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c04a61d1-6d7b-4fbf-811b-461c7aefb2d8 | Decomposed Surrendered Fishβ Hake 8 stones ditto ditto Skate 25 β ditto ditto Roker 5 ditto ditto Rippers 6 β ditto ditto Lobsters 50 lbs. ditto Seized Haddock 11 ditto ditto Rock Salmon 9 β ditto ditto Fruitβ Strawberries Β½ Bushel ditto Surrendered Peas 4 Bushels ditto ditto Cherries A Bushel ditto ditto Pears 1 β ditto ditto Tinned Foodsβ Kipp'd Her'gs. 300 lbs. ditto ditto Various 119 tins ditto ditto Rabbits One case 144 lbs. ditto ditto In view of subsequent explanations no proceedings were instituted in respect of the three seizures. 32 SALE OF FOOD & DRUGS ACTS. I am indebted to Mr. |
106f69f5-59ad-4b3c-b712-73474e7481e4 | H. C. Card, Chief Food and Drugs Officer of the Essex County Council for the following particulars of samples purchased and submitted for analysis during the year:β Milk. Butter. Miscellaneous. Total. Prosecutions. Fines. 68 62 44 174 2 Β£16 Proceedings were taken in the case of one sample of cream, the vendor being fined Β£15. And one sample of coffee found adulterated; proceedings were instituted against the vendor, who was fined Β£1. OVERCROWDING. During the year a number of serious cases were reported to the Health Committee, but owing to absence of suitable accommodation within the scope of the wage-earners income nothing could be done. In one case proceedings were instituted. The magistrates made in order to abate overcrowding, but, on an attempt to comply, confirmation could not be obtained from the County Court. Appeals against the decision of the Judge were futile. |
a01c443e-10c9-45ff-9288-7274337ceb19 | IMPROVEMENT OF EXISTING HOUSING CONDITIONS. Despite much progress and general improvement as a resulte of the activities of the sanitary staff, there is still very considerable work to be done before many of the houses in the district could by described as satisfactory, improvement lying in the removed of unsatisfactory dwellings not capable of being rendered fit without reconstruction. Every house in the district has separate closed accommodation, and with 20 exceptions, a separate water supply inside the premises. The question of overcrowding is still an urggent one, and accounts for much discontent. The Barking Town (Parson's Row) Improvement Scheme, 1926. 33 It has been stated that: "If unrest is to be converted into Contentment, the provision of good houses may prove one of the most potent agents in that conversion. |
a7f76295-32cd-4585-ae15-1cf45bafb3ef | If a healthy race is to be reared, it can be reared only in healthy homes; if infant mortality is to be reduced, and tuberculosis to be stamped out, the first essential is the improvement of housing conditions." A reference to pages 24-26 will show the work of the sanitary inspectors in regard to housing conditions generally. PARSONS ROW IMPROVEMENT SCHEME. Upon my representation in December, 1925, the Council decided to schedule a group of 51 houses described as the Parsons Row area, as an unhealthy area. An improvement scheme to deal with acquisition of the site, demolition of the houses, and rehousing of the displaced tenants at a cost of Β£34,000 was agreed upon. The Minister of Health instituted a local public enquiry in October, 1926. Official sanction to proceed with the scheme had not been granted at the end of the year, but favourable outcome is anticipated. Photographs are given illustrating the type of premises dealt with in the scheme. SCHOOLS. |
45de50a1-67d7-4776-a0ad-d293d57cbda2 | All the schools in the district are regularly inspected, when any defect in the sanitary arrangements or water supply are dealt with. With one exception, the whole of the schools are connected with the sewer. Castle School,. Rippleside, is cesspool drained. Six of the eight elementary schools have spring-bib fountains with metal cups attached, fixed in the playgrounds, for drinking purposes. The remaining two schools are without fountains of any sort, the children having recourse to taps above the wash-basins. 34 A distinct improvement from the hygienic standpoint would be the abolition of existing arrangements and the provision of spring bib fountain jets in every school. FACTORY AND WORKSHOP ACT, 1901. Factories, Workshops, Laundries, Workplaces and Homework. 1. Inspections (including inspections made by Sanitary Inspectors.) Number of Premises. Inspections. Written Notices. Prosecutions. Intimations. Statutory. |
83c4096f-af17-4965-8149-3e2225a3e4e2 | Factories 142 10 i 2 β Workshops 132 6 2 β Workplaces 297 14 0 β β Total 571 30 6 β 35 2. DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found Remedied Referred to H.M. Ins. |
cf1ef3c6-a930-40f3-b393-5d209818c5fc | *Nuisances under the Public Health Acts:β Want of cleanliness 3 3 β β Want of ventilation 2 2 β β Overcrowding β β β β Want of drainage of floors 1 1 β β Other nuisances 8 8 β β Sanitary accommodation:β Insufficient 14 14 - β Unsuitable or Defective 6 6 β β Not separate for sexes 5 5 - β Unscreened for Sexes 3 3 - β Offences under the Factory and Workshop Acts:β Illegal occupation of underground bakehouse (S.101) - - - - Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 9 9 - - Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) - - - - Total 51 51 - β * Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. |
d9a08a97-67b5-48d1-9ea0-729a968c20b2 | HOME WORK. Nature of Work. Outworkers' Lists (Section 107). Outwork in Unwholesome Premises (Section 108). Outwork in Infected Premises (Sees. 109, 110). List received from Employers. Notices served on occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (Sec. 110). Prosecutions (Sees. 109. 110). Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Contrac tors. Workmen. Contrac tors. Workmen. Wearing Apparel:β Making, etc. |
defbf5f1-e991-4d8f-8e91-223c46423245 | 2 7 18 - - - 4 - - - - - - - - Total 2 7 18 - - - 4 - - - - - - - - 36 37 REGISTERED WORKSHOPS. Workshops on the Register (Sec. 131) at the end of the year. (1) Number. (2) Bakehouses (including seven factory bakehouses) 15 Other Workshops 45 Total number of Workshops on Register 60 OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:β Failure to affix Abstract of the Factory and Workshop Act (Sec. 133) 4 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Acts (Sec. 5) 2 Other β Underground Bakehouses (Sec. |
c652f1c5-15e0-4571-a047-37952e9452a9 | 101):β Certificates granted during the year β In use at the end of the year - OUT-WORKERS. The following list shows the nature of the homework carried out in this district by 22 out-workers:β Wearing apparel 10 Tles 2 Umbrella makers 2 Boot makers 1 Paper bag makers 2 Life belt covering 7 During the year 17 lists of out-workers were received from other Authorities in respect of addresses in Barking. 4 lists were received from employers within the district. In all instances the premises of out-workers were kept in a satisfactory state. 38 HEALTH PROPAGANDA. Health Week was celebrated in the district by holding a Health and Clean Food Exhibition from September 14th to 18th, inclusively. St. Margarets Hall the largest in Barking being secured for the purpose. The exhibition was organised on approved exhibition lines, the stands, numbering twenty-eight, being erected by a professional firm of exhibition-stand fitters. |
765a82be-e914-4dce-938c-8bff6362be35 | Twenty-two stands were let to selected business firms of repute, who guaranteed to provide exhibits of public health interest, whilst the remaining six stands were occupied by the Public Health Department, The United Kingdom Dental Board, The Health and Cleanliness Council, the Institute of Hygiene, etc. It is of interest to record that, although at a preliminary meeting of exhibitors it was unanimously decided that no sale of goods should take place, the desire of the public to purchase samples, etc., was so great that the decision had to be waived, one firm recording a turnover of more than Β£50. The Exhibition was open daily from 10 a.m. to 10 p.m., advantage being taken of the smaller morning attendances to conduct organised parties of school children around the Exhibition : 1,559 children so attending. Health Lectures, by well known lecturers, Cooking Deinonstra tions, by Messrs. |
53339848-180f-4467-ae4b-af89135ef390 | The Gas, Light and Coke Co., and Demonstrations in the Use of Milk, by the Milk Publicity Council, were held daily, being all exceptionally well attended. More than 35,000 pamphlets, covering such subjects as Infantile DiarrhΕa, Scarlet Fever. Diphtheria, Whooping Cough, Measles, Danger from Flies, etc., were distributed during the run of the Exhibition. An orchestra rendered musical selections every afternoon and evening. Seven health propaganda films were shown at the local cinemas during the week. 15,642 persons, exclusive of children attended the Exhibition, the attendance on three days being over 3,000. The total cost of the Exhibition was Β£256 9s. 2d., but, on account of payments made by exhibiting business firms, the expense borne, by the Council was only Β£16 16s. l0d. 39 The Exhibition was an unqualified success and proved to be a valuable medium for health propaganda. |
873be214-b1cf-47ad-8245-d26fce11f13f | Although much has been written to the contrary since the holding of the Exhibition, I venture to express the opinion that the arrangement whereby stands wen let to selected business firms was a correct one, creating as they did, life, variety and brightness, and incidentally a public demand for admission, more people attending, and in consequence hearing the lectures, seeing the exhibits, and taking away pamphlets, etc. than otherwise might have been the case. Apart from the foregoing considerations, I would mention that in my judgment no finer medium exists for guiding the public in purchasing products of known purity and productionβa point obviously within the province of the sanitarianβthan the invitation to manufacturers of such goods to display their wares at Health Exhibitions organised by Local Sanitary Authorities. 40 SECTION 3. NOTIFIABLE INFECTIOUS DISEASES. The following table shows the number of notifications of infectious disease received during 1926:β TABLE I. Males Females. Total Total cases rem'd to Hos. Deaths. |
