ILF 14 Borough of Ilford Health Report FOR THE YEAR 1939 A. H. G. BURTON M.D., B.S., M.R.C.P., D P.M., D.P.H., Barrister-at-Law, Medical Officer of Health, etc. Borough of Ilford Annual Report OF THE MEDICAL OFFICER OF HEALTH SCHOOL MEDICAL OFFICER MEDICAL OFFICER TO THE MATERNITY AND CHILD WELFARE STATUTORY COMMITTEE AND MEDICAL SUPERINTENDENT OF THE ISOLATION HOSPITAL for the Year 1939. Ilford Borough Council NOVEMBER, 1938—NOVEMBER, 1939 Councillor Claude Augustus Farman, J.P., Mayor. Councillor John Elborne, M.A., J.P., Deputy Mayor. Aldermen: Billington, Henry Clark, Charles William, L.R.A.M., E.C.C. Dane, Frederick Hopper, M.B.E., J.P., C.A. (E.C.C.). Griggs, Albert Philip, J.P., E.C.C. Gunary, George, J.P. Pitt, Bertram Sidney John, J.P. Shipman, James Henry, C.C. Smith, Frank Douglas, J.P., C.A. (E.C.C.). Young, Alexander, Major T.D., J.P. Councillors: Barker, John. Bennett, Mrs. Florence Edith. Braithwaite, Thomas. Bramston, John. Bryan, William Allen Vernon. Collischon, Sidney Walter. Colvin, Gilbert, F.C.I.S. Cooper, Albert Edward. Cropper, Cyril Clifford. Daniels, Russell Stearn. Dixon, Robert James, F.C.I.S. (died 22.3.39). Eke, William Benjamin. Elborne, John, M.A., J.P., Deputy Mayor. Farman, Claude Augustus, J.P., Mayor. Green, Arthur William, J.P., C.A. (E.C.C.). Grecory, William Sydney. Harding, Alfred Daniel Bartlett. Harding, Mrs. Beatrice Alice Louise Ann. Heath, William Henry Charles. Holness, Richard Thomas. Parfitt, William Arnold. Spiller, Leslie Thomas. Taylor, Sidney William (from May, 1939). Tyler, George Frederick, F.C.I.I. Westhrop, George William Henry. Wetton, George John, E.C.C. Williams, Thomas Edward Woods. Sidney Charles Victor PUBLIC HEALTH COMMITTEE NOVEMBER, 1938—NOVEMBER, 1939 Councillor G. F. Tyler, F.C.I.I., Chairman. Alderman F. D. Smith, J.P., C.A. (E.C.C.), Vice-Chairman. Alderman H. Billington. Alderman C. W. Clark, L.R.A.M., E.C.C. Alderman A. P. Griggs, J.P., E.C.C. Councillor J. Barker. Councillor Mrs. F. E. Bennett. Councillor T. Braithwaite. Councillor J. Bramston. Councillor W. A. V. Bryan. Councillor G. Colvin, F.C.I.S. Councillor R. S. Daniels. Councillor W. B. Eke. *Councillor J. Elborne, M.A., J.P., Deputy Mayor. *Councillor C. A. Farman, J.P. Mayor. Councillor W. S. Gregory. Councillor A. D. B. Harding. Councillor Mrs. B. A. L. A. Harding. Councillor W. H. C. Heath. Councillor R. T. Holness. Councillor W. A. Parfitt. Councillor L. T. Spiller. Councillor G. J. Wetton, E.C.C. Councillor T. E. Williams. Councillor S. C. V. Woods. *Ex-officio Members. MATERNITY AND CHILD WELFARE STATUTORY COMMITTEE NOVEMBER, 1938—NOVEMBER, 1939 Alderman A. P. Griggs, J.P., E.C.C., Chairman. Councillor Mrs. B. A. L. A. Harding, Vice-Chairman. Alderman C. W. Clark, L.R.A.M., E.C.C. Alderman B. S. J. Pitt, J.P., Alderman F. D. Smith, J.P., C.A. (E.C.C.). Councillor Mrs. F. E. Bennett. Councillor T. Braithwaite. Councillor J. Bramston. Councillor W. A. V. Bryan. Councillor W. B. Eke. *Councillor J. Elborne, M.A., J.P., Deputy Mayor. *Councillor C. A. Farman, J.P., Mayor. Councillor A. W. Green, J.P., C.A. (E.C.C.). Councillor W. A. Parfitt. Councillor T. E. Williams. Co-opted Members : Mrs. M. Armitage. Mrs. S. Charles. Mrs. C. J. Earl. Mrs A. E. Gillard. Mrs. E. J. Hinton. Mrs. B. E. Paddon. Mrs. E. M. Wise. *Ex-officio Members. EDUCATION COMMITTEE NOVEMBER, 1938—NOVEMBER, 1939 Councillor T. Braithwaite, Chairman. Councillor A. W. Green, J.P., C.A. (E.C.C.), Vice-Chairman. Alderman H. Billington. Alderman F. H. Dane, M.B.E., J.P., C.A. (E.C.C.). Alderman B. S. J. Pitt, J.P. Alderman Major A. Young, T.D., J.P. Councillor S. W. Collisciion. Councillor G. Colvin, F.C.I.S. Councillor A. E. Cooper. Councillor R. S. Daniels. Councillor R. T. Dixon, F.C.I.S. (died 22.3.39). Councilor W. B. Eke. †Councillor J. Elborne, M.A., J.P., Deputy Mayor. †Councillor C. A. Farman, J.P. Mayor. Councillor W. S. Gregory. Councillor Mrs. B. A. L. A. Harding. Councillor W. H, C. Heath. Councillor W. A. Parfitt. Councillor L. T. Spiller. Councillor G. F. Tyler, F.C.I.I. Councillor G. W. H. Westhrop. *Miss E. Blomfield. *Mr. P. V. Faning. *Mr. S. P. Lonergan. *Mr. C. J. Ridout. *Mr. W. R. Spencer. *Mr. J. J. Taylor, J.P. *Mr. T. White. *Co-opted Members, †Ex-oflicio Members. OFFICERS OF THE PUBLIC HEALTH SERVICES, January, 1940 Medical Officer of Health, School Medical Officer, Medical Superintendent of the Isolation Hospital, Medical Officer to the Maternity and Child Welfare Statutory Committee : A. H. G. Burton, M.D., B.S., (Lond.), M.R.C.P. (Lond.), D.P.M. (Eng.), D.P.H. (Cantab.), of the Middle Temple, Barrister-at-Law. Deputy Medical Officer of Health : J. H. Weir, M.D., B.S., B.Hy., D.P.H. (Durham). Assistant Medical Officers of Health : D. M. B. Gross, M.D., Ch.B. (Leeds), M.M.S.A., D.P.H. (Lond). C. M. Gray, M.B., Ch.B. (Glas.), D.P.H. (Leeds). I. Gordon, M.D., Ch.B., D.P.H. (Edin.). E. L. Simon, M.D., B.S. (Lond.), D.P.H. (Eng.), D.C.H. (Eng.). Assistant Medical Officer of Health and Resident Medical Officer (Isolation Hospital) : S. R. Jamieson, M.D., Ch.B., D.P.H. (Glas.). Resident Medical Officer (Maternity Home) : D. E. C. Walker, M.B., B.S. (Lond.), D.A. (Eng.). Temporary Medical Officer for A.R.I'. Casualty Services: R. M. Noordin, M.R.C.S., L.R.C.P. Dental Surgeon : M. J. K. Soutter, L.D.S., R.C.S. (Eng.). Assistant Dental Surgeon : A. G. Clark, L.D.S., R.C.S. (Eng.). Matron of Isolation Hospital: Matron of Maternity Home Miss I. Millar. Miss M. E. Roberts. Senior Sanitary Inspector : T. V. Haigh, Mem. Roy. San. Inst. Deputy Senior Sanitary Inspector : H. C. Monkcom, Assoc. Roy. San. Inst., A.M.I.S.E. Sanitary Inspectors: S. G. Rackham. P. W. English. R. J. Daw. G. W. Newman. R. E. Smalley. A. C. R. Neale. J. E. Jones. Chief Clerk : F. J. Hocking. Superintendent of Council's Midwives : Miss C. Blockley. Health Visitors and School Nurses : Miss A. Batten. Miss O. Bell. Miss A. L. Drinkwater. Miss G. M. Gardiner. Miss E. M. Farrow. Miss K. B. Mathieson. Miss I. L. Mobbs. Miss E. Prior. Miss M. D. Seacer. Miss E. Thomas, Miss D. M. Whitmarsii. Miss M. N. Withams. Officers of the Public Health Services —continued Ante-Natal Clinic Nurse: Miss D. W. Whaley. Part Time :— Consulting Obstetrician (Maternity Home and Puerperal Pyrexia Regulations) : Everard H. G. Williams, M.D., M.R.C.P., F.R.C.O.G. Deputy Consulting Obstetrician : R. L. Dodds, F.R.C.S., F.R.C.O.G. Consulting Ancesthetist : Frankis T. Evans, M.B., B.S., D.A. Surgeon in charge of Orthopœdic Clinic : A. T. Fripp, F.R.C.S. Oculist : H. D. Smart, M.D., B.S. Surgeon in charge of Aural Clinic : C. R. Sandiford, M.D., F.R.C.S. Physician in charge of Rheumatism Clinic : K. Playfair, M.A., M.B., M.R.C.P. Veterinary Surgeon : Ralph Bennett, F.R.C.V.S. Public Analysts : Bernard Dyer, D.Sc., F.I.C. George Taylor, F.I.C. J. Hubert Hamence, M.Sc., Ph,D. Masseuse : Miss M. W. Lock, C.S.M.M.G., M.E., L.E.T. 7 PREFACE. Public Health Offices, Ilford. His Worship the Mayor, Aldermen and Councillors, of the Borough of Ilford. Mr. Mayor, Ladies and Gentlemen, I herewith submit the Annual Report required by the Ministry of Health and Board of Education. The Report has been curtailed as requested by these Government Departments. It will be noted that the Infant Mortality Rate has fallen to 33.9, which is the lowest recorded in the district with the exception of the year 1930;, when it was 33.0 per 1,000. Enough statistical information is contained in the Report to show that the Public Health Services have been maintained as far as possible in a normal state of efficiency in spite of the demands made upon the Public Health Services occasioned by the war. Some idea of this is shown by my stating that eight fully equipped First Aid Posts, together with a Mobile Unit, have been provided. During the year in question, 30 courses in Anti-Gas were arranged, involving 240 lectures and demonstrations, and 1,325 volunteers ; in addition, 47 courses in First Aid were arranged, 23 for the Casualty Services volunteers, 10 for the Auxiliary Nursing Services and 14 for the Wardens. These courses necessitated 263 lectures and demonstrations in respect of 609 volunteers, 79 Auxiliary Nurses and 1,399 Wardens. In addition to the above, 63 lectures in First Aid were given by the doctors of the Public Health staff to the Ambulance Drivers, Stretcher Bearers and Rescue and Demolition Parties, and other classes in First Aid were arranged at three schools for teachers, and at one school in Home Nursing. Very considerable periods of overtime have been readily undertaken by the medical and clerical members of the Department and only by this means was it possible to carry through the work to its present stage. I wish to thank the members of the Council for their support, and I have the honour to be, Your obedient Servant, A. H. G. BURTON, Medical Officer of Health. GENERAL 11 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in Acres) Land 8,402 8,435 Inland Wate 26 Tidal Water 7 Population (Census, 1931) 131,061 ,, (Census, 1921) 85,194 Registrar-General's Estimate of resident Population : June 30th, 1939, for purposes of birth rate 169,800 ,, ,, ,, average population for calculation of death rate 161,600 June 30th, 1938 166,900 Number of inhabited houses (end of 1939) according to Rate Books 42,900 (approx.) Rateable Value—October 1st, 1939 (Houses and Land) £1,556,101 Sum represented by a penny rate, October 1st, 1939 £6,200 Education Rate— 1938-39 1939-40 Elementary 2s. 5.82d. in the £ 2s. 4.64d. in the £ Higher (County) 0s. 9.53d. in the £ 0s.10.26d. in the £ ,, (Ilford Council) 0s. .06d. in the £ 0s. .06d. in the £ Combined Rate (all services) 13s. 0d. in the £ 13s. 11d. in the £ 1 he following figures as to unemployment were supplied by the Ministry of Labour, and are in respect of Ilford residents only :— (a) Number of unemployed males at end of 1938 2,619 „ „ „ „ „ 1939 2,562 (b) Number of unemployed females at end of 1938 790 „ „ „ „ „ 1939 1,739 Total M. F. 1939 1938 Live Births Legitimate Illegitimate 2,255 52 1,149 19 1,106 33 Birth Rate per 1,000 of the estimated resident population 13.9 14.0 Still Births 69 37 32 Rate per 1,000 total (live and still) births 30.2 30.5 Deaths 1,450 727 723 Death Rate per 1,000 of the estimated average population 9.2 8.3 Percentage of total deaths occurring in public institutions 34.7 31.6 12 Deaths from puerperal causes (Headings 29 and 30 of the Registrar-General's Short List) :—- Deaths. Rate per 1,000 total (live and still) births 1938 1939 1938 1939 No. 29, Puerperal sepsis 4 1 1.69 .44 No. 30, Other puerperal causes 5 3 2.12 1.31 Total 9 4 3.81 1.75 Death-rate of Infants under one year of age :— 1939 1938 All infants per 1,000 live births 33.9 36.7 Legitimate infants per 1,000 legitimate live births 33.3 37.2 Illegitimate infants per 1,000 illegitimate live births 57.7 17.8 Deaths from Cancer (all ages) 261 239 ,, Measles (all ages) — 5 „ Whooping Cough (all ages) — 1 ,, Diarrhoea (under 2 years of age) 2 4 1. Rainfall.—The total rainfall registered in the district during the year was 30.82 inches. The greatest fall in 24 hours was registered on 1st August, being 1.52 inches. The number of days on which rain fell was 168. 2. Population. The number of patients and resident staff on the 30th June, 1939, at the following public institutions, was :— Claybury Mental Hospital 2,533 West Ham Mental Hospital 1,411 Total 3,944 The net population for 1939 of 165,856 is obtained by deducting the population in institutions (3,944) from the Registrar-General's Estimate, 169,800 and this is the figure used as the basis for compiling the birth rate in this year's Report; for the death rate the figure of 3,944 is deducted from 161,600 the Registrar General's estimated average population for the death rate calculation, the figure used for the death rate is therefore 157,656. 3. Births.—The number of births registered during the year was 2,307 Males Females Legitimate 1,149 1,106 Illegitimate 19 33 i.e., 2.25 per cent. of the births registered were illegitimate. The birth-rate, calculated on the net estimate of the population of 165,856 is 13.9 per 1,000. 4. Deaths.—The total number of deaths of Ilford residents was 1,450. This is obtained by taking the total deaths registered in the district (1,288), subtracting the deaths of non-residents occurring in the district (386), and adding the deaths of Ilford residents registered as having died in other districts (548). 13 The death-rate, calculated on the net estimate of the average population of 157,656 is 9.2 per 1,000. Inquests.—During the year, 67 inquests were held in the district, 39 on Ilford residents, and 28 on non-residents. The ages at death and causes assigned were as follows:— Under 1 year 1-2 years 2-5 years 5-15 years 15-25 years 25-45 years 45-65 years 65 years and upwards 1 — 2 4 10 16 25 9 Death-Rates from Tuberculosis and Cancer, 1939. The following Table shows the death-rates for 1939 for Ilford, compared with the provisional death-rates for England and Wales for the same period, per 1,000 population ; the figures having been supplied by the RegistrarGeneral:— Ilford England and Wales Respiratory Tuberculosis .501 .537 Other Tuberculosis .038 .099 Cancer 1.655 1.668 5. Public Assistance Relief.—The total amount expended in Ilford during the year was £27,827 4s. 3d. The average weekly number of cases in receipt of relief was 1,203 including dependants. The number of admissions to Oldchurch Hospital from Ilford during the year was 917, made up as follows :— Men 318 Women 489 Children 110 In addition there were 305 admissions of patients from Ilford to other County Institutions, owing to no accommodation being available at Oldchurch Hospital ; their allocation was as follows :— Men 121 Women 183 Children 1 The number of destitute persons admitted to the Institution during 1939 was 3, made up as follows :— Men 1 Women 1 Children 1 6. Marriages.—1,647 marriages have taken place during 1939. The following details explain the allocation :— Marriages taking place in the Ilford District 1,488 Marriages of Ilford Residents at Register Office, Romford— Both Parties belonging to Ilford 101 The Male only belonging to Ilford 24 The Female only belonging to Ilford 34 7. Tables of Vital Statistics.—Table I gives a comparative statement of the population, birth-rate and death-rate for the past five years. Table 1A gives a comparison of the: vital statistics of Ilford with England and Wales, London and other towns. Table 11 gives a classified statement of the causes of death in 1939, arranged according to the age groups at which deaths occurred. 14 TABLE I.—Vital Statistics of Whole District During 1939 and Previous Years Year Gross Population estimated to Middle of each Year Net Population estimated to Middle of each Year (a) Births Total Deaths Registered in the District Transferable Deaths Net Deaths Belonging to the District Uncorrected Number Net (b) of Non-Residents registered in the District of Residents not registered in the District Under 1 Year of Age At all Ages Number Rate (c) Number Rate (d) Number Rate per 1,000 Net Births Number Rate (e) 1 2 2a 3 4 5 6 7 8 9 10 11 12 13 1935 151,390 147,470 1,697 2,050 13.9 1,069 7.0 290 433 88 42.8 1,212 8.2 1936 157,300 153,290 1,830 2,213 14.4 1,128 7.2 303 466 96 43.4 1,291 8.4 1937 163,000 159,036 1,872 2,263 14.2 1,255 7.7 338 540 95 42.0 1,457 9.2 1938 166,900 162,991 1,847 2,289 14.0 1,134 6.8 278 498 84 36.7 1,354 8.3 1939 f 169,800 165,856 1,669 2,307 13.9 1,288 7.9 386 548 75 33.9 1,450 9.2 g 161,600 157,656 (a) The net estimated population is found by deducting the population of Claybury and West Ham Mental Hospitals from the gross estimated population. The population of Dr. Barnado's Girls' Village Homes is included in the net estimated population of the district. (b) The net number of births is obtained by taking the uncorrected number of births supplied by the local Registrar and adding to or subtracting from it such a number as is supplied for this purpose by the Registrar-General. (c) and (e) Calculated on the estimated net population. (d) Calculated on the estimated gross population. (f) For birth rate. (g) For death rate. 15 TABLE 1A Table showing comparison between the Birth-rate, Death-rate, etc., of Ilford, other Towns, and of England and Wales for the Year 1939 (Provisional figures). Rate per 1,000 Total Population Annual Death-rate per 1,000 Population Rate per 1,000 Live Births All Causes Typhoid and Paratyphoid Fevers Smallpox Measles Scarlet Fever Whooping Cough Diphtheria Influenza Diarrhoea and Enteritis (under 2 Yrs.) Total Deaths under 1 Year Live Births Stillbirths England and Wales 15.0 0.59 12.1 0.00 — 0.01 0.01 0.03 0.05 0.21 4.6 50 126 County Boroughs and Great Towns, including London ... 14.8 0.59 12.0 0.00 — 0.01 0.00 0.03 0.05 0.19 6.3 53 148 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census, 1931) 15.6 0.57 11.2 0.00 — 0.01 0.00 0.02 0.04 0.20 3.0 40 London Administrative Co. 12.3 0.44 11.9 0.00 — 0.00 0.00 0.03 0.02 0.18 8.2 48 ILFORD (Estimated, Gross Population, 169,800 mid. 1939 13.6 0.40 8.5 0.01 — — — — 0.01 0.21 0.8 33.9 16 The following is the Registrar-General's Short List of Deaths and Causes :— TABLE II Causes of, and Ages at, Death during the Year 1939 Causes of Death Net Deaths at the subjoined ages of " Residents," whether occurring within or without the District All Ages Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 35 years 35 and under 45 years 45 and under 55 years 55 and under 65 years 65 and under 75 years 75 years and upwards ALL CAUSES 1450 75 7 7 17 47 58 74 158 244 360 403 1 Typhoid and paratyphoid fevers 2 — — — — — 1 1 — — — — 2 Measles 3 Scarlet Fever — — — — — — — — — — — — 4 Whooping Cough — — — — — — — — — — — — 5 Diphtheria 2 — — 1 1 — — — — — — — 6 Influenza 34 — — — — 1 1 3 2 7 6 14 7 Encephalitis lethargica 1 — — — — — — 1 — — — — 8 Cerebro-spinal fever 1 — — — 1 — — — — — — — 9 Tuberculosis of respiratory system 79 1 1 — — 12 18 14 16 10 6 1 10 Other tuberculous diseases 6 — 1 1 1 — 1 — — — — 11 Syphilis 5 — — — — — — 1 2 — 1 1 12 General paralysis of the insane, tabes dorsalis 5 — — — — 1 — — 2 — 2 — 13 Cancer, malignant disease 261 — — — 1 — 1 18 38 66 88 49 14 Diabetes 23 — — — — — 1 — 3 7 10 2 15 Cerebral haemorrhage, etc. 61 — — — — — 1 — 2 16 20 22 16 Heart disease 411 — — — — 7 8 9 30 57 131 169 17 Aneurysm 8 — — — — — — — 3 1 2 2 18 Other circulatory diseases 76 — — — — — — — 9 10 26 31 19 Bronchitis 39 2 — — — 1 1 1 3 5 11 15 20 Pneumonia (all forms) 47 4 2 1 1 1 3 4 4 11 7 9 21 Other respiratory diseases 18 — — — — 1 1 1 3 5 1 6 22 Peptic ulcer 19 — — — — — 2 — 8 2 3 4 23 Diarrhoea, etc. 5 — 1 1 — 1 — — — — — 24 Appendicitis 12 — — 1 — 2 2 1 2 2 1 1 25 Cirrhosis of liver 3 — — — — — — — 1 1 — 1 26 Other diseases of liver, etc. 6 — — — — — — 1 1 2 1 1 27 Other digestive diseases 16 3 1 — — — 1 1 3 1 3 3 28 Acute and chronic nephritis 27 — — — 1 1 7 1 3 5 6 3 29 Puerperal sepsis 1 — — — — — — — — — — — 30 Other puerperal causes 3 — — — — — 1 2 — — — — 31 Congenital debility, premature birth, malformations, etc. 65 62 1 — 1 1 — — — — — — 32 Senility 48 — — — — — — — — 1 4 43 33 Suicide 16 — — — — — — 7 4 3 — 34 Other violence 50 — — 1 6 6 6 3 4 12 3 9 35 Other defined diseases 100 1 1 1 3 9 1 11 12 19 25 17 36 Causes ill-defined or unknown — — — — — — — — — — — — Special Causes (included in No. 35 above :— Smallpox — — — — — — — — — — — — Poliomyelitis — — — — — — — — — — — — Polioencephalitis — — — — — — — — — — — — 17 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 1. (i) Laboratory Facilities.