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80068334-9ed3-475e-979a-9076fcdcc93d	Although such schools are by statute reserved for children who are not imbeciles and not incapable of receiving benefit, the benefit intended is not merely a training in body and discipline which would apply to all grades of defectives, but substantial progress in the subjects of the curriculum. At the same time, the oft-expressed dictum, "once a defective, always a defective," must be remembered, and even grade cases, although not incapable of improvement, are unlikely to prove successes in after life from any educational proficiency which may have been attained at school. The introduction of manual instruction, such as boot-mending, basket and wicker work, mat making, etc., as an important part of the educational training in all such schools is thus to be commended as an essential item in the fitting out of the defective for his appropriate place in the sphere of after-life.
7d0394b9-1a5e-4da9-8dc0-560542226efa	Apart from the slow rate of progress made by lower grade defectives if admitted to special schools, the practice has other positive disadvan- 88 tages as pointed out by Dr. Fairfield, Divisional Medical Officer. London County Council, as follows:— "It destroys the reputation of the school with parents, and enhances the stigma ; it prejudices the whole case for the education of defectives with the Local Education Authority, and, moreover, seriously interferes with the teaching of the higher grade feeble-minded whose education has a wholly different purpose. The true feeble-minded child must have a chance to float if not to swim in the world, and will want to know all that his teacher can impart of roughly the three R's, the handling of money and skilled handicraft." The institution by the Essex Voluntary Association of an Occupation Centre in this district during the past year thus seems to go far in solving the question of what to do with the ineducable child.
c6d49f52-2408-47df-9bd3-adece3bf150c	DULL AND BACKWARD CHILDREN.—While the mentally-deficient child is defective not only pedagogically but psychologically, the defect of the truly dull and backward child is pedagogic merely. Of a total of 48 children between the ages of seven and nine years, notified by head teachers as suspected dull and backward, 18 on examination were found to be mentally defective, and certified as such under the Education Act, 15 were mentally delayed on account of prolonged absence from school or as a result of neglected physical defects, such as enlarged tonsils and adenoids, defective vision, hearing, etc., while the remainder were found to be merely dull and backward. To meet the need of the last group, a special class for dull and backward children was opened in October at the Special School.
eb83e8f3-3c96-4018-8ec8-306328ed42e7	While some schools of opinion would regard all children not socially certifiable as mentally defectives but merely backward, and would assert that it should be possible to give them the benefit of a special school education without certification, and that what we now have to do is to commence at the other end and establish a properlyorganised scries of backward classes and only certify cases as defectives after prolonged observation, it is well to remember that other authorities on this question have taken quite the 89 opposite view. In the opinion of the latter, the establishment of anything like backward classes is deprecated as serving no useful purpose, on the assumption that children of inferior mental capacity will probably be unable to acquire any very much better grasp of the very simplest subjects of education without in the main its being lost in the years immediately following their leaving school.
9cf78222-2fc2-43fd-923e-5893da573df2	The recommendation in the latter case is that such children irrespective of age should be retained in the ordinary elementary school class which accords with their mental attainments and until these attainments are such as would allow them to "pass up," the object of the special backward class being thereby obtained. Personally, 1 feel that there is something to be said for the latter view, although it resolves itself into having smaller classes and special teachers, an object not at all times practicable nor possible in every school. MINOR AILMENTS.—As formerly, minor ailments were mainly discovered through the vigilance of teachers and school nurses, and when recognised referred to the school clinic for treatment. The following table gives in detail the numbers of cases dealt with:— Minor Ailment. New Cases. Old Cases (re-attendances) .
82e6cf6e-1bee-470d-8d8a-95dc126a2ec4	Ringworm—Scalp 10 19 Body 17 68 Scabies 36 71 Impetigo 329 2,084 Other skin diseases 127 643 Minor Eye Defects 140 816 Minor Ear Defects 194 1,559 Miscellaneous (e.g., minor injuries, bruises, sores, chilblains, etc.) 780 2,528 90 FOLLOWING UP. Vide Annual Report for 1923. INFECTIOUS DISEASE. The procedure carried out in regard to infectious disease, notifiable or otherwise, was considered in detail in my Annual Report for last year. Teachers contributed their assistance from time to time by excluding suspicious cases and contacts, and notifying the School Medical Officer of such exclusions. As in previous years, most reliance was placed on intelligence received from school attendance officers, more particularly when dealing with non-notifiable infections.
4aedf7c9-f23d-4c34-a908-0f5604ecae78	During the months of January and February, a severe outbreak of measles occurred, necessitating the closure of all schools for three weeks. During the last quarter of the year mumps gave rise to a troublesome outbreak, 195 cases and 127 contacts being notified and excluded from school. By virtue of the Board of Education Amending Regulations, No. 2(a), 1924, now in force, "when the average attendance of a school or department for any week has fallen below 60 per cent. of the number of children on the registers, and the Local Education Authority are satisfied by a certificate from the School Medical Officer that the fall in attendance to so low a percentage may reasonably be attributed to the prevalence of epidemic illness in the district, the meetings and attendances for that week need not be reckoned in calculating the average attendance for the purpose of the Board's grant."
6eba1c8b-828b-4018-a056-d0ae915b5144	Such action as suggested may thus be undertaken as opportunity offers instead of the hitherto more general practice of school closure, a practice, it may be said, which tended to deprive the Medical Officer of Health of much essential fact regarding the ebb and flow of non-notifiable infections amongst school children, besides being obviously of considerably less utility in urbanised than rural areas, while, for example, in the case of diphtheria, these recent. Regulations would appear distinctly superior to that of school closure in coping with the average type of outbreak. 91 (a) Scarlet Fever.—31 cases were reported in 1924, compared with 10 in 1923. (b) Diphtheria.—23 cases were reported in 1924, compared with 16 in 1923. (c) Measles and German Measles.—192 cases were notified from the schools in 1924.
58d8987b-6727-48d2-8b34-8acf233c417b	(d) Chickenpox and Whooping Cough.—41 cases of chickenpox and 7 cases of Whooping Cough were reported from the schools during the year. 340 home visits were paid by the school nurses in connection with non-notifiable disease during the year, whilst 108 visits were made by one of the sanitary inspectors in connection with notifiable cases. OPEN-AIR EDUCATION. Playground Classes.—All schools have playground classes during the summer months when weather is suitable. School Journeys.—No school journeys were undertaken during the year under review, the last one being to the Isle of Wight by the Westbury Girls' School in 1922. Holiday Camps.—Four were spent at the holiday camp at Hainault organised by the Barking Town Education Committee for necessitous children. 48 boys and 48 girls were housed in four teams each fortnight, and many interesting events took place during the period.
df77c5e7-666d-43e8-a01b-827180a337e7	The method of selecting children for holiday camp is in process of revision, so that I hope in future less robust and frequently less cleanly cases will be enabled to take advantage of these holiday facilities in preference to their more fortunate neighbours, where in many instances change of scene and environment would appear of less urgent character from a medical standpoint. 92 Open-air School.—Barking is fortunate as being at present one of the few local Education Authorities who possess an openair school, providing accommodation for 120 children. During the year 114 children were on the register, whilst 56 children were admitted and 31 children found on examination to have sufficiently improved to permit of their return to ordinary school.
2cc397d8-8f93-4cd8-b2a3-6aa8265ff2ef	This school, which is under the same roof as the accommodation for physically and mentally defectives, is supplied from routine medical inspection, the Inspection Clinic and the Tiberculosis Dispensary, and so comes to enact the part of a preventorium for suitable cases of the school population which, generally speaking, are made up of suspected or quiescent cases of tuberculosis, malnutritional, debilitated, anaemic and rickety subjects, etc. The general routine of the school consists of, apart from life under open-air conditions to the fullest extent, an early lunch, dinner at noon, and in certain cases chemical food and cod-liver oil, the latter containing an anti-rachitic and growth-promoting vitamine, Fat Soluble A, which is of great benefit to children suffering from rickets and other allied conditions.
680b6571-a5ae-4810-b5c6-990dfa24e7a9	Children are encouraged to sleep after dinner, and, when weather permits, to do so in the open air There is a nurse-attendant attached to the school, who attends to minor injuries, besides caring for younger children in their passage to and from school by ambulance. Weekly spray baths are provided, whilst clogs and jerseys are available in the colder months, no serious attempt being made to maintain any particular temperature in the class rooms. A defect exists in the present construction of the school, which might later be remedied, namely, the provision of a glass verandah roof, and the conversion of the present windows into those of the casement, or French type, whereby the class rooms could become at all times open-air rooms in the fullest sense of the word. PHYSICAL TRAINING.
477b77a9-3521-413f-afbb-378f4dd28ef2	The general scheme outlined in the report by the Organiser of Physical Training dealing with minor postural defects, etc., published in my Annual Report for last year, has remained to some extent in abeyance pending the completion of the scheme bv the establishment of a Remedial Centre for more advanced 93 oases at the Special School. Now that the latter has been established, it is hoped that the full scheme will be taken advantage of during the ensuing year. PROVISION OF MEALS. Under the provisions of the Meals Acts, 1906-1914, the feeding of necessitous children has been continued at the Municipal Restaurant. Dinners and breakfasts were provided at the cost of 5d. and 2½d. per head respectively, and during the year 27,331 dinners and 2,093 breakfasts were supplied to 598 children.
