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3ea7ad4e-f2fd-45b6-8a9a-4efbf1763260 | With this end in view the Public Health Department has given the widest publicity to the subject by memoranda, literature and by practical demonstrations. A stall at the recent Health Exhibition in Woolwich was set aside for the sole purpose of focussing attention on the bed bug, its habits, life history and the methods which are being used in the Borough to exterminate it. In the past too little attention has been paid to the fact that families living in bug infested dwellings are often led 29 to conceal the presence of these insects for fear of the comments of their neighbours, though they may be well aware that the whole area is infested. It was, therefore, decided that propaganda should be used to try and dispel some of the innate prejudice which exists in the minds of many people—one of the slogans used in the propaganda campaign, "The bed bug is not a social stigma, it is a misfortune," led to many questions being asked as to the methods of eliminating these pests and their practical application. |
37018300-370a-43e0-8724-bf9b59ed6466 | The stall was the most popular focus of interest throughout the week and has led to a considerable increase of "bug-mindedness" in the Borough. The stall itself consists of three shelves and the sides and back of the interior of the walls were used to display pictures, literature and slogans. "The first shelf was used to show the life history of the insect and live bugs were exhibited in small glass jars in the six stages of development, with separate ones for adult males and females, eggs, "Mr. and Mrs. Bug and Family" and cast skins of the insect. "On the second shelf the haunts of the bug were displayed by showing a portion of a spring mattress in a glass case infested with live bugs, a portion of the underside of a chair and of an iron bed rail, each being grossly infested, the latter clearly showing that the bug will live in an iron bedstead. |
e280383e-5099-4c5a-9976-79edddda3cc6 | Other examples were wood mouldings, skirtings, picture rails, ceiling fillets, bed ticking, and pillow casing, each showing the presence of eggs, cast skins and the filth deposited. "The third shelf was utilised to show the materials used in Woolwich to destroy the bug, but the centre of this shelf contained a model of a bug, enlarged forty-five times in a glass case. On each side were arranged the gases, solutions and implements which consisted of, tins of Cyanide, Zyklon B preparation in a glass jar, a tin opener and hammer, gas mask, a cylinder and syphon of Etox, Cyanide testing outfit, a compressed air sprayer, bottles of various solutions, sulphur cylinders, sulphur candles and a pail, soap, floor cloth and scrubbing brush on which was a card bearing the words, 'You can use soap, and water and then paraffin oil. This method is also effective but takes longer.' |
a37a8595-4480-4d23-ba37-5db67adb403f | "The whole exhibit will be on view at the Institute on the occasion of the Sessional meeting on the 13th November when Mr. McKenny Hughes opens the discussion on 'The Bed Bug as a Housing Problem.' " (i) Health Services Booklet.—In 1931 it was decided to publish a booklet which would inform the public of the services available and also act as a reference book in case of need. A booklet was accordingly prepared giving detailed information regarding the Care of the Mother and Child; the duties of foster-mothers under the Children's Act; the Nursing Services; Ambulance facilities; Infectious and other Diseases; Disinfection; Sanitary matters; Health Education, Vaccination and the Registration of Births and Deaths. A first edition of 5,000 copies was quickly distributed during Health Week and through the Council's Centres, and since then revised editions have been similarly circulated. 30 SECTION III.—MATERNITY AND CHILD WELFARE. |
d2f67533-b0c3-400f-a953-b2868894b935 | The Council's Maternity and Child Welfare Scheme embraces the following services:— (a) Administration of the Notification of Births Acts, 1907-15. (b) Home visits to mothers and children. (c) Infant Life Protection. (d) Establishment of Welfare Centres. (e) Establishment of an Artificial Sunlight Clinic. (f) The systematic medical inspection of toddlers. (g) Provision of maternity outfits. (h) Payment of compensation to midwives. (i) The services of a Consultant in cases of Puerperal Fever and Puerperal Pyrexia. (j) The services of a Consultant in exceptional cases of obstetric or ante-natal abnormality at home. (k) Provision of Home Helps in maternity cases. (l) An arrangement with the School Medical Treatment Committee for the treatment of minor ailments in young children. (m) An arrangement with the School Medical Treatment Committee for the provision of dental treatment to young children and to expectant and nursing mothers. |
0403ed99-65bd-474d-a486-16e3f1b79a09 | (n) An arrangement with the Woolwich Invalid Children's Aid Association for orthopaedic treatment for children requiring such treatment. (o) Provision of nursing assistance for young children suffering from Measles, Ophthalmia Neonatorum, Zymotic Enteritis, Whooping Cough, Poliomyelitis, Pneumonia and Influenzal Pneumonia, and for mothers suffering from Puerperal Fever, Puerperal Pyrexia, Pneumonia arid Influenzal Pneumonia. (p) Day Ambulance service for maternity cases. (q) Reservation of twelve beds for children under 5 years of age who are suffering from such conditions as are usually treated in a general hospital, at the War Memorial Hospital. 31 (r) Provision of beds for the institutional treatment of midwifery for 144 cases per annum at the British Hospital for Mothers and Babies, and for 66 cases at the War Memorial Hospital. |
e8d70fd0-530f-4e43-a212-79884a55bb2b | (s) Reservation of beds, for ante-natal treatment and emergencies of midwifery, at the War Memorial Hospital, equivalent to 18 weeks' treatment per annum. (t) An arrangement with the Woolwich Invalid Children's Aid Association for the convalescent treatment of children requiring such treatment. (u) Convalescent Home treatment for expectant and nursing mothers. (v) Arrangements for the supply and distribution to young children, expectant and nursing mothers, of milk and food-drugs at cost price, half cost or free, according to economic circumstances. In addition to these services the Council have, at the request of the London County Council, undertaken to do such work as is necessary in the case of children under five years of age:— (w) Under the Blind Persons Act, 1920. (x) Under Section 6 of the Widows', Orphans' and Old Age Contributory Pensions Act, 1925. Staff.—Three whole-time medical officers are in medical charge of the clinics. |
9237cd3d-b4e9-4cca-9f10-bc287ae2aee3 | Each of these devotes eight sessions per week to Maternity and Child Welfare and three sessions per week to Tuberculosis. One part-time medical officer takes charge of the Toddlers Examination Clinic and two Consultants have been appointed— one for the Artificial Sunlight Clinic and one for consultations in connection with cases of puerperal sepsis and difficult obstetric cases at home. The dental staff— two dentists and an anaesthetist—are part-time and are appointed by the School Treatment Committee subject to the approval of the Council. The health visiting staff now consists of eleven whole-time health visitors: two of these are part-time sanitary inspectors, three are part-time infant life protection visitors and one is the artificial sunlight clinic nurse. It is the practice of the Council to appoint additional temporary health visitors during epidemics of measles. Dr. Rachel Mackenzie, who entered the service of the Council on the 1st August, 1918, retired on the 22nd December, 1934, on superannuation. |
ba06cbbe-4d17-4c5d-9049-d9dfffd24d6a | Dr. F. E. Smith, who was appointed to the vacancy so created, commenced duties on the 27th December. Miss W. Adams, a health visitor in the service of the Council, was appointed an infant life protection visitor and commenced duty as such in February. 32 Notification of Births Acts, 1907-15.—Every birth occurring in the Borough requires to be notified to the Medical Officer of Health within thirty-six hours of birth. As a matter of fact, only a very small percentage of births are so notified. As soon as a notification is received pamphlets dealing with the care and comfort of mothers and infants are sent by post to every mother. Subsequently, between the tenth and fourteenth day, a visit is paid to the home by the health visitor who decides on her first visit the necessity for subsequent visits. |
49042d0f-76e9-4954-a81e-8973189e91e0 | It may be stated, however, that, broadly, the general basis of visiting is as follows:—three visits during the first year and one visit in each subsequent year up to the age of five years, or until the child goes to school. The Work of the Health Visitors.—The work performed by these officers during the year, with regard to maternity and child welfare, is summarised in the following Table:— TABLE No. 6. Births—First visits 2,007 , Revisits 18,656 Infant deaths investigated 35 Still-births investigated 17 Expectant mothers—home visits 687 Infectious diseases:— Ophthalmia Neonatorum—First visits 7 „ , Revisits 64 Measles—First visits 2,264 „ Revisits 585 Puerperal fever—First visits 5 , , Revisits 5 Puerperal Pyrexia—First visits 20 , |
46bf001b-763f-4ce7-a428-b63072c9ccdf | „ Revisits 3 Zymotic Enteritis—First visits 3 „ „ Revisits - Pneumonia 81 Anterior Poliomyelitis - Encephalitis Lethargica 1 Infant Life Protection 1,184 Visits unclassified 293 Visits unsuccessful 3,374 29,291 33 In 1934 the Council paid the class fees and expenses in connection with the visits to approved institutions of one of the health visitors who attended a refresher course for health visitors. Infant Life Protection.—The Council became responsible on the 1st April, 1933, for Infant Life Protection work in Woolwich, and forthwith appointed two of their health visitors as Infant Life Protection Visitors (part-time), and in 1934 a third was so appointed. When evasion of the law is suspected the necessary investigations are made by one of the male sanitary inspectors. |