—vide previous report. During the year 1,131 specimens were examined in the Bacteriological Laboratory at the Public Health Offices. (ii) Legislation in Force. (vide 1938 Report) with the addition of Byelaws with respect to Private Schools (Sec. 68, Ilford Act, 1937). Essex County Council Act, 1933. (a) (Part IV—Establishments for Massage and Special Treatment.) Inspections of licensed establishments are carried out quarterly. During the year 1939, 26 Applications for renewal of Licences and 4 Applications for Licences were received (1 on the sale of an establishment). The Council renewed the licences in respect of the 26 establishments and granted new licences in respect of 4 establishments. All such licences expire on 31st March, 1940. Change of address was sanctioned in respect of 1 licensed establishment. The Town Clerk communicated with 8 licensees in reference to the keeping of records. Legal proceedings were taken by the Council against a person carrying on an establishment for massage or special treatment without a Licence from the Council. A fine of £20 and a daily penalty of like amount was imposed. (b) (Part VI—Hairdressers' and Barbers' Premises.) During 1939 239 visits of inspection were made to these premises. (c) Camping Grounds and Moveable Dwellings. (d) (Part XI—Manufacture of Ice Cream.) 49 applications for registration in respect of 49 premises were considered during the year. Registration was granted in 49 cases (concerning 49 premises) as follows :— Purveyors retailing multiple firms' productions 44 Purveyors manufacturing and retailing their own productions (made apart from domestic premises) 5 Purveyors manufacturing and retailing their own productions (made on domestic premises) — Ilford Corporation Act 1937. (a) Section 77 of this Act provides for the registration of hawkers of meat, fish, fruit and vegetables, and their storage premises. Registration has been granted to 94 persons (concerning 70 premises). In 2 cases registration was refused on account of unsatisfactory storage accommodation. (b) Section 80 of the Act requires the registration of premises used for the preparation or manufacture of sausages, or potted, pressed, pickled or preserved meat, fish or other food intended for sale. Applications for registration were received in respect of 182 premises, all of which were granted. Shops Acts, 1912-1934 (Sections 10 and 13).—During the year 1939, 212 inspections and 4,744 reinspections were made. 34 preliminary notices were served and of these 25 notices were complied with. In addition, 68 preliminary notices served previous to 1st January, 1939, were also complied with. (iii) Hospitals :—vide previous reports. (iv) Ambulance Facilities:—vide previous reports. 18 2. Maternity and Nursing Homes. On the 1st January, 1939, there were 5 private registered nursing homes in the district, 1 for medical cases, 1 for medical and senile cases, 1 for medical and surgical cases, and two for maternity cases. On December 31st, 1939, there were five private registered nursing homes in the district—one for medical and surgical cases, one for medical and senile cases, one for medical cases and two for maternity cases. All Nursing Homes in the district are visited by the Deputy Medical Officer of Health and the Senior Sanitary Inspector (or his deputy) quarterly, and at other times when necessary. 19 SECTION C.—SANITARY CIRCUMSTANCES OF THE AREA. 1. (i) Water Supply.—This was fully dealt with in my report for 1937. Analyses :— 3 samples of the piped water supply (from the South Essex Waterworks Coy.) were sent for examination, and each sample gave a satisfactory analysis. Mr. B. W. Bryan, the Engineer to the South Essex Waterworks Coy., states that the Company has not obtained a supplementary supply of water from the Metropolitan Water Board during 1939, and that during the year 2,160 yards of main were laid in the Borough, 6 yards being of 3 in. diameter, 1,850 yards of 4 in. diameter, and 304 yards of 6 in. diameter. Mr. Bryan also stated that the analytical reports on all analyses made of the water supplied by his company to Ilford showed that the water was pure and wholesome; that it is anticipated that the Stour Supply Scheme (1935) will come into supply by June, 1940, and a laboratory has been built and equipped at the Company's Langham Works and a whole-time chemist and bacteriologist together with an assistant chemist and bacteriologist had been engaged and 1,500 to 2,000 samples per year are now being analysed. The Distribution Engineer of the Metropolitan Water Board informs me that during the year 1,304 yards oT 4 inch main were laid in the Borough. (ii) Drainage and Sewerage. The Borough Engineer has kindly supplied me with the following report :— (a) Survey of Main Trunk Sewers. The scheme for the reconstruction of the main trunk sewers has, at the present time, been suspended for the duration of hostilities, although it may be decided to apply for loan sanction to cover the expenditure on Contract No. 1, which was commenced in November 1938, and is now almost completed, only maintenance being carried out. The proportion, by expenditure, of the amount completed to the total scheme is about 4%. (Details of Contract No. 1 were given in the 1938 Report). 2. (i) Closet Accommodation.—In addition to the water carriage system of sewage, there are in the rural area 19 cesspools, 15 pail closets and 9 privies. The clearing of cesspools, privies and pail closets is carried out by the Council, the former by means of two vacuum emptiers. All pail closets are emptied twice weekly. The following were demolished in 1939. Pail Closets.—Three at Loxford Hall and one at Aldborough Hatch. Cesspool.—One at New North Road. (ii) Public Cleansing.—286 defective and unsuitable receptacles have been replaced during the year. The following particulars as to the collection of house refuse during 1939, was kindly supplied by the Borough Engineer :— REFUSE COLLECTION AND DISPOSAL, 1939. Total number of Loads collected 16,913 Total weight of Refuse collected 43,279 tons 15 cwt. 2 qrs. Average weight per load 2 tons 11 cwt 0 qrs 20 lbs. Total amount of Refuse barged under Contract 31,442 tons 16 cwt. 0 qrs. Total amount of Refuse disposed of at Refuse Destructor ((including Trade Refuse) 12,031 tons 16 cwt. 2 qrs. Number of Vehicles engaged on collection 22 20 Two new Karriers were purchased in 1939 and two old S.D. Freighters disposed of. There are 5 Vulcans, 10 Freighters, 4 Karriers and 3 Dennis engaged upon Refuse Collection. Arrangements are in force whereby a special daily collection of refuse is made from Claybury Mental Hospital, and on 3 days weekly from the West Ham Mental Hospital. Collection and Disposal of Wastepaper. Weight Collected. Income. Cost. Profit. t. c. q £ s. d. £ s. d. £ s. d. 1,055 1 2 1,557 10 4 572 16 9 984 13 7 Gross 738 10 2 Nett Of the profit made, 75 per cent. is credited to Removal of House Refuse Costs, and 25 per cent, paid in bonus to the men engaged. (iii) Sanitary Inspection of the Area.—The following is a summary of the work of the Sanitary Inspectors during the year:— Houses and premises inspected 16,312 Houses and premises reinspected (works in progress) 10,313 Visits during disinfection 1,973 Houses in which nuisances were detected 1,167 Houses in which nuisances were abated 1,173* Premises disinfected 667 Premises from which articles only disinfected 180 Articles disinfected 3,964 Premises disinfested for verminous conditions 5 Notices served :— Served Complied with Statutory :— Public Health Act, 1936 8 3 Housing Act, 1936 27 14 Housing Act, 1930 (Overcrowding) 2 2 Factories Act, 1937 2 2 Provide Dustbin (Ilford Improvement Act) 258 219 Provide Water Supply to Dwelling House 4 2 Cleanse Water Storage Cistern (Byelaws) 6 7 Cover Water Storage Cistern (Byelaws) 5 4 Informal 836 707 1,148 960 In addition to the above, 225 notices (92 statutory and 133 informal) served previous to 1st January, 1939, were also complied with. * Includes 218 nuisances detected before 1st January, 1939. Complaints.—During the year, 895 complaints of nuisances have been received and investigated. The following is a summary:— Accumulation of manure and refuse 28 Animals improperly kept 4 Bad smells 46 Dampness of premises 83 Defective drains, w.c.'s and fittings 109 Defective roofs, gutters, downpipes, etc. 67 Defective water fittings 19 Dirty and verminous houses 42 Dirty condition of rearway 9 Flooding of premises 21 Overcrowding 6 Smoke nuisances 31 Miscellaneous 430 Total 895 21 (iv) Increase of Rent and Mortgage Interest (Restrictions) Acts, 1920 and 1933.—The Senior Sanitary Inspector was authorised by the Council in December, 1919, to make visits and certify under the provisions of the Acts. One application was received under Section 2 (4) of the Act. (v) Smoke Abatement. Observation has been maintained throughout the year of factories in the eastern part of the Borough. As a result three informal and one statutory notices were served on the owners to abate smoke nuisances. Observation has also been maintained of factories and public works constructions in the remainder of the Borough. As a result, three informal and one statutory notices were served on the owners and contractors to abate smoke nuisances. (vi) Swimming Baths and Pools—vide previous reports. Samples of water for examination are taken from the indoor and open-air swimming baths monthly during May, June, July, August and September, and during November, January and March in respect of the indoor bath. The samples taken during 1939 were all satisfactory. (vii) Special Classes of Premises and Occupations subject to Control by the Local Authority.—(a) Fish-frying licences (both of which were transfers) have been granted in respect of 2 premises during 1939. The Council has decided that all new licences and transfers shall be granted for a period of one year, and be renewable annually. 6 licences, affecting 6 premises, were renewed during 1939. (b) Slaughter of Animals Act, 1933.—One licence to act as slaughterman was granted during the year. (viii) Eradication of Bed Bugs. (1a) Council Houses:— Found to be infested 5 Disinfested 5 (1b) Other Houses:— Found to be infested 44 Disinfested 33 (2) Methods employed:— Stripping of walls; removal of woodwork, viz., picture rails, skirting, mouldings, etc.; spraying by "Rodesco" Insecticide, and repeated where necessary; removal of bedding for disinfection by steam, stopping of injured wall surfaces later. (3) Where necessary the above methods have been employed for ensuring that the belongings of tenants are free from vermin before removal to Ilford Council houses. (4) The work of disinfestation has been carried out by the Local Authority in the case of Ilford Council houses, generally by the owners and occupiers in the case of private property, and by the L.C.C. for their own houses. (ix) Other Sanitary Conditions Requiring Notice. On one occasion it has been found necessary to remove an encampment of gipsies from waste land within the Borough. (x) Rag Flock Acts, 1911 and 1928.—There are no premises on which rag flock is manufactured, but 4 premises are using rag flock and are periodically inspected. Samples of flock obtained from these premises were submitted for analysis; 3 were in conformity with the requirements of the Acts and 3 samples did not conform to those requirements, the amounts of available chlorine exceeding that allowed, although the Analyst stated that the amounts were not sufficiently high to institute prosecutions. Letters of warning were sent to the firms concerned and the Medical Officers of Health of neighbouring boroughs where the premises of the suppliers of the flocks arc situated were informed of the analytical results. 22 SECTION D—HOUSING. (i) During the year 1939, the number of houses built by private enterprise was 1,051. At the end of the year 527 houses were in course of erection. (ii) Overcrowding.—Informal notices were served in respect of 3 premises, all of which were complied with. (iii) Unhealthy Areas.—No representations or complaints have been made regarding unhealthy areas during the year. (iv) HOUSING STATISTICS. The following is the table required by the Ministry of Health : 1. Inspection of Dwelling-houses during the Year :— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,604 (b) Number of inspections made for the purpose 5,263 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 128 (b) Number of inspections made for the purpose 1,933 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 840 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 843* 3. Action under Statutory Powers during the year:— a. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs 27 (2) Number of dwelling-houses which where rendered fit after service of formal Notices:— (a) By owners 59* (b) By local authority in default of owners — 23 b. Proceedings under Public Health Acts :— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 12 (2) Number of dwelling-houses in which defects were remedied after service of formal notices :— (a) By owners 13* (b) By local authority in default of owners — c. Proceedings under Sections 11 and 13 of the Housing Act, 1936 :— (1) Number of dwelling-houses in respect of which Demolition Orders were made — (2) Number of dwelling-houses demolished in pursuance of Demolition Orders — D. Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — 4. Housing Act, 1936, Part IV—Overcrowding :— (a) (i) Number of dwellings overcrowded at the end of the year 77 (ii) Number of families dwelling therein 77 (iii) Number of persons dwelling therein 548 (b) Number of new cases of overcrowding reported during the year 10 (c) (i) Number of cases of overcrowding relieved during the year 10 (ii) Number of persons concerned in such cases 66½ (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report Nil * Includes compliances during 1939 of Notices served in 1938. 24 HOUSING ACT, 1936. During the year 1939, the work of receiving applications, calling for calculations for the " permitted number," was continued with a view to the issue of housing certificates. One temporary clerk was employed. Altogether applications were received in respect of 14,456 houses. At the end of the year the total certificates issued to date numbered 17,039 in respect of 23,314 houses. Where no application for a certificate was received for the permitted number arising from the 1935 survey, lists were forwarded to the Town Clerk who communicated in 1,343 cases with the persons responsible, pointing out the requirements of the Act. Of this number 1,320 were received up to 31st December, 1939 and the balance of 23 is receiving attention. As new premises were constructed and placed upon the rating lists, these lists were obtained and survey forms sent with a view to the issue of 44 permitted number " certificates, and in all, new premises (not enumerated under the 1935 survey) have been dealt with to the extent of 7,664. As new houses continue to be built this system will have to be continued. The provisions of the Housing Act would appear to be well known to most of the agents and owners but there would seem to be a difficulty when subletting takes place. 25 SECTION E.—INSPECTION AND SUPERVISION OF FOOD. Milk Supply. (i) The following is a summary of Persons and Premises registered as at 31st December, 1939 :— Premises registered as dairies and milkshops ... ... ... 38 Cowkeepers registered ... ... ... ... ... ... 3 Persons registered as retail purveyors of milk ... ... ... 43 Persons registered as retail purveyors of milk in sealed cartons or containers ... ... ... ... ... ... ... 92 Persons registered as retail purveyors of milk (sterilised) in sealed bottles ... ... ... ... ... ... ... 54 Persons registered as retail purveyors of milk in sealed cartons or containers; and also sterilised in sealed bottles ... 18 Persons registered as retail purveyors of cream ... ... 12 Persons registered as retail purveyors of milk in the Ilford district, whose premises are outside the Borough... ... 19 Persons registered as wholesale purveyors of milk ... ... 7 Persons registered as wholesale purveyors of milk (sterilised) in sealed bottles ... ... ... ... ... ... ... 3 Person registered as wholesale purveyor of milk in sealed ' cartons or containers ... ... ... ... ... ... 1 387 inspections of dairies, milkshops, cowsheds and other premises where milk is sold were carried out during the year. 133 inspections (included in above) were made of the 4 cowsheds on farms registered under the provisions of the Milk and Dairies (Consolidation) Act, 1915, and the Milk and Dairies (Amendment) Act, 1922, and the Milk and Dairies Order, 1926. 2 of the 3 registered cow-keepers are wholesale and retail purveyors of milk ; 1 is a retail purveyor only. Of the 207 premises from which milk is retailed in Ilford, 16 are branches of one firm, 5 another, and 3 another, 2 retail from dairy shops or stores, 1 from a general shop and 5 from restaurants, 11 are retailers in a small way with rounds ; while 54 sell sterilised bottled milk only, 18 sell sterilised milk and also milk in sealed containers, and 92 retail milk in sealed containers only. In 3 premises, pasteurising plant has been installed. Only 2 of these have, however, been licensed. In addition, 1 firm, having premises outside the district, is registered as a wholesale purveyor of milk in sealed containers. (ii) Licences were granted under the Milk (Special Designations) Orders, 1936 and 1938, during 1939 for the sale of :— " Tuberculin Tested " Milk ... ... ... ... 17 " Pasteurised " Milk ... ... ... ... ... 28 The above include supplementary licences which were issued for 44 Tuberculin Tested " milk, 8 ; and " Pasteurised " milk, 9. These are licences granted to firms who already have a primary licence from another Authority, the milk 'being bottled outside the town, but sold in Ilford. In addition to the above, the Essex CounTy Council granted 3 producer's licences (2 44 Tuberculin Tested " and 1 44 Accredited ") in respect of milk produced on farms in the Borough during the year 1939. 