CRA 4 URBAN DISTRICT OF CRAYFORD ANNUAL REPORT of the Medical Officer of Health for the year 1939 by C. M. OCKWELL M.D.(Lond.).F.R.C.S.(Eng.) ,D.P.H.(Camb.) CRAYFORD URBAN DISTRICT COUNCIL To the Chairman and. Members of the Urban District Council and Health Committee LADIES AND GENTLEMEN, I HAVE THE HONOUR TO SUBMIT MY NINETEENTH. ANNUAL REPORT STATISTICS AMD-SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,696.71 Population (Census 1931) 15,896 Resident population 25,200 Number of inhabited houses 7,162 Rateable Value £151,637 Sum represented by a penny rate £600 Total M. F. LIVE BIRTHS - Legitimate 446 216 230 Illegitimate 12 5 7 458 221 237 Birth rate per 1,000 of the estimated resident population 18.2. General birth rate for England and Wales 15.0 Total M. F. STILLBIRTHS - Legitimate 9 3 6 Illegitimate - - - Rate per, 1,000 total (live and still) births 19.3. 3  Total M. F. Deaths 194 101 93 Death rate per 1,000 of the estimated resident population 9.4. General death rate for England and Wales 12.1. Deaths from puerperal causes. Puerperal Sepsis - Other puerperal causes - Death rate of infants under one year of age:- All infants per 1,000 live births 35.4 Legitimate infants per 1,000 legitimate live births 31.8 Illegitimate infants per 1,000 illegiti- mate live births 166.7 General death rate of Infant under 1 year of age for England and Wales 50 Deaths from Cancer (all ages)28 Deaths from Measles (ail ages) - Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age)- GENERAL PRPVISION OF HEALTH SERVICES FOR THE AREA PUBLIC HEALTH OFFICERS 1 Medical Officer of Health (part time). C.M, Ockwell, M.D.(Lond.), F.R.C.S.(Eng.), D.P.H. (Camb). Sanitary Inspectors (whole time) R. Milligan, Cert.R.San.I., M.S.I.A. F.C. weston, A.R.S.I.., M.S.I.A,. , Cert. S.I. B. F.H. Shaw, A.R.S.I., Cert.S.I.B., Sanitary Inspector's Pupil to 3rd March, 1939. Health Visitors (whole time) Miss E.B, Kiddell. Miss M.E, George on sick leave from 9th December, 1938, to 13th May, 1939. (Resigned). Mrs.. E. Rowe from 13th December, 1938 to 29th April, 1939. (Temporary). Miss I.E. Smith, S.R.N., S.C.M., Health Visitors' Cert. , from 2bth June, 1939. 4 No, further developments have occurred in the Health Services under the following headings:- Treatment Centres. Hospitals. Nursing in the Home. Ambulance Facilities are adequate. LABORATORY FACILITIES. The following specimens were sent to the County Laboratory from this district:- Swabs 72 Sputa 74 Others 34 Bacteriological examination of School Milk 30 Bacteriological examination of Swimming Bath Water 21 CHILD WELFARE CLINICS The toddlers clinics inaugurated in May, 1938 have proved successful, as will be seen below. In common with the Ante-Natal Clinic, the infant welfare clinics were also suspended for a short period at the beginning of the war. The average attenc lance at the Clinics is as follows:- Toddlers Clinics No. of Clinics Attendances Average Crayford 24 875 36.5 Slade Green 23 6ll 26.6 Barnehurst 23 698 30.4 Infant Clinics Crayford 43 2,156 50.1 Slade Green 26 830 31.9 Barnehurst 44 2,486 56.5 Totals at both Clinics 183 7,656 40.7 MILK 2,464 pints and 1,719 pounds (dry milk) of milk were granted to Clinic mothers and children during the year either free or at less than cost price. HOME HELPS On the 1st January a scheme for Home Helps came into force. Home Helps have carried out their duties satisfactorily to 21 families during the year. 5 MATERNAL MORTALITY Owing to the Russell-Stoneham Memorial Hospital being cleared for the reception of air raid casualties, the Council's Ante-Natal Clinic was suspended from 29th August, 1939, to 31st October, 1939. and recommenced at the Methodist Hall, High. Street, Crayford. 94 women attended the Clinic. The total number of attendances during the year was 497. MATERNITY AND .MJRSING HOMES Of the 458 births 253 occurred at Institutions and 104 of these at the Crayford Russell-Stoneham Memorial Hospital. HEALTH VISITING Daring the year the Health Visitors paid 11,646 visits. INFANT LIFE PROTECTION At the end of the year there were two persons receiving children,for reward under the Children Act, 1908, and.Children arid Young Persons Apt, 1S}2+- .. 