i To LIBRARY ILF 16 Durhrichs Borough of Ilford Health Report FOR THE YEAR 1941 A. H. G. BURTON M D., B.S.. M.R.C.P., D.P.M., D.P.H,, Barrlster-at-Law, Medical Officer of Health, etc. 1941 Ilford Borough Council NOVEMBER, 1940—NOVEMBER, 1941 Alderman Claude Augustus Farman, J.P., Mayor. Alderman Frederick Hopper Dane, J.P., C.A. (E.C.C.), Deputy Mayor. Aldermen: Billington, Henry. Clark, Charles William, L.R.A.M. Dane, Frederick Hopper, M.B.E., J.P., C.A. (E.C.C.), Deputy Mayor. Farman, Claude Augustus, J.P., Mayor. Griogs, Albert Philip, J.P., E.C.C. Pitt, Bertram Sidney Joiin.J.P. Smith, Frank Douglas, J.P., C.A. (E.C.C.). Wetton, George John, E.C.C. Young, Alexander, Major, T.D., J.P. Councillors: Barker, John. Braithwaite, Thomas, J.P. Bramston, John. Bryan, William Allen Vernon Chester, Herbert (From October, 1941). Collischon, Sidney Walter. Colvin, Gilbert, F.C.I.S. Cooper, Albert Edward. Cropper, Cyril Clifford. Daniels, Russell Stearn. Eke, William Benjamin. Elborne, John, M.A. Fallaize, Mrs. Lilian. Green, Arthur William, J.P., C.A. (E.C.C.). Gregory, William Sydney. Harding, Alfred Daniel Bartlett. Harding, Mrs. Beatrice Alice Louise Anne. Heath, William Henby Charles. (Resigned September, 1941). Hess, Philip Jack (From March, 1941). Hinton, Charles Stanley (From May, 1941). Holness, Richard Thomas. Ingham, Edgar Frank. Parfitt, William Arnold. Spiller, Leslie Thomas. Taylor, Sidney William. Tyler, George Frederick, F.C.I.I. Wainwright, Herbert William (Resigned April, 1941). Westhrop, George William Henry. Williams, Thomas Edward (Resigned February, 1941). Woods, Sidney Charles Victor. WAR EMERGENCY (EXECUTIVE) COMMITTEE NOVEMBER, 1940—NOVEMBER, 1941 Alderman F. H. Dane, M.B.E., J.P., C.A. (E.C.C.), Deputy Mayor. Alderman C. A. Farman, J.P., Mayor. Councillor G. F. Tyler, F.C.I.I. EDUCATION COMMITTEE NOVEMBER, 1940 - NOVEMBER, 1941 Councillor T. Braithwaite, J.P., Chairman. Councillor A. W. Green, J.P., C.A. (E.C.C.), Vice-Chairman. Alderman H. Billinoton Alderman F. H. Dane, M.B.E., J.P. C.A. (E.C.C.), Deputy Mayor. Alderman C.A. Farman , J .P., Mayor Alderman B.S.J. Pitt, J.P. Alderman Major A. Young, T.D., J.P. Councillor J. Barker (From February, 1941) Councillor S. W. Coilischon. Councillor G. Colvin, F.C.I.S. Councillor A. E. Cooper. Councillor R. S. Daniels. Councillor W. B. Eke. Councillor J. Elborne, M.A. (Resigned February, 1941) Councillor W. S. Gregory. Councillor Mrs. B. A. L. A. Harding Councillor W. H. C. Heath (Resigned September, 1941). Councillor W. A. Parfitt. Councillor L. T. Spiller. Councillor G. F. Tyler, F.C.I.I. Councillor G. W. H. Westhrop. Councillor S. C. V. Woods. *Mr. P. V. Faning. *Mr. S. P. Lonergan. *Miss H. S. Rich. *Mr. C. J. Ridout. *Mr. W. R. Spencer. *Mr. J. J. Taylor, J.P. *Mr. F. R. Masters. * Co-opted Members. OFFICERS OF THE PUBLIC HEALTH SERVICES 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.) M.R.C.P. (Lond.) (In H.M. Forces). A. Simpson, M.B., Ch.B., D.P.H. (Aberdeen). 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): K. R. Barker, M.R.C.S., L.R.C.P. Senior Dental Surgeon: M. J. K. Soutter, L.D.S., R.C.S. (Eng.). Assistant Dental Surgeons: A. G. Clark, L.D.S., R.C.S. (Eng.) (In H.M. Forces). Mrs. G. M. Shalders, 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. Haiqh, Mem. Roy. San. Inst. Deputy Senior Sanitary Inspector: S. R. Daly, Mem. Roy. San. Inst., D.P.A. (Lond.). Sanitary Inspectors: S. G. Rackham. G. W. Newman. P. W. English. R. E. Smalley. A. C. R. Neale. J. E. Jones. Chief Administrative Clerk: F. J. Hocking. Superintendent of Council's Midwives: Miss C. Blockley. Officers of the Public Health Services—continued Health Visitors and School Nurses: Miss A. Batten. Miss K. B. Mathieson. Miss 0. Bell. Miss I. L. Mobbs. Miss A. L. Drinkwater. Mrs. M. D. Smith. Miss M. Graham. Miss D. M. Whitmarsh. Ante-Natal Clinic Nurse: Mrs. D. W. Quick. Part Time:— Consulting Obstetrician (Maternity Home and Puerperal Pyrexia Regulations): R. L. Dodds, M.Ch., F.R.C.S., F.R.C.O.G. Consulting Anaesthetist: Frankis T. Evans, M.B., B.S., D.A. Surgeon in charge of Orthopaedic Clinic: A. T. Fripp, F.R.C.S. Oculist: H. D. Smart, M.D., B.S. Surgeon in charge of Aural Clinic: C. Keogh, F.R.C.S. Physician in charge of Rheumatism Clinic: K. Playfair, M.A., M.B., M.R.C.P. Temporary Medical Officer for A.R.P. Casualty Services: R. M. Noordin, M.R.C.S., L.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: Mrs. C. I. V. Curry, C.S.M.M.G. (M.). PREFACE Public Health Offices, Ilford. August, 1942. His Worship the Mayor, Aldermen and Councillors of the Borough of Ilford. Mr. Mayor, Ladies and Gentlemen, 1 herewith submit the Annual Report required by the Ministry of Health and Board of Education. The vital statistics for the year 1941 show that the general death rate, the infant mortality rate and the maternal mortality rate have all risen. The following shows a comparison of the general death rate for the past 3 years, other comparative figures will be found in Table 1A:— 1939 1940 1941 England and Wales 12.1 14.3 12.9 London 11.9 17.8 16.3 Ilford 8.5 10.3 11.5 The maternal mortality rate which in Ilford was 1.7 in 1939, rose to 3 in 1940, and to 4.12 in 1941. The infant mortality rate which was 33.9 in 1939, 32.8 in 1940, rose to 40.9 in 1941. In 1941 there were 266 new notifications of Pulmonary Tuberculosis compared with 177 in 1940. Although the number of cases of Diphtheria occurring in the district was very small, only 40 cases being notified during the year compared with 92 during 1940, yet 3 of the cases died, making the highest death rate for Diphtheria for the past 5 years. The immunisation of children against Diphtheria, which was first introduced in Ilford in 1929, continued, and 2,675 children were inoculated in 1941, compared with 692 in 1940, at the various Clinics. In addition 243 were inoculated by medical practitioners, compared with 37 in the previous year. The School Medical Service has had to deal with a considerably increased incidence of verminous conditions, such as Scabies and head lice, which are common in war time. The provision of milk and meals in School has kept the nutrition of school children at a satisfactory level. I am hoping that the Open Air School will shortly be re-opened to deal with the delicate children which in previous years have benefited so much by their attendance there. Although some of the above figures are of a depressing character, when compared with 1916 (the third year of the last Great War) with about half the population of that in 1941 they take on a more favourable character. In 1916, 89 infants died before completing the first year of life compared with 67 in 1941; 9 persons died from Diphtheria compared with 3 in 1941; 64 persons died from Pulmonary Tuberculosis in 1916, compared with 70 in 1941. There were 2 deaths from Enteric Fever in 1916; there were none in 1941. The figures which I have quoted show the importance of no relaxation in public health work in war time conditions. Unfortunately the nursing difficulties mentioned in the preface to my last report have not yet been dealt with, and the Committee appointed by the Ministry of Health have still to make their recommendations. I continued as Milk Officer for Ilford until 24th January, 1942, when Mr. Cadman, who carried out the scheme under my direction, was appointed as Milk Officer. The amount of work involved by myself and the staff, which entailed the scrutinising and signing about 90,000 times during the year, is shown by the following figures:— Approximately No. of Permits at 2d. 26,930 ,, ,, Free of all cost 3,015 ,, ,, National Dried Milk at Is. 2d. 515 ,, ,, National Dried Milk Free of all cost 279 6 Amount of the milk retailers claims authorised £25,219 14s. lOd. I have again to thank the members of my staff, including those in the A.R.P. Casualty Services, for their continued good work carried on under very difficult conditions. I have also to thank the members of the Council for their continued support, especially Councillor Tyler and Alderman Smith for their assistance in general Public Health and Isolation Hospital matters, Councillors Mrs. Harding and Mr. Eke in the Maternity and Child Welfare and Maternity Home Services, Councillors Braithwaite and Green in School Medical Services, and the members of the War Emergency (Executive) Committee who have had to deal with the A.R.P. Casualty Services as well as other details in the working of the department, and I have the honour to be, Your obedient Servant, A. H. G. BURTON, Medical Officer of Health. 7 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in Acres) f Land 8,402 "1 -I Inland Water 26 !- Tidal Water 7 J 8,435- Number of inhabited houses (end of 1941) according to Rate Books 44,000 (approx.) Rateable Value—October 1st, 1941 (Houses and Land) £1,565,376 Sum represented by a penny rate, October 1st, 1941 £5,914 Education Rate— 1940-41 1941-42 Elementary 2s.5.17d. 2s.4.39d. in the £ in the £ Higher (County) 0s. 10.42d. 0s.ll.41d. in the £ in the £ ,, (Ilford Council) 0s. .06d. 0s.0.07d. in the £ in the £ Combined Rate (all services) 13s. lid. 13s. lid. in the £ in the £ The following figures as to unemployment were supplied by the Ministry of Labour:— (o) Number of unemployed males at end of 1940 *679 ,, 1941 315 (6) Number of unemployed females at end of 1940 1,220 ,, 1941 306 (* These figures include approximately 10% non-residents). Total M. F. 1941 1940 Birth Rate per 1,000 Live Births Legitimate 1.756 901 855 of the 13.3 13.9 Illegitimate 60 36 24 estimated resident population Rate per 1,000 Still Births 67 32 35 total (live 35.6 37.5 and still) births Death Rate per 1,000 Deaths 1,627 850 777 of the 11.9 10.6 estimated resident population Percentage of total deaths occurring in public institutions. 61.7 38.7 Deaths from puerperal causes (Headings 29 and 30 of the Registrar-General's Short List):— Rate per 1,000 Deaths. total (live and still) births 1941 1940 1941 1940 No. 29, Puerperal sepsis 1 3 0.59 1.50 No. 30, Other puerperal causes 6 3 3.53 1.50 Total 7 6 4.12 3.00 8 Death-rate of Infants under one vear of age:— 1941 1940 All infants per 1,000 live births 40.9 32.8 Legitimate infants per 1,000 legitimate live births 38.5 32.0 Illegitimate infants per 1,000 illegitimate live births 105.3 62.5 Deaths from Cancer (all ages) 271 206 ,, Measles (all ages) 4 — ,, Whooping Cough (all ages) 9 — ,, Diarrhoea (under 2 years of age) 5 3 1. Rainfall . Total rainfall registered in the district during the year was 24.18 inches, the greatest fall in 24 hours was registered on 6th December, being .87 inches. Rain fell on 138 days. 2. Population. The number of patients and resident staff on the 30th June, 1941, at the following public institutions, was:— Claybury Mental Hospital and Emergency Hospital 2,661 West Ham Mental Hospital and Emergency Hospital 1,528 Australasian Hospital (Girls' Village Homes) 76 Total 4,265 3. Births.—The number of births registered during the year was 1,816 Males Females Legitimate 901 855 Illegitimate 36 24 i.e., 3.29 per cent, of the births registered were illegitimate. The birth-rate, calculated on the net estimate of the population is 13.3 per 1,000. 4. Deaths.—The total number of deaths of Ilford residents was 1,627 This is obtained by taking the total deaths registered in the district (1,874), subtracting the deaths of non-residents occuring in the district (754), and adding the deaths of Ilford residents registered as having died in other districts (507). The death-rate, calculated on the net estimate of the population is 11.9 per 1,000. Inquests.—During the year, 64 inquests were held in the district, 32 on Ilford residents, and 32 on non-residents. The ages at death were as follows:— Under 1-2 2-5 5-15 15-25 25-45 45-65 65 years and 1 year years years years years years years upwards 2 1 2 4 3 16 20 16 Death-Rates from Tuberculosis and Cancer. 1941. The following Table shows the death-rates for 1941 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 .511 .601 Other Tuberculosis .124 .127 Cancer 1.980 1.775 9 5.—Public Assistance Relief.