Gre 39 METROPOLITAN BOROUGH OF GREENWICH. ABRIDGED REPORT of the MEDICAL OFFICER OF HEALTH for the year 1941. F. R. WALDRON, M.D., D.P.H., Health Department, Town Hall, Greenwich. S.E.10. September, 1942. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Greenwich. Mr.Mayor, Ladies and Gentlemen, I beg to submit my report for the year 1941. It is again an abridged one in accordance with the directions contained in Circular 2604, Ministry of Health. Statistics for Infectious Disease and Infantile Mortality show pleasingly low indices and give ground for believing that the health of the population has not been adversely affected by wartime conditions. Birth and Death Rates show a slight increase and decrease respectively as compared with the figures for 1941. During the first half of the year, much attention was given to the supervision of Public Shelters and the results of war damage, the general health services being restricted. In the third and fourth quarters an increasing demand made itself felt, and at the year end the health services of the Council were functioning on practically a peace time basis. The figures for the supervision of Sanitary circumstances and Inspection of Food reflect the commendable efforts, under difficult conditions, of the sections concerned. It gives me pleasure to pay tribute to the loyal service during a difficult year of the staff of the Department. The majority of the senior members have responsible part-time duties in Civil Defence, and these they have shouldered without complaint and with gratifying success. I desire to thank my colleagues in other Departments for their assistance and advice readily available at all times, and to the Chairman and members of the Public Health, Maternity and Child Welfare Committee I tender thanks for the consideration accorded me during the year. I have the honour to be, Your obedient Servant, F1. R. WALDRON. STATISTICS. Year 1941. Statistics for the year 1941 are again presented in an abridged form. During the war period deaths of males serving in H.M.Forces are excluded from civilian records. As from lst June, 1941, this also applies to women members of H.M.Forces. POPULATION. (not available for publication) LIVE BIRTHS. Total. Males. Females. Legitimate. 871. 453. 418. Illegitimate. 49. 27. 22. BIRTH RATE. per 1,000 estimated civilian population 16.17 STILLBIRTHS. Total. Males. Females. Legitimate. 24. 9. 15. Illegitimate. 2. 1. 1. Rate per 1,000 total (live and still) births - 27.4 DEATHS. Total. Males. Females. 950. 523. 427. Death rate per 1,000 civilian population- Crude 16.7 DEATHS FROM PUERPERAL CAUSES. Puerperal Sepsis. 1 Other Puerperal causes 0 p w jl. v-». -J- v <_*» u •—> ■' a 9 < s e v 1 Rate per 1,000 total (live and still) births 1.29 DEATHS OF INFANTS UNDER ONE YEAR. All infants per 1,000 births 31 Legitimate infants per 1,000 legitimate births 34 Illegitimate " " " illegitimate births - DEATHS. Deaths from Cancer (all age s) 128 " " Measles ( " " ) 1 " " Wh. Cough. ( " " ) 2 " Diarrhoea (under 2 years) 3 MORTUARY. No. of bodies received into Mortuary due to enemy action 75. PROVISION OF HEALTH SERVICES IN THIS BOROUGH. Notification of Births. The total number of births notified in the Borough was 747. Of these 286 were transferred to other Authorities. Particulars were received of 287 births which took place in other areas, thus giving a net figure of 748. Home Nursing. Such cases needing special nursing are referred to the Ranyard Mission and the Queens Nursing Association. Health Visitors. The following is a brief summary of the work carried out during the year. Visits. Revisits. Total. Infanta under 1 year. 823. 2408. 3231. Children 1-5 years. 287. 5130. 5417. Re Infectious Diseases. 122. 492. 