WORLD HEALTH ORGANISATION
Regional Office for Europe,
Palais des Nations,
Geneva
Réf :
EUR-014.1.
10th August, 1954
Dear Sir,
In accordance with the principles of full exchange of information between the Regional Office for Europe of the World Health Organisation and the Council of Europe, I am transmitting to you herewith a copy of the Report (EUR/RC4/2) which I shall be presenting to the Regional Committee for Europe at its next session.
This report covers the year 1954, with particular reference to activities already implemented or to be implemented before the end of the year.
May I draw your attention to the main aspect of WHO programmes in Europe consisting of work carried out within individual countries in the Region and including a fellowship progamme, as summarized in Table III, and the inter-country programmes (Tables I and II), which outline the co-operation in many fields of public health between Member States in Europe.
I hope that this report will provide the Council of Europe with a broad indication of the trend of WHO activities in Europe during 1954 and I am, entirely at your disposal to supplement the information in any way desired.
Sincerely yours,
signed : Norman D. BEGG,
Director
The Secretary-General
Council of Europe,
Strasbourg
The work of W.H.O in Europe continues within the framework of the long-term objectives endorsed by the Regional Committee in 1952. Whilst it may be advisable in the not too distant future thoroughly to review these objectives in the light of present regional needs, there is little doubt that they have contributed materially to the present level of co-operation in public health between Member States of the Region. The year under review opened with a financial crisis exceeding in severity that of 1953, and yet it was found possible by adjustments of one kind or another to avoid too serious interruptions in those aspects of the long-term programme which were planned to take place in 1954. Action taken during the Seventh World Health Assembly will undoubtedly have a stabilizing effect on the regular programme in Europe within the near future. The desirability of avoiding recurring interruptions in the execution of the total programme arising from difficulties in one source of funds needs no further emphasis.
In 1954 the following Members or Associate Members have participated in the work of the Region : Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Monaco, Morocco, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, Tunisia, Turkey, United Kingdom, Yougoslavia. It must be recorded with regret that the following countries in the Region have not yet resumed active participation in the work of "W.H.O : Albania, Bulgaria, Byelorussian S.S.R., Czechoslovakia, Hungary, Poland, Roumania, Ukrainian S.S.R., U.S.S.R.
The selection of Copenhagen as a permanent site of the Regional Office was recommended by the Regional Committee at a special session during May and endorsed by the Executive Board at its fourteenth session.
This highly desirable step in the acceptance of decentralized responsibilities by the Regional Office will be taken as early as the necessary ai'rangements can be made. The decision to establish the Regional Office away from Headquarters will call for a future, revision of the. staffing pattern, particularly in regard to administrative finance and general servicing functions, but lias no immediate effect, on tlie staffing pattern for the present year. Vacancies established in 1953 for regional health officers in Mental Health and Nursing have now been tilled. On the other hand, the fact that Technical Assistance funds fell considerably short of what had been anticipated precluded the possibility' of maintaining three area health officer positions in the departments of Endemo-Epidemic Diseases, Health Education of the Public, and Medical Libraries. The difficult situation this created was temporarily solved by a re-distribution of technical responsibilities but it is extremely doubtful that all these technical functions can be adequately maintained for the future even with the employment of consultants. The only other staff change in the year was the appointment of a translator to meet the growing difficulty in providing this service from Headquarters.
During thé year the co-operation with agencies on programmes continued. The Regional Office regularly utilizes the training facilities at the International Children's Centre in Paris, and jointly plans and carries out programmes with UNICEF. F.A.O participated in the Seminar on Meat Hygiene in Copenhagen, and a sample survey was carried out oh child refugees in camps in Europe at the request of the High Commissioner for Refugees, During the year a number of the staff of the Rockefeller Foundation were re-assigned to areas other than Europe. During the formative stage of the work of W.H.O. in Europe we have enjoyed the closest working arrangements with the staff of the Paris Office of the Foundation and have benefited greatly from this experience. It is expected that ways will be found so that this kind of informal and valuable co-operation will continue.
During March, the Regional Office was consulted by the Council of Europe on some programme suggestions which had been made to the Council for the development of European co-operation in the field of public health. After a preliminary exchange of views, it was decided that the Council of Europe would convene a Committee of Experts to examine these proposals and to make recommendations. It is anticipated that the Regional Director will be in a position to present a full report on this matter at the time of the fourth session of the Regional Committee.
In the years 1953 and 1954, with the serious lack of technical assistance funds to carry out planned programmes, it is natural that priority should have been given to regions other than Europe. In effect, the total expenditures of Technical Assistance funds in Europe declined from approximately $ 580,000 in 1952 to $ 320,000 in 1953. It is anticipated that the total for 1954 will not greatly exceed $300,000 including bonus allocations specially designed to provide for the use of certain local currencies. Descriptions of the projects within individual countries are set out later in this report. In general, it can be said that minimal programmes involving a certain number of fellowships were implemented mainly in Austria, Finland, Greece and Spain. In Morocco (French zone) and Tunisia, Technical Assistance funds were used mainly to complement trachoma control projects for which the main personnel costs in 1954 were borne by UNICEF, whereas it was possible, although on a reduced scale, to continue the general public health programmes in Yugoslavia and Turkey.
The relative availability of certain Technical Assistance currencies also made it possible to carry out some activities originally planned under the regular programme for which regular funds could not be found within the reduced allocation, c. g. a teaching seminar for doctors fulfilling administrative functions and public health nurses, held in Istanbul.
