CRA 6 Urban District of Crayford Annual Report OF THE Medical Officer of Health For the Year 1941 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 twenty-first Annual Report. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 2,698.71 Population (Census 1931) 15,896 Number of inhabited houses 7,081 Rateable Value £150,871 Sum represented by a penny rate £610 Total M. . F. Live Births -Legitimate 339 172 167 Illegitimate 8 6 2 347 178 169 Birth rate per 1,000 of the estimated resident population 15.5. General birth rate for England and Wales 14.2. Total M. F. Stillbirths—Legitimate 12 8 4 Illegitimate — — — Rate per 1,000 total (live and still) births 33.4. Total M. F. Deaths 227 141 86 Death rate per. 1,000 of the estimated resident population 10.1. General death rate for England and Wales 12.9 2 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 59.7 Legitimate infants per 1,000 legitimate live births 58.1 Illegitimate infants per 1,000 illegitimate live births 125 General death rate of infants under 1 year of age for England and Wales 59 Deaths from Cancer (all ages) 29 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 5 Death from Diarrhoea (under 2 years of age) 0 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Public Health Officers. Mcdical 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. Laboratory Facilities. The following specimens were sent to the County Laboratory from this District :— Swabs ... , 56 Sputa 62 Others 10 Bacteriological examination of School Milk 28 Bacteriological examination of Swimming Bath Water 13 3 Child Welfare Clinics. The attendances at the Clinics are considered satisfactory'. The average attendances are as follows :— Toddlers Clinics No. of Clinics. Attendances Average Crayford 23 87.7 38.1 Slade Green 24 632 26.3 Barnehurst 24 1128 47.0 Infants Clinics. Crayford 49 3665 74.8 Slade Green 24 951 39.6 Barnehurst 47 3033 64.5 Totals at both Clinics 191 10286 53.9 Milk. 391 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 14 Number of children under 5 evacuated 33 Total number of children evacuated 87 Home Helps. Home helps have carried out their duties satisfactorily to 18 families during the year. Maternal Mortality. 108 women attended the Clinic. The total number of attendances during the year was 617. One maternal death and one death from Septic! Abortion (self induced). Maternity and Nursing Homes. Of the 347 births 203 occurred at Institutions and 82 of these at the Crayford Russell-Stoneham Memorial Hospital. 4 Health Visiting. During the year the Health Visitors paid 12,542 visits. Infant Life Protection. At the end of the year there were 9 persons receiving children for reward under the Children Act, 1908, and Children and Young Persons Act, 1932. 50 visits were paid to foster children during the year. At the end of the year there were 9 children remaining on the register. SANITARY CIRCUMSTANCES OF THE AREA. Closet Accommodation. Approximate number of premises containing each type of sanitary convenience in the district :— W.Q's. into drainage system 7874 W.C's. into Cesspools 11 Earth Closets or privy middens 4 Pail Closets 9 Number of premises not connected to public water supplies Nil Public Cleansing. Fortnightly collection has been maintained, and particular attention paid to salvage. Controlled tipping continued at Slade Green Road. Sanitary Inspection of the Area. No. in district No. of visits in 1941 No. of faults and defects found No. of faults and defects remedied Bakehouses 3 12 — _ Dairies t 14 19 — — Other food - preparing places, which are, as such, subject to inspection 78 246 5 5 Houses let in lodgings 1 1 — — 5 Nuisances and defects remedied during the year (other than those enumerated in the previous tabulation). Overcrowding — Buildings requiring Repointing 8 Keeping of Animals 3 Hop-Pickers Camp — Miscellaneous 152 Sanitary Accommodation : Refuse Receptacles 55 Tents, Vans & Sheds — (1) Insufficient — Smoke Nuisances 13 (ii) Defective 165 Yard Paving 6 Drainage : Dampness 32 (i) Re-constructed 1 Roofs and Rain Water Pipes 135 (ii) Repaired 21 (iii) Cleansed 164 Floors 18 Walls & Ceilings 418 Cesspools : Windows & Ventilation 29 (.1) Abolished — Baths, Lavatory Basins and sinks 38 (ii) Repaired — Offensive accumulation: 5 4 Water Supplies 27 Total number of visits of all kinds paid by Inspectors during the year 5,169 Approximate number of separate premises in area 7,687 Notices served :— Statutory Informal 581 Number of houses, etc., disinfected 44 Batches of clothing 35 Shops Acts. 333 visits were made during the year. Swimming Bath. Opened for a shorter season than usual. Trouble with algae growths was experienced following periods of very hot weather. Eradication of the Bed Bug. Particulars of the action taken in 1941 for the eradication of the Bed Bug are as follows :— Number of Infested Disinfested Council Houses 14 14 Other Houses 4 4 6 Billeting, Rehousing and Rest Centres. 