370. Ante-Natal Cases. 911. 450. 1361. 1538. Miscellaneous. 1112. 426. Infant Welfare Centre. Attendances Babies. 7169. Children 1-5 years. 5741 12910. New Cases Babies. 692. Children 1-5 years. 418 1110. Medical Consultations 5870. Ante-Natal & Post Natal Clinics. No. of New Cases - Ante-Natal 606. No. of New Cases - Post-Natal 55. No. of attendances 2340. Artificial Sunlight Treatment. No. of New Cases 602. No. of treatments given 8174. No. of Patients at 31st December, 1941 292. Child Life Protection. The number of Foster-Mothers on the Register at the end of the year was 23, but only 10 were actually receiving children. The number of children on the Register was 12. Periodical visits were made by the Health Visitors who act as Child Protection Visitors. Home Helps. In connection with the Council's Maternity & Child Welfare Scheme, 25 Home Helps were provided at a net cost to the Council of £80. 2. 5d. Foot Clinics. Attendances have been well up to the average, the number being 3542. Supply of Milk to Mothers & Children. The total amount of dried milk supplied during the year was:- Under Nat. Milk Scheme. Under M. &. C. W Scheme. (a) Distributed free 1447 pkts. 1071 pkts. (b) Sold at full or reduced prices. 8668 pkts. 1482 pkts. Supply of Vitamins to Children. By arrangement with the local Ministry of Food Office, Fruit Juices etc have been distributed at the Welfare Centres. Clothing Coupons for Expectant Mothers. Arrangements were made in August with the Board of Trade to issue coupons to enable expectant mothers to buy materials for the garments needed so that they could be ready by the time of the birth of the infant. These are issued at the Public Health Department on production of a certificate from the Doctor or Midwife in charge of the case, or from the Clinic Doctor. I am pleased to be able to record the Scheme has functioned quite smoothly. Convalescent Treatment. Despite restricted services, 29 children were sent away for convalescence. Bacteriological Examinations. The under-mentioned specimens were submitted to the Seamen's Hospital Laboratory for bacteriological investigation, the results being:- Positive. Negative. Total. Diphtheria. 20 235 255 Tuberculosis. 36 186 222 Typhoid. 1 1 2 Miscellaneous. 16 16 - Dental Clinic. M. &. C. W. T.B. Total. No. of Sessions 32 9 41 5 156 No. of New Cases 151 No. of attendances 370 16 386 No. of extractions 391 8 399 SANITARY CIRCUMSTANCES OF THE AREA. The work of the Sanitary Inspectors has again mainly been directed to supervision of First Aid Repairs of houses damaged due to enemy action. Special attention was given to sealing off of drains on sites cleared of debris with a view to combating rat infestation. Summary of Work Performed. Houses inspected (war damage) 7538 (complaints, nuisances). 1728 " " (Infectious Disease) 117 " " (Overcrowding) 7 No. of re-inspections 11331 Factories & Other Premises inspected 311 Shop Premises (Shops Act, 1934) 52 Premises (Pharmacy & Poisons Act) 10 No. of Intimation Notices served 852 No. of Statutory Notices served 73 Disinfection. No. of Rooms Disinfected 912 No. of Beds " " 350 No. of Mattresses " 1028 No. of Pillows " 1150 No. of Blankets " 7178 No. of Quilts " 446 No. of Sheets " 487 No. of Miscellaneous articles disinfected 1791 No. of " " destroyed 764 Verminous Conditions No. of persons treated at Cleansing Stations:- Vermin. Scabies. Adults and children under school age 21 580 School children 370 762 Disinfestation. No. of applications received 400 No. of rooms treated 1174 No. of rooms re-treated 15 No. of Shelters treated 64 No. of Gallons Vermicine used 393 HOUSING. The following houses were completed and occupied during the year: - Kidbrooke (L.C.C) Housing Estate......................70. INSPECTION