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6858783b-8733-4cf6-a014-711aae06f849	I feel sure that an appeal made by the Local Authority would meet with a satisfactory response. (10) PHYSICAL TRAINING. There is no area organiser of physical training. (11) PROVISION OF MEALS. Extra feeding in the form of milk, cocoa, cod liver oil, etc., is supplied to children attending the open-air classes of the Special School throughout the year, while all children at this school receive a hot mid-day meal. 26 Under the provisions of the Meals Act, 1906-14, the feeding of necessitous school children was continued as heretofore at the Municipal Restaurant. Dinners and breakfasts were provided at a cost of 3d. and 2½d each respectively. During the year 25,238 dinners, and 202 breakfasts were supplied to 394 children, suitable cases being selected by the medical officers, school teachers, nurses and attendance officers.
4a4e74d0-b814-48a4-8c6c-5f0fe8bd7ea2	The menus in use are submitted weekly to the medical officer, and I am happy to be able to state that our every suggestion has received the kind attention of the Treasurer, who is in charge of the Municipal Kitchen. (12) SCHOOL BATHS. With the exception of the Special School and Park Modern school, which are provided with spray baths, no baths exist in any of the other schools. In connection with verminous conditions and scabies, baths and disinfestations are provided at the cleansing station. Public swimming baths in East Street, belonging to the Council, are available for children attending the elementary schools on certain weekdays during part of the year, when swimming instruction is given. (13, (14), (15) & (16) CO-OPERATION OF PARENTS, TEACHERS, SCHOOL ATTENDANCE ' OFFICERS, AND VOLUNTARY BODIES.
cc7e2d89-549e-4d2f-94fb-0a5c217ad155	The attendance of parents at the medical inspections throughout the year was 62.7 per cent., compared with 60.7 per cent, in 1926. The teachers take a kindly interest in the work of medical inspections in spite of the interruption entailed, and their help is most valuable, while communication and mutual assistance are constant between the medical staff and the school attendance department. The number of parents actually refusing medical examination during the year was 21, as compared with 29 last year. It would probably be found, if these cases were investigated, that in several, 27 if not most, of them, examination could be undertaken under one or another section of the Act, but the public generally are so wholehearted in support of the School Medical Service it would not be politic to use compulsory powers in a scheme which is largely voluntary.
1e95353f-52f5-4aa9-a05f-3986fbe3a48a	The following is a brief resume of the work done by the Society for the Prevention of Cruelty to Children in the district during the year:- Total number of cases investigated 14 (a) Neglect 10 (b) Ill-treatment 1 (c) Advice, etc. 3 (d) Proceedings instituted — The work of the Society for the Prevention of Cruelty to Children is, as its name implies, essentially preventative, and only in exceptional circumstances, and where all other means have failed, are proceedings instituted. The work of this Society deserves every support by the public. It undertakes work it would be difficult for any public body to carry out, and the way in which the Society discharges its duties commends it. There are no Children's Care Committee, the additional duties which are usually carried out by such voluntary bodies, being carried out as far as possible by appropriate Sub-Committees of the Education Authority. After-care Committees have been formed in connection with all schools.
b83410d4-8ad1-4795-8487-9bcf59fc90fa	(17) BLIND, DEAF, DEFECTIVE AND EPILEPTIC CHILDREN. (a) Children subjects of the above defects are ascertained through routine medical inspection or in more severe cases necessitating school absence through the activities of attendance 28 officers, the information so acquired being passed to the school medical officer, when any subsequent arrangements necessary for the child's disposal are made. Arrangements exist whereby exceptional children may. if necessary, attend non-residential certified schools or classes outside the district, and 7 deaf and dumb children so attended at Frederick Road Centre, Custom House, during the year. The number of blind and deaf children maintained at residential institutions during the year was 2. The number of blind and deaf children in this district is insufficient to justify the provision of special classes for these defects locally. The number of known epileptics of all grades is 13.
c4fbb74b-9114-4067-a733-338c447c59b2	Unless the defect is of quite a minor character (when the child may attend an ordinary elementary school), epileptic children can only be satisfactorily educated in special residential schools or colonies. Where epilepsy is combined with mental defect, the disposal of such cases is difficult, since few institutions throughout the country are prepared to receive them. The question of mentally sub-normal and mentally and physically defective children was considered at length in my predecessor's Report for 1924. During the year, suspected mentally sub-normal and backward children were referred from various elementary schools to a temporary class at the Special School, and subsequently after a few months' observation submitted for more detailed examination by the School Medical Officer. During the year 8 such children came before the School Medical Officer, out of which number, and including those whose period of observation expired during the year, 6 were certified mentally deficient, and arrangements made for their admission to the special class for such children.
a503f87a-a025-4e00-bc44-e5928a76c021	Mentally Defective Children.—9 children were examined as to their mental condition during the year, all of whom were certified educable and arrangements made for their admission to the special class. 29 The number of physically defective children in attendance at the cripple class was 38; 4 cases left the class on attaining the age of 16 years, whilst 14 cases left the class for other reasons. The School Medical Officer examined and certified 5 cases suitable for admission to the cripple class. (b) Ineducable mentally defective children of school age come within the responsibility of the Essex County Council. (c) The question of the after-care of mentally defective children, i.e., after attaining the age of 16 years becomes the statutory duty of the Local Control Authority, and is carried cut by the Essex County Council who arrange for guardianship or institutional care in necessary cases.
8bc24268-81e1-413c-a3ad-424f65c16934	Though no provision had until recently been made for the after-care of blind or deaf children or cripples, an after-care Committee has now been formed for that purpose. (18) NURSERY SCHOOLS. There are no nursery schools in the district. (19) SECONDARY SCHOOLS. The only secondary school in the district is the Abbey School, which comes under the Essex County Council. The arrangement whereby routine inspection at this school was carried out by the School Medical Officer of the district has been discontinued. It seems invidious that many of the children passing from your elementary schools to the secondary school should lose the benefit of your very comprehensive scheme of medical inspection and treatment, and further it appears obvious that unless or until the County are in a position to supply an equally comprehensive scheme, arrangements should be made for this work to be carried out by your Authority. (20) CONTINUATION SCHOOLS. There are no continuation schools in the district.
d370798b-0265-4615-a92b-b791568675e5	30 (21) EMPLOYMENT OF CHILDREN AND YOUNG PERSONS. Milk and newspaper deliveries, general errands, hawking and newspaper selling are the usual forms of employment of children and young persons. In accordance with the Bye-laws of the Education Authority, 5 applicants of school age submitted themselves for examination prior to employment, of which number it was unnecessary to refuse any applicant on medical grounds. Street trading is permissible to boys of 15 years, although licence is refused girls under 16 years, :io prior medical examinations being required of applicants. Certain conditions, however, such as mental defect, prevent street trading being engaged in. (22) SPECIAL ENQUIRIES. No special enquiries were undertaken during the year. (23) MISCELLANEOUS. Two young persons, who desired to become bursars and student teachers, where medically examined during the year by a private medical practitioner, none being rejected on medical grounds.
f3a322d7-696a-4be0-ba8b-ec76faffae67	31 REPORT OF THE ORTHOPÆDIC CLINIC. Orthopaedic Clinic, Faircross School, Barking, Essex. To the School Medical Officer. The Orthopaedic Clinic during this year has shown an increase in every way. Thirty-eight school children and eighteen children under school age were examined by me for the first time during the year, my findings being as follows:- SCHOOL CHILDREN. Deformities—Bones and Joints— (a) Congenital: (i) Congenital dislocation of hip 3 (b) Acquired: (i) Fractures 3 (ii) Derangement—knee joint 1 (iii) Arthritis—hip joint 1 (iv) Genu Valgum 4 (v) T. B.
1d7656ed-0af1-471c-b80a-14fdb6580b99	Spine 1 Muscular Deformities— 13 (а) Congenital: (i) Torticollis 2 (b) Acquired: (i) Pes Piano Valgus 5 (ii) Kyphosis 1 (iii) Scoliosis 1 Paralysis— 9 (d) Congenital (i) Hemiplegia 2 (ii) Diplegia 2 (iii) Spastic Gait 1 (iv) Pseudo-hypertrophic Muscular Paralysis 1 (b) Acquired: (i) Anterior Polio Myelitis 3 9 32 Congenital Abnormalities— (i) Absence of Pectoralis Major 1 (ii) Absence of Clavicle 1 (iii) Morbis Cordis 1 3 Various— (i) Inguinal Hernia 1 (ii) T.B.
