411 (1) BARK 73 BOROUGH OF BARKING. ANNUAL REPORT (ABRIDGED) OF THE MEDICAL OFFICER ON THE HEALTH OF THE CHILDREN OF BARKING FOR THE YEAR 1949. C. Leonard WILLIAMS, B,Sc., M.R.C.S., L.R.C.P., D.P.H. Public Health Department, Barking, Essex. November, 1950. To the Chairman and Members of the Barking Committee for Education. I beg to submit my Abridged Report for the year ended 31st December, 1949. I am, Your obedient servant, C. LEONARD WILLIAMS. Medical Officer. 1 MEDICAL INSPECTIONS. During the year nine thousand four hundred and eighty children were medically examined at school, which represents seventy-five per cent. of the total school population. In addition there were twenty-four thousand three hundred and eighty special inspections and re-inspections at your various Clinics. The Statistical Return at the end of this Report shows the classification of defects found at these examinations and re-examinations. NUTRITION. Of the nine thousand four hundred and eighty children medically examined at school, three thousand nine hundred and nine were found to be of good nutritional standard; five thousand four hundred and seventy-eight were fair (that is, of normal nutrition), and only ninety-three were of poor nutritional standard. These results compare very favourably with those for 1948. MINOR AILMENT CLINICS. Minor Ailment Clinics were held daily at Central, Woodward, Porters Avenue and Upney, and the total attendances during the year were twenty-nine thousand two hundred and ninety-one. 2 DENTAL INSPECTION AND TREATMENT. We were unable to increase our staff of four to the approved establishment of six Dental Officers, so that it was impossible to undertake the number of dental inspections at school at which we aim. Pour thousand eight hundred and two children were actually treated, compared with over six thousand the previous year. ORTHODONTIC TREATMENT. The orthodontic treatment of school children was maintained at your Dental Clinics, and one hundred and fifty-nine orthodontic aopliances were provided. EAR, NOSE AND THROAT CLINIC. t Mr. Courtemay Mason, F.R.C.S., Consulting Ear, Nose and Throat Surgeon, continued to hold weekly sessions at Central Clinic, and eight hundred and thirty-nine attendances were made. Two hundred and twenty-six children received operative treatment for ear, nose and throat conditions at King George Hospital, Ilford; Queen Mary's Hospital, Stratford; and St. Mary's Hospital, Plaistow. 3 OPHTHALMIC CLINIC. Dr. R, Jamieson succeeded Mr. J. Ayoub, P.R.C.S., as your Consulting Ophthalmic Specialist in March, and continued to attend twice weekly at both Central and Woodward Clinics. Altogether three hundred and seventy-five new cases were seen; spectacles were prescribed for six hundred and ninety-seven children, and there were total attendances of two thousand three hundred and fifteen. ORTHOPTIC CLINIC. The Orthoptic Clinic continued under the supervision of your Ophthalmic Specialist. One hundred and forty-seven cases were given squint training, and these cases made one thousand six hundred and seventy-three attendances during the year. ORTHOPAEDIC CLINIC. Mr. A.M.A. Moore, F.R.C.S., your Consulting Orthopaedic Surgeon, held nineteen sessions at which one hundred and fifty-five children were seen. So far as orthopaedic treatment was concerned, there were times during the early part of the year when we had one only physiotherapist, and although the position improved at no time did we have our full complement of staff. One thousand and fifty five children received treatment, of which four hundred and thirty-eight attended for ultra-violet light, and during the year the total attendances at the Orthopaedic Clinic were eight thousand one hundred and twenty. 4 SKIN CLINIC. Dr. Deville, your Specialist Consultant in Skin Diseases, held weekly sessions in Paget Ward at the Barking Hospital. One hundred and ninety-one new cases were seen by Dr. Deville which was an increase of only eighteen over the number seen in 1948. In addition eight hundred and ten new cases were seen by your Medical Officers at other OutPatient Skin Clinics. Over four thousand attendances for the treatment of skin conditions were made during the The following table shows that there has been a most satisfactory decrease in the number of children requiring treatment for Scabies during the past four years:- 1946 1947 1948 1949 2 31 110 32 12 PAEDIATRIC CLINIC. Dr. A. Doyne Bell, your Children's Specialist Consultant, resigned