Page 260 - Bahrain Gov annual reports(V)_Neat

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PUBLIC HEALTH DEPARTMENT

(Report by Dr. J. D. Grant, Medical (Mccr of Health)

While there was an improvement in the standard of general health in Bahrain during the
year under review and many diseases, especially Malaria and smallpox which were endemic
a few years ago, have been brought under control by a combination of preventative and curative
measures, a disturbing economic feature was the increasing cost of living which is resulting in
an inadequate diet for the lower income groups and causing much anaemia and malnutrition.
It is my duty to stress the importance of preventative measures as, although it isg encrally agreed
that much ill health is preventable, the tendency remains to concentrate upon perfecting and
extending methods of treating specific diseases rather than upon raising the standard of com­
munity health as a whole, whereby much sickness could be avoided; and nowhere does this
apply more than in an undeveloped country.

Hygiene and Sanitation. The Municipalities confine their sanitary activities to town
cleansing, which is organized by their Secretaries and supervised by inspectors whose
knowledge of sanitation is less than elementary. The duties should be carried out by
trained staff, especially as it is now necessary for local bodies to concern themselves with other
aspects of environmental health conditions such as bad housing, overcrowding and congested
living quarters, absence of proper water supplies and baths, unsound foods and insanitary
domestic conditions. Personnel were recruited for this purpose but so far have not been admitted
to the staff of any of the Municipalities.

There was some improvement in the cleanliness of coffee shops, restaurants and other
premises where food is prepared and sold, but there is still a long way to go to attain a
desirable standard. 3 restaurants and 2 coffee shops were closed due to the insanitary state of
the premises and 27 bakers were prosecuted for using bad flour. This action had a salutary
effect on the attitude of owners and employees to suggestions made for improvements by the
Health Inspectors.

The Meat, Fish and Vegetable Markets are privately owned and are rented to contractors
who operate them on a purely commercial basis and with little regard for the principles of
hygiene. The Municipalities are responsible only for their cleanliness but claim that this task
is impossible as neither the contractors nor stall holders co-operate. These establishments
should be taken over by the Municipalities who would then be in a stronger position to enforce
the Sanitary by-laws necessary for the maintenance of a satisfactory standard of hygiene.

It was not possible, for financial reasons, to proceed with the drainage and sewage scheme
prepared by the Consultant Sanitary Engineers, and conservancy disposal continues mainly
by the objectionable cesspit method. The Public Works Department was able to drain some of
the flooded areas but sewerage disposal remains an acute problem which grows daily with the
present rapid rate of building. A more hygienic system is highly desirable and should be em­
ployed whenever possible, and with this object in view, it is advised that all building plans are
scrutinized by the Director of Works and the Medical Officer of Health.
The building of working class houses and clearing slum areas will have to be undertaken
by the Government as private builders are only interested in the better class house. During the
year about 60 houses were built, but many more will be required to make any appreciable
impact on the problem. Unfortunately the government own very few sites and the price of land
is exorbitant, but it is hoped that it will be possible to overcome this difficulty, as I cannot
think of anything that will contribute more to the health and happiness of the people than to
give them a decent home.
Under the same auspices, the problem of village sanitation will have to be tackled. Villagers
have shown keen appreciation of the measures carried out to protect them from malaria, and
I am sure that they would co-operate wholeheartedly in any schemes designed for improving
the standard of sanitation which is still in the primitive state and is the cause of much unneces­
sary sickness and disability.