—The total amount expended in Ilford during the year was £20,976 16s. 2d. The average weekly number of cases in receipt of relief was 681, including dependants. The number of admissions to Oldchurch Hospital from Ilford during the year was 655, made up as follows:— Men 207 Women 380 Children 68 In addition there were 260 admissions of patients from Ilford to other County Institutions, owing to no accommodation being available at Oldchurch Hospital; their allocation was as follows:— Men 113 Women 144 Children 3 The number of destitute persons admitted to the Institution during 1941 was 3, made up as follows:— Women 2 Children 1 6. Marriages.—1,754 marriages took place in the Ilford district during 1941, both parties or one of the contracting parties being Ilford residents. 7. Tables of Vital Statistics.—Table I gives a comparative statement of the birth-rate and death-rate for the past five years. Table Ia gives a comparison of the vital statistics of Ilford with England and Wales, London and other towns. Table H gives a classified statement of the causes of death in 1941, arranged according to the age groups at which deaths occurred. 10 TABLE I.—Vital Statistics of Whole District During 1941 and Previous Years. Year Births Total Deaths Registered in the District Transferable Deaths Net Deaths Belonging to the District Uncorrected Number Net of Non-Residents registered in the District of Residents not registered in the District Under 1 Year of Ape At all Ages Number Rate Number Rate Number Rate ^er 1,000 Net Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 1937 1,872 2,263 14.2 1,255 7.7 338 540 95 42.0 1,457 9.2 1938 1,847 2,280 14.0 1,134 6.8 278 498 84 36.7 1,354 8.3 1939 1,669 2,307 13.9 1,288 7.9 386 548 75 33.9 1,450 9.2 1940 1,558 2,024 13.9 1,538 10.3 481 484 63 32.8 1,541 10.6 1941 1,164 1,816 13.3 1,874 13.3 754 507 67 40.9 1,627 11.9 11 TABLE 1A Table showing comparison between the Birth-rate, Death-rate, etc., of Ilford, other Towns, and of England and Wales for the Year 1941 (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 Still- births England and Wales 14.2 0.51 12.9 0.00 — 0.03 0.00 0.06 0.07 0.19 5.1 59 126 County Boroughs and Great Towns, including London 14.7 0.58 14.9 0.00 _ 0.03 0.00 0.07 0.06 0.17 7.5 71 148 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census, 1931).. 16.4 0.60 13.0 0.00 - 0.03 0.01 0.06 0.06 0.20 4.6 56 London Administrative Co. 8.9 0.33 16.3 0.01 - 0.02 0.00 0.04 0.03 0.15 6.8 68 ILFORD 12.8 0 47 11 5 — - 0.03 — 0 06 0 02 0.17 2.7 40. 9 12 Registrar-General's Short List of Deaths and Causes:— TABLE II Causes op, and Ages at, Death during the Year 1941 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 1627 67 13 13 30 49 78 129 185 283 373 407 1 Typhoid and paratyphoid fevers 2 Cerebro-spinal fever 2 - — - - 1 - - - 1 - 3 4 Whooping cough 9 7 1 1 - - - - - - - - 5 Diphtheria 3 — — 1 1 1 6 Tuberculosis of respiratory system 70 - - - - 10 12 13 15 13 7 - 7 Other forms of tuberculosis 17 1 2 1 2 3 - 1 2 2 3 - 8 Syphilitic disease 12 — — — — 1 1 1 3 4 2 9 Influenza 24 — 1 — — 1 3 4 4 7 4 10 Measles 4 - 2 1 1 - - - - - - - 11 Acute Poliomyelitis and polioencephalitis - - - - - - - - - - - - 12 Acute infectious encephalitis 1 - - - - - - - - 1 - - 13 Cancer of buccal cavity and oesophagus (males only) 12 - - - - - - - 3 2 5 2 Cancer of uterus (females only) 10 - - - - - - 1 1 5 2 1 14 Cancer of stomach and duodenum 47 - - - - - 1 2 5 13 20 6 15 Cancer of breast 28 - - - - - 3 4 7 7 6 1 16 Cancer of all other sites 174 - — - 2 1 5 8 31 43 48 36 17 Diabetes 13 - — — 1 - - 1 1 5 1 4 18 Intra-cranial vascular lesions 141 - - - - - 1 6 14 40 38 42 19 Heart disease 338 — — — — 1 5 10 30 57 105 130 20 Other diseases of the circulalatory system 57 - - - - 1 2 - 4 10 19 21 21 Bronchitis 78 4 1 — — — — 4 5 7 19 38 22 Pneumonia 64 12 2 4 1 2 1 3 6 4 14 15 23 Other respiratory diseases 25 — 1 — — - 2 4 5 3 6 4 24 Ulceration of the stomach or duodenum 17 - - - - - - 1 6 5 4 1 25 Diarrhoea (under 2 years of age) 5 5 - - - - - - - - - - 26 Appendicitis 7 — — — — — — 3 1 2 1 27 Other digestive diseases 40 — — 1 1 1 1 4 3 9 7 13 28 Nephritis 45 — — — 1 5 3 2 4 9 10 11 29 Puerperal and post-abortive sepsis 1 - - - - - 1 - - - - - 30 Other maternal causes 6 — — — — 1 4 1 - - - - 31 Premature birth 19 19 32 Congenital malformations, birth injury, infantile disease . . 17 14 - 1 - - - 1 - 1 - - 33 Suicide 14 - - - - - 1 2 2 5 4 - 34 Road traffic accidents 17 — 1 — 3 1 3 - 3 3 - 3 35 Other violent causes 175 2 2 3 15 16 24 46 23 18 18 8 36 All other causes 135 3 — — 2 5 7 8 9 13 24 64 Special Causes (included in No. 36 above):— smallpox - - - - - - - - - - - - 13 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Nursing in the Home.—There is a voluntary District Nursing Committee, 10,927 visits being paid by the nurses in 1941, compared with 9,573 in 1940. Laboratory Facilities.—During the year 590 specimens were examined in the Bacteriological Laboratory. In addition 7 diphtheritic specimens were sent to other Laboratories for a test for virulence. Essex County Council Act, 1933. Establishments for Massage and Special Treatment. Inspections of licensed establishments are carried out quarterly. During 1941, 14 applications for renewal of licences and 2 applications for licences were received. The Council renewed the licences in respect of the 14 establishments and granted new licences in respect of 2 establishments. All the licences expire on 31st March, 1942. Change of address was sanctioned in respect of one licenced establishment. It was necessary to communicate with 1 licencee in reference to the keeping of records. Hairdressers' and Barbers' Premises. During 1941, 102 visits of inspection were made to these premises. Manufacture of Ice Cream. 2 applications for registration in respect of 2 premises were considered during the year. The applications were in respect of purveyors retailing multiple firms' productions, and registration was granted in both cases. Ilford Corporation Act, 1937. (а) Section 77 of this Act provides for the registration of hawkers of meat, fish, fruit and vegetables, and their storage premises. Registration was granted to 3 persons (concerning 3 premises). (б) 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 28 premises. These applications (with one exception) were in respect of premises used for fish frying. In 17 cases registration was granted, 6 of which were subject to certain specified work being carried out, the remaining 10 cases were deferred for further report. By the operation of the Public Health Act, 1936, fish frying ceased to be an "offensive trade" but registration under this Section of the Ilford Act is necessary. Shops Acts, 1912-1934 (Sections 10 and 13).—During the year 1941, 8 inspections and 3,950 reinspections were made. 3 preliminary notices were served, all of which were complied with. Maternity and Nursing Homes. On the 1st January, 1941, there were 3 private registered nursing homes in the district, 1 for medical cases, 1 for medical and senile cases, and 1 for maternity cases. On December 31st, 1941, there were two private registered nursing homes in the district—one for medical and senile cases, and one for maternity cases. One application for registration for the reception of maternity cases was refused under Section 187 (3) (d) during the year. All Nursing Homes in the district are visited by the Deputy Medic&l Officer of Health and the Senior Sanitary Inspector (or his deputy) quarterly and at other times when necessary. 14 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. 1. (i) Water Supply.—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 1941, and that during the year there were no extensions of mains in the Borough. Mr. Bryan also stated that over 2,500 chemical, bacteriological and biological analyses were made of the various water supplies during the year 1941, and all were reported on as pure and wholesome and suitable for the purposes of a public supply. The Distribution Engineer of the Metropolitan Water Board informs me that during the year no extensions of mains were laid in the Borough. (ii) Drainage and Sewerage.—The Borough Engineer regrets that owing to the pressure of work and the shortage of staff he is unable to supply the usual information regarding (a) Drainage and Sewerage and (b) Closet Accommodation, but has kindly supplied me with the following statement as regards Refuse and Salvage Collection:— Collection and Disposal of Refuse:— Tons Cwts. The total amount of refuse collected ,, ,, ,, disposed of 26,047 13 by barge 20,499 15 at Destructor 5,547 18 Trade refuse disposed of at Refuse Destructor 179 19 Salvage and Kitchen Waste:— Tons Value £ Wastepaper 1,245 5,444 Metals 999 961 Textiles 78 635 Bottles 234 780 Cullet 367 492 Bones 65 217 Kitchen Waste 1,317 1,717 "In connection with Kitchen Waste, collection has been made compulsory by the Ministry of Supply although such collection had already been in operation in this Borough for some time on the house to house system at weekly intervals." In August, 1941, a scheme utilising communal food waste bins was put into operation. Over 1,200 bins have now been located, and this method of collection is considered to be very successful." (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 22,975 Houses and premises reinspected (works in progress) 6,716 Visits during disinfection 1,364 Houses in which nuisances were detectd 945 Houses in which nuisances were abated 879* Premises disinfected 516 Premises from which articles only disinfected 182 Articles disinfected 4,052 Premises disinfested for verminous conditions — 15 In addition to the above, 97 notices (27 statutory and 70 informal) served previous to 1st January, 1941, were also complied with. Complaints.—During the year, 869 complaints of nuisances have been received and investigated. The following is a summary:— Accumulation of manure and refuse 35 Animals improperly kept 6 Bad smells 51 Dampness of premises 33 Defective drains, w.c's and fittings 205 Defective roofs, gutters, downpipes, etc. 48 Defective water fittings 54 Dirty and verminous houses 27 Dirty condition of rear way 1 Flooding of premises 13 Overcrowding fi Smoke nuisances 2 Miscellaneous 388 Total 869 (iv) Swimming Baths and Pools.—Samples of water for examination were taken from the open-air swimming bath during July (2), and during March, July and September in respect of the indoor bath. All the samples were satisfactory. (v) Eradication of Bed Buos:— Houses (Found to be infested 14 Disinfested (including 2 found in 1939 and 1940) 15 (vi) Slaughter of Animals Act, 1933.—One liccnce to act as slaughterman was granted during the year. * Includes 97 nuisances detected before 1st January, 1941. Notices served:— Served Complied with Statutory:— Public Health Act, 1936 12 — Housing Act, 1936 — — Housing Act, 1936 (Overcrowding) 1 1 Factories Act, 1937 3 3 Provide Dustbin (Ilford Improvement Act) 258 182 Provide Water Supply to Dwelling House 9 8 Cleanse Water Storage Cistern (Byelaws) 3 3 Cover Water Storage Cistern (Byelaws) 1 1 Informal 671 586 958 784 16 SECTION D.—HOUSING. (i) Overcrowding.—Informal notices were served in respect of 3 premises, two of which were complied with. (ii) Unhealthy Areas.—No representations or complaints have been made regarding unhealthy areas during the year. (iv) HOUSING STATISTICS. 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) 1,506 (b) Number of inspections made for the purpose 3,812 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 — (6) Number of inspections made for the purpose — (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 674 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 652* 3. Action under Statutory Powers during the year:— a. No proceedings were taken under Sections 9, 10 and 16 of the Housing Act, 1936. b. Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 24 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 10 (b) By local authority in default of owners — c & d. No proceedings were taken under Section 11, 12 and 13 of the Housing Act, 1936. 