CRA 8 Urban District of Crayford Annual Eeport OF THE MedicaJ Officer of Health For the Year 1943 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-third Annual Report. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 2,698.71 Population (Census 1931) 15,896 Number of inhabited houses 7,071 Rateable Value £152,899 Sum represented by a penny race £630 Total M. F. Live Births—Legitimate 419 201 218 Illegitimate 12 5 7 431 206 225 Birth rate per 1,000 of the estimated resident population 18 9 General birth rate for England and Wales 16.5. Total M. F. Stillbirths—Legitimate 10 5 5 Illegitimate 1 1 – Rate per 1,000 total (live and still) births 24.9. Total M. F. Deaths 223 115 108 Death rate per 1,000 of the estimated resident population 9.8. General death rate for England and Wales 12.1. Deaths from puerperal causes. Puerperal Sepsis – Other puerperal causes – Other Maternal Causes – 2 Death rate of infants under one year of age:— All infants per 1,000 live births 41.8 Legitimate infants per 1,000 legitimate live births 38.2 Illegitimate infants per 1,000 illegitimate live births 166.7 General death rate of infants under 1 year of age for England and Wales 49 Deaths from Cancer (all ages) 38 Deaths from Measles (all ages) 0 Deaths from Whooping Cough (all ages) 0 Deaths from Diarrhoea (under 2 years of age) 1 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.t.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 77 Sputa 64 Others 7 Bacteriological examination of School Milk 34 School Milk Tubercle Bacilli 5 Bacteriological examination of Water:— Swimming Bath 4 Emergency Supplies 5 Drinking 2 3 Child Welfare Clinics. The average attendances are as follows:— Toddlers Clinics No. of Clinics. Attendances. Average Crayford 23 888 38.6 Slade Green 24 609 25.4 Barnehurst 23 1226 53.3 Infants Clinics. Crayford 47 3260 69.4 Slade Green 24 1154 48.1 Barnehurst 48 3579 74.6 Totals at both Clinics 189 10716 56.7 Milk. 19 pounds (dry milk) of milk were granted to Clinic mothers and children during the year either free or at less than cost price. Wartime Nurseries. Slade Green Nursery opened on the 11th January, 1943. Both Nurseries are now affiliated to the National Society of Children's Nurseries. Attendances: "Shenstone," Crayford 8,868 35 Children on ,the Register at the end of the year. Attendances: Slade Green 5,006 33 Children on the Register at the end of the year. Government Evacuation Scheme. Number of expectant mothers evacuated Nil Number of children under 5 evacuated 4 Total number of children evacuated 12 Home Helps. Home helps have carried out their duties satisfactorily to 7 families during the year. Maternal Mortality. 146 women attended the Clinic. The total number of attendances during the year was 584. 4 Maternity and Nursing Homes. Of the 431 live births 287 occurred at Institutions and 133 of these at the Crayford Russell-Stoneham Memorial Hospital. Health Visiting. During the year the Health Visitors paid 13,972 visits. The Health Visitors co-operating with the School Nurse pay special visits to the homes of children notified as verminous and excluded from school. All mothers where there are children under 5 years of age are instructed in the care of the hair, and for treatment Lethane Oil is recommended where necessary. Infant Life Protection. At the end of the year there were 18 persons receiving children for reward under the Children's Act, 1908, and Children and Young Persons Act, 1932. 110 visits were paid to foster children during the year, At the end of the year there were 20 children remaining on the register. SANITARY CIRCUMSTANCES OF THE AREA. Water. Supply under constant pressure is satisfactory both in quantity and quality. No standpipes in area, no analytical evidence of plumbo solvency, supply is "hard" and therefore self protective. Closet Accommodation. Approximate number of premises containing each type of sanitary convenience in the district:— W.C's. into drainage system 7894 W.C's. into Cesspools 9 Earth Closets or privy middens 4 Pail Closets 9 Number of premises not connected to public water supplies Nil 5 Public Cleansing. The salvage aspect of refuse collection has been very much to the fore, and increased quantities of useful war materials have been reclaimed. The controlled tip at Slade Green Road has continued in use, no difficulties having been experienced in keeping crickets and rats to a minimum. No complaints in these matters have been received. Sanitary Inspection of the Area. No. in district No. of visits in 1943 No. of faults and defects found No. of faults and defects remedied Bakehouses 2 24 0 0 Dairies 4 41 0 0 Other food - preparing places, which are, as such, subject to inspection 25 367 0 0 Houses let in lodgings 1 3 1 1 Nuisances and defects remedied during the year (other than those enumerated in the previous tabulation). Overcrowding 3 Sanitary Accommodation: Defective 229 Drainage: (i) Repaired 46 (ii) Cleansed 195 Refuse Receptacles 133 Dampness 39 Roofs and Rain Water Pipes 350 Floors 32 Walls & Ceilings 587 Windows & Ventilation 150 Baths. Lavatory Basins and Sinks 74 Water Supplies 70 Total number of visits of all