77d97125-fc37-43c7-8df8-dc78aba08c93 | Scarlet Fever 61 74 135 121* β Diphtheria 25 30 55 52 2 Puerperal Septicemia β 3 3 2β Pneumonia (Acute primary and influenzal & following Measles) 47 28 75 8 27 (All Forms) Erysipelas 11 26 37 2 2 Ophthalmia Neonatorum 9 7 16 2β‘ β Puerperal Pyrexia β 1 1 β β Enteric 1 2 3 2 1 Cerebro Spinal Fever β 1 1 β 1 Anterio Poliomyelitis 2 β 2 β β Totals 156 1,2 328 189 33 * Includes 6 cases removed to Ilford Isolation Hospital, β Includes case of woman confined in Maternity Ward of Hospital. β‘ Includes 1 case removed to St. |
4cea4253-caf1-403a-9fea-a65320883965 | Margaret's M.A.B. Hospital. 41 The following diseases were notifiable in 1326 under the original Infectious Disease (Notification) Act, 1889, and 1899 :β Smallpox, diphtheria, relapsing fever, cholera, erysipelas, typhus, plague, puerperal fever, enteric fever, scarlet fever and continued fever. and by Orders or Regulations framed under Section 180, Public Health Act, 1875 Tuberculosis (all forms), opthalmia neonatorum, cerebrospinal fever, acute polio-myelitis, encephalitis lethargica, influenzal pneumonia, acute primary pneumonia, malaria, dysentery, trench fever, and puerperal pyrexia. The Barking Town (Pneumonia) Regulations, 1924, provides for the notification of Pneumonia supervening upon Measles. |
9f75092d-8413-41a8-81f6-654970720247 | The total notifications of infectious disease numbered 328, exclusive of tuberculosis, compared with 230 the previous year. During 1926 the number of notifications of tuberculosis (all forms) was 133 compared with 80 in 1925. 42 TABLE II. Notifiable Disease. No. of cases notified at age groups. Cases classified according to Wards. Under one year. 1 to 2 years. 2 to 3 years. 3 to 4 years. 4 to 5 years. 5 to 10 years. 10 to 15 years. 16 to 20 years. 20 to 35 years. 35 to 45 years. 45 to 65 years. Over 65 years. Abbey. Gascoigne. Central. Ripple. Longbridge. Westbury. |
f3529047-9ce3-43f9-851c-66ca5b1b26d0 | Scarlet Fever 3 3 6 6 19 67 20 5 6 27 15 15 42 19 17 Diphtheria β 1 5 3 4 27 9 2 3 I β β 7 19 2 10 10 7 Puerperal Septicaemia β β β β β β β β β 3 β β 1 1 β β β 1 Pneumonia (primary, influenzal and following Measles) 5 11 3 4 7 7 1 3 14 3 9 8 26 15 17 1 10 6 Erysipelas β β 1 β β β β 1 3 6 19 7 9 5 6 4 5 8 Ophthalmia Neonatorum 16 β β β β β β β β β β β 5 5 1 2 1 2 |
e7fd47fb-2197-48d8-b3db-36da197ab666 | Puerperal Pyrexia β β β β β β β β 1 β β β β β β β β 1 Enteric β β β β β β 2 β β β 1 β 1 1 1 β β β Cerebro Spinal Fever β β β β β β β β 1 β β β β 1 β β β β Anterio Poliomyelitis 1 1 β β β β β β β β β β 1 1 β β β β Totals 25 16 15 13 30 101 32 11 28 13 29 15 77 63 42 59 45 42 43 TABLE III Monthly summary of notifications of infectious disease:β Month. Scarlet Fever. Diphtheria. Puerperal Fever. Pneumonia. Erysipelas. Ophthalmia Neonatorum. Enteric Fever. |
c9d9f227-aee0-4f18-a1b8-13aad2eb1647 | Anterio Poliomyelitis Cerebro Spinal Meningitis. Encephalitis Lethargica. Totals. January 3 4 β 2 4 β β β β β 13 February 7 4 β 1 4 1 β β β β 17 March 3 2 β 12 2 1 β β 1 β 21 April 5 4 β 16 1 β β β β β 26 May 6 1 β 6 5 2 β β β β 20 June 25 4 2 2 o 3 β 1 β β 39 July 19 9 β 4 3 1 β β β β 36 August 4 5 1 2 5 β 1 β β β 18 September 17 8 β 1 2 1 1 1 β β 31 October 15 6 β 7 4 1 β β β β 33 |
b7427ed9-09bf-41af-ae30-44f918a75fad | November 16 2 β 9 3 6 β β β 1 37 December 15 6 β 13 2 β 1 β β β 37 Totals 135 55 3 75 37 16 3 2 1 1 328 44 (a) Scarlet Fever.βThe number of cases notified was 130, compared with 60 the previous year. No fatal cases occurred. 115 cases were isolated at the local Infectious Hospital, and 6 at the Ilford Isolation Hospital. The average stay of scarlet fever cases in hospital was 34.4 days, compared with 40.6 days in 1925. The longest period of detention was 66 days and the shortest 17 days. Seventy-four cases treated in hospital developed complication', as follows:β Adenitis (uncomplicated) 24 Adenitis, |
8142992a-4c7c-46c2-a751-048bb3bad6d9 | RhinorrhΕa and Albuminuria 1 RhinorrhΕa 7 Adenitis & OtorrhΕa 6 RhinorrhΕa, Pharyngitis and Adenitis 2 RhinorrhΕa & Adenitis 9 Albuminuria & Adenitis 3 Endocarditis & Arthritis 1 Septic Areas, RhinorrhΕa and Adenitis 10 Albuminuria 1 Adenitis, Albuminuria and Rheumatism 1 Abrasions (septic) 3 Adenitis & Pharyngitis 5 Bronchitis, OtorrhΕa and Conjunctivitis 1 Of all cases notified, 5 were found to be mistaken diagnoses as follows:β Nephritis 1 Septic Sores 1 Bronchitis 1 Nil diagnosed 2 Of cases treated in hospital, |
dc5f68a6-eea3-416d-8169-55e410a2030d | the age incidence was as follows:β Under one year 3 5β10 years 59 1β2 years 3 10β15 years 17 2β3 years 6 3β4 years 6 15β20 years 5 4β5 years 17 20β35 years 5 Sex.β61 cases were male and 74 female. (b) Small Pox.βNo case of Small Pox occurred in 1926, Notifications of two persons who had been in contact with cases of Small Pox were received and kept under supervision for the. usual periods. 45 The following particulars are appended of vaccinations during 1926:β Certificates of successful vaccinations 304 Postponed 4 Conscientious objections 463 Left District 16 The vaccination rate per 1,000 births was therefore 371.6, compared with 394.8 for the preceding year (c) Diphtheria.β55 cases were notified, compared with 75 the preceding year. |
03d05e24-6935-4f93-9733-eb12df85265a | Of cases notified, 52 were removed and treated in hospital. Two deaths from diphtheria occurred, one in hospital and the other in an outside institution. A child admitted the previous year diagnosed as diphtheria died in January, 1926 from Tuberculous Broncho-Pneumonia. The average stay of clinical diphtheria in hospital was 35.2 days, the longest stay being 76 and the shortest 16 days. Two cases of laryngeal diphtheria were admitted to hospital, in both instances tracheotomy being necessary. One patient died four days after admission, while the other made a satisfactory recovery. The type of diptheria present on examination was as follows Faucial 28 Naso-Pharyngeal 8 Laryngeal 2 Eight admissions were on purely bacteriological grounds. |
b7b34579-3ab3-4234-b616-452c1333a41b | Of cases notified as diphtheria and removed to hospital six on examination were found to be mistaken diagnosis, as follows:β Tonsilitis 4 Nil Diagnosed 2 Twenty cases of diptheria admitted to hospital developed complications, as follows:β Adenitis 9 Albuminuria & Neuritis 1 Adenitis & Myocarditis 1 Albuminuria & Adenitis 1 Boils 5 AbscessesβVarious 2 Otorrhoea, Adenitis & RhinorrhΕa 1 46 Of diptheria patients treated in hospital the age incidence was as follows:β 1β2 years 1 10β15 years 8 2β3 years 4 15β20 years 2 3β4 years 2 20β35 years 3 4β5 years 4 35β45 years 1 5β10 years 27 Sex.β25 cases were male and 30 female. |
53da979a-5dad-4eee-a858-02a92d06fc65 | (d) Enteric Fever.βThree cases of enteric fever were notified during the year, two of which were removed to hospital. The diagnosis of enteric fever was, however, confirmed in one instance only, the patient dying after a stay of 29 days. The other case proved to be pneumonia, making a satisfactory recovery. (e) Puerperal Fever.βThree cases were notified during the year, two of which were admitted to hospital, one being transferred from the Maternity Ward. All of the cases recovered. (f) Erysipelas.β37 cases were notified during the year compared with 18 during 1925. Two patients were removed to hospital, both dying two and three days respectively after admission. (g) Malaria and Trench Fever.βNo cases were notified during the year. (h) Acute Primary and Acute Influenzal Pneumonia.β62 cases were notified during 1926, compared with 58 for the preceding yea'. |
5a2c8b51-7056-4664-94a1-bf0dcafdeb45 | Three patients were admitted to hospital, two of whom d<ed nine hours and seven days respectively after admission. (i) Pneumonia Supervening upon Measles.β13 cases were notified under the Larking Town (Pneumonia) Regulation, 1924, Five patients being removed to hospital, one of whom died twelve days after admission. (j) Encephalitis Lethargica.βNo cases of encephalitis lethargica occurred in 1920. 47 (II) NON-NOTIFIABLE INFECTIOUS DISEASES. The most important of these are measles, whooping cough and summer diarrhoea. |
dbaf9279-c276-44e8-9905-40812684b9af | There were no serious epidemics of these diseases, and the deaths registered were as follows:β Measles 7 Whooping Cough 1 Summer DiarrhΕa 15 Measles and Whooping Cough.βCases amongst school children are reported to the School Medical Officer by school teachers, attendance officers and nurses, appropriate action being taken as regards exclusion and supervision of contracts. ISOLATION HOSPITAL. The following is the table of admissions, etc., in respect of infectious diseases during 1926:β Disease. in Hospital January. 1st, 1926. Admitted during the year. Died. Discharged In Hospital Dec. 31st. 1926. |
38c1959c-e7dd-4fa4-a815-e9683576eb34 | Scarlet Fever 10 115 β 115 10 Diphtheria 15 52* 2 60 5 Pneumonia β 8 3 4 1 Puerperal Fever 1β‘ 21 β 3 β Measles β β β β β Chicken Pox β β β β β Mumps β β β β β Epidemic DiarrhΕa β 2 1 1 β Enteric Fever β 2 1 1 β Ophthalmia Neonatorum β 1 β 1 β Erysipelas β 2 2 β β Cerebrospinal Meningitis β β β β β Tuberculosis β 1 1 β β * I death certified due to Tb. Broncho Pneumonia, β I case transferred from Maternity Ward, β‘ Case diagnosed as Phthisis. 48 Four cases of mixed infection were admitted to hospital, ar..i no instance of cross-infection occurred during the year. |
