BARK 34 BOROUGH OF BARKING. THE ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. FOR THE YEAR 1940 (War Edition) C. LEONARD WILLIAMS, B.Sc M.R.C.S., L.R.C.P., D.P.H. BOROUGH OP BARKING. ANNUAL REPORT of the Medical Officer of Health for the Borough of Barking, in the County of Essex, for the year ended 31st December, 1940. (War Edition). Public Health Department, Barking, Essex. December, 19U1. To the Mayor, Aldermen and Councillors of the Borough of Barking. Mr. Mayor, Ladies and Gentlemen, I have pleasure in submitting my report for the year ended 31st December, 1940. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, C. LEONARD WILLIAMS; Medical Officer of Health. 2 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH for the YEAR 1940 (War Edition). STAFF The following indicates the many changes that have taken place in the staff of the Public Health Department during the year 1940:- Deputy Medical Officer of Health and Deputy School Medical Officer. Violet Spiller, M.D., M.R.C.S, L.R.C.P., D.P.H. (Appointed 1st December, 1940. ) Consultant Orthopaedic Surgeon. B.Whitchurch Howell, F.R.C.S.(Service as Consultant Surgeon to the Ministry of Health as from July 1940) A.M.A.Moore, F.R.C.S. (Commenced 17th October, 1940) Consultant Ear, Nose and Throat Surgeon. Cyril R.Sandiford, F.R.C.S.(Deceased 22nd August,1940) F.Courtenay Mason, F.R.C.S.(Commenced 2nd December, 1940.) Resident Medical Officer,Upney Hospital. J.M.Brady, M.B., B.S(Commenced 1st April, 1940). Scientist. E.M.Hill, Ph.D.(Lond), Dip.Bact. (Resigned June,1940) . Health Visitors etc. +Miss M.G.Bennett (g.h and i). (Commenced 12th August., 1940. Temporary - transferred to Permanent Staff 1.11.40.) +Miss M.K.Crotty (g,h and i).(Commenced 12th August, 1940. Temporary - transferred to Permanent Staff 1.11.40.) +Miss C. Court(g,h and i). (Service in H.M.Forces as from 1st March, 1940). Miss L.B.S.Davies (Masseuse) - Temporary, (n) (Commenced 15th October, 1940). +Miss E.C.Everett (Temporary), (g and h) (Commenced 11th August, 1940). +Mrs. F.E.Fenna (Temporary), (g, h and i) (Commenced 15th •Ipril, 1940) . Miss J. Harris (Masseuse), (n) (Resigned 14th September, 1940). +Miss R. McCandie (g,h end i) (Resigned 13th August, 1940). Mrs. H. Sachs, M.B,A.Ch. (Chiropodist) - TearooFary part-time. (Commenoed 8th April, 1940). +Mrs.Sutherland (g,h and i) Temporary. (Commenced 10th June, 1940). Miss L.F.Swain (School Nurse). (h and i) (Retired 30th September, 1940). Miss M. Thompson (Masseuse), (n) Resigned 5th October 1940. -3- District Municipal Midwives. Mrs. W. Wild (h and i). (Resigned 18th December, 1940). Clerical Staff. Miss E. Brown. (Commenced 30th September, 1940). Mr. K. Calway (p) (Service in H.M.Forces from 17th December, 1940) Miss L, Dyer. (Commenced 30th December, 1940). Miss M. Eastwick. (Commenced 30th September, 1940) Mr. H. Garrod (Service in H.M. Forces from 13th November, 1940). Miss R. Hallwood (Temporary). (Commenced 30th September 1940). (Terminated 31st December 1940). Mr. S. Launchbury (Temporary). (Commenced 18th January, 1940). Transferred to Borough Engineer's Department, 14th December, 1940. Miss J. Maclean (Resigned 19th September, 1940). Miss G. Maclean (Resigned 10th September, 1940). Mr. F. Miller (Temporary). (Commenced 29th April,1940) . Mr. F. Phipps (Temporary). (Commenced 14th October,1940) Transferred to Borough Treasurer's Department since the close of the year. Mr. G. Ruff (Service in H.M.Forces from 2nd July, 1940). Mr. D.Scott (Service in H.M.Forces from 22nd July,1940). Miss P. Sparkes (Resigned 3rd December, 1940). Miss J. Wilkinson (Resigned 9th September, 1940). Miss P. Wragg (Commenced 30th December, 1940). Mr. F. Yates (o). (Service in H.M.Forces from 24th August, 1940). (g) Health Visitor's Certificate of the Royal Sanitary Institute. (h) Certificate of the Central Midwives Board. (i) General Hospital Training. (n) Certificate of the Chartered Society of Massage and Medical Gymnastics, Medical Electricity, Light and Electro-Therapy. (o) Final Examination of the National Association of Local Government Officers. (p) Intermediate Examination of the National Association of Local Government Officers. +Combined appointment - Health Visitor and School Nurse. 