26 (iii) Sampling.—The routine practice of sampling was given in the 1938 Report, the following gives the results:— Grade of milk, or ice cream Total Satisfactory Unsatisfactory Remarks Tuberculin Tested milk 10 9 1 The retailer was communicated with owing to the high B. Coli content of the unsatisfactory sample. Tuberculin Tested (Pasteurised) milk 6 5 1 The retailer was communicated with owing to the excessive number of cells in the unsatisfactory sample. Tuberculin Tested (Certified) milk 12 12 Pasteurised milk 31 30 1 The retailer was communicated with owing to the high bacterial count of the unsatisfactory sample. Ungraded milk 39 24 15 The retailers were communicated with owing to the high B. Coli content in the unsatisfactory samples. Ice cream 24 19 5 The retailers were communicated with owing to the high bacterial count of the unsatisfactory samples. (iv) Tubercular Milk. 36 samples of milk were submitted to a biological test for tuberculosis ; all of which were found to be negative. In addition to the above, 7 samples of milk were taken by the Essex County Council from farms in the Borough licensed to produce Tuberculin Tested or Accredited milk, 1 of these did not satisfy the Methylene Blue Test. (v) Milk and Dairies Orders, 1926 and 1938 : Inspection of Dairy Herds.—As a result of inspections during the year by thei Veterinary Officers of the Ministry of Agriculture and Fisheries, three notifications were received of suspected cases of tuberculosis at farms in the Borough. Three cows were slaughtered and post-mortem examination revealed the presence of tuberculosis. (vi) Legal Proceedings.—None were taken during the year. (vii) Registration.—No application for registration was refused during 1939. Articles of Food Surrendered. During the year the following articles of food were surrendered and condemned as being unfit for the food of man :— 70 lbs. Meat; 12 x 6 lbs. Tins Corned Beef; 6 tins Beef ; 1 tin Steak and Kidney Pudding; 24£ lbs. Oxtails; 1 roll Veal and Ham Tongue ; 6 doz. Escallops ; 37 tins Salmon ; 10 tins Pilchards ; 12 tins Crab ; 8 tins Sild ; 2 tins Sardines, 9 stone Skate Wings; 30 tins Peas; 18 tins Beans; 80 tins Fruit; 667 tins Milk ; 10 tins Cream ; 2 tins Cafe au Lait; 6 tins Jam ; 1 tin Syrup ; 1 bottle Pickle ; 2 bottles Tomato Ketchup and 1 bottle Salad Cream. Adulteration, etc. (i) Sale of Food and Drugs Acts.—These Acts were administered by the Essex County Council, for whom Dr. Bernard Dyer was the Public Analyst until 30th September. 27 Mr. A. Horsnell, the Chief Inspector for the Essex County Council, has kindly given me certain particulars as to samples collected in the Ilford district up to the 30th September which I append:— Samples of Milk taken 34 Samples of Butter taken 32 Other Samples 183 Total 249 Four prosecutions were undertaken during the year, by the Essex County Council relating to Sausages (2), Vinegar and Butter, the fines imposed were 10/- with 6s. costs and./iJl with 7s. costs and in the two latter cases, defendants paid 10/- costs, each, respectively. (ii) Food and Drugs Act, 1938.—This Act came into operation on the 1st day of October 1939 and the Council of this Borough became responsible for its enforcement. Since the 1st October, 1939 to the 31st December, 1939, 42 samples (40 formal and 2 informal) of Food and Drugs were obtained, all of which were genuine. The Council has appointed Dr. Bernard Dyer, Mr. George Taylor and Dr. J. Hubert Hamence as Joint Public Analysts for the Borough as from 1st October, 1939 at a remuneration of twenty guineas per annum, plus half-aguinea for each sample analysed. A fee of two guineas to be paid each time the Analyst is required to attend Court. (ii) Merchandise Marks Acts, 1887 to 1926.—On this Borough becoming the responsible Food and Drugs Authority on the 1st October, 1939, it automatically became responsible for the enforcement of the Provisions of the Merchandise Marks Act, 1926, and these duties were taken over on the 1st January, 1940. Food Poisoning. By virtue of Section 82 of the Ilford Corporation Act, 1937, food pcisoning became compulsorily notifiable in Ilford as from 1st October, 1937. 2 cases were notified under the Act and 3 cases of suspected food poisoning were reported to me, but not notified. All were investigated but none found to be cases of genuine food poisoning. Bakehouses.—There are 34 bakehouses in the district, 27 of which use motive power. 232 inspections of bakehouses were carried out during the year. It was necessary to call upon the occupiers of bakehouses to carry out cleansing and other works in 34 instances, and the requests were complied with in 31 instances. In the remaining 3, the work is in progress. Contagious Diseases (Animals) Acts, 1894-1925. (i) Regulation of Movement of Swine Fever Order, 1922.—No action was necessary during 1939. (ii) Sheep Scab Orders and Amendment Orders, 1928, 1930, 1934 and 1934 (No. 2).—There has been no occasion for this Borough to be made into a "double-dipping " area under these Orders during the year 1939. The only sheep in the Borough, at a large farm, have been double-dipped unofficially by the owner in his own interests. (iii) Swine Fever Orders, 1908, 1911, 1912, 1916 and 1917 : Swine Fever (Regulation of Movement) Order, 1922 : and Amendment Orders 1922 (No. 1), 1936 and 1936 (No. 3).—An outbreak of Swine Fever occurred at a Public Institution in the Borough. 35 pigs died ; 212 were slaughtered and the carcases examined, of these one whole pig, 6 hearts, 2 heads and 5 livers were found to be unfit for human food. In addition, 103 pigs were removed, under licence from the Ministry of Agriculture and Fisheries, and slaughtered in a neighbouring Borough, the disposal of the carcases being supervised by the officers of that Borough. 28 (iv) Parasitic Mange Orders of 1911 and 1918.—No cases occurred during 1939. (v) Importation of Dogs and Cats Order, 1928.—A Licence was issued by the Ministry of Agriculture and Fisheries for the entry of 4 leopards into the Borough for performance purposes. The animals were kept under observation and isolation and left the Borough on the 25th February. (vi) Foot and Mouth Disease Orders of 1928 and 1930 : (Foodstuffs) Order, 1932 : (Packing Materials) Order, 1925 : (Amendment) Order, 1926 : and F'oot and Mouth Disease (Restriction) Order, 1938.—No outbreak occurred affecting Ilford in 1939. (vii) Rabies Order, 1938.—No case of Rabies was notified during the year. Rats and Mice Destruction Act, 1919.—93 complaints have been received of the existence of rats affecting 173 premises. In 25 of these cases poison gas has been used, and in the remaining cases other steps have been taken. National Rat Week (November, 1939).—In accordance with the instructions issued by the Ministry of Agriculture and Fisheries, special efforts were made during National Rat Week, on the same lines as previous years. Petroleum (Consolidation) Act, 1928.—The Sanitary Inspectors made 957 visits to premises where petroleum is stored, or in conjunction with the installation of such storage, and tested 10 petroleum appliances or fittings. All the Sanitary Inspectors are authorised Officers under the Act to inspect such premises (Public Health Committee, 8th July, 1937). The number of Licences issued was 134 and the fees paid to the Council for such Licences was .£96 17s. Id. 3 Licences were issued for the storage of calcium-carbide, the fees payable being XT. Examination of Officers, Teachers and Servants. The following medical examinations were carried out during 1939 :— Officers Teachers Servants New Appointments 90 8 80 Under Sickness Regulations 10 26 72 For Anti-Gas School Course 1 — — Totals 101 34 152 29 SECTION F.—PREVALENCE OF, AND CONTROL OVER INFECTIOUS DISEASES. 1.—Infectious Diseases Generally.—The following regulations came into force during 1939 :— (a) The Ilford (Acute Rheumatism) Regulations, 1938, which commenced on the 1st February, 1939 which renewed the regulations of 1935. (b) The Puerperal Pyrexia Regulations, 1939, which commenced on the 1st April, 1939, rescinding the regulations of 1926 and 1928 (except in their application to London). (c) The Measles and Whooping Cough Regulations, 1939, which commenced on 23rd October, 1939. (These regulations were provisional, the final regulations coming into operation on 9th February, 1940). Of the cases notified, the following table shows the percentage treated in institutions, including those who were treated in the institutions from which they were notified :— Scarlet Fever 85.9 Diphtheria and Membranous Croup 96.8 Enteric FeVer 100.0 Puerperal Pyrexia 89.8 Pneumonia ' 64.5 30 TABLE III—Cases of Infectious Diseases Notified during the Year 1939 NOTIFIABLE DISEASE At all Ages Number of Cases Notified At Ages—years Total Cases Notified in each Ward Total Cases Admitted to Hospital Under 1 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Cranbrook Park Seven Kings Barkingside North Hainault Loxford Clementswood South Hainault Goodmayes Smallpox - - - - - - - - - - - - - - - - - - Scarlet Fever 370 2 58 250 37 23 - - 16 13 36 59 70 49 46 28 53 318 Diphtheria, including Membranous Croup 96 — 19 59 10 8 - - 8 11 10 13 15 4 11 7 17 93 Enteric Fever (Tvphoid and Para-Tvphoid) 11 — 5 4 - - — — — 2 — 8 1 — — 11 Pneumonia 183 11 25 17 16 39 44 31 16 13 13 35 33 11 18 17 27 118 Puerperal Pyrexia 49 — — 14 35 — — — 2 o 4 33 3 1 2 2 44 Cerebro-Spinal Fever - - - - - - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - - - - - - Acute Polio-Encephalitis - - - - - - - - - - - - - - - - - - Encephalitis Lethargica - - - - - - - - - - - - - - - - - - Dysentery 3 — — 1 — 1 — 1 — -— — 1 — — 1 1 — 2 Ophthalmia Neonatorum 6 6 — — — — — — — 1 — — — 1 1 1 3 Erysipelas 70 — 2 3 6 25 30 4 3 12 5 14 7 10 5 2 12 38 Pemphigus Neonatorum 3 3 — — — — — — — — 1 1 — — — 1 3 Tuberculosis Pulmonary 167 1 1 6 41 85 26 7 13 12 12 25 22 19 11 30 23 — Other Forms 27 —' 3 11 4 5 3 1 2 — 2 3 11 2 1 6 — — Anthrax - - - - - - - - - - - - - - - - - - M-alaria—Believed to be contracted in this - - - - - - - - - - - - - - - - - - country - - - - - - - - - - - - - - - - - - Believed to be contracted abroad 1 - - - - 1- - - - - - - - - - 1 - - Acute Rheumatism 29 — 26 1 — — — 3 1 2 7 7 — 1 — 8 16 †Measles 6 — 5 1 — — — — — 1 — 1 — — 1 2 1 1 †Whooping Cough 14 3 7 2 — 2 — — — — 1 2 1 4 5 1 — — Food Poisoning 2 — — 1 — — 1 — — — — 1 1 — — — — Totals 1,037 26 124 382 129 228 104 44 61 66 83 168 201 112 103 98 145 647 †Notifiable as from 23rd October, 1939. 31 The total number of deaths of Ilford residents from the following infectious diseases during 1939 was 175 as against 176 in 1938. 1938 1939 Scarlet Fever 1 Enteric Fever — 2 Encephalitis Lethargica 2 1 Diphtheria 8 2 Measles 5 — Whooping Cough 1 — Influenza 8 34 Tuberculosis—Pulmonary 71 79 Other forms 9 6 Pneumonia 62 47 Diarrhoea (under 2 years) 4 2 Cerebro-spinal Fever 1 1 Puerperal Fever 4 1 Total 176 175 (a) Smallpox.—Notification of 3 persons who had been in contact with a case of Smallpox on board ship was received. These were visited by the Sanitary Inspectors for the usual period. No case of Smallpox occurred. The following gives particulars as to Vaccination during 1939:— Certificates of Successful Vaccination 1,024 Postponed 73 Conscientious Objections 814 Unsuccessful Vaccination 16 Left the District 223 (b) Scarlet Fever.—370 cases were notified in 1939. The following " return " cases have occurred during the past five years, a " return " case being one which arises within 28 days of the freedom of the primary case from isolation:— Year Cases not ified (including Institutions) Admitted to Isolation Hospital " Return " Hospital Cases Per Cent. Home Cases Cases arising in same house PerCent. 1935 357 266 8 3.0 60 — — 1936 349 265 10 3.7 65 1 1.5 1937 309 254 5 1.9 51 — — 1938 303 262 6 2.3 40 — — 1939 370 283 4 1.4 53 — — (c) Diphtheria.—96 cases were notified in 1939. One death occurred at the Ilford Isolation Hospital, and one at the Waltham Holy Cross Isolation Hospital. The following table shows the number of children Schick Tested and immunised at the Diphtheria Clinics held at the Public Health Offices and the Mayesbrook School Clinic. Tabular Statement as to Number of Children Schick Tested and Immunised at the Diphtheria Clinics from 1st January, 1939, to 31st December, 1939. (Clinic not held from 1.9.39 to 3.12.39). Public Health Offices Mayesbrook Clinic Grand Totals Both Clinics School Children (Various Schools) Children under 5 years of age Total School Children (Various Schools) Children under 5 years of age Total Numbers Schick Tested :— Positive 21 2 23 16 — 16 39 Negative 15 2 17 21 — 21 38 Numbers inoculated (full course) 233* 365 598 145* 118 263 861 Positive after full course of inoculations, and re-inoculated 4 1 5 3 1 4 9 Negative after full course of inoculations ... 117 138 255 103 64 167 422 Awaiting re-test 110 216 326 36 52 88 414 Not re-tested after inoculation (on account of leaving District, etc.) 2 10 12 3 1 4 16 Positive after re-test, but not inoculated for same reason ... ... ... ... ... — — — — Final Schick Test in 1939 (1938 Cases) :— Positive after full course of inoculations, and re-inoculated 10 5 15 5 5 20 Negative 132 182 314 299 75 374 688 * Schick+1939 = 21 ; Schick+1938 = 2 ; Not Tested = 210 * Schick+1939= 16 ; Not Tested = 129. During 1939 a total number of 1,607 children attended at the Diphtheria Prevention Clinics (914 at the Public Health Offices and 663 at Mayesbrook), making a total number of attendances of 5,961 (3,717 and 2,244), with an average per session of 103 and 56 respectively. 32 33 In 1939, under the arrangements mentioned in the 1935 Report, 14 private doctors were supplied with prophylactic for the immunisation of 36 children (24 under 5 years and 12 over 5 years of age). The following is a brief summary :— 1938 Cases : Final Schick Test in 1939:— Negative 15 Positive and re-inoculated 4 Positive and not re-inoculated (left district) 3 No final Schick Test, left district, etc. 6 Of the 6 cases notified, 3 were admitted to St. Margaret's Hospital, 2 were treated at home by private medical practitioners ; and 1 was treated as an out-patient at the Royal London Ophthalmic Hospital. Cases Vision Unimpaired Vision Impaired Total Blindness Deaths Notified Treated At Home In Hospital 6 2 4 6 — — — (e) Enteric Fever.—11 cases of enteric fever were notified, 8 being due to infection by B. Para-typhosus B, and 3 to infection by B. Typhosus, one of the latter being an inmate of the Claybury Mental Hospital. One case of Para-typhoid Fever and one of Typhoid Fever died. In none of the 11 cases was it possible to find the source of infection, although extensive investigations were made. 1939 Cases : Numbers inoculated (full course) by medical practitioners 36 Final Schick Test—Negative 12 Positive and re-inoculated 1 No final Schick Test, left district, etc. 9 Forms not yet returned 7 To be Schick Tested in 1940 7 (d) Ophthalmia Neonatorum.—6 casea were notified during 1939. co Table showing Incidence of Infectious Disease, 1939, in age groups ; and total Deaths. Disease Total cases notified Under 1 year 1—2 2—3 3—4 4—5 5—10 10—15 15—20 20—35 35—45 45—65 Over 65 * Cases admitted to Hospital Total Deaths Smallpox Scarlet Fever 370 2 5 18 19 16 160 90 29 21 10 286 Diphtheria 96 — 5 4 4 6 34 25 7 9 2 90 2 Enteric Fever (including Paratyphoid) 11 1 1 4 1 1 3 10 2 Pneumonia 183 11 8 7 7 3 13 4 12 21 22 44 31 108 47 Puerperal Pyrexia 49 1 39 9 44 1 Cerebro-spinal Fever — — — 1 Acute Poliomyelitis — — Acute Polio-Encephalitis Encephalitis Lethargica 1 Dysentery 3 1 1 1 1 Ophthalmia Neonatorum 6 6 3 Erysipelas 70 — 1 1 — — 2 1 4 11 16 30 4 31 2 Anthrax ... — — — . Malaria believed to be contracted in this country Malaria believed to be contracted abroad 1 — — 1 Pemphigus Neonatorum 3 3 3 Acute Rheumatism 29 — — 1 1 16 10 1 15 Food Poisoning ... 2 — — — — — 1 — ' 1 f.Measles ... 6 — 4 1 1 1 ■(•Whooping Cough 14 3 3 2 1 1 2 — — 2 # Excludes case s occurring at Barnado's Homes, Claybury Mental Hospital and West Ham Mental Hospital. f Notifiable as from 23rd October, 1939. 35 3. Tuberculosis.—During the year 1939, there were 167 new notifications of Pulmonary Tuberculosis and 27 of other forms of Tuberculosis. 19 cases of Pulmonary and 3 cases of Non-Pulmonary Tuberculosis were transferred to Ilford. Notifications and Deaths from Tuberculosis of Ilford Residents during 1939. Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 vear 1 - - - - - - - 1-5 years 1 — 2 1 1 1 1 1 5-15 2 4 4 7 — — 1 15-25 10 31 3 1 3 9 1 1 25-35 27 29 3 8 10 35-45 23 6 1 1 9 5 1 — 45-55 13 5 1 1 12 4 55-65 6 2 1 8 2 Over 65 5 2 — 1 7 — — — Totals 88 79 14 13 48 31 3 3 Of the above new cases, the following were notified from Institutions in the district:— Respiratory Tuberculosis NonRespiratory Tuberculosis King George Hospital 4 5 Claybury Mental Hospital 1 —' West Ham Mental Hospital 11 1 Dr. Barnardo's Girls' Village Home 1 — Ilford Isolation Hospital 1 — Of the 85 deaths which occurred of Ilford residents, notification had previously been made of 70 of the cases ; 3 were notified after death ; 12 were not notified (14.1 per cent, of the deaths, or a ratio of 1 in 7). Communications were sent to enquire why notifications had not been carried out, in 10 cases the deaths occurred in Institutions where the presence of tuberculosis was discovered following P.M. and other investigations; in 2 cases the deaths were certified by the Coroner after P.M. During the year 1939 the following deaths occurred from Tuberculosis:— Pulmonary Non-Pulmonary Ilford Residents 79 6 N on-Residents— Claybury Mental Hospital 7 — West Ham Mental Hospital 14 1 King George Hospital 2 36  Pulmonary NonPulmonary Total Number of cases on register, 1st January, 1939 621 183 804 Number of cases entered on register during the year 186 30 216 Number of cases removed from the register during the year:— Pul. NonPul. Recovered 31 13 Deaths 81 5 Left District 86 19 Lost sight of 10 — Diagnosis not established 1 3 209 40 209 40 249 Number of cases remaining on register on 31st December, 1939 598 173 771 Cases of Tuberculosis, on notification, are visited by the Tuberculosis Nurse of the Essex County Councifl. 827 of the cases of longer standing were visited by the Sanitary Inspectors during the year, a visit being made to each patient every six months. The following reports were obtained :— The following reports were obtained:— Pulmonary Cases Other Cases Stated to be recovered or better 266 116 Improved or fairly well 169 25 Not so well 49 4 In Sanatorium 78 19 No information as to present condition 24 8 Removed from district, etc. 57 12 Totals 643 184 The treatment of Tuberculosis is under the control of the Essex County Council. On the 31st December, 1939, there were 1,335 patients on the register of the dispensary. • The arrangements made with the Essex County Council for the dental treatment of tuberculosis patients from Ilford, Romford, Leyton and Walthamstow were continued. Two afternoon sessions per month were set aside for the treatment of these cases. 