BARK 35 BOROUGH OP BARKING. THE ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. FOR THE YEAR 1941 (War Edition) C. LEONARD WILLIAMS, B • Sc., M. R. C. S., L.R.C.P., D. P. H. BOROUGH OF 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, 1941. (War Edition). Public Health Department, Barking, Essex. September, 1942. 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, 1941. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, Medical Officer of Health. -2- ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH for the YEAR 19U1 (War Edition). STAFF. The following indicates the changes that have taken place in the staff of the Public Health Department during the year 1941:- Assistant Medical Officers. / L.M.M. Beadnell, M.R.C.S., L.R.C.P., (Commenced 10.3.U1). T.A. Cockburn, M.D. , D.P.H. , (Resigned 10.2.41). M. Lewis, M.R.C.S., L.R.C.P. , (Commenced 17.3.4l). Health Visitors, etc. + Miss J. Egan (Temporary) (g, h and i). (Commenced 27.10.4l Terminated 15.12.41. ) Miss K.C. Hand (h and i) (District Midwife). (Terminated 31.7.4l). Miss P. Nicholls - Assistant- to Camp Matron at Hydon Heath. (Commenced 10.3.41. - Resigned since the close of year). + Miss M. Simpson (Temporary) (g, h and i). (Comnenced 27.10.4l. - Terminated 19.12.41. ). + Miss A. Thomas (Temporary) (g, h and i). (Commenced 29.94l. Terminated 19.12.4l). Miss K.B. Walker (Chiropodist) - Temporary part-time. (Commenced 9.5.41. - Resigned 26. 9.4l). Mrs. Race Wardell (Chiropodist) - Temporary part-time. (Comnenced U. 9.41. - Resigned since the close of year). Clerical Staff. C.G. Eaglesfield (Senior Assistant) (r) - transferred to Education Department 6.12.4l). Mrs. D. Benbow (Temporary) (Commenced 23.10.4l). Miss E. Clark (Resigned 2.7.41). Miss A.R. Holmwood (Temporary) (Commenced 3.3.41). Mr. W. Norris (Temporary) (Commenced 15.U.41). Mr. P.J. Olver (Service in H.M. Forces from 12.9.41). Mrs. G. Pratt (Temporary) (Resigned l4.10.4l). Mrs. M. Price (Temporary) (Commenced l4. 7.41). Miss G. Sida (Temporary) (Commenced 10.3.41). -3- (g) Health Visitor's Certificate of the Royal Sanitary Institute. (h) Certificate of the Central Midwives Board. (i) General Hospital Training. (r) Intermediate Examination of the Incorporated Secretaries Association. + Combined appointment - Health Visitor and School Nurse. During the year members of the staff 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. The arrangements made in the year 1940 for staffing the Battlers Green Emergency Maternity Home at Radlett were continued until the 12th June, 1941. Miss Hand's and Mrs. Bronnick's appointments as Municipal District Midwives terminated on the 31st July, 1941. Mrs. Bronnick re-appointed as from 1.8.41 as Municipal Midwife to serve at such places as required by the Corporation - has been at the Battlers Green Emergency Maternity Home since the 4th August, 1941. Mrs. Bishop, Municipal District Midwife, has been at Radlett continuously since the 12th June, 1941. -4- SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA. (1) BIRTHS. The total number of live births during the year was 1017, as compared with 1104 in the year 1940. There were 30 still births, the number for the previous year being 35. (2) DEATHS. (a) General. There were 362 deaths registered in Barking during 1941. Of these 25 were deaths of non-residents. Barking residents to the number of 326 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 365 298 663 The following table shows the principal causes of death during 1941:- (net Deaths). Causes of Death Total Cerebro Spinal Fever 2 Whooping Cough 3 Diphtheria - Pulmonary Tuberculosis 47 Non-Pulmonary Tuberculosis 6 Syphilitic diseases 5 Influenza 3 Acute Inf.Encephalitis 1 Cancer (all form) 97 Diabetes 7 Intra-cranial vascular lesions 35 Heart Disease 134 Other diseases of circulatory system 17 Bronchitis 33 Pneumonia 46 Other respiratory diseases 8 Ulcer of stomach or duodenum 5 Diarrhoea (under 2 years) 1 Appendicitis 3 Other digestive diseases 15 Nephritis 9 Other maternal causes 2 Premature Birth 9 Congenital Malformations, birth injury infantile diseases 10 Suicide 8 Road traffic accidents 11 Other violent causes All other causes Totals 663 -5- (b) Infant Mortality. There were 34 deaths of children under one year of age, the figure for the year,1940 being 35. The following table gives the actual causes of death of the 34 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 Streptococcal Pneumonia 1 1 Acute suppurative broncho pneumonia 1 1 Asphyxia (natural) 1 1 Asphyxia (natural) due to haemorrhage into the lungs due to iclus neonatorum gravis 1 1 Asphyxia (natural) due to inhalation of birth fluids 2 2 Broncho-Pneumonia 3 3 1 7 Broncho-Pneumonia-Acute Intussusception 1 1 turity. 