Pavilion have been paralysed
as a result of poliomyelitis, there have been a number of cases with similar conditions caused by other diseases and necessitating the same type of treatment as poliomyelitis that have been cared for in the institution.
Considerable help has been forthcoming from other agencies. The Poliomyelitis Foundation has been very generous in its assistance to the patients and in providing money for special equipment for them, such as positive pressure breathing
apparatus, chest respirators, and wheelchairs, this help being directed toward assisting the patients to spend regular intervals in their homes. The Vancouver School
Board has supplied a school-teacher, who conducts daily classes for elementary students. Three students who require junior high-school education are transported to
a nearby high school in Vancouver, where they are taking then major subjects for
Grade IX and receiving tutoring by teachers who come to the hospital to teach the
remaining subjects.
From this it will be seen that the Poliomyelitis Pavilion is an active-treatment
and rehabilitation centre where everything possible is done to help patients to do
more for themselves and to lead as normal a life as possible even if it only means
getting home occasionally for week-ends. If, after some months of work, a patient
is able to feed himself to some degree we feel that this is an achievement in rehabilitation.
The wards are now filled with patients, most of whom are able to go home for
week-ends or for short visits, and a considerable number of patients are able to be
out for periods up to two or three weeks, which some are able to take as holidays
during the summer season.
ACKNOWLEDGMENTS
Special acknowledgment should be made of the continuing assistance of the
British Columbia Tuberculosis Society in the programme of tuberculosis control.
As it has for the past forty years, the Society continues to play a very large role in
education and case-finding. Its role in community surveys has already been mentioned, and this represents a very large financial outlay. It also constitutes an ideal
arrangement between the lay and official organizations for the carrying-out of such
a programme. During the present year the Society has made another major contribution in helping to provide a new chest clinic in Victoria that will be used as the
headquarters for the operations of the Tuberculosis Division on Vancouver Island.
This was a much-needed replacement for quarters previously used for many years
 Y 86 PUBLIC HEALTH SERVICES REPORT,  1962
and provides the Victoria and Island Chest Clinic with modern and efficient facilities.
The major cost of this building, together with its planning and development, was
provided by the Society with the Provincial and Federal Governments assisting.
Special mention should also be made of the considerable part played by the
Provincial Division of Laboratories in the tuberculosis-control programme. This
Division is responsible for the bacteriological work that is carried out in connection
with tuberculosis, and it represents a great volume of work, without which the
tuberculosis-control programme could not function adequately. With the more
intensive investigation of tuberculosis cases, the volume of work has tended to
increase over the years. The bacteriological status of the tuberculous patient is
probably the most important factor in arriving at the clinical decision as to whether
or not the patient should be admitted or discharged from sanatorium, what type of
drugs should be used for treatment, and whether or not surgery is indicated, so that
it can be seen that great reliance is placed on laboratory findings. Special sensitivity
studies are necessary to treat effectively a case of tuberculosis and to be certain that
the proper drugs are being used. A special laboratory for this work has been provided by the Provincial Division of Laboratories and is very important to the clinical
assessment of the patient. The Division of Tuberculosis Control is grateful for the
service that is provided.
Organized tuberculosis services are also provided in British Columbia by two
other organizations—the Indian Health Services of the Department of National
Health and Welfare and the Sunny Hill Hospital for Children (formerly the Vancouver Preventorium), which is a voluntary agency. Both of these work very closely
with the Provincial organization and most harmoniously.
The Indian Health Service provides a complete treatment and field service for
the control of tuberculosis amongst those Indians who still retain their Indian status.
For the treatment of these Indians, three hospitals strategically located at Prince
Rupert, Nanaimo, and Sardis provide 275 sanatorium beds. In all phases of the
work the closest liaison exists and a closely co-ordinated campaign is carried out.
The Sunny Hill Hospital for Children provides the only facility for the treatment of children suffering from pulmonary tuberculosis in the Province, and under
the former name of the Vancouver Preventorium has provided these services for
about thirty years. This work is supported through the Division of Tuberculosis
Control by National Health Grants. The clinical facilities for the examination and
investigation of these children and their medical supervision is also provided through
the Division of Tuberculosis Control.
While the majority of patients now in the Sunny Hill Hospital for Children are
being treated for non-tuberculous conditions, there was a considerable increase in
the number of children admitted for tuberculosis during the year. There were
thirteen children under treatment for tuberculosis at the end of 1961, and this increased to a peak of twenty-five during the year, but at the end of the year had
reduced to about the same level as a year previously. This institution fills a very
important need in the tuberculosis-control programme, and the arrangements that
have been set up have proven most satisfactory over the years.
MORTALITY FROM TUBERCULOSIS
The changing trends in tuberculosis and the need to redirect the method of
attack on this disease are nowhere better demonstrated than in the mortality figures.
During the era of specific drug therapy for tuberculosis, this disease has changed
from a problem that most seriously affected the younger persons to a problem of
the older persons.  This fact is clearly shown from the following figures.
 TUBERCULOSIS CONTROL Y 87
Deaths from Tuberculosis in the Total Population, 1946, 1951, 1956, and 1961
Year
Under 50
Years of
Age
50 Years
of Age
and Over
Total
Ratio
1946
397
155
31
14
187
137
78
45
584
292
109
59
0.5:1
1951 	
0.9:1
1956         .	
1961   	
2.5:1
3.2:1
The dramatic decline in annual deaths from tuberculosis will be seen from this
table. At the beginning of the antimicrobial era, tuberculosis caused more than twice
as many deaths in persons under 50 years of age than in those 50 years of age and
over. In the next fifteen years the death rate in both groups was reduced, but the
reduction in deaths of persons under 50 years of age was over 95 per cent, while in
persons 50 years of age and over the reduction was about 75 per cent. During this
period the ratio of deaths among older persons as compared with younger persons
has changed from 0.5 to 1 in 1946 to over 3 to 1 in 1961. The annual number of
deaths in the total population during the same period had declined by 90 per cent in
spite of a marked increase in population. While tuberculosis in the older age-groups
results, for the most part, from infection acquired in early life, the disease, when it
develops, is frequently acute and well established.
