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cf2b73ae-ddce-4c31-a33f-0daa3c6b5bc3 | 39 It is by no means unsatisfactory that out of about 1,150 births, somewhat over 800 women attended at your Ante-Natal centres, but in the absence of evidence that the remaining 350 cases were under adequate supervision, the figure of 825 first attendances must be regarded as one on which to improve. The number of women attending for the first time at the ante-natal centres was 825, compared to 716 in 1936. This gives an increase of 14 per cent. approximately of the number of newly confined mothers who attend ante-natal clinics in Barking. This is a satisfactory figure. The average number of attendances per expectant mother is 5.1 and this is a big figure for ante-natal attendances, because a considerable number of the mothers did not come for the first time until late in pregnancy. In connection with this it is worth while to note that some mothers are beginning to take advantage of the ante-natal centres early in pregnancy. |
8db93c10-277b-41d0-8051-d6b65dd60535 | This is most noticeable amongst young mothers expecting their first baby. At the ante-natal clinics, mothers attending for the first time are seen firstly by the sister in attendance, who, if the mothers have not made arrangements for the confinement, gives them information about obtaining the services of a midwife and about admission to the Upney Hospital. After a few routine tests every mother is seen by the medical officer in charge of the clinic, and in the case of mothers attending for the first time a full history is taken, including any previous illness and the course of any previous pregnancies. Enquiries are made about the present health of the mother, and then she is examined and measured. Any abnormality is noted and steps taken to meet the situation. Abnormalities may vary from a slight physical disability, such as dyspepsia or foot trouble, to gross pyorrhoea or a gross gynaecological defect. |
cfde96b8-52e0-4f69-a569-d2098e64d4b9 | The minor troubles can be treated at once by medical prescription or by local application, more severe complaints can be referred to the appropriate clinics, and where any obstetric or gynaecological complaint is sufficiently severe it can be referred to the Consultant Gynaecologist and Obstetrician at his special clinic. Some of the mothers who attend are found to be suffering from a greater or lesser degree of malnutrition and after enquiry these cases may obtain help from you in the form of free milk, free dinners, and free tonics. The ultimate effect of this extra nutrition upon maternal mortality has not been ascertained clearly, but there is no doubt about the immediate effect it has and the benefit it gives to the mother. (b) iStill-births.—In 1926 the Medical Research Council published the results of close investigation into still-births. 40 Now, as then, many of the underlying factors remain obscure. |
8dcbbd68-1a94-4865-9061-8f9b46d43e76 | Maternal illhealth during pregnancy, and perhaps also before the occurrence of pregnancy, has been shown to be a factor which is probably of great importance in relation to the occurrence of dead births. It is presumed that maternal morbidity is closely related, both to foetal and to maternal mortality. It is certain that an intra-cranial lesion, with its accompanying haemorrhage, is at least an important contributory cause of death, although it is impossible to ascertain the precise cause that extinguished the life of the foetus. The suggestion is, therefore, that a proportion of intra-natal deaths are associated with manipulation of some kind or another. It is not supposed that such manipulation is unnecessary, but rather that efforts be directed towards the reduction of the need for such obstetric interference. The inference is that more and oftener ante-natal supervision would lead to the discovery of abnormal conditions at a time when they could be rectified by relatively simple measures, and closer co-operation between doctors and midwives, etc. is stressed. |
a7152d6d-e6e9-45e6-9ea8-d1fd4056a5c5 | Closer attention is now given to this whole question in the teaching schools, particularly in respect of post graduate courses, and periodical revision courses for midwives are now insisted upon by the Central Midwives Board. (c) Midwifery.—The Council has been the Local Supervising Authority for Midwives since the 1st April, 1935. |
fb3ad172-227e-4761-8c66-6799f7357b4f | Fifty-four midwives notified the Local Supervising Authority of their intention to practise within the Borough during the period 1st January, 1937 to the 31st December, 1937, and the number who were engaged in practice in the Borough at the end of the year was as follows:— At Upney Hospital 5 Municipal District Midwive 5 At the District Nurses' Home of the Plaistow Maternity Hospital 2 At the Salvation Army District Nurses' Home 2 In private practice 11 The number of visits of inspection paid by the Inspector of Midwives was 43, 41 The following is a summary of notifications received from midwives:— Medical Help 191 Deaths of Mother or Child 10 Laying out the Dead 6 Still-births 19 Liability to be a source of Infection 16 Artificial Feeding 3 245* *of these, 34 notifications were received from the Upney Maternity Hospital. |
4261361d-c54b-4abb-906d-b2a495ec2441 | This figure is considerably smaller than for previous years on account of the fact that, on 7th May, 1937, approval was obtained for the Upney Maternity Pavilion, to be recognised for the purposes of the Central Midwives Board Rule E.2. Rule E.2 exempts a midwife who is exercising her calling under the supervision of a duly appointed resident medical officer within a hospital approved by the Central Midwives Board from certain rules, including the one which requires her to send for medical aid in certain circumstances, to which she would otherwise be subject. |
8f81d747-d837-41cd-96dd-18dfc8f66943 | The following is a summary of the 191 cases in which medical help was sought Mother:- Anaesthetic 23 Engorged Breast 2 Haemorrhage-—Ante-partum 5 Post-partum 6 Malpresentations 19 Miscarriage 1 Prolonged labour 19 Rise of temperature 9 Retained placenta 2 Ruptured perineum 27 Uterine inertia 3 Miscellaneous causes 22 138 42 Child :— Discharging eyes 23 Prematurity 10 Spina bifida 1 Unsatisfactory condition of infant 16 Miscellaneous causes 3 53 By agreement, dated 1st January, 1924, with the Plaistow Maternity Hospital and District Nurses' Home, the Council annually subsidise the Hospital on any deficit from £300 in respect of the district midwifery work of their midwives in Barking. Their takings for 1937 amounted to £170 2s. |
04d0ceb8-68b3-4745-a714-1689749e7404 | 0d., leaving a balance payable to the Hospital by the Council of £129 18s. 0d. During the year 1937 there were 1,057 maternity cases in the district. 120 of these were conducted by the Plaistow Maternity Charity, 411 of them were conducted by your own midwives at Upney Hospital, 174 were conducted by the midwives of the Salvation Army Organisation, leaving 352 which were dealt with by medical practitioners, private midwives or otherwise. (d) Midwives Act, 1936.—Pursuant to Section 1 of the Midwives Act, 1936, the Council submitted their scheme to the Ministry of Health in January, 1937. For the purpose of the scheme the Borough was divided into four areas. |
34445a32-5c7e-4315-b70b-9d64b8b0414b | The Becontree South Area included that part of the Barking section of the Becontree Estate, south of the District Railway Line, and the scheme provided for the employment of two midwives by the Salvation Army, who for many years have maintained a centre within this area, from which their midwives have practised. The Becontree North Area included that part of the Barking section of the Becontree Estate, north of the District Railway Line, and to practise in this area three midwives were to be directly employed by the Barking Council. In the Barking Abbey Area, which included the Abbey, Eastbury and Gascoigne wards, except that part of the Borough between the District Railway Line and the Tilbury Railway Line, two midwives were to be employed by the Plaistow Maternity Hospital and District Nurses' Home, whose midwives have for some long time, been practising in the Borough, and [(possibly)] one midwife was to be employed directly by the Council. |
c3338ed9-54d5-4539-94c3-da58b879503f | 43 For the remaining part of the Borough—termed the Barking Upney Area— two midwives were to be employed directly by the Council. In July, 1937, a communication was received from the Ministry of Health which gave the Council authority to put into operation their proposals regarding the Becontree North and the Barking Upney Areas, and five midwives were duly appointed and took up their appointments towards the end of the year. The two voluntary organisations concerned,—the Plaistow Maternity Hospital and District Nurses' Home and the Salvation Army—lodged certain objections to the Council's proposals, with the Ministry of Health, and negotiations were still pending at the end of the year. Subsequent negotiations belong properly to my next year's Report. |
5f3c0c0b-9f7f-494d-9a3c-8d1eb75fcb9d | I can, however, state that agreement has been reached, that the negotiations pending at the end of last year have been successful, and that it is anticipated that the Plaistow Maternity Hospital and District Nurses' Home and the Salvation Army will be conducting their part of the scheme in the near future. (e) Upney Hospital.—The admissions to the Maternity Home during 1937 numbered 474 of which 63 were admitted for ante-natal treatment. During the past year the daily average number of beds occupied was nineteen. The total number of bed-days was 7,040. From the above figures it is clear that the admissions to the above hospital are still increasing, and particularly is this so regarding cases admitted for ante-natal treatment. This part of your service is obviously a feature which is becoming very popular amongst mothers and once again the extension of the facilities you provide becomes an urgent problem. I regret that during the year we have had the resignation of " Sister " of the Maternity Hospital. |