dced2e22-bcac-4f58-a3ac-b54ed1373b64 | The houses of all new foster-mothers are inspected by the district sanitary inspectors, who furnish in each case, a sanitary report. At the end of 1933 there were 104 foster children and 76 foster mothers on the Council's register and a year later the numbers were 93 and 68 respectively. It is the custom to report on all homes where women indicate their desire to become foster-mothers and in addition to the number of foster mothers shown above, another 45 were either temporarily without nurse children or had been noted as suitable persons. These figures do not, however, tell the whole story, as 171 foster children were added to the register and 182 foster children were removed during the year. The following Table shows the ages of the children under supervision on the 31st December, 1934:— TABLE No. 7. Under 1 year. |
44544ac0-e992-484c-9ce5-c547157b20ab | # 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 16 12 10 12 10 9 11 2 11 The number of visits paid by the Infant Life Protection Visitors was 1,184. The number of visits made by the male inspector, in connection with infringements and kindred matters was 70, while the number of visits paid by the district sanitary inspectors was 91. The number of, and nature of the various legal infringements discovered during the year were as follows:— 34 TABLE No. 8. Nature of Infringement. No. Keeping a nurse child without giving timeous notice 15 Change of address by foster mother without giving timeous notice 2 Infant removed from care of foster mother without giving timeous notice 14 Infant kept in premises or by persons prohibited from receiving same - Infant kept in excess of number fixed 1 Cautionary letters were sent in 28 cases. |
8b282ccf-c58e-4788-8afd-c8006b7fccf6 | No action was taken in 4 cases and there were no prosecutions. In 5 instances insanitary conditions were discovered, in 5 instances there was overcrowding and in 7 instances verminous conditions existed. In all cases appropriate action was taken to secure the abatement of the nuisances. Nurse infants who are kept under unsatisfactory conditions may be removed to a place of safety, but it was not necessary to remove any such during the year. All foster mothers are urged to attend the Council's welfare centres with the children under five years of age in their charge, and it is pleasing to record, that, with very few exceptions, every child of such age now regularly attends an infant welfare centre. Special care is taken to see that children who are weak and ailing attend the centres. During the year two nurse infants died—one from bronchitis and one from enteritis. The only institution in the Borough holding a certificate of exemption is the Woolwich War Memorial Hospital. |
cb71a3f9-1b9c-40f3-965f-90292e7e018f | The Work of the Welfare Centres.—These are eight in number and are all municipal. Four are in buildings belonging to the Council and four are held in church halls. Infant welfare sessions are held at all of them and ante-natal sessions are held twice weekly at three of them and once a month at one other. At the end of the year 6.25 ante-natal sessions and 21 infant consultation and weighing sessions were being held each week. \ In tabular form below are shown detailed statistics for 1934 and the consolidated statistics for the previous year:— 35 TABLE No. 9. Centre. No. on Roll of Centre. No. of Attendances. Mothers. Children. Mothers. Children. Expectant. Nursing. Expectant. Nursing. |
d5fb1104-9ce0-4a23-8b26-3a05aa618168 | Town Hall 406 443 1,459 992 885 9,775 Plumstead 256 261 1,113 637 463 8,068 Eltham 404 201 1,127 1,073 472 6,348 Slade 4 123 445 7 200 4,093 New Eltham 2 78 414 4 175 4,486 St. Luke's 1 39 279 1 62 2,323 North Woolwich 20 43 154 36 116 1,247 Beresford Street 38 78 173 62 162 1,154 Totals, 1934 1,131 1,266 5,164 2,812 2,535 37,494 Totals, 1933 979 1,225 5,210 2,532 2,474 37,743 The next Table, No. |
ce030d45-c74e-4dfe-9d42-f1e93eaca4a5 | 10, shows the number of children classified by year of birth and the number of attendances made by them during the year. TABLE No. 10. Children in Attendance At each Centre. Year of Birth. Town Hall. Plumstead. Eltham. New Eltham. Slade. St. Luke's. N. Woolwich. Beresford St. Totals. |
af272a8b-dda7-4af8-8fe6-c4c61bd66c6b | 1934 448 326 255 113 110 67 41 51 1,411 1933 418 324 276 106 126 85 36 44 1,415 1932 267 209 185 77 101 36 33 25 933 1931 195 112 165 64 50 37 24 28 675 1930 86 112 146 38 38 30 13 16 479 1929 45 30 100 16 20 24 7 9 251 1,459 1,113 1,127 414 445 279 154 173 5,164 36 Table No. 10—continued Attendances. Year of Birth Town Hall Plumstead Eltham New Eltham Slade St. Luke's N. Woolwich Beresford St. Totals 1934 3,356 2, |
ae158ff1-7539-4708-95d6-0c95fca92910 | 866 2,009 1,426 1,074 749 427 338 12,245 1933 3,550 3,186 2,325 1,867 1.606 997 400 390 14,321 1932 1,652 1,114 882 671 822 204 250 160 5,755 1931 838 473 546 303 311 176 103 155 2,905 1930 285 366 417 174 217 142 37 77 1,715 1929 94 63 169 45 63 55 30 34 553 9,775 8,068 6,348 4,486 4,093 2,323 1,247 1,154 37,494 These figures, which do not include attendances at the special Toddlers' Clinic or the Sunlight Clinic, |
5ad80c2d-5014-4d44-b960-b6397fa1ebde | show a slight decrease over 1933. Feeding of Infants in Woolwich.—In midsummer the usual enquiry was made, as in previous years, as to the type of feeding adopted in the case of infants attending the welfare centres. The method used was as follows:— (a) On the card of every child under one year of age attending a welfare centre, between the 16th July and the 24th August, was inserted once, and once only, the terms "Breast," or "Breast and Hand," or "Hand Fed." (b) The child's age was taken on the day on which this note was made. (c) At the end of the period the results were summarised for the whole Borough and the appropriate percentages worked out. The results of the enquiry are shown in Table No. 11, on the adjoining page. 37 TABLE No. 11. Feeding of Infants attending Welfare Centres—16th July to 24th August, 1934. |
ee09f70f-9666-405a-91cc-7a5b183d9868 | Method of Feeding. AGE IN MONTHS. 0-1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 Total 9-10 10-11 11-12 Grand Total Breast 61 75 58 53 41 27 26 19 5 365 3 - — 368 Breast and Hand 11 14 11 10 11 5 11 17 9 99 12 3 2 116 Hand 6 19 41 35 37 30 50 47 33 298 44 48 71 461 78 108 110 98 89 62 87 83 47 762 59 51 73 945 PERCENTAGES. |
98210e43-7441-4cb9-8285-fa618bf37af3 | Breast 78.2 69.4 52.8 54.1 46.1 43.5 29.9 22.9 10.6 47.9 5.1 — — 38.9 Breast and Hand 14.1 12.9 10.0 10.2 12.4 8.1 12.6 20.5 19.1 12.9 20.3 5.9 2.7 12.3 Hand 7.6 17.6 37.3 35.7 41.6 48.4 57.5 56.6 70.2 39.1 74.6 94.1 97.3 48.8 38 Artificial Sunlight Clinic.—The artificial sunlight clinic is held in part of the Town Hall Infant Welfare Centre. |
b4e1b393-4115-4128-a7ea-071c01db38b0 | The total number of patients treated during the year, including 133 whose course of treatment was not completed at the end of 1933, was 467. The total number of treatments given was 9,612 : of these, 7,546 were by carbon arc, 1,254 by mercury vapour lamp, and 812 by radiant heat lamp. The clinic is under the medical supervision of Dr. J. E. A. Lynham, who has furnished the following report on the year's work:— "The figures for the Sunlight Clinic show but little change from the previous year. A smaller number was carried forward, but a larger number of new cases was treated, the total being practically the same. The group under the heading 'Anæmia, Debility, etc.,' is still the largest, and is relatively considerably larger than last year. |
8f8bee8e-955c-4057-ba07-9e0a563beea2 | The total number cured or improved has dropped, but this is explained by an increase in those who ceased to attend and those who were under treatment at the end of the year. It seems undeniable that the Clinic is of real assistance in a district where social conditions are lowered by unemployment." In Table No. 12, are shown below the number and types of cases treated during the year:— TABLE No. 12. Cases treated at Sunlight Clinic, 1934. Brought forward from 1933 New Cases. Total. Much Improved or Cured. Improved. I.S.Q. Ceased Treatment. Treatment not yet complete Rickets 43 72 115 28 23 9 19 36 Anaemia, |
65cf2325-bf38-45da-ada0-37b37698b9e3 | Debility and Malnutrition 48 153 201 51 29 12 31 78 Catarrhal Children 14 28 42 9 5 3 11 14 Septic Conditions 1 2 3 1 — — - 2 Nervous Children 3 6 9 2 2 - 1 4 Enlarged Glands 12 27 39 15 5 — 5 14 Miscellaneous Nervous Conditions 1 2 3 — 1 1 — 1 Miscellaneous Skin Conditions 3 12 15 8 2 — — 5 Other Conditions 4 18 22 6 — 1 4 11 Mothers 4 14 18 2 3 — 6 7 133 334 467 122 70 26 77 172 39 Toddlers Clinic.—The routine medical examination of toddlers is now an integral part of the Council's Maternity and Child Welfare Scheme. |
91b9eda3-8543-466e-98fa-7d19d617483f | Children are examined in their birthday month, aged 2 years, 3 years and 4 years. Those requiring observation are called up for review at intervals of a few months, and those requiring *treatment are told how to obtain it. All are carefully followed up by the Health Visitors. The examinations follow the lines of the school medical examinations and are recorded in the same way. The record cards, however, are slightly modified in order to deal with special points of importance to the toddler. Three sessions are held weekly—one at the Old Town Hall, Woolwich, one at Plumstead Health Centre and one at Eltham Health Centre. The clinic is under the medical charge of Dr. Margaret Emslie and she reports below on the year's working:— "The finding at routine toddlers' inspections during the year 1934 are summarised in Table, No. 13, appended. "These figures and observations include all conditions clinically considered to show variation from the normal (i.e. |