4 The year has seen many comings and goings. Some of my colleagues have been drafted into the Forces and other people have come to take their places and amongst those who have left us I would particularly wish to mention Mr. C. R. Sandiford, F.R.C.S. who passed away on the 22nd August, 1940. He laid the foundations of your Ear, Nose and Throat Out-Potient Department; was beloved by everybody, and those of us who were privileged to work together with him felt deeply the loss of such a sincere friend. Those for whom he worked and amongst whom he worked felt his loss no less. Towards the end of September 1940, the Battlers Green Emergency Maternity Home at Radlett was opened, and arrangements were made for certain of our midwifery staff to supplement the staff at this Home. This involved all four District Midwives taking duty at varying periods. During the year members of the stiff have continued to participate in the Civil Defence Scheme, but for the most part they have been engaged upon their normal duties in connection with the Public Health and Medical Services. 5 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. (1) GENERAL STATISTICS. Area (acres) 4,174 Population (1.931 Census) 51,277 Population (Year 1940) (Registrar- General's Estimate) 66,290 Number of Inhabited Houses, March, 1941, according to Rate Books:- Houses 18,765 Shops 1,029 Total 19,794 Rateable Value - General £749,503 0 0 Sura represented by a penny rate £3,049 0 0 General Rate l6s. 0d. (2) VITAL STATISTICS. (Based on Annual Returns and Statistics received from the Registrar General). Deaths 666 Death Rate 10.05 Live Births (•(B.R.) - for calculating Birth 1,104 Rates). Birth Rate 16.65 Still Births 35 Still Birth Rate per 1,000 Total Births 30.73 Live Births ( (I.M. &c.) - for calculating Infant & Maternal Mortalities) 1,061 Number of Deaths of Infants under one year of age 35 Infantile Death Rate 32.98 Number of Maternal Deaths U Maternal Mortality Rate 3.65 6 (3) DEATHS. (a.) General. There were 390 deaths registered in Barking during 1940. Of these 24 were deaths of non-residents. Barking residents to the number of 300 died elsewhere during the year. Including the latter and excluding the deaths of visitors, the net number of deaths was as follows:- Males Females Total 376 290 666 The following table shows the principal causes of death during 1940:- ( Net Deaths ) Causes of Death Total Cerebro Spinal Fever 5 Diphtheria 1 Pulmonary Tuberculosis 41 Non-Pulmonary Tuberculosis 2 Syphilitic diseases 4 Influenza 6 Acute Inf. Encephalitis 2 Cancer (all forms) 110 Diabetes 8 Intra-cranial vascular lesions 48 Heart Disease 122 Other diseases of circulatory system 27 Bronchitis 52 Pneumonia 42 Other respiratory diseases 15 Ulcer of stomach or duodenum 5 Diarrhoea (under 2 years) 2 Appendicitis 6 Other digestive diseases 18 Nephritis 11 Puerperal & post-abortive sepsis 1 Other maternal causes 3 Premature Birth 13 Congenital Malformations, birth injury infantile diseases 7 Suicide 5 Road traffic accidents 9 Other violent causes 61 All other causes 40 Total 666 (b) Infant Mortality. It is most gratifying to me to be able to report that this figure has once again surpassed all Barking records, the infant mortality rate for 1940 is 32.95 and is probably one of the lowest for the country. In these difficult times it must be all the more a subject of satisfaction for you and a credit to the work done by your services. 7 The following table gives the actual causes of death of the 35 children who died under one year of age : - 0-1 mth. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths. Total under 1 year Acute Broncho-Pneumonia 1 1 Acute Intussusception 1 1 Anencephalous 1 1 Asphyxia Pallida and Prematurity 1 1 Asphyxia due to subdural lacmatoma due to tentorial tear due to rapid moulding at birth I 1 1 Asphyxia (natural) due to acute suppurative bronchitis l 1 1 2 Atelectasis 1 i 1 Atelectasis and prematurity 1 1 Broncho-Pneumonia 1 1 Broncho-Pneumonia and Pink Disease 1 1 Broncho-Pneumonia and congenital heart disease . 