118 patients were treated, 16 being supplied with dentures. The Council's Dentist also made 2 visits to the tuberculous patients at the Ilford Sanatorium. 15 patients were inspected, 11 of whom received treatment. The number of patients from Ilford sent to Institutions under the Essex County Tuberculosis Scheme during 1939 was as follows:— Pulmonary- Non-Pulmonary Total Males Females Males Females Adults 54 54 6 2 116 Children 1 3 3 9 16 Tuberculosis Care Association.—This Association has assisted 86 cases with extra nourishment, clothing, and in other ways. Public Health Act, 1936 (Section 163).—4 certificates in respect of the death of patients were issued, stating that bodies should not be removed from hospital except for the purpose of being buried forthwith. 37 SECTION G.—FACTORIES. The Factory and Workshop Act, 1901, was superseded by the Factories Act, 1937, which came into operation on 1st July, 1938. Factories with Mechanical Power. There are 286 factories with mechanical power on the register. Factories without Mechanical Power. There are 281 factories without mechanical power on the register. Outworkers. There are 119 outworkers on the register. 1.—INSPECTION OF FACTORIES AND OTHER PREMISES. Including Inspfxtions made by Sanitary Inspectors. Premises Number of Inspections Written Notices Occupiers prosecuted (1) (2) (3) (4) Factories with Mechanical Power 500 20 — Factories without Mechanical Power 297 8 — Other premises (not including Outworkers' premises) — — — Total 797 28 — 38 2.—DEFECTS FOUND IN FACTORIES. Particulars Number of Defects No. of defects in respect of which Prosecutions were instituted Found Remedied Referred to H.M. Inspector Want of Cleanliness (S.l) 63 62 - - Overcrowding (S.2) — — — — Unreasonable Temperature (S.3) - - - - Inadequate Ventilation (S.4) — — - — Ineffective Drainage of Floors (S.6) - - - - Sanitary Conveniences (S.7):— Insufficient 5 6* - — Unsuitable or Defective 1 1 - — Not Separate for Sexes 1 1 - — Other Offences (Not including offences to Home Work or offences under the sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937) Total 70 70 — — *Includes 1 Notice served in 1918 4.—OTHER MATTERS. Class Number (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factories Act (Sec. 114, 1937) 2 Action taken in matters referred by H.M. Notified by H.M. Inspector 8 Inspector as remediable under the Factories Act, 1937, by district councils (Sec. 9, 1937) Reports (of action taken) sent to H.M. Inspector 15 Other — Basement Bakehouses (Sec. 53, 1937):— — In use at the end of the year — ISOLATION HOSPITAL 41 ISOLATION HOSPITAL. 687 patients were admitted during 1939. 91.6 per cent. of the cases of diphtheria and 76.5 per cent. of scarlet fever occurring in the district (excluding those cases treated at the Institutions at which they were notified, or were transferred to other Isolation Hospitals) were admitted to the hospital. The 687 patients admitted during 1939 suffered from the following complaints:— Scarlet Fever 283 Diphtheria 88 Scarlet Fever and Diphtheria 1 Enteric Fever 10 Puerperal Pyrexia 23 Tuberculous Diseases 85 Pneumonia 79 Measles 2 Whooping Cough 12 Mumps 1 Chicken Pox 1 Dysentery 1 Erysipelas 31 Pemphigus Neonatorum 3 Acute Rheumatism 15 Under observation 52 Number of deaths in hospital:— Diphtheria 1 Pneumonia 14 Enteric Fever 2 Erysipelas 1 Meningitis 2 Pulmonary Tuberculosis 20 Number of patients in Hospital on 1st January, 1939 and 1940 respectively :— 1st Jan., 1939 1st Jan., 1940 Scarlet Fever 18 5 Diphtheria 31 4 Tuberculous Diseases 19 39 Puerperal Pyrexia 1 2 Erysipelas — 1 Whooping Cough 2 — Pneumonia 9 2 Acute Rheumatism 3 — Under observation 3 2 The average length of stay in Hospital was for:— Scarlet Fever 28.9 days Diphtheria 54.3 ,, Tuberculosis Diseases 60.2 ,, Average stay in Hospital of all cases 34.0 ,, The above averages are based on cases that completed their stay in Hospital during the year. Average number of patients in Hospital per day 76.5. 42 Scarlet Fever.—The diagnosis of scarlet fever could not be confirmed in 5 patients admitted. The following table shows the percentage death-rate of cases of scarlet fever admitted to Ilford Isolation Hospital during the past five years, the rate being calculated each year only on those admissions which proved to be clinically scarlet fever. 1935 1936 1937 1938 1939 Ilford 37 .39 .41 Nil Nil Enteric Fever.—10 cases were admitted. One gave positive Widal Tests for B. Typhosus, 8 positive Widal Tests for B. Para-typhosus B. and 1 was unconfirmed bacteriologically. Two patients died, ages 33 and 37 years, within 10 and 12 days of admission respectively one giving a positive Widal result for B. Typhosus and the other for B. Para-typhosus B. The other patients recovered. Diphtheria.—The following table shows the percentage death-rate of cases of diphtheria admitted to the Ilford Isolation Hospital during the past five years, the rate being calculated each year only on those admissions which proved to be clinically diphtheria. 1935 1936 1937 1938 1939 Ilford 5.7 4.5 3.3 5.3 1.3 Tuberculosis.—85 cases of Pulmonary Tuberculosis were admitted, as compared with 44 in 1938. Training of Probationer Nurses.—During 1939, 2 nurses passed Part 1 of the examination of the General Nursing Council, 10 obtained the Certificate by completing Part II (3 of these being Staff Nurses), and 7 passed the educational test of the General Nursing Council. The following table shows the number of the Staff at the Isolation Hospital who were Schick and Dick Tested during 1939, and also the number inoculated :— Numbers Schick Tested:— Staff Positive 9 Negative 36 Numbers inoculated (full course) 8 Numbers re-tested:— Negative after full course of inoculations 14 Positive after full course of inoculations, and re-inoculated 5 Numbers Dick Tested:— Positive 15 Negative 28 Numbers inoculated (full course) 15 Numbers re-tested :— Negative after full course of inoculations 15 Positive after full course of inoculations, and re-inoculated No member of the Nursing Staff contracted Scarlet Fever or Diphtheria during the year. 43 Isolation Hospital Extensions. The extensions were completed during the year, the New Central Kitchen in June and the Cubicle Block, alterations to the Old Administration Block and the Engineer's Workshop, etc., later in the year. It was arranged for the extensions to be formally opened by the Mayor (Alderman C. A. Farman, J.P.) on October 7th but owing to the war this was postponed until April 27th, 1940. The new buildings were designed, and the work supervised, by the Borough Engineer, the main Contractors being Messrs. E. A. Russell Ltd. ; the contract amounting in all to approximately £28,000. The installation of all electrical fittings and services were supervised by the Borough Electrical Engineer. Description of Buildings. (a) The Kitchen, Stores and Dining Rooms. This building has been erected on a site which is considered to be reasonably central for access to the existing and future wards and other buildings of the Hospital, and forms an addition to the group of administrative buildings recently erected nearby. It is built in dark red sand-faced bricks with artificial stone copings and has flat roofs except over the Kitchen which is covered with Bangor slates. Access to the Stores is obtained at the east end of the building, where the Unloading Room is situated. This is so planned to enable lorries, etc., to draw up and discharge the various stores. A wide corridor with tiled dado and terrazzo floor leading to the Kitchen serves also the following stores :— Hardware and Crockery, Bread, Groceries and Fruit and Vegetables whilst in addition there are four Refrigeration Rooms, Ice Box, Cleaners Cupboard and Still Room. An office is provided for the Steward next to the Entrance. The Kitchen, 60 feet long and 29 feet wide, is equipped in the most modern manner and is amply capable of dealing with the requirements of the existing hospital. Sufficient space has been allowed for additional plant to meet the needs of any future extensions. The cooking apparatus is heated by gas and steam while the mixer bacon cutter and potato peeler are each worked by their own electric motor. Opening out of the Kitchen on one side is the main wash-up Scullery and on the other are the Nurses' and Maids' Sculleries, Serveries and Cook's Room. The last mentioned Sculleries are equipped with dish washing machines, sinks and dressers, etc., and there is access from them to the back of the Dining Room Serving Table and Hot cupboards. The Dining Rooms have been designed to give a light and pleasant atmosphere When in daily use the Nurses' and Maids' Rooms are divided by a partition which when not required can be folded into recesses. This will then give a room 50 feet long and 32 feet wide and will constitute a useful adjunct to the Institution for recreational purposes. It is amply lighted at each end and by a large central lay light. The floor is of Jarrah laid in narrow boards. Doors at each end give access to Cloak Rooms and Lavatories for both branches of the Staff. (b) The Engineer's Workshop. Owing to the increasing size of the Hospital and the expansion of the Heating and Hot Water Systems it has been found necessary to provide accommodation to enable the Heating Engineer to carry out minor repairs and renewals to the equipment when wanted. The site of the old workshop has now been occupied by the new Kitchen Block and for greater convenience the new building has been placed next to the Boiler House. It measures 40 feet by 20 feet and is provided with work benches, Lathe, drill, emery wheel and Smith's hearth. It is constructed of stock bricks with flat roof over and stone coping. (c) The Coal Store. Erected opposite the Boiler House, is capable of storing 160 tons as a reserve supply of coal. This building takes the place of the old open timber sheds used for that purpose previously situated on the kitchen site. Provision is made for the storage of House Coal and Ashes in this building. (d) The Laundry Building Extension. This Extension forms a wing on the north-west corner of the Laundry and is designed to provide storage of Mattresses, Blankets, Linen, etc., and at the extreme end a Sewing Room has been built. The materials are similar to those used for the original block. (e) New Cubicle Block (No. 10). This new Ward has been designed on a similar plan to Blocks 8 and 9 and is constructed with red hand made bricks, Bangor slating and artificial stone copings. The building is cruciform in shape with Five Cubicle Wards to each of the four wings. In the centre of the block is situated the Duty Room, octagonal on plan, with observation windows to each wing. It is fitted with sinks, utensil and instrument sterilizers, electric refrigerator, gas cooker and the latest type of fire hose reel. Adjacent to the Duty Room is a large linen store, larder and staff lavatory. At the end of each wing is a Bathroom, W.C. and Sinkroom. The latter is fitted with bedpan washer, marble draining shelf and sink. One bedpan sterilizer is also provided. The building is so situated that the verandahs face either South-East or SouthWest. Several small improvements on the previous blocks have been made in the design. The verandah has been widened to 8 feet 6 inches and the glass verandah roofs have been cantilevered from the building thus doing away with all support posts. The type of window on the verandah side has been modified. The floors of the cubicles, verandahs and lavatories are paved with Terrazzo and the Duty Room with Quarry tiles. 44 (/) The Dispensary. With the provision of the new kitchen, the old kitchen and other rooms in the old Administration Block became surplus to requirements and it was decided therefore to convert the same into an up-to-date Dispensary. The old kitchen, scullery and larder have been completely stripped and re-equipped with the neccssary sinks, draining boards, shelving cupboards. A Laboratory has been provided with its store adjoining and provision made for storing dressings and serum, while the small office in the front of the building has been enlarged and converted into a Visitor's Room. The Resident Medical Officer has been furnished with an Office and a room ha? been provided for Records. The alterations and additions to the heating and hot water systems and the installation of the Refrigeration plant and Cooking Apparatus have been carried out under the supervision of Messrs. J. Roger Preston and Partners who, in collaboration with the Borough Engineer, have acted as Consultants to the Council in this connection. (g) Generally. The Isolation Hospital now provides accommodation for 190 patients. On the following pages will be found:— (1) The site plan of the Hospital showing old and new buildings ; (2) the new Cruciform Cubicle Block, and (3) the new Central Kitchen. Artificial Respirators.—There are three at the Isolation Hospital ; two of them being the " Bragg-Paul Pulsator," the other a " Both Iron Lung." The Hospital is recognised by the Conjoint Board for Part 2 of the D.P.H. Regulations of the Board. 45 BOROUGH . OF . ILFORD ISOLATION . HOSPITAL SITE . PLAN 46 L.E.J. REYNOLDS .M.INONCE BOROUGH. INQINER TOWN.HALL. ILFORD 47 MATERNITY AND CHILD WELFARE 51 Births. By the Public Health Act, 1936, all live births and stillbirths of seven months and over must be notified to the Medical Officer of Health within 36 hours. The number of live births notified under the above Act during 1939 was 1,677 (862 males and 815 females). Of these, 72 (35 males and 37 females) took place in Ilford, the ordinary place of residence of the parents being outside the district. In addition, 563 notifications of birth (271 males and 292 females) which took place outside the district, although the ordinary residence of the parents is in Ilford, were transferred to this district. During the year, 26 cases in which there was default in complying with the requirements of the Act relating to the Notification of Births were referred to the Town Clerk. The percentage of live births occurring in Ilford, notified by the various responsible persons, was as follows :— By Medical Practitioners 13.00 By Certified Midwives 79.49 By Parents and Others 7.51 In addition, 59 stillbirths (37 males and 22 females) were notified. In 2 cases (both males) the parents resided outside the district. The notifications of 7 stillbirths (2 males and 5 females) which took place outside the district, although the ordinary residence of the parents is in Ilford, were transferred to this district. Infant Mortality. The number of infants dying within the first year of life was 75, the total number born being 2,212. The latter figure is supplied by the RegistrarGeneral for calculating infant and maternal mortality rates. The infant mortality or rate of deaths per 1,000 live births was, therefore, 33.9. Neonatal Mortality. The death-rate of infants under four weeks of age is known as the Neonatal Mortality. There were 57 deaths of infants under four weeks of age during 1939 and the rate for the year was 25.8 per 1,000 live births. The deaths of infants under one month increased from 50 during 1938 to 57 during 1939. The following table gives the deaths of infants under one year of age, classified according to age. It will be noticed that prematurity still causes the greatest number of deaths. 52 Infant Mortality. Cause of Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 4 weeks and under 3 months 3 months and under 6 months 6 months and under 9 months 9 months and under 12 months Total Deaths under 1 year Smallpox — — — — — — — — — — Chickenpox — — — — — — — — — — Measles — — — — — — — — — — Scarlet Fever — — — — — — — — — — Whooping Cough — — — — — — — — — — Diphtheria and Croup — — — — — — — — — — Erysipelas — — — — — — — — — — Tuberculosis Meningitis — — — — — — — — — — Abdominal Tuberculosis — — — — — — — — — — Other Tuberculous Diseases — — — — — — — 1 — 1 Meningitis (not Tuberculous — — — — — — — 1 — 1 Convulsions — — — — — — — — — — Laryngitis — — — — — — — — — — Bronchitis — — — — — 2 — — — 2 Pneumonia (all forms) 2 2 — — 1 1 1 1 — 7 Diarrhoea — — — — — — — — — — Enteritis — — — — — — — — — — Gastritis — — — — — — 1 — — 1 Syphilis — — — — — — — — — — Rickets — — — — — — — — — — Suffocation (overlying) — — — — — — — — — — Injury at birth 6 — — — 6 — — — — 6 Atelectasis 3 — — — 3 1 — — — 4 Congenital Malformations 3 1 1 — 5 4 — 1 — 10 Premature birth 25 4 — — 29 — — — — 29 Atrophy, Debility and Marasmus 2 1 — — 3 — — — — 3 Other Causes 6 — 1 — 7 — 1 1 2 11 Totals 47 8 2 — 57 8 3 5 2 75 Foster-Children—The Public Health Act, 1936 (Sections 206 to 220). The following is a summary of the work carried out :— Foster-Children. Number of foster-children on register on 1st January, 1939 55 Number of foster-children who were notified during 1939 47 Number of foster-children returned to their mothers during 1939 32 Number of foster-children taken off register for various other reasons during 1939 43 Number of foster-children on the register on 31st December, 1939 27 53 Foster-Mothers. Number of foster-mothers with children on the register on 1st January, 1939 47 Number of persons who became foster-mothers during 1939 15 Number of foster-mothers whose names were taken off the register during 1939 40 Number of foster-mothers with children on the register on the 31st December, 1939 22 Houses Visited by Sanitary Inspectors. Number of houses visited by the Sanitary Inspectors for the purpose of the Act during 1939 26 Number of visits made by the Sanitary Inspectors for the purpose of the Act during 1939 99 Work of Health Visitors. The Ilford area is normally divided into 13 districts, one nurse carrying out all home visits both for Maternity and Child Welfare work and School Medical Service work in each area, but owing to the difficulty in obtaining the staff, the number of districts has been reduced to 12. The following is a summary of the home visits made by the Health Visitors during 1939 as far as the Maternity and Child Welfare work is concerned :— First visits to newly-born infants 2,822 Subsequent visits to children under 1 year of age 11,465 Subsequent visits to children over 1 year of age and under 5 24,978 Visits to expectant mothers 408 Home visits for other reasons 2,394 Total visits paid 42,067 Supply of Milk to Expectant and Nursing Mothers and for Infants. A total of 28,204 quarts of cows' milk and 2,056 lbs. of dried milk were given free under the Regulations of the Ministry of Health during 1939, to 102 nursing mothers, 37 expectant mothers and 554 infants. Infant Welfare Centres. 