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STORIES OF THE
WORLD HEALTH ORGANIZATION
IN THE
'ESTERN PACIFIC
Published by the
PUBLIC INFORMATION OFFICE WESTERN PACIFIC REGIONAL OFFICE
WORLD REALTII ORGANIZATION MAN I L A
1955
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FOREWORD
This mimeographed booklet entitled STORIZS OF THE ~P~D
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HEl'.1TH ORGANIZ!~TION FROH THE HT'...3TEllN PACI7IC is not a full ac- count of what ihe goverrunents in this region, other international.
organizations engaged in health \.ork, and ~mo have accomplished together during the course of 1955. The record of that achieve- ment is covered in my 0I-.'I1 report to tho ReGional Committee. vlhat is intended here is to tell the story of som3 pheses of our "rork in human terms - thet is to s:J.Y - in t,erms of tho efforts made by the men in the field, both the national an:! international counterparts, showing the difficulties they encounter and how they approach each particular problem. Our aim is to sec that programmes are successful, but success can only be achieved through the great effort and devotion of the field i.orkers in carrying out their work.
show.
That is ~mat our stories attempt to
I hope you ,,!ill enjoy reading these stories as much as I havo. They speak for our region. They carry the message that evary effort is being made in this part of the world to see that the people in the Uestern Pacific 11ill "attain the highest pos- sible level of heal th".
Hay all these efforts continue even with greater force in tii3 years to conc. Hith this thought I also send you my greet- ings and best Wishes for the coming year.
November 1955
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I. C. FArm, H.D. / Regional Directo:if
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TABLE OF CONTEm'S
FOREI.-10RD
Dr. I. C. Fang . . . .. . . • •• i --000--
HI FIJI ISLANDS ADVENTURE
Dr. Friedrich C. Tross
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1HHAT HAPPENED TO THE IlVUNmAIII
Dr.
Friedrich C. Tross ••· . . . . . . . . . . . . . .
6THE STORY OF GEORGE
Evelyn llatheson
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HOof I1ANY TIIIES HAVn: YOU BEEN POLITE TODAY?
. . . .. . .. .. . . 11 Dr. Anton Oeser • . . . . . . • • . .. . . • 16
HY UORK
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HONGKONGBetty. A1 t .. • . .. .. .. • • . . • . . . • . .. .. . . • 19
A HAPPY DAY
Dr. Olav Idsoe ~ . . . . .. . . . .. . 23
'i'O'iTARDS THE CONTROL 0:'" SCHISTOSONIASIS
Dr.
Nelson G. Hairston •. .. • • • • • 'Z7TOl"TAPJ) B:!:TTER NURSrm lWUCATIOrI
'rJllhelmina Visscher
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. . . 30A l-mO SPEC:::ALIST IN TillJAE
Dr. Donald J. Pietsch • • • • • • • • • • • . . • • • • 36
YAltlS CONTROL TIl LAQS
Dr. Edmond J. Douvie r ... .. . • . .. • .. . • • .. • • • • 38
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BY
DR. FRIEDRICH C. TROSS
On i!ovember 22, 1954; an Intorn.:'..tional Team of the vlorld Health OrGanization 2xrived by air in Suva, capital of the Fi- ji Islands. It consisted of the team leader anc writer of this story, Dr. F. C. Tross and the International Sero1o~ist,
Dr. N. J. i-Jhelan. They were ac- compcnied by Dr. D. R. HUC:rinB, Reeional V. D. Adviser, who had come with them from Hanila to usher them into a new area of WHO activity: a Yaws Control Cam- paisn in various Pacific Islanc'. ,;roups which was to stQrt in the Fiji IslC'nds.
At Nausori Airport, the small airstrip near Suva, they were received and ::;reeted by the Colony Director of the Yaws Campairrn, Dr. L. I. Verrier. A week later, after various pre- /liminary Ciscuss ions ••••
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l:L1linary discussions and introGuctions, i t was decided to visit the Island of Vanua Levu, northe~st of Viti Levu. The southern part of this isle.nd, D. e.istrict cnlled Savusavu, uns chosen as the site for the Pilot Project of the Campai?n anc for the field headquarters.
So one beautiful morninG durine: the 12.st c1nys of Nov- ember, the te~ accompanied by Dr. Verrier, boarded a small
II Dr over II plane of the IIFiji Airways!! at ITausori end after an hour I s flieht mru::e 2. smooth lanclin,:; on the small airs trip on Se- vusavu Bay •
•• • Savusavu Bay is very much uhut most people ime,--ine when they think of the South Seas. A lovelYj peaceful bey, sur.- rounded by hills, a small Mangrove 2.11(1 coconut ;:>clm borderec is- land in the midcle of the bay, frienCly people livine in their pretty e;rMshuts ar,d small trc.c1inc; stores run by Inc:ians ane.
Chinese •
••• Durinr. the next few da~~ we traveled alone the coast of Savusavu visitinc planters, villacers, medical facilities, etc. We went either by C2.r or by launch •
•• • After 1ve hed thus m~de the necessary contacts with the chiefs of the district the day of our e.eparture came •
•• • One noon down on the jetty we sew the Government I1e-
c~icaJ. Vessel IlVuniwaill, a 70-foot ketch with diesel enLine. She had come to t~e us back to Suva. On board were the master of the Ship, the Fijian Captain Taito end a crew of 10 derk-skinned seamen uho were busy to :;:et her ready for departure... 1'Jhen we left, a biC crowe; of fa:nily members e.ncl friends s tooc: on the jet- ty to wish them and us a cood trip. Ue left at seven p.m. under Diesel eneine and soon were out in open waters. There was u mo-
/derate swell and ••••
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derate swell and breeze and some scattered rain showers fell CM:!r the horioon... All together fairly good HeatiBr... The weather report vTas favourable... I decided to retire into my cabin soon after dark. The cabins were small but comfortable and soon I dozed off... Shor tly after midnight I was awakened by a grinding noise deep down in the boat, some jolts foHOl.od by some jerl'Y, unnatural motions of the ship. Then I heard a voice cry out,
"Stop engine, engino fully reversel" Thero Has commotion every- lihere on board ane_ it did not take r,:e long tD realize that vlO ,-,ere hard agrot:nd on one of the dreaded coral reefs. First I Jal a sid:ening .fGeling in my stomach and pictures of a ship sinking like a stone to the bottomless depth of the South Pacific before m;r eyes. Sharks 1iere the ooxt thought. He ;.ad caught a fairly
good sized one a feu days ago on a f':_shing trip with one of the plantors.