1 1 Broncho-Pneumonia and Marasmus 1 1 Cardiac failure due to Streptococcal pneumonia 1 1 Cardiac failure due to premature birth with natural shock 1 1 Convulsions and Influenza 1 1 Due to War Operations 1 1 Gastro-enteritis 1 1 Heart failure and Acute miliary tuberculosis. Miliary tuberculosis of lungs and Meningis 1 1 Infantile diarrhoea 1 1 Meningitis. Pneumococcal Right Lobar Pneumonia 1 1 Meningococcal meningitis l 1 Pneumococcal meningitis and Pneumonia 1 1 Post operative collapse of lung. Pyloric stenosis 1 1 Prematurity 9 9 Spina Bifida and Hydrocephalus 1 1 Toxemia, Chronic Impetigo, Infected scabies and Basal bronchitis 1 1 Totals 18 3 8 4 2 35 (c) Maternal Mortality, There were 4 deaths of Barking women due to or in consequence of pregnancy or childbirth. One of these women, however, died in November, 1939, but it is necessary to include this case in the figures for 1940 as the death was not registered until February, 1940. There were two cases where the terrqinal illness was associated with abortion, and in neither of these cases had the unfortunate woman come within the purview of your Antenatal Scheme. The third woman also had not been treated antenatally by your officers. 8 I am sorry to say that at the present time nothing is known which can prevent the one death which occurred among those women who had availed themselves of' your ante-natal service. Fortunately, deaths from this cause are relatively rare. One other woman who was pregnant died; in her case however, the death was due to tuberculosis and may not be deemed to be a maternal death. Sad as we are to report on so many deaths, it must nevertheless be a matter of gratification to you that whereas 1,114 women availed themselves of your services, one only died. (4) SOCIAL CONDITIONS. (a) General. Last year I brought to your serious consideration that the outbreak of war had resulted in the public being less and less interested in preventive medicine than it had been heretofore. It is with pleasure I report as you yourself will see from the statistics that the work has returned very nearly to normal and I have pleasure in advising you that members of the public generally have resumed their previous determination to interest themselves in their own health and the health of the rising generation. (b) Schemes of Relief. In my previous reports I have written almost regularly on the need there is for unification and simplification of these Schemes and I do hope the time is opportune for these scales to be revised. (c) Unemployment. Barking is a dormitory town and employment has been changed considerably by the War. The Ministry of Labour and National Service is unable this year to give detailed classification of the unemployed as at December 1940, but the following shows the position in total Number unemployed at December 1940 in Barking. Men Women Total 405 610 1015 The following is an extract of a communication 1 have received from the Local Branch of the Ministry of Labour and National Service "Practically all the men were of the general labouring, Dockers, and Road and Transport Classifications. "The women were mostly Factory Hands. "In comparison with the figures for the previous December, the reduction of unemployment in men is very noticeable and is entirely due to absorption into vital industries. "It mast be-appreciated that since the date of the statistics shewn above and the issue of this report, practically all local unemployed have been absorbed into vital industries, and it should further be appreciated that the demand far labour continues." 9 (d) Travelling Facilities. The standard of travelling conditions to and from Barking is a matter upon which I have always felt very strongly. I am informed that during the year 1940 some improvements have been effected and that there was a decrease in the total number of members of the public using the travelling facilities available. - 10 - SECTION B GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. (1) GENERAL HEALTH SERVICES. (a) Ambulance Facilities. On the outbreak of War your Ambulance service became virtually a part of the Air Raid Precautions Service, and has so continued. The reciprocal arrangements with adjoining areas