FuL 36 METROPOLITAN BOROUGH OF FULFAM REPORT of the MEDICAL OFFICER OF HEALTHS for the year 1945 P.L.T. BENNETT, M.C., M.R.C.S., L.R.C.P., T.D.D., D.P.H. Medical Officer of Health. METROPOLITAN BOROUGH OF FULHAM Public Health Department, Town Hall, Fulham, S.W.6. September, 1946. To the Mayor, Alderman and Councillors of the Metropolitan Borough of Fulham. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report on the health of the Borough for the year 1945, which has been marked by a gradual return to peace-time activities. In accordance with instructions of the Ministry of Health this report is once again in an abridged form. One service that has been extended is the Foot Clinic, wiich is now on a full-time basis, and about which a further note will be found in this report. The population of the borough (according the Registrar- General's estimate) again increased being 99,790 as compared with 95,090 in 1944. Both the Birth and Death rates were lower than in the previous year 17.8 against 18.5 and 13.04 against 16.6 respectively. The drop in the Death Rate is of course mainly attributable to the drop in deaths due to Violent causes (269 to 41) in which deaths from enemy action were included. The Infant Mortality Rate was again a low record, the figures the past ten years being 196 64 1941 50 1937 56 1942 48 1938 51 1943 63 1939 47 1944 43 1940 45 1945 42 I should like to thank the members of the Council in general and the Chairmen and members of the Public Health and Maternity and Child Welfare Committees in particular for their co-operation and constructive interest in the work of the Department, and the members of the staff for their loyal support, during my first year as Medical Officer of Health. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, P.L.T. BENNETT M.C., M.R.C.S., L.R.C.P., T.D.D., D.P.H. Medical Officer of Health. EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. POPULATION, estimated, 19.45 99,790 Rate per 1,000 of Population LIVE BIRTHS: Total Males Females Legitimate 1556 770 786 15.6 106 Illegitimate 220 114 2.2 1776 884 892 17.8 STILLBIRTHS: Legitimate 35 24 11 0.35 Illegitimate 7 4 3 0.07 r, ' . 42 28 14 0.42 1301 662 639 13.04 DEATHS: Percentage of deaths in public institutions 53 Deaths from puerperal causes: From sepsis. From other causes. 2 Number of deaths Rate per 1,000 (Live and Still) births 1.1 Death Rate of Infants Under One Year of Age: All Infants per 1,000 live births 42 Legitimate infants per 1,000 legitimate births 42 Illegitimate infants per 1,000 illegitimate births 49 Deaths from: Cancer (all ages) 203 Measles (all ages) - Whooping Cough ( all ages) 2 Diarrhoea (under two years of age) 12 CLASSIFICATION OF CAUSES OF DEATH: 1,301 deaths as follows:- Whooping Cough 2;' Tuberculosis of respiratory System 74; Other forms of tuberculosis 8; Syphilitic disease 18; Influenza 11; Cancer of (a) buccal cavity 9; (b) uterus 15; (c) stomach and duodenum 29; (d) breast 21; other sites 129; Diabetes 6; Intracranial lesions 118; Heart Diseases 333; Other diseases of circulatory system 48; Bronchitis 91; Pneumonia 89; Other respiratory diseases 22; ulcer of stomach or duodenum 15; Diarrhoea (under 2 yrs.) 12; . Appendicitis 2; Other digestive diseases 27; Nephritis 35; Other Maternal causes 2; Premature birth 11; Congenital malformations etc 32; Suicide 11; Road traffic accidents 5; Other violent causes 41; All other causes 85. INFANTILE DEATH . There of infants under the age of one year the causes being as follows: Whooping Cough 2; Bronchitis 5; Pneumonia 16; Diarrhoea 11; Premature birth 11. Congenital malformations etc. 25; other violent causes 3; all other causes 1. The Infant Mortality Rate was 42 per 1,000 live births. GENERAL PROVISION OF HEALTH SERVICES. Nursing in the Home. The Fulham District Nursing Association has continued to carry out this work on behalf of the Council and during the year paid visits to 495 cases. Ultra Violet Clinic. This Clinic was open throughout the year and 15,012 attendances were made, and in addition 1,018 massage, 1,260 radiant heat and 867 infra-red treatments were given. Maternity and Child Welfare Centres. The four Centres at Parson's Green, Greyhound Road, Wandsworth Bridge Road and Burne Jones House were open throughout the year, the number of weekly sessions at 31st December being for antenatal 13; postnatal 2; infant 14. The attendances of children under one year of age totalled 20,071 and of children aged one to five years 8,297. The number of attendances at the antenatal clinics was 13,457. Home Visiting. The total number of visits paid by the Health Visitors was 20, 689. Infant Life Protection. At the end of the year there were 50 children in the care of 34 foster-mothers.. Dental Clinic. Attendances at this .clinic which is open for at least one session per week, extra sessions being arranged according to the need, totalled 2,919. Maternity Home. During the year 430 women were admitted for labour arid 62 for antenatal treatment. There was one maternal death and 5 infant deaths, 4 due to prematurity and 1 to atelectasis. Additional Maternity Accommodation. Under the L.C.C. scheme four beds were allotted to this Borough in Queen Charlotte's Hospital and by the en'd of the year 94 women had been admitted. Babies' Hospital. Closed. Day Nurseries. The Eridge House Nursery, which was temporarily closed in July 1944 on completion of the Munster Nursery, was reopened in April, so that at the end of 1945 there were 7 Nurseries, with accommodation for children. Supply of sheets for expectant mothers. The arrangements outlined in Ministry of Health Circular 154/44 were adopted and by the end of the year 1,011 dockets had been issued through the Maternity and Child Welfare Centres.