But then I pulled myseLf to,'!(Jthcl', got into my clothes, threw my Lcica car.1era, money and paa.:;port into Q. .f.:urly water protective bag, checked the I'rae ;~est a...-rl then went out to see what tho situation vTas like.
The first queetion ifas- Did l-re spring a leak? A look d01ffi the hatch of too engine room shOWDd thnt 1b::; floor .lC.Ll cov- ered w.i th black o;U wh.oo:; ori~in I did not know at first. The cre't.
was busy to let tho launch and tho ~;haleboat to ~-later J uhich was a hard job since the 117uniwai" un;; :;-,;:;r.Lng ,lard from one side to the other. The .. uroleGs ope!' ator vii.:S calling "SOS" but received no answer. On tho n:ap wo saH that we wore on -the notoriOUS \va- kaya Reef J a coral roef of tllO Stlape of a long drawn number B.
Within th e next fifteen minutes \ie made a [C'W im!1ortant disco,rc- rios; that -there ,-las no loak yat, that the angine lias all right, that we were only a feu yards .from tho edge o.f too reef where it Ifallc
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falls off vertically into deep waterJ thQt the tide was recedine and that dead low tide we..s dUG in ['.bout five hour s. So we ell' op- ped <:'.n <:'.nchor on the stern side ['.nd after a few futile attempts to drac: the IIVuniw~ill off the reof, wo became resi::;ned and wait- ed for the next ris
me
tide.IISOS" was sent out every fifteen minutes but no ar..SI-;er
tole us that we were heard. \-lith tho lowerinz of the tide the ship keeled over to each side in ever vlider circles until firrJly she settled down firmly in an awkward an:;le at dead low tide ..
Thero was nothiur: we could 0.01 so VIe settled dmm ns well as we could, chewed biscuits, drank tea and smoked. And waited for
daylif~t to come.
It came at about our spirits. We coulc~ see
five a I clock and helped a :'.ot to lift the reef below us, and un island about eic:ht miles off. And we coulc~ sec the fins of the sharks cruisinG up and down the roof, as if they were wcitin~ for some- thin!,,:. Then our Whaleboat ren ar:rounc. and wc.s fillod with wa- ter the next moment ':!y a ~::reaker. Unimpressed by the sharks, some of our crew jumped oV8rboard, Wac.el~ over t l t;:c ::;)c.t :-.L:~' emp"tied i t out aC:Qin. This w<:'.s rather herd to do because i t filled fas- ter than they could empty it. But they finally succeedec:. ~Hth
the risinr: tide we all trj.~.d anew to r,et the I1Vuni~vcitl off the reef, but she WC!.S restin!? now in a scrt of ceep bnthtub .. rithin the reef and it was impossible for us to drar. her with the force and means at our disposaJ..
Atei:;ht thirty A.'1. ,·re rGceivGc~ <:'.!l answer from Suva by wireless nne. were told that a flylnc boat woulc~ come over to our aid if necessary and that a number of boa iE hr.d been ordered out to rescue us. So all we had to do 1IlceS to wait afain.
ISoon the flyin£: boat ••••
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Soon the flying boat was evor us studying the situatim.
Sho did not COIOO down, sinco the soa uas too choppy and it did not seem that we liere in imminent dan~r. ~;i th the ris:iJlg tide the ship began to l)ound harder and harder on tho roef and it be- came unpleasant on board. lie began to HondoI' tmcn she would sj,;,art coming apart. Finally, around noon, vIe saw a fast motor launch approaching frombohind -chc] nearby islam. :ct vJaS tho launch IIOvalau" which had raCed to our rescue from Levuka, for- mer capital of tho Fiji Islands. !It tre same time, a cloud of smoke in the south indicated to us tl!nt the larger rescue ship,
too
"Dogoi", iV'as approaching. Soon the "0valau" was dropping anchor a feli hundred yards away on thG other side of tho reef and we Here able to 1'0;'; '~10 whaleboat over the reef to her.Hhon we turned nnd headed back for Ovalau Island, we saw the IIDegei" had arrived on the sceno am started to nork on t:'10 "Vuniwai 11.
This onded our first visit to one of the Fiji Ialands.
110 wore ono o..'Cperience richer. 1'11(' "Vuniwai" 1fas fina.lly dragged off the reef amI 'vas docked in Suva for repairs. Sho hD.d suf- fered only minor dm;lages and we hoped to be on board again for another journey before long •
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"VUNIWAI"
My first story ended with the statement. that the Govarn- ment Medical. Veasel, the 70-foot ketch "Y.uniwaill had been taken to Snva for repairs after it had been dragged off the Wakaya Reef.
I am glad tu be able to tell you that she is back in ac-
tio~ ass.igned as a floating base of the Yaws Control Team here in Sa1OlS.avu. She has been repaired, camplete1¥ .overhauled, sporm a new coat of paint and has a new master., Captain Filipi.
Captain Taito, the forner mater, 'Has withdl!awn by the Govern- ment after the boat hit the reef some mon.ths ago. After thia introduction, I will now try to take • .you along with us on a day's work llf the Yaws Control Team along the coast of Southern WaiJ.evu. Wailevu is a IItikita" (district) situated west of "ti-
!dna" Savusavu where our field headquarters is.
Everybody :in Savusavu is awakened by the lIal~mB" of the
!'.lal.in~ the b;g wooden drum of the Fijians. The mornings here are beautiful. From the verandah of my house I have a wide view over the still waters of the bay which in the early hours 1£
the morning sleep :in the shadows of the surrounding mountains.
IAfter breakfast I ••••
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After breakfast I walk the short distance from my house to head- quarters .,here my teams are retting ready for the day's work. On this particular day there will be two surveyine teams and one follow-up team caine out. One of -;;he surveyine teams will use the IIVunhrai!' to r.e2.ch one of the villaces and I shall [SO alone.
These surveJ~nG teams consist of two assistant medic21 practi- tioners and two assistant nurses.
(The Assistant Modical Practitioners - which are called AEPS - are Southsea Isle.nc:ers who have stuc~iec: medicine for four years at the Central Nedical School in Suva. The Assistant Hurses I called IJTs are in most cases Fijian Cirls who have taken an extensive course in :'·:ursinc;. The War Ie. Heo.lth Orp,ani- zation, by the way, is workine to:-;ether with the Fijian Govern- ment of Fiji in c.ttemptine t:J raise the s tanclarcls of the :;rad- uates of the Central Nedcal Sch:)')l and has assif:ned two lectur- ers there.)
