C.I AC 4378 BER 57 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1944 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health BER57 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1944 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health TABLE OF CONTENTS PUBLIC HEALTH DEPARTMENT— PAGE Public Health Committee 4 Maternity and Child Welfare Committee 4 Staff 5 VITAL STATISTICS— Area 8 Population 8 Births 8 Deaths 9 Marriages 9 Infantile Mortality Rates 10 Deaths from Tuberculosis 10 Vital Statistics of District 11 Causes of Death 12 Infantile Mortality, Causes of Deaths 14 INFECTIOUS DISEASES— Diseases Notifiable 15 Diphtheria Prevention 15 Disinfection 16 Cleansing Station 16 Bacteriological Laboratory 17 Food Poisoning 17 Insulin for Diabetic Patients 17 Vaccination 18 Nursing 18 Cases Notified in 1944 19 Cases Notified for last ten years 20 TUBERCULOSIS— New Cases and Deaths 21 Period between Notifications and Deaths 21 Nursing, Extra Nourishment and Shelters 22 Tuberculosis Allowances 22 Work of the Tuberculosis Dispensary 23 Summary of Notifications 24 Cases on the Register 25 LIGHT TREATMENT, ELECTRO-THERAPY AND MASSAGE— Work done in the Solarium 26 MATERNITY AND CHILD WELFARE— PAGE Fairby Grange Convalescent Home 27 Premature Children, Illegitimate Children, Home Helps, Child Life Protection 27 Work of the Health Visitors 28 Attendances at Centres 29 Extracts from Vital Statistics, 1944 30 DENTAL TREATMENT— Particulars of Children Treated 31 Particulars of Treatment and Work for 1944 32 CONSULTATION AND OTHER CLINICS— X-ray Department 33 Post-Natal and Special Clinics for Women 34 Heart Clinic 34 Ophthalmic Clinic 34 Foot Clinic 34 PROPAGANDA 35 SANITARY ADMINISTRATION— Housing 36 Housing Act, 1936—Overcrowding 36 Eradication of Bed Bugs 36 Inspections and Proceedings 36 Work of the District Inspectors 39 Factories and Workshops—Homework 40 Factories and Workshops—lnspections 41 Bakehouses 42 House, Trade and Market Refuse 42 Offensive Trades 42 Mortuary 42 Street Markets 43 Drainage Work 43 Work of Factories and Shops Inspector 43 FOOD CONTROL— Imported Food Regulations—Samples taken 44 Unsound Food—Shops and Stalls 46 Milk Premises 47 Milk Licences 47 Milk Sampling 47 Pharmacy and Poisons Act, 1933 47 Food and Drugs—Samples Taken 48 Unsound Food —Wharves, etc 50 Work of the Wharves and Food Inspectors 51 WAR CONDITIONS—REVIEW 52 HEALTH SERVICES 62 PUBLIC HEALTH DEPARTMENT PUBLIC HEALTH COMMITTEE, 1944. Chairman Councillor E. J. GIBSON 1943-4, 1944-5 Vice-Chairman Alderman S. R. WEIGHTMAN 1943-4, 1944-5 Alderman Mrs. L. M. Brown. Councillor Mrs. F. Humphreys. „ A. V. Parker. „ Miss E. L. Johnson. „ E. Snowdon, J.P., L.C.C. „ A. V. Kidd. Councillor H. A. Beal. „ F. C. Langton. „ Mrs. E. V. Coyle. „ C. J. Lee. „ Mrs. M. Cushing. „ Mrs. A. E. Martin. „ Mrs. M. Donoghue. „ Mrs. W. L. Miller. „ A. M. Downing. „ Mrs. F. A. Powell. „ Mrs. D. Downing. „ Mrs. J. V. Snowdon. W. L. Ellis. „ A. E. Winch. G. W. Griffin. Ex-officio. Councillor A. C. STARR, J.P., L.C.C., Mayor of Bermondsey, 1943-4. Councillor G. LOVELAND, J.P., Mayor of Bermondsey, 1944-5. MATERNITY AND CHILD WELFARE COMMITTEE, 1944. Chairman Alderman Mrs. L. JONES, M.B.E., 1943-4, 1944-5. Vice-Chairman Councillor Mrs. J. V. SNOWDON, 1943-4, 1944-5. Alderman Mrs. L. M. Brown. Councillor Mrs. L. A. Glasson. „ Rev. L. Davison, L.C.C. „ Mrs. A. M. Hatcher. Councillor Mrs. E. V. Coyle. „ Mrs. F. Humphreys. „ Mrs. M. Cushing. „ Mrs. M. F. Lowery. „ Mrs. M. Donoghue. „ Mrs. F. J. Melvin. „ Mrs. D. Downing. „ Mrs. W. L. Miller. „ E. J. Gibson. „ Mrs. K. Potter. Co-opted Members. Mrs. F. E. Flint. Mrs. K. E. Smith. Mrs. A. P. Henley. Mrs. D. Topley. Mrs. L. M. Kidd. Mrs. F. Whitnall. Ex-officio. Councillor A. C. STARR, J.P., L.C.C., Mayor of Bermondsey, 1943-4. Councillor G. LOVELAND, J.P., Mayor of Bermodsey, 1944-5. STAFF: MEDICAL OFFICER OF HEALTH. D. M. Connan, M.D., B.S.(Lond.), M.R.C.S., L.R.C.P., D.P.H. SANITARY INSPECTORS: J. G. Frankson, Senior Inspector. G. F. J. Toll, Wharves and Food Inspector. H. E. Butcher, Wharves and Food Inspector. W. C. Tapsfield, Wharves and Food Inspector. F. L. Richardson, Drainage and Markets Inspector. H. J. Bailey, Food and Drugs Inspector. W. A. Campbell, Factories and Shops Inspector. District Inspectors. F. J. Carpenter. W. A. Pilson. A. W. Hancock. W. F. Smith. L. T. Knott. Flora Mercer. TUBERCULOSIS DISPENSARY. Deputy Medical Officer of Health and Clinical Tuberculosis Officer— C. H. C. Toussaint, M.R.C.S., L.R.C.P., D.P.H. Assistant Medical Officer and Assistant Tuberculosis Officer— *H. T. Levi, M.B., Ch.B. Tuberculosis Nurse—Celia Clapson. LADY ALMONER. Florence Child. Assistant—Mary Benford (commenced June, 1944). LIGHT TREATMENT CENTRE. Medical Officer in Charge—Florence L. Telfer, M.D, D.M.R.E. Physiotherapist—G. O. Tippett, M.B., B.S.(Lond.), F.R.C.S.(Eng.). Nurse in Charge—Mrs. Dorothy Cottier. Solarium Nurses—Estelle Jagot, Muriel Coleby, Mrs. Joyce Turner and Helen Failes. Masseuse—Zoe Ellis. MATERNITY AND CHILD WELFARE. Assistant Medical Officers for Maternity and Child Welfare— Florence L. Telfer, M.D., D.M.R.E. Eva G. August, M.B., B.S.(Lond.) (resigned October, 1944). Margaret S. Gillatt, M.B., Ch.B. (commenced October, 1944). Health Visitors. Barbara Anderson. Edith Crundwell. Gwendolen Riches. Sarah Bowles. Mrs. Avis Knott. Edith Riley. Lucy Brown. Elizabeth Lawrence. Florence Robson. Mrs. Phyllis Carson. Olive Oram. Isabel White. Kathleen Cranmer Kathleen Parry. (commenced Oct. 1944 FAIRBY GRANGE CONVALESCENT HOME. Matron—Anne O'Meara. Sister—Gladys Coleby. * At present serving in H.M. Forces. POST-NATAL AND SPECIAL CLINICS FOR WOMEN. Consultant Gynæcologist—Gladys Dodds, M.D., D.P.H., M.R.C.O.G., F.R.C.S. (Eng.). OPHTHALMIC CLINIC. Consultant Oogthalmic Surgeon-Victoria E. Brander, M.B., Ch.B., D.P.H., D.O.M.S. X-RAY SECTION. Radiologist—Florence L. Telfer, M.D., D.M.R.E. Radiographers —C. F. Lumley, Dora Gibb (resigned September, 1944) and Mrs. Janet Mason (Part-time —commenced April, 1944). DENTAL DEPARTMENT. Municipal Dental Surgeon —Grantley Smith, L.M.S.S.A., H.D.D., R.C.S. (Edin.), L.D.S., R.C.S. (Eng.). Assistant Dental Surgeon—W. H. Shapland, L.D.S., R.C.S. (Eng.). Dental Nurses—Mrs. Daisy Hodgson and Winifred Lander. Prosthetic Assistants—G. W. Clarke, W. B. Monger and T. H. Baggott. FOOT CLINIC. Chiropodists—Ethel Cook, Mrs. Florence Rock, Mary Bradley, and E. F. Part. PUBLIC ANALYST. A. Prideaux Davson, A.R.C.Sc, F.R.I.C, F.C.S. PROPAGANDA AND ADMINISTRATIVE OFFICER. H. W. Bush, F.I.P.A., M.R.I.P.H.H. CLERICAL STAFF. F. W. Smith, Chief Clerk. Alice Jones, General Clerk. C. W. Whye, General Clerk. *F. Cornwell, General Clerk. *F. R. Parker, General Clerk. *H. D. White, General Clerk. J. A. Blake, General Clerk. *J. L. Springett, General Clerk. J. F. M. Brooker, General Clerk. *F. H. Mummery, General Clerk. H. J. Smith, General Clerk. *S. R. Weightman, General Clerk. (retired July, 1944). *Nellie Simms, Junior Clerk. C. H. Harris, General Clerk. *A. E. Gambrell, Junior Clerk. *J. W. J. Saward, General Clerk. J. T. Bryant, Junior Clerk. DISINFECTING AND CLEANSING STATION. A. Manning, Supervisor. PUBLIC HEALTH DEPARTMENT, MUNICIPAL OFFICES, SPA ROAD, S.E.16. * At present serving in H.M. Forces. Borough of Bermondsey. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. To the Mayor, Aldermen and Councillors of the Borough of Bermondsey. Madam, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1944. Recent reports have been statistical summaries only, but this year I have included a note on the work of the department in connection with civil defence. The general effect of war conditions on the health and environment of this community has also been reviewed. It remains for me to express our sorrow as a department at the recent deaths, so tragically sudden, of the Mayor, Councillor George Loveland, J.P., and of Mr. H. W. Bush, Administrative Officer, both of whom, in their differing spheres, laboured for the good of the borough. I am, Madam, Ladies and Gentlemen, Your obedient Servant, D. M. CONNAN I.-VITAL STATISTICS. AREA. The area of the borough (exclusive of area covered by water) is 1,336 acres. POPULATION. Census Estimate of Registrar-General 1921 1931 to 30th June, 1943 to 30th June, 1944 119,452 111,542 45,440 44,800 BIRTHS. The total number of births belonging to the borough registered during 1944 was 846, consisting of 432 males and 414 females. The number for 1943 was 925. The birth-rate for 1944 was 18.9 per thousand persons living, compared with 20.6 for 1943. DEATHS. The total number of deaths belonging to the borough registered during 1944 was 809, consisting of 448 males and 361 females. The number for 1943 was 761. The death-rate for 1944 was 18.1 per thousand persons living, compared with 16.7 for 1943. MARRIAGES. The total number of marriages in the borough in 1944 was 370, being 88 below the number for 1943, and 567 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. Year No. Rate 1,050 19.91 1934 20.00 1935 1,027 19.32 1936 970 1,090 22.07 1937 941 19.32 1938 1,258 26.35 1939 1,186 33.13 1940 725 32.79 1941 29.97 1942 666 458 20.16 1943 Average for years 1934—1943 24.30 937 370 16.52 1944 (10) INFANTILE MORTALITY. Year Whole Borough London No. of Deaths Rate per 1,000 Births No. of Deaths Rate per 1,000 Births 100 64 3,832 67 1934 1935 103 69 3,229 58 1936 92 60 3,691 66 1937 84 59 3,309 60 1938 65 45 3,130 57 1939 45 37 2,409 47 1940 40 35 2,062 48 1941 32 61 1,543 57 1942 38 47 2,035 50 1943 49 53 2,284 51 Average for years 1934-1943 65 53 2,752 56 1944 56 66 2,250 51 TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1934. Bermondsey Rotherhithe St. Olave Whole Borough London Sub-District Year No. No. No. No. Rate No. Rate 64 22 4 90 0.86 3227 0.76 1934 1935 70 23 5 98 0.95 2847 0.68 1936 51 22 6 79 0.79 2848 0.69 1937 63 22 2 87 0.89 2888 0.71 1938 42 23 1 66 0.68 2590 0.64 1939 38 21 6 65 0.72 2650 0.70 1940 43 21 4 68 0.95 2687 0.87 1941 34 17 1 52 1.18 2552 1.10 1942 34 13 1 48 0.93 2164 0.90 1943 30 15 4 49 1.08 2204 0.88 Averages for years 1934- 1943 20 3 70 0.90 2666 0.79 47 VITAL STATISTICS OF WHOLE DISTRICT DURING 1944 AND PREVIOUS YEARS. Year 1 Population estimated to Middle of each Year 2 Births Total Deaths registered in the District Total Deaths in Public Institutions in the District 9 Deaths of Non-Residents registered in Public Institutions, etc., in the District 10 Deaths of Residents registered in Public Institutions etc. beyond the District 11 Net Deaths at all Ages belonging to the District No. 3 Rate 4 Under 1 Year of Age At all Ages No. 12 Rate 13 No. 5 Rate per 1,000 Births registered 6 No. 7 Rate 8 1934 105,060 1,577 14.8 77 49 1,223 11.6 784 229 310 1,304 12.4 1935 102,700 1,487 14.5 99 67 1,142 11.1 756 255 314 1,201 11.7 1936 100,400 1,545 15.4 76 49 1,136 11.3 723 175 328 1,289 12.8 1937 98,790 1,421 14.4 61 43 1,148 11.6 741 245 309 1,212 12.3 1938 97,420 1,439 14.8 60 42 1,002 10.3 488 201 271 1,072 11.0 *95,500 ‡90,500 1,275 13.4 40 31 968 10.7 445 201 243 1,010 11.2 1939 1940 71,590 1,232 17.2 35 28 1,483 20.7 829 304 373 1,551 21.7 1941 44,220 756 17.1 23 44 874 19.8 569 259 432 1,047 23.7 1942 44,440 814 18.3 36 44 673 15.1 520 285 285 673 15.1 1943 45,440 925 20.6 31 34 713 15.7 517 228 276 761 16.7 Averages for years 1934-1943 80,506 1,245 16.0 54 43 1,036 13.8 637 314 1,112 14.9 238 44,800 846 18.9 28 33 722 16.1 453 209 296 809 18.1 1944 * For calculation of Birth Rate. ‡ For calculation of Death Rate. CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1944. