BARN 63 THE ANNUAL REPORT of the SANITARY CONDITION of the Urban District of Barnes FOR THE YEAr 1895, by the MEDICAL OFFICER OF HEALTH, JAMES ADAMS, M D. K. W. Simpson, Printer, Barnes and Richmond. 1896. THE ANNUAL REPORT of the SANITARY CONDITION of the Urban District of Barnes FOR THE YEAR 1895, by the MEDICAL OFFICER OF HEALTH, JAMES ADAMS, M.D. R. W. Simpson, Printer, Barnes and Richmond. 1896. to the Urban District Council of Barnes. January, 1896. Gentlemen, There was more sickness, and consequently a higher death-rate, for the past than the preceding year; it is difficult to find a satisfactory reason for this. There was certainly some influenza in the early part which caused some deaths from bronchitis and pneumonia, and there were also more fatal cases of diphtheria, but not sufficient to account for the increase. The year was very trying to old people; no less than 64 died over 65 years of age out of a total of 218, which is considerably more than a fourth of the whole. Seventeen of the 64 were over 70, and some between 80 and 90; the number of those who died over 65 in the two preceding years was 40 and 42. The sanitary condition of the district, as a whole, is satisfactory. There are defects, especially in the construction of houses built before the adoption of the Building Bye-laws, but these are under constant inspection, and such work as is necessary to keep them in a wholesome condition is promptly effected. Most of the worst constructed, and those which were unfit for habitation, have been pulled down or closed, but where it has been found possible to convert them into healthy dwellings, this has been done. i have had to certify nine as unfit for habitation during the year, eight of which have been closed and one temporarily improved. Many important changes have been effected in the district since the passing of the Sanitary Acts in 1875, one of which was 4 the closing of foul wells from which the larger part of the district obtained water for domestic use; but that which is most felt and most essential to the prosperity of the district is the introduction of the sewerage system. It has, undoubtedly, added to the comfort of the inhabitants, and has, I believe, been effectual in lessening the sickness and lowering the death-rate. The substitution of upright in the place of surface ventilators has removed a source of great annoyance and injury. There are still some remaining, but they have not been a trouble so far. Some of the house drains which have been connected with the new sewers are not in a satisfactory condition. The old house drains, as they existed before the sewers were laid, have been connected without alteration. They were laid in loose soil, without concrete or any firm bed, and are, consequently, at different angles, and leaked at the joints. This has proved particularly mischievous in the cluster of houses forming the Thome Estate, Barnes. This omission has been remedied in some localities, viz., St. James's Place, Fitzgerald Road, and Victoria Place, Mortlake, and should be on the Thome Estate where it is urgently needed. The converting the private roads into wholesome and respectable thoroughfares has also helped largely in improving the health of the inhabitants. It is remarkable to what an extent the sub-soil water has diminished during recent years There were few places in the district 30 years ago where the sub-soil water was more than three feet below the surface, in some places it was less, but it has been gradually subsiding, and is not to be reached in most parts of the district at a less depth than nine or ten feet. A damp soil has undoubtedly a prejudicial effect on the health particularly in cases of Phthisis. I give a table which illustrates this. It will be seen, that although the population has very largely increased, that the deaths from Phthisis have diminished. 5 Deaths from Phthisis registered in the parishes of Mortlake and Barnes— 1874 deaths 21 1891 deaths 17 1875 „ 18 1892 „ 12 1876 „ 26 1893 „ 18 1877 „ 26 1894 „ 17 1878 „ 25 1895 „ 18 116 82 The removal and disposal of house refuse continues most unsatisfactory. The contract system is a failure. We have frequent accumulations notwithstanding the constant representations of Mr. Grylls. These accumulations are very mischievous under any circumstances, but when it occurs in the small back yards, and under the windows of cottages, it is difficult to estimate the amount of injury. The disposal of the refuse when collected is a difficult matter, but the difficulty might be overcome by the use of a destructor, a site for which might be found on the land adjoining the sewage works, where it would not be near habitations, and could not be objected to as unsightly or a nuisance. There has been an opinion amongst some of the members of the Council that certain localities in the district were overcrowded and defective in the sanitary condition of the houses. These localities constitute the poorest parts of the district, and receive a large amount of attention in the way of inspection, both from the inspector and myself, in consequence of this impression. I have made special reports which I give:— "In consequence of the report in the public papers of the discussion respecting the sanitary condition of the Westfields district, which took place at the last meeting of the Council, I have considered it advisable to give an account of the district, which will inform you on points which, I trust, will lead to a more satisfactory knowledge of its real condition. 