04ffb4d9-781e-4f70-ad5d-b68af47f6aec	As in previous years, a selection of suitable children was made by the medical officers, school teachers, school nurses, attendance officers, etc., such recommendations being considered and in suitable cases approved of by the Meals Minor Sub-Committee. SCHOOL BATHS. An arrangement exists whereby the swimming baths are available for children attending the elementary schools on certain week-days, when swimming instruction is given. As already mentioned, with the exception of the Special School, where spray baths have been instituted, no bathing facilities exist at any of the other schools. CO-OPERATION OF PARENTS. As in previous years, the attendance of parents at the routine medical inspections was invited, and 53.47 per cent. responded, as compared with 55.2 per cent. in 1923. CO-OPERATION OF TEACHERS. Much of tne success of school medical inspection is due to the sympathetic assistance shown by teachers.
8c632b28-d6aa-4890-835a-7ab31a3cbd16	In all schools considerable personal interest is shown, and valuable information made available regarding the children. Through the tactful influence of teachers, difficult parents are often induced to obtain or accept treatment for defective children. It is hoped that this practice will be further facilitated by the recent arrangement of keeping medical inspection cards at schools. 94 CO-OPERATION' OF VOLUNTARY BODIES. Valuable information in regard to crippled and other defective children has been supplied from time to time by the school nurses, health visitors and Tuberculosis Dispensary, while close contact has been maintained with the local branch of the National Society for the Prevention of Cruelty to Children. The following is a brief resume of the work done by the Society in Barking during the past year:— Total number of cases investigated 12 (a) neglect 10 (b) ill-treatment 2 BLIND, DEAF, DEFECTIVE AND EPILEPTIC CHILDREN.
6a5a7c03-f85d-43c7-b97f-1f65eaf207f9	Table 3, Appendix (a), gives an account of defective chiidren under the age of sixteen. All such children are specially examined as to their suitability for special schools, and recommendations made in appropriate cases. Blind and deaf children, after certification by the School Medical Officer, are admitted to special schools, day or residential, according to recommendation. NURSERY SCHOOLS. No nursery schools have yet been established in this district, although in certain selected cases children of 4 to 5 years have been admitted to the Infants' Departments of certain elementary schools. The institution of Nursery Schools has never been regarded by many Local Education Authorities with favour mainly from the tendency thereby created to relieve parental responsibility, and from a social standpoint the encouragement of female labour.
6229ba62-6c7e-48c0-b63a-9e60fe2b263c	It cannot be too strongly emphasised that the ordinary elementary school is in no way suitable for the child of pre-school age, while the provision of suitable nursery school accommodation for the limited number who might appropriately be admitted, would far outweigh financially any benefit which might accrue from the practice. 95 CONTINUATION SCHOOLS. There are no continuation schools in the district. SECONDARY SCHOOLS. There is one secondary school in this district, which is under the administrative control of the Essex County Council. An arrangement exists as in previous years whereby routine medical inspections are undertaken by the school medical officer of the district, particulars of which are to be found in the subjoined tables:— Entrants. Intermediates. (12 years old.) Leavers. (15 years old.) Boys. Girls. Boys. Girls. Boys. Girls. No.
b35648eb-51cd-4aa3-b6b3-200cc7eccce2	examined 32 20 18 17 8 7 Referred for Treatment 12 9 6 6 – 5 Referred for observation – 2 – 3 – – Re-Inspections. Number re-inspected. Number found to have been treated. Boys 14 6 Girls 17 9 EMPLOYMENT OF CHILDREN AND YOUNG PERSONS. Milk and newspaper deliveries, general errands, hawking and newspaper selling, are the usual forms of employment of children of school age. Bye-laws governing the employment of children and young persons and providing for the medical examination of would-be applicants came into force during the year, 8 such eases being submitted for medical examination. In no case was it necessary to refuse any applicant on medical grounds. 96 SPECIAL ENQUIRIES. At the request of Sir George Newman, Medical Branch.
c048c238-94f9-4cf8-be58-5de8deaf6788	Board of Education, records have been kept with a view to contributing to the obtaining of accurate information as to the incidence of goitre throughout the country. The need for this information arose out of a special investigation of conditions associated with enlargement of the thyroid glaad, and it was suggested that a record of the result of the examination for this purpose of all children on uniform lines on the occasion of routine examination at the age of twelve years would be valuable. The result of the record kept since the request was made, namely, the 13th March, 1921, to the end of the vear, is as follows:— No. of children examined for the purpose. 423 No. of children in whom the thyroid was sufficiently enlarged for the increase in the size of the neck to be noticed on casual inspection (without measurement or palpation). 12 MISCELLANEOUS.
0a357f9d-e861-4086-ae77-ba53d7873a1a	Four young persons who desired to become bursars and student teachers were medically examined during the year, out of which number one was rejected on medical grounds. Home and Mothercraft.—This subject continued to be taught under the heading of Domestic Science. 97 TABLE 1.—RETURN OF MEDICAL INSPECTIONS. A.—Routine Medical Inspections. Number of Code Group Inspections: Entrants 550 Intermediates 828 Leavers 553 Total 1,931 Number of other Routine Inspections 179 B.—Other Inspections. Number of Special Inspections 115 Number of Re-inspections 899 Total 1,014 98 TABLE II.—A RETURN OF DEFECTS FOUND BY MEDICAL INSPECTION IN THE YEAR ENDED, 31st DECEMBER. Defect or Disease. Routine Inspections. Special Inspections. No. of Defects. No. of Defects. Requiring Treatment.
96645c6b-0bdf-464f-99c8-dec2471ebab4	Requiring to be kept under observation, but not requiring Treatment. Requiring Treatment. Requiring to be kept under observation, but not requiring Treatment. (1) (2) (3) (4) (5) Malnutrition 5 9 1 1 Uncleanliness – – – – Skin Ringworm—Scalp 1 – – – Body – – – Scabies 3 – — – Impetigo 7 – 2 – Other Diseases (NonTuberculous) 7 – 2 – Eye < Blepheritis 8 – – – Conjunctivitis 4 – 2 – Keratitis – – – – Corneal Opacities – – – – Defective Vision (excluding Squint) 94 4 28 – Squint 13 1 1 – Other Conditions – – – – Ear 'Defective Hearing 10 2 11 – Otitis Media 37 – 7 – Other Ear Disease – – 2 – Nose and Throat
81d362be-187f-4631-a3ed-42afb7259d08	Enlarged Tonsils only 101 33 8 – Adenoids only 17 4 2 – Enlarged Tonsils and Adenoids 53 1 9 – Other Conditions 21 3 5 – Enlarged Cervical Glands (Non- T.B.) 3 6 1 – Defective Speech – – I – Teeth—Dental Diseases(see note a) – – – – (Set Table IV., Group IV.) Heart and Circulation. Heart Disease: – Organic – 18 – – Functional – – – – Anæmia 36 7 4 1 Lungs Bronchitis 3 0 10 3 – Other Non-Tuberculous Diseases – 1 1 – 99 TABLE III.—Continued. Defect or Disease. Routine Inspections. Special Inspections . No. of Defects. No. of Defects.
544f18c7-7eaa-4ad5-8171-d8caba5937c6	Requiring Treatment Requiring to be kept under observation, but not requiring Treatment Requiring Treatment. Requiring to be kept under observation, but not requiring Treatmert.
645e1467-aee0-4601-9689-99c1fdd1e2be	(1) (2) (3) (4) (5) Tuberculosis Pulmonary: Definite 1 – – – Suspected 4 11 – – Non-Pulmonary: Glands 4 14 – 1 Spine – – – – Hip 1 – – – Other Bones and Joints – 1 – – Skin – – – – Other Forms – – – – Nervous System mites Epilepsy 3 1 2 – Chorea 1 – – – Other Conditions 1 – 1 1 Rickets 1 – – – Spinal 21 8 3 – Other Forms 19 7 2 – Other Defects and Diseases 25 6 3 1 100 B.—Number of Individual Children FOUND AT Routine MEDICAL INSPECTION TO REQUIRE TREATMENT (EXCLUDING UNCLEANLINESS AND DENTAL DISEASES). Group. Number of Children. Percentage of Children found to require treatment. Inspected.
d02255ed-ea60-4f82-9166-74e5ab2a2a27	Found to require treatment (1) (2) (3) (4) CODE GROUPS: Entrants 550 135 24.54 Intermediates 828 190 22.94 Leavers 553 121 21.88 Total (Code Groups) 1,931 446 23.09 Other Routine Inspections 179 78 43.57 101 TABLE—RETURN OF ALL EXCEPTIONAL CHILDREN IN THE AREA. Boys. Girls. Total. Blind including partially blind.) (I.) Suitable for training in a School or Class for the totally blind. Attending Certified Schools or Classes for the Blind 1 1 2 Attending Public Elementary Schools — — — At other Institutions — — — At no School or Institution — — — (11.) Suitable for training in a School or Class for the partially blind.