L
 Y 88 PUBLIC HEALTH SERVICES REPORT,  1962
REPORT OF THE DIVISION OF VENEREAL DISEASE
CONTROL
During 1962 the upward trend in early infectious syphilis (primary and secondary) evidenced over the past few years was maintained, as the following figures
show: 1960, 56 cases; 1961, 64 cases; and 1962, 183 cases. The 1962 figure
represents an increase of more than 185 per cent over the 1961 figure.
The increase is not confined to British Columbia only. At a recent world forum
on syphilis, many major cities in the United States reported a marked upsurge in the
incidence of this disease.
In many places this has been blamed on the greater number of cases being found
in the younger age-groups, but as far as British Columbia is concerned, this is not
the situation. The disease here is largely confined to the population who frequent
" skid road." However, there does appear generally to be an increase in promiscuity; female prostitution has been largely replaced by the careless " good-time
girls " who treat venereal disease in a very casual manner.
Male homosexuals still continue to be responsible for the spread of syphilis.
During 1962 about 20 per cent of total syphilis reported resulted from the practice
of homosexuality among males.
In November, 1962, after reviewing treatment schedules used in other parts of
Canada and the United States, new " Recommended Standards for Diagnosis and
Treatment of Venereal Disease " were introduced, the main changes being the shortening of the course of treatment necessary and a reduction in amount of penicillin
required for therapy.
Gonorrhoea has increased slightly in incidence—3,975 notifications or a rate
of 240 per 100,000 population in 1962, as compared with 3,670 notifications or a
rate of 225 per 100,000 in 1961. Although this infection is not considered as serious as syphilis, continued interest in this condition is necessary as it is in this promiscuous group of people that new syphilis cases will be found, the two diseases often
being spread concomitandy.
ADMINISTRATION
Dr. A. A. Larsen, the previous Director, was transferred to the Health Branch
office in Victoria. Dr. J. H. Smith was appointed as the new Director of the Division in April, 1962.
In view of the fact that the new Director had other responsibilities in the Bureau
of Preventive and Treatment Services, it was decided to employ a well-experienced
public health nurse with administrative experience to act as Assistant Director. She
would be responsible for co-ordinating procedures and activities among nursing,
epidemiology, and clinical staffs. In view of the increase in syphilis, the new
appointment was very necessary to adjust staff assignments, with more emphasis on
epidemiology in particular, which is the corner-stone of veneral disease control.
The Assistant Director has been selected and will take up her appointment
early in 1963.
As was mentioned in the 1961 Annual Report, it was hoped that arrangements
would have been completed for the Medical Health Officer of the Greater Victoria
Metropolitan Board of Health to take over the direction of the venereal disease control programme in Victoria. However, a few unexpected difficulties have arisen in
regard to accommodation, but negotiations are going ahead between the Health
Branch and the Greater Victoria Metropolitan Board of Health, and it is hoped that
in the near future these problems will be satisfactorily settled.
 VENEREAL DISEASE CONTROL Y 89
EPIDEMIOLOGY
As in previous years, this sphere of activity of the Division has received excellent co-operation from the Vancouver City Police, without whose help we would be
very much handicapped. Case-finding and contact-tracing are absolute essentials
in venereal disease control. Tracing must be persevered with until every patient with
early infectious syphilis produces at least one infectious or recently infectious case
from among the sex contacts. Reporting is an important factor in epidemiology,
and it is imperative that this be done whenever a case of syphilis is diagnosed. The
role of the private physician in this is important.
In venereal disease control every effort must be made to allow more staff to
engage in field work, particularly contact-tracing, and to bring all found contacts to
treatment as early as possible. Delay at this stage means probably several more
infections daily. Unfortunately, no short cuts are of value in the epidemiology of
venereal disease. The old methods used in case-finding and contact-tracing—
namely, that of interview-investigation procedures—appears to be the only method
of control and eradication of the disease. This can be frustrating work, especially
in cases when a patient is unable to give names of contacts or provides false information, and because of this the efforts on the part of the staff are often expensive
and time-consuming. The dearth of contact information is particularly the case with
" skid road " patients, who frequently have an accompanying alcoholic problem.
The homosexual patients are particularly difficult to deal with as they are very loath
to divulge the names of any of their contacts in spite of reassurances of absolute
confidentiality.
RESEARCH
During the summer, with the help of the National Health Grant, the senior
medical student employed by the Division during 1961 was re-employed to continue
his work on a research project, "Alternative Medication for Penicillin Resistant
Gonococci." This project was completed, and the medical student prepared it in
the form of a thesis for presentation as part of the requirements for his final examination.
As in previous years, Dr. Denys Ford, Associate Professor, Faculty of Medicine, University of British Columbia, has been continuing his investigation on the
etiology of non-gonorrhceal urethritis and its relation to certain forms of arthritis,
using the patients from the Vancouver clinic of the Division of Venereal Disease
Control as the subjects of his study. As part of this investigation, the clinic undertook to treat these cases even though this condition has not been proven a communicable venereal disease.
EDUCATION
The educational programme was similar to that of previous years. Classroom
instruction is given to medical students, public health nurses, and student-nurses,
with visits to the clinic provided for the latter two groups.
A number of doctors, particularly those employed in general practice, were
employed part time by the Division to operate the venereal disease clinics. An
attempt was made to limit these appointments to one year so as many physicians as
possible could benefit from this practical training. It is obvious that the more
physicians who can have this training in our clinics, the easier it will be to have
proper treatment of venereal disease carried out in the community, and also more
co-operation and understanding in tracing contacts.