6 Mr. Grylls has taken a census and ascertained the number of inhabitants per house, and he has also furnished me with the extent of the district in acres, which he gives as 33, and which, with a population of 2,500, allows 75½ persons per acre. These 33 acres are almost entirely covered with houses with small gardens in front and rear. There are 493 houses, most of them with from four to six rooms. The average number of occupants of each house is 5.12 The streets which have the smallest number of occupants per house are the White Hart Lane, 4.26; Railway Side, 4.47; Cross Street, 5.0; Railway Street, 5.02; and St. Ann's Passage, 5.1; and the largest, Archway Street, 5.77; Thome Passage, 576; and Thorne Street, 5.27 "I am not able to find that any of the houses are so over full as to require interference, and I may say that they are kept in as satisfactory a condition by frequent inspections as is possible, and Mr. Grylls is indefatigable in this work. The 493 houses are occupied by 2,500 persons. There were 28 deaths registered dur ng the year 1894, which gives a death rate of 11.2 per 1,000, and for the three quarters of this year ending 30th September 26 deaths, which is equal to a death rate of 13.6 per 1,090 per annum. There were two deaths from infectious sickness of people belonging to the Westfields district during the year 1894, one of whooping cough and one of scarlet fever, and there have been four deaths during the present year, two of whooping cough and two of diphtheria. I think that the conclusion we must arrive at on considering the foregoing facts is that the houses are not overcrowded, that the sickness and mortality for a poor and populous place is unusually low, and that the amount of infectious sickness is very small, in fact, the district bears very favourable comparison with most healthy rural districts." "According to your instructions I have to report as to the density per acre, average number of inhabitants per house, number of infectious diseases notified, and death rate per 1,000 of the Back Lane, Mortlake, included in the space bounded on 7 the North by the High Street, South by the South-Western Railway. East by Tinderbox Alley, and West by Sheen Lane. Mr. Grylls has taken a census of the population, with number of houses and extent of area in acres, he has found that the total number of houses is 292, but deducting empties, &c., he gives the number as 278, and these are occupied by 1,336 people, giving an average of 4.84 per house on an area of 21 acres, which gives 63 6 persons per acre. The deaths registered for the locality in 1894 were 14, which is equal to a rate of 104 per 1,000. The diseases notified during the year 1894 were one of Scarlet Fever, one Erysipelas, and one Membranous Croup. The deaths registered for the eleven months of this year to the end of November were n, which is at the rate of 8.97 per 1,000 per annum, one case of Scarlet Fever and one of Diptheria were notified during the 11 months." The localities of which I have given special reports -that is the Westfields, Barnes, and the Back Lane, Mortlake—are those which you have considered the least favoured in point of their sanitary condition of any part of the district, but the result of the inquiry does not prove it. It is shown that in neither case is the population by any means dense, nor the houses crowded, and that the people as a whole are healthy. This, in a great measure, is to be attributed to the fact that a large proportion of them spend much of their time in the open air, the parents in their work, and the children, when not at school, at play in the many open spaces near at hand. Most of the four-roomed cottages are occupied by one family only, and one room is almost invariably reserved as a living room. Sometimes houses with six rooms have two families, but even then they generally have sufficient accommodation to permit of a living room indepen dent of the bedrooms. The one great failure in many of the poorer houses is a want of cleanliness in the occupants. Three wells have been closed, the water from which was found on analysis to be unfit for domestic purposes. I find that it is 8 very difficult to induce people to keep their cisterns clean, they are frequently found on inspection to contain deposit that has been collecting for a long period, and occasionally we receive complaints that the water supplied by the Company is unfit for use; it is invariably found that the fault