CEA 10 AZ 4412(3) CRA 11001 Urban District of Crayford Annual Report OF THE Medical Officer of Health For the Year 1945 BY C, M. OCKWELL M.D. (Lond.), F.R.C.S. (Eng.), D.P.H. (Camb). The Sparta Press, Crayford. Urban District of Crayford Annual Report OF THE Medical Officer of Health For the Year 1945 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-fifth Annual Report. As this is my first report since the cessation of hostilities, I would like to take this opportunity of thanking those who assisted in the work of the Civil Defence First Aid Services : The Kent County Council and the Crayford Urban District Council for their help and guidance in co-ordinating the Scheme. The St. John Ambulance Brigade, and the Women's Nursing Division of St. John's—these Divisions formed the nucleus of the First Aid Services, and 1 appreciate the help given me by the Superintendents and the members. The Women's Voluntary Service for the help rendered through their contact with the public. It is with regret that I record that three of the members lost their lives and two were seriously injured whilst carrying out their duties. To the personnel of the First Aid Posts and Ambulance Service, to the Staff of the Public Health Department for the duties so ably carried out and to all whq gave their assistance I express my appreciation, and I am deeply grateful for their loyalty and co-operation during the war period. I am, Your obedient Servant, C. M. OCKWELL, Medical Officer of Health 2 STATISTIC AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 2,698.71 Population (Census 1931) 15,896 Population estimated 23,030 Number of inhabited houses 7,082 Rateable Value £155,653 Sum represented by a penny rate £625 Live Births Total M. F. Legitimate 405 194 211 Illegitimate 27 14 13 • 432 208 224 Birth rate per 1,000 of the estimated resident population 18.8. General birth rate for England and Wales 16.1. Stillbirths Total M. F. Legitimate 12 8 4 Illegitimate — — — Rate per 1,000 total (live and still) births 27.3. Total M. F. Deaths 170 94 76 Death rate per 1,000 of the estimated resident population 7.4. General death rate for England and Wales 11.4. 3 Deaths from puerperal causes. Puerperal Sepsis — Other puerperal causes — Other Maternal Causes — Death rate of infants under one year of age:— All infants per 1,000 live births 23.1 Legitimate infants per 1.000 legitimate live births 19.8 Illegitimate infants per 1,000 illegitimate live births 69 General death rate of infants under 1 year of age for England and Wales 46 Death from Cancer (all ages) 30 Death from Measles (all ages) 0 Death from Whooping Cough (all ages) 2 Death from Diarrhoea (under 2 years of age) 0 4 5 Vital Statistics during 1945 and previous years. Year Population LIVE BIRTHS DEATHS INFANT DEATHS No. C.U.D.C. RATE C.U.D.C. Eng. &W. No. C.U.D.C. RATE C.U.D.C. Eng. & W. No. C.U.D.C. RATE C.U.D.C. Eng. & W. 1939* 25,200 458 18.26 15 194 9.4 12.1 16 35.4 50 1940* 23,770 428 18 14.6 256 13.8 14.3 16 38.9 55 1941* 22,380 347 15.5 14.2 227 10.1 12.9 20 59.7 59 1942 22,840 441 19.3 15.8 193 8.5 11.6 20 45.3 49 1943 22,850 431 18 9 16.5 223 98 12.1 18 41.8 49 1944 21,910 507 23.1 17.6 243 11.1 11.6 21 41.4 46 1945 23,030 432 18.8 16.1 170 7.4 11.4 10 23.1 46 * Instructions were issued by the Registrar General for these particular years, giving certain alternative figures for calculation of these statistics. Table showing Summary of Causes of Death registered during the year ended 31st December, 1945. CAUSES OF DEATH. Male Female 1. Typhoid and Paratyphoid Fevers — — 2. Cerebrospinal fever — 1 3. Scarlet fever — — 4. Whooping cough 2 — 5. Diphtheria — — 6. Tuberculosis of respiratory system 5 5 7. Other form of tuberculosis 1 1 8. Syphlitic diseases 1 — 9. lnnuenza 3 2 10. Measles — — 11. Acute Poliomyelitis and Polioencephalitis — — 12. Acute Infantile encaphalitis — — 13. Cancer of buccal cavity and oesophagus (M) Uterus (F) 1 2 14. Cancer of stomach and duodenum 3 — 15. Cancer of breast — 2 16. Cancer of all other sites 13 9 17. Diabetes 1 1 18. Intracranial vascular lesions 6 8 19. Heart disease 30 22 20. Other diseases of circularity system — 1 21. Bronchitis 5 2 22. Pneumonia 2 2 23. Other respiratory diseases 1 1 24. Ulcer of stomach or duodenum 2 — 25. Diarrhoea under 2 yeairs — — 26. Appendicitis 1 1 27. Other disgestive diseases 1 2 28. Nephritis 2 1 29. Puerperal and post-abortive sepsis — — 30. Other maternal causes — — 31. Premature birth 2 1 32. Congenital malformation, birth injuries, infant disease 1 1 33. Suicide - - 34. Road traffic accident 2 1 35. Other violent causes 3 1 36. All other causes 6 9 All causes Total 94 76 Population. As will be seen from the summary of statistics the Registrar General has estimated the population for the mid-year 1945 to be 23,030. This is an increase of 1,120 over last year's figure. 