Vital statistics in Malaya are of limited value but annual reports show that the infant mortality in Penang Municipality is 125, in Singapore Municipality 172.2, in the Straits Settlements 165.28, and in the State of Kedah 137 per thousand births. The tables show a similarity to those of large English towns fifty years ago.
Poverty, ignorance and superstition account for many of these deaths and much maternal ill-health. Children are seldom taken out in infancy and houses are frequently dark, stuffy and closely-shuttered. Solid carbohydrate food is given to infants even during the first month. Congenital Syphilis causes a number of deaths and in an investigation in Singapore of mothers whose infants died in the first year of life 30.9 per cent. were Wassermann-positive.
Increasing use is made of maternity wards in the Hospitals and in Kuala Lumpur there is a Chinese maternity hospital with a Chinese woman doctor on the staff. The infant death-rate among Malays is much higher than that of other races, who are more willing to make use of the hospitals.
In the rural areas labour commonly takes place under the most primitive conditions with no help except that of an untrained handy-woman (bidan). A better midwifery service for these areas is gradually being developed and Malay women are being trained to replace the old "bidan" in the villages.
Education is doing something to inculcate modern views on the bringing up of children. The teaching of personal hygiene to teachers and pupils in the vernacular girls' schools is proving of value, and the Girl Guide movement has given an added interest to this.
Medical inspection of school children is more complete in the towns than in the rural areas. Dental caries, skin conditions, intestinal worms, and enlarged tonsils are common in the junior schools.
Tables are given of vital statistics and records of school medical inspection from the reports of the health officers of the Straits Settlements, Singapore, and Kedah. W. H. Peacock.
During the early postwar years up to 1957, the three main races in Malaya - Malays, Chinese, and Indians - experienced some differences in their levels of fertility. The lowest fertility was recorded among the Malays, with Chinese and Indian fertility about 5 percent and 10 percent higher, respectively. The comparatively low fertility of the Malays was owing to the exceptionally high rate of divorce, which meant unstable marriages and shorter periods of exposure to the risk of childbearing.A fairly well-defined pattern of state differences in fertility levels is found to exist in Malaya. Briefly, fertility was on the high side in the northern states of Johore, Malacca, and Negri Sembilan, and on the low side in the northern states of Penanq, Kelantan, Perlis, Kedah, and Trengganu, with the central states of Perak, Selangor, and Pahang in the intermediate position.The usual rural-urban fertility differentials are seen to prevail in Malaya as a whole and in the smaller units at state levels. Finally, the three main races registered higher fertility in rural areas, and the greatest gap between rural and urban rates prevailed among the Chinese.
The pattern and incidence of cardiovascular disease was studied in a general practice in an urban-rural area in the west coast of West Malaysia. Hypertension, rheumatic heart disease and congenital heart disease accounted for 85% of the 476 patients with evidence of cardiovascular disease. Ischaemic heart disease, arteriosclerotic heart disease and other conditions accounted for the rest. Emphasis is laid on the salient features of incidence in general practice. Comparison is made with previous clinical and pathological studies from this region.
Study site: General practjce clinic, Telok Anson [Teluk Intan], District of Lower Perak, Malaysia