is in the cistern. If there was a constant supply, this source of mischief would in a measure be remedied. I have, in company with the Inspector, made inspections of the Bake-houses, Cow-sheds, Dairies, and Slaughter-houses. The Bake-houses are kept in very good condition, and on the whole very clean and well managed. There are several underground, and some of these are remarkably well kept under the circumstances, but the arrangement at the best is very unsatisfactory. The Cow-sheds which are in use are, with one or two exceptions, well constructed and well kept. There are very few cows kept in the district at present, most of the milk is imported. The Dairies are invariably clean and well managed. A large proportion of the meat used in the district is procured from the dead meat market. The Slaughter-houses that are in use are generally found in good condition and clean. The diseases notified during the year corresponded almost exactly in number with those of the preceding, they were ir3 for 1895, and 112 for 1894. There were not so many cases of Scarlet Fever, but more of Diphtheria. There were 52 cases of Scarlet Fever—23 in Mortlake and 29 in Barnes—one of which proved fatal from complications. Forty-three cases of Diphtheria were notified—10 in Mortlake and 33 in Barnes. An undue proportion occurred in the houses comprising the Thome Estate; there were 10 deaths, four of which were of children belonging to Mortlake, and six to Barnes. All of the Barnes and one of the Mortlake cases were taken into the Hospital; five were in a hopeless condition when admitted. 9 Ten cases of Typhoid were notified—two in Mortlake and eight in Barnes. Several were imported. One case of Small Pox was notified. It occurred in a man who had tramped from Leicester to Barnes, to work at the new reservoirs. On his arrival at lodgings which had been provided for him, it was found that he was ill. I had him removed at once to Highgate, and had what was necessary done to prevent the spread, and there were no more cases. TABLE I. Mortlake. Barnes. Total. Scarlet Fever 23 29 52 Diphtheria 10 33 43 Typhoid 2 8 10 Erysipelas 4 3 7 Small Pox — 1 1 Total 39 74 113 Extensive building operations were commenced in the district during the year, mostly in Barnes, where it is proceeding very rapidly, and will cause a considerable increase in the population in the future; but during the past year there has been very little addition either in Mortlake or Barnes, and what has taken place is from the excess of births over deaths, except that in Barnes a few navvies who work at the new reservoirs have found lodgings in the parish. I estimate the population to the middle of the year as 16,200. The registered deaths were 218, which is equal to a death rate of 13.45 per 1000; a very low rate, though in excess of that or the preceding year. This has to be corrected by the addition of people belonging to the district who died and were registered elsewhere, of whom there wtre six, but against this is to be set r4 who were registered in this district who did not belong to it, which reduces the number by eight, so that the number we have to consider is 210, and this gives a rate of 12.96. 10 The deaths for Mortlake were no, and the estimated population 7050, which gives a rate of 15.6 per 1000. The deaths for Barnes were 100, and the estimated population 9150, which is equal to a rate of 10-9 per 1000. Fifty-one children died under one year, which is equal to 3.14 per 1000. Sixty-four people died over 65 years, which is equal to 3.95 per 1000. There were 23 deaths from the zymotic class of diseases, which is at the rate of 1.42 per 1000. The hospital has continued to increase in popularity, and is a great boon to the district. I believe that it would not only be wise and beneficial, but also very popular if the accommodation were increased. Great disappointment is felt when we are so unfortunate as not to be able to receive infectious cases from want of room. One hundred and five cases were under treatment in the hospital during the year, 29 of which were from the Richmond Added Area, all of which were Scarlet Fever. TABLE II. Mortlake. Barnes. Added Area. Total. Scarlet Fever 16 28 29 73 Diphtheria 5 26 — 3i Typhoid — 1 — 1 Total 21 55 29 105 Three hundred and ninety-seven births were registered for the district during the year, 171 for Mortlake and 226 for Barnes. This is equal to a birth rate of 24.5 per 1000. Your obedient Servant, J. ADAMS. REPORT of Inspector of Nuisances For the Year ending December 31st, 1895. Notices have been served to abate 738 Nuisances in the District as against 472 for the year 1894, 58 complaints have been received and 1841 house inspections made. ABSTRACT OF NOTICES. Defective Drains 71 Pipes not sufficiently trapped 9 No water supply to Closets 2 Condemned Closet pans and traps 28 Dilapidated Closet fittings 15 Want of light and ventilation to Closets 10 Defective flushing tanks 88 Defective service water pipes 18 Insufficient water