AND SUPERVISION OF FOOD. MILK. The number of Dairy Premises on the Register is 39 and there are 96 Purveyors of Milk now registered. No. of inspections 171 ICE CREAM PREMISES. No. on Register 118 No. of Inspections 62 PRESERVED FOOD PREMISES. No. on Register 136 No. of Inspections 229 MILK (SPECIAL DESIGNATIONS) ORDERS 1936/1938 Licences granted to sell "Pasteurised" Milk 25 " " " " “Tuberculin Tested” Milk 8 Supplementary Licences granted 2 INSPECTION OF FOOD PREMISES. During the year 3356 visits were made. As a result of advice given 26 improvements to premises were carried out. Numerous visits were made to premises with a view to salvaging war damaged food stocks. FOOD DECONTAMINATION. Volunteers with special knowledge of handling foods have been trained by the Food Inspectors to work in squads in the event of food being contaminated by war gasses. Premises have been acquired and full arrangements made to provide against any such contingency. IMPORTED FOOD SURRENDERED. (Wharves & Warehouses). Total amount - 10 tons. 2 cwt. 10 lbs. UNSOUND FOOD SURRENDERED. (Shops & Meat Depot). Total amount - 20 tons. - cwt. 12 lbs. FOOD & DRUGS ACT 1938. During the year 519 samples were submitted to the Public Analyst for analysis. Of these 118 were “formal” and 401 "informal" The chief article sampled was Milk, 2 out of 102 samples were adulterated. FOOD POISONING. There were only 4 cases of suspected food poisoning notified during the year. Routine investigations were carried out in each instance. PREVALENCE & CONTROL OVER INFECTIOUS DISEASE. The total number of Infectious Diseases was 867, as compared with 501 for the previous year. There were no circumstances calling for any special comment. The notifications received were as under:- DISEASE. Under 1 yr. TOTAL. 1-5 yrs. 5 yrs & upwards. No. admitted to Hospital Diphtheria 2 15 33 50 49 Dysentery 1 1 2 2 - Erysipelas 1 29 30 11 - Scarlet Fever 15 38 53 45 - Enteric Fever 3 - - 3 3 Puerperal Fever - 4 4 4 - Puerperal Pyrexia 6 6 - - 5 Cerebro-Spinal Fever 1 3 8 12 12 Measles 18 134 156 308 60 Whooping Cough 29 119 36 184 23 Diarrhoea 11 2 13 - 10 Ophthalmia Neonatorum 5 - - 5 3 Tuberculosis, Pulmonary 95 - - 95 56 Non-Pulmonary. 6 13 19 13 - Pneumonia, Acute Primary or Acute Influenzal 5 10 68 83 48 TOTALS. 71 306 490 867 344 DIPHTHERIA IMMUNISATIONS. Since the issue of circular 2220 by the Ministry of Health in November 1940, steady strides have been made in regard to Diphtheria Propaganda and close co-operation exists between the London County Council's School Medical Officer and the Borough Services. During the year 462 children were immunised under the Council's Scheme and 698 by the School Medical Officer, making a total of 1160 cases completd. VACCINATION. Of the 1158 births registered during the year 1940, 380 were successfully vaccinated. (32.8 per cent). TUBERCULOSIS. New Cases and Mortality. New Cases Deaths Age Periods Years. Respiratory M. F. Non-Respiratory M. F. Respiratory M. F. Non-Respiratory M. F. 0-1 - - 2 - - - 2 - 1-5 - - 6 5 - - 1 2 5-15 2 3 1 1 - - 1 - 15 - 25 28 22 1 4 - 6 - - 25 - 35 21 12 2 3 3 - - - 35 - 45 11 7 1 1 2 1 - - 45 - 55 12 3 4 - 6 - - - 55 - 65 12 - - - 6 1 - - 65 & Upwards 2 3 1 - - 1 - 1 TOTALS 88 50 18 14 17 9 4 3 Death Rate from Tuberculosis (all forms) 0.57 per 1,000 (Pulmonary) 0.45 per 1,000 " " " "(Non-Pulmonary) 0.12 per 1,000 TUBERCULOSIS IS DISPENSARY. The number of definite cases of Tuberculosis on the Dispensary Register at the end of the years:- Pulmonary Non-Pulmonary Total 30 234 Adults Males 204 Females 170 34 204 14 25 39 Children Males 17 26 Females 9 GRAND TOTAL 503 Number of Patients Attendances 1374 of Visits by Tuberculosis Health Visitors 2608 " Sputum Examinations " " X-Rays 410