08651c93-9147-410a-8dbc-b1cf1133b29d | Sister Ethel Jones carries into her retirement the very best wishes of all those who knew her and knew the good work which she consistently carried out. It is significant that Sister Jones came to the hospital at a time when it was anticipated that 12 cases would be the average admissions per year, and that at the time she left the cases numbered approximately 400 per year. 44 During the 18 years Sister Jones has been with us she has laid the traditions of the hospital, and her foundations will carry the stoutest super-structures on the work she has so well begun, and her name will remind thousands of the devout care with which she carried out what to her was a high calling. (f) Post-Natal Care.—It is not sufficient for the mother to receive all the attention possible prior to and during her confinement, because full attention should also be given to the mother after the confinement. |
79f29e97-9616-45eb-81d0-08a886b63484 | Here, I am glad to say, fuller use is being made of the Humphrey Ward, where, as I have stated previously, the resident medical officer of the Upney Hospital is in attendance. The more mothers claim the advantage of this clinic the better will be their health and happiness. (g) Gynæological Clinics.—The numbers attending these clinics are steadily, if slowly, increasing and provision is made at all clinics for these examinations, when arranged by your health visitors, etc. It is now possible for women who wish to have advice on any matter associated with their womanhood to have that advice. I want to make two points quite clear. Firstly, this means that women are entitled to advice, whether they think there is anything wrong or not, and if these periodical examinations are carried out women can have the security and satisfaction of knowing that everything is right, or alternatively anything which is wrong can be dealt with whilst it is in its earliest stages, when probably treatment may be only of a minor character. |
0a2a4ae3-6b84-48a7-944c-c3372d596805 | In the second place, this means that these clinics are definitely intended for examinations from one standpoint only and that is woman's womanhood. These clinics are not intended for questions of general medicine, which apply equally to all men and women. (h) Pemphigus Neonatorum.—Pemphigus Neonatorum is in Barking an infectious disease within the meaning of the Infectious Disease (Notification) Act, 1889, and two such notifications were received during the year. (i) Maternal Mortality.—According to the return of the Begistrar-General there were during the year 1937, five deaths from puerperal causes—one death from puerperal sepsis and four deaths from other puerperal causes. This gives a rate of 4.28 per 1,000 total births. 45 The following table gives you similar information for the last fourteen years:— Maternal Mortality—Statistics. Year. Barking. |
47748b83-779b-4d22-a826-c853c84d5cd5 | England and Wales Deaths from Rate per 1,000 births. Rate per 1,000 births. Puerperal Sepsis. Other Puerperal Causes. 1924 1 2 3.66 *3.90 1925 — 1 1.21 *4.08 1926 — 1 1.22 *4.12 1927 2 1 4.23 *4.11 1928 — 2 2.48 4.25 1929 — 2 2.54 4.16 1930 — 3 3.72 4.22 1931 1 3 4.08 3.95 1932 — 1 0.88 4.06 1933 4 — 3.2 4.23 1934 1 4 3.82 4.41 1935 3 1 3.18 3. |
b1ed4b9d-a32a-44eb-920b-516d963e7795 | 93 1936 1 2 2.44 3.65 1937 1 4 4.28 3.11 *Rate per thousand live births—figure not available in respect of rate per thousand total births. Previously, I have pointed out how difficult it is to define the term " maternal death." The official definition is " a death due to or in consequence of childbirth," but in some cases, however, it is all but impossible to say whether the death does actually and definitely come within the terms of this definition. Because the term is so difficult to define in practice, it is impracticable to compare the figures of today with the figures of 25 and 100 years ago, and it is equally difficult to compare the figures of one part of the Country with another part of the Country. The figures I have given are those of the Registrar-General. There were five maternal deaths during the year—i.e., deaths due to or in consequence of pregnancy or parturition. |
502456cd-ac32-48b6-9022-4cb9838d7652 | One of these was due to very early pregnancy and would not have been looked upon as a maternal death years ago. This case illustrates what I have said above, and what I have said previously, that it is impracticable to compare the figures of today with the figures of 25 and 100 years ago. 46 None of these cases occurred in the Upney Maternity Pavilion, but one of them was a patient who was in the Upney Maternity Pavilion for ante-natal treatment, discharged herself and was re-admitted to another hospital. One other death I find was only technically a Barking case. She only acquired a Barking residence just before her death and was neither seen nor attended by any of the officers of your services. Three of these five deaths must, in the present state of our knowledge, be described as inevitable. |
b44ca9f1-a452-486b-9742-a9c0fe96d014 | You are making determined efforts to reduce maternal mortality in Barking, and I am happy to be able to tell you that of the total number of births last year, namely 1,169, a total of 825 mothers attended your ante-natal clinics during the year. This total represents roughly seventy per cent. of the total births. During the year Circular 1622, dealing with Maternal Mortality, was received from the Ministry of Health. Most of the recommendations contained in this Circular were already in operation and, after consideration of the Circular, you set up an emergency unit, i.e., a "flying squad" at your Maternity Pavilion, to be available for the domiciliary treatment of maternity patients whose conditions are too grave to justify their removal to hospital. It is not anticipated that this " flying squad " will carry out much work in the homes of Barking, that is unless your present policy should ever be altered. |
3df12606-871e-4c4d-9d52-715f87e6339e | Your present policy is to try and anticipate all difficulties, and even where a difficulty occurs which could not have been anticipated you arrange for the person to be removed, if possible, to the Upney Maternity Pavilion where only can the more serious surgical treatment be carried out under suitable conditions. All cases where any abnormality arises or is anticipated are referred to the Consultant Ante-Natal Clinic, where they are under the care of Mr. J. V. O'Sullivan. Mr. O'Sullivan also sees certain cases when complications arise during or after the confinement, and both his services and hospital beds are available for cases when such specialist treatment is required. (j) Ophthalmia Neonatorum.—During 1937 five cases of ophthalmia neonatorum were notified and all of these cases recovered with unimpaired vision. In last year's Beport a decrease in this figure was noted and again this year's figure shows a decline in the number of cases of ophthalmia neonatorum. |
e059999b-bf14-471c-a209-73aba042a841 | 47 All cases of ophthalmia neonatorum notified are visited in their homes and if treatment cannot be carried out at home both mother and baby are taken into the Barking Hospital under the care of your Consulting Ophthalmic Surgeon. Only one of the five notified cases required hospital treatment. Elsewhere, I have pointed out with what satisfaction I have been able to note over many years the improvement in the treatment of infantile paralysis. I cannot but help feeling equally happy over the way in which ophthalmia neonatorum as a disabling disease is being overcome. Two generations ago this eye affection was frequently so severe that it led to much impairment of vision and in many cases to blindness. It is a long time ago that I knew of a case of blindness due to this eye disease in the newly born, and it is a rare occurrence for one to be able to say that after treatment vision has been impaired. This improvement is largely due to improved technique in midwifery. |
dbd15540-7bef-4bba-b8e3-2e6dd4275378 | (k) Illegitimate Children.—Special attention is paid by the Health Visitors to all illegitimate children. Eighteen illegitimate children were born during the year, and one died. (1) Tonsils and Adenoids.—I have reported at length upon this matter in previous years. I have nothing to add. (m) Convalescent Treatment.—During 1937 a number of mothers and children were recommended for convalescent treatment. The following table shows the number of mothers and children who have been treated:— No. treated. Mothers 1 Mothers and toddlers 10 Toddlers (under 5 years of age) 11 (n) Ophthalmic Clinic.—On pages 59—60 will be found the Report of your Consulting Ophthalmic Surgeon upon the work of the Ophthalmic Clinics during the year. The inauguration of a squint training clinic has been much appreciated, the numbers are increasing and the results obtained have proved the benefit of such a service. |
13e11838-fec4-4656-b144-4845c2451843 | I would refer you to the statistics upon the work of this clinic on page 60. 48 (o) Ultra-Violet Light Clinic.—Special advantage has been taken of the increased facilities for ultra-violet light treatment, and during the year no less than 3,982 treatments were given to toddlers and expectant and nursing mothers as compared with 2,462 treatments for the previous year. The increase in the numbers attending this clinic has been so marked that I would refer you again to my remarks in an earlier part of the Report, where I have pointed out the urgency for increasing the accommodation at this clinic. (p) Dental Treatment.—It is my contention that dental hygiene should start when indeed the teeth first make their appearance, and an attempt was made during the year to get toddlers to attend for dental inspection only; thus trying to inaugurate what would be a regular service for toddlers. I regret to say that out of a large number of appointments made only one attended. |
4f7b1638-c31e-4d7b-84cd-f8d2dcddd863 | These appointments, however, were made during a holiday period and although we did not expect the experiment to be a great success we did not anticipate such a failure. I am also informed that it is difficult to get toddlers to attend for dental treatment at all, but perhaps the nursery classes which you propose to set up will help in this matter. The Senior Dental Officer's Report will be found on page 65. (q) Immunisation Clinic.—The scope of this clinic has been extended during the year. So far the numbers who have been immunised against diphtheria are too small to influence the number of cases occurring in Barking. A considerable proportion of the child population, particularly toddlers, would have to be immunised before there would be any appreciable falling off in the number of cases of diphtheria. Rapid and safely produced immunity can be induced by means of injections and without any unpleasant effects—152 children were immunised during the • year. |
