FEL 029 Feltham Urban District Council. MEDICAL OFFICER'S REPORT FOR 1918. H. W. NEWTON, L.R.C.F., M.O.H., Feltham, 1919. 3 Council Offices, Feltham, Middlesex. April, 1919. Mr. Chairman and Gentlemen, I beg to present to you my Annual Report, as Medical Officer of Health of your District, for the year 1918. This District covers an area of 1790 acres, and has a population of 5428. 1. Vital Statistics. The number of births during the year was 112, (59 male and 63 female), being 24 more than last year, viz.—14 male and 10 female. Of these 4 were illegitimate. The number of deaths was 71 occurring in the District (35 male and 36 female), and 23 of Feltham inhabitants occurring in institutions, such as Hospitals, Sanatoria, Workhouses, etc. Of these 8 were males and 15 females, making in all 43 male and 51 female deaths, total 94, as against 66 last year. Of these deaths 10 were of children under one year of age, all being legitimate. The causes of death were:— M F Total Diseases of the Lungs 3 4 7 Circulation 3 3 6 Digestive Tract 1 — 1 Urinary Organs 2 1 3 Malignant Disease 2 6 8 Influenza 8 14 22 Zymotic Diseases 1 — 1 Tuberculosis 2 3 5 Congenital Debility 3 — 3 Violence (One case of suicide in a female) 2 2 4 Other defined Diseases 10 15 25 The death rate per 1000 being 17.1. and the birth rate 19.0 per 1000. 4 The infantile mortality rate I am happy to be able to report, has been much reduced of late years, only 10 children under one year old having died. This mortality rate works out at practically 87 per thousand. Former reports have been as high as 206 2 per thousand. I attribute this improvement to the higher training of the midwives and to their proper supervision and to the care exercised by the Health Visitors, who, besides giving advice as to the proper treatment of the infants to the mothers, (who sadly need it,) bring any ailment or failure of progress to the notice of the Medical attendants at an early date. I should like to see this death rate still further reduced, but I must point out that it is considerably lower than that of London, 107, of the great towns, 106, or of the smaller towns, 94. I think the Council can congratulate itself on this improvement. 2. Infectious Disease. The total number of cases of infectious disease notified during the year was 11, of these 6 were erysipelas, 3 diphtheria, and 2 scarlet fever. There were also 19 centres of measle infection notified. Only one case, (of measles) was fatal. Two of the diphtheria cases and both of the scarlet fever cases were removed to the Isolation Hospital. In common with the rest of the country, your district suffered from a severe epidemic of influenza, complicated in a large number of cases with pneumonia. This epidemic caused the deaths of 8 male and 14 female patients, 22 in all. The Local Government Board have ordered that for the future all cases of influenzal pneumonia shall be notifiable. 5 I hope that means will be found to cope more efficiently with future outbreaks, and the Authorities are striving to find machinery for so doing. 3. Water Supply. The water supply of this District is from the South-West Suburban Water Co., whose central works are at Egham. I am not satisfied with this supply. I have received the chemical and bacteriological analyses of samples obtained from all parts of their District, and these have seldom been entirely satisfactory; indeed occasionally worse than this. The only redeeming feature has been that the best samples have been those drawn from your area. But, as I pointed out to your Sanitary Committee, I shall not feel free from anxiety on this score until some improvement in the bacteriological reports is shewn. 4. Slaughter Houses and Meat Supply. There are two slaughterhouses in your District, both of which I have visited and found in a satisfactory condition. The meat sold in the District has been of sound quality. I have only had to condemn one carcase of butcher's meat, and that on the complaint of the butcher. One consignment of bacon at a provision dealer's shop I also found unfit for food and condemned. This was on the complaint of the provision dealer. 5. Housing Accommodation. Owing to the large number of persons employed at the different works in the District, the supply of houses is far short of the requirements. This, of course, tends to the encouragement of overcrowding and I believe you intend to take steps to rectify this condition shortly. 6 Some of the already existing houses are so old and of such antique architecture that they are hardly fit for habitation, and are on the borderland of the condemned list, but it is difficult to take steps in this matter whilst there is the present shortage, as if the tenants are removed there is nowhere for them to go. 6. Sewage Disposal. The sewage disposal of your District is the greatest difficulty with which I have had to deal during the past vear. I have been called in twenty-six times by householders owing to the insanitary condition of their drains. I have always found the cesspools over flowing and the drains choked. Though no serious consequences have arisen from these conditions as far as I am aware at present, yet I feel we are living on a volcano, and that at any time some serious epidemic might be produced or disseminated by this chronic overflow and leakage of sewage. Every effort should be made to keep it under. The Surveyor has done his best, but with the shortage of labour and the very inferior type of labourers obtainable, the matter has been very poorly grappled with. Now that times are becoming more normal, I do hope every effort will be made to obtain sufficient and proper labour and appliances to keep this growing evil under, so that all full cesspools might be at once emptied and the District freed from this disgusting and dangerous condition. 7. New Buildings. A considerable number of large new buildings are being erected by the Air Board, and as they are Government property we must take it that the sanitary conditions are satisfactory. 7 8. Disinfection. The disinfection of premises has always been promptly carried out by your staff. The methods are somewhat oldfashioned but have given quite good results, and I am entirely satisfied with them and the manner in which they are applied. 9. Tuberculosis. Nineteen cases of tuberculosis have been reported during the year. Of these 15 were cases of phthisis. Two of these were ex-soldiers and one an employee at a factory, whose home was in Deptford. I had him at once removed there and the M.O.H. of the Borough informed. 1 he care of tuberculous patients has greatly improved of late years. The efforts of the tuberculosis Medical Officers, aided by their visitors and the organisation of tuberculosis dispensaries and sanatoria, has immensely simplified the observation and treatment of these unfortunate people ; and I look forward in the near future to a considerable diminution of this terrible scourge. 10. Venereal Disease. Efforts are being made to stamp out this form of disease, and I have been in communication with the authorities on the matter. Certain methods are being adopted which I hope will be beneficial, but in my opinion are not by any means drastic enough. I am happy to say that your district, in spite of its proximity to London, is not affected to anv appreciable extent. In conclusion I beg to tender my thanks to my colleagues Mr. Sandy and Mr. Stevens for their assistance to me in carrying out my duties, and to you, Gentlemen, for the kind and courteous manner in which you have always listened to 8 my views, and for the manner in which you have always supported me in the duties of my office. I am, Mr. Chairman and Gentlemen, Your obedient Servant, Herbert Newton, (Medical Officer of Health, Feltham U.D. Council.) Caxton Press, High Street, Feltham, Middx.