bdf3d057-b8ad-4384-bb9c-60070da2db58 | from perfect functional utility and health), but it should be noted that all the conditions recorded were not necessarily considered to require treatment. In this respect the Table varies from certain other Tables embodying results of routine examinations, since these in some instances appear to show only cases or conditions referred for treatment, and are not a summary of simple observations on the child. In the case of certain defects or pseudo-defects there is in fact a large difference, in the conditions referred to here, between the incidence of signs and symptoms patent to the observer, or interesting to him, that may hold some possible significance on the future or past health of the child, or that might offer some indication for a different orientation of teaching in preventive health work at an earlier age, and therefore be worth recording, and that which is held to be a true abnormality or pathological state requiring treatment. |
e7591913-2853-4a0b-8b55-54610d869f20 | The best instance of this is the disease of rickets, in regard to which, as will be seen later, there is a suggestion that a widespread condition of latent or non-disabling rickets may possibly prevail, but a very low rate (7 per cent. actually) of children was referred to the orthopaedic clinic for treatment of deformities, of rachitic or other origin. Any suggestion that the cases recorded (on clinical evidence) as rachitic in this Table are comparable with the totals of cases of rickets referred for treatment of the acute condition, or for orthopaedic deformity solely, in the records of other clinics, would entirely falsify the impression that is intended to be given by these figures, and falsify the actually prevailing state of affairs. The observations offered in these annual records are offered as observations only, pending further investigation and 40 the accumulation of evidence as to what is and what is not important in the protective care of toddlers or in the better concentration of teaching at an earlier age. |
29952421-2e10-4c16-bc31-59544208e17a | Evidence of disease, it need hardly be said, can only be based on accredited facts, not on external observation, but in the beginning it is observation simply that must determine when it is or is not likely to be worth while to pursue the effort of getting more exact evidence. "To go on to the recorded findings it will be seen that the nutrition of the children seen (as judged by height, weight and general appearance) was considered to be extremely satisfactory, the rate for actual malnutrition (marked 4 in the Table) being as low as 0.4 per cent.; and for sub-normal nutrition or simple thinness (3 in Table) 11 per cent. (The ability to make a thin child fat is of course not always a question at the disposition of the parents' goodwill, or of their resources). In 53 per cent. |
be602484-71f3-439d-8f2b-dca726c04a8b | of cases, i.e., more than half, the general nutrition was recorded as excellent (this, however, included some children who were too fat) and in a further 35.5 per cent. as average. These figures are believed to compare well with findings elsewhere and are on a par with what has been found in previous years, always, however, showing a slight improvement. There can be no question—if these observations are just— of any suffering of the children from under-nourishment, even in difficult times. The muscle tone, still a better test than weight of the well being of the children, was put down as excellent in 70 per cent. of those seen. "Nevertheless there remains the question of possible rickets, aforementioned, and of anaemia, both commented upon in previous years. |
ba10d0ec-c446-4474-994c-eb64b26f45e9 | The number of cases showing external evidences of rickets (not necessarily active, in fact, in most cases, presumably non-active and healed, but the remnant of a non-healthy and unsatisfactory condition at an earlier age, on such assessment of symptoms as is here possible), amounts to 30 per cent. and that of anaemia 21 per cent. These figures are in accordance with what has been noted and annotated upon previously on the same evidence. Possibly these conditions are factitious, not to be supported by laboratory findings, but the impression recurs, and one may remember that there is actual evidence (in regard to anaemia, not rickets) of a proved high incidence of this condition in non-selected children of an earlier age investigated in a neighbouring part of London (c.f. Dr. Helen Mackay's work at the Queen's Hospital). |
114faecb-e0ea-4c6c-934f-4fb69c79d24f | If the miasma that rickets (of a discernible degree) and anaemia may exist somewhat widely amongst children of pre-school age, unrealised and unchecked till disclosed by routine examination, can be dispersed, all the better; until it is there remains the uncomfortable possibility that in spite of all our efforts at intelligent teaching as we understand it, all of our education of the mothers isn't going home or some of the education we give is wanting still in knowledge, in an important sense. If the condition, or conditions, are found to exist in reality, then all the more reason for our efforts to be increased and to be amplified in knowledge so far as possible. All of this waits only for research. 41 "Some of the points that suitable research would elucidate are clear and interesting. Is the anaemia, if it exists, merely a hang-over from Dr. Mackay's nutritional anaemia of infants, or is it of a separate etiological and environmental origin? (i.e. |
290d4109-6843-478b-95cf-8bbcfd224882 | when and how must we prevent it?) Can the rickets be established by X-ray findings and biochemical reports as true rachitis arising by the same causes as in earlier infancy? Is it healed or active? At what age did it begin? Does any of it, as a result of recent difficult times, and possibly selective feeding, show evidence of having arisen as a real deprivation complex, absolute or relative, in children who have been exposed to hardship, at an age corresponding with the hardship, and possibly at an age later than rickets is usually thought to be incurred? Does it correspond with any particular social stratum or circumstance? Or is it uniform (so far as it exists) throughout the centres in the district and the grades and circumstances roughly corresponding with these? "Dental caries is a condition recorded in the Table, that elsewhere has been associated with rickets, on laboratory evidence, as being secondary to a poor formation of enamel coincident with defective calcium-phosphorus metabolism such as we know exists in rickets. |
beafd2e2-9cda-45fd-ba18-6a59a13232ed | This year the figures for dental caries in the children examined show a diminution at the earliest age (3.5 per cent. of children shows caries at the age of 2, i.e., at an age between their second and third birthdays, compared with the best previously recorded figure of 8 per cent.). At the next age, 3 years, the figure remains high at 27 per cent., and at the age of 4, unfortunately, still 48 per cent. The diminution at the youngest age is, however, very gratifying if it is real, but it may in fact be somewhat falsified by the fact that children now come more accurately in their birthday month for routine inspection, than at odd dates between birthdays, and at the exact age of two, one would expect to see less caries than for example, some months later, nearer 3. "Of the 45 per cent. of children showing tonsil enlargement only 3.6 per cent. |
32c3e55b-48b4-46cc-b1e0-38e377b9a117 | were considered to require operation." TABLE No. 13. Medical Inspection of Toddlers, 1934. Disease, Defect or Condition. BOYS Age last Birthday. GIRLS. Age last Birthday. 2 3 4 2 3 4 Total Total Children Examined 224 190 158 225 182 166 1,145 Nutrition— (a) Excellent 145 85 35 167 109 62 603 (b) Normal 67 82 85 48 60 71 413 (c) Sub-normal 12 23 36 10 13 30 124 (d) Bad - - 2 - - 3 5 42 Medical Inspection of Toddlers, 1934—continued. Disease, Defect or Condition. BOYS Age last Birthday. GIRLS. Age last Birthday. |
c94d4f39-ef1a-40a3-9ad0-21c90b51a9e0 | 2 3 4 2 3 4 Total Muscular Tone— (a) Excellent 107 142 133 131 138 148 799 (b) Good 116 47 25 90 42 18 338 (c) Sub-Normal 1 1 — 4 2 — 8 Clothing and Footgear— (a)Satisfactory 219 186 152 223 178 162 1,120 (b) Unsatisfactory 5 4 6 2 4 4 25 Cleanliness— (a) Excellent 212 181 154 217 176 156 1,096 (b) Fair 12 9 4 8 6 10 49 (c) Dirty — — — — - - - Anæmia 38 48 32 51 41 31 241 Lungs— Bronchitis 4 8 6 3 9 10 40 Asthma —- — — — - |
b489c7cc-0604-42c6-b8a0-fdb447c3ecf8 | 2 2 Nervous System— Behaviour Symptoms 81 56 37 85 45 30 334 Organic Disease 1 1 1 1 1 1 6 Alimentary System— Worms 3 - 3 2 3 4 15 Other Conditions 6 6 3 6 7 2 30 Genito-Urinary System— Enuresis and Frequency 16 10 10 22 6 3 67 Other Conditions 3 2 2 — 2 — 9 Rickets— Including Healed Cases and Early Signs 74 76 65 52 45 34 346 Skin Conditions 16 16 8 19 8 11 78 Eye Defects and Infections including Squints 6 11 8 10 10 11 56 Ears— Otorrhœa, Earache, etc. 3 10 4 2 3 7 29 Nose and Throat— |
5e3ccf25-84ac-4bce-bbcd-857129ee9198 | Enlarged Tonsils 87 96 75 93 89 76 516 Enlarged Tonsils and Adenoids Adenoids Teeth— Caries 9 58 84 7 44 72 274 Hypoplasia 2 5 2 1 4 5 19 Malocclusion 25 11 3 29 14 3 85 Heart and Circulation— (a) Functional Hearts 39 39 48 35 35 42 238 (b) Organic Heart Disease — 1 — — — 1 2 Enlarged Glands— (a) Tonsillar 61 82 80 71 64 81 439 (b) Post-Cervical 50 48 53 39 53 45 288 Other Diseases and Defects 1 3 7 2 3 4 20 43 Provision of Maternity Outfits. |
7cef3bea-671d-4044-baae-845662f7b0d9 | —In 1930 the Council agreed to supply sterilised maternity outfits for the use of necessitous mothers in order to ensure the necessary cleanliness in domestic midwifery and with a view to minimising the risks of maternity. They are supplied free, half cost, or cost price, according to the family income, the Council's economic scales being used as tests of necessity. During the year 93 applications were received; 82 were supplied—51 free, 7 at half cost and 24 at cost price. Compensation of Midwives.—Whenever an assistant medical officer finds it necessary to recommend hospital treatment for expectant mothers referred to the Council's ante-natal clinics for ante-natal examination by midwives, the midwife loses her patient if the mother accepts the advice of the medical officer and is admitted to hospital. In these cases the Council make a payment of 10s. |
