Health, Sanitation and Social Services

The period under review witnessed steadily increasing demands upon hospital services, and a broadening of social service functions to cope with all types of human problems hazardous to health.

The Guam Memorial Hospital is accredited by the Joint Commission on Accreditation of Hospitals, and is a member of the American Hospital Association, the Association of Western Hospitals and the Hawaii Hospital Association.

J. H. Feller & Associates recently concluded a study on the physical fa. cilities of the Guam Memorial Hospital with the recommendation that the Government of Guam establish an Islandwide Health Care Center composed of facilities that would provide every type of health service for its people. The proposed Health Center would be a concentration of all major groups, both public and private, interested in health care, on a common site surrounding a core of shared services. Under such an arrangement, services would be provided by an independent, voluntary, nonprofit corporation.

In the belief that such centralization of health services would lead to the best possible heal-th care at rates the patient could afford, the recommendation by Feller & Associates was accepted by the board of trustees of the hospital, and the decision made to seek legislative support to implement the recommendations .

Meanwhile, the "F" wing of the hospital was under modernization and reconstruction to provide 48 beds for tuberculosis patients. The new facility increased the number of hospital beds from 237 to 285. Vacation of the present TB wards will provide room for the much needed extended care facility. Further construction at the hospital took place on the "C" wing to provide for a public health diagnostic and water quality analysis laboratory at a cost of $220,683.

Patient services rendered during the fiscal year totaled $2,439,408, an increase of $272,080 over the previous year. Admissions to the hospital, including 1,819 newborn, numbered 7,667, an increase of 338. Outpatient visits totaled 37,246, and 34,363 X-ray examinations were performed as compared to 21,430 last year. Total collection in accounts receivable was $1,581, 222, an increase of $320,853 over the previous year.

There was an increase in free services offered to TB patients, to persons seeking Mental Health Services, ALS, NINDB, School Injuries assistance, Public Health services, etc., amounting to $458,059, an amount $92,624 in excess of last year. Eighteen social service cases were approved for abatement, amounting in dollar value to $15,570, a decrease of 207 cases and a decrease in dollar value of $110,212

from the previous year.

New equipment was installed in the Physical Therapy Department to assist in the speedier recovery of the acutely ill, the physical restoration of the chronically ill and the geriatric· patients. This department now offers three areas of treatment-hydrotherapy, electrotherapy, and a gymnasium. During the past year, 4,259 patients 'received treatment, which resulted in total billings of $18,696.

Magnetic tape selectric typewriters were leased by the hospital and one was installed in the Medical Records Department for the transcription of surgical reports, history and physical reports and the minutes of the Medical Staff Committee.

The greatest advances made by the Department of Public Health and Social Services during fiscal year 1969 were in the area of the decentralization of many services to clinics and offices in the outlying villages. There was an initiation of new services and programs in such areas as legal aid, intensive care for high-risk mothers, water pollution control, health education via television, service to older Americans and extensive planning for construction to further decentralize services in .comprehensive health, medical and social service centers.

Plans were approved for construction of a typhoon-proof diagnostic and treatment center at Inarajan at a cost of $551,434. Purpose of the center is to provide comprehensive preventive medical services and diagnostic and therapeutic services to people at the southern end of the island. The facility will include a dental clinic, laboratory, an X-ray unit, cervical cancer detection facilities, maternity and well-child facilities, and crippled children and tuberculosis clinics.

The Dental Clinic in the "C" wing of the Guam Memorial Hospital was renovated with the addition of a dental health education room, three new dental units, and improved dental X-ray equipment. The number of dental staff in the clinic was increased, and some progress was made in developing a method for long-range relief of the chronic dental manpower shortage. The Dental section now trains dental technicians to provide specific services normally performed bv other dental personnel. A dental training program in conjunction with the University of Guam is also scheduled to start in September 1970. Meanwhile, construction of a dental training facility at the University is scheduled for early fiscal year 1970.

Because of the shortage of professional staff, the b~lk of productive time in the clinic was spent performing emergency dental treatment on youngsters. A total of 5,680 school children received treatment, including topical application of fluoride. The Crippled Children Services, Maternal Child Health Service, Social Services, the Penitentiary and Detention Home accounted for 6,900 more dental treatments. In addition, dental health education programs were instituted for 810 senior high school students and some 4,750 students from Catholic schools.

The Crippled Children Services provided assistance to 4,618 children during the year, as compared with 2,830 last year. An additional 133 children from the· trust territory were also assisted. Over 450 new cases were diagnosed for speech and hearing services, and more than 40 persons were helped in the procurement of hearing aids. The major emphasis within the Hearing and Speech Center during the year was on the provision of a comprehensi~e •therapy program designed to train the more than 60 preschool deaf children who were victims of the 196364 epidemic of German measles.

The major emphasis in the tuberculosis control section has been in the

This 4-year-old girl, born deaf because of maternal illness during pregnancy, was one of the 48 children who participated in the first preschool program for youngsters with hearing impairment. The progam was conducted by the Depatment of Public Health and Social Services.

area of disease prevention. The prevention program led to the testing of 5,144 7th- and 12th-grade students. As a result, 111 students were placed on drugs and one child was given therapy. Tests were also conducted on 1,617 school employees. Of these, 114 were found to be infected with tuberculosis and were placed on drugs.

The policy of prevention also led to the screening of groups who were considered to have a high incidence of tuberculosis-the alien contract laborers. A large number of TB suspects were identified among this group.

Rabies control activities, the responsibility of the Department of Public Safety ( dog pound) and the Department of Agriculture ( predator control) , were to be placed under the jurisdiction of the new Zoonosis Control Division. A total of 2,046 dogs and cats were vaccinated during the year for rabies, as compared to 1,210 the previous year.

The Mental Health Clinic extended services to 268 patients during the year with referrals from the Social Services Division, the Public Health Nurses Division, the hospital, the Department of Education and private doctors and clinics. The program was, however, chronically hampered by the difficulty in recruiting professionally qualified persons. Arrangements were made, nevertheless, for close cooperation between the Juvenile Institution and the Department of Corrections for Mental Health Clinic services. A study was also made of the number of suicides on Guam by year and places of origin.

Legislation was passed authorizing Air Quality Control, and improvements were secured on water quality legislation. Involvement in Solid Waste Management activities also resulted in gaining a $70,000 Federal grant for planning, and in the Legislature increasing appropriations for refuse collection from approximately $250,000 in fiscal year 1969 to $500,000 in fiscal year 1970. Steps to reduce surface and ground water pollution were initiated, and all public beaches were monitored.

Modernization and construction of the . Public Health Laboratory was scheduled for completion in August 1969. The new facility will provide 2,600 square feet of additional laboratory space to complement the existing 700 square feet. The total number of tests conducted in the laboratory during the year was 50,727. Two laboratory personnel were sent)'or training at NCDC. One employee was trained in the diagnosis of Shigella and Salmonella, and the other technician underwent tl<!,ining in the diagnosis of tuberculosis.

The new Vital Statistics Act of Guam gave the Vital Statistics office a legal and enforceable base from which to operate. The U.S. standard certificates for birth, death, and fetal death were adopted during the year; vital statistics procedures were generally improved and conversion to the IBM computer system was effected. Over 5,000 copies of certificates were issued, and 2,512 births were registered.

Under the Comprehensive Health Planning program a study of the infant and fetal mortality of the indegenous population of Guam 1965-67 was completed, and a survey was initiated for measuring the impact of ill-health in the entire population.

Health education was stimulated by a series of weekly, half-hour television programs by the health educator. An emphasis program for health teaching in the area of drug abuse was also initiated in cooperation with the Attorney General's Office.