64 + REPORT OF THE GOVERNOR OF THE VIRGIN ISLANDS

Hospital Services
 The Knud-Hansen Memorial Hospital experienced one of its worst
periods of strain on all its physical facilities. Every department had
to undergo unusual demands for more service, and at a time when the
operating budget at the beginning of the fiscal year was known to
meet approximately 71 percent of its needs. Admissions to the hos-
pital reached an all-time high of 3,388-an increase of 310 over 1961
and an increase of 510 over 1960. Discharges of 3,268 patients also
represented an increase of 306 over last year. Hospital deaths de-
clined from 106 to 97. Out-patient clinic visits representing services
performed inside the hospital totaled 23,011 although an additional
842 required services of either the Record Room or Hospital Medical
Staff. The increase in clinic visits was 3,150 for the fiscal year. The
hospital staff's problems included concern over the over-crowding on
the medical and surgical wards; difficulty in handling the volume of
out-patients crowding the clinics every day, and inability to recruit
qualified capable staff in every section. The same demands on the
facilities referred to in the discussion of the Knud-Hansen Hospital
also apply to the St. Croix facilities. These facilities, as those in
St. Thomas, were designed for a much smaller population than now
exists, and did not take into consideration the influx of residents,
both tourists and aliens. Services on St. John continued to increase,
with clinic visits and home visits reflecting the increase in service.

Division of Public Health Services
 During the past fiscal year, the evaluation of the services pointed out
 the need for emphasis on the development of local health services units
 in Christiansted, Frederiksted and St. Thomas-St. John Districts.
 The unit should be staffed with a local health officer. The need for in-
 creased community health services in order to reduce accidents, and
 other conditions amenable to good health practices is becoming more
 apparent. Improvements and record-keeping, including the utiliza-
 tion of accounting machines, will undoubtedly make this service more
 efficient. A study of chronic diseases in the Virgin Islands was
 initiated during the latter part of the fiscal year and will continue
 until completed. Again, in keeping with the emphasis on community
 health services plans are now under way to provide additional physi-
 cians to work exclusively in the Public Health Services on a full-
 time basis.
 The Home Care program is in the fourth year of operation. The
 regular case load has been on the average of 76 patients. The major-
 ity of cases represent cardiovascular diseases, diabetes and para-