 Y 90
PUBLIC HEALTH SERVICES REPORT,  1962
The public health nursing students came from the University of British Columbia and were given a one-week course of instruction covering the various phases of
venereal disease control.
Senior nursing students from Vancouver General Hospital spent three days
each in the main clinic of the Division, and the superintendent nurse gave lectures
at St. Paul's Hospital, the Royal Columbian Hospital, and the Vancouver Vocational
Institute. Lectures to medical students were presented by the senior clinical consultant and the Director of the Division.
In view of the resurgence of syphilis during the past year, thought has been
given to the methods which could be used to make the public more aware of this
serious threat. It would appear that only a small percentage of today's youngsters
learn anything about venereal disease from their parents. There is no doubt that
the general opinion among the public is that syphilis has been conquered by antibiotics and it is a disease of the past. This is certainly not the truth at the present
time.
PUBLIC AND SPECIAL CLINICS
As well as public clinics operating in Vancouver, New Westminster, and
Victoria, special clinics are available at Vancouver City Gaol, Willingdon School for
Girls, and the Juvenile Detention Home. The total of persons seen was over 20,000,
the majority of these being, of course, at the main clinic in Vancouver. Approximately 3,500 persons attended to have blood tests taken either for United States
immigration purposes or for pre-marital or pre-employment examination.
Public venereal disease clinics continued to operate in several of the outlying
health units—namely, Prince Rupert, Prince George, and Dawson Creek—under
the guidance of the Division of Venereal Disease Control. These clinics continue
to be well attended, and they are very valuable in keeping down the reservoir of
untreated venereal disease in the smaller centres.
 LABORATORIES Y 91
REPORT OF THE DIVISION OF LABORATORIES
In 1962 the two major events in the Division of Laboratories were the appointment of a second physician and the beginning of a special project to study the high
incidence of human salmonella infections in British Columbia. Two senior members
of the staff resigned, and replacements are being sought.
The work load of the laboratories showed no significant change in 1962 compared with 1961. The major increases in work load were in mycology, streptococcus serology, and routine tuberculosis bacteriology; these increases were offset
by decreases in examination of milk products, agglutination tests, and enteric
bacteriology.
In Table I the total number of tests and work-load units performed in the
main laboratories during 1962 are compared with the figures for 1961. The work
load in connection with the salmonella study, amounting in 1962 to nearly 25,000
units, is not included. The work loads for 1962 in tests and units performed at the
Nelson and Victoria Branch Laboratories are recorded in Table II. Each Dominion
Bureau of Statistics (D.B.S.) unit is equivalent to ten minutes of work.
TESTS FOR THE DIAGNOSIS AND CONTROL OF
VENEREAL DISEASES
The demand for standard tests for syphilis (S.T.S.) was about 2 per cent less
than in 1961 and over 20 per cent less than in 1958. The activity of complement
provided by the Connaught Medical Research Laboratories was compared with that
of the Laboratory of Hygiene complement; the Connaught product was found to
give satisfactory results. During 1962, 612 exudates from 342 patients were
examined by the darkfield technique for the presence of Treponema pallidum. Tests
on almost 30 per cent (100 out of 342) of these persons were positive in 1962,
compared with 13 per cent in 1961 and 10 per cent in 1960. These findings
suggest a considerable increase in the incidence of infectious syphilis in the population. The Treponema pallidum immobilization (T.P.I.) test was performed by the
National Laboratory of Hygiene and the Ontario Provincial Division of Laboratories
on 245 sera; positive results were reported on ninety-one patients (37 per cent).
The service provided by these two laboratories is gratefully acknowledged.
The demand for laboratory work in the diagnosis and control of gonorrhoea
increased by about 2 per cent in 1962. Ten per cent more specimens were submitted for microscopical examination, but 8 per cent less specimens were submitted
for culture. Out of 35,000 smears examined, 4,600 were positive (13 per cent);
out of 10,000 cultures investigated, 2,000 were positive (20 per cent). The percentages positive in 1961 were 13 and 15.
Other Serological Procedures
While the demand for serological tests used in the laboratory diagnosis and
control of typhoid fever, glandular fever, and brucellosis decreased, the number of
sera submitted for antistreptolysin titre (A.S.T.O.) for the diagnosis of acute rheumatism increased by almost 20 per cent. One hundred and eighteen sera were
shipped to other laboratories for tests not performed in this Division.
-
 Y 92 PUBLIC HEALTH SERVICES REPORT,  1962
TESTS RELATING TO THE DIAGNOSIS AND CONTROL
OF TUBERCULOSIS
The number of smears examined microscopically for Mycobacterium tuberculosis increased from 9,400 in 1961 to 9,700 in 1962 after decreasing from 16,000
in 1959 to 13,000 in 1960. A comparable increase occurred in the requests for
culture from 22,000 in 1961 to 24,000 in 1962.
The identification of M. tuberculosis and its differentiation from unclassified
mycobacteria became increasingly difficult in 1962 due in part to the development
of atypical characteristics by strains isolated from patients receiving antitubercular
drugs. This resulted in an increase in the number and complexity of laboratory tests.
All mycobacteria were tested for their sensitivity to streptomycin, isoniazid, and
para amino salicylic acid;  other drug-sensitivity tests were performed on request.
ISOLATION AND IDENTIFICATION OF PATHOGENIC
ENTERIC BACTERIA
The total number of specimens received for culture decreased from 19,000 in
1960 to 17,000 in 1961 and to 15,000 in 1962. The number of isolations from
persons infected with salmonella? reached a peak of 521 in 1961 but decreased to
443 in 1962. The number of isolations of persons infected with shigella? reached
a peak of 1,161 in 1960 but decreased to only 151 in 1962. The number of isolations from children infected with pathogenic Escherichia coli reached a peak of 207
in 1959 but decreased to only 103 in 1962. The peak year for bacteriologically
diagnosed gastro-intestinal infections was 1960 with 1,832 cases; only 697 cases
were discovered in 1962.   These findings are summarized in Table III.