6 Births. The 432 births notified is a decrease of 75 compared with last year's figure. The birth rate per 1,000 of the population is 18.8 as against 23.1 for last year. The birth rate for England and Wales is 16.1. Deaths. This, year we recorded only 170 deaths out of a population of 23,030, whilst last year there were 243 in a population of 21,910, thereby giving a rate of 7.4 as against 11.1. The Death Rate for England and Wales is 11.4. Infant Deaths. During the year only 10 infants died before reaching the age of one year. Rate of Infant Deaths, under one year, per 1,000 live births is 23.1 ; that of England and Wales 46. Analysis of the Causes of Deaths of Infants under one year. Whooping Cough 2 Premature Birth 3 Broncho-pneumonia 1 Cardiac complications 2 Septicaemia 1 (Carbuncle infection of no.sp). Inattention at Birth 1 (abandoned baby—found dead). Maternal Mortality. No Deaths occurred during the year under this heading. 7 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. (Cambss). 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 resigned 31st March, 1945. Miss I. E. Smith, S.R.N., S.C.M. Health Visitors' Cert. Miss A. E. Webster appointed 14th May, 1945. The Senior Health Visitor, Miss E. B. Kiddell, retired on the 31st March, 1945. A sealed copy of the Council's Resolution of appreciation of her services, extending over a period of 21 years was presented to Miss Kiddell. Laboratory Facilities. The following specimens were sent to the County Laboratory from the District:— Swabs 29 Sputa 66 Others 7 School Milk Tubercle Bacilli 2 MATERNITY AND CHILD WELFARE FACILITIES. Ante-Natal Clinics. One session per week is held at the Council's Ante-natal Clinic at the Town Hall. 205 women made 585 attendances. X-rays. Nine Expectant Mothers were referred to the County Hospital for X-ray examination. Obstetric Consultant. Abnormalities in connection with Maternity Cases are recommended for examination when necessary, to the Council's Obstetric Consultant at Guy's Hospital. 8 Infant Welfare Clinics. Included in Child Welfare facilities in the Crayford Urban District is a system of three clinics. Four sessions arc held per week from 2.30 to -t p.m. as follows:— Crayford. Town Hall. Infants, Wednesdays. Toddlers, Alternate Fridays. Barnehurst. Methodist Hall, Infants. Thursdays Risedale Road Toddlers, Alternate Fridays Slade Green. Baptist Chapel, Elm Road. Infants and Toddlers, Alternate Tuesdays. Each Infant Welfare Clinic is attended by the Doctor in charge and the Health Visitor. Dried milk and other goods, i.e., Cod Liver Oil and Malt, Glucose, Groats, etc., are supplied to mothers on the advice of the Doctor, at cost price. Where the family income falls below a certain scale milk may be provided either free, or at half-cost. 01 lbs. Dried Milk were given during the year. Facilities are extended to the Ministry of Food for the distribution of Cod Liver Oil, Orange Juice, and National Dried Milk. The average attendances are as follows:— Toddlers Clinics No. of Clinics. Attendances. Average Crayford 23 632 27.5 Slade Green 23 445 19.3 Barnehurst 24 750 31.2 Infants Clinics. Crayford 45 2438 54.2 Slade Green 23 1408 61.2 Barnehurst 46 3249 70.6 Totals at both Clinics ... 184 8922 48.5 9 Home Helps. The Council's Home Help Scheme provides the services of women to undertake Domestic duties for confinement cases, and also in cases of sickness where there are children under five years, of age. The Scheme functioned satisfactorily during the year and no cases were refused. 15 families were attended, covering a period of 180 days. Maternity Cases. Since the 1st April, 1945, patients could only be admitted to the Kent County Council Hospitals on my recommendation and the Council's agreeing to accept financial responsibility. Admission is restricted to cases where complications are likely to occur or where home conditions are unsuitable for a confinement in the home. Number of cases recommended 36. War-time Nurseries. Two Nurseries were available in the area in 1945. One situated at Shenstone to accommodate sixty children, and one at Slade Green Road to accommodate forty children. The following attendances were made during the year:— Shenstone, Crayford 6,775. 