d1c46c73-44e2-4b60-8da4-d04850298a5e | TUBERCULOSIS. Administrative Arrangements.βUnder the Essex County Council (the responsible authority for the treatment of tuberculosis), the Medical Officer of Health of Barking continued as Tuberculosa Officer for the district during the year. The administrative arrangements for dealing with tuberculosis in the area include:β (a) A dispensary used on two half-days per week, (b) Garden shelters for suitable cases, (c) Sanatorium accommodation for surgical tuberculosis, (d) Sanatorium accommodation for suitable early pulmonary cases, and in some instances the more advanced, (e) Accommodation for a number of bedridden and advanced cases at St. Joseph's Hospice, Hackney, and Liverpool Road Hospital, Islington. A suggestion made towards the end of 1925 that certain cubicles at the Infectious Hospital be set apart by arrangement with the County Council for the segregation of advanced cases of pulmonary tuberculosis where home conditions were unsatisfactory was declined approval during the following year. |
e08773de-3db1-4a50-a46b-e96189443a31 | The number of notified cases on the register on December 31st. 1926, was 896, compared with 793 for the corresponding period the preceding year. During the year 1926 133 notifications were received of all forms of tuberculosisβpulmonary 113, and non-pulmonary 20β representing a notification rate of 3.41 compared with 2.08 for 1925. Information was received of the removal into the district of five tuberculoid persons. 49 Twenty-nine deaths of notified cases occurred (including one certified due to appendicectomy). Six cases left the district or could not otherwise be traced, leaving 896 on the register on December 31st, 1926, 443 being male and 453 female. Particulars of new cases of tuberculosis notified and of deaths the disease during 1926 is afforded by the following table:β New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. |
cc6e7296-2741-4e0c-bd10-2b83a12b335b | NonPulmonary. Male. Female. Male. Female. Male. Female. Male. Female. Under 1 year β β β β β β β β 1 to 5 years 2 2 2 2 1 β 1 2 5 to 10 years 19 11 4 1 β β β β 10 to 15 years 3 5 3 2 β β β β 15 to 20 years 3 3 1 1 1 3 β β 20 to 25 years 4 9 β β β 3 β β 25 to 35 years 0 10 1 1 β 4 1 β 35 to 45 years 11 4 1 β 3 5 I β 45 to 55 years 7 4 β β 7 β β β 55 to 65 years 3 2 β 1 2 β β β 65 yrs. |
3823b8fd-ffed-4660-a53f-142e25a3517e | & upwards β 1 β β β 1 β β Totals 62 51 12 8 14 16 3 2 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. These regulations, which came into force on July 31st, 1925, give power to a local authority to prevent any person suffering from tuberculosis of the respiratory tract entering upon any employment or occupation in connection with a dairy which would involve the milking of cows, the treatment of milk, or the handling of vessels used for containing milk. Any person who deems himself aggrieved by a requirement under these regulations may appeal to a Court of Summary Jurisdiction, and may. under certain circumstances, be compensated for any damage sustained. In no instance was it found necessary to take action under these regulations. 50 PUBLIC HEALTH ACT, 1925, SECTION 62. |
4ab0faca-e37a-4ca1-9bbe-6e46c286e779 | In no instance was it found necessary to take action under this section to secure the compulsory removal to hospital of a tuberculous person in an infective state. |
e6f7d8c7-1f16-4b18-ae28-2d6a9676715b | As regards the occupations of notified cases during the year the following table is of interest:β Waiters 1 Gatekeepers 1 Clerks 3 Errand Boys 1 School Children 50 Bakers 1 Publicans 1 Policemen 1 Housewives 16 Messengers 1 Nurses 1 Draughtsmen 1 Saleswomen 1 Warehousemen 1 Printers 4 Display Card Makers 1 Machinists 2 Cigarette Packers 1 Labourers 12 Crane Drivers 1 Shop Assistants 4 Blacksmiths 1 Match Factory Workers 1 Lightermen 1 School Cleaners 1 Barmen 1 Factory Hands 3 Engineers 1 Newsagents 1 Turners 2 Charwomen 1 Surgical Instrument Makers 1 Factory Cleaners 2 Slaters 1 Seamen 2 No occupation 9 The following figures indicate for the four quarters of the year the percentage attendances of cases per 10, |
c3999b4d-354f-46f6-8ad2-37f423b0cb15 | 000 population at the Tuberculosis Dispensary and of those admitted to sanatoria under the County Council:β Attendances at Dispensary. Admission to Sanatoria. No. Rate per 10,000 population. No. Rate per 10,000 population 1st Quarter 331 85.0 13 3.3 2nd Quarter 329 84.5 21 5.3 3rd Quarter 310 79.6 20 5.1 4th Quarter 372 95.5 18 4.6 51 the average for the year being 86.1 and 4.5 compared with 92.6 and 4.3 for the preceding year, and 100.9 and 4.92 respectively for 1924. The proportion of sanatoria admissions to cases notified was 54.1 per cent., and the incidence of tuberculosis per 10,000 population in respect of notified cases 230.2. |
38b6a493-19c5-4378-8ed8-1c2aa5861b98 | The following are particulars of cases notified under Forms C and D during the year :β Form C. Form D. Pulmonary. Non-Pulmonary Pulmonary. Non-Pulmonary. Male. Female. Male. Female. Male. Female. Male. Female. 42 35 5 6 33 23 1 6 Thirty-five deaths occurred from tuberculosis (all forms), 31 of these being pulmonary cases. The number of deaths in institutions was 18. The death rate for tuberculosis (all forms) during 1926 was 0.8, compared with 1.09 for the previous year. During 1926 seven deaths from tuberculosis were registered of persons not previously notified as suffering from the disease. The importance of notification is that the necessary steps can be taken with regard to the care of patients and contacts and the prevention of spread of the disease. Delay in notification is bad for both patients and pablic. |
9464f93b-aa58-44e5-91c9-bad4a64500df | Of deaths registered due to tuberculosis, notifications received by the Medical Officer of Health were as follows:β Number not notified at time of death 7 Number notified less than 3 months before death 11 Number notified 3 to 6 months before death 5 Number notified 6 to 9 months before death 2 Number notified 9 to 12 months before death 4 Number notified 12 to 18 months before death 1 Number notified 18 to 24 months before death β Number notified more than 24 months before death 5 52 597 patients made 1,342 attendances at the dispensary durirg the year for the purpose of medical examination, 147 being ntn cases. Of new cases attending during the year, 66 were notified as suffering from tuberculosis. The following table gives in tabular form the number of patienfaremoved from the Dispensary Register during the year:β No. on Dispensary Register during 1926. Numbers removed from the Dispensary Register. |
67311bef-8082-4bcd-b787-dfc9ce3d32ff | Number on Dispensary Register 31-12-126 Died. District. Discharged (Non Tb.i Discharged " Cured ' Trans' ferre i to another Dispensary Total 597 20 7 62 19 31 139 458 At the end of the year, 390 cases on the Dispensary Register were definitely diagnosed as suffering from tuberculosis, whilst in 68 cases the diagnosis still remained in abeyance. AFTER-CARE. Tuberculosis in the great majority of instances is a curable infection provided the patient is seen sufficiently early, undergoes sanatorium treatment and subsequently is able to pass his life under reasonably hygienic conditions. It is with regard to the latter that the activities of the After-care Association in this district particularly exist consisting inter alia in providing special splints, clothing, boots, nourishment, etc., for necessitous cases and in obtaining if possible suitable homes and employment for the tuberculous. |
46408e64-3e1c-4f83-a8b3-2901bf226b73 | During the year 25 new cases were so assisted, whilst 17 old cases were further assisted from the previous year. The funds of the Association are mainly dependent upon:β (a) Essex Insurance Committee. (b) Romford Board of Guardians. (c) Annual donations from certain Friendly Societies end Trade Unions. 53 (d) Donations from various local Sports Clubs. (e) Donations from private individuals and from proceeds raised at Whist Drives and Dances organised by the Social Sub-Committee. Equally important in the matter of after-care is that of dealing with the large number of advanced cases who are, in the majority of instances, in a highly infectious condition and not infrequently living under overcrowded home conditions. |
5bf415a7-4b39-422a-b996-de4fb762679c | For these practically no remedy hitherto existed, except the workhouse, but by virtue of Section 62 of the Public Health Act, 1925, local health authorities have become vested with powers where, in the opinion of the Medical Officer of Health the conditions of a tuberculous patient at home are inimical to the best interests of his or her dependents to secure such patient's removal compulsorily or otherwise to a suitable institution and to there detain him or her until circumstances have changed. It only remains to point out that where such steps become necessary, local institutional arrangements should be available. Compulsory disinfection of all houses after death from tuberculosis is now practised throughout the district under Section 5 of the Infectious Disease (Prevention) Act, 1890. DISINFECTION. This subject was discussed at considerable length in my report for 1924. 54 SECTION 4. MATERNITY AND CHILD WELFARE. |