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards 809 56 3 2 15 36 83 228 386 All Causes {Certified {Uncertified - - - - - - - - - Typhoid and Paratyphoid Fever - - - - - - - - - Cerebro-spinal Fever - - - - - - - - - Scarlet Fever - - - - - - - - - Whooping Cough 2 2 - - - - - - - Diphtheria - - - - - - - - - Tuberculosis of Respiratory System 47 - - - 1 9 16 16 5 Tuberculosis—other forms 2 - - - 2 - - - - Syphilitic Disease 3 - - - - - 2 1 - Influenza 4 1 - - - - - 4 - Measles 1 1 - - - - - - - Acute Poliomyelitis and Polioencephalitis - - - - - - - - - Acute Infectious Encephalitis - - - - - - - - - Cancer of Buccal Cavity and (Esophagus (Males only) 6 - - - 1 1 4 - - Cancer of Uterus 4 - - - - - - 2 2 Cancer of Stomach and Duodenum 11 - - - - - - 3 8 Cancer of Breast 11 - - - - - 1 6 4 Cancer of all other sites 2 38 34 74 - - - - - Diabetes 1 - - - 1 - - - - 32 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1944 —continued. Deaths at the subjoined ages of "Residents " whether occurring in or beyond the district. Causes of Death All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards - - 2 4 39 108 Heart Disease 153 - - - - 1 13 38 Other Diseases of the Circulatory System 52 - - - - 1 14 26 - Bronchitis 42 1 1 - - 1 1 2 11 31 Pneumonia 54 7 1 - - 1 - 3 1 Other Respiratory Diseases 5 - - - - 1 5 1 Ulceration of the Stomach or Duodenum 7 - - - Diarrhoea (under 2 years of age) 13 12 1 - - - - - - - - - - - Appendicitis 25 - - - - - - 1 7 16 Other Digestive Diseases 25 1 - 1 - 2 4 7 Nephritis 14 - - - - - 2 - 7 Puerperal and Post-abortive Sepsis 2 - - - - - 2 - - Other Maternal Causes 2 - - - Premature Births 13 13 - - - - - - - Congenital Malformations, Birth Injury, Infantile Diseases 12 12 - - - - - - - Suicide 3 - - - - 2 2 1 1 Road Traffic Accidents 4 - - 1 - 1 - 2 - 1 9 22 39 41 28 Other Violent Causes 144 3 1 - 1 4 11 35 All Other Causes 55 4 - - 2 15 36 83 228 386 809 56 3 INFANTILE MORTALITY. Deaths from Stated Causes at Various Ages under One Year of Age, 1944. Under 1 week 1—2 weeks 3—4 weeks Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year Cause of Death 2—3 weeks Measles - - - - - - - 1 1 - Scarlet Fever - - - - - - - - - - Whooping Cough - - - - - - - - 2 2 Diphtheria - - - - - - - - - - Influenza - - - - - - - - - - Cerebro-spinal Meningitis - - - - - - - - - - Tuberculous Meningitis - - - - - - - - - - Other Forms of Meningitis - - - - - - - - - - Tuberculosis of Respiratory System - - - - - - - - - - Other Tuberculous Diseases - - - - - - - - - - Syphilis - - - - - - - - - - Bronchitis - - - - - - 1 - 1 - Pneumonia (all forms) - 2 - 2 1 2 1 1 7 - Other Respiratory Diseases - - - - - - - - - - Diarrhoea and Enteritis - - - - 2 5 3 2 12 - Congenital Debility and Malformation, Premature Birth 12 1 - 1 14 4 2 1 - 21 1 - - - - 1 Injury at Birth - 1 - - Other Causes 2 3 - - 5 1 3 1 1 11 Totals 14 5 2 1 22 8 13 7 6 56 II.-INFECTIOUS DISEASES. The following diseases are notifiable: — Anthrax Acute Polioencephalitis Acute Poliomyelitis Acute Primary Pneumonia Acute Influenzal Pneumonia Cholera Cerebro-Spinal Meningitis Continued Fever Diphtheria Dysentery Enteric Fever and Typhoid Encephalitis Lethargica Fever Erysipelas Glanders Hydrophobia in Man Malaria Measles Membranous Croup Ophthalmia Neonatorum Plague Puerperal Pyrexia Puerperal Fever Scarlet Fever and Scarlatina Relapsing Fever *Scabies Small-pox Typhus Tuberculosis—all forms Whooping Cough * A notification is not required where, to the knowledge of the medical practitioner, a case of scabies has occurred in the house and has been notified within the four weeks immediately preceeding the date on which he first became aware of the disease in the case he is attending. DIPHTHERIA PREVENTION. The appended table shows the attendances at the Schick Clinics during the year. Clinic No. of Sessions No. of New Patients Total Attendances Public Health Centre, Grange Road 1,209 103 343 L.C.C. Schools 17 80 223 Totals 120 423 1,432 DISINFECTION. The figures showing the work done in the disinfecting station are set out below. Beds 217 Pillows 1,461 Blankets 4,800 Pillows (cases) 514 Bolsters 100 Quilts 202 „ (cases) 33 Sheets 411 Books 46 Miscellaneous 3,196 Cushions 93 Verminous Clothing 1,041 Overlays 1,274 Number of rooms disinfected 527 Number of air raid shelters disinfected 12 Number of mattresses and other articles destroyed 279 Furniture, Floorcloth, etc., destroyed 7 Loads CLEANSING STATION. Verminous persons cleansed Adult Females 160 Adult Males 115 Children 2,468 Persons treated for Scabies:— Number treated Number of baths given Adult Females 341 795 Adult Males 167 529 Children, Females (School Age) 268 1,263 Children, Males ( „ „ ) 259 1,350 Children, Females (Under School Age) 56 114 Children, Males ( „ „ „ ) 69 149 BACTERIOLOGICAL LABORATORY. The work done in the Laboratory during the year is set out in the appended table. Examined for Total Examinations Results of Examination Positive Negative 1943 1943 1944 1944 1944 1943 Diphtheria (specimens taken by Medical Officer of Health 272 146 4 2 268 144 Ditto (taken by general practitioners) 428 278 12 8 270 416 10 684 16 414 Diphtheria (total specimens taken) 700 424 367 425 73 352 Phthisis 45 322 20 35 - 20 35 Various - Total specimens taken 1,087 884 61 83 1,026 801 FOOD POISONING. Eight cases of Food Poisoning were notified to me during the year under The Public Health (London) Act, 1936, Section 182. There were no deaths. INSULIN FOR DIABETIC PATIENTS. Twenty-nine patients have been supplied during the year as compared with twenty-four patients in 1943. (The Public Health (London) Act, 1936, Section 227.) VACCINATION. 697 births were notified to the Vaccination Officer by the local Registrars during 1943. The number of children successfully vaccinated was 258, and the number in respect of whom statutory declarations of conscientious objection were received was 152. The percentage of children vaccinated to births notified was 37.02. NURSING. The following table shows the number of patients nursed under the Council's Scheme by The St. Olave's (Bermondsey and Rotherhithe) District Nursing Association: — Disease Cases Visits Pneumonia 755 57 108 Broncho-pneumonia 9 16 201 Bronchitis 33 340 Influenza 29 Measles 334 Whooping Cough 6 116 Tuberculosis:— I 25 1,022 (a) Respiratory System 3 33 (b) Other Forms Puerperal Pyrexia - - Puerperal Fever - - 70 848 Pregnancy and Labour Diseases of the Digestive System 7 78 4 51 Infantile Diarrhœa (under 2 years) 29 Discharging Ears 2 Discharging Eyes 22 284 Post-operative cases:— - _ _ - (a) Tonsils & Adenoids (b) Other cases - - 50 504 Other diseases 333 Totals 4,703 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1944. NUMBER OF CASES NOTIFIED Bermondsey Rotherhithe St. Olave Total Cases removed to Hospital 1 2 3 4 5 6 St. John St. Olave Total At all Ages At Ages—Year Total St.Thomas 1 2 3 Total 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 & upwards NOTIFIABLE DISEASE Diphtheria (including Membranous Croup) 30 - 7 6 2 1 2 - - 5 1 2 1 1 2 12 9 6 18 - - - - 30 11 1 3 - Erysipelas 17 - - - - 1 2 1 4 5 4 2 2 4 1 1 2 12 1 3 1 5 - - - - - - Scarlet Fever 108 3 46 40 12 5 2 - - - 10 2 13 6 14 2 47 19 22 16 57 2 2 - 4 96 - - Cerebro-Spinal Meningitis 1 1 2 1 2 - - - - - - - - 1 1 - 1 4 1 - 2 3 - - - - 7 7 Malaria 1 - - - - - 1 - - - - - - 1 - - - - 1 - - - - - - - - - Ophthalmia Neonatorum 3 - - - - - - - - - - - - 1 1 1 - 3 - - - - - - - - 3 1 Dysentery 23 4 4 5 2 2 1 - 3 1 1 2 1 2 - 2 - 7 5 8 2 15 1 - - 1 14 - Acute Polio-Myelitis 1 - - - 1 - - - - - - - - - - - - - 1 - 1 - 1 - - 1 - - Puerperal Pyrexia 6 - - - - 2 1 1 2 - - - 1 - 1 - 1 - 3 1 1 - 2 - 1 - 1 1 Pneumonia (Acute Primary and Acute Influenzal) 99 30 13 3 1 5 10 6 7 10 12 18 22 11 3 76 5 6 5 4 3 - 7 3 11 10 16 - Whooping Cough 224 40 137 44 2 1 - - - - - 23 12 38 24 11 9 117 23 54 22 99 6 1 1 8 25 - Measles 345 15 192 112 17 6 2 1 - - - 23 23 30 26 22 5 129 76 82 47 205 7 4 - 11 73 Scabies 1489 9 34 80 62 70 45 66 52 29 19 23 51 43 68 44 61 31 298 53 66 39 158 16 16 1 33 - Tuberculosis— Respiratory System 111 - 3 3 1 19 20 24 12 8 20 13 16 8 15 76 14 15 4 - 2 - 2 14 7 4 33 - Other forms of Tuberculosis 18 - 3 4 2 1 2 1 2 2 1 2 2 3 2 - 3 1 4 - 1 - 1 5 - 12 - - 1482 86 310 107 115 103 81 41 46 152 201 125 139 62 797 208 268 141 617 37 29 2 68 248 Totals 118 461 75 57 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1935-1944. Notifiable Disease. 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 Small Pox - - - - - - - - - - Diphtheria (including Membranous Croup) 273 207 167 187 135 56 89 72 74 30 Erysipelas 53 39 28 57 35 43 48 39 21 17 Scarlet Fever 367 266 167 200 112 243 75 128 197 108 Cerebro-Spinal Meningitis 2 4 10 3 8 29 18 2 7 7 Acute Polio-Myelitis and Acute Polio-Encephalitis - - 1 1 7 - 3 - 2 1 Ophthalmia Neonatorum 5 6 1 10 5 2 - 1 7 3 Anthrax - - 1 1 1 - - 1 - - Enteric Fever 3 15 5 2 - 2 1 2 3 - Puerperal Fever 3 6 1 1 - 2 1 - 3 - Puerperal Pyrexia 19 9 13 10 9 11 3 - 10 6 Encephalitis Lethargica - 2 - - - - - -- - - Dysentery 3 1 43 26 2 6 11 7 15 23 Malaria - - - - - 2 - 1 1 - Malaria (Induced) - - - - 2 - - 1 - - Pneumonia (Acute Primary and Acute Influenzal) 113 125 112 121 99 55 112 170 104 99 Whooping Cough - 103 275 101 383 25 274 93 208 224 Measles - 7 85 889 39 229 381 600 345 345 Scabies - - - - - - - - 283 489 Tuberculosis — Respiratory System 129 142 147 112 94 106 100 109 97 111 Other forms of Tuberculosis 34 34 31 18 20 6 9 19 14 18 Totals 966 1,145 1,730 973 855 1,120 1,411 1,482 1,004 1,120 (21) III.-TUBERCULOSIS. In Table I are set out particulars of new cases and deaths during the year, and Table II shows the period elapsing between notification and death. TABLE I. TUBERCULOSIS, 1944—NEW CASES AND DEATHS. AGE PERIODS NEW CASES DEATHS Pulmonary Non- Pulmonary Pulmonary Non- Pulmonary M. F. M. F. M. F. M. F. 0 - - - - - - - - 1 2 1 2 1 - - - - 5 2 1 2 2 - - 1 - 10 1 - 1 - - 1 1 - 15 12 9 - 2 2 - - - 20 11 14 - 1 4 3 - - 25 12 16 - 2 2 - - 7 35 6 10 - 1 7 - - - 45 11 3 - 1 4 1 - - 55 11 - 1 2 10 1 - - 65 and upwards 6 3 - 1 3 2 - - I 74 57 6 13 35 12 2 - TABLE II. TUBERCULOSIS, 1944—PERIOD BETWEEN NOTIFICATION AND DEATH. Period Between Notification and Death Respiratory System Other Forms Males Total Males Females Total Percentage of Total Deaths Percentage of Total Deaths Females Not notified 6 - 6 12.77 2 - 2 100.00 0-1 month 1 - 1 2.13 - - - - 1-3 months 3 3 6 12.77 - - - - 3-6 months 3 - 3 6.38 - - - - 6-12 months 4 2 6 12.77 - - - - 1-2 years 4 1 5 10.64 - - - - 2-5 years 4 3 1 14.89 - - - - Over 5 years 10 3 13 27.65 - - - - Totals 35 47 100.00 2 - 2 12 100.00 NURSING, EXTRA NOURISHMENT AND SHELTERS. District Nurses visit many patients suffering from Tuberculosis and being treated at home; 1,055 visits were paid by the nurses in 1944. A limited provision is made for the supply of extra nourishment to tuberculous persons, and this usually takes the form of extra milk; 187 patients received help in this way during the year. The scheme for the provision of shelters has been continued, and 2 shelters are at present in use. TUBERCULOSIS ALLOWANCES MADE UNDER MINISTRY OF HEALTH MEMO. 226/T. Particulars of applications for allowances dealt with under this scheme during the year are as follows:— Number of applications considered 505 Number of new cases during the year 91 Number of applicants who have received allowances during the year 121 Renewal applications and cases of changed circumstances reviewed 270 Applicants found to be ineligible 114 RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1944. Diagnosis Pulmonary Non-Pulmonary Total Adults Children Adults Children Adults Children Grand Total M. F. M. F. M. F. M. F. M. M. F. F. A.