1 1 Broncho-Pneumonia & Whooping Cough 1 1 2 Cardiac Failure & BronchoPneumonia 1 1 Cerebro Spinal Meningitis 1 1 Convulsions, Infantile Diarrhoea 1 1 Intra-cranial haemorrhage, birth injury 1 1 Myocardial Degeneration, Broncho Pneumonia 1 1 Prematurity 9 9 Prematurity, Atelectasis 1 1 Prematurity, Convulsions 1 1 Spina Bifida, Meningomyelococle 1 1 Totals 20 5 5 4 - 34 (c) Maternal Mortality. There were two deaths of Barking women due to or in consequence of pregnancy or childbirth, and in the year 1940 there were 4 such deaths. -6- (3) SOCIAL CONDITIONS., (a) General. After many years in the Public Service I am coming to the conclusion that, where the infant mortality in any area can be looked upon as "not too bad", the general social conditions are not open to much adverse comment. For the past five years you have in Barking an infant mortality of 40 per thousand births, which compares more than favourably with tho rest of the country, and is I believe an index that social conditions are not too bad. This rule is not an invariable one but I have no reason to believe that Barking is an exception and think that you can take your relatively satisfactory position with regard to infant mortality as indicating that general social conditions are not unsatisfactory. 00 Schemes of Relief. My opinions on this matter have been expressed in previous reports, viz., that it is desirable to unify these schemes. I am pleased to report that during the year 1941 the Committee have revised their scales in respect of Maternity and Child Welfare services. (C) Unemployment. The Ministry of Labour and National Service inform me that for the year ended the 31st December, 19U1, the local unemployed in this area was practically "Nil". Even persons with poor industrial records due to some physical reasons are finding work, who in former days were considered as practically unemployable. The demand for "Male" labour has far exceeded the supply available, consequently substitution of "Female" labour was introduced, with the result that several local firms for the first time accepted female labour. The shortage of labour has brought on to the registers offers of part time employment, particularly women, and whilst this scheme is more or less on trial in this area, the demand for this type of labour is increasing. (d) Travelling facilities. Certain improvements in the travelling facilities to and from Barking were, I believe, effected during the year 1940. It appears to me however, that the conditions today are far from satisfactory and I can only continue to deplore the general inadequacy of the travelling conditions. -7- SECTION B GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (1) GENERAL HEALTH SERVICES. (a) Ambulance Facilities. This service continues to "be a part of the Civil Defence Organisation and our reciprocal arrangements with adjoining areas have been maintained. (b) Hospital Facilities. As in 1940, the Barking Hospital continues to be within the framework of the Emergency Medical Service. Voluntary hospitals catering for the residents of the Borough were again given financial assistance, and the sum of £300 was allocated by you for distribution to these hospitals. (c) Clinics and Treatment Centres. The demand for our normal clinic services has not lessened and the attendances at the Out-Patient departments were very high during the year 1941. The Central Clinic was used as a First Aid Post until 6th March, 194l. when it was transferred to the new Broadway First Aid Post. As mentioned in my previous year's Report, we discontinued the use of tho Woodward Clinic in January 1941, because of serious damage by enemy action, and we have continued to use the Greig Hall adjoining as a Clinic, and Out-Patient department. (d) Nursing in tho Home. The Plaistow Maternity Hospital and District Nurses Home and the East Barking District Nursing Association. continue to be responsible for nursing in the home and the services provided are satisfactory. The amount of nursing in the home has increased since the outbreak of war. Both these organisations receive substantial financial aid