35 Children on the Register at the end of the year. Slade Green 5,414. 28 Children on the Register at the end of the year. Fortnightly Sessions were held for the routine Medical Inspection of the children. Priority. Priority Dockets for sheets are available for expectant mothers being confined in their own homes. 241 dockets have been issued during the year to 91 women. Care of Premature Infants. Two sets of equipment including draught proof cots are available for loan in the District. Daily visits are made by the Health Visitors until the infants reach 7 lbs. in weight. 10 The total number of premature babies notified, who were born:— t (a) At Home 11. (b) In Hospital 29. (i) The number of those born at home:— (a) Who were nursed entirely at home 11. (b) Who died during the first 24 hours Nil. (c) Who survived at the end of one month 10. (ii) The number of those born in Hospital:— (a) Who died during the first 24 hours 2. (b) Who survived at the end of one month 27. Total from 1st January, 1945, to the 31st December, 1945. 40. This figure includes 17 outward transfers. Care of Illegitimate Children. The agreement with Oakhurst Diocesan Home, Erith, to make contribution towards the maintenance of unmarried mothers admitted to the home, continued throughout the year. Two such cases were admitted. Maternity and Nursing Homes. Of the 444 births, 312 occurred at institutions, of these 143 at the Russell-Stoneham Memorial Hospital and 103 at the Uartford County Hospital. Health Visiting. Infant Deaths and Still Births are investigated by the Health Visitor. First visits are paid to Live Births on the fourteenth day and continued monthly during the firs,t year. Two monthly visits are paid during the second year. Three monthly visits continue until the child reaches the age of five years. Visits to children under one year 5;300 Visits to children between one and five years 6,316 Visits to Expectant Mothers 402 Total 12,018 11 CHILD LIFE PROTECTION. Adoption of Children (Regulation) Act, 1939. Foster Children—Section 206—Public Health Act, 1936. The Senior Health Visitor is responsible for the supervision of Adopted Children and also of Foster Children. A thorough investigation of the home conditions of pensons wishing to take children under their care is made before they are recommended. Children remain under supervision, and three monthly visits are paid, until they reach nine years of age. These are in addition to the routine visits made to children under five years. Visits to Adopted Children 86. Number of children on the register at the end of year 26. Number pending adoption 5. Visits to Foster Children 63. Number of children on the register at the end of year 3. Infestation. Infestation of children with head lice can lower the health of the children affected through irritation, and sometimes sceptic conditions. Co-operation exists between the School Nurse and the Health Visitor. Special Visits are paid to the homes of children notified as verminous and excluded from school. The use of Lethane Oil is strongly recommended. Dental Treatment. Children under 5 years,' can receive treatment at the Kent County Council's Clinic, Mayplace Road East, Bexley heath. Ophthalmic Treatment. Cases under ft years are seen at the Dartford County Hospital. Orthopaedic Treatment. Facilities, are available for Orthopaedic treatment at the Dartford County Hospital, and eleven Crayford patients made 122 attendances. 12 Midwives. The Midwives Act is administered by the Kent County Council who is the Local Supervising Authority, and provides two Midwives to cover the area. Maternity Hospital. The Russell-Stoneham Memorial Hospital, Perry Street, Crayford, is a Voluntary Hospital with a complement of 26 beds. 143 Crayford births took place there; during the year. An ante-natal Clinic is provided and 191 Crayford patients made 841 attendances. Nursing in the Home. A Voluntary Nursing Association supported by subscriptions and by weekly contributions by the members provides three nurses for work in the District. The service is also available to non-members on payment of a small fee. Domestic Helps. Under the auspices of the Ministry of Health a scheme for Domestic Help in homes where there is sickness came into force on the 16th January, 1945. One full-time Domestic Help was engaged and a register of women willing to work when called upon was prepared. Two women have worked continuously, and two in a casual capacity throughout the year. Although some difficulty was experienced in retaining the services of Domestic Helps, the scheme on the whole has worked satisfactorily, and again no eases were refused Twelve families were attended, the patients being mostly of a chronic type. One case of infirmity is an old lady of 93 who is still receiving our services. Nutrition and General Health Education. Supplies, of posters and leaflets on health matters have been received from the Central Council of Health Education. Posters have been displayed on the Council's hoardings and leaflets distributed at the Council's Clinics. 