Nakas1l, the villar;e we are [oinE: to survey is about seven miles away on tho other side of the cay and it will take some em a.'1C one hilf hours tO'make the crossine.
In the :Croac'. stern of the "'Yunimdll .. m discuss the mat- ters pertaininr:; to the campair:n. "He also try to catch fish b"'.r
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trollinG -- and a number of lines tr til the nVuniwai ". Fis hin,;
is a sort of perm2.nent lion the side" occupation here. ~','henever.
one cets ncar water one tries fishinG. Since it is impossible to carry alonE a lot of tackle all the time, no one uses rod and reel here. But ever;:'one carries a spool in his pocket with seV- eral hunCTed yoxds of Fylon line ,lOund around it. Hooks, sinker and bc.it are carriee, sdely in 1l sm"'-ll tin box. In this manner one is ready for fishinG at a moment's notice.
jI:Je soon reach ••••
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.We soon reach ~ shore of Nakasa and after ca.ref'ully ma- neuvering .:throu.~ a small opening in tho conl.:·reef that ru.ns along the entire coast we drop :::nc:lor c. fon hW1clrc.d ym'ds from shore.
Our cinghy brings us to loti. thin a hundred yards of the beach from lJmre 1-re wade through shallou "\'Jater until He reach dIy land. '.i'here the "Turaga ni Koro" (village chief) and his reti- nue are already awaiting us. After general handshaking and the
\Vords "Ni sa bula" ~~:re you well?") lVO are led to the village1s meeting place. There the '1ura8a sits d01ffi on ono Side, his men sitting behind him, while 1-1e sit just across from him. ~oJe i€1DI'O the cha.:ilrs brcught for us and sit dmm cross-legged on the mats just like the others. This gesture is apprec:ia ted by the Fijian villagers and after a few minutes of complete silence, the Tu.ra-
ga givos a sign and the ceremony of \Volcome with the presentation of Yanggona or Kava begins.
Yengeon~, or ll:ava, "s it is called, has a great traditio- nal importance. The Turaga speaks "Tords of \-J clcollXl in Fijian uhile his retinue murmurs agreement ffi1C~ clap their hands rhyth- mically in sign of approval. Our oldest assistant medical prac- ti tionar then 'fulks over to t.'w bundle of yanggona roots, puts his hands on thClm as a sign of acceptance and speaks words of thanks on our behalf.
After this is done, I addrQss t.llcm in English, explaining the reason fo::: our coming.and expressing thG ,nsh that they might got the greatest benefit from wh.:-.t lie arc going to do. AftGr th:is ceremony, lfC begin our Hork. Our eqUipment is spread out on ta- bles, and syringes and needles arc boiled. The villagors now pass b0forG us, one faluly aftGr another, the eldGst of each
/family introducing •••
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family introducine each member of his clr.n or explaining the whereabouts of those missine. The assistant medical practition- ers nne; ti1e assis knt nurses fEl out personc.l data forms and 3Sk qUGstions c.':out former £'.ttacks of :ra.ws, treatment received be- foreJ etc. 'i'ben each person unc'.ereoes physical eXCJ1lination 2..110.
a blood srunple is tclren at the next table. ;:!henever a c:::se of clinicc.l yaws is diacnosec'" the patient is immediately given his full treatment of penicillin in one shot. Some da}~ later, a follow-up team will revisit the villcJ"e, trentin~ cases which _vere diaGnosed to be sufferin:; from latent ya.TS accoroine; to the outcome of the serolof:ico.l exwnination of the blooc~ sc.mples ta- ken. One half of the latent cases and all persons who are appa- rentl:r free of ~T2.WS are left untreated for control ::mrposes.This method is emplo:'ed on1:T in the Pilot J<..rea.
DurinE! the colony-vride mass cnmpair:n which is to st~t in a few weeks, everytod~r .vill receive treatment whether he suffers from :raws or not.
'"/hile we are Horki.ne:, the Tur8.c;a sees to it that we have.
sufficient refreshments. Tea, fresh coconuts, bananas and papc.:. ...
yas e.re offered to the teaw. He notice a woman c~r:yin5 a chic- ken to the Itcookinf. house". At",noon we t'..re invited to the Tura.,..
Cals b~& (Fijian hous~where we are served a fine meal of chic~
ken soup, chicken with taro, casse.va ::mcl verretables cooked ineo- conut cream. It is a little difficult for mo to eat sittine
cross-le?:,~ec: on a mat and some of the ryo.vy falls on my shorts.
But the meal is c.elicious, nevertheless. ltJhile we eat, Sirls stand behind l.:S chasinr tho flies away from the food with f~.m;
made from palm leaves. After a short rest,
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fa back to work until the sum has eone down./The day has been •••
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The day has been a typical one of the Yalffl Control Cam- paign in th: Fiji Islands. Many cases of yaws lIers found. Somo persons suffering from painful "wet crabya.vs" could hardly walk.
They used a stick or fastened pieces of coconut shell under th;,:ir painfuJ soles of their feet to prevent them from touching the ground.
vIc saii many children cov.::red with the typical papillomata lih:'_ch gives yaws its scientific name of framboesia (th3 rastberr:v disccwe). These forms of yat-TS react drar.Jatically to penicillin treatment. In one villaEe the chief told us that most of the persons liho '\-lere unable to walk when we first tr'.ated them walked
painlessl~' the following morning.
After canpleting our work and storing our equipment wo go back to ilie shore and get aboard thJ "Vuniwai /I. Tho entire vil- h,gc accompanies us and 1-Tades with us to whore too dinghy is waiting. They present us with fruits, beautiful shells and seastars, ','hich troy drop into the dinghy as tokens of their appreciation.
The; Kord IIVinaka", nVinalca" (thanks, thanks) is heard ma- ny times. Then as our dinghy pulls
nHe.:r,
the y wave farewell un- til the liVunil,ai" ;:;'is appears in the '-,istance on its way to C'.no- thor village.-10-
Iy
EVELYN MATHE-SON
AB YOt' talk, you study your sixteen listeners some.
olive sldIUled, sQme a . .cocoa brown, all with the dark, in-erest- ing eyes of the Ea.st and you wonder - l'Wby am I here - what am I accomplishing - am Lmeating the needs of these students of the School of NurSing, Sandakan, North Borneo?" Your eyes tl'a1el from face to face. Yun Fah is looking at you quizzically, Paul is inElJ..'Plicably amused, Winnie has "lost" you, Mary Jane I s mis- chievous ~winkling eyes look directly into yo~, Susie looks t:ired and appears lost in cDntemplation of the landscape, Han is obviously bored, Boniface appe~s intent on catching your every word .and George •••• George answers the __ question which you have
just asked yQUl'self __ Georgets puzzled, anxious, eager expression tells you that you are here because you are needed, that you are contributing towards the deyelopment of his knowledge,~_skLDB,
his per.sonaJity- and you realize that you are doing the same for his cla.ssmates.