The commonest salmonella? isolated from man during the five-year period 1957
to 1961 are compared with those isolated in 1962 in Table IV.
A pilot study was started in August, 1961, to discover reservoirs and vehicles
of human salmonella infection. Between August, 1961, and March, 1962, 325
specimens of food or animal material were examined, and salmonella? were isolated
from forty-two (13 per cent). These findings, together with the increased annual
incidence of bacteriologically demonstrated human salmonella infection during the
period 1941 to 1961, suggested that more intensive study of the salmonella problem
in British Columbia would prove rewarding. Accordingly, a salmonella project,
supported in part by Provincial funds and in part by a National Health Grant, was
introduced in April, 1962. In the first nine months of the project (April to December, 1962), 1,627 specimens of food or animal material were examined, and salmonella? were isolated from 135(8 per cent). This is a continuing project in which
the Provincial Health Branch is collaborating with the Provincial Department of
Agriculture, the Department of National Health and Welfare (Food and Drug Division and Laboratory of Hygiene), Canada Department of Agriculture, University
of British Columbia, selected hospitals, and the Greater Vancouver Metropolitan
Health Department.
SANITARY BACTERIOLOGY
The close co-operation between health unit directors and sanitary inspectors
and this Division in the conduct of the milk and water sampling programmes is gratefully acknowledged. This co-operation was facilitated by the appointment of the
Field Consultant in Sanitation, who spent two weeks in the Milk and Water Section
familiarizing himself with the laboratory problems associated with these programmes.
 LABORATORIES Y 93
Examination of Dairy Products
The number of samples of dairy products received during 1962 was 7 per cent
fewer than in 1961. This decrease was due to three causes: several dairies discontinued the sale of raw milk, several dairies closed, and several dairies were taken
over by larger dairies. Of the 528 milk shipments received in 1962, only two
arrived at the main laboratory at a temperature in excess of 10° C, and were therefore unsuitable for examination.
Examination of Water
The demand for bacteriological examination of water samples was similar in
1962 to that in 1961. Standard plate counts were performed on about 10 per cent
of the samples received. Close liaison was maintained with the laboratory of the
Greater Vancouver Water District.
Bacterial Food Poisoning
In 1962 sixty food remnants suspected of causing food poisoning were submitted for bacteriological examination. Clostridium welchii was isolated from jellied
turkey, the suspected vehicle of infection in a small food poisoning outbreak.
Coagulase-positive Staphylococcus aureus was isolated from three specimens —
devilled eggs, egg and salad sandwich, and cooked turkey. The devilled egg incident
and the cooked turkey incident each affected four members of the same family. The
egg and salad sandwich affected a group of people attending a cafeteria. A nose
swab from one of the food-handlers and a throat swab from a second food-handler
yielded on culture coagulase-positive Staph, aureus of the same phage type as the
strain isolated from the suspected food.
OTHER TYPES OF TESTS
Diphtheria
Virulent Corynebacterium diphtherial was isolated from three unassociated
patients during 1962, compared with one patient in 1961. Two of these patients—a
woman of 30 years and a woman of 40 years—had advanced diphtheria when seen
and died in spite of treatment with antitoxin. The third patient was a man with
conjunctivitis; C. diphtherial was isolated from the conjunctival exudate. No carriers were discovered among the close contacts of these patients.
Parasitic Infections
The demand for examinations for intestinal parasites rose from 1,600 specimens in 1955 to 5,000 in 1961. In 1962, 4,900 specimens were received. The
following protozoan parasites were identified in specimens of fa?ces: Entamoeba coli
(124), Giardia lamblia (113), Endolimax nana (54), Iodamoeba biitschlii (9), and
Entamoeba histolytica (3). The following helminth eggs were also identified: Tri-
churis trichiura (48), Clonorchis sinensis (26), Enterobius vermicularis (22),
hookworm (13), Ascaris lumbricoides (8), Tcenia spp. (1), and Diphyllobothrium
latum (1). The following adult worms were also seen: Ascaris lumbricoides (8),
Tamia saginata (3), and Diphyllobothrium latum (1). Out of 1,939 National
Institute of Health swabs, 405 revealed eggs of Enterobius vermicularis.
Fungous Infections
The demand for mycological investigation steadily increased from 450 in 1955
to 3,100 in 1962.    Between 1961 and 1962 there was an increase of over 25 per
 Y 94 PUBLIC HEALTH SERVICES REPORT,  1962
cent. The following dermatophytes were isolated and identified in 1962: Trichophyton rubrum (141), Microsporon canis (70), T. mentagrophytes (52), Epidermo-
phyton floccosum (12), T. tonsurans (11), and T. violaceum (1). Pathogenic
Candida albicans was isolated on 389 occasions and other non-pathogenic strains of
Candida on 305 occasions. Six cases of Malassezia furfur infection and two of
trichomycosis axillaris were diagnosed microscopically.
Once again over 30 per cent of the specimens submitted for mycological
examination proved positive.
Miscellaneous Tests
Of the 240 blood cultures submitted for examination, ten yielded organisms.
The bacteria isolated were coagulase-positive Staphylococcus aureus (4), coagulase-
negative Staph, albus (3), Aerobacter aerogenes (2), and Escherichia coli (1).
Viral Infections
Seventeen viral complement-fixation tests were performed on sera from seven
patients. Two sera from one patient were positive when tested with the mumps
viral antigen.