d062984b-33f1-4393-a71c-974e59a11d48 | Immunisation against scarlet fever has also been started and 44 children completed their course of injections. 49 Immunisation against whooping cough was commenced last year, but the numbers so immunised were comparatively few and it is, therefore, not yet possible to give a considered opinion on this service. It is now possible to immunise for measles, but this is not practicable upon a large scale, and as yet can only be undertaken in a relatively few selected cases. (s) Minor Ailments.—Your Minor Ailments Clinics have been held at two centres and here babies and toddlers have been treated whenever necessary ; so also have certain conditions in nursing mothers. The following table shows the work which has been carried out at your Minor Ailments Clinics:— No. of cases seen by medical officers:— Central Clinic. Woodward Clinic. (a) New cases 264 892 (b) Old cases 248 497 No. |
429024b0-b5bc-4a57-9214-f5b403bc87a6 | of attendances for treatment 952 2,354 The number of new cases medically examined in 1937 totalled 1,156. (t) Infant Life Protection (under Part I of the Children Act, 1908, as amended by Part V of the Children and Young Persons Act, 1932).—Infant Life Protection Officers pay visits to foster parents during the day and during the evening. During the year there was one prosecution of a woman who had undertaken for reward the nursing and maintenance of a certain infant under the age of nine years apart from its parents, and who was a person who was required to give notice to the Barking Corporation that she had changed her address, and had failed to give this notice within the requisite forty-eight hours. |
ad4e0290-542a-41cf-bb83-623be7a024a7 | It cannot be too clearly understood that anybody who undertakes for reward the nursing and maintenance of an infant under the age of nine years, apart from its parents or having no parents, must notify the local authority in writing seven days before the receipt of the infant in the case of the first infant proposed to be received and forty-eight hours before receipt in the case of any other infant, unless the infant is received in an emergency, which makes it impossible for so long a notice to be given. Notice must be given to the Authority too when the foster-parent changes his or her address, when the child is removed to the care of another person, or if the child should die. 50 It is to be noted that the above requirements do not apply to persons keeping children for reward if the children are under their legal guardianship, or are related to them as grandchildren, brothers, sisters, nephews or nieces. |
159dcfd1-71c5-4aed-a1a4-855c9c1ea5b3 | The meaning of " reward " is very comprehensive, and means any payment or gift of money or money's worth, or any promise to pay or give money or money's worth, whether there is any intention of making profit or not. This includes, therefore, the receipt of lump sums as well as of payments at intervals. You do, I think, look upon your special care of these little foster-children as one of your most serious obligations. In my opinion the general legislation dealing with foster-children requires to be strengthened, and, until it is so strengthened, the only thing that can be done is to enforce present legislation in every way possible. May I hope that everyone who reads this Report will look upon it as a moral obligation to see that it is so widely known as possible that people who take upon themselves the responsibility of being foster-parents must comply with the requirements of the acts dealing with foster-children. |
4c2eb4f2-c759-4ea9-91ec-309928630273 | It is a happy thought that baby farming, in the sense in which these awful words were known a generation ago, does not, so far as I am aware, exist today, but the price of this is constant vigilance. (u) Maternity and Nursing Homes.—During the year no less than 414 children were born in your Maternity Home. The Upney (Maternity) Hospital is under the supervision of your Medical Officer of Health, and in addition your Deputy Medical Officer of Health pays regular visits. Visits are also made by your Specialist Consultant in Obstetrics and Gynæcology, Mr. J. V. O'Sullivan. During the year a resident medical officer has been appointed to the Upney Maternity Pavilion and the duties also couple those of medical officer to the Humphrey Ward, a clinic I have already mentioned. He is also the medical officer for the birth control clinic. No nursing homes are maintained in the Borough. |
3a1fb5c8-df5b-44b4-93e8-6eebd4822e9e | 51 (v) Infant Welfare Clinics.—The following table shows the work carried out at your various Infant Welfare Clinics during the year:— Central. Greatfields. Alexandra. Woodward. Porters Avenue. Totals. No. of sessions 104 100 99 156 148 607 No. of attendances of children under 1 year:— (a) New Cases 256 113 132 285 243 1,029 (6) Old Cases 3,252 1,674 1,856 4,875 4,691 16,348 No. of attendances of children 1-5 years of age:— (a) New Cases 68 20 61 155 160 464 (6) Old Cases 1,754 1,225 1,670 5,644 6,368 16,661 Average No. |
01ceeb24-9cfb-4fe9-bb73-f291dcbbc818 | of attendances per session 51 30 37 70 76 57 No. of sessions attended by Medical Officers 104 100 99 156 148 607 Average No. of children seen by Medical Officer per session 22 16 19 22 23 21 No. of children seen by Medical Officer other than at above sessions:— (a) New Cases 264 — — 892 — 1,156 (b) Old Cases 248 — — 497 — 745 The total attendances during the year were 34,502 as compared with 29,883 in 1936. The information which is brought out by this table is that there were 1,029 individual children (new cases), under the age of one year, who attended your clinics. You will remember that the total number of live births was 1,133 which means that approximately 90 per cent. of the children born in Barking attended at your centres. |
2a4845ac-0f83-4d20-906a-ec92ec8c4df0 | Mothers attend very regularly at the infant welfare centres with their babies, more especially when they are under one year of age. They do not, however, attend so regularly as the child grows a little older. All the children are weighed and advice is given by the health visitors on infant feeding, hygiene, etc. When the numbers permit, infants are referred to the medical officer in attendance about once every four weeks, whether they are well or ill, and at each clinic all ailing children are referred to the medical officer for advice and treatment. 52 Severe cases of illness are referred to the family doctor, except in urgent instances where they may have to be sent to hospital direct. In necessitous cases and where the illness is not severe, prescriptions for necessary medicines can be supplied at the infant welfare clinics. This widens the scope of these clinics considerably. All mothers attending the infant welfare clinics can obtain supplies of dried milk and tonics at cost price, or in necessitous cases at half price or free of charge. |
058a3942-3ff3-40b8-b1d2-d2b90ccf1455 | Children with postural defects, dental caries, visual defects or debility, necessitating ultra-violet light treatment, are referred by the medical officer to the appropriate clinic for treatment. Mothers too, with children under 2 years of age, are able to have dental treatment, ophthalmic treatment, including prescription for spectacles, radiant heat treatment, etc., and a greater number of mothers have taken advantage of these services than heretofore. More and more you are achieving co-ordination in your medical services, and there are scarcely any watertight compartments left, which is of course a good thing. |
86634ede-941c-40bc-8cc3-18ea9b82dc05 | As a single illustration, I may perhaps be permitted to draw a picture of your eye service, at any one of which sessions it might be possible to find expectant mothers, nursing mothers, toddlers, elementary school children, children from the Abbey School and the South-East Essex Technical College, candidates to be appointed to designated posts and other employees of the Council on whom it has been found necessary, under some special circumstances, to present a report upon their eyes. It is not suggested, of course, that representatives of all these types arrive at every clinic, but they do come up from time to time, and they are not only examined but also receive treatment where necessary, and this treatment includes everything which can be and which is undertaken at the out-patient department of any hospital especially devoted to eye cases. What may be said of the ophthalmic work in Barking may be said also of all the other departments which cater for all those people who have a claim upon your services. |
0f6f142b-919d-4b38-a2cb-2f9876be997b | In the massage department for instance, women come up post-natally for abdominal muscle massage, where it is considered necessary by Mr. J. V. O'Sullivan, by Dr. Bampfylde-Wells, or by one of your other medical officers. 53 (w) Home Visiting.—The home visits carried out by your Health Visitors are shown in detail in the following table:— No. of half-days devoted to visiting 1,550 No. of ante-natal visits:— First visits 394 Subsequent visits 190 No. of first visits to children under 1 year 1,186 No. of subsequent visits to children under 1 year:— (a) Attending a Centre 1,651 (b) Not attending a Centre 2,077 No. of visits to children 1 to 5 years of age:— (a) No. of visits 6,902 (b) No. of children seen 8,811 No. |
f9451c07-fc88-49cc-8fcb-3a9a2ab28f5d | of special visits in connection with ophthalmia neonatorum 16 ,, ,, ,, deaths of children up to 3 years of age 43 ,, „ „ stillbirths 29 „ ,, „ puerperal sepsis and puerperal pyrexia 9 Other visits (re infectious diseases) 135 No. of visits to foster children 279 Total home visits of all kinds 12,911 (x) Provision of Fresh and Dried Milk.—Particulars of the amounts of wet milk supplied free and at reduced rates to necessitous mothers and children are given in the following table:— No. of pints supplied at reduced price. No. of pints supplied free. Total. Total cost of milk supplied. Council's liability in respect of fresh milk supplied. |
2256cb80-049e-436b-8097-9ce1fc6297c4 | 51,878 142,047 193,925 £2,853 18 0 £2,476 14 0 Pursuant to the receipt of Circular 1519 from the Ministry of Health, Pasteurised milk was supplied as from the 1st May, 1937. 54 Particulars of the amounts of dried milks, etc., supplied free and at reduced rates are as follows:— Cost Price (pkts.) Half Price (pkts.) Free (pkts.) Total (pkts.) Ostermilk No. 1 596 148 248 992 Ostermilk No. |