These experiences in 1953 and 1954 emphasize the particular necessity in Europe to bring essential programme activities within the regular budget as rapidly as circumstances will allow.
The adjustment of total funds in all the WHO regions to meet the financial crisis resulted in a reduced allocation of regular funds to Europe in 1954. So fa-r as was possible, this situation was met by reducing temporarily the financial participation of the Organization and not by deferring projects for which planning had far advanced before the crisis became apparent. As mentioned in the previous paragraph, some inter-country activities were saved through the relative availability of certain Technical Assistance currencies.
Within the individual countries, regular programmes followed the traditional emphasis on the fellowship programme and on assistance to training institutions, particularly those providing post-graduate training in public health. Provision was made also for the continuation of programmes of assistance in the care of physically handicapped children. A summary of these and other activities within the individual countries is set out in the text which follows.
In 1953, fellowships awarded in Europe numbered 287, of which 213 fellowships were in the regular programme, 63 in the Technical Assistance programme, and 11 from funds made available by UNICEF. Fellowships awarded or approved during the first six months of 1954 are set out in Table III. They include a total of 113 fellowships, 96 in the regular programme, 15 in the Technical Assistance programme, and two from UNICEF funds. From fellowship applications in hand and available resources, it is anticipated that the final figures for 1954 will not differ greatly from those for 1953.
The whole machinery of fellowship application, placement and supervision during study is steadily improving,and this is due in no small measure to the in formal exchange of views with Members of the Regional Committee during the third regular session in 1953. Much has still to be done oil follow-up and evaluation, but the prospects of a smoothly operating fellowship; programme well integrated with the other aspects of W.H.O's work in Europe appear better now than at any period in the development of the Organization.
The essence of co-operation in public health between Member States in Europe is contained within the Inter-Country Programmes which are set out in two parts in the Appendix to this report. Table I describes the inter-country programmes which were carried out in 1954 in the period up to the end of June, and Table II lists inter-country programmes designed to take place in the second half of 1954. Whilst such tabular statements are convenient for reference, it should perhaps be borne in mind that they do not reveal the long-term character which characterizes the inter-country programmes.
For example, the Conference on Immunization in Frankfurt had direct relationship to the Conference on Vaccine Production against Whooping Cough and Diphtheria which preceded it in 1952, just as the teaching Seminar for Nurses in Istanbul will trace its content to the problems revealed at the previous Conferences of Public Health Nurses in Noordwijk and Mont Pèlerin.
In 1954, the Public Health Àdministalion Study Group visited Italy and Germany, thereby bringing to a total of seven the countries in Europe which have so far been visited by this Group. Similarly, the Conference on School Health Services in Grenoble will be greatly facilitated by the previous Study Tour of School Health in Services in Denmark and the Netherlands, and progress on treatment of alcoholism during the meeting in Noordwijk owes very much to the previous seminar on the general medical and social problems of alcoholism in Copenhagen. Perspectives of similar character could be revealed in an analysis of other programmes such as mental health, environmental sanitation, the results of which will soon require careful evaluation in regard to their long-range results.
As experience is gained in these inter-country programmes, it is evident that more could be achieved with a more careful definition of objectives and with more attention to the techniques in the preparation, conduct and follow- up of the inter-country meetings of one kind or another which occupy so much attention in our programmes in Europe.
(Work which was, or is to bo, carried out with Technical Assistance Funds is marked witli an asterisk)
This section of the report is restricted to activities actually carried on within each country during the first half of 1954 ; the participation of Governments in the inter-country programmes is recorded in Table I and will not necessarily be recorded again in this section. Inter-country activities which are to take place during the second half of 1954 are listed in Table II. The number of fellowships awarded is shown in Table III.
WHO assistance to the comprehensive health programme * of Austria will chiefly consist this year in fellowships in the fields of tuberculosis, environmental sanitation and sera and vaccine production. The visit of a consultant to advise on the last item is planned for the near future.
The Regional Health Officer for mental health visited Vienna to discuss the planning of courses in psychiatry to which W.H.O will contribute two short-term consultants.
UNICEF supplies and equipment were delivered for the Rehabilitation Programme for Handicapped Children, and a request for a WHO fellowship for a physician to be attached to this Programme has been received.
At the request of the High Commissioner for Refugees, à pilot survey will be carried out on the effect of camp life on the mental health of children resident in refugee camps in Europe. Permission has been granted by the Austrian Government to start with this survey in the camps sited in Austria, and it is expected that a survey team, composed of four members of the Institute of Preventive Medicine in Ley-den (Netherlands), will begin their work in August.
An individual fellowship was awarded to Austria,under the regular programme in the field of leptospirosis. A second fellowship in maternal and child health is approved.
Austria participated in the inter-country programmes as shown in Table I.
The Government of Belgium acted as host country to the second part of the Advanced Training Course- for Waterworks Supervisors. The first part was held in the Netherlands. Twenty-two Belgian experts lectured on the subject of drinking water supply.
The WHO Regional Adviser for health education of the public visited Belgium to discuss health education programmes with the Belgian authorities and to assist with new developments.
Two individual fellowships were awarded to Belgium in the fields of hospital organization and epilepsy. Two additional fellowships in the fields of endemo-epidemic diseases and PH administration are approved.
The participation of Belgium in the inter-country programmes is shown in Table I.
W.H.O and the Rockefeller Foundation continued to assist the Government of Denmark in carrying out a morbidity survey plan, which is now in its third year, and it is expected that the nation-wide morbidity survey will be able to reveal important results which will be of interest to other countries. Two short-term consultants are being recruited. A small amount of supplies was delivered. A WHO fellowship was awarded last year to an assistant statistician in the National Health Services who has now returned from his training abroad.