—New Cases examined during the year (excluding contacts):— I ■ 1 2 3 36 36 5 1 4 81 (a) Definitely tuberculous 34 35 3 1 2 (b) Diagnosis not completed - - - - - - 5 7 - 1 13 - - (c) Non-tuberculous - - - - - - - 144 119 23 12 298 - B.—Contacts examined during the year:— I . I I -1 I . I I II I I I I I II II I I . I I . I I I (a) Definitely tuberculous 1 3 6 1 - - - 1 3 6 1 11 - (b) Diagnosis not completed - - - - - - - - 3 3 2 - 8 (c) Non-tuberculous - - - - - - - - 82 138 43 67 330 C.—Cases written off the Dispensary Register as:— I ] I ll ll I I I (a) Recovered 7 3 5 1 1 - 2 4 8 3 7 5 23 (23) (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) - - - - - - - - 226 257 66 79 628 D. —Number of Cases on Dispensary Register on December 31st:— I I (a) Definitely tuberculous 215 223 25 17 21 18 13 14 236 241 38 31 546 (b) Diagnosis not completed - - - - - - - - - - - - - 1. Number of cases on Dispensary Register on January 1st 522 7. Number of visits by Tuberculosis Officers to homes (including personal consultations) 505 2. Number of cases transferred from other areas and cases returned after discharge under Head 3in previous years 15 8. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes *893 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 35 9. Number of:— (a) Specimens of sputum, etc., examined 409 (b) X-ray examinations made in connection with Dispensary work 1,621 4. Cases written off during the year as Dead (all causes) 40 5. Number of attendances at the Dispensary (including Contacts) 2,671 10. Number of " Recovered " cases restored to Dispensary Register, and included in A (a) and A (b) above — 6. Number of consultations with medical practitioners:— 11. Number of "T.B. plus" cases on Dispensary Register on December 31st 181 (a) Personal 79 (6) Other 357 12. Number of Artificial Pneumothorax Refills 832 were made by the Lady Almoner. * In addition to these visits 73 visits Number of Primary Notifications of New Cases of Tuberculosis 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total (all ages) Total Notifications Age Periods 2 9 4 Pulmonary, Males - 2 1 12 11 8 4 62 78 9 3 63 - - 7 11 8 - 3 49 „ Females 1 1 15 2 - - - 1 - 5 6 Non-Pulmonary Males - 2 - - - - 1 2 1 2 1 1 2 1 13 14 „ Females 2 - New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period, otherwise than by formal notification: — Age Periods 0 to 1 1 to 5 - 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total - - 12 - - 2 3 2 2 Pulmonary Males 3 - - - 2 3 1 2 - - „ Females 8 - - - Non-Pulmonary Males - - - - - - 1 - 1 - - - - - - - - „ Females - - - - - - - Returns rendered under the PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. 1st QUARTER, 1944. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 62 62 310 246 11 3 Number of Cases notified during Quarter 2 2 1 3 Inward Transfers, Un-notified Deaths, etc. 2 - - Number of Cases removed from the Register 24 10 - 1 Number of Cases remaining on the Register at end of Quarter 63 64 256 308 2nd QUARTER, 1944. Respiratory System Other Forms M. F. M. F. 308 Number of Cases on Register at commencement of Quarter 63 256 64 Number of Cases notified during Quarter 18 10 - 2 Inward Transfers, Un-notified Deaths, etc. 7 3 1 - 17 2 Number of Cases removed from the Register 9 2 316 Number of Cases remaining on the Register at end of Quarter 62 260 64 3rd QUARTER, 1944. Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 316 62 260 64 4 Number of Cases notified during Quarter 11 2 9 Inward Transfers, Un-notified Deaths, etc. - 1 - - 10 Number of Cases removed from the Register 8 1 5 Number of Cases remaining on the Register at end of Quarter 317 63 262 63 4th QUARTER, 1944. Respiratory System Other Forms M. F. F. M. 317 Number of Cases on Register at commencement of Quarter 63 262 63 Number of Cases notified during Quarter 13 14 2 4 Inward Transfers, Un-notified Deaths, etc. 3 1 - - Number of Cases removed from the Register 2 20 3 - Number of Cases remaining on the Register at end of Quarter 313 65 274 65 IV.—LIGHT TREATMENT, ELECTRO-THERAPY AND MASSAGE. The following table shows the work done in the Solarium during 1944:— Total Number of Attendances 15,366 Number of Medical Examinations 1,524 Number of New Cases 559 Number of Discharges 536 Referred for X-Ray 37 Treatments: — Massage 5,782 Physical Exercises 1,059 Diathermy 3,390 Medical Electricity 2,689 Radiant Heat 9,159 Ultra Violet Light 9,213 Special Treatments 493 Total Number of Treatments 31,785 V.—MATERNITY AND CHILD WELFARE. FAIRBY GRANGE CONVALESCENT HOME. The total number of patients received into the home during the year, including mothers, babies and toddlers, was 273. Number of women admitted 135 Number of babies admitted 56 Number of toddlers admitted 82 PREMATURE CHILDREN—ILLEGITIMATE CHILDREN — HOME HELPS CHILI) LIFE PROTECTION. Special care has been taken of premature infants in- order to secure for them the best possible chance of survival. The premature births number forty-two for the year and include five sets of twins; three pairs of twins died almost immediately after birth; the other four babies survived and are now flourishing infants. Seven other babies died in addition to the three pairs of twins, thus making a total of thirteen deaths for the year. Only one of these infants survived more than a few hours. One infant was admitted to a day nursery at five months, since the mother was compelled to go out to work, and we were able to give the baby special attention in the nursery. The number of illegitimate children in this borough has always been small; at present 52 are known to us. Besides the usual regular visitation by the Health Visitor, these homes are all visited at intervals by the Lady Almoner with the object of helping the mother with problems other than those merely of health. The Borough scheme provides for the guaranteed payment of foster-mothers and the provision of Home Helps. The number of cases in which home helps were provided during the year was twenty-five. Great difficulty has been experienced in obtaining them, and the matter has been repeatedly before the Committee. At present there is only one whole-time home help, but occasional assistance is obtained from women employed on a part-time basis and engaged to help specified patients. The difficulty appears to be due partly to the nature of the work and partly to the relatively inadequate rates of pay permitted for this kind of work. There were no foster-mothers, legally so described, in the Borough during the year, but there are known to us one or two cases where children have been cared for by people other than their parents. In some cases this has been the prelude to adoption. These homes have also been visited by the Lady Almoner from time to time. HEALTH VISITORS. The following table shows the work done by the Municipal and Voluntary Centres and Health Visitors during 1944: — District Births Notified Visits to Infants and Children Visits to Expectant Mothers Visits to Cases of Infectious Disease Unclassified or Special Visits Attendances at Centres & Clinics Health Talks Puerperal Pyrexia and Fever Ophthalmia Neonatorum Measles Whooping Cough Tuberculosis Post-Infectious Disease First Visits Re-visits Under 1 year 1-5 years Primary Visits Revisits Miss Anderson 46 69 709 850 47 217 2 27 17 - - 188 122 2 - *Miss Bowles - - - - - - - - - - - - 196 - - Miss Brown 28 39 186 366 23 109 1 15 6 2 7 83 253 - - Mrs. Carson 50 75 862 770 52 135 - 11 16 - 3 264 156 - - Miss Cranmer 20 15 219 319 10 64 1 - 2 1 - - 36 60 - Mrs. Knott 25 64 457 789 66 161 - - 64 42 - - 447 147 - Miss Oram 66 65 463 732 63 139 - 8 20 - - 751 145 - - Miss Parry 76 78 798 986 74 282 - - 73 22 6 1 135 150 - Miss Riches 27 74 308 677 36 128 3 1 35 24 - - 221 120 - Miss Riley 105 94 676 633 44 136 - - 40 37 1 - 219 123 - Miss Robson 58 59 695 1274 53 204 - 12 26 - - 108 180 - - Miss White 58 74 557 1091 61 179 - - 38 35 2 183 610 80 - Salomon's Centre 13 20 249 1012 177 327 - - 14 - - - 302 - - Totals 572 726 6179 706 2081 6 4 339 246 194 3062 2034 9499 11 - * Miss Bowles has been employed for much of her time in the X-Ray Department. Miss Lawrence is Matron of Kintore Way Nursery and Miss Crundwell is Matron of Tenda Road Nursery. ATTENDANCES AT MATERNITY AND CHILD WELFARE CENTRES. The following table shows attendances at Maternity and Child Welfare Centres during 1944: — Children's Consultations Ante-natal Clinic Sewing Class Gynæcological Clinic Name of Centre No. of Sessions New Cases Total Attendances No. seen by Doctor No. of Sessions New Cases Post- Natal Cases Total Attendances No. of Sessions No. of Attendances No. of Sessions New Cases Total Attendances Under 1 year 1-5 years Under 1 year 1-5 years Public Health Centre, Grange Road 151 255 12 1,783 101 53 1,658 - - 108 426 3,574 2,767 245 44 Community Centre 52 34 416 295 479 - - - 13 57 - - - 10 - Bermondsey Gospel Mission 47 98 8 1,128 509 853 24 87 9 324 - - - - - Rotherhithe Town Hall 49 120 9 1,497 559 990 38 23 667 12 58 - 121 - - *Stephen-the- Yeoman Mission - - - - - - 5 13 4 75 - - - - - Central Hall 97 94 6 578 979 - - 8 51 - - 1,302 - - - Salomon's Centre 99 36 4 712 507 553 203 288 - 1,548 - - - - - 495 637 49 8,629 4,231 6,621 371 754 89 4,272 33 44 108 Totals 166 426 * This Centre was opened on the 9th December, 1944. EXTRACTS FROM VITAL STATISTICS, 1944. Births. Registered— Total Males Females Live Births Legitimate 800 402 398 Illegitimate 46 30 16 Total Males Females Stillbirths 26 15 11 Rate per 1,000 total (live and still) births .. 30 Notified within 36 hours of birth— (1) Live Births, 565. (2) Stillbirths, 17. (3) Total, 582. Total Males Females Deaths 809 448 361 Maternal Deaths. Deaths. Rate per 1,000 total (live and still) births Deaths from puerperal causes: — Puerperal Sepsis 2 2.29 Other puerperal causes 2 2.29 Total 4 4.58 Death Rate of Infants under 1 year of age. All Infants per 1,000 live births 66 Legitimate infants per 1,000 legitimate live births 65 Illegitimate infants per 1,000 illegitimate live births 87 Health Visitors. Visits paid by Health Visitors during the year:— To Expectant Mothers (1) First Visits, 706. (2) Total Visits, 2,081 To Infants under 1 (1) First Visits, 726. (2) Total Visits, 6,905 To Children, 1 —5 Total Visits, 9,499 Convalescent Homes for Children under 5. Number of Beds, 16. Number of Children under 5 received during the year 138 Day Nurseries. Number of day nurseries 6. Deaths from Cancer (all ages) 106 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 2 Deaths from Diarrhœa (under 2 years of age) 13 (31) VI.