have been maintained. (b)Hospital Facilities. The Barking Hospital continues to be included in the Emergency Medical Services Hospital Scheme, it's primary function being that of a casualty clearing station. The Ministry of Health have, however, agreed to the use of a limited number of beds for cases referred by your own medical officers and for which the Corporation have accepted financial responsibility. The Ministry still have first call upon all the beds available. The Barking Hospital x-ray apparatus is at the disposal of your officers for diagnostic purposes. Again in 1940 a sum of £300 was allocated by you to those voluntary hospitals catering for the residents of the town, (c)Clinics and Treatment Centres, The Central and Woodward Clinics have been used as First Aid Posts during the year, but the Clinic sessions and attendances in connection with our normal services have continued at all Clinics and Out-Patients Departments. The services provided by the Corporation are used by the Public to a great extent. There are one or two matters which strictly belong to the year 1941, but I feel that mention should be made of them in this report. The Woodward Clinic was seriously damaged by Enemy Action in January 1941, which made it necessary to find other premises in order to maintain the services previously held at this Clinic. The Greig Hall adjoining was therefore opened as a Clinic and OutPatients Department. (d) Nursing in the Home. Nursing in the home continues as heretofore and is undertaken by the Plaistow Maternity Hospital and District Nurses' Home and the East Barking District Nursing Association. 11 (2) MATERNITY AND CHILD WELFARE SERVICES. (a) Ante-Natal and post Natal Supervision. In spite of the evacuation of many expectant mothers the number of attendances at your clinics amounted to 7,391, an increase of over 600 on the figure for the previous year; the number of postnatal attendances (401) was much the same as for the previous year and the number of gynaecological attendances (26l) rather less. (b) Midwifery. (1) Supervision. There were 15 midwives practising in the Borough at the end of the year, six of which were employed at the Upney Maternity Pavilion. During the year 1940, midwives sought medical assistance in 223 cases; 22 of these were on behalf of babies. (2) Midwives Act, 1936. Upwards of 411 mothers were delivered in Barking under your district midwifery scheme during the year 1940. In addition 62 mothers were delivered by doctors with district midwives acting as maternity nurses. (c) Upney Maternity Favilion. 454 patients were confined in Upney Maternity Pavilion and 71 patients were admitted for ante-natal treatment. In addition arrangements were made for a block of twelve cubicles at the Barking Emergency Hospital to be available for ante-natal treatment and 186 patients were admitted during the year to these beds, two of them being confined there as emergency cases. (d) Evacuation. It was impracticable to use the Twyford House Emergency Maternity Home, Bishops Stortford, when evacuation of expectant mothers started again in September 1940, as this building had been damaged; in consequence the Battlers Green Emergency Maternity Home at Radlett was opened ori the 24th September 1940. Up to the 31st December 1940, 45 mothers were evacuated there, 31 of whom were confined during 1940. The evacuation scheme provides for expectant mothers to be evacuated one month before the expected date of delivery, and at first the patients were placed in various billets in the Radlett area. This scheme did not prove very satisfactory however, and on the 27th December 1940 the "Brown Gables" Ante-Natal Hostel was opened and this is proving of much value and assistance in the evacuation scheme. - 12 - (e) Infant Welfare Centres. The number of attendances at the Infant Welfare Centres decreased on account of evacuation and also owing to daylight air-raids. 