The fourth basic course given at the Anaesthesiology Training Centre, Copenhagen, ended on the 29th May. W.H.O. provided an international lecturer to support the Danish instructors in charge of the teaching responsibilities. A WHO fellowship was granted to a Danish instructor for further training in the USA. The fifth course0 is scheduled to start on the 2nd August.
The Regional Health Officer for mental health visited Denmark to discuss the organization of psychiatric courses following on the 1953 courses. It is planned to continue this activity in 1956.
The Danish Government acted as host country to the Seminar on Meat Hygiene which took place at the Institute of Hygiene and Bacteriology of the Veterinary College, Copenhagen, in February. In addition to the lectures given, laboratory demonstrations and visits to slaughter-houses were arranged. Twenty-nine participants (veterinarians and medical officers) from twenty cotmtries in the European Region attended. Eleven Danish medical officers and veterinarians also attended as observers.
Denmark was awarded three individual fellowships in the field of child guidance, internal medicine and PH administration. Two additional fellowships in mental health are approved.
Denmark also participated in the inter- . country programmes as shown in Table I.
WHO asistance to the comprehensive health programme* of Finland will be restricted this year to fellowships to be granted in connexion with PH administration, nursing and environmental sanitation. So far only one fellowship in nursing has been awarded. Applications for the other fields are awaited.
The WHO Regional Officer for health education of the public attended a National Multi-Disciplinary Conference on Health Education which was held in Helsinki in March. Prior to the Conference, the WHO Regional Officer also presented some talks on health education at the Annual Institute of the Association of Finnish Nurses.
Finland was awarded an individual fellowship in mental health (a second fellowship in the same field is approved) and participated in the inter-country programmes as described in Table I.
The Regional Health Officer for public health administration visited France to discuss with the authorities the French system of education in hygiene and preventive and social medicine. The School of Public Health in Paris and other institutions throughout France continned to offer training facilities to WHO-spon-sored fellows.
Additional UNICEF equipment and supplies were delivered for the expansion of the Premature Infant Programme.
France acted as host country to the Conference on School Health Services, which was held in Grenoble in June and attended by 26 participants from 22 countries in the European Region, viz. 22 school physicians with administrative or practical experience, 3 school nurses and a dentist, director of a large child dental institution. In addition, representatives from the French Government were present as well as the Director General of the International Children's Centre and two representatives from UNESCO. The discussions were on some selected topics of school health services which are of basic importance, such as : extent of, and gene-ral legislation on school health services, team work, i. e. personnel and collaborators in school health services, school medical examinations, school dental health services, health and work at school, health education at school. A WHO consultant assisted in the preparation of the Conference.
Eleven leaders in the field of public health from the European Region and members of the Secretariat of W.H.O. met in Lyons in June to initiate preparation for the next European Conference on Health Education. It was agreed that the proposed purpose of the Conference would be " to explore the needs, activities and resources for training health and education personnel in health education of the public ".
The final report on the study of the health and welfare needs of the family unit, which was carried out simultaneously in France and the United Kingdom during the years 1951-1953, is now being drafted by two members (one French, one English) of the Technical Advisory Committee. It is expected that the report will be completed within the next few months.
W.H.O. continued to assist in the study on the effects of child development arising from separation from the mother which has been carried on in France and the United Kingdom since 1952 under the sponsorship of W.H.O. and the International Children's Centre.
The Regional Health Officer for social and occupational health visited France to discuss with the authorities the possibility of organizing a'refresher course on occupational health in Paris, possibly in 1955.
The Demonstration and Training Centre in rural public health at Soissons is developing and preparing for its role in practical teaching of health personnel. W.H-,0. continued to support the statistical services rendered by a part-time statistician. A WHO fellowship will be awarded shortly to the statistician for further training abroad.
W.H.O. continued, to collaborate closely with the International Children's Centre to ensure the co-ordination of work, particularly in training. W.H.O. provided 11 fellowships for attendance at the training courses on the Rehabilitation of Handicapped Children and on Social Paediatrics. Three additional fellowships are earmarked for the course on Prevention and Treatment of Tuberculosis in Children, to start in October.
The courses given at the Anaesthesiology Training Centre in Paris are going on as usual. Two 1953 WHO trainees have had their fellowships extended for further studies in 1954.
Eight individual fellowships were awarded to France in the fields of rehabilitation, maternal and child health and PH administration. Three additional ones are ap-' proved.
The participation of France in the inter-country programmes is described in Table I.
Germany acted as host country to the Conference on Immunization which was held in the Studentenhaus of the Johann Wolfgang Goethe University in Frankfurt/Main in March. Thirty-one participants from 22 countries in the European Region attended. Twenty-five German observers were also present. W.H.O. provided ten international discussion leaders to conduct the Conference. The purpose of this was to present for discussion modern methods of immunization, and to permit participants to develop or strengthen sound practices in their own countries.
The Public Health Administration Travelling Study Group, composed of 19 medical administrators from as many countries in the European Region and two sanitary engineers, visited Germany, 1-15 April, to study the health services in the country. The Group, directed by two WHO consultants, held discussion sessions on the basis of their observations and on topics of a more general nature.
W.H.O. contributed two medical consultants to the Conference on Psychological Services for Schools and Other Educational Institutions which was held in Hamburg in April under the sponsorship of UNESCO.
An individual fellowship in PH administration was awarded to Germany. Five additional applications for various fields of study are under consideration.