77 voluntary lady helpers were engaged in the work at the Infant Welfare Centres at the end of December, 1939. During the year the following attendances were recorded :— Total number of attendances of infants 43,326 First attendances 2,115 Total number of children on roll, December 31st, after omission of all those who had not attended for six months 2,859 18,021 attendances of children from 1 to 5 years were made at the Infant Welfare Centres during the year. 54 Toddlers Clinic. No. of Sessions First attendances Subsequent attendances Total attendances Average Newbury Hall 33 198 321 519 16 Mayesbrook 21 77 214 291 14 54 275 535 810 15 60 children were found to be suffering from dental caries and 93 other children had other defects requiring treatment. Dental Clinic. 97 half-days were taken up for the treatment of 300 expectant and nursing mothers, and 301 children under 5 years of age during 1939. Ophthalmic Clinic. 11 expectant and nursing mothers and 89 children under 5 years of age were treated by the Council Oculist during 1939. Orthopaedic Department. (i) Valentines Clinic.—18 sessions were held during 1939, 155 children under five years of age being examined, making 203 attendances. (ii) Mayesbrook Clinic.—9 sessions were held during 1939, 67 children under five years of age being examined, making 114 attendances. Six children were admitted to the Royal National Orthopaedic Hospital, Country Branch, Stanmore, during the year, suffering from (4) congenital equino-varus, (1) metatarsus varus and (1) congenital dislocation of hip. Three of the children were discharged during the year and the other three were remaining in hospital at the end of the year. At the Valentines Clinic, 51 children under five years of age were treated by the Masseuse during the year, and 255 attendances were made by these children. Treatment was also given to 30 children who made 235 attendances at the Mayesbrook Clinic. Artificial Sunlight Clinic. 35 sessions were held at the Valentines Clinic and 35 at Mayesbrook Clinic. 39 children in all were treated, making 526 attendances. 17 cases were still attending at the end of the year ; of the remainder, two had left the district and in six cases the parents had discontinued treatment. All the others were discharged from further treatment, having improved. Aural Clinic. The Aural Surgeon attended at 37 afternoon sessions during 1939, and 158 attendances were made by 72 children of pre-school age, 56 being new cases. Rheumatism Clinic. Nine children under 5 years of age, 5 being new cases, made 17 attendances. Convalescent Home Treatment. By arrangement with the Invalid Children's Aid Association one child under five years of age was sent to a Convalescent Home for a period of 10 weeks. 55 The Council contributed the sum of £1 10s. Od. towards the cost of the maintenance of the child. Ophthalmia Neonatorum. Three cases were admitted to St. Margaret's Hospital (L.C.C.) during the year. The present charge for maintenance and treatment is £7 0s. 8d. per week. Owing to the war, the cases are now being accommodated at White Oak Hospital, Swanley, Kent. Treatment of Minor Ailments. Children suffering from simple dietetic ailments are treated at the Infant Welfare Centres. 76 belts and 3 trusses have been supplied to infants suffering from hernia during the year 1939. A certain number of infants were brought to the Clinics at the Public Health Offices and Mayesbrook Clinic to deceive treatment for minor ailments. 33 children under five years of age were operated upon at Queen Mary's Hospital, Stratford, and at King George Hospital, Ilford, for removal of tonsils and adenoids. 7 were treated free of charge as cases of necessity. Midwives. There are 15 state certified midwives (including the Superintendent and nine Council midwives) resident and practising in the district, and 2 certified midwives resident outside Ilford, but practising in Ilford. In addition there were at the end of the year, 12 state certified midwives at the Council's Maternity Home and 2 at a private nursing home in Ilford. Their supervision has been carried out as in previous years. Payment of Midwive's Fee in Necessitous Cases. The Council paid the whole of the private midwife's fee in three cases, amounting to £6 1s. Od. Suspension from Practise. Three midwives were suspended from practise for varying periods following attendance on cases, rendering them liable to be a source of infection. All were in the employ of the Council. The reasons for suspension from practise were as follows :— (1) Attended notified case of Puerperal Pyrexia, stated to be due to Sapraemia. (2) Attended notified case of Puerperal Pyrexia, stated to be due to Septicaemia. (3) Attended notified case of Pemphigus Neonatorum. As mentioned in my Report for 1938 a private Midwife was suspended from practise in December of that year following her attendance on a notified case of Pemphigus Neonatorum, and subsequently a notified case of Puerperal Pyrexia. The sum of £50 8s. 6d. was paid to her by the Council as compensation for loss of practise. The Midwife subsequently voluntarily surrendered her Certificate under Section 5 (1) of the Midwives Act 1936. Compensation. A patient who had attended the Council's Ante-Natal Clinic at the request of a private Midwife was admitted to the Maternity Home for confinement on the advice of the Doctor. Payment of 10/6 was made to the Midwife. 56 Inflammation of, or Discharge from, the Eyes of an Infant. Medical aid was sought in 29 instances where the infant was found to have inflamed or discharging eyes. Four of the cases were subsequently notified as suffering from Ophthalmia Neonatorum, In all cases the condition of the eyes cleared satisfactorily. The Council has adopted the suggestion of the Minister of Health that they should refrain from exercising their power of recovery of the fee of the Medical Practitioner under Section 14 (4) of the Midwives Act, 1918, in this class of case. Midwives Act, 1936. (a) Refresher Course for Midwives. Rules were made by the Central Midwives Board under Section 7 (1) of the Midwives Act, 1936, to take effect as from the 1st January 1939, requiring Midwives from time to time to attend a course of instruction approved by the Board. A residential course for a period of 4 weeks at the Plaistow Maternity Hospital, Plaistow, was approved by the Board for Midwives resident in this area and the Superintendent of Council Midwives attended the course at the Hospital in March, 1939. The Rules were suspended by the Central Midwives Board on the outbreak of the war. (b) Council District Midwifery Service. During the year 691 cases were attended by the Council Midwives. In 405 cases the midwives were engaged to attend as midwives and in 286 as maternity nurses. The cases resided in the following wards : Barkingside 124 ; North Hainault 89 ; Cranbrook 26 ; Park 49 ; Seven Kings 65 ; South Hainault 107 ; Loxford 93 ; Clementswood 80; Goodmayes 58. 3,772 ante-natal visits were made during the year. 67 medical practitioners are now participating in the Council's scheme for the ante-natal examination of patients who have engaged a Council Midwife to attend them. Twenty-eight patients were referred by the private Doctors to the Council's Consulting Obstetrician at the Ante-Natal Clinic for a further opinion. 8 of these women and 36 other patients who had engaged a Council Midwife (26 as a midwife and 18 as a maternity nurse) were, for various reasons admitted to the Council's Maternity Home or other Hospitals. 40 were admitted to the Maternity Home, 3 to Oldchurch Hospital, Romford, and 1 to the London Hospital, Whitechapel. In addition one patient was admitted to the Maternity Home following confinement owing to her heart condition. The baby died prior to admission to the Home. A Doctor was called in at the time of the confinement or subsequently to 141 of the 405 cases in which the midwife only had been engaged. Eight cases were notified as suffering from Puerperal Pyrexia, 6 being removed to the Isolation Hospital. 3 of these patients had engaged their own Doctor to attend them. One mother was admitted as an emergency case to the London Hospital, Whitechapel, for confinement, and died 3 days later from gas gangrene; obstructed labour. The patient was attended by her own Doctor. Four babies were notified as suffering from Ophthalmia Neonatorum. Three of the cases were removed to St. Margaret's (L.C.C.) Hospital. The condition of the eyes cleared satisfactorily. 57 Two babies, notified as suffering from Pemphigus Neonatorum were removed to the Isolation Hospital. Of the infants born, there were 10 stillbirths. In all instances the midwife was engaged as a maternity nurse only. Twenty infants died. In seven instances the midwife was engaged as a maternity nurse only. (c) Salvation Army District Midwifery Service. In accordance with Section 1 of the Midwives Act, 1936, the Council made an agreement with the Salvation Army Mother's Hospital for the provision of a domiciliary service of midwives to attend cases in the district bordered by Goodmayes Lane, Green Lane, Bennetts Castle Lane and Longbridge Road in the Borough of Ilford and including these four roads. The agreement took effect as from the 1st January, 1938. 94 cases were attended by the Salvation Army midwives during the year ; 64 as a midwife and 30 as a maternity nurse. (d) Compensation to Midwives Ceasing to Practise. (1) Two Midwives aged 43 and 49 years voluntarily surrendered their certificates to this Council during the year in accordance with Section 5 (1) of the Midwives Act, 1936. In one case compensation of £284 2s. Od. was paid to the Midwife, and in the second case £571 6s. 6d., but of the latter amount, £106 10s. 11d. and £26 12s. 1d. was recovered from the Barking and Dagenham Councils respectively as the Midwife had also practised in those areas. (2) A Midwife, who had acted as a maternity nurse in Ilford, but had not at any time notified her intention to practise as a Midwife, voluntarily surrendered her certificate to the Southend-on-Sea Council. This Council unsuccessfully appealed against the decision of the Minister of Health to contribute towards the compensation payable to the Midwife, and they were required to pay the sum of £3 1s. 2d. as their contribution. (3) This Council joined with the Dagenham Council in giving notice to a Midwife, aged 63 years, resident in the latter area, requiring her to surrender her certificate in accordance with Section 5 (2) of the Midwives Act, 1936. As the Midwife had attended cases and notified her intention to practise in Ilford, this Council contributed £147 11s. 1d. towards the compensation paid to her. Ante-Natal Clinics. The following attendances were recorded at the respective Ante-Natal Clinics :— Maternity Home Mayesbrook Clinic First attendances 464 121 Subsequent attendances 5,504 957 Number of expectant mothers on the rolls on 31st December, 1939 189 35 All patients booked for admission to the Maternity Home are medically examined at the Ante-Natal Clinic. During the year, 128 cases other than those hooked for admission to the Maternity Home were examined at the Clinics. There were 258 attendances by such cases. The Consulting Obstetrician or his Deputy made weekly visits to the Home during 1939. 58 During the year 52 ordinary visits were made. 350 patients referred from the Ante-Natal and Post-Natal Clinics, and 105 patients referred by private Doctors, were examined. X-Ray Examination of Ante-Natal Patients. 28 examinations were made at King George Hospital in 1939. Post-Natal Clinic. The following attendances were recorded :— First attendances 319 Subsequent attendances 455 Number on roll on 31st December, 1939 34 Maternal Mortality. The total number of deaths due to childbirth during the year was 4 which gives a maternal mortality rate i.e., number of deaths per 1,000 live births of 1.81 (or 1.75 including stillbirths). The causes of death were as follows :— Puerperal Fever :— Confined at and died in London Hospital, E.l ; Gas gangrene; obstructed labour 1 Other causes :— Confined at and died in Council's Maternity Home ; Shock and haemorrhage due to Caesarian section and delivery due to large foetus 1 Confined at and died in Council's Maternity Home ; Acute eclampsia 1 Confined at and died in own home ; Pulmonary embolus ; femoral thrombosis (puerperal) 1 Cases notified as puerperal pyrexia are investigated by the Sanitary Inspectors and Health Visitors. MATERNITY HOME. During 1939, 536 women were admitted into the Home (77 direct to the Emergency Block and 459 to the Ward Blocks). In addition two patients admitted for ante-natal treatment during 1938 were re-admitted for confinement during 1939. 346 cases could not be admitted during the year owing to the difficulty in obtaining sufficient nursing staff. At the end of the year 236 cases had applied for future admission to the home. The average number of patients in the home per day during 1939 was 24.5 and the average length of stay of patients 16.5 days. Emergency Block. 139 cases were treated, 77 being admitted direct to this block and 62 being transferred from the Ward Blocks. 55 of these 77 cases had not been booked for admission to the Maternity Home. 9 of the 77 patients were admitted direct to the Emergency Block for ante-natal treatment and were subsequently re-admitted to the Ward Blocks for confinement. 59 The average number of patients in the Emergency Block per day during 1939 was 4.1 ((including cases transferred from the Ward Blocks) and the average length of stay of patients admitted direct to this Block was 15.5 days. 38 patients were confined in the Emergency Block (37 admitted direct to this Block and 1 transferred from the Ward Blocks). The nine cases mentioned above have been included in the figures for those confined in the Ward Blocks. 24 of the 38 cases were first confinements and 14 were second or subsequent confinements. 6 cases (or 15.8 per cent.) were delivered by means of forceps ; 2 of the infants were stillborn. There were two deaths of infants born in the Emergency Block and twelve stillbirths. Twelve cases were notified as suffering from Puerperal Pyrexia. Four of these cases and one other patient were removed to the Isolation Hospital. The Consulting Obstetrician or his Deputy was called in to 14 cases as follows :— To perform Caesarean section operations 2 To perform other operations 7 For consultation 5 The reasons for the two Caesarean section operations were as follows :— Contracted pelvis 1 Placenta praevia, ante-partum haemorrhage 1 The seven other operations were as follows :— Dilatation and curettage 2 Forceps delivery and excision of cervix 1 Removal of cervical polypi 4 One patient admitted in labour as an emergency case died four hours later from shock and haemorrhage following Caesarian section and delivery due to large foetus. The other 40 cases admitted direct to this block were not confined therein for the following reasons :— Abortion or miscarriage 17 Admitted for ante-natal treatment and subsequently readmitted to Ward Blocks for confinement 9 Admitted for ante-natal treatment and subsequently confined at home or evacuated 7 Born before arrival at Home 7 Ward Blocks. 461 cases were admitted to the Ward Blocks. In addition 9 patients admitted to the Emergency Block for ante-natal treatment were subsequently re-admitted to the Ward Blocks for confinement. One patient admitted to the Ward Blocks was transferred to the Emergency Block for confinement. 17 of the 461 cases had not been booked for admission to the Home. Ten cases were not confined in the Home for the following reasons :— Abortion 4 Admitted for ante-natal treatment and subsequently confined at own home or evacuated 3 Admitted for ante-natal treatment and subsequently confined in other Hospital 1 Dilatation and curettage 1 Termination of pregnancy 1 60 The average number of patients in the Ward Blocks per day during 1939 was 20.4 and the average length of stay of patients 16.7 days. 58 cases were transferred to the Emergency Block after confinement for various reasons. In 55 of the 459 confinements the patient had been previously admitted for varying periods of observation, being subsequently re-admitted for the confinement. Of the 459 confinements there were :— (a) 276 cases of first confinement. (b) 183 cases having their second or subsequent confinement. (c) 25 cases living in 2 rooms or less (16 being first confinements). (d) 69 cases living in 3 rooms (53 being first confinements). Of the 459 cases, 15 women had engaged their own doctor. 11 of these ' cases were, however, delivered by a midwife, the doctor not being present at the birth. 455 were attended by one of the midwives at the Home. Thirty-two cases (or 7.0 per cent.) were delivered by means of forceps, 6 following surgical induction ; 3 of the infants were stillborn and 1 died aged 4 days. In addition, labour was surgically induced in 27 cases; three of the infants were stillborn. There were 8 deaths of infants in the Ward Blocks. The neo-natal death-rate of babies born in the Ward Blocks was 1.8 per cent. compared with 2.7 per cent. in the district in general. The deathrate of babies who died before 14 days, born in the Ward Blocks, was 1.6 per cent. in 1939 and 1.8 per cent in 1938. The infant mortality rate of children born in the Ward Blocks of the Maternity Home was 20.3 per 1,000 births, as compared with 36.7 born in their own homes. The figure of 20.3 has been arrived at after deduction of all deaths of infants born in the Maternity Home, and is calculated on the total births in the district, excluding those in the Maternity Home. There were 19 stillbirths in the Ward Blocks. The average stillbirth rate for the Ward Blocks of the Maternity Home for the past five years was 2.65 per cent. compared with 2.92 per cent. for births elsewhere in the Ilford district. Twenty-one cases were notified as suffering from Puerperal Pyrexia. Eight of these cases and five other patients were removed to the Isolation Hospital. No cases of ophthalmia neonatorum were notified from the Home during the year. Special visits were made by the Consulting Obstetrician or his Deputy to 49 cases in the Ward Blocks as follows :— To perform Caesarean section operations 31 To perform other operations 14 For consultations 4 One mother confined in the Ward Blocks died the following day from Acute Eclampsia. The maternal mortality rate for the Ward Blocks of the Home for the five years from 1935 to 1939 is .75, as compared with the maternal mortality rate in the district generally of 3.73, the rate in each case being calculated on the total live births. Other Maternity Hospitals. (a) Queen Mary's Hospital. One case was admitted during 1939 in accordance with the arrangements made with this Hospital at a charge of 10s. per day. (b) Oldchurch County Hospital. 