4. Housing Act, 1936, Part IV—Overcrowding:— (а) (i) Number of dwellings overcrowded at the end of the year 15 (ii) Number of families dwelling therein 15 (iii) Number of persons dwelling therein 109£ (б) Number of new cases of overcrowding reported during the year 3 (c) (i) Number of cases of overcrowding relieved during the year 2 (ii) Number of persons concerned in such cases 15 (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 — (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report — * Includes compliances during 1941 of Notices served in 1940. 17 HOUSING ACT, 1936. During the year 1941, 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 15,578 houses. At the end of the year the total certificates issued to date numbered 17,749 in respect of 24,167 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, 1,335 were received up to 31st December, 1941, and the balance of 8 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 "permitted number" certificates, and in all, new premises (not enumerated under the 1935 survey) have been dealt with to the extent of 8,159. 18 SECTION E. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. <i) Persons and Premises registered as at 31st December, 1941:— Premises registered as dairies and milkshops 38 Cowkeepers registered 3 Persons registered as retail purveyors of milk 44 Persons registered as retail purveyors of milk in sealed cartons or containers 80 Persons registered as retail purveyors of milk (sterilised) in sealed bottles 42 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 11 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 a wholesale purveyor of milk in sealed cartons or containers 1 259 inspections of dairies, milkshops, cowsheds and other premises where milk is sold were carried out during the year. 58 inspections (included in above) were made of 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 185 premises from which milk is retailed in Ilford, 16 are branches of one firm, 5 of another, and 3 another, 3 retail from dairy shops or stores, 1 from a general shop and 6 from restaurants, 11 are retailers in a small way with rounds; while 42 sell sterilised bottled milk only, 18 sell sterilised milk and also milk in sealed containers, and 80 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 1941 for the sale of:— "Tuberculin Tested" Milk 14 "Pasteurised" Milk 29 The above include supplementary licences which were issued for "Tuberculin Tested" milk, 7; 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 "Tuberculin Tested" and 1 "Accredited") in respect of milk produced on farms in the Borough during the year 1941. 19 (iii) Sampling.—The routine practice of sampling was given in the 1938 Report, the following gives the results for 1941:— Grade of milk or ice cream Total Satisfactory Unsatisfactory Remarks Tuberculin Tested milk 2 2 - Tuberculin Tested (Pasteurised) milk 1 I — Tuberculin Tested (Certified) milk Pasteurised milk 3 10 2 10 1 The County Medical Officer and the retailer were communicated with owing to the high B. Coli content of the unsatisfactory sample. Ungraded milk 37 29 8 The retailers were communicated with owing to the high B. Coli content or high bacterial count of the unsatisfactory samples. In two cases the supplies were obtained from neighbouring Boroughs and the local Medical Officers were communicated with in these cases. Ice cream 4 3 1 No further action was necessary as the retailer discontinued the sale of ice cream. (iv) Tubercular Milk.—37 samples of milk were submitted to a biological test for tuberculosis, 3 of which were found to be positive. The following is a brief r6sum6 of the eases:— (a) Sample of ungraded milk taken on 19th February from retailer who obtains supplies from a farm at Stock in Essex. The Veterinary Inspector of Ministry of Agriculture and Fisheries was unable to trace source of infection. (b) Sample of ungraded milk, taken on 24th September from retailer referred to in (a). The Veterinary Inspector of the Ministry inspected the herd. One cow was found to be suffering from tuberculosis and was slaughtered, (c) Sample of ungraded milk taken on 27th March from retailer who obtained supplies from farms at Ingatestone and Billericay. The Veterinary Inspector of the Ministry inspected herds. Two cows were found to be suffering from tuberculosis, both of which were slaughtered. Further samples in each case were obtained by this Authority and the biological examinations gave negative results. (v) Milk and Dairies Orders, 1926 and 1938: Inspection of Dairy Herds.—As a result of inspections during the year by the Veterinary Officers of the Ministry of Agriculture and Fisheries, two notifications were received of suspected cases of tuberculosis at a farm in the Borough. The two cows coneerned were slaughtered. 20 (vi) Legal Proceedings.—None were taken during the year. (vii) Registration.—No application for registration was refused during 1941. Articles of Food Surrendered. During the year the following articles of food were surrendered and condemned as being unfit for the food of man:— 44 lbs. beef; 3 tins meat; 10 lbs. melts; 1 bullock's head; 7 lbs. calves pluck; 5 lbs. pressed beef; 16 tins corned beef; 6 lbs. ox tongues; 6 tins meat roll; 20 tins salmon; 10 lbs. lambs liver; 105 lbs. brawn; 2 tins ham; 340$ lbs. bacon; 56 lbs. sausages; 238$ dozen eggs; 27 cases and 7 lbs. rabbits; 2,322 tins milk; J lb. butter; 550 tins and 19 stone fish; 4 boxes kippers; 287 tins vegetables; 12 tins and 232 lbs. fruit; 145 tins soup; 10 tins jam; 5 tins Cafe au lait; 15 tins cream; 27 lbs. cheese; 262J lbs. cake; 2 jars pickles; 61 tins, assorted (unlabelled) and 1 bottle salad cream. In addition various items of food, confectionery, etc., were condemned on account of pollution by enemy action. In many instances the food was salvaged under the instructions of the Ministry of Food Salvage Officer. (i) Food and Drugs Act, 1938.—During 1941, 152 samples (151 formal and 1 informal) of Food and Drugs were obtained, 2 of the formal samples were not genuine. Prosecutions were undertaken in both cases as follows:— (a) Milk.—Containing 4 parts per cent, added water. Case dismissed on payment of costs (25s. in case of Company and 4s. in case of roundsman). (b) Pork Sausage Meat.—Containing 300 parts per million excess of sulphur dioxide; also 10 per cent, excess of meat. Defendant fined 10s. on each count and 10s. 6d. costs. Food Poisoning. By virtue of Section 82 of the Ilford Corporation Act, 1937, food poisoning became compulsorily notifiable in Ilford as from 1st October, 1937. 2 cases were notified under the Act and 11 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 38 bakehouses in the district, 29 of which use motive power. 241 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 work in 11 instances, and the requests were complied with. Contagious Diseases (Animals) Acts, 1894-1925. (i) Regulation of Movement of Swine Fever Order, 1922.—Licences were issued for entry into the Borough of 89 pigs and for removal from the Borough of 8 pigs. (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 1941. 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). A case of swine fever occurred on 19th November at a farm at Chadwell Heath, 11 of the pigs at the farm died, and the notices were withdrawn on 2nd March, 1942. Rats and Mice Destruction Act, 1919.—89 complaints have been received of the existence of rats affecting 129 premises. In 27 of these cases poison gas has been used, and in the remaining cases other steps have been taken. 21 Petroleum (Consolidation) Act, 1928.—The Sanitary Inspectors made 1,575 visits to premises where petroleum is stored, or in conjunction with the installation of such storage, and tested 4 petroleum appliances or fittings. The number of Licences issued was 97, and the fees paid to the Council for such Licences was £78. 2 Licences were issued for the storage of calciumcarbide, the fees payable being 15s. Examination of Officers, Teachers and Servants. The following medical examinations were carried out during 1941:— Officers Teachers Servants New Appointments 59 80 24 Under Sickness Regulations 14 8 65 For Anti-Gas School Course Totals 73 88 89 TABLE III—Cases of Infectious Diseases Notified during the Year 1941 NOTIFIABLE DISEASE At all Ages Number of Cases Notified At Ages—years Total Cases Notified in each Ward Total Cases Admitted to Hospital SECTION F.—PREVALENCE OF, AND CONTROL OVER INFECTIOUS DISEASES. i 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 182 36 113 22 11 — — 5 10 18 31 25 18 27 18 30 137 Diphtheria, including Membranous Croup 40 — 11 18 6 5 — — 1 6 2 8 7 3 4 3 6 38 Enteric Fever (Typhoid and Para-Typhoid) .. 18 — 2 3 3 5 3 2 3 1 1 5 4 — — 2 2 14 Pneumonia 217 21 31 23 13 42 48 39 17 18 13 52 48 5 16 15 33 128 Puerperal Pyrexia 33 — — — 9 24 — — 1 — 1 4 21 1 — 1 4 30 Cerebro-Spinal Fever 35 3 9 6 9 5 3 — 1 3 3 2 11 1 1 2 11 31 Acute Poliomyelitis 1 1 1 1 Acute Polio-Encephalitis Encephalitis Lethargica Dysentery 3 3 Ophthalmia Neonatorum 8 8 — — — — — — — 1 1 — 1 1 1 1 2 — Erysipelas 55 1 1 1 3 19 23 7 4 6 3 10 12 4 2 2 12 17 Pemphigus Neonatorum 2 2 — — — — — — — — 1 — 1 — — — — 1 Tuberculosis Pulmonary 266 — 3 9 62 117 64 11 19 15 13 45 43 29 20 52 30 — Other Forms 60 1 7 20 14 15 3 — 2 6 9 9 18 4 3 3 6 — Anthrax — — — — — — — — — — — — — — — — — — Malaria—Believed to be contracted in this country Believed to be contracted abroad .. 3 — — — 2 1 — — — — — 3 — — — — — 3 Acute Rheumatism 10 — 2 8 — — — — — 1 2 1 1 — 1 1 3 4 Measles 2408 44 822 149f 28 16 — — 137 124 •248 564 538 154 151 230 262 70 Whooping Cough 1161 71 516 561 13 — — — 35 96 104 254 228 88 96 149 111 38 Food Poisoning 2 — — — — — 2 — 1 — — — 1 — — — — — Totals 4504 151 144( 2261 184 262 146 60 226 287 419 991 959 308 323 479 512 515 22 23 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 75.2 Diphtheria and Membranous Croup 95.0 Enteric Fever 77.7 Puerperal Pyrexia 90.9 Pneumonia 58.9 (a) Smallpox.—Notification of 2 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 1941:— Certificates of Successful Vaccination 725 Postponed 36 Conscientious Objections 472 Unsuccessful Vaccination 19 Left the District 189 (6) Scarlet Fever.—182 cases were notified in 1941. 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 notified (including Institutions) Admitted to Hford Isolation Hospital "Return" Hospital Cases Per Cent. Home Cases Cases arising in same house PerCent. 1937 309 254 5 1.9 51 — — 1938 303 262 6 2.3 40 — — 1939 370 283 4 1.4 53 — — 1940 136 108 1 .9 25 1 .04 1941 182 141 3 2.1 41 — — (e) Diphtheria.—40 cases were notified in 1941. Of these, two deaths occurred at the Ilford Isolation Hospital and one at the patient's own home. The total number of deaths of Ilford residents from the following infectious diseases during 1941 was 199 as against 165 in 1940. 1940 1941 Scarlet Fever - Enteric Fever 1 — Diphtheria 5 3 Measles — 4 Whooping Cough — 9 Influenza 21 24 Tuberculosis—Pulmonary 59 70 Other forms 11 17 Pneumonia 61 64 Diarrhoea (under 2 years) 3 5 Cerebro-spinal Fever 1 2 Puerperal Sepsis 3 1 Total 165 199 24 Tabular Statement as to Number of Children Schick Tested and Immunised at the Diphtheria Clinics from 1st January, 1941, to 31st December, 1941. Newbury Hall Clinic 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 165 - 165 123 - 123 288 Negative 88 - 88 90 - 90 178 Numbers inoculated (full course) 564* 1,063 1,627 540* 508 1,048 2,675 Positive after full course of inoculations, and re-inoculated 0 1 3 - - - 3 Negative after full course of inoculations .. 317 650 967 393 265 658 1,625 Awaiting re-test 205 369 574 119 196 315 889 Not re-tested after inoculation (on account of leaving District, etc.) 40 43 83 28 47 75 158 Positive after re-test, but not inoculated for same reason - - - - - - Final Schick Test in 1941 (1940 Cases):— Positive after full course of inoculations, and re-inoculated 2 - 2 - - - 2 Negative 19 17 36 14 9 23 59 * Schick+1941 = 165; Schick + 1940 = 2; Not Tested = 397 * Schick+1941 = 123; Not Tested=417 During 1941 a total number of 2,914 children attended at the Diphtheria Prevention Clinics (1,753 at the Newbury Hall and 1,161 at Mayesbrook), making a total number of attendances of 12,673 (8,315 and 4,358), with an average per session of 109 and 79 respectively. 