Germany also participated in the inter-country programmes as shown in Table I.
The responsible Regional Health Officer paid a short visit to Greece in February to discuss the programme on Rehabilitation of Handicapped Children for which W.H.O. has provided the services of a medical director-consultant and an orthopaedic nurse. IJNTCEF supplies were delivered to the Voula Rehabilitation Centre, which is expected to open shortly. The local personnel is being trained, and the Greek holders of fellowships who studied in the United Kingdom in 1953 are prepared to take up their duties in the programme.
The physicians who are to operate the mobile units of the MCH programme in the Thessaly Region are now attending a national refresher course. W.H.O. will provide a social-paediatrician who will take up his diaties in Greece towards the end of the aforesaid course. Additional UNICEF supplies were delivered.
A WHO consultant visited Greece in March to advise the Ministry of Health and the direction of the School of Hygiene in Athens on the development of post-graduate training in the School.
WHO assistance to the Tuberculosis Programme* in 1954 will be restricted to fellowships.
Greece participated in the inter-country programmes as shown in Table I and was awarded an individual fellowship in the field of anesthesiology.
Iceland took part in the* Travelling Study Group which visited Italy and Germany. Icelandic participants also attended the Seminar for Sanitary Engineers, held in Opatija, and the Conference on Immunization, held in Frankfurt/ Main.
Three individual fellowships were awarded to Ireland for study in PH administration, and the candidates who are to hold the posts of psychiatrist and child psychologist at the Child Guidance Clinic in Dublin were granted an additional year's training prior to their assignment to the Clinic.
Ireland also participated in the inter-country programmes as described in Table I.
A WHO consultant on physical medicine spent six months in Italy to assist the Government in their Rehabilitation Programme for Handicapped Children. His objectives were : to train physiotherapists to staff the Physiotherapy Departments in Rome and Parma; to open the Rome and Parma centres; to initiate a general rehabilitation scheme in the Fdndazione Pro Juventute. The Rome centre was inaugurated in .March with a former WHO Fellow as medical supervisor ; the Parma centre opened shortly after Easter. Courses sponsored by the National War Invalids' Service were run by the WHO consultant for 16 national physiotherapy students. Three of them have been appointed at the Pome centre and two at the Parma centre. UNICEF equipment was delivered and installed.
The responsible WHO Regional Health Officer visited Italy in February in connexion with the WHO/UNICEF programme for the care of premature infants. A draft agreement was submitted to the Government for the expansion of the programme in seven centres which had not previously received UNICEF aid. These centres are sited in the cities of Bologna, Padua, Turin (2), Perugia, Bari and Palermo. The centre at the University Paediatric Clinic in Turin was officially inaugurated during an International Medical Congress. The WHO Regional Health Officer attended upon invitation, and delivered a lecture on " Some Aspects of MCH Activities of W.H.O. " to " Les Journées Internationales de Pédiatrie ".
W.H.O. continued to show interest in the School of Public Health in Rome to which support has been given for some years. A request for a fellowship for a member of the teaching staff and for a visiting lecturer is expected.
The WHO Regional Officers for health education of the public and environmental sanitation visited Perugia in June in connexion with the programme on Health Education in that city. The purpose of their visit was to observe developments in the project and to participate in a two-day health education conference. This was the occasion for the formal opening, by the Prefect of the Province, of an experimental centre for health education of the public. W.H.O. will provide a small amount of supplies.
The responsible WHO Regional Health Officer also visited Italy in connexion with a National Conference on the Rehabilitation of Handicapped Children which is organized jointly by the Italian Government and UNTAA, with the collaboration of W.H.O. and I.L.O., and which is to take place in Rome in September. W.H.O. is to provide a lecturer on the medical aspects of rehabilitation.
The Public Health Administration Travelling Study Group started its work in Rome, 15 March. A study was made of the health services in the country, both in Sicily and in the Milan area. The Group then proceeded to Germany.
Two individual fellowships were awarded to Italy in the field of endemo-epidemic diseases. An additional one is earmarked.
The participation of Italy in the inter-country programmes is described in Table I.
Luxembourg took part in the Conference on Immunization which was held in Frankfurt/ Main, in the Seminar for Sanitary Engineers, held in Opatija, and in the Conference on School Health Services, held in Grenoble (Table I).
A participant from Monaco attended the Conference on School Health Services which was held in Grenoble in June (Table I)..
W.H.O. continued to assist the Protectorate in their Communicable Eye Diseases Control Programme, which is now in its second year and very well advanced. Very favourable results are already being obtained. In addition to the WHO ophthalmologist and sanitary engineer already on duty, a statistician* has been assigned to the project to assist in carrying out a series of comparative evaluation of the different methods of control to determine the immediate effects, the possibilities of maintaining permanence of control and the overall costs in terms of supplies and personnel. At thé end of June about 31,000 school children had been treated collectively with antibiotics provided by UNICEF. A draft " Avenant'\ to the existing plan of operations has been submitted to the Government for the inclusion in the project of a Fly Control Programme. Additional UNICEF supplies and equipment were delivered. The responsible WHO Régional Health Officer paid several visits to assist in the detailed planning of field operations in some parts of Morocco. The chief of the HQ Section for Statistical Studies of W.H.O. also paid a visit to advise on the statistical analysis of tho results of various control measures to be adopted in 1954. Three fellowships'"- for the study of trachoma control are in the process of being awarded in connexion with the Programme.