from the Barking Corporation. (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 of ante-natal cases at your clinics amounted to 8,299, an increase of over 900 on the figure for the previous year. A weekly clinic session for post-natal and gynaecological cases only was commenced at the Humphrey Clinic on the 1st April, 1941, and considerable effort has been made to persuade our mothers to use this facility. As a result it can be recorded that the number of post-natal attendances (508) and of gynaecological attendances (359) each showed an increase of about 100 over the previous year. -8- This post-natal figure is still much lower than I could wish; at the same time, it shows a definite step in the right direction, and I look forward with hopefulness to still further increase next year. (b) Midwifery. (i ) Supervision. There were 11 midwives practising in the Borough at the end of the year, 6 of which were employed at the Upney Maternity Pavilion. During the year 1941, midwives sought medical assistance in 207 cases; 27 of these were on behalf of babies. (ii) Midwives Act, 1956, 307 mothers were delivered in Barking under your district midwifery scheme during the year 1941. In addition 24 mothers wore delivered by doctors with district midwives acting as maternity nurses. (c) Upney Maternity Pavilion (and Barking Emergency Hospital-), At the Upney Maternity Pavilion during 1941, 4l8 patients were confined, 63 patients were admitted for ante-natal treatment, 1 for post-natal treatment and there were 5 miscarriages. At the Barking Emergency Hospital 215 expectant mothers spent a total of l660 bed days, which I think is a matter for both note and congratulation; it certainly shows that there is a real demand for this means of hospitalisation, which no doubt you will wish to consider as one of your post-War developments when the Barking Hospital will no longer be available for this purpose. In addition, the Barking Hospital has been used in other ways also; there were 6 miscarriage cases, 6 gynaecological, 3 abortions, 3 post-mis carriage and 18 postconfinement cases, a total of 36 who spent 286 bed days, (d) Evacuation. Evacuation of expectant mothers in the last month of pregnancy proceeded in 1941 as in the previous year. 167 were sent to Radlett, and owing to the limited accomodation there 13 were sent to other places in Hertfordshire. (e) Infant Welfare Centres. The total number of attendances at the Infant Welfare Centres during 1941 was 27,028, compared with 29,347 in 1940. This decrease can be accounted for by the fact that by the early months of 1941 considerable areas of the Town had become uninhabitable by reason of enemy action and many of our mothers and children were staying elsewhere temporarily. Another factor which would contribute to this is that three of our Clinics during the first months of the "blitz" were used as First Aid Posts and it had been our habit during day-time alerts to defer the Clinics, sending the mothers and children to shelters; on account of this, the numbers had tended to decline and the mothers had rather got out of the habit of attending the Clinics,. -9- (f) Home Visiting. It is, gratifying to note that your Health Visitors were able to give more the to this part of their work during 1941, the total number of visits being 18,514 as compared with 114,301 during 1940. This v/as made possible by the fact that daylight raids were much fewer and less time was required on examinations in connection with school evacuation. (g) Circumcision Clinic. In July, 1941, circumcision sessions were commenced at Central Clinic and continued thereafter at regular intervals of approximately two weeks or a month, according to the demand. In this v/ay 27 operations (including 4 stretchings and 1 nail and 1 mole removed under anaesthetic) were performed without incident and a really urgent local need has been met. (h) Birth Control. From its inception in November, 1937, to the end of 19*40, 19 cases had attended the Birth Control Clinic, making a total of 24 attendances. During the year 1941, 1 hew case attended, on two occasions, and 1 old case, on one occasion. (i) War Time Nurseries. Proposals to establish War-Time Day Nurseries to receive children under 5 years of age of mothers in work, were considered by you in June 1941, and subsequently approval v/as received from the Ministry of Health to convert the Eastbury Ilanor House and Lodge