68901a2a-bd48-4e28-8fe9-3f144b788253	Attending Certified Schools or Classes for the Blind — 1 1 Attending Public Elementary Schools — — — At other Institutions — — — At no School or Institution — — — Deaf (including deaf and partially deaf. (I.) Suitable for training in a School or Class for the totally deaf or deaf and dumb. Attending Certified Schools or Classes for the Deaf 2 4 6 Attending Public Elementary Schools — — — At other Institutions — — — At no School or Institution — — — (If.) Suitable for training in a School or Class for partially deaf. Attending Certified Schools or Classes for the Deaf — 2 2 Attending Public Elementary Schools — — — At ether Institutions — — — At no School or Institution — — — Mentally Defective Feeble Minded (cases not notifiable to the Local Control Authority.
ec70f6a5-f93a-4d0a-9c01-4784f2d331a8	Attending Certified Schools for Mentally Defective Children 14 21 35 Attending Public Elementary Schools — — — At other Institutions — — — At no School or Institution — — — Notified to the Local Control Authority during the year. Feebleminded — — — Imbeciles 4 — 4 Idiots 2 1 3 Epilepsy. Suffering from severe Epilepsy. Attending Certified Special Schoools for Epileptics — — — In Institutions other than Certified Special Schools — — — Attending Public Elementary Schools — — — At no School or Institution 1 — 1 Suffering from Epilepsy which is not severe. Attending Public Elementary Schools 2 4 6 At no School or Institution — — — 102 TABLE III.—continued. Boys. Girls. Total. Infectious pulmonary and glandular Tuberculosis.
855927b3-3db3-477b-8dc4-1a2553c5bb66	At Sanatoria or Sanatorium School approved by the Ministry of Health or the Board 1 1 2 At other Institutions — — — At no School or Institution — — — Noninfectious, but active pulmonary and glandular tuberculosis. At Sanatoria or Sanatorium Schools approved by the Ministry of Health or the Board — — — At Certified Residential Open Air Schools — — — At Certified Day Open Air Schools — — — At Public Elementary Schools — — — At other Institutions — — — At no School or Institution — — — Physically Defective. Delicate children [e.g., preor latent tuberculosis, malnutrition debility, anaemia, etc.) At Certified Residential Open Air Schools — — — At Certified Day Open Air Schools 59 55 114 \t Public Elementary Schools — — — At other Institutions — — — At no School or Institution — — — Active non-pulmonary tuberculosis.
d2de4d64-6a36-41f6-b585-07c1ce7e5639	At Sanatoria or Hospital Schools approved by the Ministry of Health or the Board 3 1 4 At Public Elementary Schools — — — At other Institutions — — — At no School or Institution — — — Crippled Children (other than those with active tuberculous disease). e.g., children suffering from paralysis, etc and includin\| those with severe heart disease. At Certified Hospital Schools — — — At Certified Residential Cripple Schools — — — At Certified Day Cripple Schools 21 17 38 At Public Elementary Schools At other Institutions 7 2 9 At no School or Institutio 3 1 4 103 TABLE IV.—TREATMENT TABLE. Group I.—Minor Ailments (excluding Uncleanliness, for which see Group V.). Disease and Defect. Number of Defects treated, or under treatment during the year. Under the Authority's Scheme. Otherwise. Total.
7f671fd8-1993-4cc6-b8ca-529a7e3ddf16	(1) (2) (3) (4) Skin:— Ringworm—Scalp 10 — 10 Body 17 — 17 Scabies 36 — 36 Impetigo 329 — 329 Other Skin Diseases 127 — 127 Minor Eye Defects (External and other, but excluding cases falling in Group II.) 140 — 140 Minor Ear Defects 194 — 194 Miscellaneous (e.g., minor injuries, bruises, sores, chilblains, etc.). 780 — 780 Total 1,633 — 1,633 104 Group II.—Defective Vision and Squint (excluding Minor Eve Defects Treated as Minor Ailments—Group I.—. Defect or Disease. (i) Number of defects dealt with. Under Authority's Scheme. (2) Submitted to refraction byprivate practitioner or at hospital apart from the Authority's Scheme. (3) Otherwise (4) Total.
c07200a0-30a4-49bf-9495-339347b7aee9	(5) Errors of Refraction (including Squint) 143 12 — 1.35 Other Defects or Diseases of the eyes (excluding those recorded in Group I.) 1 — — 1 Total 144 12 — 156 Total number of children for whom spectacles were prescribed:— (a) Under the Authority's Scheme 123 (b) Otherwise 9 Total number of children who obtained or received spectacles:— (a) Under the Authority's Scheme 123 (b) Otherwise 9 Group III.—Treatment of Defects of Nose and Throat. NUMBER' OF DEFECTS. Received Operative Treatment. Under the Authority's Schema in. Clinic or Hospital. By Private Practitioner or Hospital, apart from the Authority's Scheme. Total. Received other forms of treatment. Total number treated.
bf3c032d-018d-4eb5-9d56-39456c90b723	(1) (2) (3) (4) (5) 146 — 146 114 260 105 Group IV.—Dental Defects. (1) Number of children who were:— (a) Inspected by the Dentist: Routine Age Groups.
12e7e632-251f-4523-96b9-d3a12e97eddc	Aged 3 — 4 15 5 431 6 451 7 512 8 393 9 529 10 536 11 433 12 579 13 517 14 83 15 4 Total 4,483 (b) Found to require treatment 3,052 (c) Actually treated 1,181 (d) Re-treated during the year as the result of periodical examination — (2) Half-days devoted to Inspection 38 Treatment 188 Total 226 (3) Attendances made by children for treatment 1,796 (1) Fillings—Permanent Teeth 343 Temporary Teeth 669 Total 1,012 (5) Extractions—Permanent Teeth Temporary Teeth 352 1,488 Total 1,840 (•>) Administrations of general anaesthetics for extractions 1,012 (7) Other operations—Permanent Teeth — Temporary Teeth 26 Total 26 106 Group V.—Uncleanliness and verminous conditions.
ab31bc2c-f712-4d43-896e-ad25feace51e	(i) Average number of visits per school made during the year by the School Nurses 3 (ii) Total number of examinations of children in the schools by School Nurses 13,632 (iii) Number of individual children found unclean 2.237 (iv) Number of children cleansed under arrangements made by the Local Education Authority 38 (v) Number of cases in which legal proceedings were taken : (a) Under the Education Act. 1921 — (b) Under School Attendance Byelaws 1
aec45491-1c54-42d7-b4b6-db68b4cfcb69	BAR 19 Barking Town Urban District Council. REPORT OF THE Medical Officer of Health AND School Medical Officer For the Year 1925. K. SIMPSON, M.D., Ch.B., M.R.C.P., D.P.H. 75149 2 , TABLE OF CONTENTS SECTION 1—GENERAL. Page Staff 5 Physical Features and General Character of Area 9 Social Conditions 10 Poor-Law Relief 12 Statistical Summary 13 Comparative Statistical Table 14 Table of Vital Statistics from 1920 to 1925 15 Summary of Nursing Arrangements 16 Clinic and Treatment Centres 17 Ambulance Facilities 18 Laboratory Work 18 Local Bye-Laws, Regulations and Adoptive Acts 19 Deaths 20 inquests 22 Causes of Death (Table) 23 Causes of Death at Various Ages under 1 year 24 Marriages 25 Births 25 SECTION 2—SANITARY CIRCUMSTANCES OF THE DISTRICT.
beaaf732-201e-4b0f-9a6c-fdab9dbb851c	Water Supply 26 Rivers and Streams 26 Rainfall 26 Sewerage 26 Closet Accommodation 27 Scavenging 27 Housing Statistics 29 Sanitary Inspection of the Area 31 Summary of Sanitary Work carried out 32 Notices Served 34 Smoke Abatement 35 Offensive Trades 35 Common Lodging Houses 36 Tents, Vans, Sheds, etc. 37 Houses Let in Lodgings 37 Food and Food Places:— (a) Dailies, Cowsheds and Milkshops 37 (b) Milk (Special Designations) Order, 1923 38 (c) Bakehouses 38 (d) Food Premises 38 3 SFCTION 2—Continued. Page (e) Public Health (Meat) Regulations, 1924 39 (f) Markets 40 (g) Fried Fish Shops 40 (h) Ice Cream 40 (i) Unsound Food 41 Sale of Food and Drugs Act.
a19f4a4a-c250-4ef5-a44e-df243cc76e36	41 Halt and Mice (Destruction) Act, 1919 41 General Housing Conditions in the Area 42 Unhealthy Area 44 Factories, Workshops, Workplaces, etc. 44 SECTION 3—NOTIFIABLE INFECTIOUS DISEASES. Table of Cast:- of Infectious Diseases notified and removed to Hospital 48 Attack Rates for past Five Years 49 Cases Classified According to Age Groups and Wards 51 Monthly Summary of Receipt of Notifications 52 Scarlet Fever 53 Smallpox and Vaccination 53 Diphtheria 53 Puerperal Fever 54 Acute Primary and Acute Influenzal Pneumonia 54 Non-notifiable Diseases 55 Table of Admissions and Discharges from Hospital 55 Hospital Problems 56 Tuberculosis 57 Tuberculosis After-care 64 SECTION 4—MATERNITY AND CHILD WELFARE.
53ca6de2-fb2d-48c4-bcc2-e7b7d0a09dfc	Notification of Births Acts, 1907-1915 66 Maternity Ward 67 Puerperal Sepsis 69 Maternal Deaths 69 Births 70 Still-births 70 Ophthalmia Neonatorum 72 Ante-natal Centres 72 Work of Health Visitors 73 Table of Attendances at Infant Welfare Centres 74 Neonatal Mortality 77 Denial Treatment 79 Provision of Meals 79 Foster Children 79 Convalescent Treatment 80 Illegitimacy 81 Infantile Mortality 81 Provision Fresh and Dried Milk 83 4 SECTION 5—SCHOOL MEDICAL SERVICE.
