LIBRARY LEW 2 METROPOLITAN BOROUGH OF LEWISHAM ABRIDGED ANNUAL REPORT On The Health Of The Borough During the year 1944. BY John W. Miller, M.B., Ch.B, D.P.H., Medical Officer of Health. Public Health Department, Lewisham Town Hall, CATFORD. S.E.6. Public Health Department, Lewisham Town Hall, Catford. S.E.6. October, 1945. To: The Mayor, Aldermen & Councillors of the Metropolitan Borough of Lewisham. Mr Mayor, Ladies and Gentlemen, I beg to submit my Annual Report on the health and sanitary conditions of the Borough for 1944.. In accordance with the instructions of the Ministry of Health the report is, like those for the war years 1939—1943, in an abbreviated form and mainly serves to record essential vital and other statistics. There was no outbreak of serious epidemic disease, and, with the exception of Scabies, infectious disease generally was less prevalent. It is satisfactory to note that Diphtheria is still on the decline end the immunisation work of the past ten years is having effect on the incidence of this disease. There are no other matters which call for special comment. The following figures are of interest and are inserted for purpose of comparison with previous years. 1939 Average 4 years 1940-1943 1944 Birth Rate 13.6 16.0 18.6 Death Rate 10.7 14.0 14.7 Infant Mortality Rate 42 39 40 It should bo borne in mind that the war-tine figures relate solely to the civilian population of the Borough. I tender my thanks to the members of the Council for the support and consideration given to no, and to the staff of the Department. I desire to express my appreciation of their loyal co-operation. I an Mr. Mayor, Ladies and Gentlemen, Your obedient servant Medical-Officer of Health. SUMMARY OF STATISTICS FOR THE YEAR 1944. AREA OF THE BOROUGH 7015 Acres POPULATION Census 1931 219,953 Registar- General's Estimate of the Civil Population 163,320 RATEABLE VALUE £1,790,892 Estimated Product of 1d. Rate £6,500 BIRTHS Number of live births 3046 Males Females TOTALS Legitimate births 1496 1365 2861 Illegitimate births 86 99 185 1582 1464 3046 BIRTH RATE PER THOUSAND OF THE ESTIMATED POPULATION 18.65 Total still-births 68 (a) Legitimate 64 (b) Illegitimate 4 Still-birth rate per thousand (live and still) 21.8 births DEATHS Number of deaths (Males = 1231 Females =1185 2416 DEATH RATE PER THOUSAND OF THE ESTIMATED POPULATION 14.79 Number of Infant deaths 123 (a) Legitimate 113 (b) Illegitimate 10 INFANT MORTALITY RATE (a) All Infants per 1000 Births 140.3 (b) Legitimate Infants per 1000 Legitimate 40.3 Births. 39.5 (c) Illegitimate Infants per 1000 Illegitimate Births. 54.0 Number of Maternal Deaths 3 (a) Puerperal Sepsis 1 (b) Other Maternal Causes 2 MATERNAL MORTALITY RATE 0.96 PER THOUSAND TOTAL LIVE AND STILL BIRTHS 0.96 Number of deaths from Measles (all ages) 1 " " " " Whooping Cough 9 '' '' " " Diarrhoea (under 2 years) 20 '' '' " " Tuberculosis 146 '' '' '' " Cancer 329 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING THE YEAR 1944. Causes of Death. Ages at Death TOTALS 0-1 1-5 5-15 15-45 45-65 Over 65 All Ages Typhoid & Paratyphoid Fevers . . . . . . 0 Cerebro-Spinal Fever 2 . 1 . . . 3 Scarlet Fever . 1 . . . .. 1 Whooping Cough 8 1 . . . . 9 Diphtheria . . . . . . 0 Tuberculosis of Respiratory System 1 . 1 73 45 9 129 Other forms of Tuberculosis 2 2 2 8 2 1 17 Syphilitic Diseases . . . . 10 13 23 Influenza . . . 2 5 9 16 Measles . 1 . . . . 1 Acute Infectious Encephalitis . . . . 1 . 1 Cancer, Buccal Cavity & Oesophagus (M), Uterus (F) . . . 1 6 14 21 Cancer, Stomach & Duodenum . . . . 17 32 53 Cancer, Breast . . . 4 26 12 42 Cancer, all other sites . . 1 15 88 109 213 Diabetes . . . 1 3 8 12 Intra-Cranial Vascular Lesions . . . 4 48 133 185 Heart Diseases . 1 1 20 118 441 581 Other Circulatory Diseases . . . . 22 60 82 Bronchitis 2 . . 3 33 73 111 Pneumonia 12 10 2 8 23 54 109 Other Respiratory Diseases . . . 2 9 8 19 Ulcer, Stomach &. Duodenun 1 . . 3 21 15 40 Diarrhoea (under 2 years) 18 2 . . . . 20 Appendicitis . 1 1 2 2 1 7 Other Digestive Diseases 2 1 . 6 8 20 37 Nephritis 1 1 1 3 15 20 41 Puerperal & Post Abortive Sepsis . . . 