31 visits were paid to foster children during the year. At the end of the year there were 2 children remaining on the register. SANITARY CIRCUMSTANCES OF THE AREA WATSlT Extensions of Water Mains have been made at Martens Avenue. DRAINAGE AND SEWERAGE Surface Water Drainage has been completed as follows:- Northend Road, Eversley Avenue, North Cray Sewer. Work on the Ellingham Estate was suspended on the outbreak of war. 6 RIVERS AND STREAMS No complaints were received and. no action taken. Since June, 1939 the problems connected with the pollution of rivers and streams have teen taken over by the Kent County Council. CLOSET ACCOMMODATION Approximate number of premises containing each type of sanitary convenience in the district:- W.C.'s into drainage system 7,864 W.C.'s into Cesspools 11 Earth Closets or privy middens 4 Pail Closets 9 Number of premises not connected to public water supplies 2 PUBLIC CLEANSIN Refuse collection interrupted by war now become normal.. Disposal was by barging until October, when tipping commenced on the old Brickfield site off Slade Green Road. SANITARY INSPECTION OF THE AREA No. in Dist- rict. No. of visits in 1939 No. of faults and defects found No. of faults anddefects remedied Bakehouses 4 15 1 1 Dairies 14 39 1 1 Slaughterhouses: Registered - 1 - Licensed 2 538 1 1 Other food-preparing places, which are, as such, subject to inspection t 1 . ' 88 387 8 8 Offensive Trades - - Common lodging houses - - - - Houses let in loggings 1 1 - - Factories with mechanical power 33 65 6 6 Factories without mechanical power 16 32 3 3 7 NUISANCES AND DEFECTS REMEDIED DURING THE YEAR (OTHER THAN THOSE' ENUMERATED IN THE PREVIOUS TABULATION) Overcrowding 7 Buildings requiring Re- Keeping of Animals 3 pointing 14 Hop-Pickers' Camp Sanitary Accommodations: Miscellaneous 72 Refuse Receptacles 70 (i) Insufficient Tents, Vans and Sheds - (ii) Defective 136 Smoke Nuisances 5 Drainage: Yard Paving 1 (i) Re-cons true ted 1 Dampness ??? (ii) Repaired 8 Roofs and Rain Water Pipes 269 (iii) Cleansed 133 Cesspools: floors 17 (i) Abolished 1 Walls and Ceilings 1,576 (ii) Repaired - Windows and Ventilation 34 Offensive accumulations 2 Baths, Lavatory Basins and sinks 82 Water Supplies 14 Total number of visits of all kinds paid by Inspectors during the year 7,080 Approximate number of separate premises in area 7,687 Notices served Statutory 1 Informal 1,059 Number of houses, etc., disinfected 77 Batches of clothing 86 SHOPS ACT 515 visits were made, during the year. One shopkeeper was prosecuted arid convicted for two contraventions of the Shops (Hours of Closing) Act, 193&. A fine of £1 on each summons was imposed. SMOKE ABATEMENT Mechanical stokers were installed to one boiler with satisfactory results. Work on the second boiler was postponed on account of the existing conditions. 8 SWIMMING BATHS OH POOLS The Martens Grove Swimming Pool proved popular in fine weather. The running of the. Ozone Purification Plant had not been perfected and the quality of the water will be improved when this is done. Samples for bacterological analysis were taken weekly during the season. ERADICATION OF THE BED BUG , Particulars of the action taken in 1939 for the eradication of the Bed Bug-are as follows:- Number of Infested Disinfested Council Houses 11 11 Other Houses 5 5 The method employed for freeing infested houses is by (a) Spray - "Lethane" liquid Concentrate. (b) Fumigation - "Sanitas" Roll Sulphur Trays. "Thermatox." A preliminary inspection is made of all, prospective Council tenants. The work of disinfestation is- carried out bythe Local Authority. HOUSING STATISTICS 1 Inspection of Dwellingt-Houses. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,152 Number of inspections made for that Purpose. 2.272 (2) Number of Dwelling-houses (included under sub head (l) above) which were inspected and recorded under the Housing. Consolidated Regulations ,1925 and 1932 310 Number of inspections made for that Purpose 622 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 15 (4) Number of dwelling houses . (exclusive of those referred to under the preceding subheading) found not to be in all respects reasonably fit for human habitation 295 2 Remedy of Defects During the Year Without Service of Formal Notices Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 1,059 3 Action under Statutory Powers During the Year. A. Proceedings under Sections 9, 10 and l6 of the Housing Act, 1936:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 1 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 1 (b) By Local Authority in default of owners Nil B. Proceedings under Public Health Act:- (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied Nil (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By owners Nil (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 15 10 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 6 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 determined, the tenement or room having been rendered fit Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil Total number of houses owned, by the Local Authority 995 Number of new houses built during 1938 (a) By the Local Authority 44 (b) By other bodies or persons 65 4 Housing Act, 193&. Part IV. - Overcrowding (a) (i) Number of dwellings overcrowded at end of year 22 (ii) Number of families dwelling therein 22 (iii) Number of persons dwelling therein 156 (b) Number of new cases of overcrowding reported during the