ad3b0a43-2bbb-469a-bc47-4e13b784427b | The Council's Scheme under the Maternity and Child Welfare Act, 1918 has been extended during the year. The institution of an additional medical session at each of the Welfare Centres following the additional appointment of a part-time medical officer, will be a factor in furthering the efficiency of the Scheme. The use of the Artificial Sunlight Clinic, working in co-operation with the Infant Welfare Clinics, is already being attended with good results. During the latter part of the year an attempt was made to reorganise this section of the department by putting into operation a number of reforms long overdue, although certain existing difficulties had continued to prevent their adoption. An improvement in the position generally was obvious by the end of the year. REGISTRATION AND NOTIFICATION OF BIRTHS. By the Registration Act, 1836, all live births must be registered within a period of six weeks. |
a4b0db45-5b5c-43bc-b25c-1172e3c9ab8f | The actual number of live births within the district during the year was 803, the net total of 818 being obtained by adjustment of inward and outward transfers, etc. The births registered included 424 males and 394 females. Tbens were 26 illegitimate births, or 3.1 per cent, of the total. In comparison with 1925, 7 fewer births were registered during the year a fall equivalent to 0.8 per cent. 55 By the Notification of Births Act, all live births and still-births of seven months and over are required to be notified to the Medical Officer of Health within 30 hours. Of the total live births all cxcept 33 or 4.1 per cent, were notified. The following table gives details of the notifications received :β By whom notified. Live Births. |
acdeb968-81d6-41a5-be6a-852f4b1f00cd | Still Births Medical Practitioners 117 4 Certified Midwives 529 14 Parents and Others 124 4 The percentage of still-births was 2.6. Of the total live births during the year 511, or 63.6 per cent, were attended by midwives, the remainder being attended by medical practitioners. BIRTH RATE. The birth rate for the year was 21.01, compared with 17.8 for England and Wales. MATERNITY AND INFANT WELFARE. The Ante-Natal Clinic. The work of the Clinic was carried on as in previous years. Briefly its aims are as follows:β (1) By maintenance of the maternal health during pregnancy to reduce the foetal and neonatal mortality; to produce healthier babies at birth, and to reduce failures in breast feeding. |
76f4eb8b-8b85-4950-8742-80cbb6f1f429 | (2) By the detection and removal of foci of infection in the mother, viz., septic conditions of the mouth and throat, and of the genital tract to reduce the incidence of puerperal sepsis and of contagious conditions such as opthalmia neonatorum in the infant. 56 (3) To arrange for suitable institutional treatment for cases in which difficulty during labour is anticipated, and thereby to avert injury to infant and mother during parturition. The attendances during the year again show an increase. The number of primary attendances was 346, compared with 325 for 1925. Reattendances numbered 659 in 1926, and 640 during 192.5 One hundred sessions were held during the year, making an average attendance of 10 mothers per session. Of the mothers attending, 127 were pregnant for the first time. |
904c4811-5d3f-4ae9-9ab0-0f9309545eb0 | Expectant mothers attending the Ante-natal Clinic are drawn from the following classes:β (a) Patients intending to enter the Upney Maternity Ward for confinement. (b) Those engaging with the midwives of the Plaistow Maternity Charity. (c) Patients engaging with private midwives. From the figures given at the beginning of this section of the report it will be seen that 511 of the live births were attended by midwives, and of these 346 mothers availed themselves of the facilities provided by the Clinic, that is, two-thirds of the cases attended by midwives are under supervision during pregnancy But in spite of this growing recognition on the part of some of the mothers of the value of ante-natal supervision, there still remains a great deal of prejudice which will only be broken down by unremitting efforts of the health visitors, together with the active co-operation of the midwives. |
4f99bf21-e5d4-4e2a-bfd1-8ac589cf5966 | The following table gives particulars of cases referred from the Ante-natal Clinic for hospital or other treatment:β Syphilis 2 (1 post natal case) Albuminuria 1 Pyelonephritis 1 Rheumatism I Pleurisy 1 Chronic Bronchitis 1 Small Pelvis 1 57 A new development towards the end of the year at the Antenatal Clinic was the attendance of one of the health visitors at one session weekly for the purpose of giving advice and instruction in ante-natal hygiene and other appropriate subjects. The number of mothers attending this class at any time is not large, so that it is possible for the health visitor in many cases to give individual instruction. These talks are of especial value to the younger mothers. Post Natal Cases. Thirteen cases attended by midwives were referred by them or by the health visitors for examination at the Ante-natal Clinic owing to the presence of defects following childbirth. |
b390c670-cd5f-4d23-80f3-fdd20a72a607 | Seven of these cases were found to be in need of special medical treatment, for which they were referred to hospital or elsewhere, according to the defect found. MATERNITY WARD. The admission to the Maternity Ward of the Municipal Hospital numbered 206, the total being the same as for 1925. Of these 37 cases were admitted for ante-natal treatment, and 169 for confinement. Corresponding figures for 1925 were 39 cases for ante-natal treatment, and 167 for confinement. The number of cases confined in the Ward represents 20.4 per cent, or approximately 1 in 5 of the total births of the district, a proportion which it is hoped will increase still further. There is no doubt that the ward is greatly appreciated by the mothers who make use of it, as is shown by the number of readmissions of patients who have previously been confined there. |
3d83efd5-76fc-4890-8abe-da5dcf98adf3 | Of the patients confined in 1926, 75 were mothers of first babies, and in these cases the two weeks' stay at Upney Hospital has a definite educational effect in emphasising the importance of breast feeding and in instilling the first principles of infant care. The return of cases as required by the Ministry of Health is given below. It will be seen that the results obtained in the ward continue to be satisfactory. 58 (1) Number of cases admitted 206 (37 of which Ante-natal) (2) Average duration of stay 12.3 days (3) Number of cases delivered by:β (a) Midwives 167 (b) Doctors 2 (4) Number of cases in which medical assistance was sought by the midwife with reason for requiring assistance:β (a) Ante-natal 2 1 Cardiac 1 Miscarriage 1 A.P.H. |
71500bbd-309e-4492-8af4-d2bd9751cac2 | (b) During Labour 3 Adherent Placenta 1 High Temperature (c) After Labour 8 Ruptured Perineums (d) For Infant 1 Prematurity (5) Number of cases notified as puerperal sepsis with result of treatment in each case 1 (recovered) (6) Number of cases notified as puerperal pyrexia with result of treatment in each case Nil (7) Number of cases of pemphigus neonatorum Nil (8) Number of cases notified as opthalmia torum with result of treatment in each case Nil (9) Number of cases of " inflammation of the eyes," however slight 1 (10) Number of infants not entirely breast fed while in the Institution, with reasons why they were not breast fed 4 (a) Weakness of mother 2 (b) Prematurity 2 (11) Number of maternal deaths Nil (12) Number of foetal deaths (a) stillborn, |
ba834310-9ee4-4a03-9969-329a08383541 | and (b) within 10 days of birth and their causesβand the results of the post mortem examination if obtainable:β (a) Stillborn 5 (b) Within 10 days of birth 69 PUERPERAL FEVER AND PUERPERAL PYREXIA. On October 1st, 1926, the Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926, came into force. These regulations require the notification of puerperal pyrexia (according to the definition given in the regulations), in addition to those cases previously notifiable as puerperal fever under the Infectious Diseases Notification Act, 1899. |
e2305cc1-ff49-4d9a-8267-5cea61cfb92d | In a circular accompanying the Regulations, the Minister of Health urges local authorities to exercise the powers conferred on them under the Maternity and Child Welfare Act for provision of facilities for diagnosis, skilled nursing at home, or institutional treatment, if in the opinion of the medical practitioner in charge of the case any one of these is necessary. In accordance with this direction, arrangements have been made by the Council for nursing of the patient at home, or in the isolation hospital as desired. In addition, Dr. A. Kennedy has been engaged as consultant for those cases in which a second opinion is required by the medical attendant. Three cases of puerperal fever were notified as compared with 4 in 1925, two of which were admitted to the Isolation Hospital. Two of the cases were attended by midwives. One case occurred in the Municipal Maternity Ward. The patient was isolated immediately on the onset of pyrexia, and no further cases occurred. |
f27dafa7-deac-4d96-a6b2-09e7fe09a39e | In addition to the cases of puerperal sepsis, one case of puerperal pyrexia was notified. All the patients recovered. No definite cause of infection was found in any of the cases, although it was noted by the health visitors in the routine investigation, that in three out of four patients foci of infection were present before labour. MATERNAL MORTALITY. One maternal death occurred during 1926, due to excessive vomiting of pregnancy. There were no deaths from puerperal sepsis. The puerperal mortality for the year is therefore the same as for 1925, 1.3 per thousand, and continues to be much below the average for England and Wales, viz., 3.06 for 1925. 60 NEONATAL MORTALITY. It is gratifying to note a considerable reduction in the neonatal mortality during the year. |