1 . . 1 Other Maternal Causes . . . 2 . . 2 Premature Birth 29 . . . . . 29 Congenital Malformations, Birth Injury, Infantile Diseases 33 . 1 2 . . 36 Suicide . . . 3 5 3 j 11 Road Traffic Accidents . 1 3 1 4 5 14 Other Violent Accidents 7 14 20 136 127 97 401 All other causes 5 2 2 16 25 99 149 Total All Causes 123 38 36 320 663 1236 2416 Note. The high figure under the heading "Other Violent Causes" is chiefly due to civilian casualties as a result on enemy action. PREVALENCE AND CONTROL OVER INFECTIOUS DISEASE The number of cases notified (corrected for altered diagnosis) and the number of Deaths during the year 1944 were as follows:- Disease. Total cases Notified Cases admitted to Hospital Total Deaths. Cerebro-Spinal Fever 4 4 3 Diphtheria 24 26 0 Scabies 654 - - Dysentery 65 59 - Enteric Fever - - 0 Erysipelas 86 43 - Food Poisoning 1 - - Measles 688 108 1 Ophthalmia Neonatorum. 4 4 0 Pneumonia 110 47 109 Puerperal Fever 1 1 0 Puerperal Pyrexia 19 17 1 Scarlet Fever 270 267 1 Whooping Cough 275 83 9 Snail pox 1 1 0 TOTALS 2202 660 124 IMMUNISATION AGAINST DIPHTHERIA. Year Number Immunised No. of cases of Diphtheria Notified. No. of Deaths from Diphtheria 1954 - 473 9 1935 236 314 14 1936 448 247 4 1937 1,027 328 11 1938 1,406 469 25 1939 686 157 8 1940 220 78 6 1941 3,100 82 8 1942 5,104 55 1 1943 5,359 26 0 1944 1,534 26 0 NOTE: The Diphtheria Immunisation Scheme was adopted by the Council in March 1955. The fall in the figures of children immunised during 1944 was primarily due to Fly and Rocket Bomb enemy attacks, which resulted in wholesale evacuation of children and a falling off in attendances of children at Schools and Clinics. TUBERCULOSIS The number of new cases notified during the year 1944 and the number of deaths (together with comparative figures for the previous year) were as follows:- NEW CASES NOTIFIED DEATHS 1943 1944 1943 1944 Pulmonary 327 320 128 129 Non-pulmonary 76 70 22 17 TOTALS 403 390 150 146 The age distribution of the New Cases notified and the Deaths from Tuberculosis arc shown in the following table:- NEW CASES NOTIFIED DEATHS Pulmonary Non pulmonary Totals Pulmonary Non pulmonary Totals M F M F M F M F Under 1 year 1 1 . . 2 1 . . 2 3 1 to 5 years 1 7 1 5 12 . . 1 1 2 5 to 10 " 4 2 6 . 12 . 1 . 1 1 3 10 to 15 " 4 4 3 5 16 . 15 to 20 " 30 17 9 4 60 20 to 25 " 31 38 6 5 80 35 38 4 4 81 25 to 35 " 32 27 6 9 74 35 to 45 " 29 18 1 3 51 45 to 55 " 25 11 2 3 41 33 12 1 1 47 55 to 65 " 26 6 3 . 35 . . 65 & Upwards 6 . . 1 7 9 . . 1 10 TOTALS 189 131 37 33 390 79 50 7 10 146 TUBERCULOSIS ALLOWANCES The scheme for the provision of allowances to patients giving up work to undergo treatment (which cane into operation in Juno 1943) continued to function as part of the Council's Tuberculosis Dispensary Service. MASS MINIATURE RADIOGRAPHY Early in the year the London County Council intimated that arrangements had been made for putting the Government Scheme for mass radiography into operation for a limited extent to serve residents of Lewisham and the adjoining areas. A Radiographic Mobile Unit was established temporarily at The London County Council's South Eastern Hospital, New Cross. The quota of Lewisham residents for examination was between 1500 and 2000 and in consequence of the United use of the apparatus arrangements were made to concentrate on selected groups from the larger industrial concerns in the Borough and from the Borough Council's. Staff. 1289 Volunteers took advantage of the Scheie and they were transported in an omnibus to the hospital and back. PROVISION OF HEALTH SERVICES IN THE BOROUGH NOTIFICATION OF BIRTHS The total number of births notified in the Borough was 2633. Of this number 41 were still births. NURSING IN THE HOME The number of visits paid to cases by nurses from Nursing Associations at the Council's expense was 4,978 at a cost of £522 5s 9d. HEALTH VISITORS The following is a brief summary of the visits made by the Health Visitors during the year:- TOTAL VISITS To Expectant Mothers 2019 To Children under 1 year 8006 To Children 1 to 5 years 12,893 INFANT WELFARE CENTRES The number of attendances at the Maternity & Child Welfare Centres were as follows:- Infant Welfare Centres Babies 2055 Children 1 to 5 years 5302 ANTE-NATAL AND POST-NATAL CLINICS Total Attendances 2890 CHILD LIFE PROTECTION The number of Foster Mothers on the Register at the end of the year was 60 and the number of children on the Register was 69. 