96 cases were admitted during 1939. The charge was increased from 11/6 to 14/- per day as from the 1st May, 1939. SCHOOL MEDICAL SERVICE 63 GENERAL SURVEY OF THE SCHOOL MEDICAL SERVICE The Board of Education, (form 6 M,) state that in view of the abnormal conditions arising out of the war, evacuation, and the disturbance of the regular medical, dental and clerical staffs in many areas, it will be impossible for the School Medical Officers to present reports on as comprehensive a scale as in previous years, and the need for economy makes it desirable that the cost of producing reports should be kept as low as possible, but the following is the information the Board particularly ask for in paragraphs 6 and 7 of their Form. 6. (a) Staff Changes Brought about by the War.—One of the two Assistant Dental Surgeons joined the Royal Air Force on 3rd September and one of the three Dental Clerk-Attendants was seconded as a whole-time A.R.P. Ambulance Driver as from 5th September (b) Arrangements for Medical, Dental and Cleanliness Inspections in force since the end of August. (i) Routine Medical Inspections.—Owing to the elementary schools being closed at the outbreak of war, no routine Medical Inspections at the schools were carried out until 4th December, when routine medical inspections were commenced of the children registered under the Educational Home Service such examinations being carried out at the various area schools. Routine medical inspection of the children attending the 7 elementary schools re-opened in early 1940, was carried out immediately following their re-opening. (ii) Dental Inspection.—No Dental Inspections at schools were carried out from the outbreak of war until the end of the year, but parents requesting treatment for their children, or children seen at the Minor Ailment Clinics and at the routine medical inspection of children attending the Educational Home Service classes, were invited to the Dental Clinic for inspection and treatment by the School Dentist. Dental Inspections recommenced in early 1940. (iii) Cleanliness Inspections.—Owing to the closure of the schools, special cleanliness inspections at the various schools 64 were not possible. They were, however, resunned, in January 1940 at the 7 schools referred to in paragraph (b) (i). (c) Curtailment of the Arrangements for the various Forms of Treatment. (i) Minor Ailment Clinics.—The accommodation both at the Public Health Offices and Mayesbrook Clinic ordinarily used for School Clinic premises were taken over as First Aid Posts, and owing to the considerable evacuation of elementary school children through the Government scheme and privately, the Minor Ailment Clinics were not re-opened from the outbreak of war until 20th and 22nd November respectively, when accommodation was arranged for these Clinics on one afternoon weekly at Newbury Hall (instead of the Public Health Offices) and at Mayesbrook Clinic. Additional sessions will be held as and when necessary. (ii) The Ophthalmic, Orthopaedic, Artificial Sunlight, Aural and Rheumatism Clinics were discontinued for the same reasons, but all these special clinics recommenced during the early part of January, 1940. (iii) Dental Clinic.—The Clinic at Mayesbrook Clinic has been in continuous session, but the Clinic at the Public Health Offices was discontinued from the outbreak of war owing to the accommodation being utilised for a First Aid Post, but arrangements have been completed for the provision of a Dental Clinic at Valentines School to cover the same area as that normally served by the Clinic at the Public Health Offices. At the end of 1939 there was only the Senior Dental Surgeon on the staff, one Assistant Surgeon having joined the Forces and the other resigned to take up another appointment. Efforts are being made to fill one of the vacancies. 7. Evacuation Arrangements.—On September 1st, 1939, 9,053 school children were evacuated to East Suffolk and to Ipswich, while on September 2nd and 3rd parties of mothers (2,253) and children (3,954) travelled to the same areas. On each of the three days an Assistant Medical Officer was on duty at the entraining 65 stations—Ilford, Goodmayes and Seven Kings. A School Nurse also attended at the stations and was available for first aid assistance should it have been necessary. Liaison has been maintained with the reception areas, any necessary medical records being sent, and arrangements made for children's admission to hospital or convalescent home on recommendation by the Medical Officer of the particular reception area. Further, considerable numbers of children were recommended at the reception areas for dental treatment, and the School Nurses visited the home addresses of the children to obtain the necessary parental consents, which when received were forwarded to the reception area authorities who carried out the required treatment. A similar procedure has been adopted in regard to Diphtheria Immunisation. Children evacuated under the Supplementary Evacuation Scheme in November and December were medically examined a day or so prior to their departure to the Reception Areas. 1. Staff.—(a) Dental Surgeons.—Mr. F. J. Lord resigned as from 1st November, Mr. K. M. H. Williams resigned as from 30th March and Mr. A. G. Clark commenced duties on 24th March. (b) Health Visitors and School Nurses.—Miss K. French terminated her appointment as from the 1st November, Miss M. E. Cartwright on the 30th June (superannuated), Miss E. Crundwell on the 24th June. Miss M. N. Withams commenced on the 14th August and Miss I. L. Mobbs on the 4th September. 2. Co-ordination.—Vide 1937 Report. 3. School Premises.—There are 28 schools, with 60 departments, including the Open Air School. The schools have accommodation for approximately 21,890 scholars, and 19,296 were actually on the rolls on July 26th, 1939, as compared with 18,973 on December 31st, 1938. The number of children in average attendance at School for the period April 1st, 1938, to July 26th, 1939, was 17,098 (or 17,193 including the Open Air School), compared with 16,609 and 16,702 for the same period the previous year. 66 The following are the additions which have taken place in he accommodation at the elementary schools during the year : School. Date of Opening. Accommodation. Parkhill Junior 15.5.39 400 Parkhill Infants 12.6.39 340 Owing to present conditions general building programme has been suspended. The Sanitary Inspectors have paid the usual monthly visits to the elementary schools (1) to enquire as to the milk supplies, (2) to inspect the sanitary arrangements. 315 visits have been made during the year. 4. Medical Inspection.—This has been carried out in accordance with the Board of Education (Special Services) Regulations, dated the 18th August, 1925, Section 17 of which states : The Authority must provide for the medical inspection of all children in Public Elementary Schools as soon as possible in the twelve months following :— (a) their first admission to Public Elementary Schools, and (b) their attaining the age of eight years, and (c) their attaining the age of twelve years. Routine medical inspection at the Mossford School, Dr. Barnardo's Girls' Village Home, was again carried out by my Department during the year, 172 children being examined, the treatment of the children being left, as previously, in the hands of the Home Authorities. 5. Infectious Disease.—The following table shows the incidence of infectious diseases in the Ilford schools since 1934 :— Measles Scarlet Fever. Diphtheria. and German Measle Chicken Pox. Mumps. Whooping Cough. Small Pox. 1934 274 178 1,053 476 363 318 — 1935 209 106 445 355 540 447 — 1936 217 60 1,098 428 187 474 — 1937 178 44 58 667 834 373 — 1938 187 62 2,026 539 318 169 — 1939 217 56 42 177 162 419 — Disinfection of all the cloakrooms at the public elementary schools was carried out during the Summer and Winter vacations. 67 No schools were closed during the year on account of infectious disease. Table VII on page 96 shows the incidence of infectious diseases in the Ilford schools during 1939. 729 home visits were paid by the Health Visitors to cases of minor infectious disease. Diphtheria Prevention Clinics.—The following shows the work carried out at Valentines (36 sessions) and Mayesbrook (40 sessions) Clinics for children of school age during 1939 :— Valentines. Mayesbrook. Primary Schick tested 36 37 Positive 21 16 Negative 15 21 Inoculated (full course) 233 145 Schick + 1938 2 — Schick + 1939 21 16 Not tested 210 129 Negative after full course of inoculation 117 103 Positive after full course of inoculation and reinoculated 4 3 Awaiting re-test 110 3b Not re-rested after inoculation on account of leaving district, etc. 2 3 Result of final Schick test in 1939 of cases inoculated in 1938 : Valentines. Mayesbrook. Positive and re-inoculated 10 5 Negative 132 299 860 individual children were treated (390 at Valentines and 470 at Mayesbrook), making 3,080 attendances (1,604 and 1,476 respectively). Since June, 1932, children under 8 years of age have not been Schick tested prior to immunisation, unless there was some parti" cular reason to suppose that the child might give a combined reaction to the Schick test. Since the first introduction of immunisation against Diphtheria in Ilford in 1929, 5,136 children of school age, and 3,467 children under school age have been immunised. Measles.—42 cases were notified from the schools, compared with 2,026 in 1938. There were no deaths from Measles in children of school age. 68 All cases of measles were visited by the School Nurses after notification. In addition, the cases were visited one month afterwards to enquire as to the child's progress. It was found that in the 42 cases, no complications occurred. Ringworm :— No. of cases at beginning of 1939. No. of cases reported during 1939. Total. Remedied during 1939. No. of cases under observation at end of 1939. Ringworm :— Scalp 2 *1 3 3 — Body 2 5 7 7 — 4 6 10 10 – *This case received X-Ray treatment at the London Hospital during the year. 6. Following Up.—During 1939, 4,533 home visits by the School Nurses were paid for the purpose, and 3,159 re-examinations of children (some on several occasions) were carried out by the doctors at school : 52 visits to schools were made for this purpose alone, and other children were seen at the visits for routine medical inspection. 7. Medical Treatment. (a) Minor Ailments Clinics.—The attendances during 1939 were as follows :— 1st Jan. to 4th Sept. 20th Nov. to 31st Dec. Valentines. Mayesbrook. Newbury Hall. Mayesbrook. Number of individual children seen 1,242 991 30 38 Number of attendances of children 2,698 2,309 41 50 Number of exclusion certificates granted 562 611 – – Number of certificates of fitness to attend school granted 416 334 – – 69 The following table shows the conditions dealt with at both the Clinics during the year :— Subnormal Nutrition 110 Uncleanliness :— Head 130 Body 1 Skin :— Ringworm :— Head 1 Body 5 Scabies 22 Impetigo 75 Other Diseases (Non-Tuberculous) 298 Eye :— Blepharitis 24 Conjunctivitis 46 Keratitis — Defective Vision (excluding Squint) 114 Squint 8 Other conditions 54 Ear :— Defective Hearing 18 Otitis Media 51 Other Ear Diseases 88 Nose and Throat :— Chronic Tonsillitis only 34 Adenoids only 1 Chronic Tonsillitis and Adenoids 42 Other conditions 157 Enlarged Cervical Glands (Non-Tuberculous) 24 Defective Speech 3 Teeth—Dental Diseases 67 Heart and Circulation :— Functional 2 Organic — Anaemia 9 Infectious Diseases :— Scarlet Fever 1 Diphtheria — Whooping Cough 13 Mumps 5 Chicken Pox 5 Measles — 70 Influenza 11 Colds 81 Coughs 70 Lungs :— Asthma 7 Bronchitis 62 Other Non-Tubercular Diseases 11 Tuberculosis :— Non-Pulmonary :— Suspected and referred to T.B. Officer 2 Nervous System :— Chorea 5 Epilepsy 1 Nervous Debility 13 Habit Spasm 14 Tachycardia 1 Other conditions 12 Deformities :— Rickets — Flat Feet 18 Spinal Curvature 4 Other forms 44 Minor Injuries 160 Rheumatism 30 Other Defects and Diseases 352 Total number of ailments 2,306 (b) Ophthalmic Department. During the year 1939 (period 1st January to 1st September), the School Oculist held 135 sessions for the refraction of children suffering from defective vision (95 at Valentines and 40 at Mayesbrook). Full details of the work are given in Table IV, Group II, on page 90. 1,558 attendances (1,092 at Valentines Clinic, 466 at Mayesbrook Clinic) were made by 1,019 school children (691 at Valentines Clinic, 328 at Mayesbrook Clinic), as compared with 1,332 school children in 1938. 71 Of the 1,019 cases, 425 were referred from medical inspections, 120 were referred from the School Clinic, 371 were " under observation " cases re-examined, 81 were re-examined at parents' requests, 2 cases referred by the Director of Education, and 20 were referred from other sources. The 1,019 children were not all suffering from grave defects of vision. The following table shows the vision in the worst eye, as tested by Snellen's Type :— 6/6 6/9 6/12 6/18 6/24 6/30 6/60 6/0 190 146 146 170 126 154 79 8 The children who saw g (practically normal vision) were suffering from symptoms such as headaches, inflamed eyelids, etc., which rendered further examination necessary. Of the 1,019 children examined, 718 were found to require spectacles, 423 being children who had previously had spectacles and 295 (new cases) by reason of the following defects :— Myopia 37 Myopic Astigmatism 46 Hypermetropia 38 Hypermetropic Astigmatism 105 Mixed Astigmatism 28 Anisometropia 12 Hypermetropia with Squint 29 Total 295 Of the remaining 301 children, (i) 15 were suffering from the following other diseases, and spectacles were not prescribed :— Chalazion 3 Congenital Cataract 3 Corneal Ulcers, Conjunctivitis, Blepharitis 3 Strabismus 1 Conjunctivitis 2 Interstitial Keratitis 1 Choroiditis 1 Optic Atrophy 1 Total 15 72 (ii) 55 children were found not to require spectacles, having no refractive error requiring correction. (iii) 197 children were wearing spectacles already and the lenses in use did not require changing. (iv) 34 children were also seen but treatment was not completed owing to the following causes :— Moved out of District 13 Parents objected to treatment or received treatment elsewhere 8 Waiting appointment 13 Total 34 Under the Education Committee's scheme 790 complete pairs of spectacles were provided, some of these being renewals after breakages. In addition, in 225 cases the lenses of spectacles were changed after re-examination or repairs of frames were carried out. 32 pairs of spectacles were provided free of charge on necessitous grounds. (c) Orthopaedic Department.— (i) Valentines Clinic.—18 sessions were held during 1939, 82 children of school age were examined for the first time during the year and 255 children were seen, who had previously attended the clinic. These 337 children made 433 attendances. (ii) Mayesbrook Clinic.—9 sessions were held during 1939, 52 children of school age were examined for the first time during the year and 111 children were seen, who had previously attended the clinic. These 163 children made 220 attendances. 11 children of school age were admitted to the country branch of the Royal National Orthopaedic Hospital, at Stanmore, in 1939, suffering from (1) Cerebellar Ataxia, (2) Multiple exostoses, (3) Hammer toe, (4) Talipes Equinus, (5) Investigation for pain in back, (6) Slipping Patella, (7) Poliomyelitis, (8) Congenital Dislocation of the hip, (9) Arthritis of the hip, (10) Perthes Disease, (11) Plantar wart. 10 children were discharged during the year. 73 During the year 12 pairs of valgus insoles, 5 pairs metatarsal insoles, 12 pairs of surgical boots, 4 pairs special night splints or shoes, 3 spinal supports, 2 walking calipers with special boots and 1 special glove were supplied to school children. 44 cases were discharged from the Orthopaedic Clinic as cured and 59 cases were discharged but recommended to be kept under observation at school. 22 cases left the district, 25 cases left school or were transferred to private or secondary schools, and 84 were evacuated under National emergency. The cases recommended to be kept under observation at school are seen periodically by the School Doctors. During the year 62 cases were found to be permanently cured and 10 cases were referred back to the Orthopaedic Surgeon for further treatment. The remaining cases are still being kept under observation. A Masseuse attended the Valentines Clinic for orthopaedic treatment on Wednesday afternoon, Thursday morning and afternoon, Friday morning, and the Mayesbrook Clinic on Tuesday morning and afternoon until 1st September and 29th August respectively. A total number of 209 sessions were held by the Masseuse for treatment during 1939 (139 at Valentines Clinic and 70 at Mayesbrook Clinic). At Valentines Clinic 211 individual children of school age were treated by the Masseuse during the year and 1,735 attendances were made by these children. Treatment was also given to 125 children, who made 1,515 attendances at the Mayesbrook Clinic. (d) Artificial Sunlight Department.—A Masseuse attended the Valentines Clinic on Monday afternoon and the Mayesbrook Clinic on Wednesday morning for artificial sunlight treatment until 28th August and 30th August respectively. 35 sessions were held at Valentines Clinic and 35 at Mayesbrook Clinic. At the Valentines Clinic 28 children of school age were treated, 14 of these being new cases. The 28 children made 351 attendances for treatment. 74 At the Mayesbrook Clinic 42 children of school age were treated, 18 of these being new cases. The 42 children made 705 attendances for treatment. The lamp used in each case is a mercury vapour one, the whole of the body surface being exposed, commencing with a minimum of one minute and reaching a maximum of ten minutes' exposure. Of the 42 cases treated at the Mayesbrook Clinic, 15 were Open Air school children. At Valentines Clinic, 14 children of school age were discharged from the Artificial Sunlight Clinic, 1 case being cured, 6 cases showing considerable improvement, 3 having left school and in 4 cases the treatment was discontinued by the parent. 14 children were still receiving treatment at the end of the year. At Mayesbrook Clinic, 18 children of school age were discharged from the Artificial Sunlight Clinic, 13 cases showing considerable improvement, 2 having left the district and in 3 cases the treatment was discontinued by the parent. (e) Aural Clinic. The Aural Clinic was held at Valentines Mansion, the Surgeon attending on one afternoon weekly until 31st August. 