Farm House, Rugby Road, for the purpose. Accomodation at these two premises would be 80 and 43 children respectively. Neither Nursery v/as opened during the year 1941. This opportunity is taken to record our appreciation of the way in which the officers of the National Trust have co-operated in making available the historic Eastbury Ilanor House for this war-time measure. (j ) Supplementary Clothing Coupons for Expectant Mothers. The scheme for the issue of a special allowance of 50 clothing coupons to expectant mothers, on meclical certificate, was commenced on the 5th August, 1941, and from that date to the end of 194l, issues were made to 723 patients, 2 of which were in respect of twin pregnancies. - 10 - (k) Issue of Vitamins to Children under 5 years. The Government Scheme for the issue of cod liver oil to all children holding-a child's ration book and of fruit juices (blackcurrant syrup and blackcurrant puree) to all children under the age of 2 years came into operation on the 8th December, 194l. Arrangements were made, where desired, for the distribution of these vitamins at your Infant Welfare Clinics at the normal sessions, the actual distribution being in the hands of the Pood Executive Officer by arrangement with the Borough Treasurer. 69.45% of the children eligible received their supplies through your Clinics and 7.75%through the Pood Office; the parents of the remaining 22.8% did not avail themselves of the facilities offered under the scheme. (3) ORTHOPAEDIC SERVICES. On the whole the work in all branches in this department has increased quite appreciably during the last year. Prom June 1941, to September 1941, the Sunlight Clinic was temporarily interrupted except for very special cases, as it was thought that natural sunlight and fresh air would be of greater benefit than artificial light. As the schools closed at 3.30 p.m. (actually 1.30 p.m. ) it will be appreciated that school children had every opportunity of enjoying out-door recreation and sunlight. Much work was done by your masseuses during this time on massage, exercises, electrical treatment, etc. It was unfortunately necessary to immobilise the High Frequency Inductotherm Apparatus early in March 1941, following a Government Circular which pointed out that under the Defence Regulations 1939, such electrical apparatus could not be used unless an earth-screened room v/as provided. It was put into commission again in September 1941 when arrangements had been made to screen off the apparatus. - 11 - PARTICULARS OP THE WORK DONE IN CONNECTION WITH THE ORTHOPAEDIC CLINIC DURING 1941. No. of Sessions held by Orthopaedic Surgeon: 11 No. of Sessions held by Masseuses: 1,052 Toddlers & Adults. School Children ATTENDANCES. Primary Examination by Surgeon 66 73 Re-examination by Surgeon 105 101 For treatment 5,986 4,751 TOTALS 6,157 4,925 TREATMENTS. • Number of Children 880 724 Number of Treatments 8,903 5,514 TOTALS 9,765 6,238 HOSPITAL TREATMENT. Admissions to Hospitals - - On Waiting List for admission - - TOTALS - - Cases dealt with for the first time during 19U1 - by the Orthopaedic Surgeon - were referred for the following defects:- (a) DEFORMITIES OF BONES & JOINTS: 1. Congenital 2 - 2, Acquired 58 4l ("b) MUSCULAR: 1. Congenital - 1 2. Acquired. - 40 (c) PARALYSIS 1 5 (d) MISCELLANEOUS 10 - - 12 - (4) EAR, NOSE AND THROAT SERVICE. Sixty-one sessions v/ere held during the year by your Specialist Consultant, Mr. F. Courtenay Mason. Twenty-eight of these were operative sessions at the Barking Hospital and 33 v/ere out-patient sessions held at Central Clinic. Final arrangements were completed for the admission of patients to Barking Hospital for tonsil operations. Members of the Civil Defence and Emergency Medical Service's nursing and medical staff were allowed to give all co-operation in this work to members of the Public Health staff, and I would like here to record my appreciation for their help, without which the scheme could never have been put into action. The first session arranged for 24th March 1941, had to be cancelled owing to enemy action, but on 6th April 1941, the first operative session was held at Barking Hospital and thereafter the scheme proceeded without incident until the end of the year. Children were admitted the day before operation and discharged two days after operation. In May 1941, this scheme was extended to cover all operative procedures of the ear, nose and