25 In 1941, under the arrangements mentioned in the 1935 Report, 36 private doctors were supplied with prophylactic for the immunisation of 243 children (194 under 5 years and 49 over 5 years of age). The following is a brief summary:— 1940 Cases: Final Schick Test in 1941:— Negative 9 Positive and re-inoculated - Positive and not re-inoculated (left district) - No final Schick Test, left district, etc. 3 1941 Cases: Numbers inoculated (full course) by medical practitioners.. 243 Final Schick Test—Negative 139 Positive and re-inoculated 2 No final Schick Test, left district, etc. 9 Forms not yet returned 44 To be Schick Tested in 1942 49 (d) Ophthalmia Neonatorum.—8 cases were notified during 1941. Of the 8 cases notified, 6 were treated at home by private medical practitioners, 1 was treated as an out-patient at the Royal London Ophthalmic Hospital, and 1 at King George Hospital, Ilford. Cases Vision Unimpaired Vision Impaired Total Blindness Deaths Notified Treated At Home In Hospital 8 6 2 8 — — — (e) Enteric Fever.—18 cases of enteric fever were notified. In 2 cases, 1 admitted to the Ilford Isolation Hospital and 1 to L.C.C. Park Hospital, confirmation of the disease could not be obtained by bacteriological examinations. Of the remaining 16, 11 were due to infection by B. Paratyphosus B. (of which 8 were admitted to the Ilford Isolation Hospital), 1 occurred at Claybury Emergency Hospital where the patient was treated, and 2 cases were nursed at home. In 5 cases the infection was due to B. Typhosus, 2 occurring at Claybury Mental Hospital, 1 at West Ham Mental Hospital (fatal) and 2 at West Ham Emergency Hospital. In none of the cases was it possible to find the source of infection, although extensive investigations were made. The cases occurring at Claybury and West Ham Mental Hospitals were probably infected by "carriers." (f) Scabies Order, 1941 (dated 28th October, 1941)..—30 cases of Scabies (9 adults and 21 children) were reported. 11 Ilford residents were admitted to the Isolation Hospital during the year. 26 Table showing Incidence of Infectious Disease, 1941, 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 182 — 4 7 9 16 82 31 19 11 3 — — 136 — Diphtheria 40 — 1 3 3 4 12 6 4 7 — — — 38 3 Enteric Fever (including Paratyphoid) 18 — — 2 — — 2 1 2 3 3 3 2 10 — Pneumonia 217 21 9 8 6 8 21 2 8 24 23 48 39 99 64 Puerperal Pyrexia 33 — — — — — — — — 27 6 — — 30 1 Cerebro-spinal Fever 35 3 — 1 4 4 4 2 3 9 2 3 — 28 2 Acute Poliomyelitis 1 — — — — — — — — — — — — 1 — Acute Polio-Encephalitis — — — — — — — — — — — — — — — Encephalitis Lethargica — — — — — — — — — — — — — — — Dysentery 3 — — — — — — — — 1 1 — 1 2 — Ophthalmia Neonatorum 8 8 — — — — — — — — — — — — — Erysipelas 55 1 — 1 — — — 1 2 6 14 23 7 17 2 Anthrax — — — — — — — — — — — — — — — Malaria believed to be contracted in this country — — — — — — — — — — — — — — — Malaria believed to be contracted abroad 3 — — — — — — — — 3 — — — 3 — Pemphigus Neonatorum 2 2 — — — — — — — — — — — 1 — Acute Rheumatism 10 — — 1 1 — 5 3 — — — — — 4 — Food Poisoning 2 — — — — — — — — — — 2 — — — Measles 2408 44 177 187 238 220 1436 62 23 21 — — — 39 4 Whooping Cough 1161 71 92 150 134 140 551 10 5 8 — — — 37 9 * Excludes cases occurring at Barnardo's Homes, Claybury Mental Hospital and West Ham Mental Hospital, 27 3. Tuberculosis. During the year 1941 there were 266 new notifications of Pulmonary Tuberculosis and 60 of other forms of Tuberculosis. 36 cases of Pulmonary and 7 cases of Non-Pulmonary Tuberculosis were transferred to Ilford. Notifications and Deaths from Tuberculosis of Ilford residents during 1941: Age Periods New Cases Deaths Respiratory NonRespiratorv Respiratory NonRespiratory M F M F M F M F Under 1 vear — — — 1 — — — 1 1-5 years 2 1 6 1 — — 2 — 5-15 6 3 10 10 — — 1 2 15-25 30 32 8 6 2 8 — 2 25-35 32 36 8 4 7 5 1 — 35-45 34 15 2 1 8 5 — 1 45-55 25 12 1 2 13 2 1 — 55-65 23 4 — — 12 1 1 2 Over 65 7 4 — — 6 1 2 1 Totals 159 107 35 25 48 22 8 9 Of the above new cases, the following were notified from Institutions in the district:— Respiratory Tuberculosis NonRespiratorv Tuberculosis King George Hospital 14 9 Claybury Mental Hospital 6 1 Claybury Emergency Hospital 2 1 West Ham Mental Hospital 10 1 West Ham Emergency Hospital 12 — Australasian Hospital (Girls' Village Homes) 3 — Of the 87 deaths which occurred of Ilford residents, notification had previously been made of 63 of the cases; 6 were notified after death; 17 were not notified (19.5 per cent, of the deaths, or a ratio of 1 in 5). In 8 cases the presence of tuberculosis was discovered following P.M.; in 7 cases notification was thought to have already been made; 1 occurred at a mental hospital, the patient having no known fixed abode; and 1 was only found to be suffering from tuberculosis just prior to death. One other death included by the Registrar-General it has not been possible to trace. During the year 1941 the following deaths occurred from Tuberculosis:— Pulmonary Non-Pulmonary Ilford Residents 70 17 Non - Residents— Claybury Mental Hospital 41 — West Ham Mental Hospital 16 — Ilford Isolation Hospital 47 1 28  Pulmonary NonPulmonary Total Number of cases on register, 1st January, 1941 597 165 762 Number of cases entered on register during the year 302 67 369 Number of eases removed from the register during the year:— Pul. NonPul. " Recovered 13 7 Deaths 88 10 Left District 102 19 Lost sight of 31 11 Diagnosis not established 7 1 241 48 289 Number of cases remaining on register on 31st December, 1941 658 184 842 Cases of Tuberculosis, on notification, are visited by the Tuberculosis Nurse of the Essex County Council. 799 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:— Pulmonary Cases Other Cases Stated to be recovered or better 18 13 Improved or fairly well 394 93 Not so well 49 4 In Sanatorium 74 17 No information as to present condition 40 13 Removed from district, etc. 60 24 Totals 635 164 The treatment of Tuberculosis is under the control of the Essex County Council. On the 31st December, 1941, there were 718 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, Walthamstow, Barking and Dagenham were continued. Two afternoon sessions per month were set aside for the treatment of these cases. 94 patients were treated, 21 being supplied with dentures. The Council's Dentist also made 7 visits to the tuberculosis patients at the Ilford Sanatorium. 62 Patients were inspected, all of whom received treatment. The number of patients from Ilford sent to Institutions under the Essex County Tuberculosis Scheme during 1941 was as follows:— Pulmonary Non-Pulmonary Total Males Females Males Females Adults 59 54 17 7 137 Children 3 3 9 3 18 Tuberculosis Care Association.—This Association has assisted 61 cases with extra nourishment, clothing, and in other ways. 4. 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. 29 SECTION G.—FACTORIES. The Factory and Workshop Act, 1901, was superseded by the Factories Act, 1937, which came into operation on 1st July, 1938. There are 311 factories with mechanical power on the register. There are 273 factories without mechanical power on the register. There are 251 outworkers on the register. 1.—INSPECTION OF FACTORIES AND OTHER PREMISES. Including Inspections made by Sanitary Inspectors. Premises Number of Inspections Written Notices Occupiers prosecuted (1) (2) (3) (4) Factories with Mechanical Power 355 13 - Factories without Mechanical Power 174 3 - Other premises (not including Outworkers' premises) — — — Total 529 16 — 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) 19 19 — — Overcrowding (S.2) —' — — — Unreasonable Temperature (S.3) — — — — Inadequate Ventilation (S .4) — — — — Ineffective Drainage of Floors (S.6) — — — — Sanitary Conveniences (S .7):— Insufficient 5 5 — — Unsuitable or Defective 5 5 — — Not Separate for Sexes 1 1 — — Other Offences 3 3 — — Total 33 33 — — 30 ISOLATION HOSPITAL. 825 patients were admitted during 1941. 95.0 per cent, of the cases of diphtheria and 74.7 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 825 patients admitted during 1941 suffered from the following complaints:— Scarlet Fever 218 (83) Puerperal Scarlet Fever 2 (2) Scarlet Fever and Whooping Cough 3 (1) Diphtheria 46 (18) Cerebro- spinal Fever 29 (12) Enteric Fever 8 Tuberculous Diseases—Pulmonary 127 ,, ,, Non-Pulmonary 3 (1) Pneumonia 60 (8) Puerperal Pyrexia 17 (2) Measles and German Measles 67 (29) Measles and Whooping Cough 3 Whooping Cough 41 (13) Chicken Pox 2 (1) Mumps 2 Erysipelas 23 (7) Pemphigus Neonatorum 1 Acute Rheumatism 4 Acute Anterior Poliomyelitis 2 (1) Scabies 15 (4) Influenza 14 Verminous Condition 1 Bronchitis 4 Gastro Enteritis 2 Impetigo 1 (1) Observation and other cases 130 (24) Number of deaths in hospital:— Diphtheria 2 Pneumonia 6 Pneumonia and Whooping Cough 1 Whooping Cough 8 (3) Measles and Whooping Cough 1 Measles 1 Erysipelas 2 Puerperal Pyrexia 1 Tuberculous Meningitis 3 (1) Pulmonary Tuberculosis 52 Cerebro- spinal Fever 3 (1) Uraemia 1 Staphylococcal Meningitis 1 Gastro- colic Fistula, Broncho-pneumonia 1 (1) Prematurity and Convulsions 1 (1) The figures in brackets represent eases admitted from Barking. Number of patients in Hospital on 1st January, 1941 and 1942, respectively:— 31  1st Jan., 1941 1st Jan., 1942 Scarlet Fever 10 22 Diphtheria 24 8 Tuberculous Diseases 39 71 Puerperal Pyrexia 1 2 Erysipelas 1 — Cerebro- spinal Fever 1 1 Enteric Fever — 1 Pneumonia 2 4 Acute Rheumatism 2 1 Measles 7 — Whooping Cough — 5 Observation and other cases 7 3 The average length of stay in Hospital was for:— Scarlet Fever 24.8 days Diphtheria 56.6 ,, Tuberculous Diseases 98.2 „ Average stay in Hospital of all cases 30.6 ,, The above averages are based on eases that completed their stay in Hospital during the year. Average number of patients in Hospital per day 107.6. Scarlet Fever.—The diagnosis of scarlet fever could not be confirmed in 10 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. 1937 1938 1939 1940 1941 Ilford 41 Nil Nil Nil Nil Enteric Fever.—8 cases were admitted. All were due to Bacillus Paratyphosus B. 7 recovered, 1 was still under treatment at the end of the year. 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. 1937 1938 1939 1940 1941 Ilford 3.3 5.3 1.3 2.4 7.1 Tuberculosis.—127 cases of Pulmonary Tuberculosis were admitted, as compared with 87 in 1940. An arrangement was entered into with the Essex County Council whereby the 26 beds in Block 1 and the 6 beds in Block 2 were allocated to the use of Tuberculosis patients as and from 26th May. These beds, together with the 20 beds in Block 10, were paid for at the rate of 55s. per bed per week as and when occupied. Training of Probationer Nurses.—During 1941, 4 nurses passed Part I of the examination of the General Nursing Council, and 11 obtained the Certificate by completing Part II (5 of these being Staff Nurses). 32 The following table shows the number of the Staff at the Isolation Hospital who were Schick and Dick tested during 1941, and also the number inoculated:— Numbers Schick Tested:— Nurses Domestics Positive 12 5 Negative 16 12 Numbers inoculated (full course) 12 5 Numbers re-tested:— Negative after full course of inoculations 3 - Positive after full course of inoculations, and re-inoculated 4 - Numbers Dick Tested:— Positive 8 4 Negative 20 13 Numbers inoculated (full course) 8 4 Numbers re-tested:— Negative after full course of inoculations 5 - Positive after full course of inoculations, and re-inoculated 2 - No member of the Nursing Staff contracted Scarlet Fever or Diphtheria during the year. The Hospital is recognised by the Conjoint Board for Part 2 of the D.P.H. Regulations of the Board. Admission of Cases from Barking.