7ac7ba6b-c73b-4624-8541-088325b26691	Glands 2 (iii) Alopecia 1 4 Total 38 CHILDREN UNDER SCHOOL AGE. Deformities—Bones and Joints— (a) Congenital: (i) Digit 3 Foot R. and L.
a925dcdf-f2a4-4abc-8727-2f7b78f5a1f3	1 (ii) Webbed Digits 1 (b) Acquired: (i) Rickets 6 (ii) Genu Valgum 1 9 Muscular Deformities— (a) Congenital: (i) Talipes 3 (ii) Amyotonia 1 (b) Acquired: (i) Pes Planus Valgus 1 5 Paralysis— (a) Congenital: (i) Tetraplegia 1 (b) Acquired: (ii) Anterior Polio Myelitis 2 3 Congenital Deformities— (i) Congenital weakness in neck muscles 1 1 Total 18 33 127 school children and 29 children under school age were re-examined by me during the year. The following operations have been carried out:- (i) Torticollis 2 (ii) Sprengel's Shoulder 1 (iii) Tarsectomy, etc.
13798f93-52a6-43cb-b31c-b549be20c761	1 (iv) Tenotomy—Tendo Achillis 2 (v) Tenotomy of Adductors 1 (vi) Left Inguinal Hernia 1 Total 8 The successful results of the operations, particularly the cases of Torticollis, and the early treatment of Congenital Talipes in infants have been the special features of the work during 1927. B. WHITCHURCH HOWELL, F.R.C.S. 34 REPORT OF DENTAL SURGEON. To the School Medical Officer. I have pleasure in hereunder presenting you with a report of the Dental Department of the Municipal Clinic for the period during the last year in which the position of Dental Surgeon to the Council has been filled by me. Routine of Work. It is with gratification that it can be stated that, not alone, has the work gone smoothly, but also that the time for treatment has been used to the utmost extent.
652815a2-1fbe-4493-bb66-1bbb1c106db0	Occasions have occurred where treatment has been accepted, yet appointments for such treatment have not been kept. To obviate loss of working time in this respect these conditions are now being considered with a view to formulating some scheme whereby the department will still be able to be fully busy when such circumstances occur in the future. The department is working with a view to completing the circuit of school treatment in the shortest time and it is hoped, if it be possible, to thereby have the routine circuits of treatment more frequently. This objective remains, however, to be governed by the amount of work found to be undertaken, and the consents of the parents to have it done. Number of cases selected at Inspections for Treatment. When studying the statistics, a large percentage of this class would at first sight be apt to convey the impression that the oral hygiene due to the teeth must be classified as bad.
fef1dfb5-7bf2-4d00-98a0-efafb00965c4	It should be pointed out, however, that in the best attended dentition decay may occur and unfortunately invariably does, in the course of the year, but though it does, this does not necessarily place the mouth in the class of bad hygienic condition, for the dentition, apart from requiring one filling or two, may be otherwise perfect. Yet such cases go to making the percentages high. On an average the oral hygiene due to the teeth, in the inspections made, has appeared to be very good. In cases where it has not been quite as satisfactory 35 as could be expected, the cases have generally been those where treatment has not been accepted before, or where treatment was not accepted when last inspected. Filling of Deciduous Teeth. By reason of the contrast in the numbers so treated now as compared with the treatment prior to my appointment it seems imperative that some comment be made.
91af48fe-dbb1-4e3d-80ca-b3ce06bb0e0a	This treatment is actuated by the fact of the great importance that the retention of the deciduous teeth are to be the position which the permanent teeth come to ultimately occupy, and is in addition to the importance of the masticatory machinery so necessary to the growing child. Though filling of the deciduous teeth is a process somewhat longer than that of extraction it is at the same time considerably shorter than the filling of a permanent tooth. If the point of time therefore is alone to be considered, this process seems to be most fully justified. Co-operation with the Schools. An effort is now in being whereby appointments are made to minimise as far as possible the loss of school time to the child in attending for dental treatment. Parents or Guardians attending Clinic with Children for Treatment. Every effort is made to stimulate interest in the importance of the care of the teeth. The seeking of information and advice from the department is at all times strongly encouraged and the reasons for the various treatments readily and fully explained. Nature of Treatment to be done.
7f6af272-45d4-47a9-9222-9d78a6be9b4b	At the present time in appointments being made a distinction is made between "cases of extractions under gas" and "cases of fillings and extraction under local anaesthetic." It does unfortunately very much depend upon what the condition is found within the tooth in preparing it for filling before it can definitely be stated whether the tooth is saveable or not. Exceptions to this are, of course, teeth which are in a condition for which it is obvious extraction is the only treatment. On every occasion where any form of treatment is particularly objected to at the Clinic, the full reasons for such treatment having been intended is made clear. 36 At the same time too if there is any special objection by the parent, conformity is made with their wishes so far as it is possible to the work.
eb09aabe-f74c-4902-a18f-4d90b20a15e5	It should also be stated that a nurse, well informed in the general clinic routine and treatment, visits all the parents from whom refusals for treatment are received, and endeavours to remove the cause of objection and to obtain consent, explaining at the same time that the dental surgeon at all times is ready to discuss and advise. Kindness and courtesy, it is hoped, does in some measure alleviate the dread of attendance. H. S. SMYTH, L.D.S., R.C.S. (Eng.), Dental Surgeon. 37 BARKING TOWN URBAN DISTRICT COUNCIL. SCHOOL MEDICAL SERVICE. TABLE 1.—RETURN OF MEDICAL INSPECTIONS. A.—Routine Medical Inspections. Number of Code Group Inspections: Entrants 918 Intermediates 483 Leavers 566 Total 1967 Number of other Routine Inspections 193 B.—Other Inspections.
dc71b845-1cae-4754-8dc3-0196275d211e	Number of Special Inspections 89 Number of Re-inspections 1574 Total 1663 38 TABLE II.—A. RETURN OF DEFECTS FOUND BY MEDICAL INSPECTION IN THE YEAR ENDED 31st DECEMBER, 1927. Defect or Disease. Routine Inspections. Special Inspections. No. of Defects. No. of Defects. Requiring Treatment. 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 12 13 2 - Uncleanliness — — - - Skin Ringworm—Scalp 1 — - - Body 2 - - - Scabies 8 — - - Impetigo 3 — 2 - Other Diseases (NonTuberculous) 6 - 6 - Eye Blepheritis
905e9dfe-93f8-4cf5-b2e9-f6dd92e1952b	8 — 3 - Conjunctivitis 1 — 1 - Keratitis - — — - Corneal Opacities — — — - Defective Vision (excluding Squint) 66 10 26 3 Squint 7 1 1 - Other Conditions 4 2 2 - Ear Defective Hearing 1 — 2 - Otitis Media 9 - 2 - Other Ear Disease 6 1 3 — Nose and Throat Enlarged Tonsils only 17 35 1 — Adenoids only 7 8 2 — Enlarged Tonsils and Adenoids 107 164 2 - Other Conditions 6 20 3 1 Enlarged Cervical Glands (NonT.B.) - 24 - 1 Defective Speech — — 1 2 Teeth—Dental Diseases (See Table IV., Group IV.) Heart and Circulation.
39668f5c-e3b8-417c-83e5-f8ed8ab32484	Heart Disease : Organic - 23 - 1 Functional — 29 — — Anæmia 5 11 4 — Lungs Bronchitis 16 29 2 — Other Non-Tuberculous Diseases 3 4 1 — 39 TABLE II.—Continued. Defect or Disease. Routine Inspections. Special Inspections No. of Defects. No. of Defects. Requiring Treatment Requiring to be kept under observation, but not requiring Treatment Requiring Treatment. Requiring to be kept under observation, but not requiring Treatment.
f9bb55cf-251d-4e8a-81e8-5ef4a01ca051	(1) (2) (3) (4) (5) Tuberculosis Pulmonary: Definite - - — — Suspected - 16 — — Non-Pulmonary: Glands 5 13 — — Spine — - - — Hip - - - — Other Bones and Joints - 1 - - Skin — — - — Other Forms — — — — Nervous System Epilepsy - — 1 — Chorea — 3 1 — Other Conditions 2 - 1 — Deformities Rickets - - — — Spinal 1 -\| — — Other Forms 11 8 1 1 Other Defects and Diseases 14 33 5 2 40 B.—Number of Individual Children FOUND AT Routinf MEDICAL INSPECTION TO REQUIRE TREATMENT (EXCLUDING UNCLEANLINESS AND DENTAL DISEASES). Group. Number of Children. Percentage of Children found to require treatment. Inspected.