13 AMBULANCE FACILITIES. Infectious Disease. Cases of Infectious Disease are removed to the Bow Arrow Hospital by the Ambulance in connection with that institution. Non-Infectious Diseases. The Council have an arrangement for the hire of an ambulance for removal of cases to hospital with the Crayford Division of the St. John Ambulance Brigade, Bexley Borough Council. London County Council, Dartford Public Assistance Committee, Sidcup Urban District Council. Mortuary. The Public Mortuary maintained by the Council is situated to the left of the Town Hall Buildings. Number of times used six. Number of Post-mortem examinations made six. SANITARY CIRCUMSTANCES OF THE AREA. Water. The Metropolitan Water Board is, the supplying Authority and I am indebted to the Director of Water Examination for the following information. The supply to the Crayford District is a mixture of water from Wilmington, Darenth, Wansunt. Crayford, and Bexley Wells. All the water is chlorinated as it leaves the works. Bacteriological analyses are made five times per week and consistently satisfactory results have been obtained. All new and repaired mains are chlorinated before being restored to use, and samples of water are tested bacteriologically. None of the supplies is plumbo-solvent. All supplies are direct and not by means of stand- pipes,. 14 A complaint was received at the Public Health Department regarding the water supply at a works canteen. Samples taken from the tap and geyser, and sent for bacteriological examination were reported as of good quality. A Sample taken from a new well at a factory was sent for chemical analysis and reported as being of bad organic quality. While this, well was opened for purely industrial purposes it was considered advisable to have it analysed, so that warning could be given as to the danger of using the water for drinking purposes. Extensions have been made to serve temporary housing sites in Lincoln Close. Drainage and Sewerage. Extensions of foul sewers to serve temporary housing scheme No. 1 and 2., Aylings Estate and Slade Green. Extension of surface water sewer to serve Whitehall Lane Section of Temporary housing scheme No. 2. Rivers and Streams. The usual maintenance clearing was carried out on the River Cray and the dykes, on the Crayford Marsh, and the sluices maintained and operated to drain the low-lying areas. Closet Accommodation. Approximate number of premises containing each type of sanitary convenience in the district:— W.C's. into drainage system 7958 W.C's. into Cesspools 7 Earth Closets or privy middens 4 Pail Closets 9 Number of premises not connected to nublic water supplies 2 Public Cleansing. Period of collection of Domestic Refuse has been reduced to once in every ten days. Salvage. Total tonage 240. Total income therefrom £1,758. 15 Sanitary Inspection of the Area. No. in district No. of visits in 1945 No. of faults and defects found No. of faults and defects remedied Bakehouses 1 14 0 0 Dairies 3 46 0 0 Other food - preparing places, which are, as such, subject to spection 35 538 0 0 Factories (with mech. power) 26 55 5 5 Factories (without mech power) 12 9 2 2 Nuisances and defects remedied during the year (other than those enumerated in the previous tabulation). Overcrowding 1 Sanitary Accommodation : Defective 335 Drainage : (i) Repaired 7 (ii) Cleansed 538 Refuse Receptacles 222 Dampness 78 Roofs and Rain Water Pipes 318 Floors 57 Walls and Ceilings 222 Windows & Ventilation 52 Paths, Lavatory Basins and Sinks 118 Water Supplies 60 Total number of visits of all kinds paid by Inspectors during the year 7,962 Approximate number of separate premises in area 8,000 Notices served:— Statutory 0 Informal 1,673 Number of houses, etc., disinfected 21 Shops Acts. Visits made during the year 65. Smoke Abatement. No action was. taken. Eradication of the Bed Bug. Particulars of the action taken in 1945, for the eradication of the Bed Bug are as follows:— 16 Number of Infested Disinfested Council Houses 1 1 Other Houses 30 30 Public Shelters, 1 1 HOUSING STATISTICS (1). Inspection of Dwelling-Houses. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1693 Number of inspections made for that purpose 3351 (2) Number of dwelling-houses (included under sub-heading (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 1 Number of inspections made for that purpose 15 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 0 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subheading) found not to be in all respects reaspnably fit for human habitation 1673 (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 Local Authority or their Officers 1673 (3). Action under Statutory Powers during the year. Statutory Notices under Housing or Public Health Acts 0 Total number of houses owned by the Local Authority 783 Number of houses built during 1945 (a) By the Local Authority 100 Temporary bungalows (b) By other bodies or persons Nil. 17 (4). Housing Act, 1936, Part IV.—Overcrowding. Until an official survey is carried out it is difficult to assess the extent of overcrowding and so long as the present acute shortage of houses exists Section 59 must necessarily remain dormant. Repair of War Damage. Approximate number of houses in district 7,500. Approximate number of houses damaged 6,500. Houses demolished 184. Houses seriously damaged 568. All repaired and occupied. Houses slightly damaged 5,750. Some on more than one occasion. Of these 5,200 are repaired. Total repaired to " tolerable comfort standard" 5,768. Houses which require attention 550 (minor repairs). OPEN SPACES. Martens Grove. A Recreation Ground covering an acreage of 30.33 is situated on the west side of the town. Facilities for recreation include a swimming pool, 100 ft. by 35 ft., a Children's Paddling Pool 40 ft. 6 ins. by 35 ft., Foot-bath and two Shower Baths,; purification plant house ; Sunbathing Terraces and Cafe. Four Hard Tennis Courts are available. Swimming Pool—period open, from 19th May, to the 17th September (104 days). Number of bathers 35,332. Play Grounds. There are two Children's, Play Grounds to serve the area, one situated at The Dell, Crayford Way, and one at Manor Way, Barnehurst. 18 INSPECTION AND SUPERVISION OF FOOD. Milk. One sample of milk procured for bacteriological examination was found to be free from Tuberculosis. During the year one milk producer closed down. At present there are no milk producers within the area. One complaint wasv received in connection with a milk bottle. Foreign matter was adhering to the sides and bottom of the bottle. Analysis proved this to consist of grit and warning was given to the dairy-man concerned. The following liccnces were issued under the Milk (Special Designations) Orders:— Principle Licences:— Pasteurised milk 4. Supplementary Licences,:— Pasteurised milk 5. Tuberculin tested milk 4. Bread. Complaints were received regarding the condition of bread supplied by two Bakers delivering in the area. The explanation given by each Baker was very similar. The inability to carry out repairs to plant owing to many of their skilled workers being in the forces. This affected the mixing of the ingredients. Meat Deliveries. The attention of the Manager and the Staff of the Local Meat Depot was drawn to Part 6 of the Public Health Meat (Regulation) 1924, pointing out that drivers in charge of Meat Delivery Vans were responsible for the cleanliness of the vehicles and the protection of their meat from contamination. \ Letters of warning were sent to one Driver and to his employers regarding the dirty condition of a vehicle which had been used for transporting meat. 19 Meat and Other Foods. During the year a total of 9 cvvts., 1 qrs., 12 lbs. of food was found to be unfit for human consumption. Classification is shown below:— Cwts. Qrs. Lbs. Meat 2 0 20 Fish 2 1 26 Miscellaneous 4 2 22 9 1 12 FOOD AND DRUGS ACT, 1938. Particulars of samples taken in the Crayford area during the year ended 31st December, 1945, by the Divisional Inspector of the Kent County Council. Milk 61 Plum Jam 1 Sausages 1 Baking Flour 1 Vinegar 2 Cake Mixture 1 Coffee 2 Mint 1 Figs 1 Lard 1 Lemon Squash 1 Self R. Flour 1 Lemon Curd 1 Barley 1 Mustard 1 Wine Essence 1 Bicarb of Soda 1 Apple Juice 1 Apple Rings 1 Cod Liver Oil 1 Beans 1 Ginger Wine 1 Batter Flour 1 Sherry 1 Custard Flavour 1 Hors D'Oeuvre 1 Tinct. of Iodine 1 Shrimps 1 Camp. Oil 1 Date Pudding 1 Arrowroot 1 Cocoa 1 Boracic Ointment 1 Barley Powder 1 Almond Flavour 1 Total number of samples 97. All the above samples were found to be genuine. 