9a8ceac6-bef4-4848-b127-ccecd721c797 | The number of deaths of infants under four weeks of age was 15, giving a rate of 18.3 per thousand, compared with 30.3 for the previous year in Barking, and 32.2 for England and Wales during 1925. It is hoped that, with the extension of ante-natal care, this low rate will be maintained. Deaths Under Four Weeks. Under seven days. Under fourteen days. Under twentyone days. Under twentyeight days. Total. Bronchitis β 1 β β 1 Atelectasis 4 β β β 4 Congenital Malformation β 1 β β 1 Premature Birth 3 β 1 β 4 Debility 2 β β β 2 Convulsions 1 β β β 1 Marasmus β β 1 β 1 Accidental Suffocation β β 1 β 1 61 STILL-BIRTHS. |
61319430-56d3-4709-a22b-2ffe364278cf | Of the total notifications received under the Notification of Births Act, 22 related to stillborn children, giving a percentage of 2.6, compared with 3.2 in 1925. In addition, two Barking women were delivered of stillborn infants in institutions outside the district, so that the total number for the year was 24. One case was that of twin pregnancyβboth infants being stillborn. Investigation of the health visitors elicited the following information :β (1) Duration of pregnancy:β (a) Less than seven months 2 (b) More than seven months 22 (2) Presentation:β (a) Vertex 19 (b) Breech 3 (c) Transverse 1 (d) Not elicited 1 (3) Supposed cause of stillbirth:β (a) Abnormal presentation 2 (b) Overwork 4 (c) Accident, etc. |
6b5ddfc1-b790-4244-890e-9447326e0228 | 4 (d) Not known 6 (e) I11 health 7 (4) Occupation of mother :β All the mothers were engaged in household duties at home. In addition, one woman did an occasional day's cleaning elsewhere, whilst one was engaged in dressmaking at home. OPTHALMIA NEONATORUM. There was again an increase in the number of .cases of opthalmia neonatorum, notifications bein? 16, compared with 12 in 1925. Thirteen of the cases occurred in the practice of midwives, the remainder being attended by medical practitioners. 62 Age Group. Cases. Vision unimpaired. Vision impaired. Total Blindness. Deaths Notified Treated. At Home. At Hosptl. |
3e909b96-e38a-4856-a8be-ad470b528971 | Under 3 weeks 16 14 0 15 1 β β The growing appreciation among midwives of the seriousness of the condition and of the value of early treatment makes for a greater readiness on their part to call in medical help to the slighter cases of discharge which previously may have escaped notification altogether. OPTHALMIA NEONATORUM REGULATIONS, 1926. These regulations came into force on October 1st, 1926. Under them it is no longer the duty of the midwife to notify cases. In accordance with the rules of the C.M.B. |
feb979f5-77fe-4594-8d81-a4570bdd5580 | the midwife is under obligation to call in medical aid for any inflammation of the eyes, however slight, and the onus is now with the medical man called in to notify if, in his opinion, the case is one of opthalmia neonatorum For the effective supervision and treatment of such cases, close co-operation between the Local Supervising Authority and the Local Sanitary Authority is essential, and suggestions are made in a circular accompanying the Regulations as to how this co-operation may best be secured. INFANT AND CHILD WELFARE. Work of the Health Visitors and the Infant Clinics. This branch of the work was greatly handicapped during the first part of the year under consideration by repeated changes in the personnel of the visiting staff. From May until August the work was assisted by the appointment of a temporary health visitor, but it was not until September 1st that the third permanent health visitor commenced her duties. |
3d750b7b-1aae-41dd-9a4b-9ef6a99b477f | 63 The use of Empress Mall as an Infant Welfare Clinic was discontinued on the 3rd May, 1926, and the Greatfield Welfare Centre in Movers Lane opened on the 31st of that month for the Ripple and Westbun Wards. This centre is a decided improvement on the premises previously in use, providing as it dors a suitable room for weighing and also a separate room for the medical officer. The accommodation in the waiting room is, however, insufficimt, and interferes to some extent with the efficient working of the sewing stall. The Clinic, in addition, has the disadvantage of not being centrally situated for the area which it serves. The premises at East Street are not suitable for the purposes of an Infant Welfare Centre, and have a detrimental effect on the work of this Centre. An analysis of the attendance at the Infant Welfare Centres is given in the following table:β Infant Welfare Centres. Clinic Premises Alex. Centre Movers Lane Total No. |
6982eacd-62f0-42c1-a083-1f6c9ed09ef2 | of sessions 97 100 93 290 No. of attendances of children under one year:β (a) New cases 140 206 152 498 (b) Old cases 1585 2221 1599 5405 No. of attendances of children 1 to 5 years of age :β (a) New cases 11 13 7 31 (b) Old cases 1010 1671 1220 3901 Average number of attendances per session 28 41 32 33 No. of sessions attended by medical officers 61 61 57 179 No. |
845badef-0a62-4ad3-8311-a06c51ae2d70 | of children seen by medical officers (a) Under one year 860 998 931 2789 (b) Over one year 419 409 445 1273 Average number of children seen by medical officer per session 21 23 24 22 64 The total attendances during the year were 10,125 as compared with 11,525 in 1925. There is no reason to anticipate that this reduction is other than a temporary one; it being probably accounted for by the changes in the staff mentioned above. Particulars of the home visits paid by the health visitors is given in the following table:β No. of ante-natal visits 221 No. of first visits to children under one year No. of subsequent visits to children under one year:β 826 (a) Attending a Centre 659 (b) Not Attending a Centre 2,671 No. |
94c5607a-5cfc-4919-a79f-1c09a7f5f82c | of visits to children 1 to 5 years of age:β (a) Attending a Centre 300 (b) Not Attending a Centre 1,511 No. of special visits in connection with Ophthalmia Neonatorum 44 Ditto Deaths of children up to 3 years of age 59 Ditto Still-births 24 Ditto Puerperal sepsis and Pueperal Pyrexia 3 Ditto Foster Children 28 Other visits (not specified) 65 65 Moreover, owing to the additional medical session at each of the centres, it is now possible for the medical officer to devote a satisfactory proportion of her time to the older children, and mothers are encouraged to continue to attend at the ccntres until the children attain school age. so that the latter may be kept under observation and submitted to routine medical inspection as often as is necessary. |
df64f257-c248-4994-a43e-ddf0683c5a26 | The more complete supervision of the pre-school child, as outlined above, leading to detection and treatment of disease in its earliest stages, together with utilisation of the special facilities available for such children under the provisions of the Maternity and Child Welfare Act, will, it may reasonably be hoped, lead to an improvement in the physical condition of the child when he comes for the first time within the purview of the School Medical Officer. Treatment may be obtained for children attending the infant welfare clinics as follows Minor Ailments.βTreatment is given at the School Clinic by arrangement with the Education Committee. Dental and orthopaedic treatment, and treatment of septic tonsils and adenoids are available as in the case of school children. Convalescent Treatment.βThis is provided for under the Scheme, and is of value for children suffering from debility following acute illness. FOSTER CHILDREN. All cases of foster children resident in the district are notified by the Guardians to the Medical Officer of Health under the Children Act, Part 1. |
ca26ed3b-2d93-4d03-888f-fc7c074c2998 | 66 Four of the foster children were resident in Barking for less than one month ; but of the others, twenty-three were in regular attendance at the Infant Welfare Clinics. This satisfactory result is due in great part to the active co-operation of the Infant Life Protection Visitor with the work of the Maternity and Child Welfare department. INFANTILE MORTALITY. The total number of deaths of infants during the year was 49, giving an infant mortality rate of 59.9 per thousand registered births, compared with 80 per thousand for 1925. The number of infant deaths in the first two quarters of the year was exceptionally low, and may be accounted for in part by the low incidence of measles and whooping couph, diseases which an? particularly fatal to infant life and which in general arc associated with an increased incidence in respiratory disease. |
7a7338c7-5196-48a9-8b56-42c89503f0fa | A disquieting feature towards the end of the third quarter was the occurrence of an epidemic of summer diarrhoea, which caused 15 deaths, all of children under 12 months of age, and of these deaths 9 occurred in infants resident in the Abbey Ward. Diseases of the respiratory system, bronchitis and pneumonia were responsible for 10 of the infant deaths. An analysis of the distribution of the deaths of infants under 1 vear of age, according to wards, is of interest, and is given in the table following:β Ward. Notified Births. Deaths. |
828d3706-195a-48a7-ac36-a8d983f55755 | 1926 rate per 1000 notified births Abbey 187 19 101.6 Gascoigne 113 7 61.9 Central 94 7 74.4 Longbridge 134 7 52.2 Westbury 145 6 41.3 Ripple 113 3 26.5 67 In considering these figures it must be borne in mind that whilst overcrowding and insanitary environment have a direct influence in inducing a high infant death rate, vet the high rate in the Abbey Ward is in part due also to the economic and social conditions obtaining in that area. The increased incidence of diarrhoea during the year was disappointing and indicates the need for persistent vigilance on the part of the Maternity and Child Welfare staff in the elimination of what is, after all, a preventable disease where adequate standards of cleanliness and mothercraft are maintained. Disease of the respiratory system continue to take their toll on infant life. |