—DENTAL TREATMENT. The attached tables summarise the work which has been done at the two dental centres during the year. TREATMENT OF CHILDREN DURING 1944. CENTRE Age Group Number Examined Number of Extractions Anaesthetics Number of Scalings Number of Attendances for Orthodontics Number Treated Number of Fillings Local General PUBLIC HEALTH CENTRE, GRANGE ROAD. Under 5 years 110 87 241 - 70 - - - 311 261 648 98 196 103 8 - Over 5 years Totals 421 348 98 266 103 8 - 889 98, ROTHERHITHE NEW ROAD. Under 5 years 33 33 96 1 30 - - - Over 5 years 191 113 444 38 141 137 7 - Totals 224 146 540 39 171 137 7 - Totals both Centres 645 494 1429 137 437 240 15 (32) DENTAL TREATMENT CARRIED OUT DURING 1944. CENTRE Type of Case Number of Patients Examined Number of Patients Treated Number of Extractions Anesthetics Number of Fillings Number of Scalings Number of Dentures Fitted Number of Repairs to Dentures Number of Attendances Local General PUBLIC HEALTH CENTRE, GRANGE ROAD Maternity Cases 667 578 1533 274 235 157 64 211 1907 67 Women 730 623 1184 368 184 233 54 168 67 1820 Men 972 866 1247 555 91 153 73 214 107 1809 Tuberculosis Cases 12 8 - 4 - 3 2 4 19 - Children (Table I.) 421 348 889 98 196 103 8 - - 736 Totals 2802 2423 4853 1299 706 201 597 241 649 6291 98, ROTHERHITHE NEW ROAD Maternity Cases 374 115 55 38 141 36 234 995 1095 151 Women 211 379 691 167 111 124 32 96 47 982 Men 408 646 49 52 32 114 36 123 288 917 Children (Table I.) 146 540 171 137 7 - - 534 224 39 Totals 792 1307 2872 482 368 109 351 119 3528 609 Totals both Centres 3594 3730 7725 1908 1188 1017 310 948 360 9819 VII.-CONSULTATION AND OTHER CLINICS. X-RAY DEPARTMENT. The following table shows the work done in this Department during 1944: — Total number of Attendances 4,866 Number of Individual Cases 4,375 Number of New Cases 3,455 Number of Screenings 1,790 Analysis of Films: — Bones 251 Gastro-intestinal Tract 186 Chests 3,835 Other Examinations 56 Air Training Corps 47 POST-NATAL AND SPECIAL CLINICS FOR WOMEN. The total number of attendances during the year, in which 44 sessions were held, was 426. The number of new cases was 108, the majority of whom were suffering from menopausal or menstruation disorders; 13 were found to be pregnant; 11 were investigated for sterility; and 2 were found to be suffering from carcinoma. Suitable cases were treated at the Clinic, others being referred to their own doctors or to hospitals. HEART CLINIC. Patients, at this Clinic, come by appointment, and are sent by their own doctors for investigation. During the year 44 sessions were held; the total number of attendances was 191; the number of new patients was 78, of which number 35 were found to be suffering from cardiac disease. OPHTHALMIC CLINIC. The number of sessions held during the year was 67. There were 379 new patients and the total number of attendances was 582. FOOT CLINIC. Attendances during the year are shown in the following table:- Clinic Men Women Total Bermondsey 1,493 4,453 5,946 Rotherhithe 1,245 3,128 4,373 Totals 10,319 7,581 2,738 VIII.-PROPAGANDA. The following is a list of lectures, demonstrations and cinema film shows given during the year:— Youth Organisations 114 attended by 5,583 Schools 91 „ 11,152 Civil Defence Personnel and Home Guard 24 „ 1,965 First Aid Groups, W.V.S., etc. 22 „ 561 Other Adult Organisations 30 „ 1,558 281 20,819 Throughout the war period a great many different organisations have made use of the facilities offered by this department for propaganda work. Lectures and demonstrations have been given for all kinds of purposes, most of them, but not all, having a direct bearing on health. Many films have been shown during courses of instruction in First Aid to Stretcher Parties, First Aid Posts and in N.F.S. Stations. More recently great interest in local government services has been evinced by certain schools and groups of children have been shown round the Public Health Centre, Bathing Centre, Disinfecting Station and other public buildings. One of the very best agencies which I have ever seen at work amongst the boys of this Borough was the A.T.C. Every boy on entry was given a most careful physical examination, which included hearing and eye-sight tests and X-ray examination of the chest. As they came up for examination in groups of three or four, they were almost always given an X-ray demonstration by Dr. Telfer, each acting in turn as "patient." Many talks were given to groups at A.T.C. Headquarters and the boys were encouraged to consult the doctor on any matter of interest to their health, one night a week being reserved for this purpose. Altogether about 895 boys .were examined in this way before admission to the corps. There is no doubt that the lads liked the uniform and the idea of service with the Royal Air Force, and there is also no doubt that the discipline was very good for them. The amazingly hard work which many of them put in, night after night, might easily have sought a much less profitable outlet. Suddenly the enthusiasm died and the corps declined, and we have yet to see whether peace-time pursuits can be made to achieve anything quite as attractive to the boys of this Borough. IX.-SANITARY ADMINISTRATION HOUSING. During the year 1944 no areas were represented or declared by the Council. No permanent dwellings were erected, but 54 Uni-Seco emergency houses were erected. Negotiations also took place towards the end of the year with the London County Council concerning the erection of temporary factory-made houses, and it is estimated that during the present year about 300 of these houses will be provided in Bermondsey. HOUSING ACT, 1936—OVERCROWDING. No detailed survey has been made during the year with regard to overcrowding, but the outstanding applications for accommodation in the Borough numbered 1,432, and these were made up as follows:— Homeless by enemy action 236 families. No separate accommodation (chiefly young married couples) 324 „ Overcrowded 63 „ Applications on Medical Grounds 46 „ General list (no special grounds) 763 „ ERADICATION OF BED BUGS. The following table shows the fumigations carried out during 1944:— Infested Disinfested Council houses or flats 34 34 Other houses or flats 115 115 INSPECTIONS, PROCEEDINGS, ETC. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1944: — Inspection of Dwelling-Houses during the Year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 5 ,226 (b) Number of Inspections made for the purpose 17,380 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 605 (b) Number of Inspections made for the purpose 616 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (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 Nil 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 691 Action under Statutory Powers during the Year: — (A) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices: — (a) By owners Nil (b) By Local Authority in default of owners Nil (B) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 909 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: — (a) By owners 218 (b) By Local Authority in default of owners Nil (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 1 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (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 Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil REGISTERED PREMISES — Premises Number on Register at end of 1944 Number of Inspections Number of Prosecutions Common Lodging Houses 42 - 3 2 8 Seamen's Lodging Houses - 135 228 - Milkshops Houses let in lodgings 345 706 - 93 - - Ice Cream Premises Offensive Trades (including Poultry Slaughter-houses) 48 13 - SMOKE NUISANCES— Number of observations 14 Number of notices Nil Number of complaints Nil Number of summonses Nil WATER SUPPLY TO TENEMENT HOUSES— Premises supplied Nil Prosecutions Nil SALE OF FOOD— Number of premises used other than ice-cream premises, milk-shops and cowsheds 348 Number of inspections 528 RAG FLOCK ACT, 1911, and PUBLIC HEALTH (LONDON) ACT, 1936:- There are three premises in the District where rag flock is used and three inspections were made during the year. WORK OF DISTRICT INSPECTORS, 1944. 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16 18 19 20 21 22 23 6 17 House-to-House Complaints Infectious Diseases Factories & Workshops Specially Inspected Offensive Trades Outworkers' Bi-Annual Inspection Underground Conveniences Drains Tested Other Calls and Visits Chimney Watched Bakehouses Common and Seamen's Lodging Houses Butchers Fishmongers, Friers and Curers Food Stores Fruiterers and Greengrocers Markets Restaurants and Eating Houses Destruction of Food Various TOTALS Ice Cream Special Inspections Ints. Visits - 318 80 - - 14 - 14 3254 - 45 25 5 60 - 2 33 - 7740 23 5 22 222 3840 395 4155 1116 243 - - 6 1 28 4696 - 14 4 16 13 68 19 - 3 14 22 - 10813 312 - 3695 440 - - 10 - 17 - 12 - 27 5 101 13 - - 14 26 - 5555 209 986 150 4881 426 - - - - 15 846 - 1 - 1 2 - - - - 2 - 6273 12 51 19 68 191 4365 1600 121 - - - - 41 2372 - 11 1 15 2 - - - 7 16 - 8773 31 174 605 20936 3900 721 - - 30 1 115 12154 - 50 84 27 260 37 - 5 59 109 - 39154 909 61 FACTORIES AND OTHER PREMISES. HOMEWORK. NATURE OF WORK (1) Outwork in Unwholesome Premises, Section 111 Outworkers' Lists, Section 110 Lists received from Employers Outworkers resident in Bermondsey received from other Districts Notices served on Occupiers as to keeping or sending lists (8) Prosecutions Instances (11) Prosecutions (13) Notices served (12) Lists (2) Outworkers Failing to keep lists (9) Failing to send lists (10) Resident in Bermondsey Resident in other Districts (5) Contractors (6) Workmen (7) Contractors (3) Workmen (4) 22 - 10 - - - - - - - 21 Wearing Apparel— 4 (1) Making, etc. 4 - 21 22 - 10 - - - - - - (2) Cleansing and washing - - - - - - - - - - - - Fur pulling - - - - - - - - - - - - Umbrellas, etc. - - - - - 1 - - - - - - Cotton Bags 3 - 13 8 - - - - - - - - Paper, etc., Boxes, Paper Bags - - - - - 3 - - - - - - Brush making - - - - - 2 - - - - - - Combs, etc. - - - - - - - - - - - - Upholsterers - - - - - - - - - - - - Cycle Engineers - - - - - - - - - - - - Coathangers - - - - - 2 - - - - - - Carding of buttons, etc. - - - - - - - - - - - - Onion Peeling - - - - - - - - - - - - Games and Toys - - - - - - - - - - - - Fancy Goods - - - 2 - - - - - - - - Total 7 34 30 - 20 - - - - - - FACTORIES AND OTHER PREMISES. INSPECTION. Premises Factories with mechanical power Number of Inspections Written Notices Occupiers Prosecuted 1 3,227 39 6 Factories without mechanical power Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) 1,532 - 253 - 13 Total 5,012 1 58 DEFECTS FOUND. Particulars Number of Defects Number of defects in respect of which Prosecutions were instituted Found Remedied Referred to H.M. Inspector 25 - 25 Want of Cleanliness (S.1.) - - Overcrowding (S.2.) - - - Unreasonable Temperature (S.3.) - - - - Inadequate Ventilation (S.4.) 1 1 - - Ineffective Drainage of Floors (S.6.) 1 - 1 - Sanitary Conveniences (S.7.)— Insufficient 4 4 - - 18 Unsuitable or Defective 18 - - 1 Not separate for Sexes 2 1 - 15 Other Offences (Not including offences relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937.) 