—The arrangement entered into with Barking Corporation for the reception of cases of infectious disease occurring in that area, as far as accommodation permitted, continued during the year. During 1941 the number of cases admitted was 207. Payment was at the agreed rate of 10/- per day, plus a charge of 2/- per mile for use of ambulance. 33 MATERNITY AND CHILD WELFARE 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 this Act during 1941 was 1,194 (611 males and 583 females). Of these 64 (32 males and 32 females) took place in Ilford, the ordinary place of residence of the parents being outside the district. In addition, 379 notifications of birth (196 males and 183 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, 9 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 8.87 By Certified Midwives 88.11 By Parents and Others 3.02 In addition, 48 stillbirths (22 males and 26 females) were notified. The notifications of 8 stillbirths (2 males and 6 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 67, the total number born being 1,638. The latter figure is supplied by the Registrar-General for calculating infant and maternal mortality rates. The infant mortality, or rate of deaths per 1,000 live births, was, therefore, 40.9. Neonatal Mortality.—The death-rate of infants under four weeks of age is known as the Neonatal Mortality. There were 36 deaths of infants under four weeks of age during 1941 and the rate for the year was 22.0 per 1,000 live births. The deaths of infants under one month decreased from 43 during 1940 to 36 during 1941. The following table gives the deaths of infants under one year of age, classified according to age. 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 Whooping Cough - - - - - - - 1 1 2 Erysipelas - - - - - - - 1 — 1 Tuberculous Meningitis - - - - - - 1 — 1 2 Bronchitis - - 1 — 1 4 — - — 5 Pneumonia (all forms) 1 — — — 1 4 5 3 3 16 Enteritis - - - - - 1 1 1 — 3 Gastritis 1 - - - 1 1 — - — 2 Suffocation (overlying) - - - - - - - 1 — 1 Injury at birth 1 - — - 1 - — - — 1 Atelectasis 8 - - - 8 - - - - 8 Congenital Malformations 6 2 — — 8 - 1 1 — 10 Premature birth 14 - - - 14 - — - - 14 Pyaemia due to whitlow of the left forefinger - 1 - - 1 - - - - 1 Asphyxia due to morphine poisoning injection (hypodermic) in arm in mistake for whooping cough vaccine - - 1 - 1 - - - - 1 Totals 31 3 2 - 36 10 8 8 5 67 34 Foster-Children . Number of foster-children on register on 1st January, 1941 23 Number of foster-children who were notified during 1941 19 Number of foster-children returned to their mothers during 1941 8 Number of foster-children taken off register for various other reasons during 1941 11 Number of foster-children on the register on 31st December, 1941 23 Foster-Mothers . Number of foster-mothers with children on the register on the 1st January, 1941 23 Number of persons who became foster-mothers during 1941 15 Number of foster-mothers whose names were taken off the register during 1941 17 Number of foster-mothers with children on the register on the 3l8t December, 1941 21 Number of houses visited by the Sanitary Inspectors for the purpose of the Act during 1941 17 Number of visits made by the Sanitary Inspectors for the purpose of the Act during 1941 28 Work of Health Visitors.—The Ilford area is divided into 12 districts, one nurse carrying out all home visits both for Maternity and Child Welfare work and School Medical Service work in each area. The following is a summary of the home visits made by the Health Visitors during 1941 as far as the Maternity and Child Welfare work is concerned:— First visits to newly-born infants 1,797 Subsequent visits to children under 1 year of age 7,011 Subsequent visits to children over 1 year of age and under 5 17,800 Visits to expectant mothers 412 Home visits for other reasons 2,480 Total visits paid 29,500 Issde of Clothing Coupons to Expectant Mothers.—The issue of 50 additional clothing coupons to each expectant mother to enable her to buy materials for garments for her baby has been made through the Public Health Offices since the inception of the Scheme by the Board of Trade on the 7th August, 1941. Up to the end of the year additional coupons had been issued to 1,211 mothers. Supply of Milk to Expectant and Nursing Mothers and Infants.— A total of 2,094 lbs. of dried milk were given free under the Regulations of the Ministry of Health during 1941 to 141 infants. These figures include the supplementary issue of 509 20 oz. packets of National Dried Milk to 7.) infants who were receiving the Dried Milk under the National Milk Scheme. Since July, 1940, the supply of liquid milk by the Council has been suspended as this is now provided under the National Milk Scheme. Infant Welfare Centres.—81 voluntary lady helpers were engaged in the work at the Infant Welfare Centres at the end of December, 1941. During the year the following attendances were recorded:— Total number of attendances of infants 28,545 First attendances 1,871 Total number of children on roll, December 31st, after omission of all those who had not attended for six months 2,715 11,372 attendances of children from 1 to 5 years were made at the Infant Welfare Centres during the year. 35 Special Clinics.—Attendances of children under 5 years of age and expectant and nursing mothers at the various Clinics during 1941 are set out in the following table:— Clinic. Number of Sessions. Attendances. Individual Expectant and Nursing Mothers. Attendances. Individual Children. Total Attendances. A. B. C. D. A. B. C. D. A. B. C. D. A. B. C. D. (i) Ophthalmic 100 52 — — 12 2 — — 54 21 — — 133 47 — — (ii) Orthopaedic 12 10 — — — — — — 75 65 — — 106 107 — — (iii) Artificial Sunlight 49 51 — — — — — — 29 35 — — 326 407 — — (iv) Remedial Exercises 99 — 61 — — — — — 13 — 12 — 142 — 122 — (v) Aural 35 — — — 2 — — — 58 — — — 132 — — — (vi) Rheumatism 16 — — — — — — — 2 — — — 4 — — — (vii) Dental — — — 148 — — — 356 — — — 232 — — — 1268 A = Newbury Hall. B = Mayesbrook. C = A11 Saints Hall. D = Valentines Dental Clinic. Note.—(ii) Two children under 5 years of age were admitted to the Country branch of the Royal National Orthopaedic Hospital at Stanmore. Both children were discharged during the year. 36 Treatment of Minor Ailments.—Children suffering from simple dietetic ailments are treated at the Infant Welfare Centres. 47 belts and 4 trusses have been supplied to infants suffering from hernia during 1941. A certain number of infants were brought to the Clinics at Newbury Hall and All Saints' Church Hall to receive treatment for minor ailments. 44 children under 5 years of age were operated upon at Queen Mary's Hospital, Stratford, and at King George Hospital, Ilford, for removal of tonsils and adenoids. 8 were treated free of charge as cases of necessity. By arrangement with the Invalid Children's Aid Association 1 child under 5 years of age was sent to a Convalescent Home for a period of 10 weeks. The Council contributed £2 5s. Od. towards the cost of the maintenance of the child. Midwives.—There are 13 State certified midwives (including the Superintendent and 9 Council midwives) resident and practising in the district, and I certified midwife residing outside Ilford, but practising in Ilford. In addition there were at the end of the year, 10 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. The Council paid the balance of a private midwife's fee in three cases, amounting to £4 19s. 3d. Five midwives were suspended from practice for varying periods following attendance on five cases rendering them liable to be a source of infection. Four of the cases only were notified as Puerperal Pyrexia. All of the midwives were in the employ of the Council. The causes of the Pyrexia of the 4 cases were as follows:—(1) Phlebitis. (2) Infection of uterus. (3) Anaemia following post partum haemorrhage. (4) Thrombophlebitis of pelvic veins. The other patient had a non-notifiable Pyrexia due to general condition and shock. Medical aid was sought in 28 instances where the infant was found to have inflamed or discharging eyes. Five of the cases were subsequently notified as suffering from Ophthalmia Neonatorum. In all cases the condition of the eye3 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. Council District Midwifery Service.—During the year 615 cases were attended by the nine Council District Midwives. In 376 cases the midwives were engaged to attend as midwives and in 239 as maternity nurses. The cases resided in the following wards: Barkingside 126; North Hainault 106; Cranbrook30; Park 43; Seven Kings 63; South Hainault 101; Loxford60; Clementswood 46; Goodmayes 40. 3,438 ante-natal visits were made during the year. 47 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. Forty-nine patients were referred by the private Doctors to the Council's Consulting Obstetrician at the Ante-Natal Clinic for a further opinion. 23 of these women and 14 other patients who had engaged a Council Midwife (27 as a midwife and 10 as a maternity nurse) were, for various reasons, admitted to the Council's Maternity Home or other Hospitals for confinement. 29 were admitted to the Maternity Home, and 8 to Oldchurch Hospital, Romford. In addition five patients were admitted to the Maternity Home following confinement for various reasons. Three patients who had engaged the Council's midwives were admitted to the Council's Maternity Home for 37 ante-natal treatment and subsequently confined at their own homes or at Oldchurch Hospital, Romford. A Doctor was called in at the time of the confinement or subsequently to 133 of the 376 cases in which a midwife had been engaged. Six cases were notified as suffering from Puerperal Pyrexia, 5 of these cases and 3 other patients were removed to the Isolation Hospital. 4 of the cases had engaged their own Doctor to attend them. One mother admitted to the Isolation Hospital 11 days after her confinement, died 20 days later from Cardiac failure due to pulmonary embolus due to thrombo-phlebitis of pelvic veins due to puerperal sepsis. Five babies were notified as suffering from Ophthalmia Neonatorum. The condition of the eyes cleared satisfactorily. Of the infants born, there were 16 stillbirths. In nine instances the midwife was engaged as a maternity nurse only. Eighteen infants died. In eight instances the midwife was engaged as a maternity nurse only. Saltation Army 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 Long bridge Road in the Borough of Ilford and including these four roads. The agreement took effect as from the 1st January, 1938. 74 oases were attended by the Salvation Army midwives during the year 65 as a midwife and 9 as a maternity nurse. Ante-Natal Clinics. Maternity Home Mayesbrook Clinic First attendances 492 110 Subsequent attendances 4,094 666 Number of expectant mothers on the rolls on 31st December, 1941 .. 150 30 All patients booked for admission to the Maternity Home are medically examined at the Ante-Natal Clinics. During the year, 170 cases other than those booked for admission to the Maternity Home were examined at the Clinics. There were 1,091 attendances by such cases. The Consulting Obstetrician made weekly visits to the Ante-Natal Clinic during 1941 During the year 52 ordinary visits were made, 234 patients referred from the Ante-Natal and Post-Natal Clinics, and 56 patients referred by private Doctors, were examined. A total of 631 examinations were made. X-Ray Elimination of Ante-Natal Patients. 27 examinations were made at King George Hospital in 1941. Post-Natal Clinic. The following attendances were recorded:— First attendances 197 Subsequent attendances 190 Number on roll on 31st December, 1941 25 Maternal Mohtality.—The total number of deaths due to childbirth during the year was 7, which gives a maternal mortality rate i.e., number of deaths per 1,000 live births of 4.27 (or 4.12 including stillbirths). The causes of death were as follows:—(1) Puerpercl Fever.