ac698422-968d-48af-8c7f-af2a7f627296 | It will be noted that pneumonia and bronchitis together were the cause of mere than 20 per cent. of the infant deaths in Barking during the year. Moreover, pneumonia is probably responsible for an even greater proportion of the deaths of children from one to five years of ageβeither as a primary condition or as a complication of measles or whooping cough. In dealing with the causes of respiratory disease, atmospheric pollution is a factor of primary importance, but so far as prevention is concerned, much may be achieved by improved domestic cleanliness and ventilation. INFANT MORTALITY AND SEX. An excessive male death rate again occurred during the year, the rate being 77.8 per thousand for male, and 40.6 for female children. ILLEGITIMACY. |
00dc905f-e67b-4008-95e3-d1e6cc751853 | Twenty-six illegitimate children were born during the year, and in the same period 4 deaths of illegitimate infants occurred ; the infantile mortality rate among these children was therefore 153.8 ; while that for legitimate infants was 50.8 68 BREAST FEEDING. The importance of breast feeding in increasing the resistance of the infant to all forms of disease has been dealt with in previous reports. An investigation into the feeding of infants at the end of the sixth month of life was carried out in cases visited from July to December. The following percentages were obtained :β Wholly breast fed 62.5 Partially breast fed 7.7 Entirely artificially fed 29.8 per cent. DENTAL CLINIC. |
9e90024f-0f32-44d2-a535-b3325e818c8f | A steady expansion in this branch of the work has been taking place, and during 1926 the attendances of expectant and nursing mothers and of children referred from the Maternity and Child Welfare Clinics were as follows:β (1) Number of children treated .. .. .. .. Β£0 (2) Number of mothers treated:β (a) New cases119 (b) Old cases 556 (3) Number of dentures supplied51 Forty-four sessions were held. Here it must be observed that the aim of the Maternity and Child Welfare Service is the prevention of the onset of dental caries in the child, and, for this purpose, the improvement of the health of the mother and of her diet during pregnancy, the encouragement of breast feeding and the use of suitable dietaries for the young child, together with the practice of mouth hygiene, are all factors which must be dealt with by the Maternity and Child Welfare staff, in order to bring about an improvement in the structure of the teeth, and delay in the onset of caries. |
711803e7-376b-41ba-86cf-80d49771845a | 69 ORTHOPAEDIC CLINIC. Seventeen children under school age were referred from the Infant Welfare Clinics or by the local medical practitioners for examitation by the Orthopaedic Surgeon during the course of the year, and, in addition, 20 cases attended for re-examination. Four of the children received in-patient treatment at Orthopaedic Hospitals, and surgical instruments were provided for 4 patients liter their discharge from hospital. The cases dealt with for the first time during 1926 were referred for the following conditions:β Rickets:β (a) With deformities 6 (b) Without deformities 4 Congenital deformities 2 Poliomyelitis 2 Erbs-palsy 1 Tuberculous spine 1 Adenitis 1 ARTIFICIAL SUNLIGHT CLINIC. The treatment of infants and children under five years of age at the Artificial Sunlight Clinic was begun in October, 1926. |
0464388b-3348-421c-a4df-dc29786aae10 | Cases are referred by the medical officers in charge of the Infant Welfare Clinics, and the children attending are kept under constant medical supervision during their course of treatment. The majority of the children referred for treatment were suffering from early rickets and malnutrition. In addition, cases were referred for the following conditionsβchilblains, prematurity, general debility, and anaemia. In all, 25 children received treatment during 1926. One session per week was devoted to these cases, and 89 treatments were given. Although it is not possible at this early stage to make a detailed Analysis of the results obtained, yet there is no doubt that benefit has accrued in individual cases, particularly those of malnutrition and rickets. 70 MEALS TO EXPECTANT AND NURSING MOTHERS. Greater advantage has been taken during 1926 01 this provision under the Act, 18 necessitous mothers having been provided with dinners as compared with 12 during the previous year. |
ef4809f5-8478-4136-9936-809c2622a285 | The total number c.f dinners supplied was 710. The nutrition of the mother during pregnancy and in the lying-in period has a very important bearing on the well being of the infant, and it is at these times that necessitous mothers are particularly encouraged to avail themselves of the Council's scheme. PROVISION OF FRESH 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:β 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. f. 9. d. f. s d. 2,692 15,438 18,130 244 1 8 225 11 11 71 purpose. The result, as will be observed from the subjoined table, has been a considerable reduction in the quantity of dried milk issued. Cost Price. |
fc915f55-9475-4f84-b864-7cccdae1040a | (lbs ) Reduced Price. (lbs.) Free. (lbs.) Total. (lbs.) Glaxo (Full Cream) 1,104 35 142 1,281 Glaxo (Half Cream) 16 β 2 18 Glaxo (Humanised) 93 β 5 98 Ambrosia 746 102 173 1,021 Cow and Gate 5,120 412 1,698 7,230 Almata 117 β β 117 |
6f80dd2b-8eab-471b-9a80-ce23c03f4d9b | BAR 68 Barking Town Urban District Council. THE OF THE School Medical Officer For the Year 1926. K. SIMPSON, M.D., Ch. Bβ M.R.C.P., D.P.H. 3 SCHOOL MEDICAL STAFF, 1926. School Medical Officer: K. SIMPSON, M.D., Ch.B., M.R.C.P., D.P.H. Deputy School Medical Officer: MURIEL J. LOUGH, M.B., B.S., B.Sc., M.R.G.S., L.R.C.P., D.P.H. Orthopaedic Surgeon: B. WHITCHURCH HOWELL, M.B., B.S.. F.R.C.S. Radiologist: ANGUS E. KENNEDY, M.R.C.S., L.R.C.P., L.S.A. Dental Surgeon: W. W. F. DAWE, L.D.S., R.C.S. (Eng.). |
a4975faf-dcd8-4f28-b439-cf8fa194bd1f | Masseuse: Miss A. E. FINDLAY, C.S.M.M.G. School Nurses: Miss L. F. SWAIN. Miss F. YOUNG (Dental Nurse). Miss S. E. W. GIBSON. * Clerical Staff: E. W. WINCHESTER (Chief Clerk). Miss A. SHAW. Miss V. SHEAD. Miss B. INGHAM. * β
of Salaries charged to School Medical Service. 4 ANNUAL REPORT OF THE SCHOOL MEDICAL OFFICER. (1) STAFF. During the year Dr. Simpson continued as School Medical Officer, the remaining personnel of the School Medical Service suffering no change throughout the year. (2) CO-ORDINATION. (a) Infant and Child Welfare. The School Medical Officer and Assistant School Medical Officer are also Medical Officer of Health and Assistant Medical Officer of Health respectively. |
aa759f54-a0eb-4ffb-8dbf-f8b844190cdd | As pointed out in my Report for the past yearβ "The nursing staff of the Education Authority is not engaged "in the work of the Sanitary Authority, so that co-ordination in "the fullest sense of the word is not complete. Although the present "position is unavoidable, a distinct gain would result were the "school nurses employed also, as part-time health visitors, so that "the care of children of all ages up to 14, and in some cases even "later, could he carried out by the same nursing staff." The School Medical Service is run in close touch with the Maternity and Child Welfare schemes of the district, the Tuber culosis Dispensary, and the Barking Tuberculosis After-care Committee. (b) Nursery Schools.βThere are no nursery schools in the district, but in certain selected cases children between 4 and 5 years of age were admitted to the Infants' Departments of certain elementary schools during the year. |
6c18c004-d060-460b-8234-3c18338730de | 5 (c) Care of Debilitated Children under School Age.β Orthopaedic treatment where necessary is available for children under school age, joint arrangements existing therefor between the Education and Public Health Committees, treatment required being given at the Orthopaedic Clinic of the Spccial School. Dental treatment and that for enlarged tonsils and adenoids is provided, the former, by arrangement with the Education Committee and available at the School Dental Clinic, the latter under similar arrangements to those for children of school age. The School Clinic for the treatment of Minor Ailments is available for children under school age by arrangement with the Education Committee. THE SCHOOL MEDICAL SERVICE IN RELATION TO PUBLIC ELEMENTARY SCHOOLS. (3) SCHOOL HYGIENE. Excepting the Roman Catholic and Church of England Schools, the general hygienic conditions of the remaining elementary schools of the district can be considered satisfactory. Hygienic defects are more keenly felt in the case of the Roman Catholic School, which continues to be considerably overcrowded. |
3c173ef8-c681-44d0-80d6-890dc11eb8be | Both schools lack, to some extent, open surroundings, and from the points of view of lighting, ventilation and heating, leave something to be desired. A site has been secured for an additional Roman Catholic School which, on completion, will go some way in minimising existing overcrowding at the present school. The New Park Central School commenced in January, 1926, was partially occupied on the 22nd November, 192G by the admission of 120 boys and 120 girls. The question of type of desk, blackboard, sanitary conveniences, water supply, etc., was dealt with at length in my Report for 1923. With the exception of the Special School, no facilities exist at any of the others for the drying of children's clothes or boots. 6 School. Number of children who do not return home for midday meal. Whether facilities exist for heating of children's meals. Whether facilities exist for the drying of children's clothes and boots. |