ab9da290-daf1-4cb9-b48f-201ca8e159f0 | 2 1,840 655 1,132 3,627 Ambrosia 155 39 109 303 Cow and Gate 4,418 1,063 2,476 7,957 Cow and Gate (half cream) 1,104 149 370 1,623 Colact 110 69 303 482 Hemolac 24 1 36 61 Lactogal 154 38 121 313 Glaxo " O " Brand 2 10 28 40 Trufood 69 4 19 92 Lactogen No. 1 93 2 40 135 Lactogen No. |
2af536ab-0731-4fa3-81bc-a357797da1f4 | 2 154 — 56 210 Virol 1,133 313 2,124 3,570 Parrish's Food 262 60 554 876 Liquid Paraffin 158 59 238 455 Malt and Oil 737 320 2,187 3,244 Pure Cod Liver Oil 758 71 289 1,118 Cod Liver Oil Emulsion 3,084 524 2,522 6,130 Totals 14,851 3,525 12,852 31,228 (y) Mothercraft Circles.—I wish to write on a matter which strictly speaking does not come within the purview of this Report. I refer to mothercraft circles. Since January, 1938, weekly meetings have been held at the Porters Avenue Centre for mothers attending your clinics in the Barking Section of the Becontree Estate. |
bf77f688-4479-48fe-9d6d-dfede1b60f22 | The mothers are encouraged to bring knitting and sewing to the meeting and are given help with patterns and material (by courtesy of the Barking Infant Welfare Society) and advice on making up garments. Talks on health, hygiene and other subjects of interest are given and occasionally there will be cinematograph and other practical demonstrations. If this undertaking proves successful, it is hoped to inaugurate a similar scheme for mothers in the other half of Barking, possibly at the Greatfields Clinic. 55 Next year I shall be in a position to report more fully upon this matter. (z) Services provided and Facilities for Treatment.—It is convenient to set these out in tabular form, although of course some of them are mentioned elsewhere in the Report. Ante-Natal Clinics Ante-Natal Clinics are held each week at four different centres, and a Specialist-Consultant holds one session per month during ten months of the year. During 1937, 95 cases attended the clinics held by the Specialist-Consultant. |
01ded089-8c8a-4e0f-ba27-dcb14951d9ba | In addition there were 77 post-natal and gynaecological attendances. Baths In certain necessitous cases, free baths are provided for expectant and nursing mothers. During 1937, 127 baths were granted free of charge. Birth Control Clinic In September, 1937 you decided to set up a Birth Control Clinic and to hold monthly sessions. The first clinic was held in November 1937 and each month a session is held at the Humphrey Clinic in the Hospital grounds. Women attending this Clinic must fall within the limits laid down by the Ministry of Health. Convalescent Treatment Convalescent treatment is provided for toddlers, for mothers and babies, on the recommendation of Medical Officers at the Infant Welfare Clinics. Charges are made to the parents in accordance with the Council's scale. During 1937, 11 toddlers, and 10 mothers with babies, and one mother received treatment under this scheme. |
f4ec6e54-0161-4d35-b1fc-cac8d2b596b2 | Dental Treatment Dental treatment for toddlers and expectant and nursing mothers is carried out at the Central Clinic, the Woodward Clinic, and the East Street Clinic. Dinners Free dinners are supplied to necessitous nursing and expectant mothers and to toddlers, on the recommendation of Medical Officers at the Infant Welfare Clinics. During 1937, 1,237 dinners were supplied to mothers and 832 to children under this scheme. 56 Prevention of Diphtheria, An Immunisation Clinic is held every Monday Scarlet Fever and Whooping morning at the Central Clinic. Cough. Gynaecological Clinic Gynaecological Clinics are held as and when required. Home Helps Although home helps as such are not provided by you under any particular scheme, you do make financial provision in cases of maternity which are aided by you, because your scale of charges in all such cases is drawn up so as to leave an amount of money in the family exchequer sufficient for this purpose. |
5a2fefb3-6aad-40d0-93f3-8c0ea4752711 | Infant Welfare Clinics Infant Welfare Clinics are held each week at five different Centres. These Clinics are available for all children under the age of five years. Maternity Services Maternity Home.—Upney Hospital is a maternity home run by the Corporation. Applications for admission are made at the Ante-Natal Clinics, and the charges are in accordance with the Council's scale. District Maternity Service.—Pursuant to the Midwives Act, 1936 you have appointed five midwives to practise in the district, and you are also entering into agreements with the Plaistow Maternity Hospital and District Nurses' Home and the Salvation Army with a view to establishing an adequate service of domiciliary midwifery throughout the Borough. Application for the services of the midwives may be made at the midwives' homes or at the Ante-Natal Clinics, and the charges are in accordance with the Council's scale. |
86f7cc22-4038-4961-8b7f-d6e627aa09f6 | Consultations.—There is a Specialist-Consultant available for consultations in cases of abnormal pregnancy, puerperal fever and puerperal pyrexia and in cases of difficult labour. 57 Medicines, Supply of During the course of the year a scheme was formulated, and arrangements were made with local chemists by which prescriptions are dispensed free in necessitous cases for mothers and children attending the Maternity and Child Welfare Centres. Milk Pasteurised milk is supplied free of charge and at half-price in certain necessitous cases of expectant and nursing mothers and babies, on the recommendation of the Medical Officers at the Clinics. Certain dried milks, etc., are similarly supplied free, at half-price and at cost price. Minor Ailments Treatment is given daily at the Central Clinic and the Woodward Clinic to children under the age of five years. Ophthalmic Service Ophthalmic Clinics for expectant and nursing mothers and toddlers are held at the Central Clinic and Woodward Clinic. |
0711b08c-cca7-422c-84f1-f24fb67610f2 | The scheme includes the provision of spectacles at a very low charge, and in some cases, where the family income is below a certain scale, at no charge. During the year seven mothers and seventeen children under the age of five years were provided with spectacles under this scheme. Orthopaedic Service The Orthopaedic Service includes treatment at the Clinic, the provision of splints, and treatment at hospital in the case of children under the age of five years. The service also provides for treatment at the Orthopaedic Clinic for expectant and nursing mothers. Tonsils and Adenoids Surgical treatment for tonsils and adenoids is carried out at two local hospitals under an agreement with the Council. A small charge is made to the parents, except in certain necessitous cases when no charge is made. During the year, 90 such operations were carried out in respect of children under the age of five years. |
b5259ca8-0f69-4475-8710-99600352106e | 58 Ultra-Violet Light Treatment Ultra-violet light treatment is given to expectant and nursing mothers and to children under the age of five years at the Orthopaedic Clinic. During 1937, 381 cases were treated, a total number of 3,982 treatments being given. Visiting in the Home Periodic visits are paid by the Health Visitors to all children under the age of five years and to all foster-children under the age of nine years. Visits are also paid in certain cases to expectant mothers. X-Ray Treatment for Ringworm. Where necessary, ringworm is treated by X-ray. No charge is made for this treatment. The way in which anyone can avail herself of any of these Services is to ask the Health Visitor for the district, or to attend at an Infant Welfare Centre, or, where this is not practicable or there is any emergency, to make an enquiry at the offices of the Public Health Department—Central Hall Chambers, East Street, Barking. |
2c7ec5dc-8fa8-40ad-bb84-691f5266a1af | 59 REPORT ON THE WORK OF THE OPHTHALMIC CLINICS. The following is a summary of the work carried out during the year in respect of toddlers and nursing and expectant mothers:— Toddlers. Tests under atropine 34 Other attendances 77 Spectacles prescribed 23 Spectacles supplied 17 External Diseases of the Eye treated at the Clinics : Blepharitis and Conjunctivitis 5 Injury to Eye 1 Ingrowing lashes 1 Daerocystitis 5 Hordeolum 1 Cases listed for Squint Training 9 Expectant and Nursing Mothers. |
31a3c550-3cc2-49c7-a4a4-3d1359925cf2 | Tests 21 Other Attendances (Blepharitis and Conjunctivitis 3, Meibomiam cyst 1) 29 Spectacles prescribed 14 Spectacles supplied 7 In these clinics the two groups of cases, i.e., expectant and nursing mothers on the one hand, and toddlers and infants on the other, differ markedly from each other but have this in common—they are both subject to mild inflammatory diseases and, in some cases, the disease has been transmitted from one to the other. In children under five years of age the chief complaint is squint, while in mothers, headache is common. 60 While headache is important in pregnancy it has, also, a special significance during the post-natal stage. It has been noted in some cases that the apparent need for glasses only arises after pregnancy. In the majority of such patients there is a small error found on testing the eyes and the cause of the headache is probably due to the general health being somewhat lowered. |
baf8914f-1409-4a2b-a6bd-740d6c4059ef | Fatigue of the eyes is then easily produced. This, fortunately, is only a temporary condition and many such cases find that after some little time the headache disappears. It is our custom to recommend glasses only in cases in which symptoms of eye strain have persisted for some months. No case of injury or disease of the eye which could be attributed to pregnancy has been seen during the year under review. Treatment of Children under 5 years of age at the Orthoptic (Squint Training) Clinic. No. of cases treated 6 No. of cases under treatment at end of year 2 Treatment commenced but transferred to Education Scheme on account of child becoming of School Age 4 No. of treatments given 49 61 REPORT ON THE WORK OF THE ORTHOPAEDIC CLINIC. Orthopaedic treatment in Barking provides massage, medical electricity, plasters, splints, remedial exercises, including those for flat feet, etc. |