20 The Control of Rodents and Other Pests. In addition to work under the Rats and Mice (Destruction) Act, 1919, such work as mosquito control and general disinfestations were given careful attention. During the year the following infestations were dealt with:— Rats, 111. Crickets 30. Wooly Bear 1 Miscellaneous 11. Mosquito Control—40 gallon metal drums—treatments 120. 300 gallon concrete tanks—treatments 96. CONTROL OVER INFECTIOUS DISEASE. Diphtheria Immunisation. Propaganda has been carried out continuously throughout the year. Attractive Birthday Cards were sent to all children on attaining their first birthday, together with letters asking parents to take advantage of the Council's free scheme. This was supported by personal appeal by the Public Health Staff. No cases of Diphtheria have occurred in the area since 1942. Immunisation is carried out at each of the Infant Welfare Clinics held at Crayford, Barnehurst and Blade Green, and also at the Public Health Department, and all the Schools in the area. Total number of children who completed the full course of immunisation during the year:— Under 5 years of age 514 Over 5 years and under 15 years 55 Total 569 Percentage of Child population considered Immunised at the end of the year:— Under Five years 81 per cent. Over Five and under Fifteen years 94 per cent. Alum Precipitated Toxoid in two doses (0.2 cc. and 0.5 cc.) is now used as routine. 21 Notifiable Diseases (other than Tuberculosis) during the year. Disease Total cases notified Cases admitted to hospital Deaths Small Pox — — — Scarlet Fever 23 7 — Diphtheria — — — Enteric Fever (including Paratyphoid) — — — Puerperal Pyrexia 1 1 — Pneumonia 17 2 4 Erysipelas 5 — — Cerebrospinal Meningitis 1 1 1 Measles 291 1 — Whooping Cough 75 2 2 Ophthalmia Neonatorium — — — Dysentry — — — Scabies 156 — — Totals 569 14 7 23 Age Groups. Ages, etc. (N.K.-age unknown) Scarlet Fever Diphtheria Whooping Cough Measles (excluding rubella) Ac Poliomyelitis Ac Polioencephalitis Civilians— M F M F M F M F M F M F 0 — — 3 6 8 6 — — — — 1 3 8 15 29 29 — — — — 3 1 3 11 9 29 37 — — — — 5 7 2 9 11 60 77 — — — — 10 4 1 4 5 — — — — 15 — 1 — 1 2 1 — — — — 25 and over 2 — — — 1 1 2 — — — — Age unknown — — — 1 — — Total Civilians 17 6 — — 31 44 133 158 — — — — Non-Civilians— 15 — — — — 25 and over (or N.K.) — —. — — — — Total Non-Civilians — — — — — — — — — — — — Ages, etc. (N.K.-age unknown) Enteric or Typhoid Fever Paratyphoid Fevers Ac Pneumonia Dysentery Cerebro Spinal Fever Ac encephalitis lethareica M F M F M F M F M F M F Civilians— 0 — 3 2 — 1 — 5 — 4 — — — 15 — — 2 2 — 45 1 1 — 65 and over — — — — 1 1 Age unknown — — — — — Total Civilians — — — — 11 6 — — — 1 — — Non-Civilians— 15 (or N.K.) — — — — 45 and over — — — — — Total Non-Civilians — — — — — 24 Age Groups Continued. Ages, etc. (N.K.-age unknown) Erysipelas Smallpox Civilians M F M F M F Puerperal pyrexia — 1 Civilians— Ophthalmia neonatorum — '— 0 — — — — Scabies 65 91 5 — — — — 15 1 — — — 45 1 1 — — 65 and over 1 1 — — Non-Civilians M F Age unknown — — — — Total Civilians 3 2 — — Puerperal pyrexia — — Non-Civilians— — — — — 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 1 - - 1 - 1 1 15 3 4 - 1 1 2 - - 25 2 2 - - 1 2 - - 35 - - 1 - 2 1 - - 45 2 2 - - - - - - 55 - - - - - - - - 65 and upwards 1 - - - - - - - Totals 9 9 1 1 5 5 1 1 Tuberculosis Dispensaries. At Overy Street Dartford and Bexley Road, Erith|. Scabies. As stated in my last report, during the war period treatment was carried out by personnel of the First Aid Post. After the official stand-down on the 30th June, 1945, a trained nurse was appointed. Two sessions are held per week at the Council's Cleansing Station at the Town Hall. Treatment consists of bathing and the application of Benzyl Benzoate. Cases notified 156 Cases and contacts treated 249 Batches of clothing disinfested 3 Venereal Diseases. Under the auspices of the Ministry of Health and Central Council for Health Education posters were displayed in the area throughout the year. 74 blood specimens for Wasserman testing were taken at the Ante-natal Clinic, all of which proved negative. 25 Venereal Disease Clinic. At the County Hospital, West Hill, Dartford. Gifts. Gifts of Cot Quilts, Woollen Clothing, and Rubber Teats have been received through the Women's Voluntary Service and distributed in the district. 26