37 sessions were held during 1939 and 803 attendances were made by 337 children of school age, of whom 193 were new cases. The following table shows the work of the Clinic :— 75 AURAL CLINIC. Nature of Disease Still under treatment Recommended Hospital treatment Discharged as cured Discharged as improved Discharged as no treatment required Discharged as left district Discharged as left school Treatment refused by Parent Total New Old New Old New Old New Old New Old New Old New Old New Old New Old (i) Acute Suppurative Otitis Media 1 7 4 2 2 5 2 1 1 4 20 9 (ii) Acute Catarrhal Otitis Media 2 — 2 2 — 4 1 — 1 — — 6 6 (iii) Chronic Suppurative Otitis Media due to:— 1. Tympanic Sepsi 1 7 2 — — — 2 4 — — — 1 — 2 — — 5 14 2. ,, and Granulations 1 4 1 — — 1 1 1 3 6 3. ,, and Polypi 1 — — 1 — — — 1 — — — — — — — 1 2 4. Other Causes I 1 1 1 2 1 1 1 3 6 (iv) Mastoid Disease (previous operation) 2 1 — — — 1 1 - - - - - - - - - 3 2 (v) Partial Deafness due to:— 1. Nerve Deafness 2 2 - - - - - - - - - - - - - - 2 2 2. Tonsils and Adenoids — 7 — — 3 1 1 1 1 — 1 9 6 3. Retraction of Membrana Tympani 1 1 - - - - - - - - - - - - 1 — 2 1 4. Scarring of Membrana - - - - - - 1 1 1 - - - - - - - 2 1 5. Wax - - - - 1 - 2 - - - - - - - - - 3 - 6. Other causes 3 — 1 3 3 — 1 1 9 3 (vi) Opinion on Tonsils 5 2 51 3 3 18 — — 3 — — — — 1 2 2 64 26 (vii) Rhinitis 5 5 6 2 I 4 1 — 1 — 2 — — 2 2 1 18 14 (viii) Other diseases or defects 13 16 15 7 4 10 2 5 5 — 2 1 1 3 1 4 43 46 Total 38 39 92 20 11 44 17 20 15 — 6 3 2 9 12 9 193 144 76 Otorrhcea in Ilford school children. Since the inception of the Aural Clinic in July, 1934, 212 cases of otorrhcea seen and recommended for examination at this Clinic have been analysed and the specific cause of the disease in each case has been ascertained with the following results:— 31.0 per cent, of cases of Otorrhoea were caused by Measles. 18.0 „ „ ,, ,, ,, Scarlet Fever. 13.0 ,, ,, ,, ,, ,, Colds or Catarrh. 8.0 ,, ,, ,, followed'Tonsillectomy. 6.0 ,, ,, ,, were caused by Influenza. 5.9 ,, ,, ,, ,, ,, Trauma. 4.9 ,, ,, ,, „ ,, Teething. 3.0 ,, ,, ,, ,, ,, Pertussis. 3.5 ,, ,, ,, ,, ,, Diphtheria. 1.5 ,, ,, ,, . ,, ,, Pneumonia. 1.9 ,, ,, ,, ,, ,, Tonsillitis. 0.9 ,, ,, ,, ,, ,, Cleft palate or nose operation. 0.5 ,, ,, ,, ,, ,, Paratyphoid. 1.9 ,, ,, ,, ,, of Unknown origin. Ionisation.—Since the inception of the Clinic in July, 1934, 24 children of school age have been treated by zinc ionisation. 7 cases were satisfactorily treated and discharged from the Clinic. They were subsequently seen at school, after a period of at least six months, and it was stated that there had been no recurrence of the condition during that period. In 7 cases the various conditions cleared up to enable their discharge from further attendance at the Clinic, but no further examination was made at school as the children had either left school or removed from the district. 2 children left school before their treatment at the clinic was completed. In 8 cases the result proved rather unsatisfactory. 4 cases were ionised during 1939 but were still attending at the end of the year for further treat, ment. 3 cases were treated and discharged from the Clinic but were subsequently referred back for further treatment, when seen at a later date at school or at the Minor Ailments Clinic ; 2 of these 3 children have since left school and are continuing their treatment as Outpatients at hospital. 1 child received 11 applications over a period of 3 years but was later admitted to a residential school for deaf children. Diastolisation.—Since the commencement of the Aural Clinic, 15 children have been treated by diastolisation. In 4 cases the nasal condition was cured and the children were subsequently seen at school after a period of at least six months, and the conditions were satisfactory. 2 children were discharged from the Aural Clinic, 1 after treatment lasting two years, but have not yet had any subsequent examination at school. 77 In 3 cases the conditions cleared up to enable their discharge from further attendance at the Clinic but no further examination was made as the children had left school. 4 children, after treatment at the Aural Clinic over a varying period, were still in attendance at the outbreak of war ; but due to evacuation have not been able to continue at the Aural Clinic. One child after treatment in 1938 was sufficiently improved to be discharged, but when seen at the Minor Ailments Clinic in 1939 was referred back for further treatment. One child has been attending the Clinic since 1934, but the condition is still giving trouble. (/) Rheumatism Department. The Physician attended 27 morning sessions up to 2nd September. The Secretary of the Ilford Branch of the Invalid Children's Aid Association attended at each clinic in order to arrange convalescent treatment for those children requiring it. During the year 241 children (99 of these being new cases) made 467 attendances. Of these, 37 were discharged, showing no active rheumatic condition. Number of cases referred to Convalescent Home 23 ,, ,, ,, Heart Home 7 ,, ,, ,, General Hospital (In-patients) 5 ,, ,, ,, Isolation Hospital 8 ,, „ ,, Ear, Nose and Throat Surgeon 36 „ „ ,, Orthopaedic Surgeon 5 ,, ,, ,, for X-ray and Electro-Cardiogram 22 ,, ,, ,, Blood Sedimentation Rate 30 ,, ,, Open Air School 3 ,, ,, ,, Ophthalmic Clinic 4 (g) Dental Department. During the year the Dental Surgeons paid 156 visits to the schools for the purpose of inspecting the teeth of children. Since the 1st January, 1938, children of all ages have been inspected by the Dental Surgeons. Some of the schools were visited on two occasions. Of 18,007 inspections by the Dentist (including special cases), 10,491 (or 58 per cent), were found to require treatment, compared with 14,597 (or 64 per cent.) in 1938 ; 9,937 (or 69 per cent.) in 1937 ; 17,738 (or 65 per cent.) in 1936 ; 7,541 (or 59 per cent.) in 1935. 78 In addition to the ordinary dental work of fillings and extractions, a considerable amount of "regulation" work has been done. 50 regulation plates, 4 crowns and 6 dentures were supplied. 858 visits were made by children to the Dental Clinic for regulation purposes. The amount of dental disease present in children at various ages is shown by the following table relating to school children inspected by the School Dentists :— Age groups (in years). No. of inspections of children No. referred for treatment. Percentage. 5 1,595 933 58.5 6 1,872 1,124 60.0 7 1,905 1,151 60.4 8 2,154 1,136 61.1 9 2,325 1,404 60.4 10 2,484 1,402 56.6 11 1,804 965 53.5 12 1,541 879 57.4 13 1,517 767 50.5 14-15 .. 579 319 50.5 Full details of the dental work are shown in Table IV, Group V, on page 91. (h) Treatment for Uncleanliness.—It was found necessary to serve statutory notices under the Education Act, 1921, Section 87, on the parents of 23 children. The Statutory Notices were complied with in all cases. In March, 1936, the Education Committee decided that reports of second offences be referred to the School Attendance Subcommittee with power to take suitable action. No cases were referred to the Committee during the year. The School Nurses paid 130 visits to the schools (an average of 5 visits to each school during the year), for the purpose of inspecting the heads and clothing of the children, with the following result :— Number of Examinations Number Per of Children. Infected. cent. 34,151 *515 1.5 *25 of this number were found to be infected with living vermin ; the remainder with nits only. A child with any nits in the hair at all is included in these figures. 79 The percentages for the past 5 years were as follows:— 1935 2.3 1936 2.3 1937 1.7 1938 1.5 1939 1.5 (t) Other Ailments.-—During the past year 43 children have been operated on for the removal of enlarged tonsils and adenoids, under the agreement with Queen Mary's Hospital, Stratford, 25 as in-patients. 6 children were treated free on necessitous grounds. Under the agreement with the King George Hospital, 29 children were operated on at that Hospital, 21 as in-patients, for the removal of enlarged tonsils and adenoids, 5 children being treated free on necessitous grounds. In addition to the treatment of tonsils and adenoids, 38 letters were given to Ilf3ord school children, for whom hospital treatment was required, to attend Queen Mary's Hospital. 8. Open-air School.—During 1939,39 children were admitted, 40 ceased attendance, and on the 26th July, 1939, 109 children were on the school roll. The School was closed on the outbreak of war. Those admitted were recommended for examination from the following sources :— School Medical Officer 34 Tuberculosis Officer 1 Rheumatism Clinic 1 Others 3 46 of the children discharged since the opening of the school were re-examined at their ordinary schools during 1939, and 42 were found to have maintained their improvement in health, but in 4 cases there was no improvement in health ; in one case the child was certified " feeble-minded " and recommended admission to special Residential School; in another case the child is suffering from pulmonary fibrosis and is not likely to improve ; in the third case the child is suffering from asthma, and has had treatment at Convalescent Home and Hospital; and in the last case the child suffers from bronchitis and asthma, and has had Convalescent Home and Hospital treatment. 80 Of the children admitted to the Open Air School since its commencement in 1929, 37 children had never previously attended school (1 admitted in 1929, 2 in 1930, 5 in 1931, 5 in 1932, 3 in 1933, 4 in 1934, 3 in 1935, 5 in 1936, 7 in 1937, and 2 in 1938), and 48 children had not been in attendance at school for long periods (of these, 4 were admitted in 1929, 4 in 1931, 1 in 1932, 2 in 1933, 1 in 1934, 9 in 1935, 6 in 1936, 7 in 1937, 9 in 1938 and 5 in 1939. The Dental Surgeon has carried out one inspection of the children's teeth at the Open Air School. The following table shows briefly the dental work carried out:— Number of children examined by the School Dentist 91 Number of children referred for treatment 31 Number of children treated by Dental Surgeon 20 As a result of the Medical Officer's periodic examinations, a number of the children have been recommended certain treatment as follows:— Administration of Milk in school 30 Administration of Cod-liver Oil Emulsion 25 Administration of Malt and Oil, Parrish's Food, etc. 13 To see Ophthalmic Surgeon 5 To see Orthopaedic Surgeon re Remedial Exercises, etc. 6 To see Dental Surgeon 1 To see Aural Surgeon 3 Recommendations have also been made to the Head Teacher as to the amount of exercise individual children should undergo, and also as to the taking of shower-baths and natural sunshine. 15 children received artificial sunlight treatment during the year. 9. Physical Training.—The following is the report of the Supervising Instructor in Physical Training:— I. Staff. No addition has been made to the staff during the year. II. Duties and Organisation. The duties of the Supervising Instructor in Physical Training continue to be of an advisory, instructional, and supervisory character as regards the physical training (inclusive of swimming instruction and organised games) throughout all the schools under the jurisdiction of the Authority. As formerly such duties are inclusive of staff conferences and practical demonstrations, and are governed, as is also the instruction given, by the various relevant Syllabuses issued from time to time by the Board of Education for use in schools. Prior to evacuation, regular and systematic visits were made to the schools, the public baths, and the several playing fields. 81 III. Special Features. (a) On 10th and 11th February the Supervising Instructor attended the Twentieth Annual Conference of the National Association of Organisers of Physical Education. The Conference was held in London and demonstrations of Keep Fit Work and Remedial Tests were given by students from the Aldershot School of Physical Training. In addition, visits were paid to a number of lecture demonstrations ; one in particular, held at University College being of special interest in view of the participation of teams from America, Denmark, Germany and Sweden. (b) Demonstrations in modern methods of physical training were again given in a number of schools and in the presence of parents. (c) During the year increased facilities have been made available by the provision of further playing fields and additional apparatus. (d) In the summer months annual athletic meetings were held by all senior and middle schools either on the Cricklefield Playing Field or, where existing, on the playing fields attached to the school concerned. (e) The Supervising Instructor attended a Vacation Course during July and August at Gorleston-on-Sea organised by the Southern Counties Physical Education Association, and approved by the Board of Education. The course proved most interesting and instructive. (f) The Ilford Schools Athletic Association held their annual meeting on the 29th June at the Cricklefield Playing Field. The Association also competed in the Essex County Athletic Meeting held at Dagenham and five of the successful entrants were chosen to represent the County at the National Athletic Championships held at Loughborough on the 22nd July and gained one first place and three third places. (g) Swimming instruction at the Public Baths continued up to the time of evacuation when it became necessary for the Baths to be closed. The Ilford Schools Swimming Association won the Essex County School Championship for the sixth successive year. (h) The Football, Cricket, and Netball Associations experienced a very successful season. (i) Cases of minor postural defects referred by the School Medical Officer continue to receive appropriate attention by way of physical exercises. 10. Provision of Meals.—No meals were provided in 1939 under the Provision of Meals Act, 1906-14, from voluntary sources or otherwise. Circular, 1,437, issued by the Board of Education, dated the 5th September, 1934, provides for the supply of milk to children in school at the price of |d. for one-third of a pint. 82 The Director of Education states that in July 1939, 11,907 children were receiving milk in school. Of this number 562 received it free of charge. During the year 139 children were recommended, on medical grounds, to have milk in school, free if parents were not in a position to pay for it, and 98 previously recommended were reported to the Director of Education for continuance. 10a. Supply of Free Cod-Liver Oil Emulsion, Cod-Liver Oil and Malt, etc.—During 1939, 186 necessitous cases were dealt with. 11. School Baths.—Vide Annual Report for 1938. 12. Co-operation of Parents.—During 1939, 4,872 parents, or 91 per cent., attended the medical inspections. 13 and 14. Co-operation of Teachers and Enquiry Officers.— Vide Annual Report, 1937. 15. Co-operation of Voluntary Bodies.—Since January, 1920, I have acted as Hon. District Correspondent for the National Society for the prevention of Cruelty to Children. (1) Inspector Cutbush has continued to render very valuable services in this district, with excellent results. The following is a resume of the work done by the Society in Ilford during the past year :— Total number of cases investigated, 51, made up as follows:— (1) Of Neglect ... ... ... ... ... ... ... 26 (7 cases were reported from the Public Health Department for neglecting medical advice, and 44 reported from other sources for general neglect.) (2) Ill-treatment cases 7 (3) Other cases 18 101 children (58 boys and 43 girls) were involved, 57 being of school age. In addition to this work, 251 supervision visits were paid to different cases, some of which were made to those reported during the previous year. 83 (2) The Invalid Children's Aid Association, established an Ilford Branch on 1st December, 1933, and still continues to do very valuable work in the district. The Secretary, Miss C. H. H. Burns, informs me that 23 children were sent to residential schools and paid for by the Education Committee in 1939. In addition 41 children were sent to Convalescent Homes or Residential Schools and paid for through voluntary funds. Also 15 children were placed in various Homes, their parents voluntarily paying the full cost or at a reduced rate. 16. Physically and Mentally Defective Children.—A return of all children falling within this category is included in Table III, information having been obtained from the records in this department and from a circular addressed to all the Head Teachers of the various departments of the public elementary schools. All children certified as being " feeble-minded " are reexamined once a year and all physically defective children are examined at least twice a year. (a) Physically Defective Children:— During 1939, 3 cases were referred for medical examination and report by the School Medical Officer, and the following is a detailed summary of the children dealt with under this heading :— Epileptic Children.—Recommended special school for Epileptic Children 1 Deaf Children.—Recommended special school for Deaf Children 1 Crippled Children.—Recommended school for Physically Defective Children 1 3 (b) Mentally Defective Children :— During 1939, 29 children were medically examined and reported upon under the Mental Deficiency (Notification of Children) Regulations, 1928, classified as follows :— Feeble-minded Children.—Total number certified in 1939 and recommended for admission to a special school (day or residential) 19 Imbecile Children.—Total number certified in 1939 and recommended for notification to Essex County Council 4 84 Idiots.—Total number certified in 1939, and recommended for notification to Essex County Council - Dull and Backward Children.—Total number certified in 1939 and recommended attendance at special class for dull and backward children for one year, and then to be reexamined 6 (1) Idiots.—The Authority responsible for dealing with such children is the Essex County Council. There are 7 cases under the age of 16 years known to the department. 4 are in a residential institution and 3 are at home. (2) Imbeciles.—The Authority responsible for dealing with these children is also the Essex County Council. There are 27 cases under the age of 16 years known to the department. 5 are in a residential institution and 22 are at home. (3) Feeble-minded Children.—The Authority responsible for the proper instruction of these children is the Ilford Education Authority. There were (at the end of 1939) 65 such cases under the age of 16 years known to me, of whom 39 are attending public elementary schools in the district (5 being in Dr. Barnardo's Girls' Village Homes, Barkingside) ; 4 attend private schools, 7 are in residential schools, and 15 are not at school (8 being over 14 years of age). (4) Dull and Backward Children.