19a15839-e936-4937-8f27-5548b715e867 | by way of compensation to the midwife subject to certain conditions, which are referred to in detail in my Annual Report for 1931, being complied with. During the year compensation was paid in 8 instances. Administration of the Public Health (Puerperal Fever and Puerperal Pyrexia) Regulations, 1926.—The Council's scheme under these regulations was fully described in the Annual Report for 1928. The extent to which it was made use of is reported on fully in that part of the Infectious Disease Section of the report which deals with the notification of these diseases. Obstetric Complications in Private Practice.—In September, 1931, the Council arranged for the services of Mr. Harold Taylor, F.R.C.S., the Council's Consultant under the Puerperal Fever and Puerperal Pyrexia Regulations, to be available in such exceptional cases, and to pay him a fee of £5 5s. 0d. for each such case. |
2fdb495b-7430-4e57-92af-406d4d9f975c | No case was dealt with under this scheme during the year. Home Helps.—During the year 43 applications were considered by the Committee and 40 home helps were provided. The total cost of this service was £123 2s. 0d. Treatment of Minor Ailments.—Children requiring medical or surgical treatment for certain minor ailments are referred to the School Clinics at Brewer Street, Woolwich, or to the Eltham and Plumstead Health Centres; to a private practitioner or to a hospital. During the year 280 children were sent to these clinics and for each case the Council paid 5s. 0d. hildren referred to them suffered from the conditions set out in the following Table, No. 14, but it is well worthy of notice that the number of children treated at the Eltham Health Centre and the Plumstead Health Centre appear out of all proportion to the number sent to Brewer Street Clinic, Woolwich. |
5eb7e76c-81c5-4fa6-8d9b-cb7cdaf63812 | The explanation 44 does not lie in the fact that Woolwich children require less treatment; it is entirely due to the fact that facilities exist in the same building for the required treatment to be given at the time of the visit at Eltham and at Plumstead. TABLE No. 14. Brewer Street. Eltham. Plumstead. Impetigo 11 32 1 Ear Discharge 17 45 25 Eyes 19 37 34 Miscellaneous 2 40 17 49 154 77 Dental Treatment.—Mothers and children requiring dental treatment are referred from the Welfare Centres to the School Clinics at Brewer Street, Woolwich, at Westhorne Avenue, Eltham, and at Plumstead High Street. This service, which had been established at Woolwich for many years was extended to Eltham in 1932 and to Plumstead in 1933. |
aad4b19a-6402-4647-a2ce-50705761b662 | There are three sessions per month at Woolwich, two per month at Plumstead and two per month at Eltham. The following Table, No. 15, shows the cases attending and the total attendances during the year. The number of sessions was 84 excluding anaesthetic days. TABLE No. 15. Expectant Mothers. Nursing Mothers. Children under 5. No. Attendances. No. Attendances. No. Attendances. Woolwich 90 180 44 117 143 216 Eltham — — — — 126 221 Plumstead — — — — 112 161 90 180 44 117 381 598 Dentures are provided free, at part cost, or at cost price, according to the ability to pay, and payment is spread over many weeks. In consequence, the income received during the year includes money received in respect of dentures 45 supplied in previous years. |
52d668ef-4951-41a0-83cb-0afc8cf56515 | Twenty-five sets (complete or partial) of artificial teeth were supplied during the year at a total cost of £133 10s. 6d. Payments by mothers amounted to £72 1s. 0d. Orthopædic Treatment for Children under Five Years of Age.— Children requiring orthopaedic treatment are referred to the remedial clinic of the Woolwich Invalid Children's Aid Association. The Council pay for children under five years of age sent by their medical officers to the clinic, 2s. 0d. per attendance for cases requiring massage or electrical treatment and 1s. 6d. per attendance for any other form of treatment. The cost of these services for the year was £169 10s. 6d. Only cases recommended by the Medical Officer of Health are included in this scheme, and payment is only made for the number of attendances approved by him. In detail, the children referred to the clinic required treatment for the following conditions:— TABLE No. |
8cc8c712-10e0-4923-8818-b6166eac8d0f | 16. Cases treated at Orthopaedic Clinic, 1934. Type of Case. Number remaining over from 1933. New Cases. Total Cases. Number who completed treatment by end of year. Number with treatment not completed. Talipes (Club Foot) — 12 12 10 2 „ (Flat Foot) 2 9 11 10 1 Rickets— General 5 35 40 36 4 Genu Valgum (Knock Knee) 4 31 35 32 3 Genu Varum (Bow Leg) 2 18 20 13 7 Infantile Paralysis — — — — — Erb's Paralysis — 1 1 1 — Bad Posture 1 5 6 5 1 Muscular Weakness 1 4 5 5 — Mouth Breathing 1 3 4 3 1 Torticollis — 2 2 2 — . |
263d6b88-95f3-4b92-b53f-c43461ada50f | Other Deformities 1 — 1 1 — Other Diseases 4 2 6 5 1 Constipation — 1 1 1 — 21 123 144 124 20 46 Provision of Nursing Assistance for Certain Diseases.—In Section 1 of the report the general scheme of nursing assistance is described in full. The extent to which these services have been made use of in respect of specific diseases has been dealt with under these diseases, q.v. In February the Council considered an application from the Woolwich and District Nursing Association requesting that payments should be made in respect of the nursing of children under five years of age, suffering from diseases, other than those specified infectious diseases for which payment is made under existing agreements. The Association asked that payments should be made in respect of children suffering from threadworms, discharging eyes, otorrhœa, blepharitis and boils. |
0208f923-b094-4949-ab68-e7fb031385d6 | As arrangements already existed at the Minor Ailments Clinic for the treatment of these conditions, except threadworms, the Council decided to make payments in respect of the nursing of cases of threadworms only and to include all the nursing associations in the arrangement. It was agreed that during the financial year ended 31st March, 1935, a payment at the rate of 1s. 0d. per visit should be made in respect of such cases, that the total expenditure should not exceed £18, and that in the event of this amount being exceeded a pro rata reduction would be made in the payment to each of the associations. During the nine months of 1934 the number of cases so treated was 46, payment being made at approximately eleven pence per visit. Day Ambulance.—In accordance with an agreement entered into with the London County Council, ambulances are hired from that body for the conveyance of mothers to maternity hospitals between the hours of 8 a.m. |
3ae8c20d-d678-4814-bd89-7f2fb54f3e22 | and 11 p.m., and, except in rare instances, the cost is recovered from the patient. During the year this service was used on 8 occasions. Children's Beds.—Twelve beds have been reserved by the Council in the Woolwich War Memorial Hospital for the treatment of children under 5 years of age suffering from such conditions as are usually admitted to general or children s hospitals. Including those remaining in hospital at the beginning of the year, the number of children who received treatment during the year was 193. Of these 167 were discharged cured or very much improved in health, 14 were discharged as improved and 5 died. No children were transferred to other hospitals, 4 others were discharged showing no improvement, and the number remaining in hospital at the end of the year was 3. |
beb3b5df-7326-4a0b-90f5-3a02961cb9f1 | The surgical conditions for which these children were admitted included:—enlarged tonsils and adenoids, phimosis, hernia, abscess, injury, pyloric stenosis, rectal prolapse, and cleft palate, etc., and those admitted for medical treatment included children suffering from prematurity, marasmus, pneumonia, bronchitis, diarrhoea, urinary infection, catarrhal jaundice, and chorea, etc. Institutional Midwifery.—(1) British Hospital for Mothers and Babies.— There are 42 beds in this hospital, and I am informed by Miss Gregory, the Secretary 47 of the Hospital, that 801 babies were born during the year. At the ante-natal clinics in connection with this hospital, 8,682 attendances were made, and at the infant clinics, 2,687 attendances. In addition there were 190 extern cases. |
ba20a1f9-a2e5-4718-840f-cbcbba19cd37 | The number of mothers admitted under the Council's scheme was 138, the nett cost to the Council being £974 3s. 0d. (2) War Memorial Hospital.—There are 7 maternity beds in this hospital and I am indebted to Mr. R. S. G. Hutchings, the Secretary, for the following information regarding the admissions to the maternity unit during the year. The number of children born in the hospital was 195, and 40 mothers were admitted for ante-natal or emergency treatment. The number of attendances at the ante-natal clinic was 1,195. The number of mothers admitted under the Council's scheme was 61, the nett cost to the Council being £501 18s. 6d. Ante-Natal Treatment and Emergencies.—The number of cases admitted for ante-natal or emergency treatment under the Council's scheme was 4. |
c922a7a0-5083-48cb-9a6e-e47b680b6dc7 | The reasons for admission were: —Albuminuria, 1; Pyelitis, 1; Heart Trouble, 2. Convalescent Home Treatment for Children under 5 years of Age.— ♦ The necessary arrangements for this are made by the Woolwich Invalid Children's Aid Association to whom the Council give grants-in-aid for this purpose. During the year such grants were made in respect of 70 children, the total cost of whose convalescent treatment amount to £422 16s. 4d. The Council's grants amounted to £200. The children were sent away for periods varying from 2 to 27 weeks, and payment was only made in respect of children sent to homes approved by the Medical Officer of Health. During the year at the request of the Metropolitan Boroughs' Standing Joint Committee, proposals on the subject of a scheme which has for its object the provision of a convalescent home for the reception of mothers after confinement and their babies, was considered. |