15 - - 66 65 1 - Total BAKEHOUSES. In Use Not in Use Underground Above ground Above ground Underground 6 4 9 24 27 of these are Factory Bakehouses HOUSE, TRADE AND MARKET REFUSE. The following table shows the amount of house, trade and market refuse disposed of during 1944: — Disposal Loads tons cwts. qrs. 9,486 6,020 2 16 House Refuse to Barge Trade Refuse to Barge 2,038 1,662 9 - 5 Street Markets Refuse to Barge 457 354 - 11,503 10 Totals 8,515 2 OFFENSIVE TRADES. The offensive trades on the Register are as follows: — Fellmongers 3 Fatmelters 1 Glue and size makers 3 Dresser of Fur Skins 6 MORTUARY. The Public Health (London) Act, 1936, Section 234, requires the Borough Council to provide a proper place for the reception of dead bodies before interment. The London County Council acts as agent for the Borough Council in this matter and receives into the mortuary at St. Olave's Hospital those bodies for which it is the duty of the Borough Council to provide. A fee of one guinea per body is paid by the Borough Council for this service. Number of infectious bodies removed Nil Total number of bodies removed 14 STREET MARKETS. The market scheme continues to work smoothly and satisfactorily. Number of Licences in operation 165 Income £716 1bs.. 6d. There were no prosecutions during the year. DRAINAGE WORK. Particulars of work carried out by the Drainage Inspector during 1944:— Drains Tested 116 Visits to Shelters (Civil Defence) 603 Other Visits 976 WORK OF THE FACTORIES AND SHOPS INSPECTOR. Shops. Visits 13 Notices served under Shops Act, 1934 1 Notices served under Public Health (London) Act, 1936 3 Factories (with mechanical power). Visits 153 Notices under Factory Act, 1937 24 Notices under Public Health (London) Act, 1936 10 Factories (without mechanical power). Visits 51 Notices under Factory Act, 1937 4 Notices under Public Health (London) Act, 1936 2 Workplaces. Visits 103 Notices served 13 Visits to Offensive Trade premises 48 Chimneys watched 14 Visits to Underground Conveniences 263 Other calls and visits 432 X.-FOOD CONTROL. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937. FOOD AND DRUGS ACT, 1938. Thirty samples were taken during the year by the Senior Inspector and Wharves Inspectors. Article Examined No.of Samples Purpose of Examination Result Action Satisfactory. Sulphur Dioxide, 704 parts per million; Zinc, 5 parts per million 1 Apples, Dried For preservative Released 1 Definite reactions for iron Bacon, Stained To ascertain cause of stain Stopped. Released for cleaning and trimming 2 To ascertain composition Unsatisfactory. Excessive free-fatty acid Butter Fat Stopped. Released for refining 1 For presence of metals Zinc, 20 parts per million; copper, 16 parts per million; Arsenic, nil Gelatine, Powdered No action 1 „ „ Zinc, 10 parts per million; Copper, 20 parts per million; Arsenic, 3 parts per million Released „ „ 1 Unfit for food. Arsenic, 3.6 parts per million; copper, 60 parts per million; Lead, 7 parts per million; Zinc, 800 parts per million Released for industrial purposes „ „ „ „ 1 Unfit for food. Arsenic, 1.6 parts per million; Copper, 30 parts per million; Lead, 3 parts per million; Zinc, 80 parts per million Further sample taken. Released for industrial purposes „ „ „ „ Article Examined No.of Samples Purpose of Examination Result Action Unfit for food. Arsenic, 2.4 parts per million; Copper, 5 parts per million; Lead, 1.5 parts per million; Zinc, 200 parts per million Gelatine, Powdered 1 Released for industrial purposes. For presence of metals Further sample taken. Released for industrial purposes „ „ 1 Unfit for food. Arsenic, 1.2 parts per million; Copper, 17.5 parts per million; Lead, 3 parts per million; Zinc, 20 parts per million „ „ Released for industrial purposes 1 „ „ Unfit for food. Arsenic, 8 parts per million; Copper, 50 parts per million; Lead, 3 parts per million; Zinc, 120 parts per million „ „ Gelatine, Kibbled No action 1 Satisfactory. Arsenic, nil; Copper, 26 parts per million; Zinc, 80 parts per million „ „ No action Gelatine, Leaf 1 Satisfactory. Arsenic nil; Copper, 18 parts per million; Zinc, 80 parts per million „ „ 2 Stopped. Released for processing to reduce excessive Sulphur Dioxide Grapefruit Juice For preservative Sulphur Dioxide, 1,850 and 2,020 parts per million Ground Nuts 2 For presence of Hydrogen Cyanide after fumigation for destruction of insects Hydrocyanic Acid positive. No sign of beetles Aerated to disperse gas and released for processing „ „ 2 „ „ „ „ Released „ „ 1 For metallic contamination Satisfactory. Zinc, nil Copper, 10 parts per million; Lead, 3 parts per million; Arsenic, nil Satisfactory Satisfactory Jam Pectin Released 1 To ascertain if suitable for edible purposes Jus, Premier 1 „ „ „ „ „ „ „ Article Examined No.of Samples 1 Purpose of Examination Result Action Muscats, Extra Fancy Sulphur Bleached Released Satisfactory. Sulphur Dioxide, 332 parts per million For preservative 1 Oil, Mutton Oleo To ascertain if suitable for edible purposes Satisfactory „ 1 Satisfactory. Sulphur Dioxide, 654 parts per million For preservative Peaches, Dried „ 1 „ „ Pears, Dried Satisfactory. Sulphur Dioxide, 750 parts per million „ 1 To ascertain composition Pepper, Ground White Genuine Pepper „ 1 „ „ „ „ Pepper, Ground Black „ For preservative Raisins, Seedless 1 Satisfactory. Sulphur Dioxide, 20 parts per million „ „ „ Satisfactory. Sulphur Dioxide, 190 parts per million Sultanas, Golden Bleached 1 „ UNSOUND FOOD. The general inspection of food in shops and on stalls forms part of the duty of the District Sanitary Inspectors. Food, in the quantities stated, came under the notice of the Inspectors during the year, and being found unfit for human consumption was destroyed or disposed of for animal feeding purposes. Description of Food Weight tons cwts. qrs. lbs. Fish — 4 3 13 Dairy Produce — 1 1 14 Meat — — 5 24 Various — 16 — 22 Total 1 3 3 17 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. FOOD AND DRUGS ACT, 1938. No milk sellers were registered under the above Acts during 1944, and none were removed from the Register. There were 135 milk sellers on the Register at the end of the year. MILK (SPECIAL DESIGNATIONS) ORDER, 1936. During the year under report the following licences were granted:— Dealers' Licences. To sell Tuberculin Tested Milk 17 To sell Pasteurised Milk. 25 Supplementary Licences. To sell Pasteurised Milk 11 To sell Tuberculin Tested Milk 6 All premises used for the sale of milk are regularly inspected to ensure that the standard of cleanliness laid down is maintained. MILK SAMPLING. Samples of milk, both for bacteriological and chemical examination, are taken from milksellers, and special arrangements are made for the sampling of the milk supplied to all schools in the borough. The total number of samples submitted for analysis during 1944 was 405, of which number 7 were taken from schools. For Chemical (i.e., Fat and non-Fatty Solids) Examination. Liquid Milk, undesignated 244 Sterilized Milk 116 Pasteurised Milk (informal) 7 Condensed Milk (informal) 8 Tuberculin Tested (informal) 6 581 For Bacteriological Examination. Pasteurised Milk (from schools) 7 Pasteurised Milk (other than from schools) 4 For tubercle bacilli 4 For brucella abortus 2 Tuberculin Tested 15 32 PHARMACY AND POISONS ACT, 1933. Thirty-three premises were entered on the Council's list for the year under report. As a result of samples being purchased, it was found that four contraventions of the Act occurred, poisons being sold wrongly by unlisted vendors. Warnings were given in all cases. FOOD AND DRUGS. During the year 1,237 samples were submitted by the Food and Drugs Inspector. In twenty-two cases the analysis disclosed an infringement of the law. Remarks No. Date purchased Sample Infringement 725 14.1.44 Public Analyst of opinion should contain 6.0% available Carbon Dioxide. No action taken as Food Standards (Golden Raising Powder) Order, 1944, did not come into force for retail sale until 16.7.44. Manufacturers interviewed Egg Substitute Powder Available Carbon Dioxide 3.5% Accurate analysis impossible. Public Analyst not prepared to give evidence. Verbal warning Meat (probably Beef or Mutton), 20%; Soya (estimated), 20% 829 10.2.44 Pork Sausages Milk 835 11.2.44 Retailer and Supplier warned. Later samples genuine 4.2% added water 889 Zinc Oxide, 11.1 % (should contain 15% ZnO, B.P.) Resampled. 22.2.44 Zinc Ointment 23.3.44 Prosecution. Packer pleaded warranty; summons dismissed. Summons against manufacturer dismissed under Probation of Offenders' Act with £55s. costs 994 Zinc Oxide 11.0% Zinc Ointment 28.2.44 Flour, 90%; Flavouring, 10% The label on container in shop stated "Powder Flavour Mixed Spice." Facts reported to Ministry of Food. On 17.6.45 the Ministry of Food informed us that the manufacturer had been warned 912 Mixed Spice 1.3.44 Total Solids, 8.7%; Protein, 1.7% Informal sample 925 Brown Windsor Soup Date purchased Sample Infringement Remarks 4.4.44 Brown Windsor Soup According to the Canned Meat and Canned Soup (Control and Maximum Prices) Order, 1941, the total solids should be 10% and the protein 1%. In view of the high protein value no action was taken Total Solids, 8.32%; Protein, 1.73% 17.4% deficient in meat Pork Sausages In view of the difficulty of analysis—a warning 2.5.44 Vinegar 15.5.44 Warning 5% deficient in Acetic Acid Baking Powder Available Carbon Dioxide 5.2% (standard 8% available CO2) The Food Standards (Baking Powder) Order, 1944, only came into force for retail shops on the 16.7.44, and as the sample was old stock a warning letter was sent. Retailer withdrew remainder of stock from sale 21.7.44 Dripping 10.8.44 Prosecution. Summons withdrawn. Defendant already in prison Free Fatty Acids, 5.5% 15.9.44 Shredded Suet 7.01% deficient in fat Warning 18.10.44 Shredded Suet 1.2% deficient in fat Warning 20.9.44 Vinegar 5.0% deficient in Acetic Acid Warning 5.10.44 20.0% deficient in Acetic Acid Vinegar Prosecution. Dismissed under Probation of Offenders' Act. Costs, £4 4s. Mustard 11.10.44 26.6% deficient in Allylisothiocyanate Warning. This sample was purchased by the retailer from the wholesaler before the Order came into force Semolina 17.10.44 Weevils and maggots Retailer surrendered remainder of sack (weight 102 lbs.), which was old stock. Warning 1.11.44 Tomato vegetable Soup (Informal Sample) 3.34 grains per lb. of tin Resampled 14.11.44 with two tins and found to be satisfactory. No action No. Date purchased Sample Infringement Remarks 781 Baking Powder (Informal Sample) Available Carbon Dioxide, 7.26% Resampled 20.11.44 Illegally sold by wholesalers to this retailer. In view of explanation given by wholesaler a warning letter was sent 6.12.44 Available Carbon Dioxide, 7% 841 Baking Powder 28.11.44 Available Carbon Dioxide 4.4% 929 Golden Raising Powder This sample was old stock and manufactured before the coming into force of the Food Standards (Golden Raising Powder) Order, 1944. Warning PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937. Quantity Unsound Disposed of for purposes other than human food Released for disposal under other Sanitary Authorities Articles Destroyed Weight Weight Weight Tons cwts. qrs. lbs. Tons Tons cwts. cwts. qrs. lbs. qrs. lbs. Canned Goods - 7 45 3 2 17 3 - - - - - Cereals 2 1 2215 19 3 27 2 75 11 3 7 - Dairy Produce 1 24 230 9 3 21 - - 6 3 - - Evaporated Milk 3 22 - - - - 128 7 2 21 6 1 Flour - - 1757 12 1 11 - - 7 17 - - - - Fruit, Dried 11 19 7 10 4 3 - - - - - 7 Meat 3 14 1 1 13 5 - - - - - 14 40 - - - Various 13 6 3 1 15 1 *4176 - 2 14 8 8 3 19 Total 377 8 2 - * This item is almost wholly accounted for by two "incidents" which caused damage and fire in riverside wharves. WORK OF THE WHARF AND FOOD INSPECTORS, 1944. 1 2 3 4 5 6 7 8 10 11 9 Number of Samples taken Visits Food Factories Food Wharves and Depots Milksellers Pharmacy and Poisons Condemnation of Food Nuisances Found Intimations Served Food Control Various Food and Drugs Imported Food Regulations Milk (Special Designation) Order Samples of Milk for presence of Tubercle Bacilli Milk for Bacillus Abortus Pharmacy and Poison Butter and Margarine Other Food Stores Jam (51) - 21 410 403 1224 - - 246 4 4 - 273 - - - - Mr. Toll 12 - Mr. Butcher 14 12 139 732 1215 - - 343 - - - 325 - 14 - - - - Mr. Tapsfield 36 10 384 400 1232 - - 256 1 1 - 115 - 4 - - - - Mr. Bailey - - - - 10 228 39 70 - - 842 378 1237 - 26 - - 1 Totals 50 43 933 1535 228 39 915 5 5 842 1091 1237 30 26 - - 1 3681 XI.