1c27817a-10f2-416f-9893-963f5c05d561	PAGE* Co-ordination 1 School Hygiene 2 Medical Inspection 3 Findings of Medical Inspections 5 Table of Results of Cleanliness Inspections 7 Heights and Weights 8 Infectious Disease 10 Following-up 10 Medical and Surgical Treatment 11 Payments for Clinic Treatment 13 Table of Attendances at Clinics 14 Tabic of Work done in connection with Orthopaedic Clinic IB Open-air Education 17 Provision of Meals 18 School Baths 19 Co-operation of Parents, Teachers, etc. 19 Blind, Deaf, Defective and Epileptic Children 20 Medical Inspection at Abbey School 23 Employment of Children and Young Persons 23 Report of Orthopædic Surgeon 25 Report of Dental Surgeon 27 Statistical Tables:— Table I. Return of Medical Inspections 29 Table II. (A) Return of Defects Found 30 Table II. (B) Number of Children found to require Treatment 32 Table III. Return of all Exceptional Children 33 Table IV.
d85614ef-c188-406e-9b5a-3fc53b2dae99	Group I. Treatment of Minor Ailments 3.5 Table IV. Group II. Treatment of Eye Defects 36 Table IV. Gioup III. Treatment of Defects of Nose and Throat 36 Table IV. Group IV. Dental Defects and Treatment 37 Table I\. Group V. Uncleanliness and Verminous Conditions 38 School Medical Officer's Report Section. 6 ANNUAL REPORT OF THE Medical Officer of Health and School Medical Officer *or the Urban District of Barking Town, in the County of Essex, for the Year ended 31st December, 1925. Public Health Offices, Barking', Essex. To the Chairman and Members of the Urban District Council of Barking Town. Mr. Chairman and Gentlemen, I beg to submit my Annual Report op the Public Health and School Medical Services of the District, for the year ended 31st December, 1925.
af8ecfe2-b865-4f51-9a7e-2f77fa2b1846	In accordance with the requirements of the Ministry of Health, the Report is a survey, covering the period of the last five years, and being my third Annual Report. Following the death of the late Dr. Ewart, who had been M.O.H. since November 1912, I was appointed to the vacancy in July, 1923. According to the Registrar-General, the estimated population in June, 1925, was 38,450, giving an increase of 560 over 37,890 in 1924, while the excess of births over deaths was 439, contrasted with the average quinquennial figure, which was 488. The birth rate for 1925 was 21.4, a steady annual fall having taken place from 1921 onwards, as follows:—26.0. 24.0. 23.1, 22.3, 21.4. The principal causes of the present birth rate decline are referred to on page 67.
e849e024-8bde-493f-9af7-b173db46d678	5 STAFF, 1925 Medical Officer of Health, School Medical Officer, Medical Superintendent. Isolation Hospital, and District Tuberculosis Officer: K. SIMPSON, M.D., Ch.B., M.R.C.P., D.P.H. Asst. Medical Officer of Health and Asst. School Medical Officer: MURIEL J. . OUGH, M.B., M.S., B.Sc., M.R.C.S., L.R.C.P., D.P.H. Orthopadic Surgeon (Part Time): B. WHITCHURCH HOWELL, M.B., B.S., F.R.C.S. School Dentist: W. W. F. DAWE, L.D.S., R.C.S. (Eng.). Sanitary Inspectors: N. BASTABLE (Chief Sanitary Inspector) (b, c and f). *H. WOOD (Sanitary Inspector) (b and c).
57927cc7-916d-4787-ba02-848310dbb1ad	H. CARR (Sanitary Inspector (b, c and e). MISS E. PODMORE (Assistant Sanitary Inspector (b and g). School Nurses: MISS L. F. SWAIN (h and i). M1SS F. YOUNG (Dental Nurse) (i and j). MISS S. E. \V. GIBSON. Health Visitors: MRS. G. STOKES (i). MISS A. C. KFENAN (g, h and i). MISS H. M. LYAL (g and i). Matron, Isolation Hospital: MISS M. J. HEDGCOCK (h, i and j). Masseuse, Orthopedic Clinic (Part Time): MISS A. E. FIXDLAY, C.S.M.M.G. (k). Chief Clerk oi Department: E. W. WINCHESTER (a, c and d).
d371aa4b-25e1-442e-b876-aa2d0096be81	Disiufector and Mortuary Keeper: . H. LONG. (a) Sanitan Inspector's certificate of Sanitary Inspectors' Examination Board. (b) Sanitary Inspector's certificate of Royal Sanitary Institute. (c) Meat, etc., Inspector's certificate of Royal Sanitary Institute, (d) Meat, etc.. Inspector's certificate of Sanitary Inspectors' Examination Board. (e) Building inspector's certificate of Worshipful Company of Carpenters. (f) Sanitary Science C'eitificatc of Royal Sanitary Institute. (g) Health Yisitor's certificate of Royal Sanitary Institute. (h) Certificate of Central Midlives' Board. (i) General Hospital Training. (j) General Fever Training. (k) Certificate M..E. and S..R..E. *Proportion of salary contributed under Public Health Acts or by Exchequer grants.
06a6f1ac-d8ed-4965-9e85-ae227e33abab	7 The general death rate for 1925 was 10.0, the annual fluctuations during the past five years, from 1921 onwards, being as follow:—10.8, 9.0, 8.5, 10.0, 10.0. The average rate for the period was 9.8. Important from the Public Health point of view are the Infantile and Tuberculosis death rates, the former for 1925 being per thousand births, whilst the latter was 1.09. Some of the probable reasons for the disproportionately high infantile mortality of the district are discussed on pages 81.84. The tuberculosis death rate still remains high, the average rale for the past five years being 1.1., defective housing, it is now well known, playing the major part in the incidence of this disease.
3d173106-1a67-488f-ab83-b775fadc42f5	It may be observed, therefore, that though the general death rate for the district is not unduly high, those rates which depend more particularly upon hygienic conditions, such as infantile mortality and deaths from tuberculosis, are considerably above the average. The Chief Sanitary Inspector reports that between six and seven hundred houses in the district are unfit, nearly all of which are still inhabited. Of the above number of dwellings, 51, comprising the "Island" Site, have been the subject of a recent Ivepresentation under the Housing Act. During the Quinquennium 352 houses have been built by private enterprise, while the Authority has added 456 for letting purposes. A scheme for the efficient sewerage of the district now occupies attention, being one of considerable urgency even as regards the present population of the district. The question of refuse disposal, considered more particularly on pages 27-29, still awaits investigation on lines more favoured by present-day sanitarians.
a5cfade3-08e8-44f9-96bf-3bab2ae0ba23	The question of hospital accommodation for infectious diseases can hardly be considered satisfactory; fortunately, during 8 the past three years, the district has had to contend with only a small incidence of infection. Some of the main points in connection with the present hospital problem are considered on pages 56-57. It is gratifying to record the satisfactory progress which has been made with respect to the School Medical Service during the past five years. The year 1922 saw the institution of an open-air school, including separate mentally and physically defective departments, among the first in the country. Towards the latter end of 1923 a cleansing and disinfesting station was opened at East Street, for which, and other reasons, the incidence of uncleanliness amongst schooi children has now fallen by nearly 100 per cent. The School Medical Service has been benefited by the acquisition of a full-time dental surgeon.
53dd8077-8106-4d71-bfe3-90421e5a37fb	The institution of an orthopædic clinic (including the installation of ultra-violet light), for the treatment of various crippling conditions, has been a boon to the district as a whole. The principal difficulty of the School Medical Service at present, is the lack of more satisfactory premises for the dental, eye, and general-medical examination and treatment of the school population, a question further referred to on pages 14 and 15 of the section of this Report devoted to the School Medical Service. My thanks are more particularly due to Mr. Bastable, Chief Sanitary Inspector, who, since his appointment last year, has been of great assistance in connection with the sanitary work of the Public Health Department; and to Mr. Winchester, my Chief Clerk, who has been responsible for the statistics and certain other of the information required for this Report. I am, Mr. Chairman and Gentlemen, Your obedient servant, KERR SIMPSON, Medical Officer of Health. School Medical Officer.
9f382a15-499a-475d-8c32-81102a37b988	9 SECTION 1 PHYSICAL FEATURES AND GENERAL CHARACTER OF THE AREA. The Urban District of Barking extends over the area of the parish of that name, and lias an acreage of 4,106, 300 acres being watercourses. It is bounded on the North by liford, on the South by North Woolwich and the River Thames, on the East by Dagenham, and on the West by East Ham, and includes well defined district's spoken of as Rippleside, Faircross, Creeksmouth, and a portion of the L.C.C. Becontree Estate. 450 acres are developed residentially and 320 acres industrially, the number of houses and persons to the acre being 1.8 and 9.3 respectively. Particulars of the parks, pleasure grounds, etc., are afforded by the following table:— Designation of Open Space. Acreage.