throat. Actually 256 children v/ere operated on at the Barking Hospital during 1941. The total number of cases who received operative treatment during the year was as follows:- Toddlers 86; School children 277; Total 363. In October 1941, arrangements were completed whereby the facilities available at this Clinic could be afforded to members of the adult population. Since the inception of this scheme, and up to December 1941, two patients have availed themselves of consultations with the Ear, Nose and Throat Consultant. (5) OPHTHALMIC SERVICES. The services provided by you for the examination and treatment of the eyes have been carried on entirely at the Central Clinic during 1941, owing to the damage done to the ophthalmic equipment at the Woodward premises in the early part of the year. At first only two sessions per week were held but it was found possible as time v/ent by to increase this number to three sessions per week, and a total of 104 sessions were held during the year compared with 82 sessions in 1940. Treatment of Defective Vision and Squint - Table of Statistics. Mothers & Toddlers. Public Ophth. Scheme. School children. Total. Errors of Refraction requiring treatment. 198 85 551 834 No.for whom spectacles were: - (a) Prescribed 59 59 , 270 388 (b) Obtained 48 36 294 378 TOTALS 305 180 1,115 1,600 - 13 - Squint Training. Squint training was resumed during the year 1941 and 93 sessions were held for this purpose, a considerable amount of valuable work being accomplished as will be seen by tho following table:- Toddlers. School Children Total No.of children attended 1 28 29 No.of new cases 1 11 12 No.of old cases - 17 17 No.of attendances 18 511 529 No.discharged cured - 4 4 No. evacuated - l 1 No. left school - 1 1 No. discontinued 1 3 4 (6) DENTAL SERVICES. Mr.Foy, Senior Dental Surgeon, has submitted to me the following report:- During the year ending December 31st, 1941, some handicap to the Dental Scheme has existed, owing to the loss of the Woodward Clinic due to enemy action, and to the use of the dental premises of the Central Clinic by the Civil Defence as a Gas Cleansing Station, The value of this could be regarded as equal to the loss of ,75 of the services of one Dental Surgeon on Education conservative treatment, but the loss was not absolute, as the Dental Staff, by acting as Dental Anaesthetist to each other, instead of calling on the medical staff, were able to utilize sessions to advantage. Evacuated children who returned to Barking, presented individual oral conditions far less satisfactory than one might reasonably expect had they received routine examination and treatment in Barking, and considerably more time per child was spent in restoring such mouths to a state of dental fitness than under normal circumstances. No blame or reproach may be made against Reception Authorities, who must have been sorely taxed by the responsibility of examination and treatment of a number of children far in excess of their peace-time anticipations, and often working with a depleted staff. It is ironical that those children v/hose parents were unwilling to consent to a National Request to evacuate children, should remain favourably placed for health services, but should he mostly those whose past nistory had been one of indifference to those services. The constant refusals remained at home, and the constant acceptances intelligently departed. - 14 - Mr.nor Clinic fulfils a useful purpose and geographically is well placed for a few schools, but the need is for the re-opening of the Central Clinic Dental premises in order to relieve the pressure on the East Street Clinic. MATERNITY & CHILD WELFARE DENTAL SERVICE. The evacuation of mothers did not materially affect the Dental Service, since those mothers who elected to receive treatment did so "before departing to the Maternity Centres or on their return. The Service, however, was handicapped "by lack of premises in the same manner as the Education Dental Service. PUBLIC DENTAL SCHEME. This proved a most popular service, and may he regarded as an undertaking which is available for the potential dental needs of the total population, and obviously this is more than can be completely undertaken by a Dental Staff. whose strength was assessed on the dental requirements of the school population and expectant and nursing, mothers. Nor should the Service be regarded as one which will disappear after hostilities, and an increase in staff and premises as and when required should be seriously considered. Already, large waiting lists exist, and the only apparent solution is to undertake the provision of extra sessions preferably in the evening so as not to trespass on the time allocated for the existing Service. * I have the honour to be, Sir, Your obedient Servant, (sgd) W.H.Foy, L.D.S., R.C.S. (ENG.) Senior Dental Officer. 