A tripartite plan of operations (W.H.O./ UNICEF/Government of Morocco) has been signed for an Anti-Venereal Diseases Programme'"' for which UNICEF has already provided supplies and equipment. Three applications for WHO fellowships" arc now being studied.
The participation of the French Protectorate of Morocco in the inter-country programmes is shown in Table I. In addition, Morocco was awarded an individual fellowship for the study of tuberculosis ; a second one is earmarked for this country.
The Deputy Director and the responsible Regional Health Officer visited Leyden and met with the directors of the three public-health training institutions, viz. : the Netherlands Institute for Preventive Medicine, the Institute foi-Tropical Medicine of the University of Leyden and the Institute for Tropical Hygiene of the University of Amsterdam. They discussed in some detail the programme for the course in the academic year 1954-1955. At the request of the Regional Office for Europe, the Regional Director of the WHO Eastern Mediterranean Office acted as WHO lecturer and gave a series of lectures and seminars in the School in April. Two fellowships were awarded to members of the teaching staff.
W.H.O. continued to provide assistance to the VD Port Demonstration and Training Centre in Rotterdam. It is expected that a course (in the French language) will start next autumn. European countries and other WHO regions are being consulted regarding fellowships.
The Netherlands acted as host country to the Seminar on Treatment of Alcoholism which was held in Noordwijk aan Zee in March/ April. Twenty-six physicians, public-health adr ministrators and psychiatric social workers from countries in the European Region attended. In addition, WHO provided a consultant organizer and 11 discussion leaders.
The first part of the advanced training course for waterworks supervisors was held in the Hague in April. A comprehensive programme of lectures and visits was arranged for the 13 participants representing nine countries in the European Region. Thirteen Dutch experts lectured on the subject of drinking water supply. W.H.O. provided for the attendance of the participants and contributed a consultant organizer. The second part of the course was held in Belgium.
Two individual fellowships have so far been awarded to the Netherlands in the fields of hygiene in food industry and laboratory research. Two additional ones are earmarked.
Information on the participation of the Netherlands in the inter-country programmes is contained in Table I.
Two individual fellowships were awarded to Norway for studies in PH administration. A third one, in the same field, is approved.
Norway also participated in the inter-country programmes as shown in Table I.
At the request of the Government, a WHO consultant is being recruited to assist in the organization and production of rabies vaccine. It is expected that the consultant will visit Portugal in September.
Portugal was awarded two individual fellowships in the field of venereal diseases control. An additional fellowship in health education of the public is approved.
The participation of Portugal in the inter-country programmes is described in Table I.
W.H.O. continued to assist the Government of Spain in their Bndemo-Epidemic Diseases Programme. * A WHO consultant visited the rice fields in the south of Spain to assist the Spanish workers to determine the extent of leptospirosis. Pour fellowships '" related to the programme are in the process of being awarded ; a fifth one is earmarked.
The joint assistance of W.H.O. and UNICEF has been requested for a reorganization of the venereal diseases control in Spain. * This request is now being studied jointly by the two Organizations involved.
An individual fellowship in the field of cancer was awarded to Spain. Two additional ones are earmarked for that country.
Spain participated in the inter-country programmes as set out in Table I.
Efforts have been made over a number of years to establish post-graduate training of health officers on an inter-country basis between the five Nordic countries, i. e. Denmark, Finland, Iceland, Norway and Sweden. In 1953 a first course was given in Gôteborg, with the assistance of W.H.O., on the subject of epidemiology, statistics and environmental sanitation. In September, 1954 the course will be repeated with minor changes. Twenty-one Scandinavian health officers, including three veterinary officers, are being awarded WHO fellowships. W.H.O. will also provide the services of an international lecturer.
Th e Government of Sweden has agreed to act as host to the Study Group on Children in Hospitals which is to be held in Stockholm in September. A WHO consultant is in charge of the technical arrangements and will prepare the subsequent report. W.H.O. has invited 21 experts to attend the Group (Table II).
Three individual fellowships in the fields of mental health and maternal and child health have so far been awarded to Sweden. Three additional ones are approved.
The participation of Sweden in the inter-country programmes is shown in Table I.
The WHO Regional Health Officers for maternal and child health and health education of the public attended a meeting of the Swiss Society of Medical Officers, held at Burgenstock in May. One of the participants of the 1953 WHO Conference on Health Education of the Public presented an interesting report on the Conference. The WHO Regional Officers spoke respectively on health education in regard to maternal and child health and on recent developments in health education within the European Region.
Switzerland was awarded an individual fellowship in PH administration; four additional ones are approved.
Information on the participation of Switzerland in the inter-country programmes is contained in Table I.
The Deputy Regional Director visited Tunisia in March to discuss health problems with the authorities. He also investigated, together with the responsible Regional Health Officer, the development of the Communicable Eye Disease Campaign * which is being conducted by the Government of Tunisia with the assistance of W.H.O. and UNICEF. An ophtalmologist, acting as team leader of the project, and a bacteriologist, in charge of the Control Laboratory at Gabès, have been assigned by W.H.O. to the programme. Collective antibiotic treatment of 9,000 trachomatous children in schools of the island of Djerba was completed in June. On the mainland, the mass campaign against acute seasonal conjunctivitis, which was commenced in April and suspended during the month of Ramadan, was recommenced in early June. Under the existing programme, approximately, 175,000 inhabitants will receive treatment in two phases during the summer of 1954. A Government proposal to increase the scope of the operations to cover a total of 450,000 inhabitants in the southern oases during the coming epidemic season is being studied by W.H.O. and UNICEF. A bulk of UNICEF supplies and equipment comprising antibiotics and vehicles (one jeep and six station wagons) was delivered in May.