-WAR CONDITIONS. REVIEW. July, 1945. From the middle of 1938 to the outbreak of war we lived in a state of spiritual oppression, common to most other folk throughout the country: we lived and wondered and feared. I cannot say that the effect of this strain upon the physical condition of our people was noticeable, though by all the canons of medicine it should have been. Certainly a few broke down, but generally the older people were quieter and more sober-minded, the youthful were mostly bent on pleasure and the children, though not wholly without apprehension, seemed little affected. There was, however, a noticeable spirit of helpfulness abroad and though tempers were sometimes short a spirit of kindliness and a desire to help the more burdened and the less fortunate was manifest. This was particularly noticeable at the tirpe of the Munich incident when evacuation was in the air, and hundreds of people were pressing for registration. War actually brought a sense of relief and people went about their work preoccupied, it is true, but also with a certain cheerfulness which before had been absent. Immediately prior to the war the population of the Borough was about 100,000; the Registrar-General's estimate to 30th June, 1938, was 97,420. By the middle of June, 1940, the population was estimated to be 71,500, and twelve months later it had fallen to below 45,000. These figures are estimates and may be too low, but it is probable that the population was as low as 45,000 in the autumn of 1940, and it had only shown a comparatively slight increase up to the end of 1944. This substantial exodus included large numbers of children and a fair proportion of old people, while many of the young and fit, of both sexes, left the Borough to join the Forces or to do war work. There was a corresponding depletion of the staff of the department and of the active membership of the Council, and I am the more pleased on this account to be able to record that the two committees which are most closely associated with the work of this department — namely, the Public Health and the Maternity and Child Welfare Committees, met throughout the war with peace-time regularity. So many problems arose requiring immediate solution and so much abnormal responsibility had to be accepted that it was a comfort to be able to report at regular intervals to a committee and so share the responsibility and receive advice, instructions and occasionally reproof. The Chairman (Mr. Gibson) and the Vice-Chairman (Mr. Weightman) have held office throughout the war and both having had long rience of the work of the Public Health Department and having the confidence of the staff, their advice and support have been invaluable. So far as the staff is concerned, it is not only a duty but a very real happiness to be able to record in this report my great appreciation of their whole-hearted and unselfish work. I am convinced that no other local authority in the country has had better service. The Civil Defence organisation operated under the Civil Defence Committee, of which Councillor G. Loveland was chairman. Mr. W. E. Baker, the general manager of works, was appointed Controller and retained this responsible post throughout the war, being awarded the 0.B.E. for his services. In this organisation the Medical Officer of Health had charge of the casualty service of the Borough and was responsible for all training in first-aid work, for the mortuary services and for precautions against gas contamination. As a result of these extra duties in the earlier part of the war, the actual staff of the department rose from the normal number of about one hundred to about five hundred. First Aid Posts were set up in carefully selected places. At first these numbered six, but it became apparent quite soon that six was too many and so the number was reduced to three, of which two were situated at the Central Baths and St. Olave's Hospital and one was in the Redriff School " down town." Owing to the somewhat isolated position of this area, it was decided to station both the Stretcher Party and the First Aid Post as one large unit in this school, but in the remainder of the Borough First Aid Posts and Stretcher Party Posts were separate units in different buildings. Mr. Frankson, the senior inspector, took charge of the First Aid Posts throughout the Borough, and he and most of the other senior officers in the department did their ordinary work during the day and remained on duty at night almost continuously throughout the bombing period. In this Borough we adopted the arrangement, perhaps unique, of placing a permanent officer of standing in administrative charge of the First Aid Posts instead of the practice more common elsewhere, of placing a part-time visiting doctor in charge. These officers we called " administrative officers " : there were three to each First Aid Post and each one did duty for twenty-four hours every third day throughout the war. Most of these posts were filled by Sanitary Inspectors, the only exceptions being Mr. Shapland and Mr. Lumley, who most happily expressed their willingness to give service in this way. Certainly this arrangement was very effective and these posts ran most efficiently with each administrative officer taking a pride in the training and welding of his own team. There was one State-registered nurse on each shift, and she, of course, was the mainstay of the team in the operative periods. Most of the Health Visitors volunteered for this work, and so far as the First Aid Post at the Central Baths is concerned, I record with gratitude the invaluable help given to us by the staff of the Bermondsey Medical Mission Hospital. There was always a doctor on call for each First Aid Post, usually a general practitioner, but sometimes one of our own staff, and some of the doctors of the district helped in this way from beginning to end of the war period. All the First Aid Posts suffered damage by enemy action. The Post at the Central Baths was twice damaged, but never put out of action. The Post at St. Olave's Hospital was partially wrecked by a high explosive bomb in September, 1940, and had to be re-established in Rotherhithe Town Hall. Both St. Olave's Hospital and the Rotherhithe Town Hall were subsequently very seriously damaged, twice by flying bombs and twice by rockets, and Guy's Hospital, the only other hospital connected with the Borough, also suffered damage, but was never totally out of action. The First Aid and Stretcher Party Post at the Redriff School, in the Surrey Dock area, was destroyed by fire on the exciting night of Saturday, September 7th, 1940. It was subsequently replaced by a Mobile Unit stationed at a Fixed Aid Post in Amos Estate. The Stretcher Party Posts suffered less severely than the First Aid Posts and, with the exception of the combined post at Redriff, not one of them was severely damaged, though every one of them did receive some damage, and the post at Rotherhithe New Road School was evacuated on account of a time-bomb and was not re-occupied. The other Stretcher Party Posts were situated at Neckinger Depot, St. Olave's Grammar School, Corbett's Passage and Sunderland Wharf, the latter replacing the Redriff Stretcher Party Post. From the outbreak of war until June, 1940, Mr. J. Blake was in charge of the stretcher parties; at that time he was transferred for whole-time work with the controller, where he subsequently gained the George Medal, and the parties were then put in the charge of Mr. W. A. Campbell (Factories Inspector). When Mr. Campbell took over this work there were about 250 men employed in the service and thirty second-hand cars were in use. There were constant difficulties with the cars, which broke down frequently and caused us much worry. So far as the force itself was concerned, the men worked willingly and hard whenever they were called to an incident, but there were long spells of idleness and as no code of discipline had been laid down by the Government a high degree of tact and considerable weight of personality was called for in the officer controlling them. In April 1942, the Stretcher Parties were merged in the Rescue Service and became Light Rescue squads, which, by agreement with the Controller, were transferred to his department. Apart from their work at incidents, the Stretcher Party men gave much valuable aid in other directions, such, for instance, as in the removal of furniture from bombed houses, the distribution of food and the carriage of stores. We were often by their means enabled to repay some of the multitudinous debts owed to the W.V.S., who came to our aid in innumerable ways and on occasions too many to recount. Rest Centres were provided by the London County Council, eleven or twelve in all, well distributed over the Borough. Except for the fact that we provided the Medical Officer to visit these centres from our own staff, the Public Health Department had but little to do with them, and this visiting only occasionally entailed work which was done in the main by Dr. Grantley Smith. From the public health point of view the shelters set us one of our most difficult problems. Many different types were to be found in the Borough affording different degrees of comfort and protection. Small shelters were disliked, but there is no doubt that the larger shelters, with a good many people, a canteen, and an occasional entertainment were quite popular. Apart from the Tube at London Bridge Station, and possibly the shelter at Platform Wharf, none of these large shelters offered any real protection. Yet they were filled night after night with men, women and children, and it was our duty to do our utmost for their safety and comfort. I remember going into the basement of a jam factory one night early in September, 1940, and finding a crowd of five or six hundred people in possession—men, women and children —sleeping on the sacks of sugar, which made fairly comfortable mattresses. Obviously strong measures had to be taken and tact and kindness as well as firmness were required. The sugar was removed and some of it, having been soiled, was destroyed; water-closets were installed; wash-basins were fitted and bunks erected; and when the Minister of Health visited these premises, as he did one night later on, conditions were so greatly improved that he found a nurse in charge of a Medical Aid Post set up in this same shelter. These Medical Aid Posts were established in all the larger shelters and we had fourteen in all in the Borough, situated in the following shelters :—London Bridge Tube, Dockley Road (Railway Arch), Courage's Brewery (Basement), Hay's Wharf (Basement), Guinness Buildings, Page's Walk (Ground Floor Flat), Platform Wharf, Lenham House, Tabard Street (Ground Floor Flat),' Ordnance Wharf, Lucas Tooth Institute, St. Augustine's Crypt, Naval Brigade Arch, Butler's Wharf, No. 61 Arch (St. Thomas' Street). Apart from the Tube shelter it is probable that No. 61 Arch had the largest nightly population. About 1,500 people slept on the earth in these