year 5 (c) (i) Number of cases of overcrowding relieved during the year 7 (ii) Number of persons concerned in such cases 43 (d) Particulars of any cases in which dwellinghouses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil 11 INSPECTION AND SUPERVISION OF FOOD Milk Supply Periodical inspections of Dairies, Cowsheds and Farms are made and all Retailers' premises. There has teen no cause for complaint during the year. Meat and Other Poods Carcases Inspected and Condemned Cattle excluding cows Cows Calves Sheep and Lambs Pigs Number Killed 113 0 85 1,241 2,075 Number Inspected 113 0 85 1,241 2,075 All Diseases except Tuberculosis Whole carcases condeemed 0 0 0 0 4 Carcases of which some part or organ was condemned 31 0 0 6 75 Percentage of the number inspected affected with disease other than tuberculosis 27.4% 0% 0% 5% 3.8% Tuberculosis only Whole carcases condemned 0 0 0 0 15 Carcases of which some part or organ was condemned 12 0 0 0 97 Percentage of the number inspected affected with tuberculosis 10.6% 0% 0% 0% 5.4% Daring the year 2 tons 4 cwt. 0 qrs. 22 lbs. of food was condemned, comprising 1 ton 19 cwt. 3 qrs. 4 lbs. of meat, and 4 cwts. 1 qr. 18 lbs. of other foods tuffs. 12 Nutrition and General Health Education Supplies of Posters and Leaflets on Health matters have been received from The Central Council for Health Education. The Posters have been displayed on the Council's hoardings and leaflets distributed at the Clinics. There is nothing further to note under the following headings:- Adulteration. Chemical and Bacteriological Examination of Pood. Shell Pish (Molluscan). CONTROL OYER INFECTIOUS DISEASE Diphtheria Immunisation During the year 107 children presented themselves either for immunisation or for Schick Test, as follows: Name of School or Clinic Pre-school Age School A£6 For Iiamuni zation For Schick Test For Immunization For Schick Test Crayford Child Welfare Clinic 44 - 9 - Barnehurst Child Welfare Clinic 25 - 7 - Slade Green Child Welfare Clinic 19 - 3 - Totals 88 - 19 - Alum precipitated Toxoid in two doses (0.1 00. and 0.5 cc.) is now used as a routine. No special pressure is put upon parents to have the Schick Test done subsequently. They are told that to provide full assurance it ought to be done and facilities are offered. 13 Notifiable Diseases (other than Tuberculosis) during the year Disease Total cases notified Cases admitted to Hospital Deaths Smallpox - - - Scarlet Fever 60 25 - Diphtheria 7 7 - Enteric Fever Including Paratyphoid 1 1 - Puerperal Pyrexia 7 2 - Pneumonia 14 2 - Erysipelas 2 0 - Totals 91 37 0 Age Groups Disease Under 1 l 2 3 4 5 10 15 20 35 45 65 upwards Total Smallpox - - - - - - - - - - - - 0 Scarlet Fever 1 l 3 2 5 26 10 6 4 l 1 - 60 Diphtheria - - l - - 1 - 3 2 - - - 7 Enteric Fever Including Paratyphoid - - - - - - - - 1 - - - 1 Puerperal Pyrexia - - - . - - - 7 - - - 7 Pneumonia 2 - l - - 3 1 l - 2 3 1 14 Erysipelas 1 - - - - - - - - - l — 2 Totals 4 1 5 2 5 30 11 10 14 3 5 1 91 ; » , • ; i. . ; It will be seen that 'of the 60 cases of Scarlet Fever notified, only 25 were admitted to Isolation Hospitfii. 14 Public Health Act,1916 , Section 176 No. action Neonatatorum Ophthalmia Neonatorum CASES Vision unim- paired Vision impaired Total Blind- ness Deaths Notified. Treated At Home In Hospital - - - - - - - Public-Health (Prevention of Tuberculosis) Regulations . 1925 No.action was taken Public-Health Act, 1936, Section 172 No. action was taken. Tuberculosis Age Periods New Cases Deaths Respiratory NonRespiratory Ssspiratoryt NoriRespiratory M F M F M F M F 0 — — — — — — — — 1 — — — — — — — — 5 2 1 : — — — — — 15 2 1 ; 1 — 2 — — — 25 3 1 1 2 1 — — 35 3 — 2 1 1 — 45 2 1 — 1 1 — — 55 — - — - 1 — 1 — 65 and upwards 1 — — — — — — — Totals 14 4 3 1 8 3 2 2 Two Tuberculosis deaths had not been previouslynotified and the doctors were written to in each case. 15 1. Inspection of Factories, Workshops and Workplaces. Including inspections made by Sanitory Inspectors Premises Inspections No. of written notices Occupiers Prosecuted Factories 65 6 — (with mechanical power) Workshops 32 3 — (without mechanical power) Other premises under the Act. (including works of building and engineering construction, but not including Outworker premises) Total — 97 9 - 2. Defects found in Factories, Workshops and Workplaces [##]Particulars No. of Defects, No. of Prosecutions Found Remedied Referred to H.M. Inspector Nuisances under the Public Health ActsWant of Cleanliness 3 3 — — Overcrowding - - - - Unreasonable Temperature - - - - Inadequate Ventilation - - - - Ineffective drainage of floors — — — — Sanitary Conveniences- — Insufficient l l — — Unsuitable or defective 5 5 — — Not separate for sexes — — — — Other Offences — — — Total 9 9 — — I am, Your obedient servant, C.M. OCKWELL, Medical Officer of Health. 16