15 SUCTION c. SANITARY CIRCUMSTANCES OF F?£ AREA. (1) RAINFALL. The rainfall for the year ended 3lst December 1941 was 21.7 inches, as compared with 18.45 for the previous year Rain fell on 258 days in the year 19U1. (2) "7ATER S TP PLY. There has "been no extension of mains, nor any important developments. (3) DRAINAGE AND SEV/ERAGE. Drainage arrangements continue as heretofore. (U) RIVERS AFP STREA :S. 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. (5) CLOSET ACCCMMQDATION. At the end of the year there remained a total of 16 premises unconnected With the sewer, nine of which were factory premises. (6) PUBLIC CLEANSING. During the year 3,496 loads of refuse were collected with an average weight of 2,17 tons. (7) REFUSE DISPOSAL. The refuse of the Borough by arrangement with the County Borough of East Ham, was taken to the destructor works of that Authority. (8) SANITARY INSPECTION OF THE AREA. Emergency and war conditions have interfered seriously with the routine work of the Department. (a) 70RF, OF SANITARY INSPECTORS. (i) Inspection of Dwelling Houses. Total Houses inspected under Public Health or Housing Acts 2,162 Total Number of Inspections made 4,570 Housing (Consolidated) Regulations 155 After Infectious Disease 375 Overcrowded Premises 32 Defects Pound 3,582 Notices Served (Preliminary) 1,560 Re-inspections re Notices Served 2,408 'Inspection of Works in Progress 516 16 (ii) Promises Controlled "by Bye laws and Regulations. Inspecti ons. Contraventions. Notices served. Houses Let in Lodgings — — — Common Lodging Houses 3 — — Offensive Trades 34 14 10 Tents, Vans and Sheds — — — Dairies, Cowsheds and Milkshops 38 u 4 Slaughter Houses — — — Hairdressers £ Barbers Premises 27 3 1 Smoke Observations 46 4 4 (iii) Factories, Workshops and Workplaces. Inspections. Defect s. Notices. Factories 78 8 3 Bakehouses 11 — — Workplaces 15 — — Outworkers Rooms 20 — — Butchers premises 128 31 15 Fishmongers 15 5 3 Restaurants and Dining Rooms, and Canteens 96 32 16 Stables and Stable Yards 4 6 2 Piggeries 7 1 1 (iv) Miscellaneous. Inspections. Defects. Notices. Rats & Mice (Destruction) Act I9I9 112 42 26 Vacant Land and Refuse Dumps 104 19 10 Public Lavatories 31 4 2 Schools 26 5 — Markets and General Shops 297 64 42 Ice Cream Vendors 16 1 — Drainage Inspections 295 — — Milk Sampling 19 — — Other Miscellaneous 160 — — Shops Act, 193U 329 16 4 Water Sampling 12 — — Food Manufacturers 36 — — Street Traders — — — Food Byelaws 59 — — Watercourses 7 — — Air Raid Shelters 118 — — (b) NOTICES SERVED. Informal Noticos 1,560 Statutory Notices:- Public Health Act, 1936:- Section 39 2 Sectxon 45 22 Section 83 1 Section 9.3 123 Housing Act, 1936;- Sections 9 and 10 17 Secti on 24 — S e ct i on 32 — Barking Corporation Act Section 148 147 312 17 (c) Premises and Occupations which are controlled by Byelaws or Peculations. The following is a list of the above type of prerases: - (1) Houses let in lodgings. (2) Comon Lodging Houses. (3) Tents, Vans and Sheds. (M Underground sleeping roons. (5) Offensive Trades. (6) Piggeries. (7) Stables. (d) Rats and Mice Destruction Act, 1919. There were 112 visits nade to premises under this Act, and any necessary work arising has been carried out. (9) ERADICATION OF BED BUGS. The following houses have been disinf ested:- Barking Council Houses 12 Privately owned houses T" _ ~l - J /N • *1 * T _ 6 London County Council Houses — Total 18 18 SECTION D. HOUSING. (1) STATISTICS. (a) General. Nuriber of new houses completed during the early part of 19U1 (1) Total 14 (2) As part of a municipal housing scheme;- (a) Barking — (^) L.C.C. 12 Others 2 ("b ) Uni'it Dwel1ing-Houses. 