29,347 attendances were made during 1940 compared with 32,163 during 1939* (f) Home Visiting. The constantly disturbed population, either evacuating or returning, or changing address because of bomb damage, made home visiting more difficult although increasingly important. Your Health Visitors were thus unable to make as many visits during 1940, the numbers being 14,301 as compared with 17,696 in 1939* (3) ORTHOPAEDIC SERVICES. Work in this department was carried on in a comparatively normal manner during 1940 as will be seen by the number of sessions held by the Orthopaedic Surgeon and by the Masseuses as compared with previous years. Mr. Whitchurch Howell left us in July and tor. A. M. A. Moore has taken over his work for the duration. The High Frequency Inductotherm Apparatus has been in use throughout the year and has proved invaluable in the treatment of many painful conditions; all other forms of work associated with electrical treatment, exercises, massage and appliances etc., have been carried on as usual. It will be noticed that the attendances per session have remained comparatively even during the course of the last three years, thus apparently unaffected by war conditions. The following tables show the work which has been carried out in the various branches of orthopaedic work. -13- PARTICULARS OF THE WORK DONE IN CONNECTION WITH THE ORTHOPAEDIC CLINIC DURING 1940. No. of Sessions held by Orthopaedic Surgeon 9 No. of Sessions held by Masseuses 1,353 School Children Toddlers & Adults ATTENDANCES Primary Examination by Surgeon Re-examination by Surgeon For treatment 84 52 87 89 2,505 5,816 TOTALS 2,676 5,957 TREATMENTS " Number of Children 377 1,023 Number of Treatments 3,145 8,248 TOTALS 3,522 9,271 HOSPITAL TREATMENT Admissions to Hospitals 2 3 On Waiting List for admission - - TOTALS 2 3 Cases dealt with for the first time during 1940 - by the Orthopaedic Surgeon- were referred for the following defects a. DEFORMITIES OF BONES & JOINTS 1. Congenital 5 15 2. Acquired 70 32 b. MUSCULAR 1. Congenital 1 7 2. Acquired 38 16 C .PARALYSIS 1 4 d. MISCELLANEOUS 7 8 -14- SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. (1) RAINFALL. The rainfall all for the year ended 31st December 1940 was 18.45 inches, as compared with 24.05 for the previous year. Rain fell on 157 days in the year 1940. (2) DRAINAGE AND SEWERAGE, . Drainage arrangements continue as heretofore. (3) RIVERS AND STREAMS. The rivers and streams running through the area are tidal in character and are not controlled by the Corporation. Attention is directed to the continued unsatisfactory condition obtaining in the River Roding. (4) CLOSET ACCOMMODATION At the end of the year there remained a total of l6 premises unconnected with the sewer, nine of which were factory premises. (5) PUBLIC CLEANSING. During the year 5181 loads of refuse were collected with an average weight of 2 tons 5 cwts. (6) REFUSE DISPOSAL. The refuse of the Borough from the 1st January until 9th September was deposited at the Corporation tip situated near the North Bank of the Roding, and covered with earth or other suitable covering material. As from 9th September, by arrangement with the County Borough of East Ham, all refuse collected was taken to the destructor works of that Authority. (7) SANITARY INSPECTION OF THE AREA Emergency and war conditions have interfered seriously with the routine work of the Department. (a) WORK OF SANITARY INSPECTORS. -15- (1) Inspection of Dwelling Houses. Total Houses inspected under Public Health or Housing Acts 3,097 Total Number of Inspections made 3,823 Housing (Consolidated) Regulations 658 After Infectious Disease 196 Overcrowded Premises 34 Defects Found 4,683 Notices Served (Preliminary) 1,954 Re-inspections re Notices Served 2,903 Inspection of Works in Progress 252 (2) Premises Controlled by Byelaws and Regulations. Inspections . Contraventions Notices . served. Houses Let in Lodgings - - - Common Lodging Houses 10 — — Offensive Trades 36 14 10 Tents, Vans and Sheds 3 — — Dairies, Cowsheds and Milkshops 28 4 4 Slaughter Houses — - — Hairdressers & Barbers Premises 1 3 1 Smoke Observations 90 4 4 (3) Factories. Workshops and Workplaces. Inspections . Defects. Notices. Factories 153 11 Bakehouses 18 16 5 Workplaces 44 8 o Outworkers Rooms 28 1 1 Butcners Premises 193 32 21 Fishmongers 27 9 5 Restaurants and Dining Rooms, and Canteens 83 11 Stables