arches, which were, I believe, the old cab-horse stables for the London Bridge Station. There were no w.c's, no means of washing and no drinking water. Bedding was dumped on the damp earth and in wet weather rain dripped down everywhere, so that the beds were almost always damp and sometimes actually wet. Families were crowded together—men, women and children of unrelated folk —in close proximity and there was no privacy. Elsan chemical closets were the usual sanitary appliances, screened around with Hessian canvas; there was hardly any light and the places were damp, dirty and smelly, an extraordinary comment on our present civilisation. In the winter of 1940-41 these conditions were common in many of the public shelters, but I think the shelter known as 61 Arch was probably the largest and most insanitary. To deal with these problems Mr. Richardson, the drainage inspector, for months devoted practically his whole time to the shelters. Three-tier wooden bunks were supplied by the Government and erected by the Borough Council. From November, 1940, onwards a cleansing gang was employed continuously, going from shelter to shelter taking bunks down, cleansing creosoting and reassembling them. Even with this degree of supervision, many bunks were found to be verminous and required disinfestation and sometimes destruction. In all the larger shelters washing accommodation was fitted and water-closets were installed with a proper degree of privacy, greatly improved lighting was achieved, in most of them a canteen was set up and, as already mentioned, Medical Aid Posts were established. These posts were staffed by girls who were members of the British Red Cross Society and the St. John's Ambulance Brigade and who had had some degree of training in the care of the sick and injured. They volunteered from units all over the country, not a few coming from as far north as Edinburgh and Glasgow, and they gave us invaluable aid, often working in circumstances none too pleasant and sharing risks and discomfort cheerfully. They usually came for two or three weeks during their holidays, but one or two remained with us throughout the war. Altogether about six hundred came to Bermondsey for this work. Mr. Richardson did a nightly round of all the larger shelters and visited the smaller ones at regular though less frequent intervals. Once a week during all the bombing period the girls were visited on alternate weeks by the heads of the two organisations to which they belonged, Lady Louis Mountbatten and Lady Limerick. His Majesty the King, the Duke of Kent and the Princess Royal all paid visits at different times to the shelters, and many distinguished folk from this and from other countries also visited them. Early in May, 1941, a shelter Medical Officer was appointed and did valuable work, but by this time the worst period was over and a thoroughly efficient organisation had already been established, and from the very first we had always had a doctor on call at night. Some of the practitioners in the Borough gave us very valuable help in this way, and it was while she was on this work that Dr. Lesley Probyn was killed with two members of the British Red Cross Society—Miss Hartley of Liverpool, and Mrs. Little of Lancaster Gate—in Stainer Street Arch. One development of the Medical Aid Posts took the form of a small underground hospital, which was established at Willson's Wharf in Tooley Street by the very kind co-operation of the STAINER STREET ARCH Proprietors of Hay's Wharf. Here we had eight separate bays, each with two beds, in the basement of the Wharf. It was staffed by the nurses from our own department and, during the short period in which it was in use, when the flying-bomb attack was at its height, this post was invaluable. A somewhat remarkable coincidence might be mentioned here as a matter of interest in connection with flyingbombs. On 23rd June, 1944, one of these missiles struck a ship in the Surrey Commercial Dock. Five men were killed and three injured. The vessel went to sea and returned to the same berth about three weeks later and was again hit by another flying-bomb, when six men were killed and twenty injured. The flying-bombs did enormous damage to property, though the number of casualties caused by them was not so high in this Borough as in neighbouring areas. One incident occurred on August 4th, 1944, which caused an immense amount of trouble and discomfort to many people and a good deal of anxiety to the staff. On this date a flying-bomb struck Dudin's Wharf in Bermondsey Wall, where about nine thousand tons of grain, linseed and ground nuts were stored. Fire broke out and lasted several days, the walls of the wharf collapsed and both Bermondsey Wall and Loftie Street were completely blocked by an enormous mass of wet grain, linseed and nuts mixed with the charred debris of the building. The upper end of Loftie Street and the ground floor rooms of the houses there were covered to a depth of three feet with wet grain which had been carried along by water from the fire-hoses; grain had completely blocked the sewer for the whole length of the street. The weather was warm and a plague of flies was anticipated and, indeed, was present almost at once. Great difficulty was experienced in obtaining labour and transport; deodorants and disinfectants applied to the grain gave but little relief from the plague and tended also to destroy what value remained in the grain as poultry food. It was six weeks before the nuisance was substantially removed and more than six months before it was finally and satisfactorily cleared. A good deal of damage was done to other wharves and food stores in the Borough at various times and large quantities of food damaged in this way, and by enemy action at sea, came under the control of the Food Inspectors. In these cases there has always been conflict between the natural desire to save as much precious food as possible and the duty of protecting the public from unsound and contaminated food. When there was doubt we always erred on the side of safety. One curious incident happened in the spring of 1940, which still remains unexplained so far as I know. Two ships came into one of the wharves with bacon. Both had been stopped, taken into an enemy port and kept under guard for a week while the cargo was discharged and investigated. No one knew what was the object of the seizure nor why the ships were released, but everybody pected deliberate infection of the cargo, and there were some anxious minds for a long time afterwards. As well as the risk of infection of food there was always the possibility of contamination of the water supply, and I believe there were instances in which sewage was forced into the water mains for some considerable distance. The very high standard of the Metropolitan Water Board was maintained throughout the war, and it was only on rare occasions that chlorination was perceptible to the taste. The establishment of the Ministry of Food has led to some modifications of procedure so far as the Food Inspectors are concerned and has greatly increased the number of legal requirements with which they have to be familiar, but there has been no slackening of vigilance and there does not appear to have been any great increase in adulteration or sophistication of foodstuffs during the war. One of our most serious problems before the war was that of overcrowding. At the end of 1938 there were nearly 2,000 dwellings over-crowded in which lived more than 11,000 people. It is quite impossible to obtain any reliable statistics of the present position, but enormous damage was done to house property in this Borough, and it seems likely that over-crowding may become a serious problem in the near future. In August, 1939, the total number of houses in the Borough was 19,529. As a result of bombing 3,200 houses were either destroyed or so seriously damaged as to require demolition and 15,599 other houses were damaged less seriously. Only about seven hundred houses escaped and most of these had windows broken. A good many houses were damaged on more than one occasion, and the total number of "damages" in this sense was 33,251. In common with other districts much harm was done here to council property. Bermondsey Town Hall was wrecked on 14th September, 1940, and again damaged on 10th May, 1941, on which night the Mayor, Councillor Henley, was killed; and Rotherhithe Town Hall was wrecked last year by a flying-bomb. Incendiaries fell on the Public Health Centre on two or three occasions, but a fire-watch patrol was maintained in this building from the outbreak of war and no serious harm was done. In the case of the Centre at 98, Rotherhithe New Road, the hall was so badly damaged that it had to be demolished and only the premises of the dental clinic at present remain standing. Of the conveniences under the control of the Public Health Committee, two were demolished. The Southwark Park Road convenience has not yet been replaced, but a temporary structure is in use in Thurland Road. I suppose that after invasion and starvation the fear which has afflicted us most during the war has been that of infection, and in this matter there is cause for great thankfulness that such apprehensions have so far been falsified. Considering the shelter life, over-crowding, food rationing, the long hours of work and the anxiety of mind under BERMONDSEY TOWN HALL which all have laboured, it is not much less than marvellous that no epidemics have occurred. Really comparable figures are not available, but it is quite clear that there has been no serious increase in any of the common infectious diseases in this Borough during the war and no re-appearance of uncommon infections. There certainly has been a considerable rise in the number of cases of scabies treated in the bathing centre, but this disease, though a serious nuisance, carries no threat to life and is readily curable. Infection has, however, been a serious trouble in the day nurseries. There were two day nurseries in the Borough when war broke out; both were transferred to country premises at once and have not yet returned. As the demand for women workers increased, war-time day nurseries were opened in various parts of the Borough, and we received much help from the London County Council in this matter. Three nurseries, taking twenty children each, were opened in school premises in Riley Street, Credon Road and Townsend Street. The latter school is in Southwark, but it was agreed that we should be responsible for the running of the nursery. Since August, 1942, we have also had the use of the Kintore Way Nursery School. This beautiful school was opened by the London County Council just before the war and has been ideal as a day nursery, taking sixty children. Five other nurseries were opened in what are known as "hutted" buildings provided by the Ministry of Health ; these are at Rother-hithe Street, Fulford Street, Tenda Road, Whitstable Street and Marine Street. These nurseries take fifty children. Admission has not been limited to Bermondsey children, the qualification being solely that the mother is employed in war work. They are open from 7 a.m. till 7 p.m. and on Saturday mornings ; breakfast, dinner and tea are provided, with some few additional items which may be ordered by the doctor, such as fruit juice or emulsion. Each mother pays Is. a day. Very conflicting opinions are