84ededaf-8277-4e53-921b-f30182ff9002	Found to require treatment CODE GROUPS : Entrants 918 149 16.23 Intermediates 483 69 14.28 Leavers 566 85 15.01 Total (Code Groups) 1,967 303 15.4 Other Routine Inspections 193 8 4.1 41 TABLE III.—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 - - - Attending Public Elementary Schools - - - At other Institutions - — — At no School or Institution - — — (II.) Suitable for training in a School or Class for the partially blind.
a0371bd1-1cad-4d28-993d-a825e2948bf3	Attending Certified Schools or Classes for the Blind Attending Public Elementary Schools - 1 1 At other Institutions — - — At no School or Institution — - — Deaf (including deaf and dumb 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 3 5 8 Attending Public Elementary Schools - - - At other Institutions - — — At no School or Institution - - - (II.) Suitable for training in a School or Class for partially deaf. Attending Certified Schools or Classes for the Deaf - - - Attending Public Elementary Schools - - - At other Institutions — — — At no School or Institution — — — Mentally Defective Feeble Minded cases not notifiable to the Local Control Authority.
3cc4a859-19b0-4e1d-9987-50e2eea61540	Attending Certified Schools for Mentally Defective Children 23 23 46 Attending Public Elementary Schools - - - At other Institutions __ - — At no School or Institution — — — Notified to the Local Control Authority during the year. Feeble minded - - - Imbeciles — 1 1 Idiots - - - Epilepsy. Suffering from severe Epilepsy. Attending Certified Special Schools for Epileptics - 2 2 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 5 5 10 At no School or Institution — - — 42 TABLE III.—continued. Boys. Girls. Total. Physically Defective. Infectious pulmonary and glandular Tuberculosis.
7309421b-bfae-49a7-8820-b04a6d1d3ba2	At Sanatoria or Sanatorium Schools approved by the Ministry of Health or the Board 2 1 3 At other Institutions — — — At no School or Institution —— —— — Non-infectious, 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 - - Delicate children (e.g., pre- or latent tuberculosis. ' malnutrition debility, anaemia, etc.) At Certified Residential Open Air Schools - - - At Certified Day Open Air Schools 62 63 125 At Public Elementary Schools 6 5 11 At other Institutions — - — At no School or Institution - - —— Active non-pulMonary tuberculosis.
76dc2b35-bba6-4b5f-9c13-26d360ffc156	At Sanatoria or Hospital Schools approved by the Ministry of Health or the Board 2 2 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 including those with severe heart disease. At Certified Hospital Schools - - - At Certified Residential Cripple Schools - - - At Certified Day Cripple Schools 24 14 38 At Public Elementary Schools — - — At other Institutions — - — At no School or Institution - 1 1 43 TABLE IV.—TREATMENT TABLE. Group I.—Minor Ailments (excluding Uncleanliness, for which see Group V.). Disease or Defect. Number of Defects treated, or under treatment during the year. Under the Authority's Scheme. Otherwise. Total.
b03ed4f6-4588-495e-ad59-a95f8ac7441c	Skin:— Ringworm—Scalp 9 - 9 Body 25 - 25 Scabies 23 2 25 Impetigo 290 1 291 Other Skin Diseases 135 1 136 Minor Eye Defects 120 6 126 (External and other, but excluding cases falling in Group II.) Minor Ear Defects 125 18 143 Miscellaneous 330 1 331 (e.g., minor injuries, bruises, sores, chilblains, etc.). Total 1,057 29 1,086 44 Group II.—Defective Vision and Squint (excluding Minor. Eye Defects Treated as Minor Ailments—Group I.) Defect or Disease. Under Authority's Scheme. Number of defects dealt with. Submitted to refraction by private practitioner or at hospital apart from the Authority's Scheme. Otherwise Total.
bd667527-4bc3-4023-9eea-accb97470fca	(1) (2) (3) (4) (5) Errors of Refraction (including Squint) 137 35 172 Other Defects or Diseasesof the eyes (excluding those recorded in Group I.) — — Total 137" 35 ' 172 Total number of children for whom spectacles were scribed:— (a) Under the Authority's Scheme 126 (b) Otherwise 35 Total number of children who obtained or received spec tacles:— (a) Under the Authority's Scheme 126 (b) Otherwise 35 Group III.—Treatment of Defects of Nose and Throat. NUMBER OF DEFECTS. Received Operative Treatment. Received other forms of treatment. Total number treated. Under the Authority's Scheme, in Clinic or Hospital. By Private Practitioner or Hospital, apart from the Authority's Scheme. Total.
30e8941e-2fb3-452c-b187-67a4e307fe87	(1) (2) (3) (4) (5) 239 48 287 15 302 45 GROUP IV.—Dental Defects. (I) Number of Children who were:— (a) Inspected by the Dentist.
74603904-415b-4af4-94a0-d8ee9391ecfe	Routine Age Groups— Age 3 - 4 20 5 621 6 866 7 761 8 470 9 464 10 506 11 599 12 593 13 492 14 116 15 7 Total 5515 (b) Found to require treatment 3092 (c) Actually treated 2193 (2) Half-days devoted to Inspection 44 Treatment 347 Total 391 (3) Attendances made by children for Treatment 2377 (4) Fillings—Permanent Teeth 743 Temporary Teeth 150 Total 893 (5) Extractions—Permanent Teeth 311 Temporary Teeth 3562 Total 3873 (6) Administrations of General Anaesthetics for Extractions 497 (7) Other Operations—Permanent Teeth 136 Temporary Teeth 46 GROUP V.—Uncleanliness and Verminous Conditions.
b09ee07d-e79d-41f5-bd67-525a7d36a2a2	(i) Average number of visits per school made during the year by the School Nurse 3 (ii) Total number of examinations of children in the schools by School Nurses 18367 (iii) Number of individual children found unclean 2081 (iv) Number of children cleansed under arrangements made by the Local Education Authority 184 (v) Number of cases in which-legal proceedings were taken:— (a) Under the Education Act, 1921 - (b) Under School Attendance Bye-laws 4
e3de63c6-1654-403d-b19f-76bed0b3fcef	BARK 22 Barking Town Urban District Council. REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1928. C. LEONARD WILLIAMS, B.Sc. Hons. (Lond.) M.R.C.S. (Eng.), D.P.H. (Camb.) 75150 BARK 22 3 TABLE OF CONTENTS SECTION 1—GENERAL. page Staff 5 Statistical Summary 12 Comparative Statistical Table 13 Table of Vital Statistics from 1922 to 1928 14 Summary of Nursing Arrangements 17 Clinic and Treatment Centres 19-20 Ambulance Facilities 21 Laboratory Work 22 Local Bye-Laws, Regulations and Adoptive Acts 23 Deaths 24 Inquests 25 Causes of Death (Table) 26 Causes of Death at Various Ages under 1 year 27 Marriages 28 Births 28 SECTION 2—SANITARY CIRCUMSTANCES OF THE DISTRICT.
dc5d3533-27aa-4e42-81ac-678663bf18c6	Water Supply 29 Rivers and Streams 29 Rainfall 30 Sewerage 30 Scavenging 31 Housing Statistics 31 Sanitary Inspection of the Area 34 Summary of Sanitary Work carried out 35 Notices Served 37 Smoke Abatement 37 Offensive Trades 39 Common Lodging Houses 39 Stables 39 Tents, Vans, Sheds, etc. 39 Piggeries 39 Houses Let in Lodgings 39 Inspection and Supervision of Food:— (a) Milk 40 (b) Meat 41 (c) Unsound Food 42 4 SECTION 2—Continued. page Sale of Food and Drugs Act 42 Schools 42 Factories, Workshops, Workplaces, etc. 43 Improvement of Existing Housing Conditions 46 Overcrowding 47 SECTION 3—NOTIFIABLE INFECTIOUS DISEASES.
e8518314-14da-4f79-a26a-3802bb572cc0	Table of Cases of Infectious Diseases notified and removed to Hospital 49 Cases Classified According to Age Groups and Wards 51-52 Monthly Summary of Receipt of Notifications 53 Scarlet Fever 53 Smallpox and Vaccination 53 Diphtheria 55 Puerperal Fever 55 Acute Primary and Acute Influenzal Pneumonia 56 Pneumonia Supervening upon Measles 56 Non-notifiable Diseases 56 Table of Admissions and Discharges from Hospital 56 Tuberculosis 56 Tuberculosis After-care 60 Asbestosis 60 SECTION 4—MATERNITY AND CHILD WELFARE.
c54e78a4-f0d4-4154-8403-749bc1e553f7	Notification of Births Acts, 1907-1915 61 Ante-Natal Clinic 62 Post-Natal Cases 62 Maternity Ward 63 Puerperal Fever and Puerperal Pyrexia 64 Maternal Mortality 65 Neonatal Mortality 65 Still Births 65 Ophthalmia Neonatorum 66 Work of Health Visitors and Infant Welfare Centres 67 The Pre-School Child 68 Foster Children 68 Infantile Mortality 68 Dental Clinic 68 Orthopaedic Clinic 69 Artificial Sunlight Clinic 70 Provision of Meals and Fresh and Dried Milk 71 5 STAFF, 1928. Medical Officer of Health, School Medical Officer, Medical Superintendent, Isolation Hospital, and District Tuberculosis Officer. *C LEONARD WILLIAMS, B Sc. Hons. (Lond.) M.R.C.S. (Eng.) D P.H. (Carnbs.) Asst. Medical Officer of Health and Asst.