2baac88b-b573-497a-8913-782b1b299fce	Longbridge Park 75½* Abbey Playing Field 2¼ Abbey Site 1½ Greatfields Park 14 Victoria Gardens ¾ Vicarage Field 4½ Essex Garden 1/5 Cemetery 16 *66½ acres is situated in the Urban District of liford. 10 The main lines of the Midland Railway to Southend-on-Sea and Tilbury divide the district to a certain extent, having a tendency to isolate various parts from one another. The northern half of the district slopes from north to south, and is suitable for residential purposes. The southern half consists of marshland, and, being practically flat, and. having a general level of from 5 to 6 O.D., is unsuitable for residential purposes. Geologically, the whole district has a gravel subsoil lying generally close to the surface of the ground, which has a general surface declivity from the north towards the rivers and outcrops in the bed of the watercourses.
d9a9ab77-d231-40d5-a3f0-945501ef219a	An exception to this statement may be found on the marsh levels, where there is a bed of marsh clay of varying thickness overlying the gravel. In this connection it is of interest to note that recent borings at Abbey Rubber Mills indicated the first 12 feet to be made soil, the next 5 feet sandy clay, and the next 1 feet of gravel resting on London clay. SOCIAL CONDITIONS, ETC. The chief occupations of the residents in the district at the time of the 1921 census are shown by the following table, which is a summary of the census return:— 11 Occupations. Male. Female. Total. Agricultural Occupations 218 97 315 MoKers of Bricks, Pottery and Glass 102 2 104 Workers in Chemical Processes, Makers of Paint, etc-.
d586202b-4982-4d67-9ed7-28416b0e2b97	348 198 546 Metal "Workers (not electro plate or precious 999 89 1.088 Workers in Precious MotaU and Electro Plate 13 2 15 Electricians and Electrical Apparatus Makers 204 72 276 Workers. in Skin and Leather (not boots and shoes 39 29 68 Textile Workers 26 92 118 Makers of Textile Goods and Articles of Dress 107 365 472 Makers of Food, Drinks and Tobacco 179 136 315 Workers in Wood and Furniture 459 81 540 Makers and Workers in Paper (Printers etc.) 261 116 377 Builders Bricklayers, Stone and Slate Workers 571 1 572 Painters and Decorators 211 2 213 Workers in materials (vulcanite, ebonite, bone, horn etc.)
4c949268-234e-40d0-ab28-0c9536c99f68	206 204 410 Workers in Mixed or Undefined Materials 98 50 148 Persons employed in Gas, Water and Electrical Undertakings 546 1 547 Persons Employed in Transport, etc. 1,501 61 1,562 Commercial, Finance and Insurance Occupations (excluding clerks) 774 410 1,184 Persons limpioyed in Public Administration and befence (excluding professional men and typists) 292 38 330 Professional Occupations (excluding clerical saff 160 178 338 persons Employed in Entertainments and Sport 23 11 34 Persons engaged in Personal Service (including institutions, clubs, etc.) 228 713 941 Clerks and Draughtsmen (not Civil Service or locat Authoritv), Tvpists 625 577 1,202 Warehousemen. Storekeepers and Packers 288 257 545 Stationary Engine Drivers, Dynamo and Motor Attendants 304 – 304 ???
e4fce674-a178-4a7c-8ca4-f5cffd6e759f	and Undefined Workers (general labourers, etc.) 2,342 183 2,525 It will be seen from the foregoing table that Barking is fargely industrial. It was found in the 1921 census that G,7G2 inhabited houses," comprising 31,930 rooms, were occi'pied ky 7.091 " families or occupiers," that 279 families were living in nne room, 614 families in two rooms, and 706 families in ii ' w»ree rooms, and that a population of 4,052 persons were living * "tore than two persons to one room. 12 The amount of out-relief granted during the past five years is indicated in the following table (kindly supplied by the Clerk to the Romford Guardians), which gives for the calendar years stated the amounts spent in outdoor relief, the numbers chargeable in the middle week of each year, and the numbers chargeable in Romford Institution:— Calendar year ending.
4acdbd97-5cf3-4055-8c2a-6daf59a6ad26	Amount spent in Barking in the year. Xumbers chargeable in the middle week of the year. Numbers chargeable in Romford Institution in the middle week of the year. 31st Dec. 1921 Ordinary £5,878 0 7 Ordinary 442 135 Unemploymt 11,362 5 2 Unemploymt 503 31st Dec. 1922 Ordinary £7,151 11 11 Ordinary 457 133 Unemploymt 29,120 9 7 Unemploymt 2,442 31st Dec. 1923 Ordinary £7,437 5 7 Ordinary 512 124 Unemploymt 15,988 13 1 Unemploymt 1,249 31st Dec. 1921 Ordinary £7,741 8 6½ Ordinary 509 141 Unemploymt 6,402 18 4 Unemploymt 540 31st Dec.
e0ee50e9-16d9-4670-83bc-a670a1141f7e	1925 Ordinary £8,447 11 3 Ordinary 563 136 Unemploymt 3,112 1 7 Unemploymt 330 13 SUMMARY OF PARTICULARS REQUIRED BY CIRCULAR 648 OF THE MINISTRY OF HEALTH. DATED 10th DECEMBER, 1925. Genera1. Statistics. Area (acres) 4,100 Ward areas 3,806 Tidal Water H.W.M. Thames 240 Roding 58 Loxford Water 2 300 4,106 Population (Census, 1921) 35,523 Population (June, 1925) (Registrar General's estimate) 38,450 Number of inhabited houses (1921) 6,762 Number of Families or separate occupiers (1921) 7,594 Population Density, i.e., No. of persons per acre 9.3 Rateable Value—Houses, Buildings, etc.
ecd5834d-0a14-478f-b13d-85e9839057cc	£263,460 10 0 Lands £3,008 10 0 Sum represented by a penny rate £1,100 0 0 Education rates :— Elementary 3 5 Secondary 5 Assessable Value £244,077 10 0 General District Rate 7 9 Poor Rate 9 8 2. Extracts from Vital Statistics for the Year. Births Males. Females. Total. Birth Rate. Legitimate 408 394 802 20.85 Illegitimate 3 20 23 0.59 Total 411 414 825 21.44 Deaths :— Male. Female. Total. Death Rate. Standard Death Rate (Factor 1'049) 199 187 386 10.03 10.5 Number of deaths of women during, or in consequence of, childbirth:— From Sepsis. From other causes. Total.
1ab3a763-93f9-4ef2-883d-dc74b6fc5d65	– 1 1 Number of deaths of infants under one year of age:— Males. Females. Total. Death Rate. Total Infantile Death Rate. Legitimate 35 26 61 76.05 80.0 Illegitimate 1 4 5 217.39 dumber of deaths from Measles (all ages) 1 „ „ Whooping Cough (all ages) 13 „ ,. Diarrhoea (under 2 years of age) 9 14 3. BIRTH RATE, DEATH RATE, AND ANALYSIS OR MORTALITY DURING THE YEAR. Birth Rate per 1,000 Total Population. Annum. Death Rate per 1,000 Population. Rate pf.r 1,000 Births. Percentage of Total Deaths. All Causes. Enteric Fever. Small Pox Measles. Scarlet Fever. Whooping Cough.
be73249f-fa03-4155-b2a4-08ad0db56a23	Diphtheria. Influenza. Violence. Diarrhoea and Enteritis (under Two years). Total Deaths under One year. Causes of Deaths Certified by Registered : Medical Practitioners Inquest Cases. Uncertified Causes of Death. England and Wales 18.3 12.2 0.01 0.00 0.13 0.03 0.15 0.07 0.32 0.47 8.4 75 92.1 6.9 1.0 105 County Boroughs and Great Towns including London 18.8 12.2 0.01 0.00 0.17 0.03 0.18 0.00 0.30 0.43 10.8 79 92.1 7.3 0.6 157 Smaller Towns (1921 Adjusted Populations 20,000-50,
c68a0e4f-6363-4f1e-aa2f-4cc2f6e60517	000) 18.3 11.2 0.01 0.00 0.15 0.02 0.14 0.06 0.31 0.38 7.6 74 93.0 5.9 1.1 London 18.0 11.7 0.01 0.00 0.08 0.02 0.19 0.11 0.23 0.46 10.6 67 91.1 8.9 0.0 BARKING 21.4 10.0 – – 0.02 0.02 0.33 0.05 0.40 0.33 10.9 80 92.0 8.0 – 15 VITAL STATISTICS Of WHOI.E DISTRICT FROM 1920 to 1925. Year. Population estimated to Middle of each Year. Births.
29cc0d93-bfc7-4487-a1d9-f4d0a28507fb	Total Deaths Rcgistered in the District. Transferable Deaths Nett Deaths belonging to the District. Nett. Number. Rate. Of Nonresidents registered in the District. Of residents registered out of the District. Under One year of age. At all Ages. Number. Rate. Number. Rate per 1,000 Nett Births. Number Rate. 1 2 3 4 5 6 7 8 9 10 11 12 1920 35,151 1,086 30.9 339 9.6 – 110 92 83.0 449 12.6 1921 36,250 968 26.0 297 7.1 – 97 74 74.1 394 10.8 1922 36,680 882 24.0 308 8.1 – 56 49 55.