During 1962, specimens from eighty-six patients were submitted to the virus
laboratories of the National Laboratory of Hygiene. Enteroviruses were isolated
from eleven of these patients—Polio virus Type 1 (7), Coxsackie A 23 (3), and an
unidentified virus. Two of the patients infected with poliovirus are of interest: one
had received oral Sabin vaccine; the other subsequenly died of cerebral tumour.
Over 300 blood specimens from immunized and unimmunized children were
separated and sera shipped to the Connaught Medical Research Laboratories for
polio-antibody titre estimations.
Chemical Analyses
The work load was maintained at about 25,000 units in 1962. The resignation
of the chemist in October resulted in a decreased work load in the fourth quarter;
otherwise the work load for 1962 would have exceeded that for 1961.
BRANCH LABORATORIES
A senior bacteriologist visited the Nelson Branch Laboratory to carry out a
survey of the laboratory work load, to discuss the operation of the laboratory with
the Director of the Selkirk Health Unit, and to make recommendations. During
her visit she provided vacation relief for the technician in charge.
The same senior bacteriologist later visited the Victoria Branch Laboratory
and carried out a similar survey of the laboratory work load, techniques, and method
of operation. As a result of these visits, suggestions were made to the two laboratories for increasing efficiency.
GENERAL COMMENTS
Among the most significant achievements in 1962 was receipt of approval from
the Royal College of Physicians and Surgeons of Canada of the Division of Laboratories for advanced graduate training in bacteriology. Four physicians were given
postgraduate training in public health bacteriology. Eight members of the staff
lectured or instructed at the University of British Columbia in the Faculty of Medicine and in the Departments of Bacteriology and Nursing. Sixty medical laboratory
technology trainees attended the two one-week courses on serological techniques.
 LABORATORIES Y 95
The first progress report on the salmonella project (supported in part by
Provincial funds and in part by a National Health Grant) was submitted in October, 1962.
Plans for the establishment of the new virus laboratory were prepared; the
help of Dr. D. M. McLean, virologist, Hospital for Sick Children, Toronto, who
acted as consultant, is gratefully acknowledged. Dr. G. D. M. Kettyls, M.D.,
D.P.H., appointed physician specialist in February, received instruction in the Division and in the department of bacteriology at Vancouver General Hospital until
August, when he proceeded to the School of Hygiene, University of Toronto, to
attend the Diploma in Bacteriology course from September, 1962, to May, 1963;
his training was supported by a National Health Training Grant.
The chemist attended two courses at the Robert A. Taft Sanitary Engineering
Center, Cincinnati, Ohio, on a National Health Grant. The Assistant Director attended the fifth annual refresher course at the School of Hygiene, University of
Toronto; the theme was " Infectious Diseases." In August the Director presided
at the seventeenth annual meeting of the International Northwest Conference on
Diseases in Nature Communicable to Man, at Seattle. In December the Director
attended the seventeenth annual meeting of the Technical Advisory Committee on
Public Health Laboratory Services to the Deputy Minister of National Health and
Welfare, in Ottawa, and presented a paper at the thirtieth annual Christmas meeting
of the Laboratory Section, Canadian Public Health Association, in Quebec.
All members of the staff are to be congratulated on the maintenance of a high
standard of performance of their duties.
 Y 96
PUBLIC HEALTH SERVICES REPORT,  1962
Table I.—Statistical Report of Examinations and Work Load in 1961 and 1962,
Main Laboratory
Unit1
Value
1962
1961
Tests
Performed
Work-load
Units
Tests
Performed
Work-load
Units
Enteric Laboratory—
Cultures—
Salmonella-shigella 	
Pathogenic E. coli    	
Chemistry Laboratory—
Water—
Complete analysis	
7
10
100
150
4
2
3
1
2
5
15
6
5
5
5
5
5
2
2
2
2
5
1
2
2
2
2
2
2
3
4
2
10
25
25
6
2
3
13,274
2,097
113
485
25
4,482
4,037
2,794
333
1,378
13,429
60
6
11,180
10,959
3,829
3,106
10,037
34,618
125
3,362
12,959
2,532
124,615
1,558
8,952
1,706
11
49
70
612
17
86
648
1,174
312
24,260
9,674
4,909
92,918
20,970
11,300
9,838
3,750
17,928
8,074
8,382
333
2,756
67,145
900
36
55,900
54,795
19,145
15,530
50,185
69,236
250
6,724
25,918
12,660
124,615
3,116
17,904
3,412
22
98
140
1,836
68
172
6,480
29,350
7,800
145,560
19,348
14,727
15,034
2,293
121
477
34
4,849
4,355
3,144
375
1,459
13,485
52
4
11,717
11,500
3,311
2,463
10,967
31,190
132
2,885
14,341
2,133
125,668
1,522
10,288
1,795
26
78
79
365
63
100
632
1,222
259
22,374
9,403
5,054
105,238
22,930
12,100
8,081
B n,r>.
5,100
Milk and Water Laboratory—
Milk and milk products—
19,396
8,710
9,432
Resazurin.   	
Water—
375
2,918
67,425
780
Miscellaneous Laboratory—
Animal virulence (diphtheria)	
Cultures—-
24
58,585
57,500
16,555
12,315
54,835
Direct smear—
62,380
264
5,770
Serology Laboratory—
Agglut. tests—Widal, Paul-Bunnell, Brucella
28,682
10,665
Blood—
V.D.R.L. (qual.)     _   ..
125,668
V.D.R.L. (quant.)  	
3,044
Complement-fixation  	
C.S.F.—
20,576
3,590
52
156
158
Darkfield—T. pallidum	
Viruses—
1,095
252
200
Tuberculosis Laboratory—
6,320
30,550
6,475
Cultures—M. tuberculosis , 	
134,244
18,806
15,162
Totals  	
313,873
929,321
315,249
936,408
i One D.B.S. unit=10 minutes of work.
