Health > Intergovernmental conference of Far-Eastern countries on rural hygiene : report by the Preparatory Committee

II
They treat patients at the dispensaries, but are also allowed
to take private patients ; and at the same time they are
responsible for the supervision of the water-supply and of sewage
and refuse disposal, the inspection of foodstuffs, infectious
disease control, the school medical service and the supervision of
child welfare centres. Here, then, we have a case in which the
two services are merged together both at the top and at the
bottom—i.e., in the directing staff and in the person of
the doctor, who comes into immediate contact with the
people.
The system in Java is somewhat like that in the Philippines,
except that only public health inspectors and residency medical
officers can be said to be specialists in public health. The
residency medical officers, who represent the director of ti e
medical and public health department wherever they are
stationed, are entitled to inspect hospitals and dispensaries,
although their functions do not include curative medicine.
The medical officers under them, each of whom is responsible
for a small group of municipalities, engage in both preventive
and curative work.
Even in countries which have no separate public health
department, however, specialisation is generally found in the
lowest ranks—vaccinators, mosquito inspectors, members of
malaria squads, quinine distributors and sanitary inspectors.
The dangers of over-specialisation should, however, be
emphasised. When, for example, the whole personnel of the
department has to be mobilised to fight an epidemic, the medical
staff ought to be capable of assisting in preventive work. For
this reason, the sub-assistant surgeons in charge of rural
dispensaries in India receive instructions regarding preventive
measures from the Public Health Department when an epidemic
breaks out. In some provinces, indeed, there is a tendency,
even in ordinary times, to put the rural dispensaries under
this Department, the object being to extend their therapeutic
field (the public health services being always more mobile
than the medical services) and to make them responsible for
certain specified public health work. The same is the case in
Malaya, so far as travelling dispensaries are concerned.