—Confined at own home and died in Council's Isolation Hospital; Cardiac failure due to pulmonary embolus due to thrombophlebitis of pelvic veins due to puerperal 38 sepsis. (2) Died in King George Hospital, Ilford; Toxaemia due to hyperemesis gravidarum. (3) Died in King George Hospital, Ilford; Asphyxia due to inhalation of vomit due to hyperemesis gravidarum. (4) Died in King George Hospital, Ilford; Broncho Pneumonia; operation for ectopic gestation. (5) Confined at own home and died in Council's Maternity Home; Post partum haemorrhage due to retained placenta. (6) Confined at private Nursing Home and died in Surrey County Hospital, Kingston-on-Thames; Shock and haemorrhage following retained placenta. (7) Confined at and died in Council's Maternity Home; Acute cardiac failure due to exhaustion in labour. MATERNITY HOME. During 1041, 369 women were admitted into the Home (58 direct to the Emergency Block and 311 to the Ward Blocks). 330 cases could not be admitted during the year owing to the difficulty in obtaining sufficient nursing staff. At the end of the year 140 cases had booked for future admission to the home. The average number of patients in the home per day during 1941 was 16.8 and the average length of stay of patients was 16.7 days. Emergency Block.—116 cases were treated, 58 being admitted direct to this block and 58 being transferred from the Ward Blocks. 38 of these 58 cases had not been booked for admission to the Maternity Home. 4 of the 58 patients were admitted direct to the Emergency Block for ante-natal treatment and were subsequently transferred to or re-admitted to the Ward Blocks for confinement. The average number of patients in the Emergency Block per day during 1941 was 4.1 (including cases transferred from the Ward Blocks) and the average length of stay of patients admitted direct to this Block was 16.4 days. 43 patients were confined in the Emergency Block (36 admitted direct to this Block and 7 transferred from the Ward Blocks). The four eases mentioned above have been included in the figures for those confined in the Ward Blocks. 20 of the 43 cases were first confinements and 23 were second or subsequent confinements. 8 cases (or 18.6 per cent.) were delivered by means of forceps; 1 of the infants was stillborn. There were two deaths of infants born in the Emergency Block and six stillbirths. Five cases were notified as suffering from Puerperal Pyrexia. The Consulting Obstetrician or his Deputy was called in to 11 cases as follows:— To perform Caesarean section operation 1 To perform other operations. 9 For consultation 1 The reason for the Caesarean section operation was as follows:— Disproportionate measurements 1 The nine other operations were as follows:—Dilatation and curettage 2; Forceps delivery 2; Hysterotomy and sterilisation 1; Removal of cyst in posterior fornix 1; Rupture of membranes and application of vulsellum forceps 1; Sterilization 1; Termination of pregnancy 1. One mother, confined at her own home, died two hours after admission to the Emergency Block from post partum haemorrhage due to retained placenta. The other 18 cases admitted direct to this block were not confined therein for the following reasons:— 39 Abortion or miscarriage 5 Admitted for ante-natal treatment and subsequently evacuated, confined at own home or admitted to Oldchurch Hospital 4 Born before arrival at Home 7 Hysterotomy and sterilization 1 Not pregnant and transferred to Oldchurch Hospital 1 Ward Blocks.—311 cases were admitted to the Ward Blocks. In addition four patients admitted to the Emergency Block for ante-natal treatment were subsequently transferred to or re-admitted to the Ward Blocks for confinement. Seven patients admitted to the Ward Blocks were transferred to the Emergency Block for confinement. 25 of the 311 cases had not been booked for admission to the Home. Seven cases were not confined in the Home for the following reasons:— Admitted for ante-natal treatment and subsequently confined at own home or Oldchurch Hospital 2 Abortion or miscarriage 3 Termination of pregnancy 1 Not pregnant 1 The average number of patients in the Ward Blocks per day during 1941 was 12.7 and the average length of stay of patients was 16.8 days. In 21 of the 301 confinements the patient had been previously admitted for varying periods of observation, being subsequently re-admitted for the confinement. Of the 301 confinements there were:— (a) 188 cases of first confinement. (b) 113 cases having their second or subsequent confinement. (c) 27 cases living in 2 rooms or less (21 being first confinements). (d) 48 cases living in 3 rooms (37 being first confinements). Of the 301 cases, 1 woman had engaged her own doctor who was present at the birth. Twenty-nine cases (or 9.6 per cent.) were delivered by means of forceps, 9 following surgical induction; 1 of the infants was stillborn and 1 died aged 3 weeks. In addition, labour was surgically induced in 61 cases; 3 of the infants were stillborn and 1 died aged 5 days. There were 5 deaths of infants in the Ward Blocks. The neo-natal death-rate of babies born in the Ward Blocks was 2.4 per cent, compared with 2.1 per cent, in the district in general. The deathrate of babies who died before 14 days, born in the Ward Blocks, was 2.0 per cent, in 1941 and 1.3 per cent, in 1940. The infant mortality rate of children born in the Ward Blocks of the Maternity Home was 43.3 per 1,000 births, as compared with 39.9 born in their own homes. The figure of 39.9 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 12 stillbirths in the Ward Blocks. Thirteen cases were notified as suffering from Puerperal Pyrexia. Five of these cases and seven other patients were removed to the Isolation Hospital. In addition one baby notified as suffering from Pemphigus Neonatorum was removed to the Isolation Hospital. One case of ophthalmia neonatorum was notified from the Home during the year; the only organism found in the discharge from the eye was Staphylococcus Albus. The condition of the eyes cleared up without difficulty. 40 Special visits were made by the Consulting Obstetrician or his Deputy to 20 cases in the Ward Blocks as follows:— To perform Caesarean section operations 10 To perform other operations 8 For consultations 2 One mother confined in a Ward Block died from Acute cardiac failure due to exhaustion in labour. The maternal mortality rate for the Ward Blocks of the Home for the five years from 1937 to 1941 is 1.67, as compared with the maternal mortality rate in the district generally of 3.59, the rate in each case being calculated on the total live births. Other Maternity Hospitals.—122 cases were admitted to Oldchurch County Hospital during 1941. The fee payable to the Essex County Council is at the rate of 14/- per day. 41 GENERAL SURVEY OF THE SCHOOL MEDICAL SERVICE The Board of Education, Form 6 M, desires that the Reports for 1941 might be as brief as possible, and the following is the information which the Board particularly ask for. (a) Changes in the Staff of the Service. (See Staff). (b) Nutrition. This shows no appreciable change, and attention is called to the summary of heights and weights over 10 years which is printed at the end of this Report. (c) Incidence of Pediculosis and Scabies. (i) pediculosis.—This shows an increase over 1940, 36 children being found, to be infected with living vermin as against 10. (ii) Scabies.—This also shows an increase, 109 cases (43 from routine medical inspection, 6 being Oibraltarians) being seen at the Minor Ailment Clinics, as compared with 25 in 1940. In addition to the 109, 8 casts were treated privately. The treatment of cases at the Clinics is the issuing of the ointment of potassium poly sulphide, with printed instructions, and usually it is found that the cases are ready to return to school in a few days. Cases which cannot be so treated are offered admission to a cubicle ward in the Isolation Hospital. The homes of all cases of scabies are visited by the Sanitary Inspector, and disinfection is offered. (d) Details of the Provision of Meals and Milk for School Children. Given in the body of the Report. Changes in Staff.—(a) Dental Surgeons.—Mrs. G. M. Shalders commenced duties as Assistant Dental Surgeon on 17th February. Miss Richardson resigned on 11th January. (6) Health Visitors and School Nurses.—Miss E. Thomas terminated her appointment on 21st January, and Miss G. M. Gardiner on 28th February. Miss M. Graham commenced duties on 11th August. School Premises.—There are 23 schools, with 37 departments, 12,299 children were actually on the rolls on 12th December, 1941, as compared with 9,420 in December, 1940. The number of children in average attendance at school for the year ended 19th December, 1941 = 8,737. On the 12th December, 1941, 2,717 children were in reception areas evacuated under the Government Evacuation Scheme and there were approximately 4,000 private evacuees. 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. 290 visits have been made during the year. Medical Inspection.—In accordance with the Board's Circular, 1523, dated the 21st August, 1940, a rapid survey of all the children in the schools was carried out during each term of the year, 22,177 examinations were made, 205 were recommended for special treatment and 335 for supplementary nourishment; in addition a full routine medical examination is made of all the following children seen at each survey:— 42 (a) Newly admitted to Public Elementary Schools, (b) who had attained the age of eight years, (c) who had attained the age of twelve years. During 1941, 4,455 parents, or 86 per cent., attended the full routine medical inspections. Infectious Disease.—The following table shows the incidence of infectious diseases in the Ilford schools since 1936:— Scarlet Fever. Diphtheria. Measles and German Measles Chicken Pox. Mumps. Whooping Cough. Small Pox. 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 — 19 40 53 30 341 73 6 55 — 1941 .. 107 14 1,401 214 21 495 — Disinfection of all the cloakrooms at the public elementary schools was carried out during the Summer and Winter vacations. No schools were closed during the year on account of infectious disease. Table VII shows the incidence of infectious disease in the Ilford schools during 1941. 2,336 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 Newbury Hall (76 sessions) and Mayesbrook (55 sessions) Clinics for children of school age during 1941:— Newbury Hall. Mayesbrook. Primary Schick tested .. 253 213 Positive 165 123 Negative 88 90 Inoculated (full course) .. 564 540 Schick — 1940 2 — Schick — 1941 165 123 Not tested 397 417 Negative after full course of inoculation .. 317 393 Positive after full course of inoculation and reinoculated .. 2 Awaiting re-test .. 205 119 Not re-tested after inoculation on account of leaving district, etc. 40 28 Result of final Schick test in 1941 of cases inoculated in 1940: Newbury Hall. Mayesbrook. Positive and re-inoculated 2 Negative 19 14 1,317 individual children were treated (673 at Newbury Hall and 644 at Mayesbrook) making 5,682 attendances (3,487 and 2,195 respectively). Since June, 1932, children under 8 years of age have not been Schick tested prior to immunisation, unless there was some particular 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, 6,554 children of school age, and 5,416 children under school age have been immunised. 43 Ringworm:— No. of cases at beginning of 1941. No. of cases reported during 1941. Total. Remedied during 1941. No. of cases under observation at end of 1941. Kingworm :— Scalp - 1 1 1 - Body - 7 7 7 — — 8 8 8 — Following Up.—During 1941, 2,688 home visits by the School Nurses were paid for the purpose, and 1,041 re-examinations of children (some on several occasions) were carried out by the doctors at school; 13 visits to schools were made for this purpose alone, and other children were seen at the visits for routine medical inspection. Medical Treatment. (a) Minor Ailments Clinics.—The attendances during 1941 were as follows:— Newbury Hall Mayesbrook Number of individual children seen .. 1,065 876 Number of attendances of children .. .. 1,707 1,433 Number of exclusion certificates granted .. 488 '515 Number of certificates of fitness to attend school granted .. .. .. .. 