—There are a number of dull and backward children in school in which the backwardness is due to dullness owing to mental retardment and not to their absence from school or of physical disability. There are 30 children who fall into this category attending the public elementary schools. All feeble-minded children and dull and backward children are re-examined once a year and the feeble-minded children are visited at home by the School Nurses at least once a quarter. 17, 18, 19. Nursery, Secondary and Continuation Schools.—Vide Annual Report for 1938. 20. Employment of School Children and Young Persons. —From special inquiries made at the various schools during 1939, it was found that 102 children were employed out of school hours. 68 children were submitted for medical examination in accordance 85 with the Byelaws made under Part II of the Children and Young Persons Act, 1933, with the following result:— Medically fit 61 Medically unfit—certificate not granted 7 The Byelaws made under the Children and Young Persons Act, 1933, came into force on 1st February, 1935. Employment of Children in Entertainments Rules 1933. One certificate has been granted during the year by the School Medical Officer. 21. Examination of Officers, etc.—In accordance with the Education Committee's regulations, the undermentioned teachers and other officers were medically examined and reported upon during the year by the School Medical Officer :— Newly-appointed teachers 8 Teachers—Sickness Regulations 31 Newly appointed School Caretakers 3 School Caretakers—Sickness Regulations 1 Total 43 22. National Health Insurance (Juvenile Contributors and Young Persons) Act, 1937.—No applications for records were received during the year. Table Showing the Principal Causes of Death among Children of School Age (i.e., from 5—15 years,, in England and Wales during 1937, compared with those in Ilford for 1937 and 1938. The Table also gives a Comparative Percentage of Deaths registered at all Ages, from 5—15 years. Disease England and Wales, Percentage of total deaths (all ages) Ilford. Percentage of total deaths (all ages) England and Wales, Percentage of total deaths at ages 5—15 Ilford, Percentage of total deaths at ages 5—15 1937 1938 1937 1938 1937 1938 1937 1938 1. Measles 0.2 Not Available 0.3 0.4 Not Available 4.5 2. Scarlet Fever 0.07 0.1 0.07 1.3 3 4 3. Whooping Cough 0.3 0.2 0.07 0.7 — — 4. Diphtheria 0.6 0.1 0.6 18.0 6.9 18.2 5. Influenza 3.7 3.1 0.6 2.6 6. Tuberculosis 5.6 4.5 5.9 11.4 6.9 13.7 7. Rheumatic Fever 0.2 0.4 0.07 2.9 8. Bronchitis, Pneumonia and other re spiratory diseases 10.3 8.7 8.6 9.2 10.3 9. '.Meningitis and Nervous system 7.8 6.2 6.8 8.1 13.8 9.9 10. Heart Diseases 25.3 25.9 26.7 5.6 6.9 9.1 11. Acute and Chronic Nephritis 3.0 2.4 1.6 3.2 3.4 — 12. Violence 4.5 3.9 4.9 16.6 17.2 13.7 13. Other causes 38.43 44.5 43.79 20.0 31.2 30.9 100.0 100.0 100.0 100.0 100.0 100.0 * Excludes Meningococcal infections. England and Wales.—The deaths of children of School Age during 1937 represent 1.8 per cent, of the Total Deaths registered (all ages). Ilford.—The deaths of children of School Age during 1937 represent 1.6 per cent, of the Total Deaths registered (all ages), and during 19J7 represent 1.9 per cent. 87 Table I.—Return of Medical Inspections. A.—Routine Medical Inspections. Number of Inspections in the prescribed Groups Entrants 1,658 Second Age Group 1,844 Third Age Group 1,288 Total 4,790* Number of other Routine Inspections Nil B.—Other Inspections. Number of Special Inspections and Re-Inspections 10,923 * Includes 562 children attending Home Instruction Classes, but medically examined at elementary schools. Table II. A.—Classification of the Nutrition of Children Inspected during the Year in the Routine Age Groups up to 31st August, 1939. Age Groups No. of Children Inspected A. (Excellent) B. (Normal) C. (Slightly- Subnormal) D. (Bad) No. % No. % No. % No. % Entrants 1,460 220 15.1 1,064 72.9 174 11.9 2 0.1 Second Age-Group 1,594 223 14.0 1,145 71.9 222 13.9 4 0.2 Third Age-Group 1,174 169 14.4 903 76.9 99 8.4 3 9-3 Other Routine Inspections Total 4,228 612 14.5 3,112 73.6 495 11.7 9 0.2 Table III. Blind Children. At Certified Schools for the Blind At Public Elementary Schools At Other Institutions At no School or Institution Total 4† — — 1 5 f Two of these certified by other Local Authorities, taken over by Ilford on parents removal into this area. 88 Deaf Children. At Certified Schools for the Deaf At Public Elementary Schools At Other Institutions At no School or Institution Total 13*†‡ — 1§ — 14 * One over 14 years of age. †Three certified by other Local Authorities, taken over by Ilford on parents removal into area. ‡| Two of these are also Mentally Defective. § Is over 14 years of age. Also Mentally Defective, and in a Residential School for such children. Table IIIa. (Form 307 M.) Statement of the Number of Children Notified During the Year Ended 31st December, 1939, by the Local Education Authority to the Local Mental Deficiency Authority. Total Number of Children Notified 5 Analysis of the Above Total. Diagnosis Boys Girls (1) i. Children incapable of receiving benefit or further benefit from instruction in a Special School : (a) Idiots - (b) Imbeciles 2 1 (c) Others - ii. Children unable to be instructed in a Special School without detriment to the interests of other children : (a) Moral defectives - (6) Others (2) Feeble-minded children notified on leaving a Special School on or before attaining the age of 16 2 - (3) Feeble-minded children notified under Article 3, i.e., " Special Circumstances " cases - - Note. No child should be notified under Article 3 until the Board have issued a formal certificate (Form 308m) to the Authority. (4) Children who in addition to being mentally defective, were blind or deaf - - Note. No blind or deaf child should be notified without reference to the Board—see Article 2, proviso (ii). Grand Total 4 1 89 Table IV.—Return of Defects Treated during the Year ended 31st December, 1939. TREATMENT TABLE. Group I,—Minor Ailments (excluding Uncleanliness, for which see Group VI). Number of Defects treated or under treatment during the year Disease or Defect. Under the Authority's Scheme Otherwise Total (i) (2) (3) (4) Skin :— Ringworm—Scalp (i) X-Ray Treatment — 1 1 (ii) Other — — — Ringworm—Body 5 — 5 Scabies 22 2 24 Impetigo 75 5 80 Other skin diseases 298 43 341 Minor Eye Defects 123 21 144 (External and other, but excluding cases falling in Group II.) Minor Ear Defects 139* 16 155 Miscellaneous 1,047 243 1,290 (e.g., minor injuries, bruises, sores, chilblains, etc.) Total 1,709 331 2,040 * These are figures of children seen at the Inspection Clinics, the details of the children seen at the Aural Clinics are embodied in this report on page 81. 90 Table IV.—Continued. Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments—Group I). No. of Defects dealt with Defect or Disease Under the Authority's Scheme Otherwise Total (1) (2) (3) (4) Errors of Refraction (including squint) 1,004 58 1,062 (Operations for squint should be recorded separately in the body of the School Medical Officer's Report.) Other Defect or Disease of the Eyes (excluding those recorded in Group I) 15 11 26 Total 1,019 69 1,088 No. of Children for whom spectacles were (a) Prescribed ... ... ... .... 825 58 883 (6) Obtained 798 67 865 Group III.—Treatment of Defects of Nose and Throat. Number of Defects Received Operative Treatment Received other forms of Treatment Total Number treated Under the Authority's Scheme, in Clinic or Hospital By Private Practitioner or Hospital, apart from the Authority's Scheme Total (1) (2) (3) (4) (5) (i) (") (iii) (iv) (i) (ii) (iii) (iv) (i) (ii) (iii) (iv) 6 159 1 1 71 10 5 1 59 5 6 2 130 15 (i) Tonsils only. (ii) Adenoids only. (iii) Tonsils and adenoids, (iv) Other defects of the nose and throat. 91 Table IV.—Continued. Group I V.—Orthopaedic and Postural Defects. Under th e Authority's Scheme (H) Otherwise (2) Residential treatment with education Residential treatment without education Nonresidential treatment at an orthopaedic clinic Residential treatment with education Residential treatment without education Nonresidential treatment at an orthopaedic Total number treated (i) (ii) (iii) (i) (ii) (iii) No. of children treated 12 — 500 — — 25 525 Group V.—Dental Inspection and Treatment. (I) Number of Children inspected by the Dentists :— (a) Routine Age Groups— Age 5 6 7 8 9 10 11 12 13 14 Total Number 1,595 1,872 1,905 2,154 2,325 2,484 1,804 1541 1517 579 17,776 (b) Specials 231 (c) Total (Routine and Specials) 18,007 (2) Number found to require treatment 10,491 (3) Number actually treated 4,239 (4) Attendances made by children for treatment 7,683 (5) Half-days devoted to Inspection 156 Total 1,067 Treatment 911 (6) Fillings Permanent Teeth 3,430 Total 6,053 Temporary Teeth 2,623 (7) Extractions Permanent Teeth 758 Total 6,882 Temporary Teeth 6,124 (8) Administrations of general anaesthetics for extractions 1,847 (9) Other operations Permanent Teeth 1,755" Total 2,439 Temporary Teeth 684 Group VI.—Uncleanliness and Verminous Conditions. (i) Average number of visits per school made during the year by the School Nurses 6 (ii) Total number of examinations of children in the Schools by School Nurses 34,151 (iii) Number of individual children found unclean 515* (iv) Number of children cleansed under the arrangements made by the Local Education Authority Nil (v) Number of cases in which legal proceedings were taken :— (a) Under the Education Act, 1921 Nil (b) Under School Attendance Bye-laws Nil * In addition 75 children were found unclean at medical inspection and 130 in the School Clinic. 92 93 Table VI. A.—Table Showing the Average Heights and Weights of the BOYS Examined. School Age Groups Age Groups 5—6 Years 6—7 Years 7—8 Years 8—9 Years 9—10 Years 10—11 Years 11—12 Years 12—13 Years 13—14 Years Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight . (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Barkingside 26 111 19.3 5 116 20.3 — — — — — — — — — — — — — — — — — — — — — Beal Modern — — — — — — — — — — — — — — — — — — — — — — — — — — — Becontree 57 108 18.6 7 114 20.6 11 118 23.6 77 126 25.5 13 126 24.9 10 134 31.6 7 140 33.6 77 143 37.0 6 154 43.5 Benton (Open Air) 1 105 16.8 6 117 19.9 9 121 22.5 11 127 26.2 5 129 24.2 13 134 28.0 11 143 35.2 10 144 37.1 5 147 35.9 Chad well 57 111 19.6 7 119 22.2 11 120 24.2 28 127 26.4 5 129 28.3 5 138 29.9 1 145 40.2 — — — — — — Christchurch 38 110 19.7 10 115 22.4 1 120 23.0 35 127 27.1 1 128 23.8 4, 137 35.2 2 133 32.2 — — — — — — Cleveland 27 107 18.5 8 121 21.8 2 121 22.9 57 127 26.6 12 131 27.9 10 135 30.1 3 137 32.6 — — — — — — Dane Central — — — — — — — — — — — — — — — — — — 2 141 31.9 54 146 37.6 5 153 42.3 Downshall 50 109 19.7 12 114 20.4 8 116 21.8 70 127 25.6 10 134 29.9 9, 133 31.1 6 140 34.9 67 145 36.8 8 154 44.7 Fairlop 90 110 19.3 12 118 22.0 13 121 22.7 117 127 26.3 9 132 29.1 8 136 31.7 4 139 31.4 64 145 36.9 8 152 41.5 Gearies 73 113 20.7 13 118 22.6 8 123 25.3 98 127 26.7 6 130 29.5 7 133 29.0 12 143 38.2 31 146 39.4 11 150 42.2 Goodmayes 21 109 19.1 5 116 20.6 2 118 25.0 38 128 26.1 3 140 31.4 3 133 28.2 — — — — — — — — — Gordon 19 109 17.7 5 114 19.1 2 117 23.2 12 126 24.6 — — — — — — — — — — — — — — — Highlands 27 110 19.3 4 117 20.6 4 121 22.3 30 127 26.7 7 133 32.9 3 134 29.3 3 140 33.5 — — — — — — Loxford Central — — — — — — — — — — — — — — — — — — 8 141 35.1 105 145 37.1 9 149 40.5 Mayfield Central - - - - - - - - - - - - - - - - - - 8 141 35.6 64 147 38.5 9 148 39.5 Mossford 5 107 19.6 - — — — — — — — — — — — - — — — — — — — — — — — Newbury Park 11 113 20.5 2 115 20.6 1 125 28.2 22 128 26.3 1 127 25.2 l| 123 22.4 — — — 23 146 37.6 1 153 38.0 St. Augustines - - - - - — — — — — — — — — — - — — — — — — — — — — — S.S. Peter & Paul 13 110 19.4 6 116 21.4 3 124 24.7 21 128 26.5 1 126 22.2 3 136 30.8 4 140 32.8 15 144 36.4 7 149 39.4 South Park 41 112 19.9 5 115 20.3 1 117 20.7 34 128 26.5 5 134 28.7 1 143 33.0 — — — - — — — — — St. Vincent's 6 111 19.3 6 121 24.4 — — — 6 124 25.6 — — — 1 138 31.5 1 144 34.0 10 146 37.2 — — — The Mount Central - - - - - - - - - - - - - - - - - - - - - - - - - - - The Redbridge 20 110 19.6 5 116 20.2 4 124 23.5 28 129 27.3 — — — 1 134 30.1 - - - - - - - - - The Wm. Torbitt 13 112 19.6 — — — — — — 20 128 26.5 2 130 28.1 1 - - - - - - - - - - - Uphall 23 113 19.2 4 117 21.0 2 123 24.7 18 128 26.6 - - - - - - - - - - - - - - - Woodlands 16 110 18.4 6 115 22.3 5 118 21.7 17 126 25.6 - - - - - - - - - - - - - - - Average Heights and Weights of Ilford Children 634 110 19.4 128 116 21.4 87 120 23.3 739 127 26.3 80 131 28.2 80 134 30.2 72 141 35.0 520 145 37.8 69 151 41.1 Ages Ages Anthropometric Standard (Boys) 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 11 Years 12 Years 13 Years Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) 103 17.5 108 19.1 114 21.0 120 23.5 124 25.3 129 27.3 134 30.1 139 32.9 142 35.1 94 95 Table VI. B.—Table showing the Average Heights and Weights of the GIRLS Examined. School Age Groups Age Groups 5—6 Years 6—7 Years 7—8 Years 8—9 Years 9—10 Years 10—11 Years 11—12 Years 12—13 Years 13—14 Years Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) | Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Barkingside 22 110 18.6 2 119 25.5 — — — 2 121 23.2 - - - - - - - - - - - - - - - Beal Modern — — — — — — — — — — — — - — — — — - — — — — — — — — — Becontree 45 108 17.9 15 116 21.4 14 119 22.3 64 125 24.5 6 136 30.3 12 133 28.4 6 139 31.5 43 144 35.3 12 151 41.3 Benton (Open Air) 2 110 16.5 4 113 19.1 11 118 21.6 9 124 23.2 10 132 26.5 6 130 27 6 7 143 33.7 4 148 38,1 2 147 40 1 Chadwell 51 108 18.4 16 116 20.9 6 121 23.5 30 126 25.1 4 131 27.0 6 132 29.3 1 141 33.4 — - — — — - Christchurch 18 108 18.3 8 113 19.9 — — — 37 125 25.0 3 128 25.9 2 135 28.4 1 144 33.4 — - — — — - Cleveland 29 109 19.3 4 113 20.6 7 118 21.9 26 123 25.2 3 133 27.7 - 134 28.9 — — — — - — — — — Dane Central - - - - - - - - - - - - - - - - - - - - - 55 146 36.1 6 150 40.1 Downshall 57 109 19.0 16 113 19.8 11 122 23.1 67 126 25.2 9 134 30.8 3 139 32.1 7 141 31.5 79 150 39.6 8 156 44.4 Fairlop 71 109 18.7 7 111 20.3 13 120 23.3 108 126 25.3 7 134 30.7 11 137 31.3 20 145 38.1 61 148 39.3 10 159 45.2 Gearies 72 111 19.4 7 117 22.5 8 118 22.9 68 126 25.8 10 128 27.6 5 138 36.2 9 144 35.1 52 146 38.8 4 155 48.2 Goodmayes 17 109 17.9 3 115 21.1 5 119 22.7 28 125 24.2 2 132 30.3 3 138 34.3 — - - — — — — — — Gordon 14 111 19.1 2 113 19.5 1 121 25.8 15 126 24.3 - - - - - - - - - - - - - - - Highlands 36 111 16.6 6 116 21.5 1 122 25.8 22 127 25.5 5 127 25.4 3 136 28.5 4 139 30.2 - - - - - - Loxford Central - - - - - - - - - - - - - - - - - - - - - - - - - - - Mayfield Central - - - - - - - - - - - - - - - - - - 1 141 30.0 78 147 37.4 6 156 50.2 Mossford 10 107 20.7 11 111 19.7 7 115 23.2 28 121 23 9 12 126 27.1 8 129 28.6 16 136 32.8 43 143 37.2 26 146 42.0 Newbury Park 17 111 18.5 2 114 20.3 - - — 16 128 25.6 2 129 28.9 - - — 1 142 36.4 16 146 36.0 2 150 44 4 St. Augustines - - - - - - - - - - - - - - - - - - - - - - - - - - - S.S. Peter & Paul 18 112 20.4 5 113 20.1 1 113 20.7 11 126 23.9 5 132 27.9 2 136 29.6 2 135 31.0 26 147 38.2 7 155 44.9 South Park 23 110 18.5 2 117 22.2 3 128 27.0 32 127 25.6 4 132 28.4 2 143 30.3 — — — — — — — — — S. Vincents 10 107 17.5 3 112 19.4 7 123 26.0 8 124 24.3 1 137 29.6 1 141 37.2 1 158 41.0 15 146 38.3 2 150 39.5 The Mount Central - - - - - - - - - - - - - - - - - - 9 146 36.9 95 148 39.4 21 151 39.7 The Redbridge 29 112 19.5 2 117 21.5 — — — 25 129 26.3 — — — 1 131 24 3 — — — — — — — — — The Wm. Torbitt 9 112 20.2 1 116 20.4 — — — 15 126 25.3 3 136 34.7 - - - - - - - - - - - - Uphall 19 109 18.5 4 118 22.8 2 127 28.3 11 130 28.4 1 133 26.3 - - - - - - - - - - - - Woodlands 19 110 18.5 1 117 19.6 3 122 24.4 17 125 24.7 - - - - - - - - - - - - - - - Average Heights and Weights of Ilford Children 588 110 18.7 121 114 20.7 100 120 23.2 634 126 25.1 87 131 28.3 67 134 30.1 85 142 34.8 567 147 37.7 106 151 42.7 Anthropometric Standard (Girls) Ages Ages 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 11 Years 12 Years 13 Years Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Klgms.) Height (in Cms.) Weight (in Kigms.) 102 17.1 108 18.7 113 20.3 119 22.4 123 24.5 128 26.6 134 29.7 140 33.5 144 36.4 96 Table VII.—Summary of Cases of Infectious Diseases among School Children, and of Contacts of such Cases, excluded from School Attendance during the Year ended the 31st December, 1939. SCHOOLS No. on Roll DISEASES AND CONTACTS Scarlet Fever Diphtheria Measles & German Measles Chickenpox Whooping Cough Mumps Pneumonia Totals, 1939 Totals, 1938 Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Cases Contacts Cases Contacts Barkingside 201 2 1 3 2 - - 17 7 29 9 9 - 1 61 19 103 9 Beal Modern 637 4 7 1 1 - 2 — — — — 1 - 1 7 10 15 16 Becontree 1,739 18 35 5 7 12 7 20 8 16 3 16 - 1 88 60 177 81 Benton (Open Air) 112 2 — — — — — — 1 — — 2 - - 4 1 20 3 Chadwell 798 6 3 1 — 6 3 3 1 3 — 6 - - 25 7 187 23 Christchurch 738 6 5 3 2 — — 1 — 36 4 7 - - 53 11 265 30 Cleveland 1,320 18 30 4 5 3 1 3 3 10 1 4 - - 42 40 139 55 Dane 453 2 — 2 1 1 — — — 1 — — - - 6 1 15 9 Downshall 1,363 15 11 5 9 — 3 — — 34 11 7 - 2 63 34 273 63 Fairlop 1,622 15 16 3 6 — — 35 13 48 10 8 - — 109 45 258 73 Gearies 1,456 5 5 — 1 4 — 6 1 47 7 5 - 1 68 14 444 84 Goodmayes 684 7 13 3 1 1 — 46 9 26 4 4 - — 87 27 174 39 Gordon 236 4 1 — 1 1 — — 1 7 1 — - — 12 4 86 9 Highlands 667 1 2 5 5 1 — 4 — 45 2 1 - 1 58 9 198 46 Loxford Central 442 5 10 1 1 — — 1 1 — - 3 - 1 11 12 7 13 Mayfield Central 694 2 7 2 2 — — 2 — 2 — 2 - — 10 9 8 17 Newbury Park 649 5 6 2 2 — — 2 2 28 8 — - 2 39 18 116 23 Parkhill 624 3 2 2 1 — — 1 - - - - - — 6 3 - - St. Augustine's 114 1 — — — — — — — 7 1 1 - — 9 1 — 1 SS. Peter and Paul's 532 14 11 5 11 — — — — 3 1 21 - — 43 23 103 52 S. Vincent 369 1 — 1 — — — 10 12 6 2 15 - — 33 14 68 14 South Park 955 13 8 3 — 3 — 3 2 27 1 40 - 1 90 11 155 35 The Mount Central 433 1 4 1 - - 1 - - - - 1 - - 3 5 17 9 The Redbridge 572 6 2 1 1 1 1 1 — 1 — 1 - — 11 4 144 36 The William Torbitt 651 6 9 — — — — 1 — 8 — 1 - 1 17 9 179 33 Uphall 240 8 4 — 1 4 1 5 — 7 — 1 - — 25 6 53 17 Woodlands 311 7 5 1 1 1 — 13 6 26 6 4 - — 52 18 98 20 *Mossford (G. V. H.) 684 23 — 2 - - - - - - - - - 25 — 7 I *County High — 9 15 — — 4 1 1 1 — — 2 - — 16 17 7 6 *Private — 8 28 — — — — 2 — 2 — — - — 12 28 11 8 Totals 19,296 217 240 56 61 42 20 177 68 419 71 162 - 12 1,085 460 3,327 825 Erysipelas: 1 case at Goodmayes. Dysentery: 1 case at William Torbitt. *Notification of minor infectious diseases in these schools are not received. south essex recorders ltd., high road, ilford.