kinds paid by Inspectors during the year 5,987 Approximate number of separate premises in area 7,480 Notices served:— Statutory 1 Informal 1,216 Number of houses, etc., disinfected 64 6 Shops Acts. Visits made during the year 131. One shopkeeper wa5 warned for a contravention of Section 5, Shops Acts, 1912. Swimming Bath. Increased use made of Swimming Pool during 1943, standard of cleanliness of water was further improved. Eradication of the Bed Bug. Particulars of the action taken in 1943, for the eradication of the Bed Bug are as follows:— Number of Infested Disinfested Council Houses 7 7 Other Houses 9 9 HOUSING STATISTICS. (1). Inspection of Dwelling-Houses. (lj Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1225 Number of inspections made for that purpose 2508 (2) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 1 Number of inspections made for that purpose 4 (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 subheading) found not to be in all respects reasonably fit for human habitation 1216 (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 1216 (3). Action under Statutory Powers during the year. Statutory Notices under Housing or Public Health Acts 1 7 Total number of houses owned by the Local Authority 989 Number of houses built during 1943:— (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 8 (ii) Number of families dwelling therein 11 (iii; Number of persons dwelling' therein (54 (b) Number of new cases of overcrowding reported during the year 3 (c) (i) Number of cases of overcrowding relieved during the year 1 (ii) Number of persons concerned in such cases 13 (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. 34 samples of milk taken from school supplies for bacteriological examination were found to be satisfactory. Two samples of milk submitted for biological test showed no signs 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 4 tons, 7 cwts., 1 qrs., 19 lbs. of food was found to be unfit for human consumption. Classification is shown below:— Tons Cwts. Qrs. Lbs. Meat 6 1 27 Fish 1 3 15 Vegetables and Fruits 3 12 1 6 Milk Products 1 1 10 Miscellaneous 5 1 17 4 7 1 19 8 In addition various foodstuffs totalling 1 ton, 3 cwts., 2 qrs., 9 lbs. were sent to the Salvage Division of the Ministry of Food. 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 422 Over 5 years and under 15 years 188 610 Percentage of Child population considered Immunised at the end of the year — Under Five years 90.6 per cent. Over Five and under Fifteen years 93.5 per cent. Alum Precipitated Toxoid in two doses (0.2 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 55 13 – Diphtheria – – – Enteric Fever (including Paratyphoid) – – – Puerperal Pyrexia 3 3 – Pheumonia 15 3 – Erysipelas 8 – – Cerebrospinal Meningitis 3 3 – Measles 138 1 – Whooping Cough 59 – – Ophthalmia Neonatorium – – – Scabies 157 – – Totals 438 23 – 9 10 Ages, etc. (N.K.-age unknown) Sqarlet Fever Diphtheria Whooping Cough Measles (excluding rubella) Ac Poliomyelitis Ac Polioencephalitis M F M F M F M F M F M F Civilians— 0 – – – – 4 6 1 2 – – – – 1 – 3 – – 6 4 18 8 – – – – 3 8 4 – – 7 14 22 14 – – – – 5 14 19 – – 3 13 30 21 – – – – 10 1 3 – – – 1 7 8 – – – – 15 – 1 – – – – 2 2 – – – – 25 and over – 1 – – – 1 – 3 – – – – Age unknown – – – – – – – – – – – – Total Civilians 23 31 – – 20 39 80 58 – – – – Non-Civilians— 15 – – – – – – – – – – – – 25 and over (or N.K.) 1 – – – – – – – – – – – Total N on -Civilians 1 – – – – – – – – – – – Ages, etc. (N.K.-age unknown) Enteric or Typhoid Fever Paratyphoid Fevers Ac Pneumonia Dysentery Cerebro Spinal Fever Ac encephalitis lethargica M F M F M F M F M F M F Civilians— 0 – – – – 1 – – – – – – – 5 – – – – 4 1 – – 1 – – – 15 – – – – 2 1 – – 1 1 – – 45 – – – – 5 – – – – – – – 65 and over – – – – 1 – – – – – – – Age unknown – – – – – – – – – – – – Total Civilians – – – – 13 2 – – 2 1 – – N on-Civilians— 15 (or N.K.) – – – – – – – – – – – – 45 and over – – – – – – – – – – – – Total Non-Civilians – – – – – – – – – – – – 11 Ages, etc. (N.K.-age unknown) Erysipelas Smallpox Civilians M F M F M F Puerperal pyrexia – 3 Civilians— Ophthalmia neonatorum – – 0 – – – – Scabies 66 91 5 – – – – 15 3 1 – – 45 – 3 – – Non-Civilians M F 65 and over – 1 – – Age unknown – – – – Total Civilians Puerperal pyrexia – – Non-Civilians— 3 5 _ – 15 (or N.K.) – – – – 45 and over – – – – Total Non-Civilians – – – – Tuberculosis. Age periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F 0 – – – – – – – – 1 – – – – – – – – 5 1 – – – – – – – 15 3 4 2 2 – 3 – – 25 5 3 2 – 3 2 – – 35 6 2 – 1 – 4 – – 45 2 – 1 1 3 – – – 55 1 1 – – 1 2 – – 65 and upwards – – – – – 1 – – Totals 18 10 5 4 7 12 – – Scabies. The Council's application to the Ministry of Health for compulsory notification of Scabies was granted as from the 15th March, 1943. Cases notified 157 Cases and contacts treated 413 Batches of clothing disinfested 25 Venereal Diseases. Lectures and film shows on Venereal Disease were arranged in conjunction with the Central Council for Health Education on Friday, 5th June, 1943. Approximately 600 people attended. I am, Your obedient servant, C. M. OCKWELL, Medical Officer of Health. 12