3b973595-306e-49c7-bceb-7080083022af | C.of E. Boys - No School fires in winter only. Girls β ,, β β Infants β β β β Rippleβ Boys - ,, β β Girls - ,, β β Infants - ,, β β Catholic Mixed 18-20 ,, β β Infants 4 ,, β β Gascoigne Boys 8 ,, β β Girls 2 Gas ring β β Infants β No β β Westbury Boys 4 ,, β β Girls β ,, β β Infants β ,, β β North Street- β Boys 5 ,, β β Girls 2 ,, β β Infants 2 ,, β β Crecksmouth- β ,, β β Castleβ 40-50 Small stove in teachers' private room β β Faircrossβ All children stay at school for mid-day meal, the food being supplied from Municipal Kitchen Yes Yes 7 PROVISION OF MEALS. (i) A hot mid-day meal of two courses is provided for children attending the Special School, parents contributing to the cost thereof according to means. |
a9876973-04f4-4fc7-82b9-a2f9f00e4207 | Meals are served in the Dining Hall of the School under the supervision of certain teachers, who, at the close of the children's dinner, are supplied with meals at a nominal charge. Food is cooked in the Municipal Kitchen, arrangements existing for keeping food hot during transit and at the school before service. The actual service of meals is in the hands of assistants, although selected children take part in its distribution. (ii) All but a few children as shown by the foregoing table can return home for the mid-day meal. (4) MEDICAL INSPECTION. The first table in the appendix shows the number of children inspected and ages at inspection, the Board's scheme being followed throughout. Every child is submitted to routine medical inspection three times during its school life as one of the fundamental functions of the School Medical Service, the system employed ensuring that no child is omitted. Briefly all the schools in the district are visited in rotation each term. Head Teachers sending to parents notice thereof according to an arranged programme. |
1cca23e6-0f99-4fbc-a309-04b01cd433bc | Parents are specially urged to attend the Inspection. The number of children examined as entrants, intermediates and leavers, besides those examined otherwise than during routine inspection, together with the percentage of defectives found, is furnished by the subjoined table:β 8 Entrants. Intermediates Leavers. Specials. Other Routine Examinations. Total. No. of children examined 1038 738 677 153 142 2748 No. referred for treatment 201 172 134 94 18 619 No. referred for observation 186 134 101 41 10 472 Percentage of defective children 37.2 41.4 34.7 88.2 19.7 39.7 The proportion of children, whose parents were present at school examination, was 60.7 per cent., compared with 65.5 per cent. daring the preceding year. |
b5025438-5f71-4936-a974-b0b90d0188ad | The number of children on the school register on 31st December, 1926, was 6,855, compared with 6,794 on 31st December, 1925. During the year, the Medical Officer paid 116 visits to 22 departments for inspection purposes, examinations being con ducted throughout the year on the various school premises Certain cases of defect were, as in previous years, referred to the School Clinic for further examination and treatment. Very little disturbance of school routine is occasioned by these inspections, the convenience of teachers being followed as far as possible. The following table shows the number of children examined at routine and special inspections during 1926, classified according to the schools attended, the number of inspections held in each school and the number of parents or guardians present:- 9 COUNCIL SCHOOLS. School. No. of inspections. Numbers inspected. No. of parents present. Boys. Girls. |
93cf1c06-9dfe-4609-bf92-69665f43d2d9 | Gascoigne 26 317 299 374 North St. 22 278 231 346 Castle 2 28 27 22 Creeksmouth 1 6 5 11 Westbury 22 302 282 367 Ripple 19 224 221 304 Faircross 4 79 63 60 VOLUNTARY SCHOOLS. Church of England 13 130 142 137 Roman Catholic 7 57 57 49 (5) FINDINGS OF MEDICAL INSPECTIONS. Table II, Appendix (a), gives a return of defects found during the course of routine examination. Of those examined at routine and special inspections, 1091, or 39.7 per cent., had some defect, and the actual percentage requiring treatment was 22.5. (a) Uncleanliness.βThis defect in more recent years has shown a constant and satisfactory decline. |
30e3a684-d2f6-4302-a71f-de78dcb4878d | Owing to the condition of some of the homes from which the children come, and of the other inmates, this defect cannot be stamped out by the School Medical Service alone. In this connection, close co-operation with the sanitary authority is valuable, though the homes of children are visited and parents instructed in the cleansing of heads, bodies, etc. as the case may be. Surveys under the above heading were carried out at (i) routine medical inspections, and (ii) special inspections conducted by the school nurses. (i) At the former, 299 children out of a total of 2,748, or 10.8 per cent., had nits in their hair, while 3 or 0.1 per cent. had head 10 or body vermin. As formerly, cases were seen at the School Clinic after exclusion by nurses or teachers, of which number 63 had nits and 76 head or body vermin. |
641b8fd8-700e-42c6-a55c-adb25c2540f7 | (ii) During the year the school nurses made 17,952 individual investigations, compared with 17,504 in 1925, of which number 198S children were found to have nits only, 131 harboured nits and head vermin, whilst 6 had verminous bodies and clothing. 278 visits in connection with uncleanliness were made during the year. For purposes of these inspections the various schools undivided between two school nurses, every school is fully inspected during each term, and the results of these examinations are as follows:β School. Dept. Nits only. Nits and Vermin (head) Body and clothing verminous. Gascoigne Infants 137 7 β Boys 43 3 1 Girls 268 11 β North St. |
cf5fdea1-6c21-4203-85f1-6bcaa8e159fd | Infants 112 10 1 Boys 30 4 1 Girls 151 5 - Castle Infants 56 6 β Boys Girls Creeksmouth Infants 12 - - Boys Girls Westbury Infants 132 13 β Boys 33 10 β Girls 208 8 - Ripple Infants 58 7 - Boys 19 3 β Girls 109 6 β C. of E. Infants 135 7 β Boys 41 1 - Girls 211 13 - RC. Infants 42 6 1 Boys 117 8 1 Girls Faircross - 74 3 1 11 Printed instructions are in all cases sent to parents or guardians of children excluded from school as result of verminous conditions, cleansing of the verminous person and clothing when necessary being subsequently undertaken at the School Cleansing Station. During 1926, 120 cases were dealt with. |
84d618bf-7859-4904-a44f-5011b7ffd6a9 | Clothing.βChildren with dirty clothing numbered 14 or 0.5 per cert., compared with 10 or 0.47 per cent. in 1925. Children with defective footgear numbered 10 or 0.3. Cases of children with defective footgear were as heretofore referred to the Boots Minor Sub-Committee, who considered applications for the provision of boots in 198 cases, compared with 133 in 1925. In all 186 children were supplied with boots during the year. (b) Heights and Weights.βThe following table gives the average heights and weights of children examined at the three undermentioned age periods in four of the schools, compared with the results at similar age periods in 1925. Age Period Average Height in inches. Average Weight in pounds 1925. 1926. 1825. 1920. |
91ca9ca5-fc93-4baf-adce-cb281708446e | 5 years 42.1 42.4 41.1 40.3 8 years 49.05 49.9 54.1 54.6 12 years 56.5 57.5 78.8 82.4 (c) Minor Ailments.βMinor ailments are seen, daily at 9 a.m., excepting Sundays, at the Clinic premises in East Street, the staffing of this Clinic being provided by nurses of the Plaistow Maternity Charity. For particulars of cases treated, see Table IV, Group I. Instances of uncleanliness found amongst children seen at this Clinic were those excluded by teachers, school nurses, or attendance officers prior to being re-admitted to school. 12 (d) Skin Disease.βThe common skin diseases met with are Impetigo, Septic Sores, Seborrhoea, Scabies and Ringworm Table II gives the numbers found among the routine and special examinations. |
81d3d8f8-7253-4ed3-bcb9-0b06b2d77c92 | They amount to 1.6 per cent, among routine cases No case of Ringworm of the scalp was met with during the year. (e) Eye Diseases.βThese diseases chiefly comprising Blepharitis, Conjunctivitis and styes, either indicate faulty personal hygiene or some error in refraction. They form a very important section of the minor ailments found in school children. Table II gives the findings under the respective heads. They amount to 25 among routine and special cases. (f) Vision and Squint.β169 cases of defective vision weft found and 26 cases of Squint, 135 and 16 cases respectively beirg referred for treatment. This gives 5.4 per cent, requiring treatment (g) Ear Disease.βDefective hearing is measured by means of the whisper test at 20 feet. |
a7e397c7-62a3-4ae4-8ac8-e51e601e8415 | 23 children, or 0.8 per cent., were found to be deaf, while 47 or 1.7 per cent., suffered from ear disease, the latter generally having discharging ears and a certain amount of deafness in consequence. Defective hearing is either due to wax or middle ear disease which is much more untractable, a third and very common cause of defective hearing being adenoids, the removal of which usually cures the deafness. The prevalence of ear disease among entrants amounted to 1.4 per cent. (h) Tonsils and Adenoids.β357 children, or 12.9 per cent of those examined, were found suffering from enlarged tonsilsor adenoids, or both, with such symptoms that it was found necessary to refer them for treatment or further observation Of cases referred for treatment, 185 were found on re-inspcctien to have been treated. As in former years arrangements for the operative treatment of post-nasal growths at the Threat Departments of St. |
