22 With acknowledgement to the Director of Medical Services, Cyprus. RURAL MALTS Medical research and - experience - has by now achieved a great fund of knowledge about the protection and defence of humanity against disease. Very much still remains to be learnt, and research of vital importance is going on all the time. | But it will be generally accepted that the most important and. pressing question is how to make | widely available the benefits of the — . knowledge already gained. There are few countries now in which ‘hospitals are not reasonably accessible for the treatment of people suffering from disease. This is an essential and fundamental service but it is one side only of the campaign for health. It is now realised to an ever increasing extent that it is of even greater importance to prevent . disease and to take positive action to promote good health. To achieve this it is necessary to provide a he- alth service which is in close contact with ordinary people to an extent impossible for the centralized hospital services and, which can give them education and advice concerning the day-to-day conditions of their life. ~~ . Tt follows that such a health service will have to adapt itself to the type of community it serves. Cyprus is almost entirely agricultural. Before the war eighty per cent of its. people lived in the country, though some of these have gravitated to the towns during the course of the war. Administratively, Cyprus is divided into six districts, each with-a capital town. But in the life of most of the population, the natural centre of life is the village. - The health of the country people is the health and prosperity of the whole island. Not only beacuse they are the majority of the population, but also because most of the prevalent diseases of Cyprus are to be found in the rural areas. Malaria, typhoid, dysentery and trachoma are almost entirely rural diseases, and in the villages the infant. mortality rate is high. This state of affairs is mainly due to bad living conditions and to the ignorance in health matters particularly of mothers and children. It can only be remedied by the close contact of medical officers, nurses, midwives, Health Visitors and Health Officers with the people in their own homes. The scheme of Rural Health Units has been worked out to meet the case. The Colonial Development and Welfare Fund made a free grant of £125,000, and the scheme is now beginning to go into operation. So far, one unit has been established. This is at Athienou, ‘a big village of some 3,000 inhabitants in the middle of the Mesaoria plain. It first went into action in February, 1945, and now, after eight months. 7 It is still very much at the experimental stage. It is necessary to find out by careful trial how best to meet actual . needs and to carry out work in each line. So far there are only temporary buildings, which involve a great deal of improvisation. And not all of the staff are fully trained. © However, the Athienou Unit is a going and living concern, which is due to the keenness and good-will of everyone connected with it, both staff and villagers. The villagers feel that it is their affair, and that they are intimately concerned both in helping to get it going and in keeping it running. Such an attitude is an essential factor of success in a project of this kind. Ne Welfare Clinic at Athienou - Rural Health. Centre. , vNITS | : By M, 8, There is no. spoon-feeding this | is not a service applied to the- , Village from outside by the benevolent ‘despotism of. the Medical Depart- ment. The spirit of self-help is. . strongly in evidence on all sides. The Rural Health Units will eventually cover the whole island they came - to Athienou first. because of the great interest and keenness of the inhabi- tants. The local Agricultural Club made a collection for the Centre, and ‘has paid the rent of the temporary ~ buildings for three years. Four girls were. chosen to go to Nicosia to be trained as nurses at the General, Hospital, after which they will: work at the centre in, their own village. Meanwhile, the. Club is helping to support their families, who would otherwise be hard hit by the loss of the girls’ earnings while they are. in . training. oo, : fo Preparations for the permanent buildings are. already well in hand. A farmer has given a very good piece - of land, with olive trees bordering it, which will be welcome for shade in summer in this hottest part of the plain. The villagers have cut the stone and carted it to the site, and the actual work of building is now ready to . begin. And the villagers do not consider that their respon- ~ sibility ends once the Centre is established they have agree to make a. regular contribution to the running expenses, The temporary buildings are cramped, but-spotlessly clean and tidy. There is a house which is used as a small hospital with beds for nine patients, and also provides quarters for the nurses. Another room is used for the welfare clinics, with a room for the doctor adjoining it. The outhouses have been converted into a dispensary, a’consulting room and office for the doctor, a room used in Box and Cox fashion by the visiting dentist and the eye clinics, and an office for-the Health Inspector and the clerk who keeps the records. At Athienou itself there is a regular system of out-patient dispensaries and ante-natal and infant welfare clinics, as well as the special clinics for eyes and teeth. In addition, weekly clinics are now held in some of the other villages. Eventually there will be many more of these, as more villages establish their own sub-centres, and as more staff becomes available. The main object of the Rural Health Units-Scheme is preventive médicine and the promotion of positive good health. This object will have to be achieved gradually, but there can be no doubt that achieved it certainly will be. However, there are many difficulties which must first be overcome. For one thing, there is a far greater amount of sickness than had been expected. “i 3 Many people who come to the Centre, even to the welfare | clinics intended primarily for healthy people, are found to be ill. Every child without exception has threadworm, and enteritis, impetigo and septic sores are partiéularly common. Their treatment naturally has to take precedence over general welfare. And people need to be educated in ideas of general health and sanitation, starting from a basis of almost complete ignorance. ~ - . The amount of sickness found means that the original estimate for staff was too low, and it will take a long time | to find and train enough of them. An additional difficulty is that the people are very doctor-conscious, and need educating to be satisfied to see a nurse only, 7 ὃν (to be concluded) -