/Who is George? •••
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vJho is Georee? He tells his story much more effectively than can this writer:
"!\ly full nrune is Gcoree Labaclin. My race is Dusun. My father I s neme is Sabirrlil. By mother WOoS dead in 1944. I have Got me.ny brothers and sisters, we are nine in all. I have sot three sisters and we brothers six uut one of my sis- ter was dead in
1949
and also one brgther wes dead in 2Jrd of June 1954. I am one of my father's youneester son and I am the only have cot school. But in case that my father can- not afford me futher school, I passed only secondary one. Af- ter tha..:b, my father ordered me to find job and first of all I have to do is to obey my father I s will. Host of all I like to be this job as Probationer Dresser. I was apply in 14th July 1954 and",as
ap9roved end Matron baa send me in Hos- pitel Jesselton to be Medical examination. After that, I received a letter and from thet I know that I was accepted to be a Probationer Dresser. I went to start in 3rcl of January 1955 and there I had caxried a bedpan and bedmakinc for one 1.eek. After that, I heaxd that I have trunsfere to this p1:lce,Sandakan~ therefore, I have two c:ays holiday to wishing good- bye to In;,r beloved father, brothers anc~ sisters. I am very sorry to have part from them, but in ny Hatron, will I must obey. l1y hocby is pla;rine: football. I like to joint this service because I 1-mnt to lC2.rn medicine and hospital usinG.
I will try to (,Gscribe my home IIk=poncll • Now to beCiro Penampan::- is .ny home k=ponf.. The people there in Penampang are farmers. They livec: in villaGes~ and do their own worksl as cultivate the 1r-.nds, usine plOUGh nne: ouffa10es bccL'.use no machine to:)l to do this. lmen the pac:dy Grown up and ripe, they garther the seeds, in doinr; this they used knife to cut
/pnc~dy .•••
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paddy.
I lived in a small house, also have big building church.
\uth my father. Penampang This church was made of oon- oret and stained a white colour. There is ~ school, too.
But this school Nas made of planks rud its roof was zinc. I have beon studied in this school for the period of seven years.
It was a very nice town in Pcnampang. Hany people there are working for the Govornment. They mc.ke "Ro(l.d p!:ogresa".
The Government imports rubber to other country a."J.d tr~
:from other transport fran other country and sorne other thing!.
The people who were 1i v:J.ng
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re .tere many kinds. Sana of them I know: Dusun are toore in groups to produce paddy and Malay, Bajaus for fishingmen, Chinese for merchants and r.nglishmen. The CXluntry was governed by the English people.I only describe the place which I actually knmi. I have no nore to write. I am very sorry that I don't know hOlf to ,.jrite correct &lglish. I .. rould like to ask pardon of~ gram- matical English. I em very low education."
This is George - George, 1.ho, with his classmates, is be- ing prepared to J7\eot the health ~eods of his country - a country of apprOximately 400,000 people, of 29,388 squarc miles, which is largely covered by dense forest, has central mountain ranges traversed by valleys and occasional plaioc and t-rn3rc an exten- sive system of rivers ::;:oVides too only highways in many parts of the country.
The needs of Geor go's countrymen are described by 2. fel- low Dusun student dresser:
jll!oly purpose of •••••
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"Ny purpose of becorainr; a (.resser is to be under the con- trol of doctors who c.re fishtins 1:'.;~;ainst dise1:'.se. Unfortun- ately" illness ene: diaease 1:'.re very common ae;ainst us. Lvory-
e\a~rl in every land" people e.re sufferine from many kind of illness. Disease is much less common than it used to 'oo-t we live in ~J€tter houses than the people of lone; aeo and we ect better food then they did. l-Je e.re more careful about clean clothes ane: cleem bodies the.n they used to be. These things have helped to ree:uce the amount of sickness in the world. But, even nowadays, people who are icnorant, me~ of them believed th1'.t ma"ic would cure their illness. 8specially in my villw;e called Kinuta, When a man is sufferinE from any disease, he "oes to 11 witch or to 11 wizard e.nd he is E'.ive me- cicine mac~e up of all sorts of unusual thinpsJ even such thin[;s as snakes' skin and the hair of mice. '.r!hile he is
c~rinkinf: itJ he has to pronounce certe.in words. They do not understcnd, they are afraid. Their fear is led them to put their trust in_useless macic. As I am the first ('_rossor from KeIl1pons Kinuta" I must my bost to study hard so that one day 1ihen I ~:ecome a senior staff I may be able to viSit the peo- pIe in Kinuta 11nc~ ter..ch them the vmnderful works
tors ane: perhaps they will believe it anc: (,ecide
of the doc- to send their chil(~ren to s cho'Jl to s tUl~~r their personal lives also."
To prepare him for the role th2_t is to be his, Georce is enrolled in the basic nursin- ec~ucation prOENlll1ll1e in Sandake.n.
This pro.c:rClmme is 1)2in~ conducted b;y the Government with the 2.Ssistance of a "JI-lO nursinc: education team. It was one of the members of this team who was askin~: herself - Ills it worthWhile?
Is the job beinc done?tI
/Tha problems •••••
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The problems encountered in corxluct:ing such a programe arc many: shortage of trained personnel :in all departments, in all agencies; shortage of equipment and supplies. students who, like Goorgc, have poor basic educational backgrounds; the many difficulties of a country that is but starting to recover from the extensive darrage of Vlorld Ivar II. Houover, it is recogni:!lCi that no assistance is too great, no job :Ls so small that it does not make a contribution, no effort una~prGcia ted when George writes:
III 0J!l very sorry to learned from some of my friends that that you are go ing home. If you are go ing home, thon uho is going to taka your place to -ce.:?ch us? I think we all stu- dents lilcci your teaching and advice. I like you very muc h to teach us, Sisters, but i f you are going, what can be help. '.Ie thank yru very much for your goed teaching and.
advico tOHards us. I dare to write ;you this poor and simple English to lot you know about my opinion tOl1ards you becalm I knou very much that you arc kindly sisters whom I never mot since m:r life. I knoh' very little knowledge because my father did not prolong my study on account of lack of money, but I 1.'2.11 try very !:luch to study and do hope to lm01i l i tt:lJ::
more experience abO'.1 t this job. Hillions of thanks for uhat you did toward poor G_orge. mllions of thanks for you, for your kindness toward all studonts. God may bless you and on the way to your home."