16c996b2-8881-4061-9bc0-414e972305c6 | Mary's Hospital, Plaistow, and Queen Mary's Hospital, Stratford, parents contributing to the cost thereot according to means. 13 Adequate facilities at either of these hospitals do not exist for the overnight detention of all children after operation. Home visits by the school nurses to children operated upon are paid on the patient's return home, while in certain cases children are brought home by ambulance after operation. A distinct advantage would result were this arrangement made a general one. The percentage of the above affection found among entrants was 17.5. (i) Tuberculosis.βThe total number of cases of tuberculosis in school children notified to the Medical Officer of Health during the year was 50. During the year 27 cjses were referred to the Tuberculosis Officer, of whom 5 were subsequently notified as tuberculous. |
1d5a730e-6941-4672-8434-77d6de94ec11 | The total number of attendances by children of school age at the Dispensary amounted to 259, while during the year 11 children were recommended through the Essex County Council for hospital or sanatorium treatment. Quiescent cases of the disease were as in previous years admitted to the Open-air School, Faircross, and numbered 55. (j) Dental Defects.βThe findings at Medical Inspection mostly relate to oral sepsis, i.e., gum boils and inflamed gums due to decayed teeth. These are matters of some urgency leading to digestive and other troubles due to absorption of purulent matter. The amount of dental trouble amongst entrants amounted to 42.87 per cent. This matter is further dealt with in the dental surgeon's report on pages 32 and 33. |
d25e6adb-cf24-45de-9cbf-aba39a7f6f7d | (k) Crippling Defects.βMarked deformities of such a degree as to cripple a child are becoming less numerous, as these conditions are being dealt with under the orthopaedic scheme now in existence in the pre-school age. Such defects as come to notice are found in Table II of the Appendix and consist of various degrees of flat foot, knock knee and spinal curvature. Cripple children are educated at the cripple class of the Special School, Faircross. (6) INFECTIOUS DISEASE As the School Medical Officers are also the Public Health Medical Officers, the occurrence of infectious disease is. known to them at once and steps taken accordingly. 14 Code: Articles 45 (b), 53 (b) and 57.βNo schools were closed during 1925 for infectious disease, nor was the School Medical Officer required to submit any certificate under the Board of Education Amending Regulations, No. 2 (a), 1924, for purposes of apportioning grant. |
b879c5b1-9524-4596-b023-2e74ec30e6ee | (a) Scarlet Fever.β78 children were reported in 1926, compared with 35 in 1925, the number of contacts excluded numbering 160. (b) Diphtheria.β35 cases were reported in 1926 compared with 37 in 1925, contacts excluded, numbering 68. (c) Measles and German Measles.β353 children were reported from schools during the year, compared with 61 in 1925. (d) Chicken-pox and Whooping Cough.β153 children were reported during the year. 533 home visits were paid by the school nurses in connection with infectious disease during the year, whilst 206 visits were paid by the sanitary inspectors in connection with notifiable cases. (7) FOLLOWING UP. |
3f3c1a08-8bbc-408a-9fab-f751f01d3b09 | Arrangements for following up cases of defect are as follow-: Children referred for treatment from routine inspection artvisited and advice offered the parents by the school nurses as how best whatever treatment may be necessary can be obtained Following-up cards are kept in respect of all children referred for treatment from routine or special examination, and on subsequent visits of the medical officer to the school such children are re-it) inspected as to whether treatment has been carried out and it results. Children for whom glasses have been prescribed are re-inspect": within three months of the original examinations. Children whose tonsils and adenoids have been operated upon are re-inspected at 15 the Clinic, the necessity for further attendance at hospital being thus minimised. Cases where treatment is not obtained elsewhere and which fall within the category of Minor Ailments are dealt with at the school Clinic. |
d404fb9d-d5b9-445e-af80-6930f8d49c6e | It is gratifying to notice that of the number of children referred for treatment during the year, 59.45 were found to have been treated, compared with 56.79 in 1925. A summary of the work of the two school nurses during the year is as follows:β No. of visits to schools 220 No. of visits to schools for medical inspection 116 No. of home visits in connection with:β (a) Routine Medical Inspections 2989 (b) Infectious Disease 533 (c) Uncleanliness inspections 278 (d) Non-attendance for treatment, etc. 603 No. of children cleansed at cleansing stations 120 (8) MEDICAL AND SURGICAL TREATMENT. The presence of defects having been ascertained, provision is made for treatment as follows:β Parents are notified as to what has been found, and requested to make arrangements for medical attention either locally, if possible, or with neighbouring hospitals or institutions. |
7795d064-34d2-47ab-838e-28f299ada3d5 | There are numerous conditions, minor ailments especially, which would escape attention altogether unless the authority arranged for their official attention. The number of cases referred for treatment will be found in the sub-divisions of Table II, while the numbers treated, and whether by the authority's scheme or not are set forth in Table. IV. 16 The methods adopted to secure treatment are the consistent following up of cases; the provision of clinics (set forth as under) and other items referred to in this Report such as transference fo. the Open air School, etc. in regard to dental work, there were as usual too many refusals. Parents do not yet appreciate the necessity of proper attention to teeth. It has not been necessary to institute proceedings in 1926, but much pressure has been necessary in some cases to secure that treatment is accepted even when offered Ifree In 1926 the various clinics established included:β 1. |
31399e26-1c81-4755-af43-b779c10ce3a4 | Minor Ailments Clinic, East Street.βMornings on days at 8.30 o'clock. 2. Opthalmic Clinic, Central Clinic, East Street.β Half day, Saturday mornings. 3._ Throat and Nose.βOperations for tonsils and adenoids are carried out by arrangement with neighbouring institutions, no facilities for the purpose being available locally. 4. Examination Clinic, East Street.βFor the further tion of special cases and cases referred from routine inspections which are seen at the close of the Minor Ailments Clinic. Examination of backward children and the subjects of suspected mental or physical dcfect are carried out by the School Medical Officer at the Public Offices. arrangements are made to suit the convenience of parents and others. 5. Dental Clinic, East Street.βTwice daily except one session per week employed on dental inspections at school 6. Tuberculosis.βBy arrangements with the Essex County Council, the Medical Officer of Health is Tuberculosis Officer for the district. |
4cd87edc-9470-4be9-a9cc-42e8005a2982 | Suspected cases of tuberculosis are referred from routine inspections or from any of the 17 special clinics to the Tuberculosis Dispensary at 37, Linton Road. The Tuberculosis Dispensary is run in close touch with the open-air classes of the Special School, arrangements being made through the Essex County Council for appropriate cases being admitted to hospital or sanatorium. 7. Ringworm Clinic.βAttendance by arrangement at the rooms in Plaistow of the Radiologist, Dr. A. Kennedy. 8. Orthopaedic Clinic.βMassage, electricity, radiant heat, remedial exercises, etc., are provided for cripples and others at the Orthopaedic Clinic of the Special School during six sessions per week, when the masseuse is in attendance. Artificial sunlight treatment now forms part of the treatment of rickets, surgical tuberculosis, and various other debilitating conditions. Advantage is taken of the facilities provided at this clinic by the Public Health Committee for children under school age by arrangement with the Education Committee. |
c8411ff0-9ece-4cfb-b2b4-565bf84028bb | Monthly visits to the clinic are paid by the orthopaedic surgeon for purposes of examining rew cases and those undergoing treatment. When necessary children from the Orthopaedic Clinic are admitted to Brookneld Orthopaedic Hospital, Walthamstow, and Queen's Hospital, Hackney, for operation or other special surgical treatment, facilities also existing for X-ray examination at the latter institution. Payment for Clinic Treatment.βBy instruction of the Board of Education, the following scale of charges has been made:β (a) Spectaclesβ2/9 per pair. (b) Tonsils and Adenoids operationsβ5/- per operation. (c) X-ray TreatmentβNo charge. (d) Minor Ailmentsβ1/- per 3 monttis alter 14 days free treatment. (e) Dentistryβ6d. per extraction, and 1/- fillings or wiring. (f) Orthopaedic TreatmentβNo charge. |
8ad7fa9c-dff2-4b7a-bb24-81458da98394 | 18 Free medical treatment will continue to be given where parents cannot afford to pay. During 1926 payments made in accordance with scale amounts to Β£92 15s. 3d. CLINICS.βThe numbers of school children attending in 1926 were as follows:β Clinic. No. of children seen. Total No of attendances. Minor Ailments 1070 8085 Opthalmic 98 390 Dental 2365 2736 Ringworm 5 5 Orthopedic FOR EXAMINATION 30 1262 FOR TREATMENT 72 Minor Ailments Clinic. No. of days clinic was open 302 Total No. of attendances 8085 Dailv average attendance 26.7 No. of cases treated 1070 In the absence of local hospital facilities, this clinic continues to supply among school children an undoubted need within the district. |
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