CRA5 Urban District of Crayford Annual Report OF THE Medical Officer of Health For the Year 1940 BY C. M. OCKWELL M.D. (Lond.), F.R.C.S. (Eng.), D.P.H. (Camb.) The Sparta Press, Crayford. 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 twentieth Annual Report. STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,098.71 Population (Census 1931) 15,896 Resident population 23,770 Number of inhabited houses 7,049 Rateable Value £152,294 Sum represented by a penny rate £618 2  Total M. F. Live Births Legitimate 418 212 206 Illegitimate 10 6 4 428 218 210 Birth rate per 1,000 of the estimated resident population 18.0. General birth rate for England and Wales 14.6. Total M. F. Stillbirths—Legitimate 10 7 3 Illegitimate — — — Rate per 1,000 total (live and still) births 22.8. Total M. F. Deaths 256 145 111 Death rate per 1,000 of the estimated resident population 13.8. General death rate for England and Wales 14.3. Deaths from puerperal causes. Puerperal Sepsis — Other puerperal causes 1 Death rate of infants under one year of age:— All infants per 1,000 live births 38.9 Legitimate infants per 1,000 legitimate live births 34.9 Illegitimate infants per 1,000 illegitimate live births 200 General death rate of infants under 1 year of age for England and Wales 55 Deaths from Cancer (all ages) 27 Deaths from Measles (all ages) — Deaths from Whooping Cough (all ages) — Death from Diarrhoea (under 2 years of age) 2 3 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Public Health Officers. 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. Health Visitors (whole time) Miss E. B. Kiddell. Miss I. E. Smith, S.R.N., S.C.M. Health Visitors' Cert. 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 33 Sputa 62 Others 13 Bacteriological examination of School Milk 23 Bacteriological examination of Swimming Bath Water 37 Child Welfare Clinics. The attendances at the Clinics are considered satisfactory in view of the day light air raids and also the number of children evacuated from the area. 4 The average attendances are as follows:— Toddlers Clinics No. of Clinics. Attendances Average Crayford 23 772 33.6 Slade Green 25 454 18.2 Barnehurst 24 823 34.3 Infants Clinics. Crayford 47 2319 49.3 Slade Green 24 763 31.8 Barnehurst 47 2066 44.0 Totals at both Clinics 190 7197 37.9 Milk. 1,364 pints and 1,503 pounds (dry milk) of milk were granted to Clinic mothers and children during the year either free or at less than cost price. Government Evacuation Scheme. Number of expectant mothers evacuated 15 Number of children under 5 evacuated 267 Total number of children evacuated 464 Home Helps. Home helps have carried out their duties satisfactorily to 21 families during the year. On the 1st October, 1940, the Ante Natal Clinic was transferred from the Methodist Hall, High Street to the First Aid Post. 164 women attended the Clinic. The total number of attendances during the year was 587. Maternity and Nursing Homes. Of the 428 births 224 occurred at Institutions and 70 of these at the Crayford Russell-Stoneham Memorial Hospital. Health Visiting. During the year the Health Visitors paid 13,533 visits. 5 Infant Life Protection. At the end of the year there were 5 persons receiving children for reward under the Children Act, 1908, and Children and Young Persons Act, 1932. 16 visits were paid to foster children during the year. At the end of the year there were 5 children remaining on the register. SANITARY CIRCUMSTANCES OF THE AREA. Water. No extensions of Water Mains have been made in the district. Drainage and Sewerage. No extension of the sewer system has been made. In spite of hostile air attack it has been possible to maintain in working order the foul sewerage system. The numerous cases where drains and sewers have been damaged, have been promptly cleared and only in very few instances has the use of W.C's. and sanitary appliances had to be suspended. Rivers and Streams. Except for temporary pollution by oil, due to enemy action there is nothing to mention. Cioset Accommodation. Approximate number of premises containing each type of sanitary convenience in the district:— W.C's. into drainage system 7872 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 Cleansing. It has been necessary by reason of heavy claims on labour and transport for the repair of air raid damage to increase the period of collection from weekly to fortnightly. Efforts have been made to maintain and increase the interest and efforts of the public in the salvage of material useful in the national interest, with a fair amount of success. 