and Stable Yards 25 7 Piggeries 8 3 2 (4) Miscellaneous. Inspections . Defects. Notices. Rats dc Mice (Destruction) Act 1919 £3 6 6 Vacant Land and Refuse Dumps 69 18 18 Public Lavatories 101 16 4 Schools 19 5 1 Markets and General Shops 189 28 27 Ice Cream Vendors 34 1 1 Drainage Inspections 189 - — Milk Sampling 60 - - Other Miscellaneous 142 — — Inspection of Meat from outside District 3 Shops Act, 1934 214 24 10 Water Sampling 21 - - Food Manufacturers -f - - Street Traders — — — Food Bye laws 27 3 3 Watercourses 48 9 5 Air Raid Shelters 56 - - (b) NOTICES SERVED. Informal Notices 1,954 Statutory Notices Public Health Act, 193& Section 39 1 Section 45 24 Section 83 3 Section 93 259 Housing Act, 1936 Sections 9 and 10 58 Section 24 — Section 32 — 345 16 (c) FACTORIES ACT, 1937. (1) Inspections (including inspections made by Sanitary Inspectors) . Premises. Inspections. Number of Written Notices. j Prosecutions . Intimations. Statutory. Factories 155 - - - Workplaces 44 6 - - Totals 197 6 - - (2) Defects Found. Number of Defects. Number of Prosecutions . Particulars. Found Remedied Referred to H.M. Inspector. +Nuisances under the Public Health Acts:- Want of Cleanliness 21 21 — — Inadequate Ventilation . 1 1 — — Overcrowding _ - - Want of drainage of - floors - - — Sanitary accommdation:Insufficient 6 6 Unsuitable or defectiv 14 14 — — Wot separate for sexes 2 2 — - Other offences 6 6 - Totals - ' 50 50 Including those specified in Sections of the Factories Act, 1937, as remediable under the Public Health Acts. (3) Homework. 10 notices were issued to the occupiers of premises in the district where outworkers are employed, who supplied lists twice during the year of 49 workpeople engaged on making wearing apparel, etc., in their homes. (4) Other Matters. Class Number. Matters notified to H.M. Inspector of Factories - Failure to affix Abstract of the Factory and Workshop Act Action taken in matters referred by H.M. Inspector as remediable under tne Public Health Acts, but not under the Factory and Workshop Act - Other Underground Bakehouses Ceitificates granted during the year In use at the end of the year -17- (5) Outworkers. The Register of outworkers coxitains the names and addresses of 75 persons carrying out work at their homes on behalf of other people. (d) PREMISES AND OCCUPATIONS WHICH ARE CONTROLLED BY BYELAWS OR REGULATIONS . The following is a list of the above type of premises :- (1) Houses let in lodgings. (2) Common Lodging Houses. (3) Tents, Vans and Sheds. (4) Underground sleeping rooms. (5) Offensive Trades. (6) Piggeries. (7) Stables. (e) RATS AND MICE DESTRUCTION ACT, 1919. There were 63 visits made to premises under this Act, and any necessary work arising has been carried out. (8) ERADICATION OF BED BUGS. The following houses have been disinfested Barking Council Houses 14 Privately owned houses 1 London County Council Houses Total 15 (9) CIVIL DEFENCE SERVICES. To meet the needs of the general public, an appropriate number of trench and surface shelters was provided. As the result of enemy action, commencing in August, numbers of people took up nightly occupation. The problems associated in the matter of hygiene and sickness were dealt with in my special report to the Civil Defence Committee. 18 SECTION D. HOUSING. (1) STATISTICS. (a) General. Number of new houses completed during the early part of 1940 (1) Total 55 (2) As part of a municipal housing scheme (a) Barking 4 (b) L.C.C. 42 (3) Others (including private enterprise and subsidy houses) 9 (b) Unfit Dwelling-Houses. 