BOROUGH OF MITCHAM Annual Report of the Medical Officer of Health for 1940 To the Mayor, Aldermen and Councillors, Borough of Mitcham. Sir, Ladies and Gentlemen, Owing to war conditions this annual report is confined to the urgent and essential matters effecting the public health during the year. In November 1940 your Medical Officer of Health was unfortunately killed by enemy action, and Mitcham lost one of it3 most popular and efficient Officers. Heavy and almost continuous night raids during the latter months of the year put a great strain on the Health Services, but I am glad to report that the general health of the population remained good and in spite of shelter life, no epidemic of infectious disease occurred. There was an increase in the birth rate, which is the highest reported since 1936, end an increase in the death rate, the highest since 1918. Meopham Road and Western Road Infant Welfare Centres were discontinued in 1939, but in spite of this the number of new attendances increased. Woodlands Maternity Home- continued its work satisfactorily. Although the upper wards were closed, 239 cases were admitted, 15 fewer than in 1939. During the latter part of the year, the routine duties of the Sanitary Inspectors were limited by war conditions, and they gave an increasing amount of time to the a.R.P. services, their help proving most valuable during a difficult period. A. ASHWORTH Medical Officer of Health. August, 1942. Statistics and Social Conditions. Area (in acres) 2935 acres. Population, Census 1921 35,119. „ „ 1931 56,856. „ Registrar-General 1940 60,630. Number of inhabited houses 16,635. Rateable Value 1940 £503,507. Sum represented by 1d. rate £1,950. MIT9 2 Births. Live births. Male. Female. Total. Legitimate 448 460 908 Illegitimate 14 12 26 Total 462 472 934 Rate 15.4 per 1000 population. Still births. Male. Female. Total. Legitimate 11 13 24 Illegitimate 1 1 Total 11 14 25 Rate 26.06 per 1000 total births. Deaths. Male. Female. Total. 577 339 716 Rat® 11.8 per 1000 population. Maternal Mortality. From Puerperal Sepsis From other Puerperal Causes 1 Total. 1 Rate 1.04 per 1000 births. Death rates of infants under one year of age: All infants per 1000 live births. 46. Legitimate infants per 1000 legitimate live births. 44. Illegitimate infants per 1000 illegitimate live births. 115. Deaths from: Cancer (all ages) 94. Measles (all ages) Whooping Cough (all ages) Diarrhoea (under 2 years of age) 2 Notifications of Infectious Disease. Cerebro-Spinal Meningitis. 13. Diphtheria. 36. Erysipelas. 17. Measles. 301. Non-Pulmonary Tuberculosis. 11. Ophthalmia Neonatorum. 1. Pneumonia. 30. Puerperal Pyrexia. 2. Pulmonary Tuberculosis. 60. Scarlet Fever. 48. Whooping Cough. 16. Notifications of Food Poisoning. 4. 3- Birth-rates, Death-rates, Analysis of Mortality, Maternal Mortality and Case notes for certain Infectious diseases in the Year 1940. Provisional figures based on Weekly and Quarterly Returns. Mitcham England and Wales. 126 C.Bs. and Great Towns including London. 148 Smaller Towns Resident Pop. 25,000 50,000 1931 Census. London Adm. County England 126 C.Bs. and and Great Wales. Towns including London. |148 Smaller Towns Resident Pop. 25,000 -50,000 1931 Census. London Adm. County Mitcham. . >Rates per 1,000 Civilian Population:- Deaths under 1 year of age. Deaths from Diarrhoea and Enteritis under 2 years of age. Rates per 1,000 Live Births:- Live births 15.4 14.6 16.0 15.7 13.7 55 61 54 50 46 Still births 0.41 0.55 0.64 0.55 0.44 Deaths:- All Causes 11.8 14.3 15.8 12.8 17.8 Typhoid and Paratyphoid 0.01 0.00 0.00 0.00 0.00 4.6 5.9 4.4 5.8 2.14 Small-Pox - - — - _ Measles 0.00 0.02 0.02 0.02 0.01 Scarlet Fever 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.00 0.02 0.02 0.02 0.00 Rates per 1,000 Total Births (Live and Still) Diphtheria 0.06 0.06 0.07 0.05 0.01 Influenza 0.08 0.32 0.29 0.30 0.18 Notifications:- Maternal Mortality: Puerperal Sepsis Others Total 0.52 - Small-pox - 0.00 - - - 1.64 not available 1.04 Scarlet Fever 0.79 1.63 1.53 1.57 0.82 2.16 1.04 Diphtheria 0.54 1.16 1.29 1.21 0.61 Enteric - 0.07 0.06 0.10 0.06 Notifications:- Erysipelas 0.29 0.33 0.36 0.30 0.35 Pneumonia V.booping Cough 0.49 0.26 1.20 1.34 1.37 1.29 1.00 1.35 0.87 0.22 Puerperal Fever „ Pyrexia 11.96 13.90 9-73 3.34 13.30 1.04 Measles 4.96 10.24 9.23 9.99 1.78 * including Puerperal Fever. 4. Deaths Registered during the Year, 1940. Cause of Death. Males. Females. Total. Typhoid and paratyphoid ... 1 . 