ca76b5ec-d6c8-41bf-b7d5-11868d337813 | As I have reported before there is a modern duo-therapy lamp and an up-to-date therapeutic switch table at the Orthopaedic Clinic. During the year you have employed two full-time masseuses, and as and when the occasion arises these masseuses even visit people in their own homes, in order that some necessary treatment may be completed. The work at the Orthopaedic Clinic is linked up with that of your Hospital— one of the masseuses attending at the Hospital to treat cases of acute anterior poliomyelitis, and to treat difficult posture in cases recovering from diphtheria. It is well known that children recovering from diphtheria are oftentime very weak indeed upon their legs, and I am very appreciative of the co-operation which has been achieved between the Hospital Staff and the Orthopaedic Clinic. The following tables, which are prepared on lines similar to those previously used, show the work which has been carried out at the Orthopaedic Clinic amongst toddlers. No. |
b2d71787-c5bd-4b9e-8dc2-22df22b706b6 | of primary examinations by Orthopaedic Surgeon 130 No. of re-examinations by Orthopaedic Surgeon 175 The cases dealt with for the first time during 1937 were referred for the following conditions :— (a) Deformities—Bones and Joints. (1) Congenital: Flexion deformity—digit-—hand 1 Deformed toes 3 Deformed cranium 1 (2) Acquired: Pes planus 9 Genu valgum 35 Bowed tibiae 16 Hallux valgus 2 Genu varum 6 73 62 (b) Deformities—Muscular. (1) Congenital: Torticollis 4 Talipes 6 (2) Acquired: Pes planus 25 Intoeing 6 Scar—hand 1 42 (c) Paralysis. Anterior poliomyelitis 1 Facial paresis 1 ? |
ee7473c7-bffe-471d-b4db-f16c968d58c5 | Old hemiplegia 1 Hemihypertrophy 1 4 (d) Miscellaneous. Eversion right lower limb 1 Pain in hip joint 1 Re gait 8 No diagnosis 1 11 Total defects found 130 During the year six toddlers were admitted to hospital, five for operations and one for observation, as follows:— Operations : Manipulation and plaster 3 Tenotomy Tendo Achilles and plaster 2 Supernumerary thumb—removal 1 Osteoclasis and plaster 2 Median stoffel 1 Observation 1 Total 10 63—64 PARTICULARS OF THE WORK DONE IN CONNECTION WITH THE ORTHOPAEDIC CLINIC DURING 1937. No. of sessions held by Orthopaedic Surgeon No. of sessions held by Masseuses ATTENDANCES. |
96ccf16d-4e71-474a-a40b-82b3519388db | Primary Examination Re-examination For Treatment Totals School Children Toddlers and Expectant & Nursing Mothers School Children Toddlers and Expectant & Nursing Mothers School Children Toddlers and Expectant & Nursing Mothers School Children Toddlers and Expectant & Nursing Mothers 11 834 146 130 263 175 8,084 6,301 8,493 6,606 TREATMENTS. Massage Electricity Remedial Exercises U Itra-Violet Therapy Radiant Heat Dressings and Splintage Totals. No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. |
0faaf89a-9555-477c-8353-90a033431ccb | of Treatments School Children 28 1,180 14 446 207 2,333 328 4,635 9 182 166 1,143 752 10,609 Toddlers and Expectant & Nursing Mothers. 40 1,093 7 120 54 807 381 3,982 5 186 205 1,659 692 7,847 Admissions to Hospitals School Children Toddlers Total School Children Toddlers Total 16 (Under Council's Orthopaedic Scheme) 6 22 — — — On Waiting List for Admission 31/12/37 65 REPORT OF THE DENTAL SURGEON. May, 1938. To the Medical Officer of Health, Borough of Barking. I have the honour to present the Annual Report of the Dental Work under the Maternity and Child Welfare Scheme for the year ending 31st December, 1937. |
e80c31db-d595-4e87-aaf3-b13451a86efb | Figures are comparable with those of last year, an increase of approximately one hundred dentures supplied being the most noticeable variation. The number of patients attending for treatment at the Woodward Clinic is larger than that which can be adequately handled and to overcome this, a certain percentage now attend the East Street and Central Clinics for prosthetic work to relieve the pressure that is experienced with this part of the treatment. No patients for extractions attend the Central Clinic from the Woodward area except in emergency, as a journey following extractions under nitrous oxide anaesthesia is not considered advisable. Considerable prejudice still exists against the filling of temporary teeth and it is difficult to convince parents that very little discomfort is experienced by children of six years of age and under while such work is carried out. I have to thank the Medical and Nursing Staff and the Health Visitors for their very generous assistance and to assure them that the effect of their good offices really is noticeable in the attitude that parents and expectant mothers are now taking towards dental treatment. |
3faa0093-a5bb-4c4e-9435-6c3c8ac9d659 | I have the honour to be, Sir Your obedient Servant, W. H. FOY, L.D.S., R.C.S. (ENG.), Senior Dental Officer. 66 DENTAL CLINIC. Mothers and Toddlers. Extractions 3,669 Scalings 125 Dressings 31 Inspections 203 Fillings 278 Dentures supplied 467 Anaesthetics— General 774 Local 66 Patients— Old 2,247 New 470 Number of Sessions held 228 Toddlers— Treatments 879 67 REPORT UPON THE WORK OF THE PATHOLOGICAL LABORATORY For the Year 1937 I include herewith in this Annual Report a special report by Dr. E. M. Hill, who has done much admirable work at the Pathological Unit attached to the Barking Hospital. The Report speaks for itself. |
afcf3f44-2b2b-4916-9830-e8777d96126d | It cannot, however, be other than a source of satisfaction to me that this development I so earnestly recommended has proved itself to be a success beyond any hopes I held out, and has been of more benefit to the people of Barking than I could see at the time I recommended it. It is strictly speaking unnecessary for me to add to Dr. Hill's thanks to Dr. Camps of Chelmsford, but I would like to say how heartily I agree with her, and how particularly fortunate are the people of Barking that Dr. Camps' Laboratory is relatively near by, and that Dr. Camps has been so untiring in his kindness. "As was stated in last year's Report, a pathological unit was opened in the grounds of the Barking Isolation Hospital late in 1936, in order to extend to the Barking Public Health Services, some of the most recent advances in pathological methods. |
52f8c9da-2762-49ef-9bb4-ea5eda60ebbb | This laboratory is not intended in any way to replace the services of the Counties Public Health Laboratory, nor to be used as a routine laboratory. In every Public Health Service, problems arise which cannot be submitted to a routine laboratory, but must be dealt with on the spot: if no laboratory is available, such problems are left unsolved to the detriment of the service. If a laboratory is available, the Medical Officers are brought closely into touch with the scientific aspects of medical problems, and the pathologist is able to come into personal contact with the patients, a state of affairs which has much to commend it. 68 Not the least valuable advantage of having a local laboratory is the time factor which is so important in medicine. In many cases it is of vital importance to produce the result of a pathological examination within a few minutes or at the most, an hour or two; with only a distant laboratory to rely on there is inevitably a delay bf many hours, which may be fatal. |
3ef7eb5f-0420-496d-ac0b-f01c89a37100 | One of the most widely examined fluids in Pathology is urine, which is a notoriously perishable liquid and in most cases must be examined immediately after voiding to obtain reliable results. Further, there are a number of organisms which die out within an hour or two of leaving the body and which would not therefore survive long enough to be transported by post. Numbers of patients have already experienced the advantage of being able to have tests carried out near their homes, instead of suffering the fatigue and expense of journeys to London Hospitals. There has been prepared a comprehensive catalogue of all the tests which can be carried out in this Laboratory, and which has been circulated to all the Medical Officers. It would be superfluous to print this in a report of this nature. In the space available it is only possible to give a bare outline of some of the lines of enquiry which have been examined. A constant source of problems is the pregnant woman. |
a74b9ec5-5a89-4eb5-b897-aec600b0124f | It is becoming increasingly apparent that there is a very large incidence of anæmia among the women in industrial districts, and we have found by wholesale blood tests that Barking is no exception to this rule. Such anaemia if untreated may become very severe and is definitely a great source of danger during pregnancy. It is not necessarily due to acute illness but arises chiefly through continuous malnutrition or multiple pregnancies or both. Sufficient work has been done here and elsewhere to show that the administration of iron to expectant mothers as a routine precaution should be an important part of ante-natal supervision. Whenever the anaemia becomes severe enough to cause distressing clinical symptoms, full blood tests are carried out in order to determine the type of anaemia present, and the patients are given suitable treatment. Whenever it is considered advisable, such patients are followed up post-natally. |
b3ef5ba2-ccc8-46d0-b88a-6b21fbd8173b | The toxaemias of pregnancy provide another source of pathological examinations which must be carried out in order to help determine the severity of the toxaemia, and also to trace the patient's progress under treatment. Incidentally, workers in this field have found that the anaemic woman is much more liable to toxaemia than the woman who has been treated for anaemia with iron. 69 A very interesting and important piece of work is being carried on here at the laboratory in collaboration with the Pathologist of the Chelmsford and Essex Hospital in connection with Streptococcus pyogenes. This rather formidably named creature is no less formidable than its name. It is the germ which is common to scarlet fever, tonsillitis, mastoiditis, erysipelas, cellulitis and a host of other suppurative conditions, not least of which is puerperal septicaemia. |
f3f35c44-6a39-4726-b56d-635af1c57e9e | When it is realised that there are nearly thirty so-called " types " of this germ which are dangerous to man, no one of which gives complete immunity to any other, it must be apparent that this germ is a very grave menace. These types are strictly permanent, in other words one type can never be transmuted into any other type. Briefly what is being done here is to isolate the germs from the throats, nasal discharges or ear discharges of scarlet fever patients or from other likely sources ; these strains are sent to the Pathologist at Chelmsford for typing (a process which requires special materials which are not on the market). In common with other workers, we have found that in a high percentage of cases the complications commonly attending scarlet fever, viz., otitis media, rhinorrhæa and so-called secondaries, are due to streptococci of a different type from those which caused the initial symptoms. |