0aa1a9b1-3225-4082-acb3-b087147868ab	School Medical Officer: MURIEL J. LOUGH, M.B., B.S., B.Sc., M.R.C.S., L.R.C.P., D.P.H. Orthopaedic Surgeon (Part Time): B. WHITCHURCH HOWELL, M B., B.S., F.R.C.S. School Dentist: H. S. SMYTH, 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). H. CARR (Sanitary Inspector (b, c and e). Health Visitors: MRS. G. STOKES (g). MRS. M. W. WALTON (a. h, and 1). *MISS G. ELLIOTT (a, h and 1).
44cb20c3-1e70-477b-9c59-560ef85ce4b2	Matron, Isolation Hospital: MISS M. J. HEDGCOCK (h, i and j). Masseuse, Orthopaedic Clinic (Part Time): *MISS A. E. FINDLAY, C.S.M.M.G. (k). Clerical Staff. E. W. HILL (Chief Clerk) (Commenced June, 1928). E. W. WINCHESTER (Chief Clerk) (Resigned May, 1928). D. G. TONKIN. MISS V. SHEAD. MISS H. NUNN MISS H. KING. Disinfector and Mortuary Attendant: H. LONG. (a) Sanitary 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.
7a62f605-359a-402e-95ca-ba5f1a6b402b	(e) Building Inspector's certificate of Worshipful Company of Carpenters. (f) Sanitary Science Certificate of Royal Sanitary Institute. (g) Health Visitor's certificate of Royal Sanitary Institute. (h) Certificate of Central Midwives' Board. (i) General Hospital Training. (j) General Fever Training. (k) Certificate M.E. and S.R.E. (l) Health Visitor's Diploma of Board of Education. *Proportion of salary contributed under Public Health Acts or by Exchequer grants. 7 ANNUAL REPORT OF THE Medical Officer of Health for the Urban District of Barking Town, in the County of Essex, for the Year ended 31st December, 1928. Public Health Offices, Barking, Essex. To the Chairman and Members of the Urban District Council of Barking Town. Mr. Chairman, Mrs.
c59fe615-153d-47c4-8e52-9cb060e6072b	Jackson and Gentlemen, Herewith I beg to submit for your favourable consideration the annual report on the Public Health Services for the year ending 31st December, 1928. Although last year I was responsible for and signed a report for the year ending 31st December, 1927, this is really my first annual report to you, because, having only joined your Services in September, 1927, I was last year only able to speak personally of a small portion of the year then under review. The first year in the important office to which you elected me has of necessity been spent largely in stock-taking and enquiry, and, equally of necessity, this stock-taking and enquiry has been somewhat of the nature of an inspection. It will, I feel sure, be interesting and gratifying to you to hear the very favourable opinion I have formed of your Public Health Services.
841ca2d0-760f-417b-8a12-94a1521b9e85	8 There can be but few Councils in England with resources comparable to your own who have made provision for carrying on Public Health Services in the same way and to the same extent as you have done, and I am happy in my belief that you yourselves recognise this good work you have already accomplished is essentially the foundation of good work which still remains to be carried out. The Clinics you have established for Maternity and Child Welfare, Dentistry, Ante-Natal Supervision, Ultra Violet Light Treatment, etc., all show promise of an increasing reward in health and contentment. This work throughout the whole of the country is even yet in a pioneer phase, and one of the greatest lessons we are learning is the vast amount of work which still remains to be done. With particular reference to Barking, it may be said that, even without any increase of population, an extension of these Services would be desirable; with the increase in population which is taking place and which is likely to take place, this extension is inevitable.
2d46be45-ba0b-42fa-b74b-6c50138df899	If criticism can indeed be offered to these Services, it is only such as can be given to all such progressive Services. These Services grow from small beginnings, and from different beginnings. There is, therefore, at first, during the growing stage, of necessity a certain uncouthness about them and a certain lack of co-ordination between them. It will be my endeavour to advise you how to train your adolescent Services so that they may retain the present vigour of their youth and yet fit, as it were, into a united family life in which each part promotes the welfare of the whole. This task requires time, not only the months and years necessary to accomplish so desirable an end, but also time for personal administrative work to achieve this end. During the year under review I personally have not had the time and opportunity I could have wished to devote to this object. 9 Daring the year much has been done with regard to your proposals for rebuilding and extending your present hospital accommodation for infectious fevers and for maternity cases.
44360556-2312-4e4c-93bd-df8f0c204820	The year 1928 has been a heavy one from the standpoint of infectious diseases, and the accommodation at present available has been strained to the uttermost. The situation has been met generally by cutting down the period of isolation in individual cases to the minimum, and on one occasion by opening an auxiliary infectious fever hospital at Creeksmouth. In my opinion it is better to cut down the period of isolation in scarlet fever than so to overcrowd infectious fever wards that complications are likely to arise, the which they are wont to do under overcrowded conditions. The danger to the community by cutting away the factor of safety by curtailing the period of isolation is less than the personal danger to the patients of possibly developing complications in overcrowded wards. Special mention must be made of the auxiliary hospital at Creeksmouth. The Chairman of the Health Committee, Councillor Mr. A. Edwards, authorised opening up Creeksmouth School for this purpose late one afternoon. Patients were admitted early the next evening.
be081ab0-5c30-41b0-9fd4-355e6b638c06	This was not just a stunt of the Public Health Department. It represented the united efforts of every department of the Council and is a very fine testimony of the team spirit I am so happy to meet in Barking. In all my recommendations to you I have not so much the present needs of Barking before me as the needs of Barking a few years hence, when without question or doubt the population will have doubled itself, and I do urge you very seriously to take time by the forelock, to build the necessary clinics and office 10 accommodation and to make all the necessary foundations for the provision of staff before this, which is almost a threatened invasion, actually takes place. During the year there has been a lot of substantial work done in committee with reference to the drainage of the town as a whole.
9421262f-9800-472e-a1c2-1e0510cde87c	There have been numerous conferences with Ilford and with Dagenham and with other authorities, and it seems that at last— what Barking urged so many years ago—we shall have a system whereby the greater part of the town drains into the Northern Outfall Works. The London County Council will no doubt proceed almost immediately with the erection of houses adjoining those they have already built within the district of Dagenham, the drainage from which no doubt will be dealt with by arrangement, together with that from the houses on the Becontree Estate already erected. Considerable work too has been done in committee with reference to the provision of further and more up-to-date hospital accommodation for infectious diseases. I am strongly of opinion that every Local Authority should be, as far as possible, autonomous, and that each Local Authority should provide for the isolation of its own infectious diseases unless the Local Authority is so small as to make it a particular economic disadvantage to do so.
7435f4a9-11e4-4090-a4ea-8db0bfd699eb	With Barking a town of about 40,000 population I am of opinion that we can economically undertake our own obligations. You have further had under consideration the provision of more suitable and hygienic vehicles for the collection of refuse, and this work will be undertaken in the New Year under much more advantageous circumstances than have obtained hitherto. Altogether the year has been one of steady progress and I sincerely trust that in the year that is coming we shall show an 11 equally creditable record of achievement, and at the same time lay a substantial foundation on which to build the extensions in public services which must take place in the immediate future. It can only be with regret that Mr. Wood terminated his services to the Corporation on December 31, 1928, retiring on superannuation. As an officer of the Health Department he had served for 31 years.
f6d59e43-10f5-4758-af01-9008919af902	His services, I know, have been appreciated and he takes into retirement the well wishes of the Council and his colleagues in the Public Health Department and no less I feel confident that of his colleagues in the whole of the Corporation services. Mr. E. Winchester, too, resigned his post as chief clerk to take up another appointment elsewhere, and these positions have been filled. I am, Mr. Chairman, Mrs. Jackson and Gentlemen, Your obedient servant, C. LEONARD WILLIAMS, Medical Officer of Health. 12 SUMMARY OF PARTICULARS REQUIRED BY CIRCULAR 834 OF THE MINISTRY OF HEALTH, DATED I5th DECEMBER, 1927. 1. General Statistics. Area (acres) 4,106 Ward areas 3,806 Tidal Water H.W.M.
ecd94ca9-f807-481a-95d6-1b3ae2ddaa61	Thames 240 Roding 58 Loxford Water 2 300 4,106 Population (Census, 1921) 35,523 Population (June, 1928) (Registrar General's estimate) 40,870 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 9.9 Rateable Value—Houses. Buildings, etc. £305,493 0 0 Lands £2,738 0 0 Sum represented by a penny rate £1,178 0 0 Education rates:— Elementary 3 1 Secondary 6¼ Assessable Value £280,851 0 0 General District Rate 7 0 Poor Rate 9 2 2. Extracts from Vital Statistics for the Year. Births:— Males. Females. Total. Birth Rate.