supply 18 Defective Covers to Cisterns and foul Cisterns 48 No Cisterns provided 5 Soil.Pipes not sufficiently ventilated 9 Houses in need of cleansing and repairing 81 Overcrowding 2 No Dustbins, and Dustbins out of Repair 264 Houses condemned as unfit for human habitation 8 Foul Deposits 13 Animals so kept as to be a nuisance 7 Defective roofs and gutterings 16 Factories with no Sanitary Convenience 2 Leaky and Defective Cisterns 11 Yards not properly Paved 13 738 12 Summonses were taken out against 5 persons for not complying with Notices to abate Nuisances, and Magistrates' orders obtained. Forty-one houses in the District have been entirely re-drained according to regulations after serving notices on the owners, viz., 8 in Barnes, and 33 in Mortlake. The drainage of the Real Estates property in the Westfields, Barnes, has caused great trouble from the frequent stoppages in the pipes, and requires immediate measures to be taken to amend the system. Number of Registered Cow-keepers, Dairymen, and Purveyors of Milk 12 *Number of Cowsheds 5 Number of Bakehouses 11 Number of Registered Slaughter Houses 5 Number of persons licensed to sell Petroleum 4 THOS. GRYLLS, Inspector of Nuisances to the Urban District Council of Barnes. *The greater portion of Milk is supplied by wholesale dairymen outside the District. 13 TABLE IV. 62 Townshend Terrace, Richmond, Surrey. Report oj Vaccination for the Urban District of Barnes and Mortlake, being within Richmond Union, from 1st January to j/st December, 1895. Name of Parish. Number successfully Vaccinated. Number insusceptible to Vaccination. Number had Small Pox. Number Dead Unvaccinated. Number Postponed. Number removed Information to Vaccination Officer. Number removed and not found. Number Unvaccinated. Total. Barnes 148 1 — 8 5 8 5 55 230 Mortlake 115 — - 15 2 1 3 31 167 263 1 - 23 7 9 8 86 397 14 TABLE V. BIRTHS AND DEATHS IN THE PARISHES OF MORTLAKE AND BARNES FROM 1873 TO 1895. Mortlake. Barnes. Total Births. Total Deaths. Births. Deaths. Births. Deaths. 1873 183 82 120 73 303 155 1874 167 106 139 62 306 168 1875 188 77 138 80 326 157 1876 175 100 151 73 326 173 1877 202 98 172 95 374 193 1878 196 82 182 67 378 149 1879 204 91 186 91 390 182 1880 201 100 192 105 393 205 1881 207 90 175 96 382 186 1882 219 102 196 105 415 207 1883 240 120 196 98 436 218 1884 258 119 220 107 478 226 1885 228 112 212 100 430 212 1886 238 134 241 113 479 247 1887 227 88 216 137 443 245 1888 240 126 229 114 469 240 1889 226 112 229 131 455 243 1890 230 169 235 120 465 289 1891 236 115 223 119 459 234 1892 227 159 228 135 455 294 1893 193 123 219 123 412 246 1894 165 80 202 80 367 160 1895 171 116 226 103 396 219 TABLE VI. MORTALITY PER THOUSAND FOR THE PARISHES OF MORTLAKE AND BARNES FOR THE YEARS 1875 TO 1895. For the Years. 1875 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 MORTLAKE. 14. 181 17.3 14.38 15.4 16.5 14.2 15.45 17.26 16.30 14.45 16.4 10.7 15. 13.3 19.8 14.88 20.1 17.9 11.4 15.6 BARNES 17.2 156 20. 13. 16.2 18.1 16. 16.8 15.55 16.46 15.2 13.8 17.5 14. 15.4 13.6 14. 15.2 14. 8.8 10.9 table vii. Giving Deaths from subjoined Diseases for each Year, from 1874 to 1895. rural district. Year. Small-Pox. Measles. Scarlatina. Diphtheria, including Croup. Whooping Cough. Continued Fever. Diarrhoea. Erysipelas. Total. 1874 4 10 3 2 1 9 29 1875 6 2 7 13 28 1876 1 5 1 10 14 31 1877 2 12 3 6 2 5 30 1878 1 3 5 2 10 1 22 1879 3 3 11 10 27 1880 5 11 1 5 22 1881 13 5 3 10 31 1852 7 3 8 11 4 10 43 1883 6 11 11 1 8 1 38 1884 5 5 13 3 15 1 42 1885 9 2 2 1 10 24 1886 9 1 3 15 1 13 1 43 1887 5 1 4 1 10 21 1888 1 1 15 8 5 30 1889 3 1 1 3 3 11 1 23 1890 21 2 1 17 2 4 1 48 1891 2 1 5 1 2 11 1892 16 1 17 18 2 5 59 1893 1 33 2 4 1 41 1894 3 1 1 4 2 2 13 1895 3 1 8 3 2 6 23 Table vii. Table of Deaths Registered during the year 1895, in the Urban District of Barnes ; classified according to Diseases, Ages, and Localities, and showing also the Population of such Localities, and the Births therein during the year. Names of Parishes. Population at all Ages. Registered Births. Mortality from all Causes, at Subjoined Ages. Mortality from Subjoined Causes, distinguishing Deaths in Persons under Five Years of Age. Census 1891. Estimt d to middle 1895. At all ages. Under 1 year. 1 and under 5 5 and under 15 under 25 25 and under 65 65 and upwards Small pox. Measles. Scarlatina. Diphtheria. Croup (not "spasmodic"). Whooping Cough. Continued Fevers. Diarrhoea and Dysentery. Cholera. Rheumatic Fever. Erysipelas. Pyaemia. Puerperal Fever. Ague. Phthisis. Bronchitis, Pneumonia, & Pleurisy. Heart Disease. Injuries. Influenza. Other Diseases. Typhus. Enteric or Typhoid. Other or doubtful. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 PART OF MORTLAKE 7050 171 116 26 10 9 8 31 32 Under 5 1 6 2 8 19 5 upwards 2 1 4 1 10 10 7 1 5 39 BARNES 8445 9150 226 103 25 5 4 7 30 32 Under 5 2 4 4 1 1 18 5 upwards 1 1 8 17 8 1 4 33 TOTALS 16200 397 219 51 15 13 15 61 64 Under 5 1 6 2 6 12 1 1 37 5 upwards 2 1 4 1 2 1 18 27 15 2 9 71