One's efforts are mado Horth"hile by the very worth of Goorge and all otmrs like him.
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.~'
...
1
HOW MANY TIMES HAVE YOU BEEN POLITE TODAY?
Dr.
~NTONGESER
For the lest three years I have spent my life among the Chilc'.ren of Asia, first in carryine out BCG vaccination campaiGIlfl ane durinG' the past year as lead.er of the WHO/UNIC:GF Assessment Team.
The BeG l.asessment Team with which I am connected has as its main purpose to map the frequency of t~berculosis and to measure the response of chilGren to BCG vaccination. Hy teem, which was composed of two Danish nUJ."ses, Hiss ::::Va Friis and lirs. R. Ecemose-Nielsen, myself I plus the national counterparts (of each country) worked in Indonesia, Notth Taiwan and certain parts of Cambodia, Vietnam and the Philippines, All tocether we examined and vaccina -ted some 50,000 child1'en.
I am not
coine
to give you our scientific findines. Ourassessl1lallt and whatever we coulc~ contribute to BCG work will all be carefully written in a report .Thich will be made available by WHO to those technicians who are interested in our findin.:;s.
This short story is to tell you about my impression of the children we have been in contact with in Asia. They are children that I will never foreet for their lova1..::le qualities, /their couraee and •••••
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their courage and their beautiful attitude toward life. Day after day as they linec1 up for their injections I h""d the oppor- tunity to admire their ense and cOP~idence.
The aEe did not matter. vlliether they were trree or fivel or sevenJ when the time came for the injections they would courteously raise one of their arms wi thou t the slichtos t pro- test nnd without crying. In many c<'.5cs) they smiled as if to
sa~r I hope I run not f:ivinC you too much trouble. That was in contrast with the children of
:c
urope who" C:urinr: the mc:ss campai[}1B" were seen turninc pale) c;roppinC ou·\:' of the line and some times faintinG for a moment.You m<:.y think that perhaps this lack of fear for injec- tions amonc; Lsiatic chilc'cren mi::ht be due to the fact that in ::urope chil(~ren knov, whnt to expect. But· thD.t is not so. In many of the schools testec1 by the Lssessment Terun in Asia, as many as from four to six injections ,,;ere siven to the srune child
at different perioc$. That s~e child did not chanr.e its atti- tude after the first and subsequent injections.
The Team also o'Jtained ac~ditional evidence of the relaxed minds of the happy lookinc children in these tropicat countries when the vaccination work was occaSionally carried out in class- rooms where the teacher, after a friendly smile of welcome, often woule continue teachin~ with the full attention of her pupils
w~i1e the intruders went ~lonc their business in a corner of the class.
One of the thincs I c~nnot forcet and perhaps may sive you a clue fo~ understandins the attitude of these children and on the national char~cter of the people is what I was able to see nne hear curine my visits to Filipino schools. Time and
/acain I overheard ••••
-17-
1'1
again I averreard the teacher ask her pupil: "How many times have you been polite today?" And the boys and girls would enthusiastically r1lise tmir hands to reply proudly: IlMany times, I have been polite today."
In this gr cceful atti tude of the happy, uninhibited ani all 1 d hildr b I t the question, "'.Thy natur y re axe c en may e a c ue 0 ..
didn't they faint?" .And at the same time also the answer to the problem of why psycho-neurosis and other minor men tal dis- turbances, so frequent in tomperate overstressed ccuntries, arc rare in at least rural dis tricts in Asia.
-18-
rrty W~ Ltt
ft¢N~ ~<>N~'
by BETTY ALl
To the tOU1'ist~ Hon;:konc: will rc,·~,dn a memorable picture of a modern city, a very busy port, overflowine with people (it has an estimated population of 2,300,000 persons with a density of over 2,000 persons per square mile in some places), with shops overflowine with every :ilnn[ine.~.)le ware, with flowerine trees ane' beautiful temples. One never foreets the ricksha boys in the streets, the boats, fishinr: junks and sampans ~
its ~ictU1'esque harbor with the mountains in tho backproun~
Nobody who has stayed in Honckone for more than a day will for- eet the industry of its people ••• and its vitality as a city.
As a health worker, who arrived in this city in 11arch of
1954,
on an assir:nment as a public hee.lth nurse of the World Hce.lth Orp,anize.tion, to help the Government in its maternal and child health prosramme, I have come to know e~other Honf,kone also. The Honekone of the pe.tient Chinese who sits on tho pavement all day and sloops there by nicht, of the boy with lean face ane! the scrawny body with a rackinG cough, of the.mother in dirty rae:s holc:inr~ a baby WTe."?ped in a filthy cloth, of tho berr[;ar who is found in almost every street corner. It
is that HonEkone the:. t has bee orne a par t of my daily life.... and /has revealed to me •••
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haa reveel.ed to me that like:my other overcrowc!ed city in the.
world, i t has its share of pro:'lems arisine from poverty, ienor- ance anc: ill-heaUh.
I beran my work in Honekone by conductine a survey o:f its maternal and chile health facilities and proeramme. For :four monthel with the assistence of Dr. S. Y. Cheng ane Hiss H. Chow of the HeclicaJ. anc', Health Services of Hon::konCI I visited aJJnost every nook and corner of the cit~', [ntherinc the information I neGued, availin!: myself of all times o:f the excellent cooper2.tim of the various covernment a~~encies whose work had somethine to eb with mine.
The result o:f the survey showed the creat effort of the Gove:'nrnent in the promotion of me.ternal Mel child health end welfare. It also confirmed~ however, the many difficulties which it faced.which I had been told about earlier, like its l::.c!: of suffici::nt s k.fi r.n': the o7ercJ:oToK~e<l conc'i tions o:f its health centresl hospitals end dispensaries. It made me realize that the work still to be done to improve the health of mothers anC. chilc:ren in Honckone was enormous inclose:.
In accordance with a plan of action prepared by the Government with the advice of the 1-Torld Health Or£anization, work in two selected health centres was started which made these centres the focal points of an educational and demonstration proGramme, the teaching of covernment personnel ~nd private
practitioners~ the e~ucation of parents in the basic principles of self-care nne child care and the stimulation of community interost and participation in the Government's mnternal and chile hedth prosremme.