in November and was succeeded by Dr, S.B. Dimson. This Clinic continued to be held on alternate Thursdays, and during the year one hundred and ten attendances were made. 5 SPEECH THERAPY. The Speech Therapy Clinic held in the Paget Ward of Barking Hospital was closed for nearly two months whilst we were without a Speech Therapist. Since June, however, a full-time Speech Therapist has been engaged, and during the year over eighty children have attended for treatment. FOOT CLINICS. Five hundred and ninety-five children attended at the Foot Clinics during the year and one thousand three hundred and twelve treatments were given. This showed a slight decrease as compared with 1948. SCHOOL CAMPS. Five hundred and seventy-three children were medically examined before their admission to Hydon Heath and other Camps. If, at this examination, some minor defect was found everything possible was done to arrange immediate treatment so that the child should not be deprived of the opportunity of going away to Camp. UNCLEANLINESS INSPECTIONS. Although there were three thousand more uncleanliness inspections at school during the year than in 1948, there was an increase of only fourteen pupils found to be infested. 6 INFECTIOUS DISEASES AMONGST SCHOOL CHILDREN. (a) Scarlet Fever. One hundred and five children were notified as suffering from Scarlet Fever during 1949, compared with eighty-four in 1948. (b) Whooping Cough. There was a decrease in the number of cases of Whooping Cough, eighty-one being notified in 1949, and one hundred and sixteen in the previous year. (c) Measles. There was a very considerable decrease in the number of Measles notifications; there being only one hundred and sixty-four this year as against five hundred and twentythree in 1948. (d) Diphtheria. One only case of Diphtheria was notified, whilst in the previous year there were seven. IMMUNISATION. Immunisation against Diphtheria was carried out by your Medical Officers not only at the Clinics but at schools also, and at the end of the year no less than 83 per cent. of the school population were immunised against Diphtheria. 7 HANDICAPPED PUPILS. The physically-handicapped, delicate, and educationally sub-normal children attending Faircross Day Special School continued to receive constant medical supervision, twentythree sessions of medical inspection being carried out at the school during the year. The number of physically-handicapped and delicate children on the roll at the end of the year was sixty-three, which included nine from Dagenham and East Ham. There were ninety-five educationally subnormal children in attendance at the school, although of this number sixty-one came from Ilford, Dagenham and East Ham, Six children from this area attended Tunmarsh Lane (Day) Deaf Centre, West Ham. Other handicapped children were treated in residential special schools as under:- Educationally sub-normal: 1 Epileptic: 1 Physically-handicapped: 1 Blind: 1 Partially blind: 1 Partially deaf: 1 8 CONVALESCENT TREATMENT. During the year arrangements were made for convalescent treatment (up to a maximum of eight weeks) in thirty-four cases. In four other cases, where more prolonged treatment was considered necessary, the children were admitted to Boarding Open-Air Schools. FOLLOWING-UP. "Following-up" work by your Health Visitors and School Nurses is, of course, a material factor in maintaining and, indeed, improving the general level of the health of your school children. This work has been carried out successfully during the year and one thousand four hundred and forty-two home visits were made. 9 SCHOOL HEALTH SERVICE. MEDICAL INSPECTION RETURNS. Year ended 31st December, 1949. TABLE I. Medical Inspection of Pupils attending Maintained Primary and Secondary Schools. A. PERIODIC MEDICAL INSPECTIONS. Number of Inspestions In the prescribed Groups: Entrants 1,687 Second Age Group 1,432 Third Age Group 1,134 Tota1 4,253 Number of other Periodic Inspections 5,227 Grand Total 9,480 B. OTHER INSPECTIONS. Number of Special Inspections 12,126 Number of Re-Inspect ions 12,254 Total 24,380 10 TABLE I. (Contd.) C. PUPILS FOUND TO REQUIRE TREATMENT. Number of Individual Pupils found at Periodic Medical Inspection to Require Treatment (excluding Dental Diseases and Infestation with Vermin). Group For defective vision (excluding) squint) For any of the other conditions recorded in Table IIA. Total Individual pupils (1) (2) (3) (4) Entrants 10 232 222 Second Age Group 