1. Inspection of dwelling-houses during the year :- (1) (a) Total number of dwelling-houses inspected for housing defects (underPublic Health or Housing Acts) 3,097 (b) Number of inspections made for the purpose 5,823 (2) (a) Number of dwelling-houses (included under sub-head No. 1. above) which were inspected and recorded under the Housing Consolidated Regulations 658 (b) Number of inspections made for the purpose 1,260 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 1,954 2. Remedy of Defects during the Year without Service of formal Notices Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 1,218 3. Action under Statutory Powers during the Year:- A. -Proceedings under sections 10 and 16 of the Housing Act, 1936 (1) Number of dwelling-houses in respect of which notices were served requiring repairs 58 19 (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By owners 51 (b) By local authority in default of owners - B. - Proceedings under Public Health Acts:- (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 287 (2) Number of dwelling-houses in which defects were remedied after service of formal notices (a) By owners 230 (b) By local authority in default of owners 25 C. - Proceedings under Sections 11 and 13 of the Housing Act, 1936:- (1) Number of dwelling-houses in respect of which Demolition Orders were made - (2) Number of dwelling-houses demolished in pursuance of Demolition Orders D. - Proceedings under section 12 of the Housing Act, 1936 (1) Number of separate tenements or underground rooms in respect of which closing orders were made (2) Number of separate tenements or underground rooms in respect of which closing orders were determined, the tenement or room having been rendered fit E. - Number of dustbins supplied by local authority in default of owners 240 20 section a. INSPECTION AND SUPERVISION OF FOOD. (1) MILK SUPPLY AND ICE CREAM. (a) Milk Supply. There are no cowkeepers in the district and we have only one dairy where milk is handled or treated. The remaining 77 premises on the register retail pre-packed supplies. In addition there are 15 milk purveyors who occupy premises in other districts, but retail in Barking. The following table sets out the results of the bacteriological examination of various samples, from which it will be seen that of the total of 37, only two were unsatisfactory. Type of sample. Satisfactory. Unsatisfactory. Totals. "Sterilised" Milk - — - "Pasteurised" Milk 17 2 19 Raw Milk 1 - 1 "Homogenised" Milk 3 - 3 Tuberculin Tested Milk 16 - 16 Totals! 37 2 39 There were during the year, 14 samples of milk submitted to biological examination for the presence of tubercle, none of which were found to be infected. The following table shows the number of licences granted during the year for the sale of graded milks under-the Milk (Special Designations) Order, 1936 Tuberculin Tested 6 Pasteurised 11 (b) Ice Cream - Barking Corporation Act, 1933 Section l60. There are 116 manufacturers and vendors registered in accordance with this Act. This is an increase of three in the number of registered premises. Many of the shops are supplied from one source with pre-packed containers and sampling is therefore directed to control the main supplies, rather than the individual vendors. The general standard of cleanliness has been good. Ten samples were submitted for bacteriological examination, all of which were satisfactory. 21 (2) MEAT AND OTHER FOODS. (a) Meat. There is one licensed slaughterhouse in the district, the licence of which is renewable annually. Since the outbreak of war slaughtering in Barking has been discontinued. (b) Supervision of Food Preparing Premises. The number of premises in the district at the end of the year at which the following foods are prepared were Sausages 25 Pot tea Meat and Brawn 4 Roast anchor Boiled Ham 4 Pressed, Pickled, Cooked, etc., Beef and Tongue34 Roast Pork Bacon Boiled Crabs and Lobsters 2 Pickled Fish 2 Pickled Onions 1 Smoked Fish 3 Bakehouses 10 (c) Unsound Food. The following list gives particulars of unsound food destroyed during the year :- 200 lbs. Beef. 40 lbs. Rabbits. 11 Chickens. 110 lbs. Bacon. 1,207 Eggs. 422 lbs. Fish. 15 lbs. Mutton Fat. 335 Tins Food (Various). (3) FOOD POISONING. There were no cases of food poisoning notified during the year. (4) FOOD & DRUGS ACT. 1938. SAMPLING. During the year your authorised officers have submitted a total of 141 samples, divided as follows :- Milk 8 Butter 3 Others 130 Total 141 The reports of the Borough Analysts, Dr. B. Dyer and Dr. J.H. Hamence, Great Tower Street, London, E.C. show that of this total, four were found not genuine. In connection with these unsatisfactory samples, proceedings were instituted and a sum of £35.10. Od. paid in fines. -22- (5) chemical aND Bacteriological examination of food. The bacteriological examination of all milk, ice-cream and water samples is carried out for tnis Authority by the Counties Public Health Laboratories, of 91, Queen Victoria Street, London, whilst the examination of samples of milk for the presence of tubercle is carried out by Dr. S. R. Gloyne, of the Victoria Park Hospital, Hackney. -23- SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. 