For four da~~ a week~ I alternate between these two health /centres tryinG to •••
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.,J I
.. ~
..
-~-• 1
1
....
.,.-..
centres tI"',ling to share with my fellow workers of the local health services my experiences ani knowledge in order that we may be able to demonstrate and teach to an ever growing number
of people the modern methods of maternal and child care within the re~ources of Hongkong and suitable to its cultural back- gllound •
The work is far from being easy. There are so many thing!
to do, all of them needing i.rnm:ldiate attontion that I wish every now and then that there were 48 hours in a day and 10 days to a l.eek and that I had trIO pairs of hands. One day, my concern is to devise ways and means as to hOi-; tm records of examina.-
tions made at ante-natal clinics can be kept accurate and ~
Another day, I am busy lecturing to a group of staff members of the health centres as part of the in-service training programme on maternal and child health. Then, there are the weekly infant welfare anI mothercraf't sessions which I help to organize.
These sessions are one of tho most important phases of the work in maternal and child hGaJ. th for the belief in certain cus toms and tho lack of basic knOivledge on mother and child care contri- bute greatly to the significant number of deaths and illness among them. Tho many dialects of the refugees require us to plan lessons in picblros in order that the work move on and tre mothers understand.
There are many phases to my _"ark. For instance, some times before I give a lecture I feel forced to go to one of the local markets to learn first hand the prices of vegetables and fruits and other fruits so that I can recommend what the wo- men should buy in view of their limited purchasing power.
\Vhen after a hard day!s work I go to bed, i t is a rare /night indeed that I .•.•
-21-
night indGed_ that I do not see ... ,he tired faces that Lhave met dUl'ing the course __ of my work p~u'ade befor e my eyes. Ea.ch face is a challenge,. and it gives me a certain feeling of ·satisfac~
tian to mow that I am doing my share to help improve theu health.
-22-
I
..
.' ,
..
~
DR. OLAV IOSOE
The day had been hot and dusty Old we were tirod. It was rather late in the afternoon ani we wore looking forward to tak- ing a shower, haVing a good [ilGal o.nd a night1s rest ill a cool Japanese-styled hotel.
My national counterpart and I were on a trip in the west- ern part of Tail-J-aIl for the purpose of inspecting the vemreal di- sease control "lork being carried out at ·~hc various Health sta- tions in that region. Vie had had some encouragement and some disappoirrtIoonts. Some of the stations had already established a well-working venereal disease control service and the personnel had demonstrated great interest in the new project which the
Go-
vernment had initiated to improve and strengthen the health of the people. Some of tt.e stations had met With a number of dii'- ficul ties, others lacked enthusililBm.
Now, the re was only one moru station left in our list. It was si1oun-ood at some distance up jn a mountain area, and served a mountain tribal population. The road was bad :md although none of us said it, I think We all folt the SaDIO and expressed one ldsh: "I shall be glad woon we are on too way dwn., I am sure that this particular station will mot show any remarkable accomplishments ." We sat in the station wagon in silence, kepi;
/thewindows tight •.••••••
the .. 'i.ndows tight to protect us P.g2inSt. the dust and could not really enjoy the wonderfUl scenery we passed'~long our w~y.
lIB we reached the her.lth st2tion, the doctor :md the ptb- lic hefl~th nurses welcql1ed us outside the door. I iJnmediately recognized the doctOl! pS having c'ltten:l.ed ane of our: trcining COUllSes. I pl'!rticuJE.rly renember.ed him becl'!use even at tht'.t 11:16
I had my doubts about him. He Nas .::'.b-::ut sixty years of
age,
short and slba. He always ha.d a cigarette hanging from the left side of lUs mouth, the slde "Whi~h dropped dONn a bit. He . Hore spectacle s • 1clliile co nduc ting the course. La.lways remember him sitting down find listening to me with a strpnge dr~ smile.
I was .. never able to decide what he thought of the COUl1se • ifuether i t was so much nonsenae unworthy of r.eceiving much at-
•
tention, Hhether I was just p fumy individua~, or whether. he really enjoyed our. course. Sometimes he closed his .. ojEls as if to truce a short nap, but he always kept his Mona Lisa smile.
I ree~ly did not expect very much at this station. He had not received .. advl1nce notice .. of our arriv;u, so I wondered what he would hnve to show. us about his 'Tork. l.fter. we t!rrivod there were the •. excilange of polite greetings so chara.cter~tic of the Chinese, nn approach which makes life more ple2sant. vIe s tapped imide the heplth station and my firs.t surprise was to see the ne!~t mld apotlessly clean office. Tea was brought in ..
I1y counterp.:>l't clr~ttered ond joked with the doctor and his nurse, .for lJlY caunterppxt ruWl'yB. lmows when to joke. ."nd when to .. be ser- ious. He took his tim:3 A.S he flJways does :md I spt patiently
and wldted the next turn. At laa.t
,Ie
were 2sked to go into the consulting r.oom. It WI'.5 clep.n and orderly p~though the equip- ment Wl'.5 scpnt. But the instruments they did have were clel'njl'nd neatly placed ••
-24-
--""'"":
; I
T
and neatly placed on· shelves. The examination table was very old and out of date, but it too had been very well washed. Even the papers on his desk were arranged neatly.
Then he produced his records and I was_ most. pleasantly surprised. There they were, complete in every detail, showing the result of examinations, skin tests, treatments. "iliat was still more important and the thing W3 Yiere looldng for rlere the records of family contacts of the infected per sons were to be fa],.
lowed UP. and examined. These records were so well kep"\:. that they might have served as model. Uy counterpart began to cross exa- mine him ••• why did he do that ••• what 'Tas the result of that •••
why did he not treat this case •.• why did he not treat that oiber c.:l.Sa... And the old doctor, vhom I had suspected of hal.f sleep- ing through our training course was a match for all of my coun- terpart's q,testions. He explained his <:rJ.swers with gesttres, and tiith our mimeograp-lwd manual on VD control methods which he kept on his desk, pointed to this and the other sentence lmich he had underlined. He had euccGGded in giving blooe examinations to all pregnant WOJ!len in the villaee and hQd even traced some sour- ces of infection from a nearby to,n. The doctor's nurse who had.
als 0 attended our crurse, ~Tas just as eager and well informed.