Three individual fellowships were awarded to Tunisia for study in the fields of cardiology, nutrition and PH administration. Two additional ones are under consideration.
Tunisia also participated in the intcr-country programmes as set out in Table I.
The responsible Regional Health Officer visited Turkey in February to work out a plan of operations, together with a representative from UNICEF, for a joint WHO/ UNICEF project in maternal and child health. " W.H.O. is to provide a team composed of a paediatrician, a public-health nurse and a nurse-midwife, while UNICEF is providing supplies and equipment. It is expected that the team will be in operation in October.
W.H.O. continued to assist the Government in the development and establishment of nursing and midwifery schools. The two WHO nursing advisers assigned to the project arc about to complete their mission after a two years' stay in Turkey. Post-graduate courses for nurses were given in Ankara under their supervision. Eleven students graduated in 1953 and 15 in 1954. Of the first group of 11, two are now assigned to the post-graduate course, three are in the UK ou WHO fellowships, four are teaching in various nursing schools in Turkey, one is head nurse of a maternity hospital in Istanbul, and one is chief nurse of the Etimesgut Eural Health Unit. Before leaving Turkey, the WHO nursing advisers will, with the assistance of Turkish staff, give two courses on teamwork to two groups of chief nurses. The courses will be run concurrently in Istanbul and Ankara from 12 July to 7 August. Additional WHO fellowships * for training abroad will be granted in connexion with this project ; one application is at present tinder consideration.
The BÇG campaign, Avhich started in 1952, is now in its evaluation phase. A WHO nursing adviser assisted the special evaluation team in their work in Bursa; Balikesir, Aydin, Erzurum, Kastamonou, Sinop and Izmir. A Turkish physician to head this team was appointed in May and will work with the WHO nursing adviser until she leaves the project in July.
A refresher course for medical officers was given at the Public Health Training School* in Ankara from end of March to end of June. A. WHO expert lectured and conducted seminars on epidemiology. Another course, to be attended by medical officers and some public health nurses, will start in August. For this course W.H.O. will provide four international lecturers.
In response to a new request from the. Turkish Government, the three consultants (an architect, an installation engineer and a medical expert) who spent two months in Turkey in 1953 will spend a further two months there in September- October, 1954 to advise on the construction of three hospitals, * respectively in Ankara, Istanbul, and Izmir, and of a sanatorium and a rehabilitation centre at Izmir.
W.H.O. continued to assist the Government of Turkey in their Vital and Health Statistics Programme. * With continuing active support of the Central Statistical Office, the WHO consultant statistician, who has been assigned to the project since summer 1953, has been nearly able to complete the setting up of the vital statistics sample units. Eighty-eight per cent. of the units are already set up, 98 per cent. of the agents have been recruited, and some of the units had completed their initial surveys by the end of May.
The responsible Regional Health Officer visited Ankara in June with UNTAA and ILO representatives to discuss with the Turkish authorities the possibility of setting up a rehabilitation centre for the physically handicapped and the organization of national social welfare services, * for which the joint assistance of U.N.T.A.A., I.L.O. and W.H.O. would be requested.
Five WHO fellowships * to be granted to physicians attached to the Turkish Workers' Medical Insurance have been approved (one is already awarded).
During a period of two years, the International Anti-Tuberculosis Training and Demonstration Centre in Istanbul was assisted by a team of WHO experts, and post-graduate TB training courses were established. The tenth such course * is scheduled to start towards the end of 1954 for a duration of approximately six to eight weeks. Another TB training course * for nurses will also be given at the Centre, probably in November. W.H.O. will contribute fellowships and lecturers to both courses (Table II).
A seminar * for medical administrators, hospital and public-health nurses will take place in Istanbul in October. This seminar will discuss problems affecting hospital and PH administration in order to create a better understanding of the inter-relation of the work of the two groups. It will also give attention to principles and practice of straff education teamwork. Twelve European countries have been invited to participate (Table II).
Two individual fellowships in haematho-logy and bacteriology were awarded to Turkey ; two additional ones are approved.
Information regarding the participation of Turkey in the inter-country programmes is contained in Table I.
The study of the health and welfare needs of the family unit, which was carried out simultaneously in the United Kingdom and France during the years 1951-1953, is completed. The final report is now, being drafted by two members of the Technical Advisory Committee (one English, one French) and nearing completion. It is expected that this report will be submitted to the next meeting of the Technical Advisory Committee in December.
W.H.O. continued to contribute to the cost of the teams working simultaneously in the United Kingdom and France with the objective of making a study on the effects of child development arising from separation from the mother. The study is sponsored by both the International Children's Centre and W.H.O.
The responsible Regional Officer visited the United Kingdom in February to attend a, meeting of the Planning Committee for the Post-Graduate Diploma Course in Content and Methods of Health Education which will be given as from October, 1954 by the University of London Institute of Education, in cooperation with the London School of Hygiene and Tropical Medicine, the Institute of Child Health, and the London School of Economics. This is the" first course of its kind which will be given in Europe.
The United Kingdom continued to offer training facilities to W.H.O. — sponsored Fellows coming from all regions of W.H.O.
Seven individual fellowships were awarded to the United Kingdom for studies in various fields. An additional one is earmarked.
The United Kingdom also participated in the inter-country programmes as described in Table I.