27ba515e-0a74-4475-be1f-b6982c999b0f	5 364 9.9 1923 37,210 862 23.1 234 6.2 5 86 43 49.8 318 8.5 1924 37,890 846 22.3 273 7 2 3 109 72 85.1 379 10.0 1925 38,450 825 21.4 287 7.4 8 107 66 80.0 386 10.0 *Registrar General's Figures. 16 . 5. CAUSES OF SICKNESS. No special causes of sickness fall to be discussed. 6. SUMMARY (FOR REFERENCE) OF NURSING ARRANGEMENTS, HOSPITALS, AND OTHER INSTITU. TIOXS AVAILABLE FOR THF DISTRICT. (a) Nursing in the Home.
27bcdb2c-743b-4502-8298-c6babdbb5834	(i) The Plaistow Maternity Charity provide a staff of nurses, who attend at the homes of the sick once or twice a day, carry cut such skilled nursing as is required, and offer instructions where advisable in hygienic home practices in relation to the sick. (ii) For infectious diseases. In the event of an epidemic, the Council can provide nurses for such cases as may require to be nursed in their own homes. Of late years this has not been necessary. No other provision of home nursing is carried out by the Department, but Health Visitors and School Nurses regularly advise parents as to the nursing and general care of children. (b) District Midwifery Provision. By agreement dated January 1st, 1924, with the Plaistow Maternity Charity, the Council annually subsidise the Charity on any deficit from £300 in respect of 300 District Midwifery cases attended by the Charity reckoned at the rate of £1 per case.
0e56e7a5-4314-4d84-ab7a-2572a72e5b3f	The takings of the Charity for the year amounted to £229, leaving a balance due to the Charity from the Council of £71, such sum ranking for grant. 17 (c) CLINIC AND TREATMENT CENTRES. Name and Situation. Nature of Accommodation. By Whom Provided. I. Maternity and Child Welfare:— (a) Centres Clinic premises, East Street. Empress Hall, Ripple Road. Alexandra Centre St. Pauls Road. Accommodation for consultation, weighing of babies, waiting room. etc. „ „ „ „ Local Authority. „ „ „ „ (b) Ante-natal clinic Clinic premises, East Street. Accommodation for consultations. „ „ (c) School Nurseries Nil. Nil. Nil. (d) Day Nurseries Nil. Nil. Nil. II. School Medical Service:— (a) Inspection Clinic and treatment of minor ailments Clinic premises.
8b27dce5-bdd6-41ed-bc09-19698f75f5d3	East Street. Three rooms. Local Authority. (b) Eye Clinic „ ,, One room. „ „ (c) Dental Clinic „ „ Two rooms. „ „ (d) Orthopedic Clinic Faireross School. Ono room. „ „ III. Tuberculosis 37, Linton Road. Three rooms. Essex County Council. IV. Venereal Diseases London Hospitals, etc. — By arrangement with Essex County Council. 18 (d) Hospitals provided or subsidised by the Local Authority: (i) Smallpox.—An arrangement exists with the neighbouring County Borough of West Ham whereby an unlimited number of beds are available at Dagenham for the reception and treatment of cases of smallpox which may occur in the Barking area. (ii) The only hospital provided by the Local Authority is that for the isolation and treatment of infectious diseases situated in Upney Lane, where 40 beds are available for such cases.
59600c85-83d4-42c3-a1f1-9e94b2babf01	Twelve additional beds are available for maternity cases in a separate portion of the hospital buildings. (e) Ambulance Facilities:— (i) A horse ambulance is provided for the removal of infectious cases to the Isolation Hospital, Upney Lane. (ii) For non-infectious and accident cases, two motor ambulances are kept at the Fire Station, the ambulancc and fire services being run in conjunction under the Chief Fire Officer. 7. LABORATOR\ WORK. The necessary laboratory work of the district is carried out by arrangement with the Essex County Council at the Counties' Laboratory, situated in Queen Victoria Street, London, E.C.4, particulars of the number of specimens submitted for examination .being supplied by the following table: – Specimen Number examined Diphtheria 442 Sputaj 226 Typhoid 6 Ringworm 10 Miscellaneous 15 8. List of Adoptive Acts, Byelaws, and Local Regulations relating to Public Health in force within the district.
0245361f-2c0d-4b2c-9497-7324259cccdf	(i) Local Acts: Barking Town Wharf Act, 1893, Barking Parish Act, 1888. 19 (ii) General Adoptive Acts: Local Government and other Officers' Superannuation Act, 1922. Public Health Acts Amendment Act, 1890, Parts 2, 3 and 5. Public Health Act, 1925. Baths and Washhouses Acts, 1847, etc. Infectious Diseases (Prevention) Act, 1890. Public Health Acts Amendment Act, 1907, Parts 2, 3, 4, 5, 6 and 9, and Section 95 of Part 10. (iii) Regulations: Regulations as to Dairies, Cowsheds and Milkshops, 1900 (revised 1924). Regulations as to Cemetery, 1902. Barking Town (Pneumonia) Regulations, 1924.
a7ee30b9-e386-4b9c-9702-739fb0bc5144	(iv) Byelaws with respect to: Nuisances, 1884. Ccmmon Lodging Houses, 1884. Offensive Trades, 1907 (revised 1924). Houses let in lodgings, or occupied by members of more than one family, 1921. Public Baths, 1900. Tents. Vans, Sheds and similar structures, 1909. Paving of Open Spaces, 1901. Nuisances in connection with the removal of offensive matter, 1908. Employment of Children and Young Persons, 1921 (revised 1924). (v) Among the Special Acts and Orders in force within the district, and important from a Public Health standpoint, are:— 1910.—Orders declaring the trades of fish-skin scraper, fish fryer, dealer by retail in rags, bones, skins, fat or other like articles in an .
f5342919-19d3-496f-8458-72423d46bf7b	offensive condition, blood drier, tanner, leather dresser, fat melter or fat extractor, giue maker, size maker, gut scraper, and oil boiler to be offensive trades, the last being so declared in 1925. 20 9. DEATHS. There were 287 deaths registered in Barking in 1925. Of these, 8 were deaths of non-residents. Barking residents to the numoer of 107 died elsewhere during the year. Including the latter and excluding the deaths of visitors, the net number of deaths were as follows:— Males. 199 Females. 187 Total.
84f5475a-2d4b-4fe1-937e-2ab75db66e6b	336 The death rate for 1925 was 10.0 per 1,000, compared with 10.0 in 1924, calculated on the Registrar-General's estimated population and number of deaths, compared with 12.2 for England nnti Wales, 12.2 for the hundred and five Great Towns, 11.2 for the hundred and fifty-seven Smaller Towns, and 11.7 for London. Sex Mortality. –The 386 deaths of 1925 were divided as. follows:— 199 males, equal to a death rate of 5.17 per 1,000 population. 187 females, equal to a death rate of 4.86 per 1,000 population. Age Mortality.—The deaths in various nge groups, accord ing to the figures obtained locally, were as follows:— Age Group. No. of Deaths. Death Rate per 1,000 Population.
7b616f1b-cb2c-4797-9514-211b0f163df9	Under 1 year 66 1.71 1 to 2 years 6 0.15 2 to 5 years 13 0.33 5 to 15 years 12 0.31 15 to 25 years 22 0.57 25 to 45 years 47 1.22 45 to 85 years 93 2.41 Over 65 years 127 3.30 Causes of death in 1925 The table on page 23 shows the principal causes of death at various ages. Those diseases, etc. 21 Causing Most deaths or important from a Public Health aspect were as follows: – Disease No. of Deaths. Percent age ol total net deaths registered. Cardio-Vascular System 41 10.62 Cancer 47 12.17 Tuberculosis(all forms) 42 10.88 Pulmonary affections.
8f768fee-3ecd-4488-a31d-976957bfaa3b	(exclusive, of tuberculosis), viz., Bronchitis 38 9.84 Pneumonies 25 6.47 other respiratory disease 6 1.55 Zymotic Diseases 26 6.73 Of the total deaths, tuberculosis caused one in every 9.1, heart diseases one in every 9.4, bronchitis one in every 10.1, cancer one in every 8.2 pneumonia one in every 15.4, suicide and violence one in every other respiratory diseases one in every 64.3, and Zymotic diseasse one in every 14.8.