cd3fd4db-12af-4589-ad70-3484110dcf12 | It is noteworthy that a person who has had scarlet fever in childhood through infection with one type of streptococcus is not safeguarded against streptococcal diseases of other descriptions caused by a different type, although it is rarely that the clinical syndrome designated “scarlet fever ”appears more than once in the same person. A demonstration of the usefulness of typing occurs in the event of a possible return case of scarlet fever. If the type of Streptococcus in the throat of the new case is of the same type as that in the throat of the discharged patient with which it has been in contact, then the chances are that it is a true return case. In the event of the types being different then it is quite out of the question that the new case has been infected by the late patient and it is not a return case. In the field of midwifery the source of the infecting organism in a case of streptococcal puerperal septicaemia can often be traced. |
428d1d75-f84d-42ba-8647-e92df5108477 | This may be the patient's own throat or the throat of one of her attendants. 70 It has of course only been possible to develop gradually and development is still proceeding. Although the laboratory has been open for a little over a year, this is far too brief a period in which to discover all the material on which investigations can be carried out. Fresh problems crop up every week and it will only be in the fullness of time that the whole vast field of possible scientific enquiry will become apparent. In conclusion, I should like personally to express my deepest thanks to Dr. F. E. Camps, the Pathologist of the Chelmsford and Essex Hospital, for his kindness in typing over 300 strains of Streptococcus pyogenes for us during the past year. The materials for such typing are only available to very few laboratories and we are extremely fortunate to have the opportunity of working in co-operation with such a prominent pathologist as Dr. Camps. |
47edc862-57a5-43e4-82a2-59176b34da44 | E. M. HILL, Ph.D., Dip., Bact., Scientist." 71 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. 1. WATER. South Essex Waterworks Company Supplies.—The Engineer of the South Essex Waterworks Company informs me of the following facts:— " During the year 1935 the Company obtained an Act of Parliament for the abstraction of a further supply of water from the River Stour (Essex and Suffolk), and constructional work is proceeding satisfactorily. The Company is empowered to abstract additional water up to a maximum of 35 million gallons per day from the river, and to construct a reservoir in the neighbourhood of Abberton which will hold over 5,000 million gallons. The water will be normally abstracted from the river from November to May, when a large amount of surplus water is available, and the large reservoir is for the purpose of storing the water so abstracted for use at other times of the year. |
f568792c-85f0-4af0-98f4-ee8c010dd014 | The scheme further authorises the construction of three pumping stations, filtration plant and about 26 miles of pipe lines. It is not anticipated that the scheme will come into supply before 1940. Extension of mains in your Borough:— 3” 104 yards. 4” 2,620 ,, 6” 207 ,, 9” 676 ,, 12” 2,582 ,, There was no form of contamination for the year 1937. The supply has been satisfactory in quality and in quantity. During the year 1937 about 200 samples of water were submitted for chemical examination and a like number for bacteriological examination; analytical reports in respect of all water supplied were that the water was pure and wholesome for the purpose of public supply.” 72 Additional to the examinations which are mentioned above, three samples were submitted to the Public Health Laboratories for chemical and bacteriological examination, and all three were found to be satisfactory. Consumers continue to complain of the hardness of the water supplied. |
232f4c39-4ded-4938-9183-5d123135f8da | Our examinations show the number of degrees of total hardness on Clark's Scale to vary from 19 to 24. The Company point out that they are prepared to reduce the hardness, provided consumers will suffer an increase in the charges. It is the permanent hardness which fluctuates. Supplies from local wells.—There are in the district seven wells, one of which is operated by the Metropolitan Water Board with a yield of 1,000,000 gallons per day. Of the remaining wells, two are operated by a mineral water company for the purposes of their business, and notwithstanding the fact that these two wells are comparatively shallow and near the River Roding (to which I give special mention on pages 73 and 74) they continue to yield a perfect water. One deep well at factory premises is used for drinking purposes and again yields a good water. The three remaining wells are used for industrial purposes only. Where well supplies are used for drinking purposes, arrangements have been made for monthly examinations of the supplies. 2. |
21ff90bb-49e1-4ec8-9d00-132c0610dad0 | RAINFALL. The rainfall for the year ended 31st December, 1937 was 23.25 inches as compared with 16.57 inches for the previous year. Rain fell on 181 days in the year 1937. 3. DRAINAGE AND SEWERAGE. The joint drainage arrangements between Ilford and Barking have functioned satisfactorily during the year. 73 4. RIVERS AND STREAMS. The rivers and streams running through the area are tidal in character and are not controlled by the Corporation. A Joint Advisory Committee was set up by the Minister of Health and the Minister of Agriculture and Fisheries with the following terms of reference:— "To consider and from time to time to report on the position with regard to the pollution of rivers and streams, and on any legislative, administrative or other measures which appear to be desirable for reducing pollution." This Committee issued its report in July, 1937. |
66e5de3f-f246-4ac9-a21e-34c084ba93c1 | I note that under present legislation tidal waters of a stream are exempt from the operation of the Rivers Pollution Prevention Acts, unless otherwise determined by an Order made by the Ministry of Health. River Roding.—In the Annual Report of the Medical Officer of Health for Barking for the year 1898, he referred to the River Roding in the following terms "Of course in times of drought, such as prevailed during the summer of 1898, the river's channel is converted into a stinking sewer, not much to the credit of modern sanitary science or sanitary authorities." In the year 1932 I referred to an outbreak of typhoid fever arising from conditions in the River Roding in the following terms:— "During the months of August and September bathing took place in the tidal limits of the River Roding. Such bathing was followed by a minor epidemic of enteric fever. Two samples of water obtained from different locations in the river were submitted for examination. |
e6b6b900-e9bf-4f01-ac01-cd360903e865 | The bacteriologist reported on these samples as follows:— 1. This is a grossly contaminated river water, having the bacterial composition of sewage effluent. 2. This is a grossly contaminated river water, having the bacterial composition of sewage effluent. In addition typhoid bacilli could be isolated." 74 I want now again to express my horror and alarm at the conditions prevalent in this river. Recent analyses have shown that in times of drought the water in the river is almost completely sewage effluent. The discharge of sewage or factory effluent is not an offence, if the best practical and available means are used to render the effluent harmless. In view of the fact that a number of sewage works discharge their effluents into the River Roding and that at times the Roding is a carrier of disease, it is, in my opinion, imperative that every possible precaution should be taken to make quite sure that these effluents comply with the conditions referred to in my previous paragraph. |
908c877e-cb32-4116-991d-62c99608a938 | Even with this precaution, I think the Roding may still be contaminated other than from sewage works owned by local authorities. All these points of possible contamination require investigation and supervision. I note that the Essex County Council have eight representatives on the River Roding Catchment Board and am hopeful that progress will be made in the direction I have indicated. 5. CLOSET ACCOMMODATION. At the end of the year there remained a total of 17 premises unconnected with the sewer. Eleven of these were factory premises. Of these 17 premises, 7 have cesspools, 9 have earth closets, and one has a sewage disposal plant (septic tank and percolating filter). The premises still unconnected are isolated properties. Cleansing is carried out by means of covered vehicles and suction pumps. 6. PUBLIC CLEANSING. |
364b6b6d-f60d-44c8-9575-ea17cb6d2c52 | (a) Storage, Collection and Disposal.—The collection and disposal of domestic refuse is controlled by the Borough Engineer and Surveyor, 75 During the year, 7,440½ loads of refuse were collected, with an average weight of 1 ton 12 cwts. This figure shows a yield of 8.2 cwts per 1,000 of the population per day. When the present standard bin was introduced in 1934, I felt that a capacity of 1.7 cubic feet for a week's storage was less than would be sufficient for some households. It is however for me to report that we have had but little complaint outside the estate of the London County Council at Becontree, where the tenants were accustomed to a much larger bin. Standards however are generally rising and people today are becoming more interested in and critical of the public services. During the year the question has been raised of a more frequent refuse removal service. |
04887e14-bd1f-47a0-956d-cc7474a4c357 | Naturally, so far as we are concerned, it is scarce possible to think of a service that would be too frequent. I feel, however, it is difficult to put forward convincing arguments in support of a proposition that the much increased collection costs would be offset by any substantial increase in comfort, convenience or health to the householder, particularly where the householder uses the sanitary dustbin with discrimination. (b) Trade Refuse.—During the year nuisance was occasioned by occupiers of shop-premises, with multiple flat dwellings above, burning refuse in their small back yards. Arrangements were made for more frequent removals and easier charges in the removal costs. (c) Street Cleansing.—The Council still relies upon manual sweeping. I would remind members of the Council that speedier cleansing with mechanical sweepers would mean more frequent cleansing, also releasing manual labour for the cleansing of streets where mechanical sweeping cannot be operated effectively. 7. REFUSE DISPOSAL. |