W.H.O . continued to assist Yugoslavia in the latter's comprehensive public health programme. * A WHO consultant * visited the areas facing problems in pellagra and endemic goitre. Applications for fellowships * in the fields of endemo-epidemic. diseases, tuberculosis, PH administration, maternal and child health, health statistics and social and occupational health have been received and are being studied. (Two fellowships are being awarded.)
A WHO consultant paid a short visit to Yugoslavia in January to assist in the preparation of a recommendation for a further allocation of UNICEF supplies for the Maternal and Child Health Programme." The WHO liaison officer with UNICEF spent three weeks in the country in April to discuss the implementation of the programme and to agree with the Government on the revision of some parts of the draft plan of operation.
A revised plan of operations for a joint WHO/UNICEF project in trachoma control is in the process of being signed by the Government.
Two fellowships were awarded on UNICEF funds for the study of plasma fractions.
Yugoslavia acted as host country to the fourth European Seminar for Sanitary Engineers which was held in Opatija in April. The Seminar itself lasted one week and was followed by two-day field visits in Zagreb. The main themes discussed were water pollution and water ehlorination, and it is hoped that the conclusions reached on this question will be of practical value to European Governments in dealing with a problem of vital importance from the point of view of public health and economics.
A Seminar on Physically Handicapped Adults, organized by U.N.T.A.A. with the collaboration of I.L.O. and W.H.O., will be held in Belgrade in October. W.H.O. will provide the services of a psychiatrist to lecture on the mental aspects of rehabilitation (Table II).
Four fellowships under the Regular Budget have been approved for members of faculties of medicine for studies in physiology, haematology, pharmacology and neuropathology (one is already awarded).
Information on the participation of Yugoslavia in the inter-country programmes is contained in Table I.
| DESCRIPTION OF PROGRAMME | DURATION | GOVERNMENT ( s ) PRINCIPALLY CONCERNED | OTHER PARTICIPATING COUNTRIES | PARTICIPANTS OR PEL LOWS | PARTICIPATING AGENCIES AND ROLE OF REGIONAL OFFICE |
|---|---|---|---|---|---|
| Alcoholism | |||||
| A Seminar for physicians, PH administrators, and psychiatric social workers actively engaged in the prevention and treatment of alcoholism ; held in Noordwijk. | 3 week s 28 March- 10 April | Netherlands | Austria Belgium France German y (Fed. Republic) Ireland Italy Spain Turkey United Kingdom | 26 | Government of the Netherlands and Regional Office which provided a consul - tant organizer and 11 Faculty Members. |
| Environmental Sanitation | |||||
| (a) An advanced Training Course for Waterworks Engineers, held in the Hague and Liège. | 2 week s 22 March- 10 April | Netherlands Belgium | Austria Spain Greece Tunisia Ireland Turkey Morocco Yugoslavia Portugal | 13 | Governments of the Netherlands and Belgium and Regional Office, which provided a consultant organizer. |
| (b) A Seminar for Sanitary Engineers on water pollution and water chlorination ; held in Opatija | 10 days 21-30 April | Yougoslavie | Austria Luxembourg Belgium Morocco Denmark Netherlands Finland Norway France Portugal Switzerland Sweden Germany (Federal Republic) Tunisia Greece Turkey Iceland United Ireland Kingdom • Italy | 30 | Government of Yugoslavia, Rockefeller Foundation and Regional Office, which provided 7 Faculty Members |
| (c) A Study of Sanitary engineering terms aiming at the development of an accepted terminology in Europe (in the French and English languages) | 2 years 1953-54 | UNESCO and Regional Office, which contributes to the cost of the study. | |||
| Foster Home Care | |||||
| A Seminar, on Foster Home Care, held in Paris. | 10 days 26 May- 5 June | France | European Office of U. N. T. A. A. in cooperation with the Government of France ; EURO contributed a lecturer. | ||
| Health Education | |||||
| An ad hoe Committee to advise on the next Conference on Health Education of the Public ; held in Lyons.. | 2 day s 11-12 June | France | Regional Office, which financed attendance of 9 experts. | ||
| Health Visitors | |||||
| Drafting of the Report on the Pilot Study carried out in France and the U. K. in 1951-53 to determine the kind of worker best suited to meet family health and welfare needs. | 4 years 1951-54 | Franc e United Kingdom | Rockefeller Foundation and Regional Office, which financed the services of the experts in charge of the drafting of the report. | ||
| Immunization | |||||
| A Conference for Medical Officers on the modern methods of immunization ; held in Frankfurt /Main. | 6 day s 15-20 March | Germany (Fed. Rep.) | Austria Morocco Belgium Netherlands Denmark Norway Finland Portugal France Spain Greece Sweden Iceland Switzerland Ireland Tunisia Italy Turkey Luxem- United bourg Kingdom Yugoslavia | 31 | Government of the Federal Republic of Germany and Regional Office, which contributed 10 discussion leaders. |
| Meat Hygiene | |||||