 LABORATORIES
Y 97
Table II.—Statistical Report of Examinations and Work Load during the Year 1962,
Branch Laboratories
Unit1
Value
Nelson
Victoria
Tests
Performed
Work-load
Units
Tests
Performed
Work-load
Units
Enteric Laboratory—
Cultures—
Salmonella-shigella  - - 	
7
10
4
2
3
1
2
5
15
6
5
5
5
5
5
2
2
2
2
1
2
2
2
2
2
3
10
6
2
3
172
1,204
1,235
494
840
717
663
181
1,648
3,480
15
5
1,261
1,261
91
489
426
516
13
148
566
15,641
182
1,185
353
267
269
13
5
1,447
838
454
8,645
4,940
Milk and Water Laboratory—
Milk and milk products—
708
571
340
137
2,832
1,142
1,020
137
3,360
1,434
1,989
181
Water-
3,296
2,056
10,280
17,400
Food poisoning examination— 	
Miscellaneous Laboratory—
225
30
Cultures—
402
402
525
2,010
2,010
2,625
6,305
6,305
455
2,445
2,130
Direct smear—■
303
6
38
313
3,848
20
606
12
76
626
3,848
40
1,032
26
Miscellaneous   	
Serology Laboratory—
Agglut. tests—Widal, Paul-Bunnell, Brucella
Blood—
V.D.R.L. (qual.)    	
296
1,132
15,641
V.D.R.L. (quant.) 	
364
2,370
C.S.F.—
	
706
534
538
	
39
Tuberculosis Laboratory—•
50
66
129
8,682
Direct smears—M. tuberculosis—	
33
43
1,676
1,362
Totals
9,917
28.663
34,703
93,588
i One D.B.S. unit=10 minutes of work.
Table III.—Pathogenic Enteric Bacteria—New Patients with Positive
Laboratory Results
Year
Salmonella;
Shigella;
Pathogenic
E. coli
Total
1957                                                      .	
1958
1959
I960
1961
1962    	
243
344
458
472
521
443
1
174
552
388
161
323
151
7
143
207
199
153
103
424
1,039
1,053
1,832
997
697
 Y 98
PUBLIC HEALTH SERVICES REPORT,  1962
Table IV.—The Commonest Salmonella; Isolated from Man in the
Five-year Period 1957 to 1961 and in 1962
No. and Organism
1957 to 1961
Average per
Year
1962
Total
1. S. typhi murium (B)..
2. S. heidelberg (B)	
3. S. thompson (CI)	
4. S. newport (C2)_. _
5. S. paratyphi B (B)	
6. S. typhi (D) 	
7. S. brandenburg (B)...
8. S. tennessee (CI)	
9. S. san diego (B)	
10. S. montevideo (CI)...
11. S.bareilly (CI)	
12. S. oranienburg (Cl)_
13. S. blockley (C2)	
14. S. saint paul (B)	
15. S. cholera: suis (Cl)~
....   Other salmonella?	
Totals..
620
591
258
133
127
37
30
29
28
26
18
10
10
6
3
112
2,038
124
118
52
27
25
7
6
6
6
5
4
2
2
1
1
22
408
34
163
120
38
10
6
5
7
4
15
7
261
443
1 Includes cultures not yet identified.
 OCCUPATIONAL HEALTH DIVISION Y 99
REPORT OF THE DIVISION OF OCCUPATIONAL HEALTH
The Division of Occupational Health has been transferred to the Bureau of
Special Preventive and Treatment Services, and the new Director, who took up his
appointment in April, 1962, is located in Vancouver. This move was considered
necessary as most of the industrial development is taking place in the Lower Mainland area, and also the staff of the Occupational Health Division have more opportunity to meet and work with other specialists in this field, be they physicians,
engineers, chemists, or inspectors.
To date the Director has been reviewing the programmes which have been
developing since the Division was established in 1952, and a start has been made
to improve the effectiveness of the Employees' Occupational Health Service.
In respect to occupational hygiene, other departments of government, such as
the Factories Branch of the British Columbia Department of Labour, the Workmen's Compensation Board, and the Federal Food and Drug Directorate, have been
visited in order to ascertain the extent of their activities in this field, and also the
facilities they have available, so that in future development duplication of services
may be avoided, or, better still, co-ordination of activities may be established.
There were several highlights during 1962—the main one being the occasion
of the Third Annual Occupational Health Conference, when the Minister of Health
Services and Hospital Insurance, the Deputy Minister of Health, and the Director
of the Division were all speakers on the programme. Their presentations were
designed to emphasize the importance of occupational health as a part of generalized
community health.
During the year the Director attended a course on radiation protection given
by Atomic Energy of Canada Limited at Chalk River, Ont. He attended also the
Ninth Annual Pacific Northwest Occupational Health Conference, held in Portland
on September 10th and 11th.
EMPLOYEES' OCCUPATIONAL HEALTH SERVICE
When the employees' occupational health programme for employees of the
Provincial Government was first established, arrangements were made with the personnel officers of the various Government departments for referral of problems
which might involve health factors. Unfortunately these referrals have not been
forthcoming as expected, or they have been made at a stage when very little can be
done about them as far as the Occupational Health Service is concerned.
In order to identify health problems at an early stage, plans are being made
with the British Columbia Civil Service Commission to have the Medical Declaration Report replaced by a new form consisting of two sections. One section of this
will go to the employee's department and contain information indicating estimated
absence from work and recommend any necessary work limitations when he returns.
The other section will contain the above information plus the attending physician's
confidential report on the nature of the illness, and will be sent directly to the Medical Director of the Occupational Health Service. When provided with this information, which should be more reliable as it is now confidential, the Occupational
Health Service will be in a position to detect potential health problems early. These
new forms are now being printed and should be ready to use at the beginning of
the new year.