c28bb607-2ac8-40a8-9dfa-aa7350ea40da | It appeared that money was available from a Trust for erecting and equipping such a home free of cost, but that no funds would be available for the maintenance of the home. The proposals provided for a home of thirty single rooms for mothers and babies, and nurseries for babies and toddlers. The Trustees who were responsible for the home asked whether the Metropolitan Boroughs as a whole would be responsible for 13 beds. The Council agreed to cooperate in the scheme. Convalescent Home Treatment for Expectant and Nursing Mothers.— In June, 1931, the Council decided to make provision under their maternity and child welfare scheme for the convalescent treatment of expectant and nursing mothers. The scheme included payment of railway fares where necessary. It was resolved also to recover some of the cost from patients after consideration of each case on its merits. During the year one mother was so admitted to a convalescent home. |
722614b1-f7c7-47be-aa34-ec0b1807dc77 | 48 Supply of Milk, etc., to Necessitous Mothers and Children.—Under the provisions of the Maternity and Child Welfare Act, 1918, milk, etc., is provided by the Council for necessitous expectant and nursing mothers, and children under the age of five years, under the conditions laid down in Circular 185, issued by the Ministry of Health, in March, 1921. The approximate cost of these services during the year was as follows:— Dried milk, £1,956 0s. 9d.; Fresh milk, Nil; Dinners, Nil. In January the Council decided to co-operate with the London County Council in regard to the supply of extra nourishment to maternity cases where domiciliary relief was being granted by the County Council. The details of the scheme may be summarised as follows:— (a) Grant of extra nourishment shall be considered as additional to, and not part of, ordinary relief. |
19e6daf3-2c92-4418-82e1-4b6c4dc02ae7 | (b) There shall be no material interval between the recommendation of extra nourishment, and the issue thereof, the Welfare Centre's recommendations shall be regarded as matters of urgency by Relieving Officers and District Medical Officers. (c) Women in receipt of relief who attend London County Council antenatal clinics for examination and advice prior to confinement in London County Council hospitals shall be dealt with by the London County Council, except in special cases. (d) After confinement the nursing mothers will be referred to Borough Council's clinics, with a view to any extra nourishment required being supplied through such centres. (e) Recommendations from Welfare Centres with regard to nursing mothers will be dealt with in the same way as expectant mothers. |
e55e24a7-1da1-4d0f-aa9f-cca9c4e8bb4d | All expectant mothers in receipt of relief not attending London County Council ante-natal clinics must attend Borough Council Welfare Centres, and the procedure suggested is as follows:— (1) The medical officer of the centre will forward to the relieving officer his recommendation for any milk or special foods which may be necessary for a nursing or expectant mother. (2) The relieving officer will consult the district medical officer on each recommendation, and will satisfy himself that the applicant is unable to provide the special nourishment without further assistance. The recommendation will then be submitted to the district sub-committee. 49 (3) If the district sub-committee agree to the recommendation received from the local welfare centre, arrangements will be made by the relieving officer for the supply to be issued by the centre. In cases of sudden or urgent necessity, the relieving officer will exercise his responsibility under Section 17 of the Poor Law Act, 1930. |
536515a2-5483-495a-a064-c8c3189210a9 | (4) Accounts for the supplies issued by the welfare centre will be forwarded to the Chief Officer of Public Assistance for payment. In May the scheme was modified as follows (1) To extend the scheme to provide that nourishment over and above the normal diet and necessary on medical grounds may similarly be supplied for delicate children, attending the metropolitan borough councils' maternity and child welfare centres, whose parents are in receipt of out-relief. |
a661ba15-96ba-464a-8d1c-724afdcb396e | (2) To modify the scheme by the deletion of the provision that a relieving officer must consult the district medical officer upon each recommendation as to extra nourishment received from a maternity and child welfare centre before the submission of the recommendation to the district sub-committee, on the clear understanding:— (a) That the district sub-committees, and (in cases of sudden or urgent necessity) the relieving officers may consult the appropriate district medical officer whenever in any case they consider such a course desirable, and (b) That the district medical officer shall be consulted in those cases in which medical relief is being afforded to the family. |
0b9da886-f6e1-428d-9a71-fe9782d97517 | In September the Council decided to accept certificates from medical officers in charge of London County Council ante-natal clinics at hospitals in the cases of expectant mothers attending such clinics who, though not in receipt of relief, are nevertheless in such financial circumstances as to be unable to bear the cost of such nourishment; reserving the right, however, of requiring a certificate from one of the Council's medical officers whenever such course is considered desirable. At the end of the year it was estimated that the amount due from the London County Council in respect of extra nourishment was £353. Blind Persons Act, 1920.—The Council, at the request of the London County Council, have arranged that home visiting of blind children under five years of age should be carried out by the Council's health visitors. Reports are furnished to the County Council, as the occasion arises, when the home conditions are unsuitable for blind children or it is advisable that the child should be admitted into a suitable institution. |
9681c239-63fe-430b-86e6-126f1092c724 | During the year no new cases came to the knowledge of the department. Widows', Orphans' and Old Age Contributory Pensions Act, 1925.—The local authority may, in case of desertion of a child who is an orphan, administer the payments on behalf of the child. No case under the provisions of this Act was dealt with during the year. 50 SECTION IV.—SANITARY ADMINISTRATION. Staff.—At the end of the year there were on the staff of the Sanitary Section of the Department, one Chief Sanitary Inspector, ten male Inspectors, one female Inspector and two part-time female Inspectors. Water Supply—The Metropolitan Water Board is responsible for the water supply of the Borough, and no complaints were received as to the quality of the water supply during the year. Removal and Disposal of Refuse.—House refuse is collected and disposed of by direct labour under the control of the Works Department of the Council. |
64796a66-b1e5-4e88-a1b3-aa1015b017d5 | Collection is made once weekly, with the exception of a small central area, where a twice-weekly collection is made. All refuse is disposed of by burning at the Council's destructor at White Hart Road, Plumstead. An opportunity of improving the present system of refuse collection was taken during the year, when the necessity arose for replacing the electric collection vehicles. These vehicles were definitely out of date, inasmuch as dust blew about during collection and transport, and the loading, line was too high. After trials of six different types of vehicles, it was decided to purchase four "Pagefield Prodigy" refuse collection vehicles of 15 cubic yards capacity each. Steps were also taken to improve the efficiency of the method of disposal of refuse at the Plumstead Destructor by a decision to provide a new hopper and refuse handling plant, together with the necessary conveyors. The cost of this improvement, including a new approach roadway and certain new buildings, was £12,000. |
78b32733-b57b-4182-9ddf-d666619a36be | Offensive trade refuse is removed by contractors, who remove fish waste from shops in the Borough and make their own arrangements with the shopkeepers as to the time and day of removal. The contractors provide airtight containers of a type approved by your Medical Officer of Health, the number of these supplied varying according to the individual requirements of the proprietors of the shops. Inoffensive trade refuse is removed by the Works Department at a charge of five shillings per load and 1,886 tons of such refuse were removed. Drainage.—Practically every house in the Borough is connected with the water-carriage system for the disposal of sewage. The exceptions are in out-lying parts of Eltham. 51 The inspection of new drainage and of extensive reconstruction of old systems is carried out by the Borough Engineer, but in all other cases alterations are supervised by the Sanitary Inspectors. |
d39e1998-ed43-46ee-822b-77d1a656fa21 | During the year 47 complaints were received regarding the defective action of combined drains; on investigation 244 houses in all were found to be affected. In all systems, except seven, the obstruction was of a temporary character. In 17 instances choked interceptors were found. Costs recovered from the owners amounted to £3 7s. 6d. In the following 7 instances reconstruction was necessary, and the work was carried out by the owners after the service of notices :—Mast Pond Wharf and Tuff & Hoar's Wharf, Woolwich High Street; 78 Archery Road, Eltham; 5-7 Speranza Street, Plumstead; 52-72 Tuam Road, Plumstead; 38-46 Spray Street, Woolwich; 28-29 Albion Road, Woolwich; 89-91 Kingsman Street, Woolwich. Seven single private drains were cleared at the request of the owners, from whom the costs, £1 14s. |