85f952a1-c92b-4f9e-8fb9-7d65e98be0df | Refuse tipping has been carried on throughout the year by the Corporation on land being reclaimed on the north bank of the Roding, adjoining the sewage works. 76 There has been a gradual improvement in the operations but there is still much to criticise in the tipping methods, and these criticisms have been brought to the notice of the Borough Engineer and Surveyor from time to time. The only complaint we have received from residents during the year relates to an infestation of crickets. Private Tips.—In connection with such tips the Corporation administers the relevant section of the Essex County Council Act, and '261 visits were paid by your officers to such tips during the year to see that no nuisance was committed, and to offer advice as to methods of disposal. 8. SANITARY INSPECTION OF THE AREA. |
4b48f0f5-b337-4591-8f14-a6f6a3f43d88 | The number of complaints received and recorded in the register of complaints was 659, as compared with 759 in 1936, 855 in 1935, 551 in 1934 and 927 in 1933. The premises were inspected forthwith and any necessary action taken. The total number of visits paid by sanitary inspectors to various premises for all purposes was 15,054 and are summarised below, together with the number of defects found arising from those visits. The housing defects dealt with numbered 6,801. (a) Work of Sanitary Inspectors. (1) Inspection of Dwelling-Houses. |
04715391-36d4-483f-8ad0-539e7e7c16c4 | Total Houses Inspected under Public Health or Housing Acts ... 3,695 Total Number of Inspections made 10,644 Housing (Consolidated) Regulations 981 After Infectious Disease 844 Overcrowded Premises 1,416 Defects Found 6,801 Notices Served (Preliminary) 2,349 Re-inspections re Notices Served 3,942 Inspection of Works in Progress 599 (2) Premises Controlled, by Byelaws and Regulations. Inspections. Contraventions. Notices served. |
3883cb46-b084-4be9-a95d-81f65bf13cac | Houses Let in Lodgings – – – Common Lodging Houses 29 – – Offensive Trades 143 18 12 Tents, Vans and Sheds 97 16 13 Dairies, Cowsheds and Milkshops 123 15 6 Slaughter-houses 175 – – Hairdressers' & Barbers' Premises 42 7 6 Smoke Observations 225 53 49 77 (3) Factories, Workshops and Workplaces. Inspections. Defects. Notices. |
1ee7ace4-e7fc-405a-b55a-f725d041d771 | Factories 245 15 10 Laundries 3 – – Bakehouses 35 14 7 Domestic Workshops 20 2 1 Other Workshops 107 11 4 Other Workplaces 126 16 8 Outworkers' Rooms 110 – – Butchers' Premises 250 76 54 Fishmongers 54 15 13 Restaurants and Dining Rooms 123 47 28 Stables and Stable Yards 37 10 9 Piggeries 13 – – (4) Miscellaneous. Inspections. Defects. Notices. |
3cf3a83f-1bba-467e-9bd4-e6b01b479821 | Rats and Mice (Destruction) Act, 1919 66 4 4 Vacant Land and Refuse Dumps 261 21 18 Public Lavatories 26 3 3 Schools 41 4 1 Markets and General Shops 303 36 35 Ice-Cream Vendors 166 19 18 Petroleum and Celluloid Stores 69– – –– Drainage Inspections 308 – – Milk Sampling 90 – – Other Miscellaneous 279 3 3 78 Inspections. Defects. Notices. |
b5b40ce1-186b-45c2-bc47-55d71200a781 | Inspection of Meat from Outside District 162 – – Shops Act, 1934 466 21 17 Water Sampling 9 – – Food Manufacturers 28 5 5 Picturedromes 2 – – Street Traders 126 1 1 Food Byelaws 40 23 23 Boilers 24 – – Obstructive Outbuildings 127 – – Pleasure Grounds 4 – – Noise Nuisance 1 – – (b) Summary of Sanitary Work Carried Out. (1) Drainage. Choked drains, opened, repaired and cleansed 276 Drains reconstructed 83 Ventilation shafts repaired or new fixed 27 New inspection covers 12 (2) Closet Accommodation. W.C. structures repaired:— Roofs Walls Floors Doors 11 Seats fixed 51 W.C. pans fixed or cleansed 75 Flushing apparatus repaired or renewed 137 (3) Sinks. |
7442005c-c086-4dc8-9ce4-32f05b08b99c | New fixed 58 New sink and bath wastepipes 53 New gully traps 25 (4) Dampness. Roofs and flashings 575 Eavesgutters 325 Rainwater pipes 154 79 (5) Water Supply. Defective water fittings repaired and supply reinstated 48 (6) Paving. Forecourt paving repaired or relaid 31 Yard paving repaired or relaid 104 Gully dishing repaired or renewed 119 (7) Dustbins. New ones provided 695 (8) General Repairs. |
1145d011-5c90-4972-b888-4bbd1d2b15ee | External walls repointed 315 House floors repaired 125 Windows repaired or renewed 319 Windows reglazed 22 Window and door reveals repaired 100 Window sills repaired or renewed 128 Sashcords renewed 176 Washing coppers repaired or renewed 81 Stoves repaired or renewed 158 House doors and frames repaired or renewed 141 Stairs repaired 34 Handrails fixed 1 Chimney pots renewed and stacks rebuilt 274 Dirty or defective rooms repaired, cleansed and redecorated 1,727 Damp walls remedied 162 Insufficient floor ventilation 93 External painting 162 Internal painting 1 Weatherboards fixed 16 Door sills repaired or renewed 54 (9) Miscellaneous. Offensive accumulations removed 86 Animals so kept as to be a nuisance15 Verminous rooms disinfested 46 Drains tested 159 Dangerous structures reported 14 Overcrowding 21 Flooding19 Dust Nuisances 9 Other conditions 9 80 (c) Notices Served. |
2cba8697-ca81-4aa0-a800-f8aa951b0c7f | Informal Notices 2,349 Statutory Notices:— Public Health Act, 1875:— Section 23 – Section 36 11 Section 41 5 Section 94 176 Public Health Act, 1925:— Section 46 1 Public Health Act, 1936:— Section 39 17 Section 44 1 Section 45 1 Section 46 1 Section 93 65 Housing Act, 1936:— Section 9 150 Section 10 1 Other Acts:— Shops Act, 1934, Section 10 1 Smoke (Abatement) Act, 1926, Section 1 1 431 (1) Inspections (including inspections made by Sanitary Inspectors). Premises. Number of Inspections. Written Notices. Prosecutions. Intimations. Statutory. |
faf8b45d-e5fb-43df-ae30-b22f672afd52 | Factories 276 15 – – Workshops 142 11 – – Workplaces 126 8 – – Totals 544 34 – – (d) Factory and Workshop Act, 1901. Factories, Workshops and Workplaces. 81 (2) Defects found. Particulars. Number of Defects. Number of Prosecutions. Found Remedied Referred to H.M. Inspector *Nuisances under the Public Health Acts:— Want of cleanliness 23 23 – – Want of ventilation – – – – Overcrowding – – – – Want of drainage of floors 1 1 – – Other nuisances 12 12 – – Sanitary accommodation:— Insufficient 8 8 – – Unsuitable or defective 11 11 – – Not separate for sexes 1 1 – – Unscreened for sexes – – – – Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (s. |
536e91bf-bdcb-49a1-afa1-0687e361b960 | 101) – – – – Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 1† 1† – – Other offences – – – – Totals 57 57 – – * Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. † Bakehouse demolished. (3) Home Work. Eight notices were issued to the occupiers of premises in the district where outworkers are employed, who supplied lists twice during the year of 25 workpeople engaged on making wearing apparel, etc., in their homes. 82 (4) Registered Workshops. Workshops on the Register (sec. 131) at the end of the year. Number. Bakehouses (including eight factory bakehouses) 11 Other Workshops 45 Total number of Workshops on Register 56 (5) Other Matters. Class. Number. |
c8f5ac1d-4c64-4825-97aa-e175e219b4df | Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (sec. 133) – Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (sec. 5) – Other – Underground Bakehouses (sec. 101):— – Certificates granted during the year – In use at the end of the year – (6) Outworkers. |
d956d03a-a068-4202-b7da-72b307371397 | The following list shows the nature of the homework carried out in this district by 61 outworkers:— Wearing apparel 31 Millinery 3 Tie-making 3 Life-belt covering 4 Machinery 1 Box makers 3 Paper hats, Christmas crackers and novelties 5 Flags 4 Handbags 1 Infants' bibs 1 Fancy leather goods 1 Umbrellas 2 Christmas cards 1 Brushes 1 83 During the year, 54 lists of outworkers were received from other Authorities in respect of addresses in Barking. Eight lists were received from employers within the district. (e) Premises and Occupations which can be controlled by Byelaws or Regulations. (1) Houses Let in Lodgings.—Action under the Housing Act, 1936 has revealed that accommodation over many of the larger shop premises in the district is becoming used for living purposes, and as the Council is aware we are awaiting confirmation of new byelaws for the control of such premises. |
f93dc569-63a6-4878-b8cf-6b37d9889c51 | (2) Common Lodging Houses.—There remains one common lodging house in the district and this is included in a clearance area, which has received confirmation and this common lodging house will therefore be demolished at an early date. I have on other occasions and in other reports referred to the need for a municipal hostel for the use of the casual labourers in the district. (3) Tents, Vans and Sheds.—There are seven van dwellings situated in two yards in the district where water supply and sanitary accommodation are provided. Ninety-seven visits were paid and thirteen notices were served in respect of sixteen defects discovered at these and other temporary van sites. The Barking Corporation Act, 1933 provides that approval is now necessary before this type of dwelling can be established in the district. (4) Underground Sleeping Rooms.—There are no such occupied rooms in the district. |
577be41c-fe79-446a-8270-acf81c35db67 | (5) Offensive Trades.—The number of premises used for this purpose are as follows:— Fish Fryers 23 Dealers in Rags and Bones 7 Gut Scraper 1 Fat Melters 2 Fish Skin Scraper 1 Oil Boiler 1 Soap Makers 1 Total 36 84 One hundred and forty-three visits were paid to these 36 premises, and 18 contraventions of the byelaws were discovered and any necessary action taken. At the oil boiling factory the installation is of modern design, and the general supervision is careful. Notwithstanding this there has been emission of noxious odours due no doubt, amongst other things, to acrolin. Your officers have consulted with H.M. Inspector of Alkali etc. Works and the County Analyst. Certain suggestions have been put forward, and although the present position is unsatisfactory, it can be said that steps are being taken to try to deal with the situation. |