6 Sanitary Inspection of the Area. No. in district No. of visits in 1940 No, of faults and defects found No. of faults and defects remedied Bakehouses 3 24 1 1 Dairies 12 24 — — Slaughterhouses: Licensed 2 26 — — Other food - preparing places, which are, as such, subject to inspection 78 477 10 10 Houses let in lodgings 1 1 — — Factories with mechanical power 34 70 14 14 Factories without mechanical power 12 21 — — Nuisances and defects remedied during the year (other than those enumerated in the previous tabulation). Overcrowding 2 Buildings requiring Riepointing 9 Keeping of Animals — Miscellaneous 100 Hop-Pickers Camp — Refuse Receptacles 57 Sanitary Accommodation: Tents, Vans & Sheds — (i) Insufficient — Smoke Nuisances 24 (ii) Defective 187 Yard Paving 1 Drainage: Dampness 40 Roofs and Rain Water Pipes 107 (i) Re-constructed 1 (ii) Repaired 8 Floors 12 (iii) Cleansed 134 Walls & Ceilings 1017 Cesspools: Windows & Ventilation 54 (i) Abolished 1 Baths, Lavatory Basins and sinks 49 (ii) Repaired — Offensive accumulation: 51 Water Supplies 23 7 Total number of visits of all kinds paid by Inspectors during the year 5,316 Approximate number of separate premises in area 7,687 Notices served:— Statutory — Informal 713 Number of houses, etc., disinfected 35 Batches of clothing 30 Shops Acts. 591 visits were made during the year. During the short days the majority of Shop Keepers closed their premises in advance of the legal hours to allow their Assistants to get home before the blackout. Smoke Abatement. Activity in connection with smoke abatement has been supended for the war period and in one or two instances installation of Mechanical Stokers has been held up. Swimming Bath. Retained popularity in 1940. By installing additional ozone cells the growth of algae was reduced and some very satisfactory reports on water samples were received from the County Pathologist. Eradication of the Bed Bug. Particulars of the action taken in 1940 for the eradication of the Bed Bug are as follows:— Number of Infested Disinfested Council Houses 8 8 Other Houses 4 4 8 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 by the Local Authority. HOUSING STATISTICS. (1). Inspection of Dwelling-Houses. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,467 Number of inspections made for that purpose 2,415 (2) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 882 Number of inspections made for that purpose 1,181 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (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 713 9 (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 713 (3). Action under Statutory Powers during the year. A. Proceedings under Section 9, 10 and l6 of the Housing Act, 1930:— (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 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 10 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 Nil (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 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 houses built during 1940:— (a) By the Local Authority Nil (b) By other bodies or persons 2 (4). Housing Act, 1936, Part IV.