The services of a part-time physician have been obtained for the Occupational
Health Centre in the Legislative Buildings.  This was necessary as the Director of
 Y 100 PUBLIC HEALTH SERVICES REPORT,  1962
Occupational Health Services was no longer located in Victoria and so was unable
to give service at this Centre.
The occupational health programme is building up gradually in the Vancouver
area. The nurse attends five different Government centres routinely each week, as
well as making visits to other departments when so requested. The doctor also
makes visits to the centres to see employees who have been referred for his attention.
The total number of services given by the occupational health nurse at the various
Vancouver centres was 2,454.
The establishment of a well-equipped examination-room at the Provincial
Health Building in Vancouver would be of great value to the Service, and arrangements are being made to set this up during 1963.
OCCUPATIONAL HYGIENE SERVICES
Industry in British Columbia could be provided with a good occupational
hygiene service if more co-ordination of efforts could be established. The control
of environment requires the services of several disciplines, none of which can deal
with the problem adequately when working alone. This team approach is now
recognized as the most logical and efficient method of dealing with environmental
health problems. The scientific skills usually required by such a team are those of
medicine, engineering, and chemistry. In British Columbia we have the necessary
trained personnel to make up the hygiene team, but a co-ordinated approach must
be maintained.
In the last few months the Director has been doing some work with the Factories Branch and has gone on tours with the Inspectors to assist in assessment of
health hazards. This liaison with the Factories Branch will undoubtedly expand
and could be extended to all areas of the Province as the work of the Factory Inspectors is similar to that performed by the sanitarians. Contact has also been
made with the Department of Mines and Petroleum Resources. This involved a
visit to a mining area to observe an operation which was thought to be hazardous
to health.
Radiation survey reports, which were considered to be of value in settling
employee claims, were made freely available to the Workmen's Compensation Board
whenever requested.
RADIATION PROTECTION SERVICES
With the transfer of the Occupational Health Division from Victoria to Vancouver and the appointment of another radiation inspection technician, it has been
possible to expand the programme to cover a wider field, particularly relating to
industry. This resulted in the carrying-out of the first inspection of oil-well drilling
operations in Northern British Columbia where radioisotopes are extensively used
in a process called " well logging."
Radioisotopes are being used more and more in a variety of situations. Examples of these are geological exploration, thickness gauges, anti-static devices in
the pulp and paper industry, and industrial radiography. Also, isotopes are useful
in many types of research projects. The Health Branch receives copies of licences
which are required by all radioisotope users. These are issued by the Atomic Energy
Control Board and have been coming in to the Department at an average of eight
per month. There are approximately 125 current licences for the use of radioisotopes in the Province. These are routinely checked, and on forty-six occasions a
complete radiation survey of the operation was performed.
 OCCUPATIONAL HEALTH DIVISION Y 101
Excellent co-operation is being received from the health professions as efforts
continue to keep radiation exposure to the public at a minimum consistent with good
medical practice as recommended by their respective associations and this Division.
A close working relationship has been developed with the Radiation Protection
Division of the Department of National Health and Welfare and the Atomic Energy
Control Board in Ottawa, and although their requests for information and inspections have increased, the technicians have been able to deal with these as the work
involved is often closely related to the radiation programme.
The Provincial law-enforcement bodies, the Provincial Fire Marshal's Office,
and the Division have been participating in the development of a plan to deal with
vehicular accidents and outbreaks of fire where there is involvement of radioactive
material.
Results obtained from the Film Badge Monitoring Service of the Department
of National Health and Welfare led to several investigations where overexposure
had occurred. In most cases, changes in operating technique and some mechanical
adjustment to equipment corrected the hazard. The value of this monitoring service is beyond question, and every person handling radiation equipment of any kind
which is capable of giving out harmful ionizing radiation should be encouraged to
use it.
Radiation inspections and surveys carried out this year totalled 177, and these
included users in industry, commercial establishments, and many medical and dental
offices. The greatest problems were again found to be the lack of proper shielding
due to the absence of lead diaphragms or aluminum filters on the X-ray machines
and lead aprons and partitions for the protection of patient and operator.
Other related services carried out by the Radiation Protection Section are listed
under " Radiological Services " in the report of the Bureau of Special Preventive
and Treatment Services.
MISCELLANEOUS ACTIVITIES
Two papers were given by the Director on occupational health topics at the
Health Officers' Refresher Course held in February, 1962.
Air-pollution problems have been coming more and more to the fore, and
assistance has been given to several health officers in dealing with these matters.
 Y 102 PUBLIC HEALTH SERVICES REPORT,  1962
REPORT OF REGISTRY AND REHABILITATION SERVICES
THE REGISTRY
Integration of the Registry and Rehabilitation Services has continued during
the year, and some policy covering both areas has been evolved. The number of
registrations has increased to 22,700, of which approximately 1,700 are adults and
21,000 are children under 21 years of age.
The registration of children proceeds at a steady pace between 150 and 200
registrations per month. The registration of adults has been very slow, although
registration from health units has been requested during this last year. It may be
that with the establishment of the principle that cases being discussed at the Local
Rehabilitation Council be registered will cause the adult registrations to rise.
The work with regard to the Family Registry has continued during the year,
and the geneticist has reviewed 5,061 individual records. Of these records, 16 per
cent or 800 cases were members of family groups. These family groups number
372 families. As well as reviewing cases, the geneticist visited Chalk River and
assisted the Head of the Biology Branch, Atomic Energy of Canada, in matching
the Registry cards in the record linkage system. During his time at Chalk River,
he experimented with the linkage principle and how this would operate in evolving
the total family groups. The geneticist has also during the year worked very closely
with the Registry and the medical staff of the Health Centre for Children in improving registration procedures in that area. He has been very active with parent groups
in the various specific disease entities and has done a great deal to persuade these
groups that registration of themselves and their children would be extremely beneficial to the study of the disease entities with which they are concerned. The Registry has felt greatly benefited by having him as a consultant.