- - 2 - SANITARY CIRCUMSTANCES OF THE AREA. Sanitary Inspection. The following table gives a summary of the inspections made by the sanitary inspectors during the year: Cause of Inspection First Inspections Re- Inspections Total Inspections 4,122 9,196 13,318 Complaint Infectious Disease 1,387 34 1,421 Infirm and Dirty Tenants 22 - 22 Rent Restrictions Act applications 12 17 29 5,543 14,790 TOTALS 9,247 As a result of these inspections 2,815 Intimation Notices and 1,023 Statutory Notices were served. In addition to the inspections shown above the inspectors paid 30 4 visits in connection with the repair of drains and 439 in connection with other repairs, caused by enemy action. Factories &c. The visiting of food premises, factories etc. was continued 1,095 visits being made. Legal proceedings were instituted in 31 instances for non-compliance with Statutory Notices. Drainage of Buildings. During the year 54 plans were aporoved by the Public Health Committee. Rent Restrictions Acts. in response to applications by tenants 16 certificates were, issued during the year. Aged, Infirm and Physically incapacitated persons. During the year 22 visits were paid by the woman sanitary inspector to aged persons, and in one instance a notice was. served regarding the condition of the premises. Rat Repression. During the year 2,691 visits were made and 705 rats are known to have been destroyed as the result of action taken by the Rat Officer. In connecticn with the Government's publicity campaign, 482 visits were paid to premises reported as infested. Disinfestation. Number of rooms disinfested was 425 and 66 families had their furniture treated, by HCN process prior to removal to a Borough Council estate. In addition public air raid shelters were treated on 56 occasions. Scabies. Treatment for Scabies was arranged for 192 men, 443 women and 311 children. All cases were foil wed up to ensure that contacts received appropriate treatment. Other conditions. Treatment was given for 5 men, 42 women and girls and 36 children who were suffering from Pediculi capitis. Close contact with the hairdressers in the borough is maintained and many of the girls and women had been referred by them. Supervision of Food. During the year 1,000 samples of food and drugs were submitted to the Public Analyst and 53 or 5.3 per cent were reported adulterated. None of these adulterated samples call for any special comment. PREVALENCE AND CONTROL OVER INFECTIOUS AND Notifiable ediseases. The number of notifications received, after correction, were: Diphtheria 51; Scarlet Fever 238; Erysipelas 31; Puerperal Fever 8; Puerperal Pyrexia 17; Cerebro-Spirial Meningitis 8; Ophthalmia Neonatorum 14; Tuberculosis of Respiratory system 209; Non- Pulmonary Tuberculosis 22; Measles 1,131; Pneumonia 70; Diarrhoea (under 2 yrs. of age) 68; Whooping Cough 160; Dysentery 75; Scabies 450. The number of cases of Diphtheria increased by 32 compared with the previous year, of measles by 918, Diarrhoea by 23. The number of cases of Scarlet Fever deoreased by 15, and whooping cough by 49. Smallpox. Contacts of cases of smallpox numbering 23 were kept under observation, during the year but no cases occurred in the borough. Diphtheria Immunisation. The number of sessions held was 10 2 and 1546 new cases attended, a total of 6,680 attendances being made. By the end of the year 11,531 children had been immunised since the beginning of the campaign in 1934. Cancer. The percentage of deaths from this cause was 16.3 a slight increase compared with last year. Tuberculosis. The death rate from this cause was 0.82 (pulmonary 0.74 and non-pulmonary 0.08). During the year 209 notifications of pulmonary and 22 of non-pulmonary were received. At the Dispensary 3,912 attendances were made including 623 cases who attended for the first time; 122 were referred for institutional treatment. Vaccination. The annual return furnished to the Ministry of Health showed that 59.0 per cent of the children born in 1944 had been successfully vaccinated by 31st January, 1946. Disinfection. The routine disinfection of premises after the occurrence of infectious disease was continued and 14,552 articles were treated at the Disinfecting Station. Foot Clinic. The demand for the services of this Clinic increased to such an extent that the four sessions per week were insufficient and a full-time chiropodist was appointed as from September 10th, 1945. During the year a total of 1,354 treatments was given (608 from January to September, and 740 from September to the end of the year). Mortuary. During the year 242 bodies were received into the Mortuary, and 210 Postmortems were carried out.