cb7e5732-4b60-4a85-ad47-86a2b62c28e8 | 0d., were recovered. Action with Regard to Smoke Abatement.—Twenty-six special observations were made to ascertain whether there were any breaches of the law regarding smoke emission and four nuisances were discovered, notices being served in each instance. No legal proceedings were instituted, as the action taken by the Sanitary Inspectors resulted in the abatement of the nuisances. Fouling of Pavements by Dogs—By-law.—In view of the fact that nuisance and inconvenience caused to pedestrians by the fouling of pavements by dogs appeared to be increasing, and because of representations made by ratepayers and residents in the Borough, the Council decided to make a by-law in the interests of public health. The by-law is as follows:— "(1) No person being in charge of a dog in any street or public place and having the dog on a lead shall allow or permit such dog to deposit its excrement upon the public footway. |
e60f6ce6-d2d5-404e-ac54-658c47178a7c | (2) Any person offending against this By-law shall be liable on summary conviction to a fine not exceeding Forty Shillings." The by-law was adopted by the Council at their meeting on the 3rd October, 1934. The Home Secretary confirmed the by-law on the 30th November, 1934, and fixed the date upon which it was to come into operation as the 1st January, 1935. The Rats and Mice (Destruction) Act, 1919.—Each district Inspector is the rats officer for his area and investigates all complaints received. The total number of inspections made was 381. In 50 instances defective drains were repaired, 12 premises were rat-proofed, and other effective measures were taken in 30 instances. National Rat Week was held from the 5th to the 10th November, and during it co-operation was obtained from the Borough Engineer and many large firms in the Borough. |
2ae31643-ebda-48e6-b10e-b2ef3ab46413 | The number of baits laid in old sewers in Woolwich and Plumstead, which were regarded as infested, was 10,548. 52 Complaints.— During the year 3,402 complaints of nuisances were made to the Health Department or to the Sanitary Inspectors on the district, and all these were investigated by the Sanitary Inspectors. Notices for the remedy or abatement of the defects or nuisances discovered were served upon the owner or other person responsible under the provisions of the Public Health (London) Act, 1891, or the appropriate Sections of the London County Council (General Powers) Acts, or under By-laws. Sanitary Inspection of the Area.—A summary of the inspections carried out by the Sanitary Inspectors will be found in Table No. 17. In connection therewith the number of Intimation and Statutory notices served was 2,642 and 444 respectively. |
aa4e34ac-d90f-4656-8e28-2461b1ceba07 | The Statutory notices related to 379 premises and included 315 general, 48 ashpit, 9 water-closet and 33 paving notices. In addition to these notices under the Public Health (London) Act, 1891, 39 notices were served under London County Council (General Powers) Acts and under By-laws. In 38 instances, where owners did not comply with the Statutory notices, the Town Clerk was asked to institute proceedings. It was only necessary, however, to issue summonses in three instances, as in all the other cases the necessary steps were taken on receipt of a letter from him. In Table No. 18, will be found a summary of the nuisances abated and defects remedied. TABLE No. 17. Inspections. |
c35120f1-cb1f-4b30-a788-ba0c4ee28d9c | Housing Survey — Houses Inspected 772 Drainage Inspections 1,690 Drains Tested by Smoke Test 418 Clearance Areas — Houses Surveyed 122 Drains Tested by Water Test 68 New Houses 1,627 Complaints Investigated 3,402 Tents and Vans 60 Outworkers' Premises 151 Factories 329 Houses Let in Lodgings 702 Workshops 418 Houses re Infectious Disease 1,550 Workplaces 121 Houses re Smallpox Contacts 33 Theatres and Cinemas 27 Houses re Verminous Cases 4,471 Rag and Bone Premises 5 Houses re Scabies Cases 192 Urinals Accessible to the Public 195 Houses re Other Diseases 243 Women's Lavatories 248 Common Lodging Houses 152 Smoke Observations 26 Overcrowding Investigated — Special Inspections re Rats 381 Rooms 30 Miscellaneous 1,905 Underground Rooms Illegally Occupied 5 Re-Inspections 8,196 53 TABLE No. |
dcaf5e39-eab3-4aa7-ad68-50029be1e38a | 18. Nuisances Abated. Cleansing- Sinks Repaired or Provided 233 Interiors Cleansed 966 Wastes Cleansed 14 Rooms Cleansed 2,239 Wastes Trapped or Repaired 322 Damp Conditions— Water Closets— Walls 587 Flushing Apparatus Repaired 210 Sites 16 „ „ Renewed 83 Roofs 483 New Pans 270 Rain Water Pipes and Gutters 290 New Traps 254 Others 46 Foul Pans Cleansed by Owner 24 Dilapidations— „ „ „ Occupier 65 Walls 771 Additional W.C.s Provided 1 Ceilings 596 Doors and Fastenings Remedied 58 Floors and Hearths 239 Coppers 146 Dust Bins Provided 708 Stoves 202 Others 70 Underground Rooms Closed 8 Verminous Conditions— Overcrowding—Cases Remedied 18 Rooms Cleansed 1,391 Water Supply— Defective Lighting— Additional 5 Windows Repaired |
f9dd222e-8cdf-4682-98d5-26f162f0adcc | 200 Re-instated 20 „ Enlarged 10 Cisterns Cleansed 2 „ Additional — „ Covered 2 Defective Ventilation- „ Removed 1 Windows Rendered Usable 431 Foul Accumulations— „ Additional Provided 3 Manure Removed 11 Other Means 6 Offensive Accumulations Removed 29 Defective Paving— Yards Re-paved 185 Back Yards Cleansed 13 „ Repaired 162 Dung Pits Provided 7 Scullery Floors Re-paved or Repaired 92 Rats— Drains Repaired in Consequence 50 House Drains— Defective Drains Repaired 280 Premises Rat Proofed 12 Choked Drains Cleared 286 Other Effective Measures 30 Vent Pipes Repaired 22 Rag and Bone Premises— Soil Pipes Repaired 12 Premises Cleaned — Gullies Fixed 119 Rain-proof Premises Provided — New Drainage 5 Vermin-proof Conditions Provided - Rain Water Tanks Repaired — „ „ , |
9bd666d0-bca4-461d-8f4a-856e2bf41d8f | Abolished 2 Miscellaneous 124 54 The Condition of the River Thames.— During the summer months there was a most offensive smell from the River Thames and this was the subject of general complaint, not only from those who worked or travelled on the river, but also from householders and shopkeepers in those areas near the River. London sewage effluent is discharged into the River from two main outfalls belonging to the London County Council, situated near Barking and Crossness, both in close proximity to Woolwich. Strong representations were made by the Council to the London County Council who were urged to take steps towards securing a permanent improvement in the state of the Thames so far as this was affected by the discharge of sewage into it. The quantity of sewage reaching the Outfalls is approaching 300 million gallons per day and most of it is discharged into the river after preliminary settlement of the sewage for removal of solid matters in suspension. |
16fe17ef-f6df-4b4b-b3da-fa866275f658 | A small proportion is treated with activated sludge, one large unit being installed at the Northern Outfall in 1931. In 1934 the County Council resolved to instal an additional five units and this will enable one third of the total dry weather flow at the Northern Outfall to be treated by this process, but the construction of these works will take time and will not be complete at the present rate of progress till 1940. As a temporary measure the County Council propose to use sulphate of iron, but this is only a palliative. The County Council, in November, in a letter to the Council enclosed the following statement:— "During the past summer the water of the Thames from some distance below the Council's outfalls up to the tidal limit at Teddington has been in an unusually bad condition. |
fa68ca9a-b356-4874-a677-8a20164d28a2 | So far as the reaches below, say, London Bridge are concerned, this condition is no doubt mainly due to the effluent entering the river at the Council's outfalls making more demands on the self-purificatory powers of the river than can be satisfied under the unusually difficult conditions which have prevailed during the last two years and which became more difficult when the fresh water flow of the river was allowed to be reduced to about onefifth of the volume of effluent discharged from the outfalls. "It must be admitted that the progress of self-purification has at times reached the point where it has been physically impossible for the oxygen of the air to be absorbed at a rate sufficient to keep the water free from offensive smell or to oxidise fully compounds in the water which would discolour white lead paint. |
d21746b6-2597-4e90-ada1-193ce3599fd6 | "Careful investigation shows, however, that the condition of the upper tidal reaches is due rather to the polluted state of water coming over Teddington weir, combined with the many discharges of effluent between Teddington and 55 the County of London. It has been realised for some years that the water of the Thames during the summer does not progressively improve from the outfalls to Teddington. The improvement which is observed on the early part of the journey does not continue, but a zone of deteriorating water is reached followed by some improvement towards Teddington. The low salt content of the bad water in these upper tidal reaches shows that it is not water which has come up with the tide from the region of the outfalls of the Council but is rather fresh water from the non-tidal reaches which has become polluted on its way to the outfalls and ultimately to the sea. |
171d3a2e-b870-4ceb-8657-568cef8b7223 | It is this water only which is available for dilution of the Council's effluent and it is insufficient both in quantity and quality for this purpose. "During the summer months (June to September) of this year the flow of sewage from the Council's outfalls averaged 238.9 million gallons per day (the average for the last ten years was 273.3 million gallons per day), and it is estimated that the effluent from other sewage works discharging directly or indirectly into the Thames below Teddington weir and above the Council's outfalls averaged 65 million gallons per day, and that the flow of upland water in this length into the Thames which is not measured would be, perhaps, 15 million gallons per day. |