c3ae05ad-9df8-4329-93c8-3466bbd184f5	Deaths from Zymotic Diseases These diseases caused 6.7 Per cent of tfi& total deaths, such deaths being caused in the M'owng proportions:— Enteric fever – Measles 0.25 Whooping Cough 3.36 Scarlet Fever 0.25 Diptheria 0.51 Diarrhœa 2.33 Smallpox – The average death rate for the quinquennium ended 31st December, 1925, was 9.8 per 1,000 population. 22 INQUESTS.—Coroner's inquests were held on 31 deaths. The ages at death and causes assigned were as follows:— Causes of Death. Under one year. 1-2 years. 2—5 years. 5 15 years. 15-25 years. 25 45 years 45-65 years. Over 65 years. Total. Accidental Cause – l – 2 4 2 – 2 11
989cc370-697b-4a4a-a3ed-704955e82261	Suicide – – – – 1 – 1 – 2 Senile Decay and Broncho Pneumonia – – – – – – – 1 1 Pulmonary Tuberculosis – – – – – 2 – – 2 Heart Disease – – – – – – 2 5 7 Broncho Pneumonia 2 – – – – – – – 2 Cerebral Hæmorrhage – – – – – – 1 – 1 Chronic Bronchitis – – – – – – – 1 1 Chronic Endocarditis and Pneumonia – – – – – – 1 – – Want of Proper Attention at Birth 1 – – – – – – – 1 Rupture of Blood Vessel in Brain – – – – – – – 1 1 Premature Birth and Debility 1 – – – – – – – 1 Totals 4 1 – 2 5 4 5 10 31 23 CAUSES OF AND AGES
cf124b22-7ea0-4e4d-ad07-0ca367b3d5ef	OF DEATH DURING YEAR, 1925. (Nett Deaths.) Causes of Death. Deaths at the subjoined ages of Residents '" whether occurring in or beyond the district. I Under one year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 an d under <55 05 and upwards Total Encephalitis Lethargica - - - 1 - - - - Influenza 1 1 — - 3 5 9 19 Scaret Fever — 1 — - -— — - 1 Small Pox - - - - - - - - Measles — 1 - - — - - 1 Whooping Cough 8 4 1 - — - - 13 Epidemic Influenza - - - - - - - - Diarrhoea and Enteritis (under 2) 9 - — - - 1 - 9 Diphtheria —
a036675b-9f3a-4ef5-8b8c-537df23a1a18	1 1 - - - - 2 Enteric Fever - - - - - - - - Puerperal Fever - - - - -- - - — Phthisis (Pulmonary Tuberculosis) — — - 10 10 9 1 30 Other Tubercular Diseases 2 2 1 — 1 - — 6 Oncer, Malignant Disease — - - 6 23 18 47 Bronchitis 6 — — - 1 5 20 38 Pneumonia 7 5 3 — 3 6 1 25 Other Respiratory Diseases — — 1 — — 2 3 6 Alcoholism (Cirrhosis of Liver) — - - — 2 2 — 4 Premature Birth, Malformation and Debility.
3feaa2a5-c2bf-47a6-abc8-594fc972db9f	18 - _ - 18 Accidents — 1 2 4 2 — 2 11 Suicides - — 1 1 — 2 Rheumatic Fever - - 1 - - 2 3 Diabetes - - - - 1 1 3 5 Cerebral Hæmorrhage - - 2 - 5 17 24 Heart Disease - - 1 1 5 18 16 41 Artero-Ssierosis - - - - 2 6 8 Ulcer of stomach or duodenum — ;
f4143f77-7693-40a7-ad7f-6d4c9f88c98b	_ - 1 2 3 Appendicitis and typhlites 2 1 1 1 — 5 Acute and Chronic Nephritis 1 - - - 2 2 1 6 Other accidents and diseases of pregnancy and parturition _ - - 1 1 Other defined diseases 14 1 — 4 3 10 20 52 Causes ill-defined or unknown — — — — - — _ Totals 66 19 12 22 47 93 127 386 24 INFANT MORTALITY DURING THE YEAR 1925. The following table gives the actual causes of death of children dying under one year of age. Net deaths from stated causes at various ages under one year :— Causes of Death. (All causes certified.) Under 1 week. 1—2 weeks. 2—3 weeks. 3—4 weeks. Total under 4 weeks. 4 weeks and under 3 months.
c6c0ac18-fd8a-4b80-b647-264f0ae11ed2	3 months and under 6 months. U months and under 9 months. 9 months and under 12 months. Total under one year. Small Pox - - - - - - - - - - Chicken Pox - - - -- Measles - — - - - — - - - _ Scarlet Fever - — - - — - _ - — Whooping Cough - — - - - 4 1 - 3 8 Diphtheria and Croup - — - - - — - - — Erysipelas - — - - - — - - — — Tubercular Meningitis .
243a8ab3-864f-4abb-ba47-bcf61c68a11f	- - - - - — - - 1 1 Other Tubercular diseases - - - - - - - - 1 1 Meningitis (not tubercular) - - - - - - - 1 1 2 Convulsions - — - - — - 1 - 1 Larvniritis - - - - - - - - - - Bronchitis - - - 1 1 1 3 2 - 6 Pneumonia (all forms) - - - - - 3 2 1 1 7 Diarrhœa 1 - 1 2 3 2 1 9 Gastritis - - - - - - - Syphilis - - 1 1 Rickets - - - _ — — — - — — Suffocation,
9f9fdb8a-2e43-408b-8667-28810c487604	overlaying —- - - - - - - - - - Injury at birth - 2 - - 2 - - - - 2 Atelectasis 1 - - - 1 - - - - 1 Congenital malformation - - - 1 1 - - - - 1 Premature Birth 8 2 - - 10 1 — - - 11 Atrophy, debility and Marasmus 3 - - 3 2 1 - - 6 Other causes 1 4 - 1 6 2 — 1 — 9 Totals 13 9 - 3 25 - 9 8 8 66 Nett Births in the year :— Legitimate 802 Illegitimate 23 Nett Deaths in the year :— Legitimate 61 illegitimate 5 28 10. marriages. There were 258 marriages registered in the district in 1925.
4a63ed6a-ef52-4657-bd48-fda765694f91	This is equal to a marriage rate of 6.7 per 1,000 population. In 1922 there were 208 marriages, equal to a rate of 5.6, in 1923, 2l9 marriages, equal to a rate of 5.9 per 1,000, and in 1924, 208 marriages, equal to a rate of 5.4. 11. births. The net number of births registered in 1925 was 825, affording an annual birth rate of 21.4 per 1,000 population, compared with 22.3 in 1924 and 23.1 in 1923. Of all births, 23 were illegitimate, or a proportion to total births of 2.7 per cent. The average birth rate for the quinquennium ended 31st December, 1925, was 23*3 per 1,000 population.
c7cbb773-60f8-444d-b087-2f1a7e168147	Notification of Births Act, 1907-1915.—Of the total births recorded in the district during 1925, all except 33 or 3.9 per cent. of the total, were notified to the Medical Officer of Health, 555 being notified by raid wives and 242 by parents and doctors. 28 still-births were notified, 20 being notified by midwives and 8 by doctors and others. 26 SECTION 2 sanitary circumstances of the district. (a) WATER SUPPLY. Water is supplied by the South Essex Water Company from deep wells in the chalk at Dagenham, Chadwell Heath, Ilford and Barkingside. Analytical particulars of a sample appeared in my Report for 1923. (b) RIVERS AND STREAMS.
83cdbbae-0a36-437d-86f5-6268f27fecb2	The Rivers and Streams of the district come within the jurisdiction of the Essex Sewers Commissioners (who are the Tidal Flush and Flood Water Drainage Authority) and the Port of London Authority, who are the recognised Navigation Authority for the Thames, as defined by the Port of London Consolidation Act, 1920, and who have also certain powers as to the fouling of streams, etc. The Council's attention during the year was directed to the standard of purity of their sewage effluent as discharged into the Roding, a tributary of the Thames. (c) RAINFALL. The rainfall for the year ended December 31st was 24.7 inches. Rain fell on 179 days throughout the period in question. (d) SEWAGE. A water-carriage system is general, except in certain parts referred to elsewhere. Over the greater part of the area there is a separate sewage and storm water system.
2255dda9-24b7-40a8-9567-27e6a393bf90	Sewage is treated within the district by precipitation and sedimentation, the resulting effluent being discharged into the River Roding. The sewage disposal works (originally erected in 1888 for a population of some 20,000 inhabitants) are now 27 employed to their utmost capacity. The question of extension these works in view of the proposed erection of some 2,000 houses by the London County Council on the Barking part of the Jiecontree Estate, together with anticipated building by private individuals and the Local Authority, received consideration during the latter part of the year. A scheme was selected for the proposed construction of sewage disposal works within the district, but, apart from an application to the Ministry of Health for the acquisition of certain lands for this purpose by Provisional Order, no further progress in the matter had been made at the end of the year. (e) CLOSET ACCOMMODATION. With the following exceptions, the district is served by the water-carriage system:— Ward.
4a429834-4587-4977-a4c7-3042dfa9f240	Type of Closet. Privy. Pail. Cesspool Drained Abbey - 3 1 West bury — 4 4 Longbridge 1 7 18 Ripple 17 2 46 Totals 18 16 69 Of the above premises, six are factories, three temporary dwellings, two schools, one a workplace, and 91 dwellinghouses. During the year seven premises were sewered, while 47 houses situated at Creeksmouth were provided with adequate flushing arrangements, together with the installation of sanitary pans in place of the long-hopper type. if) SCAVENGING. The question of scavenging (which is closely linked with 'hat of sewage disposal in several respects) comes under the 28 control of the Engineer. Domestic and trade refuse is collected weekly in horse-drawn two-wheeled vehicles, and deposited on low-lying land. During the early part of the year tipping took place directly into stagnant water, some few feet in depth.
bcf9bbdd-4346-420b-a5ea-e2c3352ff27a	This practice has now ceased, tipping at present taking place into meadow land adjoining the Cemetery, near the junction of Ripple Road and Upney Lane. Cleansing experts are agreed that the dumping of crude refuse cannot be justified on any grounds, sanitary or otherwise, such a method only "perpetuating and concentrating those evils which would arise from the storage of refuse at the home." Various constituents are present in refuse which can be economically used, and in my opinion any change in the present method of refuse disposal should be along those lines. Many, if not most, Sanitary Authorities, now approach this question with a view to putting down plant to obtain from their refuse all usable material, and apply it in a suitable and economical way rather than destroy it. Were the 5 cwts.