1,556 visits were made in connection with the billeting and rehousipg of persons rendered homeless by enemy action. HOUSING STATISTICS. (1). Inspection of Dwelling-Houses. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 649 Number of inspections made for that purpose 1,300 (2) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 154 Number, of inspections made for that purpose 311 (3) Number of dwelling-houses found t6 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 581 (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 581 (3). Action under Statutory Powers during the year. No Statutory action taken under Housing or Public Health Acts. Total number of houses owned by the Local Authority 989 7 Number of houses built during 1941 :— (a) By the Local Authority Nil (b) By other bodies or persons Nil (4). Housing Act, 1936, Part IV.—Overcrowding. (a) (i) Number of dwellings overcrowded at end of year 13 (ii) Number of families dwelling therein 13 (iii) Number of persons dwelling therein 108 (b) Number of new cases of overcrowding reported during the year Nil (c) (i) Number of cases of overcrowding relieved during the year Nil (ii) Number of persons concerned in such cases Nil (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. One sample of milk taken from school supplies for bacteriological examination was found to be unsatisfactory. Representations were made to the retailer and wholesaler regarding same and no further complaint has been received. One sample of milk was procured from a cowkeeper for pathological examination ; the result showed no evidence of tuberculosis. 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 10 tons, 10 cwts., 1 qr., 25 lbs. of food was found to be unfit for human con- 8 sumption. This includes feeding. Classification is shown below :— Tons Cwts. Qrs. Lbs. Meat 4 1 23 Fish 4 2 15 Vegetables 10 0 0 21 Miscellaneous 1 0 22 10 10 1 25 CONTROL OVER INFECTIOUS DISEASE. Diphtheria Immunisation. Total number of children who completed the full course of immunisation during the year. Under 5 years of age 784 Over 5 years and under 15 years 556 1,340 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 18 9 — Diphtheria 6 5 — Enteric Fever (including Paratyphoid) — — — Puerperal Pyrexia 1 1 — Pneumonia 16 3 — Erysipelas 3 — — Cerebrospinal Meningitis 3 3 1 Measles 249 3 1 Whooping Cough 187 6 5 Poliomyelitis 5 3 — Totals 488 33 7 A Medical Practitioner was prosecuted for not notifying a case of Puerperal Pyrexia, and a fine of £1 with £2 2s. Od. costs was imposed. 9 Age Groups. Disease Under 1 1 2 3 4 5 10 15 20 35 45 65 upwards Total Smallpox - - - - - - - - - - - - 0 Scarlet Fever - 1 - 2 - 2 13 - - - - - 18 Diphtheria - - - - 1 - 4 - - 1 - 6 Enteric Fever (including Paratyphoid) - - - - - - - - - - - - 0 Puerperal Pyrexia - - - - - - - - - 1 - - 1 Pneumonia 3 4 2 1 - - - - 1 2 1 2 16 Erysipelas - - - - - - - - 1 1 1 - 3 Cerebrospinal Meningitis 1 - - - - - - 1 1 - - - 3 Measles 6 12 24 26 29 35 104 6 4 3 - - 249 Whooping Cough 16 14 18 27 26 34 48 1 - 3 - - 187 Poliomyelitis - - - 1 1 1 1 - - 1 - - 5 Totals 26 31 44 57 57 72 170 8 7 12 2 2 488 Tuberculosis. Age periods New cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. 0 - - - - - - - - 1 - - 1 - - - 1 - 5 - - - - - - - - 15 l - 1 2 - - - - 25 8 7 - 2 3 5 - - 35 2 2 - 3 4 2 - - 45 2 - 1 - 2 - - - 55 2 - 1 - 4 - - - 65 and upwards 2 1 - - 1 - - - Totals 17 10 4 7 14 7 1 0 10 Scabies Orders, 1941, No. 1724. Treatment for Scabies is now carried out at the First Aid Post, Crayford, commencing from the 26th September, 1941. At the end of the year, 39 cases had been treated, and their clothing disinfested at the Bow Arrow Hospital, Dartford. I am, \ Your obedient servant, C. M. OCKWELL, Medical Officer of Health. 11