2a13db86-1b83-4b40-a893-902c526a6407	Legitimate 409 376 785 19.2 Illegitimate 11 9 20 0.48 Total 420 385 805 19.7 Deaths:— Male. Female. Total. Death Rate. Standard Death Rate (Factor 1.049) 230 184 414 10.1 10.5 Number of deaths of women during, or in consequence of, childbirth:— From Sepsis. From other causes. Total. 0 2 2 Number of deaths of infants under one year of age :— Males. Females. Totai. Totai Infantile Death Rate. Death Rate.
7d2e8353-2e6e-49c9-a4fa-12915f735e90	Legitimate 20 25 45 57.3 63.3 Illegitimate 3 3 6 300.0 Number of deaths from Measles (all ages) 13 „ Whooping Cough (all ages) 6 „ Diarrhoea (under 2 years of age) 6 THE YEAR. Birth Rate per 1,000 Total Population. Annual Death Rate. per 1,000 Population. Rate per 1,000 Births. Percentage of Total Deaths. All Causes. Enteric Fever. Small Pox Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence. Diarrhoea and Enteritis (under Two years). Total Deaths under One year. Causes of Deaths Certified by Registered Medical Practitioners Inquest Cases. Certified by Coroner after P.M. No Inquest. Uncertified Causes j of Death.
ce7fb0f9-e6c5-4c5c-9d23-af66fd7ad442	England and Wales 16.7 11.7 0.01 0.00 0.11 0.01 0.07 0.06 0.19 0.53 7.0 65 90.9 6.7 1.4 1.0 107 County Boroughs and Great Towns including London 16.7 11.6 0.01 0.00 0.15 0.02 0.09 0.09 0.17 0.48 9.6 70 91.0 6.5 1.9 0.6 155 Smaller Towns (1921 Adjusted Populations 20,00050,000) 16.6 10.6 0.01 0.00 0.08 0.01 0.06 0.08 0.21 0.41 4.8 60 92.6 5.7 0.
633fc859-6ce2-4b56-be43-d28029fef116	5 1.2 London 15.9 11.6 0.01 0.00 0.30 0.02 0.09 0.09 0.13 0.55 10.2 67 88.7 7.6 3.7 0.0 BARKING 19.7 10.1 0.00 0.00 0.31 0.00 0.14 0.00 0.17 0.44 7.4 63 87.4 10.1 0.72 0.0 VITAL STATISTICS OF WHOLE DISTRICT FROM 1922 to 1928 Year. Population estimated to Middle of each Year. Births. Total Deaths Registered 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.
d6799986-7116-4c47-a97e-005d83a47496	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 ' 8 9 10 11 12 1922 36,680 882 24.0 308 8.1 - 56 49 55.5 364 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 7.4 107 66 80.0 386 10.0 1926 38,920 818 21.0 259 6.
21fe65f8-cb5a-46f2-8c54-787a93b49bb5	6 11 118 49 59.9 366 9.4 1927 39,900 710 17.7 251 6.2 7 162 47 66.1 406 10.1 1928 40,870 805 19.7 276 6.7 6 144 51 63.3 414 10.1 * Registrar General's Figures 15 5. CAUSES OF SICKNESS. Amongst things prejudicial to health must be counted the condition of the Underground Railway to Barking. The fatigue of strap-hanging from the City after a day's work is not inconsiderable. That this has to be accomplished in a fetid atmosphere adds to its difficulties and dangers and certainly tends to undermine the vitality of the poor travellers.
8b095892-b54e-49d5-8ff5-aaace358db8a	Under these conditions, to jostle cheek by jowl with all sorts of conditions and persons is to invite infection, and it may safely be assumed that our dormitory population bring down with them every infection prevalent in the City and the East End. During the year, my work at the Chest Clinic in Linton Road has drawn my attention to a particular disease, which, whilst resembling consumption in many ways, is not due, I feel sure, to the germ of tuberculosis (i.e., consumption). As Medical Officer of Health, the possible association of this disease with industrial life has had my attention, and certain steps have been taken in the matter. I am hopeful that our experience in Barking when correlated with that in other similar towns may help to clear up the somewhat difficult and serious problem. A careful enquiry was held into the origin of an outbreak of scarlet fever at Creeksmouth.
b1c71f06-abcc-4971-8778-211578f5f738	It appears that there must have been one or two minor undetected cases which occurred some little time before the outbreak and which were discovered during the outbreak in the later stages of the disease. It appears also that the explosion, if I may so term this outbreak, was due to food poisoning, although there were a few cases no doubt directly due to the undetected cases of scarlet fever and not due to such food poisoning. 16 I am happy to be able to put on record that we had no difficulty whatsoever in dealing with the food aspect of the outbreak and this no doubt materially helped in preventing any further spread of the epidemic. Diphtheria and scarlet fever have been prevalent more or less throughout the whole of the year, and these cases, together with those which occurred during the special outbreak, have made what is perhaps a record year for infectious fevers in Barking.
1fdd7e92-f41b-472f-9f0d-5e0f9cf0b760	These disastrous years come in cycles, and I am happy to be able to say I hopefully expect that the next few years will show a very considerable decline in the incidence of infectious disease. May I once again take an opportunity of pointing out that ultimately the control of infectious disease is in the hands of the public themselves. Scarlet feVer, diphtheria and kindred complaints are not so much spread by the bad cases, which are immediately detected and isolated, as they are spread by the mild cases, so mild that medical attention is not even procured. These cases are nursed for a minor illness at home, the nature of which is sometimes guessed but oftentimes not known, and they give rise to the disease in others, oftentimes of a severe type. 17 6. SUMMARY (FOR REFERENCE) OF NURSING ARRANGE MENTS, HOSPITALS, AND OTHER INSTITUTIONS AVAILABLE FOR THE DISTRICT. (a) Nursing in the Home.
6f11c38e-d6d5-41d7-9d5f-f6461daf68e3	(i) The Plaistow Maternity Charity provide a staff of nurses, who attend at the homes of the sick once or twice a day, carry out 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. This course of action has been taken in some areas with special reference to scarlet fever, but it will be, I believe, a long time before such action becomes general.
91df9eb5-5efb-4969-a97f-2cf0034a423a	It has been stated that ailments such as scarlet fever and measles, to which so much attention has been given, have received the attention they have more because of the rash with which they are accompanied than because of their intrinsic powers of disablement, and certainly it must be said that other infectious diseases, such as rheumatic affections of the throat, are equally important by reason of the complications which are involved and are equally deserving of isolation and of special hospital treatment. It seems to me, therefore, fairly evident that, whilst there may be a re-distribution of the classes of cases which are to be isolated in the future, the actual need for such hospital beds is likely to increase rather than diminish. 18 (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.
45f77547-e6ed-4061-bdc1-7c463305532b	The takings of the Charity for the year ending 31st December, 1928, amounted to £228, leaving a balance due to the charity from the Council of £72, such sum ranking for grant. (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. Accommodation for consultations, weighing of babies, waiting room, etc. Local Authority. Greatfields Centre, Movers Lane. „ ,, „ ,, Alexandra Centre St. Pauls Road „ ,, „ ,, (b) Ante-natal clinic Clinic premises. East Street. Accommodation for consultations. „ ,, (c) School Nurseries Nil. Nil. Nil. (d) Day Nurseries Nil. Nil. Nil. II.
31b24e59-d0f0-4f5a-b0b5-5d45bda76d93	School Medical Service:— (a) Inspection Clinic and treatment of minor ailments Clinic premises, East Street. Three rooms. Local Authority. (b) Eve Clinic „ ,, One room. „ ,, (c) Dental Clinic „ ,, Two rooms. „ ,, (d) Crthopædic Clinic Faircross School. One room. „ ,, III. Tuberculosis 37, Linton Road. Three rooms. Essex County Council. IV. Venereal Diseases London Hospitals, etc. — By arrangement with Essex County Council. 21 (d) Hospitals provided or subsidised by the Local Authority: (i) Smallpox.—By arrangement with West Ham, sporadic cases of smallpox are treated at Orsett Smallpox Hospital, whilst in the event of an epidemic, cases would be sent to Dagenham Smallpox Hospital, which is now used by West Ham as a Sanatorium and which can be vacated at short notice.