There was no doubt that this doctor and his nurso "ero putting into practice eVerything 1'1'0 had taught them. I could not have felt happier than to seo this result of our work. vJhatever dis- apyointmcnts I had suffered melted away on that day. Hare, in an isolated area in Talwan, among mountain tribes, uas the liv:ing embodiment of people l,ho had made our efforts in Taiwan worth- Hhile. Probably, the old doctor had been rlOrking in th£.t lonely village fo:!" many, many years after his graduation from medical school, idthout tho benefit of being able to absorb now medical /knowledgo a~d technicues •••
-25-
lmowledge and techniques. Medical literature was expensive and rare, the world has undergone a.medical revolution with poni- cillin, the other antibiotics, ather drugs and new techniques~
while he sat in his .. li ttle village far away from i t all. Maybe this.Doctor has always been looking for something more than the IIcurativell aspect of medicine.
Now a public health conscioos GoveI'IllOOnt got things ml4V- ing, and with the aid of the United Nations Children's Fund and the ~orld Health Organizatio~.had opened new ho~zons for such men and women as this doctor and his nurse. Laboratories wi;th modern equipmflnt had been established for the serVice of IOOdical personnel to assist in diagnosis, •. equipment and supplies for treatment facilities had been made available and technical laww- ledge had been offelled through international experts. This doc- tor and his nursa had received it
all
with open arms. They had utilized well what had been offered them in their small communi- ty in the mountains.Through these two persons I began to aee a... dreal.1l. come true. Up .. there a tree had been planted. Many hands assisted in the planting. The .. tree had been placed in good soil. I t would cartainly • .graw and grow for many years after w£1 had JAt'.t
the island of Taiwan 2nd after we had been forgotten as individ- uals.
OUr work had been fin:iBhed. Vie SI'.id goodb¥e to the d.Qo"
tor 2nd his nurse. 11. few . .minutas later mycoW1terpart and I:were on the way down the mountain road. The sun . .was 'OOginning to set..
Lcould sse the mountains, the trees" the lakes and the streams painted in that wonder.fu1 hue of colors one sees in the :tropics.
n.
all looked very be2.utiful. It had turned out to be a happy day.-26-
'.
-
NELSON G. HAIRSTON
- .
. -
_ . _ . 0 " -
- -~ ~ .":'-::
-.:. ~ -. -~ -
Theoretically, controlling schis-i;.osomiasiB is easy. Since tho parasi to must have a particular kind of snail to complete ita life cycle, eradication of th& snail .. lOuld mean eradication at:
tho disease and there aro chc~p, cOllJIllOreially available chemicals that .. lill ldll snails ~lhen applied in tho low rate ot: 1 kilogram per 100 square metors. vmy then can't we simpJy go ahead and buy enough chemical and kiD. all of the snails in Layte? One answer is that even t:.hough the chemic.il. is cheap the aroa inhab- ited by snails is very large. Ii'or example, in Pr,lo, 1-m.ere all of the snail inhabited areas are known, about 1/13th of the total aroa 1-lOuld havo to be treated with the chGJllical. Ii' this figure.
is representative, about 200 square kilometers of land would re- quire treatment in Loyto alone, entailing an expam e at: well ov- er half a million pesos t:or chemicals. This figure does not in- clude
too
painstaldng and highly technical job of .t':lJJding all/snail habitats ••
-2:7-
BUil habitats nor the l:,bour of. aI'pljdng the chemical. A second and importC'nt drawb"ck is .the .:t.:"lCt that the chemical inter1'el!es Wi th the growth of rice pU'.n ts ~1')j about 1/2 of the snails are in places whe..re rice is cultivp.-ted aither continuously or once
t: .•• year. Firullly, nnt cll the snails are killed and the survi'Uls can repopulate the area within a few . .months.
'WOuld not be once but severr>.l times a yep.r.
The expense then
Our job in ~.lo is to find a way out of the dilemrl'.a. We are trying to discover the lLUlnerablc spots in..the transmission of schistosnmiasis so that ~dva.ntages caIl be t?ken of them in.tams of a National Control Progrrunrne. This requires 1'.n unbelie..vable amount of information. Surveys bP.ve to be peJ:!formed so that we con know the extent of .. the disease and the dmnage done. to the peopJa. This a.gr>in maans that we must __ be able to separate the effect of schistosomiasis. from that caused by ather diseases,.
hookworm, tuberculosis and malnutrition for exa.mple. This in- volves the habits ?nd agricultun.l p1'?ctices of •. the .. peopla and this in tu.rn their social .and economic status, all C'. series of widening circles of information concerning the hU!1l".n host.. But
E.~:l :iJ: .. not tl:0 0:'.11 source of infection. Domestic animals and wild ra.ts c?rry the disep.se C'nd our sunreys include information on theae reservoir hosts" as they are c~led. The impo.rtanc.e of i.hese aniJnala will mve 'm effect upon the success 01' 2!ly sanit-
ation that ma.y be carr ied out.
Concerning the snails, we are trying to find out· when I'M where they.: p.r.e most likely to be infected and hence when the conditions that make them more or. less. dangerous. Since chemical control costs too much~ some practical method .. of eradication needs to be fiOWld. l-J.hat do they need.. and how can we •. depr:i..ve them of it? Here we 1'.1'e trying to learn to think like a snail
I
ani the mas t •••••-28-
and the most detailed information concerning their distribution, life history and habits is being collected. To evaluate all of tho information, detailed maps are essential and we have on ocx:a- sian resorted to aeriaJ. photogralils as well as maps of our 01m
engineers. What have we faun:!. so far? We knou how many people are infected and the age when they becomo infected, in an area
or
intense transmission such as Palo, Lcyte. He are fairly certain that aani tary moasur es will decrease the infection in snails, reducing the chances of thJ parasite. We know that "the snails are sensitivo to any disturbance of their habitat, whether thru removal of vegetation at' whether through plmdng of the rice fields ~ vIe have made a start towards an understandi. ng of what Bet of conditions make for the transmission of the disease both to people and to snails. Our chn.nces of success in this project are greatly incroased by two factors. Tho first of this is the goodwill and friondliness of tho peoplQ of Loyte, vmo have given splendid cooperation to all of our roquests many of vlhich must seem very peculiar to tmm. The soco;xi factor is the presence of the alert, enthusiastic and 'Hell trained staff of the Divis- ion of Schistosomiasis of tho Department of Health of the Phil:lp- pines, tre tochnicians, helpers and supervisors, '-'Tho actually do the work of the project. vTithout tho roliable results that they obtain daily, the project could not possibly succeed.
lTe do not have any final answers yet, but ole are learning to ask "tin right ques tions. 7horo ma;;r not be ansHers to s orne of them but vIe are certain t.lJ.at the information that is piling up v7i11 eventUally be v.il.. uable in establiShing control methods be- cause HO havo started where ue must - at the bottom.
