At independence almost all major hospitals were operated by the government. Companies owning rubber estates provided elementary care for workers in their own facilities (which were called hospitals) and there were four private hospitals and two Christian mission hospitals, as well as six Chinese maternity hospitals [4]. Most health services were in the cities and in mines and estates owned by foreign companies. Although more than 70% of the population lived in rural areas, with the exception of some mobile dispensaries, these were grossly underserviced. Nor were there any national programmes to deal with many of the endemic communicable diseases causing severe problems [5].