433 426 The following table shows the conditions dealt with at both the Clinics during the year:— Subnormal Nutrition 72 Uncleanliness:— Head 191 Body 3 Skin Ringworm:— Head 1 Body 7 Scabies 109 Impetigo 70 Other Diseases (Non-Tuberculous) 206 Eye:— Blepharitis 18 Conjunctivitis .. 21 Defective Vision (excluding Squint) 112 Squint 13 Other conditions 30 Ear:—• Defective Hearing 12 Otitis Media 16 Other Ear Diseases 16 Nose and Throat:— Chronic Tonsillitis only 16 Adenoids only 2 Chronic Tonsillitis and Adenoids 40 Other conditions 78 Enlarged Cervical Glands (Non-Tuberculous) 10 Defective Speech 1 Teeth—Dental Diseases 228 44 Heart and Circulation:— Functional 3 Organic 2 Anaemia 8 Infectious Diseases:— Whooping Cough 14 Chicken Pox 3 Measles 1 Colds 69 Lungs:— Asthma 14 Bronchitis 36 Other Non-Tubercular Diseases 11 Nervous System:— Epilepsy 3 Nervous Debility 2 Habit Spasm 3 Other conditions 4 Deformities:— Genu Valgum 1 Round Shoulders 1 Rickets 3 Flat Feet 14 Other forms 22 Minor Injuries 30 Rheumatism 7 Other Defects and Diseases 75 Total number of ailments 1,598 Special Clinics.—Attendances at the various Clinics during 1941, are set out in the following table:— Clinic. Number of Sessions. Attendances Individual Children. Total Attendances. A. B. C. A. B. C. A. B. C. (i) Ophthalmic 100 52 578 322 — 1094 643 — (ii) Orthopaedic 12 10 — 195 103 — 311 173 — (tit) Artificial Sun light 49 51 — 56 25 — 987 386 — (iii) Remedial Exercises 99 — 61 103 — 63 1364 — 783 (v) Aural 35 — — 219 — — 603 — — (vi) Rheumatism 16 — — 120 — — 272 — — A=Newbury Hall. B = Mayesbrook. C = All Saints Hall. Note.—(i) 424 children were prescribed and provided with glasses, of which 11 were supplied free. (ii) 10 children of school age were admitted to the Country branch of the Royal National Orthopaedic Hospital at Stanmore and 10 discharged. 40 children were supplied with appliances. (in) 22 cases referred for X-ray and Electro-Cardiogram and 15 for Blood Sedimentation Rate. School Dentists.—Of 12,664 inspections by the Dentist (including special cases), 8,289 (or 65 per cent.), were found to require treatment, compared with 5,583 (or 56 per cent.) in 1940, 10,491 (or 58 per cent.) in 1939, 14,597 (or 64 per cent.) in 1938; 9,937 (or 69 per cent.) in 1937. 45 In addition to the ordinary dental work of fillings and extractions, a considerable amount of "regulation" work has been done. 91 regulation plates, and 4 dentures were supplied. 1,082 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 1,145 731 63.8 6 1,401 943 67.3 7 1,320 904 68.4 8 1,564 1,136 72.6 9 1,633 1,120 65.5 10 1,585 1,059 66.8 11 1,159 787 67.9 12 1,024 743 72.5 13. 1,059 738 69.7 14-15 202 128 63.4 Full details of the dental work are shown in Table IV. Treatment for Uncleanliness .—No statutory notices were served under the Education Act, 1921, Section 87. The School Nurses paid 122 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 of Children. Number Infected. Per cent. 24,543 *697 2.8 *36 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. The percentage for the past 5 years were as follows:— 1937 1.7 1938 1.5 1939 1.5 1940 1.8 1941 2.8 These figures do not include the Gilbraltarians housed at the Girls' Village Homes, Barkingside, 171 were inspected in 1941, of whom 82 were found unclean and cleansed by nurses of the Essex C.C. Other Ailments.—During 1941 36 children were operated on for the removal of enlarged tonsils and adenoids, under the agreement with Queen Mary's Hospital, Stratford, 2 as in-patients. 1 child was treated free on necessitous grounds. Under the agreement with the King George Hospital, 67 children were operated on at that Hospital, 44 as in-patients, for the removal of enlarged tonsils and adenoids, 8 children being treated free on necessitous grounds. In addition to the treatment of tonsils and adenoids, 19 letters were given to Ilford school children, for whom hospital treatment was required, to attend Queen Mary's Hospital. The Open-Air School was closed at the outbreak of war and has not been re-opened. 46 Provision of Meals and Milk fob School Children in War-Time. The provision of meals in the schools commenced 7th October, 1940. The total number of meals served during 1941 was 386,806, approximately 2,109 daily, 66 being free and 2,043 at full or part payment. There are five kitchens in the Borough, established at the following schools:— Benton, Dane, Fairlop, Goodmayes and The Mount. 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 Jd. for one-third of a pint. In December, 1941, 8,915 children were receiving milk in school. Of this number 222 received it free of charge. During the year 145 children were recommended, on medical grounds, to have milk in school, free if parents were not in a position to pay for it, and 48 previously recommended were reported to the Director of Education for continuance. 124 necessitous cases were dealt with during the year for the supply of free Cod Liver Oil, Emulsion, Oil and Malt and Virol. The following is a resume of the work done by the N.S.P.C.C. in Ilford during the past year:— Total number of cases investigated, 36 (4 cases were reported from the Public Health Department for neglecting medical advice, and 17 reported from other sources for general neglect) made up as follows:— (1) Of Neglect 21 (2) Ill-treatment cases 3 (3) Other cases 12 70 children (31 boys and 39 girls) were involved, 34 being of school age In addition to this work, 206 supervision visits were paid to different cases, some of which were made to those reported during the previous year. An annual grant of £2 2s. is made by the Ilford Education Committee to this Society. The Invalid Children's Aid Association.—10 children were sent to residential schools and paid for by the Education Committee in 1941. In addition 11 children were sent to Convalescent Homes or Residential Schools and paid for through voluntary funds. Also 4 children were placed in various Homes, their parents voluntarily paying the full costs. The Ilford Education Committee made an annual grant of £50 to this Association for the years 1936 to 1939. Physically Defective Children.—During 1941, 5 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: Deaf Children.—-Recommended special school for Partially Deaf Children 1 Crippled Children.—Recommended school for Physically Defective Children 2 Heart Cases.—For children suffering from severe heart defect 1 Epileptic.—Special school for Epileptics 1 5 47 Mentally Defective Children:— During 1941, 47 children were medically examined and reported under the Mental Deficiency (Notification of Children) Regulations, classified as follows:— upon 1928, Feeble-minded Children.—Total number certified in 1941 and recommended for admission to a special school (day or residential) 16 Imbecile Children.—Total number certified in 1941 and recommended for notification to Essex County Council 7 Idiots.—Total number certified in 1941, and recommended for notification to Essex County Council 2 Dull and Backward Children.—Total number certified in 1941 and recommended attendance at special class for dull and backward children for one year, and then to be re-examined 22 Idiots, Imbeciles, Feeble-Minded, Dull and Backward Children. Summary of cases at end of 1941:— Idiots. Imbeciles. FeebleMinded. Dull and. Backward At Residential Institution 3 8 14 — At Elementary School — — 28 46 At no School or Institution 2 30 15* — Total 5 38 57 46 * 6 of these are over 14 years of age. All feeble minded children and dull and backward children are reexamined once a year and the feeble-minded children are visited at home by the School Nurses at least once a quarter. Employment of School Children and Young Persons.—From special inquiries made at the various schools during 1941, it was found that 24 children were employed out 6f school hours. 25 children were submitted for medical examination in accordance with the Byelaws made under Part II of the Children and Young Persons Act, 1933, with the following result:— Medically fit .. .. .. .. .. 25 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 99 Teachers—Sickness Regulations 23 Newly-appointed Physical Training Instructor 1 School Enquiry Officers—Sickness Regulations 1 Newly-appointed Camp Nurses and Helpers 4 ,, ,, Evacuation Officer 1 ,, ,, Supervisor British Restaurants 1 130 School Camps.—The three Ilford School Camps are still in being, and the general procedure outlined in my report for 1940 still continues. 48 The Camps were visited by Ilford Medical Officer as follows:— Camp. Routine Medical Inspection. Rapid Survey. Date. Number Inspected. Date. Number Inspected. Elmbridge March 195 May 184 Finnamore Wood March. 212 May 212 Kennylands February 197 May 207 Total 604 Total 603 Immunisation. Elmbridge Finnamore Wood. Kenny lands. June. Nov. June. Nov. June Nov. Scarlet Fever 25 29 35 42 60 45 Diphtheria 21 23 21 26 49 23 Tested (Previously inoc. S.F.) 82 41 111 81 103 87 Tested (Previously inoc. Diph.) 78 13 110 20 103 58 Table Showing the Principal Causes of Death among Children of School Age (i.e., from 5—15 years) in Ilford for 1939 and 1940. The Table also Gives a Comparative Percentage of Deaths Registered at all Ages, From 5—15 Years. Disease. Ilford, Percentage of total deaths (all ages). Ilford, Percentage of total deaths at ages 5—15 193# 1940 1939 1940 1. Measles — — — — 2. Scarlet Fever — — — — 3. Whooping Cough — — — — 4. Diphtheria 0.1 0.3 6.0 9.5 5. Influenza 2.3 1.4 — — 6. Tuberculosis 5.9 4.6 6.0 14.2 7. Rheumatic Fever 0.1 0.1 — 4.8 8. Bronchitis, Pneumonia and other respiratory diseases 7.2 12.7 6.0 4.8 9. 'Meningitis and Nervous system 7.3 11.7 11.7 19.0 10. Heart Diseases .. 28.3 22.8 — 4.8 11. Acute and Chronic Nephritis 1.9 2.4 6.0 4.8 12. Violence .. 4.6 11.4 35.0 33.3 13. Other causes 42.3 32.6 29.0 4.8 100.0 100.0 100.0 100.0 * Excludes Meningococcal infections. Ilford.—The deaths of children of School Age during 1940 represent 1.3 per cent, of the Total Deaths registered (all ages), and during 1939 represent 1.2 per cent. 49 Table I.—Return of Medical Inspections. A.—Routine Medical Inspections. (1) Number of Inspections in the prescribed Groups:— Entrants 1,531 Second Age Group 2,289 Third Age Group 1 ,327 Total 5,147 (2) Number of Other Routine Inspections:— Gibraltarians at Mossford School 192 Grand Total 5,339 B.—Other Inspections. Number of Special Inspections and Re-Inspections 8,299 Number of Children seen at "Rapid Surveys" at Schools 22,177 Table II. Classification of the Nutrition of Children Inspected during the Year in the Routine Age Groups. Age Groups No. of Children Inspected A. (Excellent) B. (Normal) C. (Slightly Subnormal) D. (Bad) No. % No. % No. % No. % Entrants 1,531 208 13.7 1,169 76.4 152 9.9 2 0.1 Second Age-Group 2,289 282 12.3 1,742 76.1 265 11.6 – – Third Age-Group 1,327 169 12.7 1,022 77.0 135 10.2 1 0.1 Total Ilford Children 5,147 659 12.8 3,933 76.4 552 10.9 3 0.1 Other Routine Inspections "Gibraltarians'' 192 19 9.9 160 83.4 13 6.7 – – Total 5,339 678 12.7 4,093 76.7 565 10.5 3 –0.1 Group I.—Treatment of Minor Ailments. (Excluding Uncleanliness), for which see Table V. Total Number of Defects treated or under treatment during the year under the Authority's Scheme 1,404 50 Table II.—Continued. Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments—Group I). Defect or Disease No. of Defects dealt with Under the Authority's Scheme Otherwise Total (1) (2) (3) (4) Errors of Refraction (including squint) (Operations for squint should be recorded separately in the body of the School Medical Officer's Report.) 883 18 901 Other Defect or Disease of the Eyes (excluding those recorded in Group I) 17 9 26 Total 900 27 927 No. of Children for whom spectacles were:— (a) Prescribed 424 18 442 (b) Obtained 424 18 442 Group III.—Treatment of Defects of Nose and Throat. Number of Detects Received Operative Treatment. Received other forms of Treatment. Total Number treated. 139 4 143 Table IV.