8211eb31-29c3-43e7-87aa-d9df34cc0512	Orsett Smallpox Hospital is situated at Stifford in the Orsett Rural District, and has accommodation for twenty-two patients. Before leaving this question of smallpox I cannot help contrasting the work expended in this direction with the services we have available for other commoner diseases, which certainly, so far as our present circumstances are concerned, are even more important. It is such diseases as scarlet fever and diphtheria which arc not only causing a drain on public resources but are causing a considerable amount of invalidity and permanent disability. If a commensurate amount of time were spent on these diseases you would require a very extended service. (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. Twelve additional beds are available for maternity cases in a separate portion of the hospital buildings.
a59afa14-5054-4c8f-a7c2-6e69761337cc	(e) Ambulance Facilities:— (i) 'A motor 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 ambulance and fire services being run. in conjunction under the Chief Fire Officer. 22 7. LABORATORY 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 1,708 Sputa 364 Typhoid 22 Ringworm 22 Miscellaneous 6 8. List of Adoptive Acts, Bye-laws, and Local Regulations relating to Public Health in force within the district.
2c4db6fc-a4d3-4229-9605-88e9cae58c11	(i) Local Acts: Barking Town Wharf Act, 1893, Barking Parish Act, 1888. (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 Wash-houses 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.
e7d63b70-fd79-447f-bb5f-14fa95f04889	23 (iv) Bye-laws with respect to : Nuisances, 1884. Common Lodging Houses, 1884. Offensive Trades, 1907 (revised 1924). Houses let in lodgings, or occupied by members of more than one family, 1924. 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).
801bebac-922e-43a1-babe-1fe7d6774965	(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 offensive condition, blood drier, tanner, leather dresser, fat melter or fat extractor, glue maker, size maker, gut scraper, and oil boiler to be offensive trades, the last being so declared in 1925. 24 9. DEATHS. There were 274 deaths registered in Barking in 1928. Of these 4 were deaths of non-residents. Barking residents to the number of 144 died elsewhere during the year. Including the latter and excluding the deaths of visitors, the net number of deaths were as follows:— Males.
28bc7179-fca0-4944-a7d0-316691fe5ed1	Females Total 230 184 414 The death rate for 1928 was 10.1 per 1,000, compared with 10.1 in 1927, calculated on the Registrar-General's estimated population and number of deaths, compared with 11.7 for England and Wales, 11.6 for the hundred and seven Great Towns, 10.6 for the hundred and fifty-six Smaller Towns, and 11.6 for London. Sex Mortality.—The 414 deaths of 1928 were divided as follows: 230 males. 184 females. Age Mortality.—The deaths in various age groups, according to the figures obtained locally, were as follows:— Age Group. No. of Deaths.
cb8f955f-f296-4ab8-bd6a-c974706cab17	Under 1 year 51 1 to 2 years 15 2 to 5 years 9 5 to 15 years 14 15 to 25 years 31 25 to 45 years 52 45 to 65 years 112 Over 65 years 130 25 Causes of death in 1928.—The table on page 26 shows the principal causes of death at various ages. Those diseases, etc., causing most deaths or important from a Public Health aspect were as follows:— Disease. No. of Deaths. Percentage of total net deaths registered.
a959ae52-9b33-4855-abeb-efa55b113755	Cardio vascular system 94 22.7 Cancer 45 10.8 Tuberculosis (all forms) 48 11.6 Pulmonary affections, (exclusive of tuberculosis), viz., Bronchitis 16 3.8 Pneumonia 23 5.5 Other respiratory disease 4 0.9 Zymotic Diseases 25 6.0 Deaths from Zymotic Diseases.—These diseases caused 6.0 per cent, of the total deaths, such deaths being caused in the following proportions:— Enteric Fever — Measles 3.1 Whooping Cough 1.4 Scarlet Fever — Diphtheria — Diarrhoea 1.4 Smallpox — INQUESTS.—Coroner's inquests were held on 42 deaths. 26 CAUSES OF AND AGES OF DEATH DURING YEAR, 1928. (Nett Deaths.) Causes of Death. Deaths at the subjoined ages of "Residents " whether occurring in or beyond the district.
d1c26fa6-6763-4234-9927-687a933e3221	Under one year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Total Encephalitis Lethargica — — — — — — — — Influenza — 1 — — — 2 4 7 Scarlet Fever — — — — — — — — Small Pox — — — — — — — — Measles 3 8 2 — — — — 13 Whooping Cough 2 4 — — — — — 6 Epidemic Influenza — — — — — — — — Diarrhoea and Enteritis (under 2) 5 1 — — — — — 6 Diphtheria — — — — — — — — Enteric Fever — — — — — — — — Puerperal Fever — — — — — — — — Phthisis (Pulmonary Tuberculosis) — — 2 11 19 12 2
79aee0b0-f366-43b8-8bd3-e94b726eda6c	46 Other Tubercular Diseases — — — — — — 2 Cancer, Malignant Disease — — — — 5 22 18 45 Bronchitis 2 2 — — — 1 11 16 Pneumonia 7 4 2 — 1 5 4 23 Other Respiratory Diseases — — — — — 3 1 4 Alcoholism (Cirrhosis of Liver) — — — — — — — Premature Birth, Malformation and Debility 23 — — — — — — 23 Accidents 1 1 3 5 2 2 — 14 Suicides — — — — 2 2 — 4 Rheumatic Fever — — 1 1 — — — 2 Diabetes — — — — — 3 1 4 Cerebral Haemorrhage — — — — 1 9 12 22 Heart Disease 1 1 1 6 8 28 49 94 Arterio-Sclerosis
a70f6689-1f95-4b56-9381-6368b47185d6	— — — — — 2 7 9 Ulcer of stomach or duodenum — — — 2 1 3 — 6 Appendicitis and typhlitis — — — — 2 2 — 4 Acute and Chronic Nephritis — — — 1 2 6 7 16 Other accidents and diseases of pregnancy and parturition — — — — 2 — — 2 Other defined diseases 7 2 3 3 7 10 14 46 Causes ill-defined or unknown — — — — — — — — Totals 51 24 14 31 52 112 130 414 27 INFANT MORTALITY DURING THE YEAR 1928. The following table gives the actual causes of death of children dying under one year of age. Nett deaths from stated causes at various ages under one year:— s of Death. (All causes certified.) Under 1 week. 1—2 weeks.
b978e388-ab11-4657-8083-f2c7f7e0aad0	2—3 weeks. 3—4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total under one year. Small Pox — — — — — — — — — — Chicken Pox — — — — — — — — — — Measles — — — — — — — 1 — — Scarlet Fever — — — — — — — — — — Whooping Cough — — — — — 1 1 — — 2 Diphtheria and Croup — — — — — — — — — — Erysipelas — — — — — — — — — — Tubercular Meningitis — — — — — — — — — — Other Tubercular diseases — — — — — — — — — — Meningitis (non tubercular) — — — — — — — — — — Convulsions 1 —
ffadc09a-6a4c-4eca-8fb7-42ceabc7c94c	— — 1 1 1 1 — 4 Laryngitis — — — — — — — — — — Bronchitis — — — — — — 1 — 2 3 Pneumonia (all forms) — — — 1 1 2 5 — 1 9 Diarrhœa — — — — — — — 3 3 Gastritis — — — — — — — — — — Syphilis — — — — — — — — — Rickets — — — — — — — — — — Suffocation, overlaying 1 — — — l 1 — — — 2 Injury at birth — — — — — — — — — — Atelectasis 1 — — — l — — — 1 Congenital malformation — — — — — 1 — 1 — 2 Premature Birth 9 3 — — 1.2 2 1 — 15 Atrophy,
212566a6-90f1-4517-bf05-5525f0a32082	debility and Marasmus 3 — 2 — 5 — — — 1 6 Other causes 1 1 1 — 3 — — — — 3 Totals 16 4 3 1 24 8 8 4 7 51 Nett Births in the year :— Nett Deaths in the year:— Legitimate 785 Legitimate 45 Illegitimate 20 Illegitimate 6 28 10. MARRIAGES. There were 311 marriages registered in the district in 1928. This is equal to a marriage rate of 7.6 per 1,000 population.