| A Seminar for veterinarians and medical officers ; held in Copenhagen. | 5 days 22-27 February | Denmark | Austria Netherlands Belgium Norway Finland Portugal France Spain Germany, (Federal Republic) Switzerland Sweden Tunisia Greece Turkey Ireland United Italy Kingdom Morocco Yugoslavia | 29 | Government of Denmark and Regional Office, which contributed 10 discussion leaders and a consultant organizer. |
| Morbidity Survey | |||||
| Continuation of the survey carried on in Denmark since 1951, with the objeotive of publishing results of international interest | 4 years 1951-1954 | Denmark | Rockefeller Foundation and Regional Office. | ||
| Mother /Child Separation Study | |||||
| A study on the effects of child development arising from separation from the mother in the early years of life. | 1952-1954 | France United Kingdomi | International Children's Centre and Regional Office, which contributes to the cost of the Study Teams working in France and England. | ||
| Public Health Administration | |||||
| ((a) Continuation of a study of certain aspects of public health administration, in Italy and Germany. | 1 month 15 March- 15 April | Italy Germany (Fed. Rep.) | Austria Netherlands Belgium Norway Denmark Portugal Finland Spain France Sweden Greece Switzerland Iceland Turkey Ireland United Kingdom Yugoslavia | 21 | Regional Office, which provided two leaders and an administrative officer for the travelling study group. |
| (b) Development of the demonstration and training area in rural public health in Soissons. | 4 years | France | Rockefeller Foundation and Regional Office, which provides for the statistical services. | ||
| Rehabilitation of handicapped children | |||||
| A Group Training Course for physicians, medical auxiliaries and social workers ; held in Paris.. | 6 week s 11 Jan. | France | Italy Spain Portugal Yugoslavia | 6 | International Children's Centre |
| School Health | |||||
| (a) A Conference on some selected topics of School Health Services, for school physicians and persons actively engaged in School Health ; held in Grenoble. | 6 day s 14-19 June | France | Austria Monaco Belgium Morocco Denmark Netherlands Finland Norway Germany (Federal Republic) Spain Sweden Switzerland Greece Tunisia Iceland Turkey Ireland United Italy Kingdom Luxembourg Yugoslavia | 26 | The Government of France and Regional Office, which provided a Conference Organizer. |
| (b) A Conference on Psychological Services for Schools and Other Educational Institutions, for specialists in child psychology ; held in Hamburg. | 6 day s 5-10 April | Germany (Fed. Rep.) | UNESCO and Regional Office, which provided 2 lecturers | ||
| Social Paediatrics | |||||
| A Group Training Course for physicians, either paediatricians or PH administrators ; held in Paris. | 12 weeks 26 April- 18 July | France | Greece Tunisia Italy Yugoslavia Spain | 5 | International Children's Centre |
| Venereal Diseases | |||||
| CContinuation of the " Port Demonstration and Training Centre" situated in the Port of Rotterdam. (Maritime YD Control) | Netherlands | Regional Office, which continued to contribute to the operational costs of the Centre. |
| ACTIVITY | PLACE | DATE |
|---|---|---|
| Scandinavian PH Training Cours | Göteborg | 2-30 September |
| UN Seminar on Institutional Treatment of Juvenile Offenders | Vienna | 27 september/6 october |
| Training Course in Anaesthesiology | Copenhagen | 2 August, 1954/31 september, 1955 |
| UN Seminar on Social Case Work | Leicester | 14-28 August |
| Study Group on Children in Hospitals | Stockholm | 2-11 september |
| UN Seminar on the Rehabilitation of Handicapped Adults | Belgrade | 2-12 october |
| Training Course on the Prevention of Tuberculosis in Children (ICC) | Paris | october/7 Nov. |
| Ad hoc Committee of Sanitary Engineers | Bruxels | 12-13 October (tentative) |
| Teaching Seminar for PH Nurses | ||
| Istanbul | 17-30 October | |
| Training Course (French) in Maritime VD Control | Rotterdam | |
| 15 October/15 Dec. | ||
| TB Training Course for Physicians | ||
| Istanbul | 15 November, 1954/15 January, 1955 | |
| TB Training Course for Nurses | Istanbul | |
| 5 November, 1954/15 January, 1955 |
| SOURCE OF FUNDS | TYPES OF FELLOWSHIP | |||||||
|---|---|---|---|---|---|---|---|---|
| COUNTRY OF ORIGIN | WHO | UNICEF | TECH. ASSIST. | TOTAL | INTER- REGIONAL | REGIONAL | INDIV. TRAINING | GROUP TRAINING |
| Austria | 2 | 2 | 1 | 1 | 2 | |||
| Belgium | 4 | 4 | 3 | 1 | 4 | |||
| Denmark | 6 | 6 | 3 | 3 | 6 | |||
| Finland | 2 | 1 | 3 | 3 | 3 | |||
| France | 11 | 11 | 1 | 10 | 11 | |||
| Germany (Fed. Rep. ) | 6 | 6 | 2 | 4 | 6 | |||
| Greece | 2 | 2 | 2 | 1 | 1 | |||
| Iceland | ||||||||
| Ireland | 3 | 3 | 3 | |||||
| Italy | 6 | 6 | 2 | 4 | 4 | 2 | ||
| Luxembourg | ||||||||
| Monaco | ||||||||
| Morocco (French Prot.) | 2 | 3 | 5 | 5 | 5 | |||
| Netherlands | 6 | 6 | 2 | 4 | 6 | |||
| Norway | 3 | 3 | 1 | 2 | 3 | |||
| Portugal | 4 | 4 | 4 | 3 | ||||
| Spain | 6 | 4 | 10 | 10 | 7 | 3 | ||
| Sweden | 6 | 6 | 1 | 5 | 6 | |||
| Switzerland | 5 | 5 | 5 | 5 | ||||
| Tunisia | 4 | 4 | 4 | 3 | 1 | |||
| Turkey | 4 | 5 | 9 | 9 | 9 | |||
| United Kingdom | 8 | 8 | 8 | 8 | ||||
| Yugoslavia | 6 | 2 | 2 | 10 | 10 | 8 | 2 | |
| TOTAL | 96 | 2 | 15 | 113 | 16 | 97 | 103 | 10 |