held as to the value of day nurseries. We have had two major troubles with ours —infectious disease and staffing difficulties. Our nurseries have rarely been free from infection and there have been long periods of quarantine with a resultant low average attendance and high cost of operation. Staff difficulties have been serious ; much depends on the matron. At Kintore Way and Tenda Road two of our own experienced Health Visitors have been matrons —Miss Lawrence at Kintore Way and Miss Crundwell at Tenda Road; these two nurseries have been run excellendy. With the other nurseries we have not been so successful and this is undoubtedly due to lack of suitable staff. Many of the persons directed to us for this service have been totally unsuited for this kind of work. If any of these nurseries are continued after the war, the selection of a suitable staff will certainly be of prime importance, since these folk do in fact replace the mother for many hours of every day. One of the most painful features associated with this war has been its disruptive effect on the family. In previous wars the men only have been taken, but this time the families have often been disintegrated as if by some invisible centrifugal force —men to the services or the factory, girls to the services or directed labour and mothers to industry. Only too often family life has suffered a disaster. I do not know the figures for venereal disease, but, judging from interviews with people in trouble, these diseases have increased, as they always do in war-time. One very revealing case came to my notice. An unmarried girl, a little over twenty, was sent to me wanting treatment for gonorrhoea. According to her statement she already had one child, blind and in a public institution as the result of this disease. She wished to be treated so that she might marry a young man to whom she was engaged. When I suggested that what she proposed to do was wicked, she promptly produced the young man, who threatened physical violence if I interfered. I ascertained, however, that he really did know the facts and understand the risks. Inquiry at the Ministry and from the Registrar revealed the astonishing state of affairs that no legal action whatever was possible, and the couple were duly united in a registry office. Illicit unions and illegitimate births are also frequently the evidence of family disruption. One powerful factor in this direction which existed in the Borough long before the war, but has been grently accentuated by the war, is lack of privacy. It is beyond human achievement to establish and bring up a family creditably in the conditions which are the common lot of many a couple in this Borough. These are physical conditions which certainly could be remedied, but there are other factors which justify apprehension about the future of family life. There have been great and rapidly developed changes in our Habits, especially in those of women. The adoption of male garb, the use of cosmetics (even by school-girls) and the enormous increase of smoking among women all seem of doubtful value to family life. I have seen a mother breastfeeding a baby while smoking a cigarette, and when it is remembered that nicotine can be demonstrated in the milk of a nursing woman and in the urine ante-natally, there is justification for the view that this habit cannot be of benefit to the infant. If the national health is to be built upon that of the family then obviously something more than mere physical and material change is needed. Owing to the vital importance of identification it fell to my lot as Medical Officer of Health to see the bodies of all those killed. This was a distressing duty, but personal experience thus acquired enables me to express appreciation of the kindness and sympathy evinced by the mortuary attendants and of the painstaking care with which they carried out their work. Two mortuaries were maintained, capable together of taking between three and four hundred bodies. One of these was the permanent mortuary of the Council at St. Marychurch Street and the other was a temporary structure erected for the purpose Reproduction by courtesy of Planet News, Ltd., and the Port of London Authority. LONDON DOCKS ABLAZE, SEPTEMBER, 1940. Reproduction by Courtesy of the Port of London Authority. SURREY COMMERCIAL DOCKS, SEPTEMBER, 1940 in Bacon Grove. Eighty-one was the largest number of bodies received into this mortuary at one time. First Raid (Incendiaries): 29th August, 1940. First H.E. Bomb Raid: 6th September, 1940. Linsey Street Arch Shelter 23 killed. 7th September, 1940: Surrey Commercial Docks burnt out. Keetons Road School Rest Centre 34 killed. 15th September, 1940: Bermondsey Town Hall 12 killed. 25th October, 1940: Druid Street Arch Shelter 77 killed. 17th February, 1941: Stainer Street Arch Shelter 63 killed. Worst Raid: 10th May, 1941. 132 H.E. bombs 67 killed. (including the Mayor, Mr. H. E. R. Henley). No H.E's from May, 1941, till 20th January, 1943. Last Incident: 26th March, 1945. St. Olave's Hospital: 24th September, 1940: H.E. 13th August, 1944: Fly bomb. 14th November, 1944: Rocket. 3rd March, 1945: Fly bomb. 26th March, 1945: Rocket. 28 Fly bombs; 9 Rockets ; and approximately 1,000 H.E's fell on the Borough. Total killed 796 Total Casualties treated at First Aid Posts (exclusive of those treated at Hospitals) 1,424 XII.-HEALTH SERVICES. MATERNITY AND CHILI) WELFARE CENTRES. Public Health Centre, Grange Road. Monday 2.0 p.m.—4.0 p.m. Wednesday 10.0 a.m. —12 noon. Thursday 2.0 p.m.—4.0 p.m. Ante-natal Clinics: — Tuesday 2.0 p.m.—4.0 p.m. Thursday 10.0 a.m.—l2 noon. Bermondsey Gospel mission, 1-3, Jamaica Road. Monday 2.0 p.m.—4.0 p.m. Stephen-the-Yeoman Mission, Cranbourne Place. Friday 2.0 p.m.—4.0 p.m. Ante-natal Clinics: — Monday 2.0 p.m.—4.0 p.m. Wednesday 2.0 p.m.—4.0 p.m Community Centre, Redriff Estate. Thursday 2.0 p.m.—4.0 p.m. Central Hall, Bermondsey Street. Wednesday 2.0 p.m.—4.0 p.m. Salomon's Centre, Newcomen Street. Monday 2.0 p.m.—4.0 p.m. Thursday 2.0 p.m.—4.0 p.m. Ante-natal Clinics: — Monday 8.30 a.m.—l2 noon. Wednesday 8.30 a.m. —12 noon. Thursday 8.30 a.m.—12 noon. Friday 8.30 a.m.—l2 noon. GYNÆECOLOGICAL CLINIC. Public Health Centre, Grange Road. Wednesday 2.0 p.m.—4.0 p.m. OBSTETRIC CONSULTANT. Miss Gladys Dodds, F.R.C.S., 15, Devonshire Place, W.l. (Telephone: Welbeck 5868.) Application should be made direct to the Consultant. PUERPERAL FEVER-CONSULTANT. Miss Gladys Dodds, F.R.C.S., as above. Application should be made direct to the Consultant. FAIRBY GRANGE CONVALESCENT HOME, Hartley, near Longfield, Kent. For expectant and nursing mothers and mothers with children under five years of age. Application forms and full particulars can be obtained at any of the Maternity and Child Welfare Centres. DAY NURSERIES. Kintore Way, Whitstable Street, Marine Street. Fulford Street, Tenda Road. Townsend Street. Application for admission to be made to the Medical Officer of Health, Public Health Centre, Grange Road. DENTAL TREATMENT CENTRES. Public Health Centre, Grange Road. Monday and Wednesday 10.0 a.m.—12.30 p.m. 2.0 p.m. —4.30 p.m. 5.30 p.m.—7.0 p.m. Tuesday 10.0 a.m.—12.30 p.m. Thursday and Friday 10.0 a.m.—12.30 p.m. 2.0 p.m. — 4.30 p.m. 98, Rotherhithe New Road. Monday, Tuesday and Friday 10.0 a.m.—12.30 p.m. 2.0 p.m. —4.30 p.m. Wednesday 10.0 a.m.—12.30 p.m. 2.0 p.m.—4.30 p.m. 5.30 p.m. — 7.0 p.m. Thursday 2.0 p.m.—4.30 p.m. TUBERCULOSIS CLINIC, Public Health Centre, Grange Road. Patients are seen by appointment only. An evening session is held for patients who are at work. Appointments are made at the Public Health Centre. SOLARIUM, Public Health Centre. Grange Road. Patients are seen by appointment at the request of their own medical attendant. (Light treatment, electrical treatment and massage). Evening sessions are held for patients who are at work. HEART CLINIC, Public Health Centre, Grange Road. Patients are seen by appointment only. Appointments are made at the Public Health Centre. X-RAY CLINIC, Public Health Centre, Grange Road. Patients are seen by appointment only at the request of their own medical attendant. Evening sessions are held for patients who are at work. EYE CLINIC, Public Health Centre, Grange Road. Patients are seen by appointment only. An evening session is held for patients who are at work. Appointments are made at the Public Health Centre. FOOT CLINICS. Public HealthCentre, Grange Road. Monday to Thursday (inclusive) 9.0 a.m.—1.0 p.m. 2.0 p.m.—5.0 p.m. 5.30 p.m.—7.30 p.m. Friday 9.0 a.m.—1.0 p.m. 2.0 p.m.—5.0 p.m. Saturday 9.0 a.m.—l2 noon. 98, Rotherhithe New Road. Monday to Thursday (inclusive) 9.0 a.m.—1.0 p.m. 2.0 p.m.—5.0 p.m. 5.30 p.m.—7.30 p.m. Friday 9.0 a.m.—1.0 p.m. 2.0 p.m.—5.0 p.m. Saturday 9.0 a.m.—12 noon. DIPHTHERIA IMMUNISATION CLINIC, Public Health Centre, Grange Road. Monday 9.30 a.m. DIPHTHERIA "CONTACTS" CLINIC, Municipal Offices, Spa Road. Monday and Thursday 9.30 a.m. DIPHTHERIA "CARRIER" CLINIC, Guy's Hospital. Thursday 9.30 a.m.—12 noon and 1.30 p.m.—4.0 p.m. VENEREAL DISEASE CLINIC, Guy's Hospital. Women Monday to Friday (inclusive), 12 noon —6.0 p.m. Saturday, 10.0 a.m. —4.0 p.m. Men Monday to Friday (inclusive), 9.30 a.m.—12.30 p.m. and 5.0 p.m.—7.0 p.m. Saturdays, 9.30 a.m.—12.30 p.m. and 5.0 p.m.—6.0 p.m PUBLIC VACCINATOR. Dr. W. B. Pemberton, 50, Grange Road. NURSING ASSOCIATION. St. Olave's (Bermondsey and Rotherhithe) District Nursing Association, 13, Cherry Garden Street. INVALID CHILDREN'S AID ASSOCIATION (Bcrmondsey Branch), 7, Storks Road. Office Hours Monday to Friday (inclusive), 9.0 a.m.—6.0 p.m. Saturday, 9.0 a.m.—12.30 p.m. AMBULANCE FACILITIES. The following facilities are afforded by the London Ambulance Service of the London County Council. Ambulances are provided free of cost except where otherwise stated. Infectious Cases. Telephone—Waterloo 3311.At any hour of the day or night. Patients will not be removed to hospital unless a medical certificate stating definitely the nature of the disease is handed to the ambulance nurse. Infectious cases are conveyed to hospitals other than the L.C.C. hospitals for infectious diseases at a minimum fee of 12/6. Non-Infectious Cases. Telephone—Waterloo 3311. At any hour of the day or night. Minimum fee, 12/6. Accident Cases. Dial 999 and ask telephone operator for "Ambulance." At any hour of the day or night. Serious Illness. Telephone—Waterloo 6000, Reliance 3622, Central 6301, or Regent 4000. At any hour of the day or night. Ambulances are provided for persons suffering from illnesses in their homes if a medical practitioner certifies that the case is one of life or death, and that arrangements have been made for the reception of the patient in a hospital. Maternity Cases. Telephone—Waterloo 6000, Reliance 3622, Central 6301, or Regent 4000. Urgent Cases At any hour of the day or night on application by a doctor or certified midwife, provided that either a doctor or midwife accompanies the case and that arrangements for the reception of of the patient in a hospital have been made. Non-urgent Cases At any hour of the day or night—provided that admission to a maternity bed has been pre-viously arranged and a card (issued by the London County Council to hospitals, maternity homes, etc.) for such admission obtained. This card must be handed to the ambulance attendant at the time of removal. The husband or a female friend must accompany the patient.