455c1765-0b5e-4d91-be6d-581e3f60737b	In 1922, there were 208 marriages, equal to a rate of 5.6; in 1923, 219 marriages, equal to a rate of 5.9 per 1,000; in 1924, 20S marriages, equal to a rate of 5.4; in 1925, 258 marriages equal to a rate of 6.7; in 1926, 249 marriages equal to a rate of 6.3; and in 1927, 304 marriages equal to a rate of 7.6. 11. BIRTHS. The net number of births registered in 1928 was 805, affording an annual birth rate of 19.7 per 1,000 population, compared with 17.7 in 1927 and 21.01 in 1926. Of all births, 20 were illegitimate, or a proportion to total births of 2.4 par cent.
d4a53300-06f6-497b-abd0-aed5973cc467	Notification of Birihs Act, 1907-1915.—Of the total births recorded in the district during 1928, 703 were notified to the Medical Officer of Health, 493 being notified bv midwives and 210 by parents and doctors. 14 still-births were notified, 9 being notified by midwives and 5 by doctors and others 4 still-births, which took place in the district, were not notified. 29 SECTION 2. SANITARY CIRCUMSTANCES OF THE DISTRICT. WATER SUPPLY. The water supplied to the area by the South Essex Waterworks Co., comes from various sources, principally from the Company's wells in the chalk at Ilford, Seven Kings, and Dagenham. The water is untreated and varies in hardness from 10 to 20 degrees, according to the source from which it is obtained. The supply is periodically analysed and is always reported on as of the highest degree of bacteriological and chemical purity.
6411d2b0-5c39-496a-bad8-912471950f4b	RIVERS AND STREAMS. 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. In the early hours of the morning of January 7th there was an exceptionally high tide when the River Roding overflowed its banks with subsequent flooding and damage to properties situate in the vicinity of the river. The level to which the previous highest recorded tide had reached was 16.75 feet above ordnance datum. The tide on January 7th reached 17.80 feet above ordnance datum. 30 About 250 houses were flooded, those in Bridge Street to a height of 3 feet.
aeb83caf-cd8a-4a20-b34c-8cf1c2bb6f1a	In addition, serious damage was caused at the Council's sewage disposal works through portions of the river wall giving way under the pressure of the water, and admitting tidal water to 40 acres of land. At Westbank, Little West Marsh was flooded, and to relieve this condition it was necessary to make a cutting communicating with the river. RAINFALL. The rainfall for the year ended December 31st was 23.73 inches. Rain fell on 201 days throughout the period in question. SEWAGE. A water-carriage system is general, except at Rippleside. Over the greater part of the area there is a separate sewage and storm water system. Sewage is treated within the district by precipitation and sedimentation, the resulting effluent being discharged into the River Roding. Sewage Disposal-—General.
1d9c8503-5117-4373-a3f2-8f7fe7027c98	Since the latter part of the year 1927, meetings and discussions have taken place between the Urban District Council of Barking and the Corporation of Ilford with a view to preparing a scheme for the reception and treatment of the sewage of the two districts at the Northern Outfall Works of the London County Council. Such a scheme has now been agreed, the capital cost of which is estimated at approximately £162,000; preliminary steps have been taken and it is anticipated that the work will commence at the earliest opportunity. Sewage Disposal West of the River Roding. A Local Inquiry was held on the 4th April into the raising of a loan for £7,420 to lay a new sewer from Over-the-Gates to Hertford Road, where a new pumping station will be erected 31 fitted with centrifugal pumps of a capacity sufficient to lift the whole of the sewage from Hertford Road and Over-the-Gates through a rising main along London Road to the main sewer on the east side of the River Roding.
39d6f609-f507-49fb-8b9f-db9c057b9eaa	SCAVENGING. Street cleansing, together with the collection and disposal of the domestic refuse, is under the control of the Engineer and Surveyor. The method of collection by antiquated and unsuitable vehicles which has occasioned adverse criticism in the last two Annual Reports is shortly being ended, and vehicles of the freighter type introduced. Crude refuse continues to be dumped on low-lying land at Mayesbrook. During the summer, residents in that locality complained of nuisance from flies. Tipping is carried on entirely in accordance with the recommendations of the Ministry of Health CESSPOOLS, PRIVYMIDDENS AND PAIL-CLOSETS. In the unsewered portion of the district there remains 54 premises with cesspools, 41 with pail-closets and 6 with privies. So soon as the sewerage scheme which is now in preparation is completed, these premises will be connected with the sewer it is proposed to provide.
a139a72e-4ef4-4b90-9c5e-602f3a4220cd	For cesspool emptying, a tank vehicle is employed, the contents being pumped out and afterwards discharged into the sewers. Privymiddens are emptied into tumbrils and the contents buried; the same remark being applicable to pail-closets. Housing Statistics for the year 1928. 1. GENERAL. Number of new houses erected during the year :— (i) Total 375 (ii) As part of a municipal housing scheme 40 (iii) Others (including private enterprise and subsidy houses) 270 32 2. UNFIT DWELLING HOUSES. I.—Inspection.
088705ac-7cf5-4a88-8357-00169bab958b	(i) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 4.151 (ii) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 739 (iii) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 2 (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 2,182 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. 1,676 III.—Action under Statutory Powers. A.—Proceedings under Section 3 of the Housing Act, 1925.
b2fb0ff5-4d5c-478f-8009-246504dfe7f4	(i) Number of dwelling houses in respect of which notices were served requiring repairs 129 (ii) Number of dwelling houses which were rendered fit— (a) by owners 123 (b) by Local Authority in default of owners 6 33 (iii) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations of owners of intention to close Nil B.—Proceedings under Public Health Act.
d72ad629-abdb-4c93-8bf9-2712c7795b73	(i) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 377 (ii) Number of dwelling houses in which defects were remedied :— (a) by owners 377 (b) by local Authority in default of owners Nil 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 2 (ii) Number of dwelling houses in respect of which Closing Orders were made 2 (iii) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling houses having been rendered fit Nil (iv) Number of dwelling houses in respect of which Demolition Orders were made Nil (v) Number of dwelling houses demolished in pursuance of Demolition Orders Nil 34 SANITARY INSPECTION OF THE AREA. (Work of Sanitary Inspectors.) 1. Inspection of Dwelling Houses.
2a18fd5c-74e7-4fbc-9531-9d8caa75b107	Total under Public Health or Housing Acts 4,151 Housing (Inspection of District) Regulations 735 After Infectious Disease 647 Defects Found 7,852 Notices Served (Preliminary) 2,182 Re-inspections re Notices Served 3,042 2. Premises Controlled by Bye-Laws and, Regulations. Houses Let in Lodgings 23 Common Lodging Houses 90 Offensive Trades 268 Tents, Vans and Sheds 108 Dairies, Cowsheds and Milkshops 307 Slaughterhouses 120 3. Factories, Workshops and Workplaces. Factories 108 Laundries 19 Bakehouses 40 Other Workshops 129 Other Workplaces 127 Outworkers' Rooms 26 Butchers' Premises 490 Fishmongers 53 Restaurants and Dining Rooms 145 Markets 63 Stables and Stable Yards 116 Piggeries 199 35 4. Miscellaneous.
9a3aeaff-0744-4283-8bb1-b7d165927307	Smoke Observations 196 Rats and Mice (Destruction) Act, 1919 83 Vacant Land and Refuse Dumps 132 Public Lavatories 88 Schools 81 General Shops 249 Ice-Cream Vendors 90 Petroleum Stores 86 SUMMARY OF SANITARY WORK CARRIED OUT. (a) Drainage. Choked drains, opened, repaired, and cleansed 331 Drains reconstructed 80 New Drains nil Ventilation Shafts repaired or new fixed 14 New Inspection Covers 19 (b) Closet Accommodation. Roofs Walls Floors Doors W.C. structures repaired 182 Seats Fixed 91 W.C. Pans Fixed or Cleansed 183 Flushing Apparatus Repaired or Renewed 304 Privies to Pail Closets 6 (c) Sinks. New Fixed 121 New Sink Wastepipes 136 New Gullies 67 (d) Dampness.
66ee8458-6633-4263-a24e-6a5f762c652f	Roofs 715 Eavesgutters 471 Rainwater Pipes 175 Damp Walls Remedied 150 36 (e) Water Supply. Storage Cisterns Abolished 26 Defective Water Fittings Repaired and Supply Reinstated 108 Supply provided inside houses 8 Existing supplies increased 10 (f) Yard Paving. Yard paving repaired or relaid 247 (g) Dustbins. New ones provided 281 (/») General Repairs. House floors repaired 366 Windows repaired or renewed 200 Window sills repaired or renewed 213 Sashcords renewed313 Stoves or coppers repaired or renewed 387 House doors repaired or renewed 230 Stairs repaired 112 Chimney pots renewed and stacks rebuilt 76 Dirty or defective rooms repaired, cleansed and redecorated 1,678 External walls repaired 175 Insufficient floor ventilation 51 External painting 23 Wash-houses added 7 (») Miscellaneous.