43 132 159 Third Age Group 48 106 141 Total (prescribed groups) 101 470 522 Other Periodic Inspections 256 509 655 Grand Total 357 979 1,177 11 TABLE II. A. RETURN OP DEFECTS POUND BY MEDICAL INSPECTION. Defect Code No. Defect or Disease. Periodic Inspections Special Inspections No. of defects No. of defects Requiring Treatment under Observation but not requiring Treatment Retiring Treatment Requiring to be kept under Observation but not requiring. Treatment (1) (2) (3) (4) (5) 4. Skin 169 35 930 8 5. Eyes-a. Vision 357 33 217 9 b. Squint 21 11 92 - c. Other 19 10 574 - 6. Ears-a. Hearing 30 5 43 2 b. Otitis Media 16 7 28 2 c. Other 18 15 331 19 7. Nose or Throat 227 153 225 62 8. Speech 28 13 40 4 9. Cervical Glands 4 21 31 16 10. Heart and Circulation 16 26 19 20 11. Lungs 37 74 43 68 12. Developmenta1- a. Hernia 10 7 2 - b. Other 1 12 2 1 13. Orthopaedic- a. Posture 17 14 12 - b. Plat Foot 112 44 14 - c. Other 178 83 54 3 14. Nervous system- a. Epilepsy 2 9 2 - b. Other 16 40 20 11 15. Psychologica1- a. Development 4 17 38 3 b. Stability 4 10 11 9 16. Other 499 174 6,495 168 12 TABLE II. (Contd.) B. CLASSIFICATION OF THE GENERAL CONDITION OF PUPILS INSPECTED DURING THE YEAR IN THE AGE GROUPS. Age Groups. Number cf Pupils Inspected A.* (Good) B. (Fair) C. (Poor) No. % of col. 2, No. % of col. 2. No. % Of col. 2. (1) (2) (3) (4) (5) (6) (7) (8) Entrants 1,687 924 54.77 740 43.87 23 1.36 S e c o nd Age Group 1,432 589 41,13 836 58.38 7 .49 Third Age Group 1,134 464 40.92 663 58.46 7 .62 Other Periodic Inspections 5,227 1,932 36.97 3,239 61.96 56 1.07 Total 9,480 3,90 9 41.23 5,478 57.79 93 .98 A, - Excellent Nutrition. B. - Normal Nutrition. C. - Slightly sub-normal Nutrition. 13 INFESTATION WITH VERMIN. (i) Total number of examinations in the schools by the school nurses or other authorised persons17,341 (ii) Total number of individual pupils found to be infested 477 (iii) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) 143 (iv) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (3), Education Act, 1944) - 14 TABLE IV. TREATMENT TABLES. GROUP I. - MINOR AILMENTS (excluding Uncleanliness, for which see Table III) (a) Number of defects treated or under treatment during the year. Skin - Ringworm - Scalp - (i) X-ray treatment. If none, indicate by dash 1 (ii) Other treatment 2 Ringworm - Body 7 Scabies 12 Impetigo 125 Other skin diseases 943 Eye Disease (External and other, but excluding errors of refraction, squint and cases admitted to hospital). 775 Ear Defects 523 Miscellaneous (e.g. minor injuries, bruises, sores, chilblains, etc). 6,407 Total 8,795 (b) Total number of attendances at Authority's minor ailments clinics 29,291 15 TABLE IV. TREATMENT TABLES. (Contd.) GROUP II. - DEFECTIVE VISION AND SQUINT (excluding Eye Disease treated as Minor Ailments - Group I). No, of defects dealt with. ERRORS OF REFRACTION (including squint) 1,037 Other defect or disease of the eyes (excluding those recorded in Group I) 20 Total 1,057 No. of Pupils for whom spectacles were (a) Prescribed 697 (b) 0 b t a i ne d 648 GROUP III. - TREATMENT OF DEFECTS OF NOSE AND THROAT. Total Numbertreated. Received operative treatment - (a) for adenoids and chronic tonsillitis 219 (b) for other nose and throat conditions 7 Received other forms of treatment 355 Total 581 16 TABLE IV. TREATMENT TABLES. (Contd.) GROUP IV. - ORTHOPAEDIC AND POSTURAL DEFECTS. Total number treated. (a) No. treated as in-patients in hospitals or hospital schools 2 (b) No, treated otherwise, e.g. in clinics or outpatient departments 1,055 GROUP V. - CHILD GUIDANCE TREATMENT AND SPEECH THERAPY. Total number trea ted. No. of pupils treated - (a) under Child Guidance arrangements 6 (b) under Speech Therapy arrangements 85 17 TABLE V. DENTAL INSPECTION AND TREATMENT. Total number treated. (1) Number of pupils inspected by the Authority's Dental Officers - (a) Periodic Age Groups 2 ,660 (b) Specials 2,225 (c) TOTAL (Periodic and Specials) 4,885 (2) Number found to require treatment 3,782 (3) Number actually treated 4,802 (4) Attendances made by pupils for treatment 12,702 (5) Half-days devoted to: (a) Inspection 19 (b) Treatment 1,070 Total (a) and (b) 1,089 (6) Fillings: Permanent Teeth 4,678 Temporary Teeth 2,013 Total 6,691 (7) Extractions: Permanent Teeth 1,092 Temporary Teeth 4,151 Total 5,243 (8) Administration of general anaesthetics for extraction 2,646 (9) Other Operations: (a) Permanent Teeth 6,459 (b) Temporary Teeth 9 Total (a) and (b) 6,468 18