1.Notification. The following table shows the number of notifications of infectious diseases (other than Tuberculosis) received during 1940;- ]D I S E A S E Total Total cases removed to Hospital. Deaths Scarlet fever 57 53 - Diphtheria 42 42 1 Enteric Fever (including Par a-Typhoid Fever) 22 22 - Puerperal Fyrexia 13 10 1 Pneumonia Acute Influenzal ) (12) (3) (- Acute primary ) 51 8 (3 Following Measles ) ( 1) (1) (- Erysipelas 21 9 — Ophthalmia Neonatorum 3 2 - Dysentry 1 1 - Measles 131 3 — Whooping Cough 13 - " Cerebro Spinal Fever 17 23 5 TOTALS 384 177 10 -24- 2. Hospitalisation. During the first half of the year 1940, cases of infectious disease reauiring Hospitalisation were sent to the Waltham Cross Isolation Hospital. This arrangement was discontinued early in July 1940, and such cases were from that time admitted to the I^ford Isolation Hospital. The following tables show the Barking cases dealt with during the year at these two Hospitals. Waltham Cross Isolation Hospital during the period 1st January 1940 to 10th July, 1940. Disease. In Hospital December 31st 1939 Admitted during the year Died Dis charged In Hospital July 10th 1940 Scarlet 3 21 - 20 4 Feve Diphtheria 5 23 1 23 4 (including Membranous Croup) Puerperal Pyrexia 1 1 - 0 Pneumonia - 2 — 2 — Myelitis - 1 - 1 - Erysipelas - 4 — 4 - Ophthalmia Neonatorum - 2 2 Cerebro Spinal - Fever - 16 3 13 - Others Enteric Fever (including Para 1 10 - 10 1 typhoid) * 18 — 3 15 Ilford Isolation Hospital during the period 10th July 1940 to the 31st December 1940:- Disease. Admitted from 10th July 1940 Diec Discharged In Hospital December 3lst 1940. Scarlet Fever 32 26 6 Diphtheria (including Membranous Croup) 19 12 7 Enteric Fever (including Paratyphoid) Cerebro Spinal 2 2 - Fever 4 - 2 2 Pneumonia 3 - 2 1 Puerperal Pyrexia 2 — 2 - Erysipelas 5 4 1 Others 3 — 1 2 -25- (3) PARATYPHOID FEVER. Below I give a table showing the number of cases of Paratyphoid Fever which have occurred in Barking over a period of six years Year No. of cases notified. Admitted to Hospital. 1935 5 5 1936 6 6 1937 17 17 1938 8 8 1939 2 2 1940 22 22 In common with adjoining districts there was a minor outbreak of Faratyphoid Fever. Investigations were directed to the consumption of bread and cakes which were drawn from a supply common to notified cases. It, was found that patients in other districts had also consumed food from the same source. No final decision however, was obtained as to the cause of the outbreak. (4} TUBERCULOSIS. Particulars of new cases of Tuberculosis and of deaths from the disease in the area during 1940 are given below New Cases Notified. Deaths. Pulmonary Non Pulmonary. Pulmonary Non Fulmonary M F M F M F M F Under 1 year - - - - - - - -_ 1 to 5 years - - 1 1 — 1 — - 5 to 15 „ 2 1 1 5 — 1 — — 15 to 25 „ 16 20 2 2 1 2 - 1 25 to 35 „ 18 21 - 1 5 4 — — 35 to 45 „ 14 6 — 1 7 2 — 1 45 to 55 „ 9 2 — 1 5 3 - — 55 to 65 „ 4 - - - 8 1 — 65 years and upwards 4 - - - 1 - - - 67 50 4 11 27 14 - 2 During the year 132 notifications were received of all forms of tuberculosis - Pulmonary 117 and non-pulmonary 15, and there were 6 deaths of un-notified cases, making a total of 138 new cases during the year. Information has been received of the removal into the district of 48 tuberculous persons, included in the number of notifications received - five of these are old cases returned to Barking. This compares with 22 received during 1939 and 44 for 1938. (5) ARTIFICIAL IMMUNISATION. Artificial Immunisation was carried out weekly at one of the Clinics, but the attendances on the whole were poor. Towards the end of the year however, figures have started rising and I hope I shall be able to report in 1941 extension and development of the scheme. -26-