dc5f4787-2587-469e-81be-3410a12d57f4 | The flow of the Thames itself over Teddington weir averaged 76.7 million gallons per day (June, 129.6 million gallons per day, July, 73.8 million gallons per day, August, 54.1 million gallons per day, September, 50 (approximately) million gallons per day. "The statutory flow in the Thames under the Thames Conservancy Act, 1932, is fixed at 170 million gallons per day, but under powers provided in that Act the Minister of Health reduced the minimum to 100 million gallons per day on 22nd June and to 50 million gallons per day on 11th July. |
c75e0ada-f5d8-49fd-9193-84a8c0837935 | "The result is that during the last four months a quantity of sewage effluent approximating to 300 million gallons has been discharged each day into the above-mentioned length of the Thames and has been carried up and down by the tides, while the flow of upland water tending to drive it down stream was on occasions as low as 1 /15th of this quantity, while during an average year the flow of upland water was at least equal to the sewage flow and generally exceeded it two and three times. "The Thames has not received a winter scouring by flood water for two years. As far up as Twickenham at high water it is both dirty and covered with floating matter—barges are employed in collecting driftwood. The quantity and quality of the freshwater flow available or permitted do not suffice to remove all this matter, to remove and oxidise accumulation of foul mud and to purify the Council's effluent. |
b71e1068-1fea-40a9-aeef-9078d3284c80 | 56 "It does not appear that there is any hope of improvement of the quality of water available for dilution—except the natural improvement due to increased freshwater flow—until the standard of purification of the sewage effluent in the upper part of the tidal portions of the river is improved. "Until the further purification plant which has been authorised is in use it will therefore be necessary to avoid bad summer periods by the use of chemical agents which will oxidise the more readily putrescible matters in the effluent as at present discharged rather than merely as heretofore to attempt to fix, without oxidising, constituents which might cause odours." Offensive Trades.—By the Transfer of Powers Order, 1933, consideration of, and decision on applications to the establishment anew or the enlargement of certain offensive businesses, or imposition, modification, or removal of conditions, was transferred from the London County Council to the Metropolitan Borough Councils. |
fadef308-817b-4ee5-9c25-83c8e5cca3c1 | In Woolwich, however, there is only one offensive trade, namely, that of a slaughterer of poultry. The premises were approved by the London County Council in November, 1931. Rag Flock Act.—Two samples of rag flock were taken for analysis. Such material must comply with the Rag Flock Regulations, in which it is laid down that the soluble chlorine in the form of chlorides must not exceed 30 parts of chlorine in 100,000 parts of flock. Both samples complied with the Regulations, as the results of analyses show, the number of parts of chlorine being, respectively, 3 and 4. Mortuaries.—The Public Mortuary is in Sun Street, Woolwich, and a temporary mortuary is provided in Eltham High Street. The following Table shows the use made of the mortuaries during the year:— TABLE No. 19. Sun Street. Sun Street (Infectious). Eltham. Ml Mortuaries. |
52803266-41a2-4c2e-9647-08a218d91fc1 | Number of Bodies Received :— 1933 1934 (a) For Inquest — — — — — (b) For Custody 11 — 3 16 14 11 — 3 16 14 Number of Post-Mortem Examinations — — - - - 57 Cemeteries.— There are two cemeteries in the Borough, known as the Woolwich Cemetery and the Plumstead Cemetery, the Woolwich one being divided into two parts, the old and the new. Both are owned by the Council and both are in the Parish of Plumstead. In 1932, land at Eltham was purchased by the Council for an additional cemetery. During the year, development of the land, and the erection of a Chapel and other buildings was undertaken by direct labour, under the supervision of the Borough Engineer. Only the western half of the land is being laid out at present, and provision is being made for three Church of England, two General and one Roman Catholic Sections. |
a0ef3439-3ef5-4e99-af4f-df1829e3ee3a | These sections comprise 4, 2 and 1¼ acres respectively. Two other sections of approximately 2½ acres are in course of development. A site has been reserved in the grounds for a Crematorium and a Garden of Rest. Burials also take place in Eltham Churchyard and in a private burial ground within the grounds of Christ Church Priory in Eltham High Street. In the following Table is shown the number of interments in the different graveyards. The information in the case of the cemeteries is given through the courtesy of the Town Clerk, and, in the case of the Eltham Churchyard, through that of the Vicar of Eltham. TABLE No. 20. Number of Interments. |
b08a59dd-0da8-401a-b7e7-c57316a5717b | 1932 1933 1934 Woolwich Cemetery 560 545 661 Plumstead Cemetery 765 769 755 Eltham Churchyard 232 252 236 Exhumations.— During the year one exhumation under Home Office Licence was carried out. Factory and Workshop Act.— The following Table No. 21, is in the form adopted by the Secretary of State to provide for uniformity throughout the country in the presentation of certain particulars of this work which lend themselves to statistical treatment. 58 TABLE No. 21. Factories, Workshops and Workplaces. 1.—Inspection. Premises. (1) Number of Inspections. (2) Written Notices. (3) Occupiers prosecuted. |
ea589d73-6cd7-4896-912f-8d8b6e14920e | (4) Factories (Including Factory Laundries) 329 17 — Workshops (Including Workshop Laundries) 418 6 — Workplaces (Other than Outworkers' premises) 121 1 — Total 868 24 — 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. |
1d77f524-92f8-45d0-92a0-e86ea8cad8e7 | (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:— Want of Cleanliness 24 24 — — Want of Ventilation — — — — Overcrowding — — — — Want of Drainage of Floors 2 2 — - Other Nuisances 12 11 1 - Sanitary Accommodation Insufficient 1 1 — — Unsuitable or Defective 27 27 — — Not separate for Sexes — — — — Offences under the Factory and Workshop Acts:— Illegal Occupation of Underground Bakehouse (S. 101) - - - - Other Offences 3 — 3 - Total 69 65 4 — 59 Table No. 21 —continued,. 3.—Outwork in Unwholesome Premises, Section 108. Nature of Work Instances. Notices Served. Prosecutions. (1) (2) (3) (4) Wearing Apparel— Making, etc. |
dfa9456e-8cf8-4cf2-aa07-61ee93701f72 | 2 2 — Removal of Infirm and Diseased Persons.— Power is given by Section 28 of the London County Council (General Powers) Act, 1928, to remove infirm and diseased persons living under insanitary conditions to institutions. Usually such persons are persuaded to enter an institution, but occasionally difficulty is experienced in this connection, and it is necessary to make application to a Magistrate for an Order. No such application was made during 1934. Sandpits.— It is the practice of the Council to disinfect all children's sandpits under their control at regular intervals during the year. Public Baths and Washhouses.— There are three bathing establishments in the Borough, one at Plumstead, one at Woolwich, and a small one at North Woolwich. At Plumstead there is a First Class Swimming Bath (capacity 120,000 gallons); a Second Class Swimming Bath (capacity 80,000 gallons); 64 Slipper Baths and a separate building for Turkish and Russian Vapour Baths. |
ac74936b-2bee-4b1b-91ec-14590d16ef68 | There is also a Public Washhouse. At Woolwich there is a First Class Swimming Bath (capacity 120,000 gallons); a Second Class Swimming Bath (capacity 90,000 gallons) and 60 Slipper Baths. At North Woolwich there are 22 Slipper Baths. Through the courtesy of the Baths Superintendent I am able to say that the total number using the Swimming Baths during the year was 334,070; Turkish and Russian Vapour Baths 13,335; Slipper Baths 195,159, and the Public Washhouse 18,242. Legal Proceedings.—The particulars of the various prosecutions instituted under the Public Health (London) Act, 1891, and kindred Acts are set out in detail in the following Table No. 22. 60 TABLE No. 22. Prosecutions under Public Health and Kindred Acts. No. Date of Hearing. Offence. Situation. Result. |
57c66c3a-b570-41b8-965e-19ff9df12de7 | 1 13th February An occupied dwelling-house without a proper and sufficient supply of water. "The Woodlands," Shooters Hill Closing Order made. Costs £1. 2 29th June Defective W.C. flushing apparatus, defective and dilapidated ceilings. 23, Sand Street Work done. Summons withdrawn on payment of 10s. 0d costs. 3 29th June Defective and choked rain water pipe; defective W.C. flushing apparatus. 25, Sand Street Work done. Summons withdrawn on payment of l0s. 0d. costs. 4 7th December Exchanging toys for rags contrary to the by-laws relating to Rag and Bone Dealers. - Fined 10s. 0d. |
56816c34-32e5-4601-a999-7fc1d1241c38 | Nuisance from Pigeons.— Under Section 52 of the London County Council (General Powers) Act, 1927, a Borough Council is empowered to seize and destroy, sell or otherwise dispose of house-doves or pigeons in excessive numbers, if they appear to have no owner. No action under this Section was taken during the year. Shops Act, 1934.—This Act, which came into operation on the 30th December, contains, inter alia, provisions for the health and comfort of shop workers, and it applies to retail shops, wholesale shops and warehouses. These welfare provisions deal with ventilation, temperature and lighting; with the provision of sanitary conveniences and sufficient washing facilities; and with facilities for taking meals, if these have to be taken in the shop. Metropolitan Borough Councils are responsible only for the administration of those sections which deal with ventilation, heating and the provision of sanitary conveniences. |