1,452 visits and re-visits were made to foster mothers and foster children. CARE OF ILLEGITIMATE CHILDREN Towards the end of the year the Council adopted a scheme for the care of Illegitimate Children including guaranteed payments to Foster Mothers, in accordance with Ministry of Health Circular No, 2866. The scheme provided for financial assistance to voluntary associations engaged on this work and a contribution of £184 per annum, based on the rateable value, was authorised. HOME HELPS Under the Council's Maternity & Child Welfare Scheme Home Helps wore provided to mothers during the lying-in period in 406 cases. WAR-TIME NURSERIES In August 1944 after consultation with the Ministry of Health arrangements were made to transfer sons of the Nursery Staff and equipment for temporary duty in the reception areas. Consequently the St. Peter & St. Paul Nursery at Bellingham was closed and placed on a care and maintenance basis. The remaining five Nurseries continued to function. BACTERIOLOGICAL EXAMINATIONS. The under-mentioned 1,402 Bacteriological Examinations were carried out at the St. John's Hospital Lewisham, Laboratory, under contract, and the results were as follows:- Positive Negative Total Diphtheria 10 547 557 Tuberculosis 136 692 828 Typhoid 1 4 5 Miscellaneous . 12 12 VACCINATION The Annual Return made by the Vaccination Officer to the Registrar General respecting the vaccination of children whose births were registered in the Borough during the year ended 31st December 1943 shows that of the 2346 births so registered 1342 or 57.2 per cent were successfully vaccinated. PUBLIC MORTUARY AND CORONER'S COURT. The number of bodies taken to the Public Mortuary during the year was 477, Inquests were hold in 185 cases. Those figures do not include deaths due to war operations for which separate provision was made. SANITARY CIRCUMSTANCES OF THE BOROUGH Sanitary Inspectors Work The following brief summaries serve to show the work carried out by the Sanitary Inspectors and the Disinfecting Station Staff during the year:- Pause of Inspection Number of Inspections made Complaints 1015 Infectious Disease 1698 War Damage 1876 Notice from Builders 242 Re Building Licences 224 Rats & Mice and other Posts 211 Re Landlord & Tenant Act Certificates 58 Re Rent Act Certificates 5 Re Water Certificates 2 Re Pharmacy & Poisons Acts 45 Re Housing 101 To Meat Distributing Depot 437 Slaughterhouses 9 Factories, Workshops and Outworkers 1791 Miscellaneous 889 Re-Inspections 3492 Statutory Notices Served 152 Intimation Notices Served 828 Disinfection Number of Premises Disinfected 1477 Number of Articles (bedding etc) Disinfected 26,210 Disinfestation Number of Rooms treated 586 " of Articles treated 765 Verminous Conditions Persons treated at the Council's Cleansing Stations Number of Verminous Children cleansed 2,294 " " " Adults " 158 " " Baths given for Scabies 8,164 INSPECTION AND SUPERVISION OF FOOD MILK At the end of the year there Were 125 Dairy Promises and 204 Purveyors of Milk on the Registers. Fifty-nine Licences for the sale of Pasteurised Milk & Tuberculin Tested Milk were granted during the year. Inspection of Food Promises. The Food Inspectors made 1,816 inspections of promises where food is prepared stored or sold in addition to daily visits to the Government Meat Distributing Depot. A considerable amount of work was also involved in the inspection of food surrendered as unfit for human consumption largely due to damage resulting from enemy action, FOOD & DRUGS AT 1938 During the year 832 samples were submitted by the Council's Sampling Officers to the Public Analyst for examination; Of these 46 were "formal" and 786 "informal". Seven (or 0,84 per cent) samples were found to be adulterated.