—Dental Inspection and Treatment. (1) Number of Children inspected by the Dentists:— (a) Routine Age Groups— Age 5 6 7 8 9 10 11 12 13 14 Total Number 1145 1401 1320 1564 1633 1585 1159 1024 1059 202 12,092 (b) Specials 572 (c) Total (Routine and Specials) 12,664 (2) Number found to require treatment 8,289 (3) Number actually treated 4,182 (4) Attendances made by children for treatment 6,716 (5) Half-days devoted to Inspection 94 Total 799 Treatment 705 (6) Fillings Permanent Teeth 3,810 Total 6,351 Temporary Teeth 2,541 (7) Extractions Permanent Teeth 785 . Total 6,574 Temporary Teeth 5,789 (8) Administrations of general anaesthetics for extractions 1,630 (9) Other operations Permanent Teeth 1,931 . Total 2,333 Temporary Teeth 402 51 Table V.—U ncleanliness and Verminous Conditions. (i) Average number of visits per school made during the year by the School Nurses 5 (ii) Total number of examinations of children in the Schools by School Nurses 24,543 (iii) Number of individual children found unclean 67* (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 197 children were found unclean at medical inspection and 191 in the School Clinic. Table VI. Blind and Deaf Children. (1) At a Public Elementary School (2) At an Institution other than a Special School (3) At no School or Institution (4) Total not receiving suitable Education Blind Children – – – – Deaf Children 2 – 1 3 Mentally Defective Children. Total number of children notified during 1941, by the Local Education Authority to the Local Mental Deficiency Authority, under the Mental Deficiency (Notification of Children) Regulations, 1928 52 53 Table VI. A.—Table Showing the Average Heights and Weights of the BOYS Examined. Age Groups. Age Groups School 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 Hedgnt (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Heigfil (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 – – – – – – – – – – – – – Beal Modern – – – – – – – – – – – – – — Becontree 17 111 19.6 18 112 20.2 11 120 22.2 65 125 25.1 25 131 27.9 32 140 32.4 22 142 35.1 42 143 35.7 16 151 41.3 Benton (Open Air) – – – – – – – – – – – – – Chadwell 23 111 19.6 17 115 20.8 7 124 25.0 25 128 26.9 7 133 28.9 5 143 34.2 2 137 32.1 1 138 32.9 — — — Christchurch 34 111 19.6 13 115 21.0 7 121 23.0 24 127 26.7 7 135 31.9 9 135 31.2 4 142 32.6 — — — — Cleveland 6 113 20.7 8 114 21.8 2 120 23.5 31 127 26.3 22 131 27.6 27 138 32.8 8 144 34.4 1 155 43.1 1 137 33.8 Dane Central – – – – – – – – – – – – – 14 146 36.9 23 148 36.2 11 153 44.8 Downshall 23 111 19.2 17 115 21.2 14 123 23.7 32 125 25.3 14 125 26.7 17 138 32.4 23 143 35.6 38 144 36.7 23 150 39.4 Fairlop 50 111 19.5 32 115 21.3 15 120 22.7 63 125 23.1 29 131 28.8 27 136 31.7 21 144 35.7 40 145 36.0 29 150 40.7 Gearies 38 110 19.1 18 116 21.3 18 124 24.0 39 128 26.5 13 132 29.4 13 135 30.0 26 143 36.1 73 145 37.9 33 153 41.1 Goodmayes 20 110 19.5 14 116 21.5 7 121 23.2 24 128 26.6 21 132 29.3 12 137 31.3 2 140 30.8 1 139 31.1 — — — Gordon – – – – – – – – – – – – – Highlands 19 112 20.2 2 115 22.3 3 124 25.7 6 127 25.5 7 134 30.8 8 134 30.1 1 161 46.0 —. — — — Loxford Central – – – – – – – – – – – – – ___ 9 142 35.5 57 146 37.8 28 155 41.5 Mayfield Central – – – – – – – – – – – – – 117 147 39.4 45 151 41.4 Mossford 19 113 19.5 18 117 21.5 8 122 24.1 32 127 25.7 18 134 28.4 1 138 29.4 1 141 32.8 — — — — Newbury Park 12 112 20.4 7 114 20.8 6 120 21.7 22 126 25.6 3 129 27.8 11 135 30.1 4 140 31.3 — 1 135 31.7 Parkhill 31 111 19.5 18 116 21.6 7 123 25.2 25 132 28.1 17 132 29.2 12 138 32.7 3 144 37.1 — — — — — — St. Augustines 9 108 18.7 1 108 18.0 12 119 23.3 10 127 25.8 7 129 27.8 8 136 31.1 4 145 35.9 5 142 37.0 1 151 40.2 S.S. Peter & Paul 10 113 20.0 10 116 21.5 7 121 27.1 7 125 25.2 14 130 28.2 8 134 29.9 4 139 31.8 19 146 36.8 8 151 41.1 South Park 14 114 21.2 16 118 22.8 3 127 25.4 30 128 26.2 17 134 29.3 11 137 30.3 7 139 32.5 — — — — — — St. Vincent 3 105 18.5 9 112 20.0 4 116 20.9 14 125 26.3 10 133 28.9 3 137 32.9 5 141 33.4 9 147 38.4 3 143 38.1 The Mount Central – – – – – – – – – – – – – The Redbridge 22 112 19.7 15 116 20.6 11 122 23.4 24 126 25.7 16 131 28.2 11 139 32.5 2 141 33.7 – – — — — — The Wm. Torbitt 9 110 18.5 12 113 19.3 6 121 24.1 17 126 25.1 9 136 29.8 6 141 33.9 6 141 33.0 1 141 31.0 — — — Uphall 8 110 19.0 5 117 21.1 5 121 22.6 14 125 24.4 7 143 29.8 5 134 29.9 1 139 33.2 – – — — — — Woodlands 10 110 18.7 7 118 21.9 5 124 23.4 15 128 25.5 2 134 29.2 1 125 24.5 2 145 37.2 – – — — — — Average Heights and Weights of Ilford Children 377 111 19.6 257 116 21.2 158 122 23.5 519 127 25.9 265 128 28.7 227 137 31.7 201 143 35.9 427 145 37.2 119 151 41.1 Gibraltarians 20 106 18.3 9 110 19.2 12 118 22.5 10 123 25.7 10 130 26.7 11 131 28.5 9 136 33.3 13 139 33.6 9 151 41.6 • Averages—Ilford Boys—Previous 10 years:— 1940 626 111 19.5 296 119 21.6 210 122 23.5 632 127 26.1 239 132 28.7 208 136 31.2 296 142 35.1 601 146 37.7 215 151 42.1 1939 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 1938 982 110 19.5 224 115 21.2 132 120 22.6 1106 127 26.7 160 131 28.2 104 136 31.1 188 141 34.5 770 145 37.3 85 150 40.2 1937 1007 109 19.3 251 110 20.1 152 121 23.6 947 126 25.9 149 131 28.3 153 137 31.3 135 141 33.1 681 146 37.2 118 151 42.3 1936 1040 111 19.4 235 115 20.9 147 121 23.0 964 127 26.0 176 132 28.9 148 136 30.7 166 141 34.3 748 145 36.6 88 150 40.8 1935 897 111 19.2 207 115 20.8 154 121 23.1 1020 126 25.3 154 132 28.5 121 135 30.3 182 141 33.6 773 145 47.5 109 149 39.7 1934 828 110 19.1 218 115 20.9 135 121 23.5 909 126 26.2 167 130 27.8 132 135 30.7 165 141 33.4 832 145 36.7 109 150 40.0 1933 819 109 18.8 207 114 20.9 144 120 22.2 915 125 25.2 141 131 28.6 99 135 29.7 158 140 32.8 846 144 35.9 81 150 40.3 1932 713 109 18.9 179 114 20.9 138 120 22.9 879 126 25.1 144 129 27.3 119 135 31.2 172 138 32.8 753 144 35.9 44 149 38.9 1931 897 108 18.6 190 114 20.9 159 119 22.5 903 124 24.9 157 129 27.1 144 134 29.9 142 137 32.8 464 142 34.5 49 144 38.5 54 55 Table VI b.—Table Showing the Average Heights and Weights of the GIRLS Examined. Age Groups Age Groups School 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 – – – – – – – – – – – – – – – – – – – – – – – – – – – Beal Modern – – – – – – – – – – – – – – – – – – – – – – – – – – – Benton tree 16 110 19.7 17 113 19.7 10 122 24.1 66 127 25.0 26 132 28.8 24 135 29.8 15 143 35.2 44 146 37.0 9 149 38.3 Benton (Open Air) – – – – – – – – – – – – – – – – – –– – – – – – – – – – Chadwell 24 111 18.8 18 115 21.9 11 122 23.9 24 128 26.6 18 132 27.5 12 140 32.4 3 139 31.2 – – – – – – Christchurch 28 111 19.5 13 113 20.2 13 123 23.9 26 126 26.1 7 133 30.8 9 140 34.2 1 140 32.2 – – – – – – Cleveland 10 113 19.7 10 113 19.4 3 119 20.8 34 127 27.1 28 131 27.5 21 136 30.4 4 141 35.7 – – – – – – Dane Central – – – – – – – – – – – – – – – – – – 3 148 41.4 29 149 36.7 8 155 40.8 Downshall 25 110 18.4 20 115 19.7 14 120 22.6 24 125 24.3 14 131 27.2 16 137 30.1 20 142 33.9 29 147 38.5 14 154 44.5 Fairlop 35 111 18.8 41 116 21.3 16 112 23.4 53 126 25.2 24 132 28.1 26 136 31.2 14 139 31.6 51 147 38.2 16 153 44.4 Gearies 27 109 18.2 18 116 21.3 10 121 22.6 40 128 26.4 17 131 28.9 12 141 32.2 22 141 32.7 59 149 39.4 28 154 43.2 Good m ayes 18 111 20.2 14 114 20.8 11 122 21.8 42 127 25.8 20 132 29.5 7 140 33.2 4 143 36.1 – – – – – – Gordon – – – – – – – – – – – – – – – – – – – – – – – – – – – Highlands 7 111 20.6 4 120 22.5 3 121 22.1 17 129 27.0 3 132 26.8 7 141 36.2 1 155 50.0 – – – – – – Loxford Central – – – – – – – – – – – – – – – – – – 7 138 31.5 69 149 38.9 34 154 43.5 Mayfield Centra – – – – – – – – – – – – – – – – – – 27 142 34.2 110 147 38.6 37 152 42.2 Mossford 6 111 20.1 6 111 19.3 8 120 24.0 26 126 26.2 10 131 27.4 4 139 33.9 – – – – – – – – – Newbury Park 13 111 18.9 7 115 19.3 12 119 22.9 13 127 26.1 8 131 27.9 8 138 30.7 4 145 35.0 – – – – – – Parkhill 21 114 19.9 11 115 19.6 14 120 22.5 30 127 25.9 10 133 29.4 14 135 29.2 4 138 30.3 – – – – – – St. Augustines 13 110 19.8 8 114 19.7 1 118 19.6 6 127 25.1 4 130 26.8 1 139 33.1 2 146 37.2 5 149 40.8 3 154 51.2 SS. Peter & Paul 14 112 19.4 8 114 20.3 6 121 22.2 17 126 24.7 13 130 26.4 11 133 29.6 2 141 32.8 17 150 38.6 10 156 44.9 South Park 15 112 19.7 15 115 20.3 3 119 25.2 27 129 26.9 17 133 29.1 17 139 32.6 – – – — – – – – – St. Vincent's 4 110 18.3 3 110 20.1 1 122 22.7 7 131 29.5 1 137 31.4 3 133 29.9 – – – 10 149 39.3 4 154 40.7 The Mount Centra] – – – – – – – – – – – – – – – – – – – – – – – – – – – The Redbridge 26 110 18.8 22 117 21.5 7 126 23.7 30 127 26.0 14 133 28.1 10 138 33.3 4 142 32.5 – – – – – – The Wra. Torbitt 8 111 19.8 11 117 21.0 8 119 22.1 17 127 25.2 7 131 26.2 4 141 36.3 2 144 37.3 – – – – – – Uphall 7 111 19.5 9 113 19.1 3 125 23.1 10 128 24.0 8 130 28.2 2 142 32.7 – – – – – – – – – Woodlands 13 111 18.9 13 116 20.6 7 121 22.8 14 127 23.8 6 130 25.6 – – – – – – – – – – – – Average Height ane Weights of Ilford Children.. 330 110 19.2 268 115 20.6 161 121 23.0 523 127 26.0 255 132 28.1 208 137 31.5 139 142 33.9 423 148 38.5 163 153 43.1 Gibraltarians 12 105 17.7 12 112 20.5 8 116 21.5 15 124 24.1 6 127 27.9 7 135 29.5 8 139 33.1 6 141 35.1 9 145 38.1 Averages—Ilford Girls—Previous 10 years:— 1940 548 110 18.9 286 116 209.9 185 121 23.5 579 127 26.6 216 133 28.3 192 137 30.9 232 143 35.6 540 148 39.8 172 153 44.7 1939 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 1938 993 110 18.9 221 114 20.5 139 120 22.9 1083 126 25.2 145 130 27.3 127 135 30.2 193 143 35.6 709 147 38.2 122 151 42.5 1937 937 109 18.9 224 114 21.0 144 119 22.3 1022 126 24.1 164 131 27.5 144 136 31.3 205 141 33.9 841 147 38.0 169 150 40.9 1936 897 109 18.6 257 113 20.1 186 121 22.6 1011 125 24.0 158 131 27.4 157 136 30.5 193 142 34.1 805 147 38.1 115 153 42.9 1935 868 110 18.6 232 115 20.3 131 120 22.2 1059 125 25.0 149 130 27.5 168 135 30.1 193 139 32.8 884 146 37.8 140 152 43.6 1934 837 109 18.5 221 114 20.3 150 119 22.6 925 125 24.9 181 129 27.1 155 135 30.4 219 141 34.7 764 146 38.6 154 150 42.2 1933 799 109 18.6 236 114 19.9 152 119 22.1 932 125 24.5 165 129 26.9 129 134 30.0 180 140 32.8 790 147 37.1 117 150 41.3 1932 751 108 18.6 195 1 113 20.2 151 119 22.5 853 126 25.3 163 129 26.8 143 133 29.5 221 140 32.5 920 145 36.1 81 150 41.8 1931 851 108 18.2 204 110 19.5 198 119 22.4 949 123 24.2 177 1129 26.8 173 133 29.5 244 132.1 32.1 536 144 35.8 83 149 41.1 99 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, 1941. SCHOOLS DISEASES AND CONTACTS No. on Roll Scarlet Fever Diphtheria Measles & German Measles Chickenpox Whooping Cough Mumps Totals, 1941 Totals, 1940 Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Cases Contacts Cases Contacts Barkingside Closed – – – – – – – – – – – – – – – –Real –Modern– –Closed– - - - - - - - - - - - - - Becontree 1139 8 7 1 2 84 63 6 5 13 9 112 86 13 19 Benton (Open Air) Closed - - - - - - - - - - - - - - Chadwell 603 3 3 2 - 84 7 10 6 52 6 152 22 7 8 Christchurch 452 4 4 2 - 42 7 1 - 23 7 72 18 54 16 Cleveland 522 9 6 1 2 96 14 1 - 12 7 119 29 22 17 Dane 421 - - - - - 2 1 - - 1 11 3 2 Downshall 1078 8 10 2 - 130 23 2 - 42 9 184 42 43 12 Fairlop 1237 3 5 1 1 148 32 16 5 55 12 223 55 85 36 Gearies 1049 7 8 - 1 82 5 1 3 45 10 135 27 102 42 Goodmayes 350 11 3 - - 41 5 1 - 28 5 1 82 13 8 9 Gordon Closed - - - - - - - - - - - - - - HIghlands 336 1 1 - - 57 6 2 - 6 1 66 8 2 3 Loxford Central 606 2 4 - 2 3 - 2 4 - - 1 8 10 18 17 Mayfield Central 634 2 1 1 1 2 1 4 4 1 - 10 7 10 3 Mossford 371 2 - - - 100 14 13 6 27 3 142 23 16 13 Newbury Park 333 1 2 - - 70 9 53 14 30 9 2 156 34 10 6 Parkhill 605 7 3 2 3 108 29 5 1 25 7 - 147 43 12 5 St. Augustine's 166 1 2 - - 29 7 - - 2 1 - 32 10 4 3 SS. Peter and Paul's 255 2 2 - - 8 - - - 7 1 - 17 3 14 2 St. Vincent's 271 1 - - - 8 3 - - - - - 9 3 1 2 South Park 658 12 4 1 1 63 3 3 - 41 3 - 120 11 57 22 The Mount Central Closed - - - - - - - - - - - - - - - The Redbridge 329 3 1 - - 64 13 58 11 25 1 1 151 26 6 8 The William Torbitt 304 3 1 - - 83 8 3 1 13 4 - 103 14 3 7 Uphall 238 1 - - - - - 9 2 2 - - 12 2 4 1 Woodlands 341 3 1 1 - 19 4 22 11 18 2 4 67 18 35 4 *County High - 9 5 - - 6 2 1 1 2 - 11 29 8 7 2 *Private - 4 4 - - 73 17 – – 26 – 103 21 22 13 Totals 12299 107 77 14 13 1401 283 214 74 495 97 21 2252 544 558 272 *Notification of minor infections diseases in these schools are not, received. Tottenham : Crusha & Son, Ltd., 825-7, High Road.