77500462-782d-4f69-af08-1ba64cf783f9 | Adequate means of ventilation and of lighting must be provided and maintained, and, unless the shop be specially exempt, suitable and sufficient sanitary conveniences must be provided, not only for those employed in the shop, but also for those employed about the shop. The Medical Officer of Health and all the Sanitary Inspectors were appointed Inspectors for the purposes of the Act. 61 Pharmacy and Poisons Act, 1933.—This Act places upon Metropolitan Borough Councils the duties of enforcing the provisions of that part of the Act which relates to poisons in Part 2 of the Poisons List. Poisons in Part 1 of the Poisons List may only be sold by "authorised sellers" and those in Part 2 by authorised sellers and by persons whose names appear in a register to be kept by the local authority. |
0e0487a5-3414-42d9-bf83-2108a1e13cc6 | "Authorised sellers," i.e., pharmacists, will be inspected by Inspectors appointed by the Pharmaceutical Society, but the Borough Council are required to arrange for the necessary inspection of all other persons. It will be necessary to appoint an inspector for this purpose and also to see that the requirements of the law relating' to the marking and storage of poisons are enforced. The Act will come into force on an appointed day. 62 SECTION V.— INSPECTION AND SUPERVISION OF FOOD. Each district sanitary inspector exercises a general supervision over all food exposed for sale and all food premises in his district. In addition three food inspectors have been appointed, two of whom are responsible for the inspection of meat at the slaughterhouses and for the taking of samples under the Food and Drugs (Adulteration) Act, 1928, while the third systematically and regularly inspects all food premises. Immediate steps are taken to secure the abatement of any insanitary condition discovered. |
f89e87a9-a6f0-4224-bce0-3eb58f910aee | The inspectors, in turn, are responsible for bi-weekly inspections of the markets. Registered Premises.—The London County Council (General Powers) Act, 1932, requires the registration of premises used for the following purposes:— (a) The sale, manufacture or storage of ice cream or similar commodity; (b) The manufacture of sausages; (c) The preparation or manufacture of potted, pressed, pickled, or preserved meat, fish or other food. Since the Act came into force an inspection of all food shops in the Borough has been undertaken and any structural alterations or improvements which have been regarded as necessary in such premises have been required by the Council to be carried out before registration is granted. |
594d547e-c924-4969-85e2-e3130e0ad2d3 | The register of such premises is kept in five parts, and the numbers in each part at the end of the y£ar, were as set out below:— (a) Sale, manufacture or storage of Ice Cream 195 (b) Manufacture of Sausages (c) Preparation or manufacture of Potted, Pressed, Pickled or Preserved Meat 93 (d) Preparation or manufacture of Potted, Pressed, Pickled or Preserved Fish 32 (e) Preparation or manufacture of Potted, Pressed, Pickled or Preserved other foods 4 The total number of inspections made was 968. 63 Inspection of Food Premises.— In addition to the premises dealt with above registers of other food premises in the Borough are kept, and Table No. 23, shows the number of inspections made in respect of each of these during the year:— TABLE No. 23. Premises. On Register 31st December. Number of Legal Proceedings. Inspections. Notices. |
4da25f11-2bb0-4779-adab-b2c32594dc83 | Bakehouses 35 93 10 — Cowsheds 8 86 3 — Dairies 77 254 2 — Slaughterhouses 4 27 5 — Fried Fish Shops 62 311 11 — Butchers' Shops 108 133 8 — Premises where food is prepared (other than above) 66 70 — — Shops and Markets — 1,312 3 — Milk Supply.— The Borough Council is required to keep registers of all persons carrying on in the Borough the trade of cowkeeper or dairyman, and of all premises in the Borough which are used as dairies. The following Table No. 24 shows the state of the registers at the end of the year:— TABLE No. 24. No. |
ca1aa11c-503f-44dd-af41-621031b4a134 | Dairy premises 77 Dairymen with premises in Borough 49 „ „ outside Borough 39 Cowkeepers 2 Cowsheds 8 Purveyors of milk in sealed bottles 145 The standard of cleanliness in cowsheds and dairies and in other premises where milk is sold has been maintained at a high level. The cowsheds in the Borough at the end of the year were as set out in the following Table No. 25. 64 TABLE No. 25. Situation of Cowhouse. No. of Sheds. No. of Cows. Licencee. Avery Hill Farm, Eltham 3 69 W. F. Fisher. Coldharbour Farm, Eltham 2 88 C. U. Fisher. Chapel Farm, Eltham 3 59 C. U. Fisher. Eleven samples of raw milk were bacteriologically examined during the year. The results are shown below. |
425edc0a-a5e4-4b0c-8280-e93f74745ae7 | Bacillus Coli was present in all these samples except those marked with an asterisk:— Bacteria per 1 c.c. January 16,666* 17,666 February 117,666 80,000* March 17,200 May 38,333 77,000 July 8,200,000 14,800,000 September 78,666 27,666* Designated Milks.— Under the Milk (Special Designations) Order, 1923, the Council are authorised to grant licences to persons other than a producer to sell milk under special designations. Each licence automatically terminates on the last day of the year in which it is issued. |
f8904481-a39f-4aad-9498-c417eb7a5a39 | In tabular form is shown below certain information relating to this Order:— Number of pasteurisers' licences issued 2 Number of dealers' licences issued to use the designation :— (a) "Certified" 5 (b) " rade A (Tuberculin Tested)" 7 (c) "Grade A (Pasteurised)" 13 (d) "Pasteurised" 14 Number of supplementary licences issued to sell:— (a) "Certified" milk 2 (b) "Grade A (Tuberculin Tested)" milk 3 (c) "Grade A (Pasteurised)" milk 2 (d) "Pasteurised" milk 8 65 Thirty-eight samples of pasteurised milk were bacteriologically examined during the year, including milk supplied to hospitals and schools in the Borough. The results of the examinations are shown below. Such milk must not contain more than 100,000 bacteria per cubic centimetre. Bacteria per 1 c.c. |
075d4d73-4d69-4491-8ab3-e03c02988ea9 | January 27,000* 1,500 — — February 15,800 2,500 — — March 15,000* 4,700 — — April 4,800 2,700 — — May 10,433 6,066 5,200 30,000* July 3,400 4,600 14,833 — September 5,200 7,000 4,200 3,700 49,000* 24,000 — — October 212,000* 2,600,000* 36,000* 124,000* November 920 730 94,000 57,000* December 16,800* 8,600* 11,200* 23,000* 222,000* 318,000* 98,000 102,000 320,000 Bacillus Coli was present in those samples marked with an asterisk. |
1ccdfed8-0594-449b-a149-6e961b73d697 | Dried and Condensed Milks.—Seven samples of condensed milk and five samples of dried milk were examined. The appropriate Regulations were being complied with in every respect. Artificial Cream Act, 1929.—This Act has for its object the regulation of the manufacture and sale of artificial cream. The Council are required to keep a register of all premises where artificial cream is manufactured, sold, exposed or kept for sale. No premises are registered in this Borough. Meat Supply.—Notice of intention to slaughter any animal must be given to the Council in accordance with the provisions of the Public Health (Meat) Regulations, 1924. Hie following Table, No. 26, shows the number of animals slaughtered and inspected in the Borough during the year. In 1933 the number was 38,763. 66 TABLE No. 26. Month. Cattle. Sheep and Lambs. Pigs. Calves. Total. January 231 1, |
5a9cc98a-d1ae-405f-863f-e5021e4fbf57 | 913 2,012 — 4,156 February 199 1,258 1,774 1 3,232 March 239 1,409 1,695 — 3,343 April 201 1,637 1,328 1 3,167 May 204 1,906 439 70 2,619 June 208 1,751 94 35 2,088 July 186 1,950 30 — 2,166 August 222 1,913 237 — 2,372 September 234 1,657 1,439 1 3,331 October 266 1,750 1,923 — 3,939 November 288 1,391 1,898 — 3,577 December 246 1,259 2,099 — 3,604 2,724 19,794 14,968 108 37, |
dc72ae5c-7bed-44d9-8870-77671a2c8890 | 594 The number of whole carcasses condemned on account of disease or injury was 54 (44 pigs, 7 sheep and 3 cattle). In 2,330 instances partial condemnation was necessary in respect of 1,965 pigs, 41 sheep and 324 cattle. Slaughter of Animals Act, 1933.—This Act, which deals with the humane slaughter of animals, came into force on the 1st January, 1934. It conferred new powers on local authorities and imposed new duties upon them as well as upon persons carrying on slaughterhouses and knackers' yards. The subject matter of the Act is not, however, new to local authorities as there is already a statutory duty to make by-laws for preventing cruelty in slaughterhouses. In London, the London County Council had, by their by-laws, required the use of mechanical stunning instruments for all animals (except in the case of animals killed according to the Jewish method of slaughtering) and this is the central requirement of the new Act. |
3f16bbf5-3c14-4117-8b3b-de4d2d5ddf61 | The Act requires that animals in slaughterhouses and knackers' yards are to be stunned before slaughter, and that the stunning shall be by a mechanically operated instrument which is defined to include an electrical instrument. This does not apply to sheep unless the local authority apply it by resolution, while goats 67 may be excluded by resolution. The requirement applies to pigs, but if electrical energy is not available this is a defence to proceedings unless it can be shown by the prosecution that electricity can reasonably be made available. Provision is made for slaughtering by Jews or Mohammedans for their co-religionists. In accordance with the provisions of Section 2, the Council at their meeting on the 3rd January, 1934, resolved that Section 1 should, on and from the 1st February, 1934, apply to sheep, ewes, wethers, rams and lambs, and they decided not to pass a resolution exempting goats or kids. |
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