1. Inspection of dwelling-houses during the year:- (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,162 ("b) Number of inspections made for the purpose 4,570 (2) (a) Number of dwelling-houses (included under sub-head No.1 ab ove) whi ch were inspected and recorded under the Housing Consolidated Regulations 155 (b) Number of inspections made for the purpose 296 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (U) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 1,560 2. Remedy of Defects during the Year without Scrvice of formal Notices:- Number.of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 949 3. Action under Statutory Powers during the Year: - A3. - Proceedings under sections 9> 10 and 16 of the Housing Act, 1936:- (1) Number of dwelling-honges in respect of which noting were served rqquir(???) repairs 7 19 (2) Nuriber of dwelling-houses which were rendered fit after service of formal notices:- (a) By owners 36 (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 148 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a} By owners 70 (b) By local authority in default of owners 5 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 245 20 S E C T I ON E. 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 10 milk purveyors who occupy premises in other districts, hut retail in Barking. The following table sets out the results of the bacteriological examination of various samples. Type of sample. Satisfact ory. Unsatisfactory Totals  "Sterilised" Milk — — — "Pasteurised" Milk 11 — 11 Raw Milk 2 — 2 "Homogenised" Milk — — — Tuberculin Tested Milk — — — Totals 13 — 13 There were during the year, 6 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 mi lies under the Milk (Special Designations) Order, 1936:- Tuberculin Tested 6 Pasteurised 10 (b) Ice Cream - Barking Corporation Act, 1953 - Section 160. There are 03 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. 21 (2) MEAT AND OTHER FOODS. (a) Heat. 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 22 Potted Heat and Brawn 4 Roast and/'or Boiled Ham 4 Pressed, Pickled, Cooked, etc., Beef and Tongue 34 R oa st P ork — 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:- Bacon 2 cwts. Chi ckens 11 Jam, Fruit, Vegetables, Soups, Fish, Pickles, etc., in Tins and Jars 2280 Sweets 14½ lbs. Fish 90 sts. Jellies 16 Sugar 178 lbs. Suet 5 lbs. Margarine, Butter, Cooking Fats 54½ lbs. Flour, Rice, Custard Powder, Cornflour, Cake Flour, pudding Mixture, etc. 105 lbs and 102 pkts. Biscuits, Rusks, etc. 8 pkts. Shredded Wheat, Cornflakes, Porridge Oats, Breakfast Cereals, etc. 57 pkts. Cocoa 2 lbs. Coffee 4 lb. Tea lbs. Split Peas, Lentils, Haricot Beans 18¾ lbs. Cakes 13 lbs. 11 Swiss Rolls. Meat 57½ lbs. Meat Roll 8 tins. Meat Pies 34 Rabbits 7½ cwts. Pressed Beef 570 lbs. Brawn 1193 lbs. Fish Roll 6482 tins. Cheese 104½ lbs. Eggs 73. " (frozen) 30lbs. Sausages 33¼ lbs. Crumpets 15 doz. Sliced Bread 1 loaf. Gherkins 8 tons. Carrots 2 casks. Beetroots 1 cask. - 22 - (3) FOOD POISONING. There wore no eases of food poisoning notified during the year. (U) FOO'O DRUGS ACT, 1938, SAMPLING. During the year your authorised officers have submitted a total of 160 sample Si, divided as follows:- Milk 15 Butter & Margarine 4 Others 141 160 The reports of the Borough Analysts, Dr.B.Dyer and Dr. J.H.Hanence, Great Tower Street, London, E.C. show that of this total, 24 were found not genuine. In connection with these unsatisfactory samples, proceedings v/ere instituted and a sun of £128. 0. 0. paid in fines. (5) CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF FOOD. The "bacteriological examination of all milk, ice-cream and water samples is carried out for this Authority "by the Counties Public Health Laboratories, of Gidea Park College, Essex, whilst the examination of samples of milk for the presence of tubercle is carried out "by Dr.A.L.Sheather, of Chorley Wood, Herts. 23 SECTIO N F PRLVAIENCE OF, AND CONTROL OV1R INFECTIOUS AND OTHER DISEASES. 1. Notification. The following table shows the number of notifications of infectious diseases (other than tuberculosis) received during 19U1:- DISEASE Total Total cases removed to Hospital Deaths. Acute Anterior Poliomyelitis 2 2 _ Scarlet Fever 93 85 _ Diphtheria 31 31 _ Enteric Fever (including Para-Typhoid Fever) 1 1 - Puerperal Pyrexia 8 8 - Pneumonia Acute Influenzal) (11) (3) (- Acute Primary ) (62) (22) (2 Following lieasles ) (12) ( 5) (- Erysipelas 15 8 - Ophthalmia Neonatorum 5 3 - 'Measles 1305 29 - 'Whooping Cough 658 15 3 Cerebro Spinal Fever 22 22 1 Others 9 9 - TOTALS 2234 243 6 2. Hospitali sation. During the year 1941, cases of infectious disease requiring hospitalisation were admitted to the Ilford Isolation Hospital. - 24 - The following table shows the Barking cases dealt with during the year at this Hospital. Disease In Hospitali 31st Dec. 19U0. Admitted during year. Died. Discharged In hospital Dec. 31st 1941. Acute Anteø rior Poliomyelitis - 2 - 1 l Scarlet Fever 6 85 — 81 10 3 Diphtheria , (including Membranous Group) 7 31 35 Cerebro Spinal Fever 2 19 1 19 1 Pneumonia 1 9 1 9 — Puerperal Pyrexia — 4 — 2 2 Erysipelas 1 8 — 9 — Whooping Cough — 13 3 8 2 Measles — 27 — 27 — Others 2 9 — 11 — ø One of these cases subsequently proved not 'to be Acute Anterior Poliomyelitis 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 seven years;- Year No. of cases notified. Admitted to Hospital. 