-29-
..
~#er~rs/n?
Edvct2hOh
b~
WILHElMINA VISSCHER
In December 1951, two nurses of the l'iorld Health OrBaniza.., tion went to Cambodia as the first members of a nursinB e duc a..."
tion team to assist the Government iu.estaJlishine a basic nurs- inG and midwifery education proeramme.
As. you know, Carr.bodia is one of the three states of Indo- China and is situated between Thailand and Vietnam.
It has a population of four milJion people of which 600;00 are livinB in Phnom-Penh, the capital. The relieion of Cambodia is for the treater part Buddhism and it is a colourfUl picture to see the monks in their bri[,ht yollow habits walkine one after the other when they lee.ve the temple.
The main river which runs through Phnom-Penh is the Mek- one. One brrnch is cdled Tonle' Se.p. At the chane'e of see.sons from the wet to the dry the Tonle' Sap clk".nees its current and great water festivals are held. For two or throe days boat ra- ces in old fashioned boats 0allec piroques) take place. The days are finished with national de.nces, performec: by the dencine ci.:da at the RoyaL Palace and we are usually invited to attend these /festivi ties •••
-30-
festivities.
The national costume for the women is a jacket and a sam- pot (skirt) and these are worn
9Y
those men mlo have not yet ta- ken to Hearing western clothing.The working class women wear a towel round the head for protection from the sun. This. towel is often used for all kinda of purposes, e.g., shopping bags, baby hammock, cleaning towel,
e~. ~
Life is. peaceful and ea_s~ going tor the .. Cambodiana and their needs are . .few... The normnL temperature varies from 30-33 degrees contigrade and the prOVision of clothing for children ;I.s not a problem. One can see many children running abru t as na- ture has made them. Rice is a staple food and the Mekong River provides enough fish.
Most at the education in the pasz has been given by the bonses, who are the. Buddhist rriests" and only boys were .. allowed to attend classes at thll.t..t:iJne. Education for girls was not thought to be JZ:ery necess1'.ry. Some changes .. have taken place'l girls are now attending the public schools and unde~ the 1aAder- ahip of a..few educated ones, women have begun to participate in a very small nn asure in community affairs.
The infant mortclity rate .. is very high and i t is not unus- ual tn bave mothers tell..you that from the 10 to 12 children she has had, only a few are alive.
The Goven:unent realizes the necessity for improving Lhe.
health of the na.tion. This will require ~,.urses who will be cap- able of a.ssisting the mothers <>nd children to keep well.
Two Cambodian nurses, one male am one female, were as- fsigned as national ••
-31-
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•
signed as national counterparts to thG Horld Health Organization nurses. lve started to war k with them in an informal way ani slowly introduced them to tl:e con::ept of modern nursing. A health centre called a "dispensaire" whioh gives out-patient SEr- vice was made available by tro Government to be usod as a demon- stration centre for all public heclth actiVities.
-~ell baby and pre-natal clinics were started. The nursos .rere given a special course in public health and home visits !-me started. Hore than a hundred pcti.ents ca~ in daily to seo the
"0i'ficiJr de Sante" who is 11 loccl1.y trained doctor. The popula- tion do not oonsider him a good doctor if he does not prescribe at least ono injection of some kind .. so every patient receives an injection.
1,VO learned to ImoH tm people in their homes and tho dif- ficulties they had. The Cambodi<m people like to make you happy"
and all qmst.ions are ansi'rered with 1fyesll as t!1C:' do not like .to disagree with you. Negative questions cun never be asked for they .. 'ill answer llyes" E,nd you are s·dll as puzzled as you 'trcre before.
The giving away and adoption of babies are common practices and are treated vcrJ' casualJ,y by all concerned. A mother will tell us fuat the baby is not groliing too well. . After we have heard that she does not nurse 'her baby, thc value of breast feed- ing is .explained. She listens very patimtly. After the expla- nation has gone on far 10 rnJ_nutes, HO then discover that the ba- by is not her own be.by but ".as been adopted from one of her neighbours.
In the hospital we . assisted \·ii th the opening of a child- renl S lVard and fue nurses had to be trained to care for the ba- bies.
!Nursing as it is .•.•.•.
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Nursins as it is known in most countries has been unknown in Cambodia in. the p2.St. TreC\tJnent as prescribed by the doctor woule: be Given, but the actual beclsicle nursinc care W1'.S left to the relatives. They wouIe: sae th1'.t the pe:t.ient -eras mac~e comfor- table ane: l<JC::ulc' i-mah him, i f they felt it to be necess2ry.
The patient W2,S tr.ken to the hospital as a last resort.
Hany methoc:s of curine the patient such 2S elrinkin:: a concoction of different herbs or the ac'ministration of other unknown mecic ..
ines were first taken, so that by the time the patient was admi~
ted, he was often in a c ri tical condition.
Slowly tr.e people have bE;;un to re2JJ ~e that the has pi tal is there to help them~:et better.
The nurses have been taucht how to cure for the babies"
how to bathe them, how to prepare the feedincs and how to feed them. They have leurnec' that milk should be civen to thE. bnby after it he.s been heated, anc: that the hot water bottle should be placec_ next to the premature baty rather than on top of the
child. The mothers now have confidence in the hos)itd st~.ff.
The 1;';orlc: Health Orc;Ocnization nursinr team has Crown ancl now consis ts of 4 nur s inC r.nd mic:1Jifery ec~ucZ\ tors. 3ach of us has 1'. national counterpart, .. lho works "With us J who Will erac:uill.;y, assume. more and more resI'onsibility for the procrmnme. At pres- ent pre-fabricatec~ '.::uilc~incs are servin::; as school '.::uilc;ings 9-nd a b2.sic nursin:; course is 'cein,: ,~ivcn to 13 selectee: s tuclents.
vlith the assisto.nce of ;iInerican fun~ls, a nursinG school is beinG :.:uil t.
Teachin:: materials have already arrived. He hope that the status of nursin,: in Cmnboda will be raisec anc~ thRt better ed- ucatec' "irIs anl: '.::oys will :Je attractec1 to tc:ke up nursinG.
jIn July this year ••••
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