f3fd21d0-e52e-4a13-9f6a-32b6db17bb9b	of refuse which is produced per head each year treated by methods more favoured by present-da)' sanitarians, much could be salvaged and sold, and I think the Council would be wise in looking ahead for a site suitable for the erection in the near future of refuse disposal plant, prior to the more extended development of their district taking place. As to whether present refuse collection by two-wheeled vehicles is an economic problem, no definite opinion, in the absence of data, can be expressed. To draw any satisfactory conclusions, records of work done are essential, while the weighing of all refuse would provide a valuable index as to loading-time and travelling-time required. The ratio between loading-time, travelling-time and maintenance, would then provide the factor of economy for deciding the haulage system to be adopted. With the dump at its present site, considerable time must obviously be wasted in travelling.
bd49259d-5ae8-4d80-9113-6523563b3526	There is now little difference of opinion, 1 think, in that four-wheeled horse-drawn vehicles 29 With tow loading line, form the most economical units for house-to-house refuse collection, though motor transport would obviously be preferred for longer distance conveyance, combined, if necessary, with the transference of loads from carts to motors at certain selected depots throughout the district. CESSPOOLS, PRIVYMIDDENS AND PAIL-CLOSETS. For cesspool emptying, a tank vehicle is employed, the contents being pumped out and afterwards discharged into the sewers. Privymiddens, of which there are 24, are emptied into tumbrils and the contents buried; the same remark being applicable to pail-closets. STREET REFUSE. Dustless road construction and the development of motor road transport have materially reduced the quantity and character of street refuse. So far Barking has not yet acquired motor-brooms, vacuum gully cleaners, or combined street sweepers and collectors.
eea0bf5b-f999-4acc-a5f1-a77645d5d4d8	Though street cleansing may be said, up to a point, to be satisfactory, its principal defect consists in that heaps of refuse left on streets for later collection, prove at times, a nuisance. This difficulty could be surmounted by the institution of street bins for temporary storage purposes. Housing Statistics for the year 1925. 1. GENERAL. Number of new houses erected during the year:— (i) Total 183 (ii) As part of a municipal housing scheme Nil (iii) Others (including private enterprise and subsidy houses) 183 2. UNFIT DWELLING HOUSES. I.—Inspection.
b73135a7-2817-4368-aae3-fc5d7ae3bd03	(i) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 3,134 30 (ii) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 1,164 (iii) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 6 (iv) Number of dwelling houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 1,759 II.—Remedy of Defects without Service of Formal Notices. Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 1,331 III.—Action under Statutory Powers. A.—Proceedings under Section 3 of the Housing Act, 1923.
b0a8260b-02fa-4983-8e1f-e37a08ef9e59	(i) Number of dwelling houses in respect of which notices were served requiring repairs 49 (ii) Number of dwelling houses which were rendered fit— (a) by owners 49 (b) by Local Authority in default of owners Nil (iii) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations of owners of intention to close Nil 3. Proceedings under Public Health Act.
dc71ec42-59de-4105-a16a-e0ba373efebe	(i) Number of dwelling houses in respect of which notices were served i aquiring defects to be remedied ... ... 355 31 (ii) Number of dwelling houses in which defects were remedied:— (a) by owners ... ... ... 355 (b) by Local Authority in default of owners — C. Proceedings under Sections 11,14 and 15 of the Housing Act, 1925: — (i) Number of representations made with a view to the making of Closing Orders 11 (ii) Number of dwelling houses in respect of which Closing Orders were made 6 (iii) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling houses having been rendered fit — (iv) Number of dwelling houses in respect of which Demolition Orders were made — (v) Number of dwelling houses demolished in pursuance of Demolition Orders — SANITARY INSPECTION OF THE AREA. (Work of Sanitary Inspectors.) I. Inspection of Dwelling Houses.
c69515b9-2000-4acb-8185-76ef892e8003	Total under Public Health or Housing Acts 2,851 Housing (Inspection of District) Regulations 1,161 After Infectious Disease 209 Miscellaneous 14 Defects Found 5,432 Notices Served 1,759 Re-inspections re Notices Served 3,803 32 2. Premises Controlled by Bye-Laws and Regulations. Houses Let in Lodgings 134 Common Lodging Houses 84 Offensive Trades 218 Tents, Vans and Sheds 134 Dairies, Cowsheds and Milkshops 274 Slaughterhouses 248 3. Factories, Workshops and Workplaces. Factories 40 Laundries 11 Bakehouses 123 Other Workshops 172 Other Workplaces 47 Outworkers' Rooms 38 Butchers' Premises 407 Fishmongers 45 Restaurants and Dining Rooms 154 Markets 133 Stables and Stable Yards 15 Piggeries 87 4. Miscellaneous.
c45d98b6-c468-4d7a-badd-3d9538329d83	Smoke Observations 116 Rats and Mice (Destruction) Act, 1919 227 Vacant Land and Refuse Dumps 164 Public Lavatories 88 Schools 43 Petroleum Stores 117 SUMMARY OF SANITARY WORK CARRIED OUT. (a) Drainage. Branch drains, opened, repaired, and cleansed 77 Main drains, opened, repaired and cleansed 44 Drains reconstructed 4 New Drains 2 Ventilation Shafts repaired or new fixed New Inspection Covers * 33 Water-Closets. Roofs 54 Walls 72 Floors 13 Doors 49 Seats 39 New Pans Fixed 97 Pans Cleansed or Repaired 53 New Flushing Cisterns 137 Flushing Apparatus Repaired 146 (c) Sinks. New Fixed 43 New Sink Wastepipes 85 Waste Pipes Repaired 11 New Gullies 17 (d) Dampness.
b9af2c69-aef7-4706-b56e-2f06793f0fd4	Roofs 578 Eavesgutters 357 Rainwater Pipes 131 Damp Walls Remedied 38 (e) Water Supply. Storage Cisterns Abolished 22 Defective Water Fittings Repaired 59 Supply Reinstated 10 Supply provided inside houses 6 (f) 1 ard Paving. Yard paving repaired or relaid 183 (g) Dustbins. New ones provided 207 34 (h) General Repairs.
d43cf656-b30f-48d1-86a8-bee0ba2229d1	Internal walls repaired 179 Ceilings repaired 121 House floors repaired Windows repaired or renewed 190 Window sills repaired or renewed 36 Fixed windows made to open 10 Sashcords renewed 219 Stoves or coppers repaired or renewed 237 House doors repaired or renewed 97 Stairs repaired 47 Chimney stacks rebuilt 5 Chimney-pots renewed 55 Dirty or infectious rooms cleansed and redecorated 590 Houses painted 6 Connections to main walls rendered watertight 60 External walls repaired 86 (i) Miscellaneous. Offensive accumulations removed 35 Animals kept so as to be a nuisance 7 Insanitary conditions remedied 5 Verminous rooms and persons disinfected 15 Stables cleansed 3 NOTICES SERVED.
208656c5-4954-46f1-be5b-ce15f127c075	Informal Notices 1,759 Statutory Notices 423 Section 36, Public Health Act, 1875 Section 94, Public Health Act, 1875 355 Section 49, Public Health Act (Amendment) Act, 1907 1 428 Section 5, Infectious Disease (Prevention) Act, 1980 4 Section 3, Housing Act, 1925 49 35 SMOKE ABATEMENT. The smoke shafts of the district were kept under observation during the year, and 11G inspections recorded. In 4 instances informal notices were served, 11 offenders were reported and warned, while in 1 instance it was necessary to serve formal notice. As a result of continuous pressure, an additional boiler has been erected at the factory of the worst offender. Until existing legislation on smoke abatement is amended, it will be cheaper for the offender to pay any penalty that may be imposed, rather than provide proper coal and improved methods of stoking.
661b9bc3-5766-4907-8771-84e5963e4c8b	Further, the emission of dense smoke of any colour should be a nuisance within the meaning of the Act, and not, as at present, "dense black" smoke only. The Earl of Onslow's Bill contains proposals to increase the maximum penalty for smoke nuisance to £50, while smoke which is not black would be regarded as a nuisance, the term "smoke". including " soot, ashes and grit." OFFENSIVE TRADES. The following shows the nature of the businesses carried on, and the number of premises registered (a) Fish Fryers 17 (b) Fishskin Scrapers 2 (c) Dealers by retail in Rags and Bones 9 (d) Fat Melters and Extractors 2 (e) Gut Scraper 1 (f) Oil Boiler 1 During the year, in addition to my own inspections, the Sanitary Inspectors paid 218 visits, and 50 notices were served for various breaches of the Bye-laws.
0d5bb265-af92-48d6-91ee-418749e12469	(a) FISH FRYERS (see page 40.) (b) FISHSKIN SCRAPERS. Both of these premises are situated on marsh land, some considerable distance from dwellings. Every effort is made by the Sanitary staff to secure these businesses being carried on in conformity with the bye-laws, and with a minimum of nuisance. 36 (c) DEALERS IN RAGS AND BONES. In this district the amount of noxious material collected is negligible. Dealers confine themselves to the collection of rags, bottles and newspapers, and these usually in a cleanly condition. There is little or no storage as the dealers find a ready market with a wholesaler at Creeksmouth. (d) FAT MELTERS AND EXTRACTORS. At both premises an efficient apparatus has been installed, and these businesses are now carried on practically without any nuisance. (e) GUT SCRAPER.

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