9f34bafa-ff7d-495e-b0c1-7a69fb2f0703	Offensive accumulations removed 80 Animals so kept as to be a nuisance 21 Verminous rooms and persons disinfected 37 Smoke nuisances 70 Drains tested 167 37 NOTICES SERVED. Informal Notices 2,182 Statutory Notices 506 Section 36, Public Health Act, 1875 38 Section 94, Public Health Act, 1875 334 Section 41, Public Health Act, 1875 4 506 Section 5, Infectious Disease (Prevention) Act, 1890 1 Section 3, Housing Act, 1925 129; SMOKE ABATEMENT. During the year 196 observations were made of factory chimneys in the district and in 70 instances there were emissions of black smoke in excess of the permissible period of 2 minutes in each 30-minute observation. Most of the offences occurred at a factory where the processes have since been electrified, with a consequent decrease in black smoke emission from the chimney.
6f592c18-804e-48ae-a0a3-ec27389ce9f7	The question of "grit" discharge from the super-power station at Creeksmouth has received attention and the station kept under observation. A considerable amount of grit escapes into the atmosphere, causing nuisance to workmen in the locality, and would undoubtedly be a serious matter if the station was situated other than in its present position of isolation. The demand for higher and higher efficiency in steam raising installations, with consequent increasing popularity of high temperature air pre-heating and the rapid increase in the capacity of boiler units designed for a high rate of evaporation per square foot of heating surface have brought about many new problems, the most serious of which from the public health point of view are the discharge of sulphur fumes and very fine grit from the chimneys of modern electric power houses where there is a concentration of a large amount of power in a relatively small space. How serious these discharges are can best be gauged when it is realised that the modern furnace is designed to burn any class of fuel, and that the average fuel contains 2 per cent.
864c2910-4883-4677-95cb-5e74d19c9481	of sulphur and 14 per cent ash. 38 The super stations which are now being erected, of which Barking station is one, will have a coal consumption of 2,000 tons per day containing 40 tons of sulphur which passes out into the air as sulphur gases and 280 tons of ash of which 140 tons will be discharged into the atmosphere in such a finely divided state that until saturated with moisture will remain suspended in the air. So far, engineers have been unable to design any equipment satisfactorily to deal with the problems arising from the new methods of steam raising. Pure water supplies and pure food supplies have been established, but we are still without a pure air supply.
cb9cfc93-c520-4133-a96a-6e9156108e68	It is now accepted that smoke and other items of air pollution fill the atmosphere with acrid, poisonous compounds and soot particles which irritate the sensitive membranes of the eyes, nose, throat, lungs and gastro-intestinal tract, increasing the susceptibility to gastro-intestinal, pulmonary and naso-pharyngeal disorders and so lessening the working capacity and well-being of the individual. Any improvement in air pollution depends upon :— 1. A campaign of education aiming at acquainting the general public with the gravity of the air polution evil. 2. The extension of smoke control to all classes of buildings now exempt, including dwelling-houses. 3 (a) Provision of facilities to permit control of visible smoke to the limit physically possible. (b) Research by the chemist, physician and engineer to cover thoroughly the field of air pollution.
98a5d1f5-2269-4acd-8d4b-fd5b73605736	The marketing of a smokeless fuel suitable for all purposes now served by coal at a price the public can afford will be an important move forward, and with the completion of the factory, which is to be erected at Creeksmouth, I am hopeful that such a fuel will be available to Barking inhabitants. 39 OFFENSIVE TRADES. The 35 registered premises received 268 visits and 27 breaches of the bye-laws were found. The business of fat melter carried on by Mr. Hornett at Manor Farm, Clap Gates Lane, was discontinued in October. He does, however, still carry on the business of fish-skin scraper at these premises. The isolated position of the piggeries at Jenkins Lane mitigates any serious nuisance, but conditions at these piggeries are far from the standard we would wish to obtain. The 60 stables in the district received 116 visits during the summer months. COMMON LODGING HOUSES.
6573f0b2-99c5-4ac1-b6a8-f93bd91455a5	Ninety visits were paid to the two common lodging houses. At the end of the year the licence granted to the keeper of the Heath Street house was terminated owing to his unsatisfactory methods. The other lodging house continues to be kept in good order. TENTS, VANS, SHEDS and HOUSES LET IN LODGINGS. Until such time as homes can be obtained at rentals which the poorest of the poor can afford to pay, premises of the above type will be found occupied. The best one can say of them is that they are a habitation. In Barking there are about 55 families living in such dwellings, all hopeful of obtaining a house. The premises need constant supervision to secure maintenance of anything like decent home conditions. 40 INSPECTION AND SUPERVISION OF FOOD. MILK SUPPLY. Including five whose premises are situated outside the district, there are 34 retail purveyors. The premises are frequently inspected.
0eff0b54-173f-4f6c-8fe8-aeb273e07e19	Generally speaking, the cleanliness of the milk supplied is of a high standard. Of the samples examined during the year it is interesting to note that whilst all the samples of raw milk submitted were satisfactory, 3 samples of pasteurised milk (although not retailed under that designation) were found below the standard of cleanliness. During the year two dairymen were prosecuted and fined for the bottling of milk in the street, since which time the larger retailers have gradually discontinued the distribution of loose milk, a policy which it is hoped will be extended. Whilst the sanitary inspectors are always on the alert for instances of street bottling, they cannot be aware of every offence. Below are particulars of samples submitted for bacteriological examination:— Type of Sample. Satisfactory Unsatisfactory Total. Grade A (T.T.)
d62e7043-1df9-4a01-ab44-df5d327fa7a6	Milk 4 — 4 Grade A Milk 1 — 1 Raw Milk 8 — 8 Pasteurised Milk 10 3 13 Sterilised Milk 3 — 3 26 3 29 The following table shows the number of licences granted during the year for the sale of graded milks' under the Milk (Special Designations) Order, 1923:— (a) "Certified" Milk 1 (b) Grade A Milk 3 (c) "Pasteurised" Milk 2 (d) Grade A (T.T.) 3 41 Licences were granted to 2 local firms for the bottling of Grade A (T.T.) Milk. There are in the district 45 retailers and 9 wholesale distributors of sterilised milk. MEAT INSPECTION. Slaughtering is still carried on at the one licensed premises in the town. The occupier slaughters good class animals in a satisfactory manner.
010783bc-84ed-4061-9cc4-0421b288e0e8	During the year 126 notifications to slaughter were received and 40 beasts, 409 pigs, 815 sheep and 71 calves were examined. Diseased meat was destroyed as under:— Description Disease Weight 2 Beasts Heads Tuberculosis 56 lbs. 4 „ Lungs „ 19 lbs. 1 „ Pluck Echinococcus 20 lbs. 5 „ Livers Distoma Hepaticum 70 lbs. 3 „ „ Cirrhosis 42 lbs. 1 „ Mesentery Tuberculosis 1 lb. 11 Sheep Plucks Parasites 77 lbs. 11 „ Livers „ 44 lbs. 87 „ Lungs „ 261 lbs. 3 Pigs Heads Tuberculosis 29 lbs. 13 „ Plucks „ 104 lbs. 2 „ Congestion 12 lbs. 7 „ Livers Cirrhotic 35 lbs. 10 „ Lungs Tuberculosis 60 lbs. 2 „ Congestion 7 lbs.
2da22cf2-e04d-4a50-852c-0a83de3b03ff	2 „ Pneumonia 7 lbs. 9 „ Stronglyus Paradoxus 34 lbs. 2 Legs of Mutton Caseous Lymphadenitis 10 lbs. Total weight 888 lbs. 42 UNSOUND FOOD. The following list gives particulars of the unsound food destroyed during the year:— 5 stone of Dabs. One bushel of Winkles. One Loin of Pork. One Sirloin of Beef. SALE OF FOOD AND DRUGS ACTS. I am indebted to Mr. 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:— During the year ended 31st December, 1928, the following articles of food were taken in Barking and submitted to the Public Analyst for analysis:— Milk. Butter. Other Samples. Total. 62 50 72 184 Proceedings were instituted in one case and were withdrawn.
c141fcdb-a40f-4cf9-9c4f-09a9ee274780	SCHOOLS. 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. A distinct improvement from the hygienic standpoint would be the abolition of existing arrangements and the provision of springbib fountain jets in every school. 43 FACTORY AND WORKSHOP ACT, 1901. Factories, Workshops, Laundries, Workplaces and Homework. 1. Inspections (including inspections made by Sanitary Inspectors.) Premises. Number of Inspections. Written Notices. Prosecutions. Intimations. Statutory.

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