Considerable work has been done by the Registry with the Health Centre for
Children to facilitate easy registration from this area, and this appears to be working very well. There has also been a plan evolving to allow lay members of specific
disease organizations to register their members by the use of a short-type form which
can be completed by a lay person and then signed by either a family physician or
the local health officer. This plan will be in operation shortly, and it is hoped that
this will increase registration in groups that are not as adequately registered as other
more spectacular groups.
There has been a great deal of interest in the Registry by persons outside of
British Columbia, and during this year a constant stream of visitors has reviewed
the Registry work and considerable material has been issued upon request all over
the world.
All staff members of the Registry still participate on commmittees and executives of voluntary agencies in order to offer co-ordinating service both on the individual patient level and on the agency level.
REHABILITATION SERVICES
The Rehabilitation Services has continued to carry a small case load of its own
in the field of vocational rehabilitation. This has been derived from referrals by
outside agencies, including private and public health and welfare agencies, hospitals, private physicians and employment services, and by the Registry, as well as a
considerable number of social welfare cases selected in the Nanaimo and Chilliwack
surveys and in other areas.
 REGISTRY AND REHABILITATION SERVICES Y  103
As these surveys have developed, the staff of this department has devoted much
time to the setting-up of rehabilitation teams in the local areas to deal with rehabilitation problems on the local level.
The details have been worked out by the staff of the Central Rehabilitation
Services as a result of experience gained in the surveys, and continuing supervision
and assistance are being given to the local teams. This has enabled the central staff
to extend its activities to other regions of the Province. A similar rehabilitation
programme has now commenced in the Prince George region, while interest in developing such projects has been expressed by at least four other communities in the
Province. It is hoped that eventually many of the outlying population areas will
have their own rehabilitation teams capable of conducting their own programmes,
but with a loose control and supervision by the Central Rehabilitation Services.
This should increase considerably the scope of rehabilitation throughout the Province, besides stimulating interest in the development of local services.
Furthermore, as a result of the development of local rehabilitation teams, there
has developed a closer liaison between the various services involved—the practising
physicians, the British Columbia Medical Association, the Local Health Services,
the British Columbia Hospital Insurance Service, the Mental Health Services, the
welfare services, the Department of Education, and the National Employment Service. This co-operation at the local level has necessarily led to a closer association
at higher levels of central control.
Co-ordination of rehabilitation in the community is steadily improving, and
many community agencies have one or more members of the Rehabilitation Services
on their boards.
Discussions on various aspects of rehabilitation have been held throughout the
year with medical and paramedical groups, as well as with many agencies concerned
with providing a service to the handicapped in the community.
The Vocational Rehabilitation of Disabled Persons Agreement with the Federal
Department of Labour has not materially altered the basic Provincial programme,
though it should markedly facilitate and increase the range of services available.
Casework of the Rehabilitation Services
In the casework service referred to above, during the last year 123 cases were
accepted for service and included those with mental as well as physical disabilities.
While direct services, with the exception of some vocational counselling, are
not undertaken by the Rehabilitation Services, a careful analysis of the presenting
problems is made in each accepted case. Such services as may be relevant are
arranged in a logical sequence, and appropriate agencies are requested to provide
such attention as may be required in each individual case. Thus the resources
within the community are mobilized and co-ordinated for the benefit of the disabled
person.
Case Load of the Rehabilitation Service
Cases active at January 1, 1962  109
Cases deferred at January 1, 1962       2
Cases accepted January 1, 1962 to December 31, 1962  123
  234
Cases active at December 31, 1962  147 147
Cases deferred at December 31, 1962       4
Caseload at December 31, 1962  151
Cases closed, January 1, 1962, to December 31, 1962     87
 Y 104 PUBLIC HEALTH SERVICES REPORT,  1962
Eighty-seven closures were reported, which is an increase over last year. Of
the eighty-seven, sixty were receiving Social Allowance and the remaining twenty-
seven were supported by private resources at the time of referral. Of the eighty-
seven closed cases, fifty-six were closed after the goal of job placement had been
obtained. Thirty-one cases were closed without obtaining employment, but other
benefits, such as improved physical condition and personal independence, accrued
as a result of Rehabilitation Services.
At closure, fifty-five of the eighty-seven were employed and financially independent. Two applied for and received War Veterans' Allowance, sixteen remained
on Social Allowance, and one is presently receiving a combination of the two. Thirteen continued to be supported by parents or relatives.
It is interesting to note that the annual public cost of supporting those who
were receiving Social Allowance at acceptance was nearly $73,000. At closure the
total cost of supporting those who had not achieved job placement and financial
independence had been reduced to just over $18,000. The annual earning of those
placed in employment exceeded $122,000, which does not take into account the
earnings of six closed cases whose earnings were not reported.
Twenty-three of the eighty-seven closed cases had received vocational training
under the provisions of Programme 6 of the Canadian Vocational Training Agreement. Thirty-seven others were placed directly into employment commensurate
with their physical and mental ability.
Printed by A. Sutton, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1963
660-263-5200

Cite

Citation Scheme:

        

Citations by CSL (citeproc-js)

Usage Statistics

Share

Embed

Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                        
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            src="{[{embed.src}]}"
                            data-item="{[{embed.item}]}"
                            data-collection="{[{embed.collection}]}"
                            data-metadata="{[{embed.showMetadata}]}"
                            data-width="{[{embed.width}]}"
                            data-media="{[{embed.selectedMedia}]}"
                            async >
                            </script>
                            </div>
                        
                    
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:
https://iiif.library.ubc.ca/presentation/cdm.bcsessional.1-0363984/manifest

Comment

Related Items