1935 5 5 1 1936 6 6 1937 17 17 1938 8 81 1939 2 2 1940 22 22 1941 1 1 25 4. Tuberculosis. Particulars of new crses of tuberculosis and of deaths from the disease in the area during 1941 are given below:- New Cases Notified Deaths. Pulmonary Non Pulmonary ' Pulmonary Non I pulmonary M F M P M F H P Under 1 year _ _ _ _ _ _ _ _ 1 to 5 years _ 1 1 1 _ _ 1 _ 5 to 15 years _ — 2 3 _ _ 1 _ 15 to 25 years 18 13 5 6 2 8 2 _ 25 to 35 years 13 16 1 6 5 5 2 _ 35 to 45 years 12 13 2 1 8 4 1 _ 45 to 55 years 11 4 _ _ 2 2 _ 1 55 to 65 years 9 2 _ _ 9 1 _ _ 65 years and upwards 1 _ _ _ _ 2 _ _ 64 49 11 17 26 22 7 1 Daring the year 14I notifications were received of all forms of tuberculosis - pulmonary 113 and nonpulmonary 28, and there were 10 deaths of un-notified eases, making a total of 151 new cases during the year. Information has been received of the removal into the district of 37 tuberculous persons, included in the number of notifications received - 12 of these are old cases returned to Barking. This compares with 48 received during 1940 and 22 for 1939. 5. Artificia1 Immunisation. In Hay 194l, the Government- sent out circulars stressing the dangers of diphtheria and pressing Local Authorities to carry out diphtheria immunisation in an extensive manner. As a result of this, numbers attending Immunisation Clinics rose, and the number of sessions per week increased from one to nine. The total number of children inoculated against diphtheria during the year was 2,047 as compared with 5U in 1940. Immunisation against whooping cough and scarlet fever was carried cut simultaneously, the total number of children inoculated against these two complaints being respectively 423 and 569. Table of Statistics - Year 1941. Toddlers School children Total, Inoculations against Diphtheria 677 1,370 2,047 Scarlet Fever 230 339 569. " " Whooping Cough 288 135 423. 26 RESUME. Insofar as this Report is of necessity scrappyit nay "be of some snail value if I rehearse a few of the nore inportant it-ens of information. Clinical attention provided "by your Services has maintained the inportant role it has played for the past few years. All your Services, including the School Service, my he looked upon as one large Out-patient department. Your out-patient attendances were over 120,000, which represents the out-patient attendances of a large hospital. The tuberculosis figure of 151 compares unfavourably with 138 of the previous year. This nust be weighed in the balance against the favourable remarks I have made of the advantageous position you hold with regard to infant mortality. The incidence of tuberculosis is a very sensitive indicator of our state of health, and, although the increase is not alarming, it is sufficiently definite to show the need there is for increased vigilance in matters of health, and here I may say I look upon food as the fundamental factor, v/ith housing not quite but almost bracketed with it in importance. The statistics with regard to inoculation against diphtheria are unsatisfactory. Diphtheria is one of the small number of diseases which can be conquered, but in general it appears the public run after all sorts of quack nostrums, both in the way of medicines and ideas, and seem determined to avoid such a well-tried and well-founded method of prevention as inoculation against diphtheria. Advertising methods of the more flashy variety dealing with immunisation do seem to achieve a momentary success, but there is no sound public opinion on this matter. If I may be permitted to audit what after all is my account, I do believe that you are doing quite well, and I do believe that the children of to-day, v/ho will be the men and women of tomorrow, will say that, in spite of the very difficult time of the world war, you have done well. Medical Officer of Health. 27