—Overcrowding. (a) (i) Number of dwellings overcrowded at end of year 20 (ii) Number of families dwelling therein 20 (iii) Number of persons dwelling therein 150 (b) Number of new cases of overcrowding reported during the year Nil (c) (i) Number of cases of overcrowding lieved during the year 2 (ii) Number of persons concerned in such cases 13 11 (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 INSPECTION AND SUPERVISION OF FOOD. Milk Supply. Periodical inspections of Dairies, Cowsheds and Farms are made and all Retailers' premises. There has been no cause for complaint during the year. Meat and other Foods. Local Slaughterhouses are closed owing to the Centralised Slaughtering Scheme of the Ministry of Food. During the year, a total of 13 cwt. 0 qrs. 16 lbs. of food was found to be unfit for human consumption, comprising 7 cwt. 3 qrs. 23 lbs. of meat and 5 cwt. 0 qrs. 21 lbs. of other foodstuffs. Of this amount 1 cwt. 2 qrs. 5 lbs. was rendered unfit through enemy action representing 19 lbs. meat and 1 cwt. 1 qr. 14 lbs. of other foodstuffs. Nutrition and General Health Education. Supplies of Posters and Leaflets on Health matters have been received from the 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 Food. Shell Fish (Molluscan). 12 CONTROL OVER INFECTIOUS DISEASE. Diphtheria Immunisation. During the year 1,006 children presented themselves for Immunisation as follows:— Name of School or Clinic Pre-school Age School Age Crayford Child Welfare Clinic 133 40 Bannehurst Child Welfare Clinic 193 16 Slade Green Child Welfare Clinic 50 5 Public Health Department 140 52 Central Girls' School — 53 Central Boys' School — 61 Iron Mill Lane Junior Council School — 81 Crayford Roman Catholic School — 18 Slade Green Council School — 19 Northend Council School — 20 C/E Boys', Girls' and Infants' Schs. — 51 Barnehurst Junior and Infants' Schs. — 65 Mayplace Road School — 9 516 490 Alum Precipitated Toxoid in two doses (0.1 cc. and 0.5 cc.) is now used as routine. Notifiable Diseases (other than Tuberculosis) during the year. Disease Total cases notified Cases admitted to hospital Deaths Small Pox – – – Scarlet Fever 7 2 — Diphtheria 4 4 — Enteric Fever (including Paratyphoid) — — — Puerperal Pyrexia — — — Pneumonia 15 1 — Erysipelas — — — Cerebrospinal Meningitis 4 4 1 Measles 19 — — Whooping Cough 6 — — Totals 55 11 1 13 Age Groups. Disease Under 1 1 2 3 4 5 10 15 20 35 45 65 upwards Total Smallpox — — — — — — — — — — — — 0 Scarlet Fever — — — — — — 4 2 — — 1 — 7 Diphtheria — — 1 — — 1 1 — — — — 1 4 Enteric Fever (including Paratyphoid) — — — — — — — — — — — — 0 Puerperal Pyrexia — — — — — — — — — — — — 0 Pneumonia — — — — — — — — 1 4 4 6 15 Erysipylas — — — — — — — — — — — — 0 Cerebrospinal Meningitis... 1 — — 1 — — — — — 1 — 1 4 Measles — — 4 1 1 — 2 4 3 4 — — 19 Whooping Cough 1 — — 2 — — 3 — — — — — 6 Totals 2 — 5 4 1 1 10 6 4 9 5 8 55 Public Health Act, 1936, Section 176. No action was taken. Ophthalmia Neonatorum. CASES Vision unimpaired Vision impaired Total blindness Deaths Notified Treated At home In hospital 1 — 1 1 — — — Public Health (Prevention of Tuberculosis) Regulations, 1925. No action was taken. 14 Public Health Act, 1936, Section 172. No action was taken. Tuberculosis. Age periods New cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. 0 — — — — — — — — 1 — — — — — — — — 5 3 2 — 1 — — — 1 15 3 — 2 — 2 1 — — 25 1 4 — — 2 2 — — 35 8 4 1 1 2 3 — — 45 1 — — — 5 1 — — 55 6 — — — 4 — — — 65 and upwards — — — — 1 — — — Totals 22 10 3 2 16 7 0 1 Two Tuberculosis deaths had not been previously notified and the doctors were written to in each case. 1. Inspection of Factories, Workshops and Workplaces. Including inspections made by Sanitary Inspectors. Premises Inspections No. of written notices Occupiers prosecuted Factories (with mechanical power) 70 11 — Workshops (without mechanical power) 21 — — Other premises under the Act (including works of building and engineering construction, but not including Out-workers' premises) Totals 91 11 — 15 2. Defects found in Factories, Workshops and Workplaces. Particulars Number of defects Number of prosecutions Found Remedied Referred to H.M. Inspector Nuisances under the Public Health Acts— Want of cleanliness 8 8 — — Overcrowding — — — — Unreasonable temperature — — — — Inadequate ventilation — — — — Ineffective drainage of floors — — — — Sanitary conveniences— Insufficient — — — — Unsuitable or defective 2 2 — — Not separate for sexes — — — — Other offences 3 3 — — Totals 13 13 — — I am, Your obedient servant, C. M. OCKWELL, Medical Officer of Health. 16