6aacba89-6035-476a-8057-b3b78c74ea97 | (6) Piggeries.—There are three remaining piggeries in the district. (7) Stables.—These premises continue to be a source of trouble. The occupiers are invariably unable financially to carry out any improvements. The Council has made byelaws for the control of these premises. Thirty-seven visits were paid during the year to stable premises, and 9 notices were served in respect of unsatisfactory conditions. (/) Rats and Mice Destruction Act, 1919. There were 66 visits made to premises under this Act. The location of the source of infestation is of the greatest importance, and little can be achieved to prevent re-infestation unless this is discovered. Usually infestation is found to be directly due or associated with defective or disused drains, particularly where the premises are subject to interior infestation. At some houses in Romford Street, abutting upon open land, we were unable to discover the source of infestation and unfortunately re-infestation has occurred. |
dd39af9f-8a73-4ee1-96f0-70664b608166 | The matter is being dealt with by the use of baits. Repressive Measures.—Occupiers are encouraged to carry out the trapping of rats themselves, and the owners are called upon to effect rat-proofing where the source of the infestation is other than defective drains. Advice is given by the sanitary inspectors and a free issue of suitable raticides is made to householders. 85 Rat Week Propaganda.—In connection with Rat Week the following action was taken by the Corporation:— (1) Large illustrated posters were exhibited at 28 stations in the district inviting co-operation and giving advice to the general public. (2) The attention of the Borough Engineer and Surveyor was directed to the Corporation properties and sewers. (3) Special applications of raticides were made at the Corporation Hospitals. (4) The Corporation had available for free issue four different kinds of raticides. Again there was indifferent support by the public and during the week only three applications were made to the local authority for assistance. |
a04b61d0-65a9-45f5-b931-a9a714c8f5b5 | Although it is my duty to report this indifferent support by the public during the particular week which was given to this propaganda, I think that in some small measure this redounds to your credit, because in my opinion, this means that, at least to a considerable extent, you are dealing continuously throughout the year with the rat problem, and that all those who are concerned with this problem are more or less in constant touch with the Department. It may be that this experience may have some bearing on any future decisions you make with regard to propaganda. In the first place, I have to say that the only real propaganda is efficient service, and in the second place I should like to say as a result of Rat Week that where the service is efficient, propaganda is of only very limited value. (g) Rag Flock Acts, 1911 and 1928. There are two premises where upholstery repairs are carried out and these premises are regularly inspected. |
7782dd38-1d2a-4657-be04-1fe7b01ade72 | We have not found rag flock in use at either of these establishments, which are quite small repair shops. (h) Removal of Infirm and Diseased Persons. The Barking Corporation Act, 1933, empowers the Medical Officer of Health to certify that a person is infirm or diseased, and is incapable of taking care of himself, and is not receiving proper care and attention from others. The certificate enables the justices to grant an order for the compulsory removal to hospital of the person concerned. 86 Two cases of such infirm persons were reported during the year. One was persuaded to enter hospital and the other was kept under observation at home, after increased attention and medical care had been provided, until death. 9. SHOPS ACT, 1934. Inspections carried out for the purposes of Section 10 of this Act numbered 466. In 17 instances notices were served requiring additional sanitary accommodation, washing facilities or improved heating. For the purposes of administration a temperature of 55°F. |
a8a4addd-4a63-4d51-8ed9-6b50d5822ad9 | has been regarded as a suitable minimum, and the shops have been divided into three classes:— (1) Shops for the sale of non-perishable articles. (2) Shops for the sale of perishable articles. (3) Open shops and Forecourt Traders. The problem of heating in respect of the three types of shops has been dealt with in the following manner:— (1) General heating for the whole shop ; (2) Local heating by gas or electricity from ceiling fires at the positions where the assistants are on duty; and (3) Local heating with coke-bucket fires and withdrawal rooms where heating is provided for the assistants when disengaged in the shop. The purchasing public are accustomed to the open shop door and I am afraid rarely give a thought to the discomfort of the shop assistants arising from this "convenience." The maintenance of a reasonable temperature in a shop with an open door is another of our problems. |
0006ce2b-60b0-4752-b546-c32ecea82ed6 | Several instrumental methods of measuring the standard of warmth and ventilation have been carried out by research workers and most have agreed that a dry kata-thermometer reading within the limits of D.K. 5.0 and D.K. 7.0 indicates a zone of comfort which can be obtained in most shops. 87 We have not experienced any serious difficulty in relation to the provision of sanitary conveniences or washing facilities. Hairdressers' and Barbers' Premises.—There are 36 premises where this type of business is carried on. They are subject to control by byelaws made under the Essex County Council Act, 1934. There are 36 premises where this type of business is carried on. They are subject to control by byelaws made under the Essex County Council Act, 1934. We were disappointed with the code of byelaws as approved finally, but have found they are of value in the matter of cleanliness. |
72bd3ccc-fc40-4823-ba83-145c63575f79 | Although the introduction of these byelaws did not meet with approval from all quarters of the trade, it was, in reality a charter to all the members of the trade who were running their establishments satisfactorily, and we have found that there is a tendency for those shops who do not maintain a sufficiently high standard to close down. Generally speaking, the saloons catering for women are cleaner and better managed than those for men, and here I should confidently suggest that the public themselves can do a lot of useful work. It is only for men to demand the same high standard that their women-folk do, and I have no doubt that the trade will see that their requirements are supplied. 10. SMOKE ABATEMENT, &c. A considerable portion of your sanitary officers' time has been taken up by the investigation of smoke and grit nuisances. In some instances the evidence necessary to definitely name an offender is very difficult to obtain. |
b611c2ea-682f-4aea-be13-c56e41696e35 | During the year 225 smoke observations were made in respect of factories, 53 offences were registered and necessary action taken. Grit Emission from Coal Combustion.—During the year a petition was received from residents in the neighbourhood of the Generating Station at Creeksmouth, and the grit emission from the chimneys of the Station was the subject of questions in Parliament. 88 In December, I issued to the Council a special report which set out in detail particulars of the Station (which is the largest generating station in Europe and will shortly have a capacity of 540,000 kilowatts) and also of modern practice for the prevention of grit and sulphur emission. The coal consumed is 20,000 tons weekly. We have been in conference with the Engineers of the Company, with a view to reducing the grit emission, particularly from the pulverized fuel installation. |
170dcc5b-e9ee-4a59-9db4-2c2dfc2450dd | Grit Emission from Wood Fuel.—Complaints of grit emission were received from 260 residents in the neighbourhood of a wood-block factory, where the wood refuse was being burned in the furnace of a Lancashire Boiler. Considerable nuisance was being caused. The Company in the autumn installed a new furnace, but the nuisance continued. A gas-producer furnace was later placed on order but at the time of writing we are unable to say with what success this will be operated. The cost of the installation is £3,200. A summons was issued against the Company and at present stands adjourned. Grit Emission from Mechanically Fired Vertical Boiler.—At a small factory near Abbey Road grit was emitted and deposited in nearby houses. A grit arrestor of the centrifugal type has been fixed. Stone-dust Emission.—In the industrial area at River Road, we have experienced trouble from the operations of road material hauliers and manufacturers. |
912677d5-9943-4ea0-af7e-9383dce8a131 | In the one case the nuisance arises from the discharge from the steamer to the road lorry of fine granite and similar dusty material and in the second case from the grading and screening plant. Although de-dusting screens were in operation the nuisance was considerable. Whilst alterations in handling have been effected this has only mitigated the nuisance. It is clear that an elaborate and expensive electro-static precipitation plant would effect a cure, but the cost of this on such a small plant would be considerable. 89 Sawdust Emission.—At some large sawmills in Abbey Road a nuisance was created by the emission of sawdust from electrically operated cyclones. The offending cyclones have now been totally enclosed, thus reducing the nuisance considerably, but not entirely. Smoke Abatement Byelaws.—For a number of years now the Corporation has been issuing warning notices when black smoke has been emitted in excess of 2 minutes in the aggregate in any observation of 30 minutes duration, excluding bursts of less than 25 seconds. |
70351e0d-adbe-48b4-9228-ad0cd446b66d | It was felt, therefore, with the coming into force of the Public Health Act, 1936, that the time was opportune for the Corporation to make byelaws on these lines, and at the end of the year such byelaws were awaiting confirmation. There are in the district 105 chimneys which would be subject to the byelaws and 16 which are exempted, owing to the special processes with which they are connected. Soot Deposit Gauges.—From what has been said about grit emission it appears that there is in the atmosphere of Barking an excess of suspended matter and it would be of value if this could be measured and compared with standards elsewhere. The measurement could be carried out with soot deposit gauges and I propose to ask for authority to install such equipment at suitable points in the district. 11. SWIMMING BATHS AND POOLS. There are no privately owned swimming baths in the area. Corporation Swimming Pool at Barking Park.—The. |
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