1 Measles ... ... ... Scarlet Fever ... ... • • • Whooping Cough ... ... • • • Diphtheria 1 3 4 Influenza 4 l 5 Encephalitis Lethargica ... l l Cerebro-spinal Fever 2 5 7 Tuberculosis of the Respiratory System 22 22 44 Other Tuberculous Diseases 6 3 9 Syphilis 4 4 8 General Paralysis of the insane, tabes dorsalis ... ... ... Cancer, malignant disease 50 44 94 Diabetes l 5 6 Cerebral Haemorrhage 17 30 47 Heart disease 70 87 157 Other Circulatory Diseases 8 2 10 Bronchitis 36 26 62 Pneumonia (all forms) 22 22 44 Other Respiratory Diseases 5 2 7 Peptic Ulcer 6 1 7 Diarrhoea, etc. (under two years) 1 1 2 Appendicitis 3 1 4 Other Digestive Diseases 6 4 10 Acute and Chronic Nephritis 7 5 12 Puerperal Sepsis ... ... ... Other Puerperal causes ... 1 1 Congenital Debility, Premature Birth, Malformations, etc 16 10 26 Suicide 2 ... 2 Road Traffic Accidents 10 1 11 Other Violence 46 39 85 Causes ill-defined or unknown ... ... ... All other Causes 32 18 50 Total 377 339 716 5- 5 General Provision of Health Services for the Area. Laboratory Facilities. Bacteriological examinations for this district are carried out at the Wandle Valley Isolation Hospital. The following number of specimens from this borough have been examined during the year:- Swabs for diphtheria 277 Sputa for tubercle 56 Total Hospital Facilities. The Wilson Hospital is a voluntary Hospital situated in the Borough, for Mitcham residents. Other voluntary Hospitals are the Nelson Hospital, Croydon General Hospital and the London voluntary Hospitals. Cases may always be admitted to furrey County Hospitals. Cases of infectious disease are admitted to the handle Valley Joint Isolation Hospital. Ambulances. The Borough has two ambulances for the removal of general and accident cases. Since the outbreak of war these ambulances have been under the control of the Public Health Department. The Wandle Valley Joint Hospital Board provide two ambulances for the removal of infectious disease cases. Mid wives. There are four municipal midwives practising in this Borough. The Surrey County Council is the Local Supervising Authority. Health Visiting. Five health visitors are employed in this Borough. The Superintendent Health Visitor also acts as Infant Life Protection Visitor. During 1940, 8,457 visits were made by the Health Visitors, 362 of these visits were paid to expectant mothers, 3,084 visits to children under 1 year of age, and 3,614 visits to children between one and five years of age. In addition 620 visits were paid to cases of tuberculosis. Nursing in the. There are three nursing associations in the Borough. The following are the returns from each association for the year ended December 3lst 1940. Association. No. of nurses. No. of Patients Visited. No. of visits made. St. Barnabas 1 full-time 112 4,269 Mitcham South & East 2 „ „ 447 9,996 1 part-time Christchurch, Mitcham, 1 full-time 167 3,086 Provident 1 part-time 6. Clinics and Treatment Centres. Church Road (4 sessions per month). No. of new cases registered during year - 277. No. of children under 1 yr. attending for first time - 220. No. of children between 1-5 years attending first time - 57. No. of children under 1 yr. on Dec. 31st, 1940 - 149. No. of children between 1-5 yrs. on Dec. 31st, 1940 - 514. Total attendances - 2132. West Centre (4 sessions per month). No. of new. cases registered during year - 200. No. of children under 1 year attending for first time - 157. Ho. of children between 1-5 years attending first time - 43. No. of children under 1 year on Dec. 31st, 1940 - 111. No. of children between 1-5 years on Dec. 31st 1940 - 296. Total attendances - 1611. St. Barnabas (4 sessions per month). No. of new cases registered during year - 246. No. of children under 1 year attending for first time - 205. No. of children between 1-5 years attending first time - 41. No. of children under 1 year on Dec. 31st 1940 - 140. No. of children between 1-5 years on Dec. 31st, 1940 - 443. Total attendances - 1947. Sherwood House (4 sessions per month). No. of new cases registered during year - 194. No. of children under 1 year attending for first time - 126. No. of children between 1-5 years attending first time - 68. No. of children under 1 year on Dec. 31st, 1940 - 94. No. of children between 1-5 years on Dec. 31st, 1940 - 374. Total attendances - 173. Ante-Natal Clinics No. of expectant mothers attending - Mitcham Court - 208. Mitcham Court (Midwives) - 255. Woodlands - 248. Post-Natal Clinic. No. of mothers attending - 84. Home Helps. The services of Home Helps were provided for 24 mothers Orthopaedic Clinic. 36 cases were referred for treatment during the year. X-Rey Examinations. 16 expectant mothers were sent for X-ray examination during the year. Immunisation Clinic. 139 children were immunised against diphtheria during the year. Infant Life Protection. No. of foster-mothers on register Dec. 31st, 1940 - 14. No. of foster-children. 15. No. of visits paid by visitor. 200. No. of foster-mothers who have evacuated taking foster-children with them. 10. 7. Woodlands Maternity Home. No. of beds. 15. No. of eases admitted. 239. No. of cases delivered by midwives. 226. No. of cases delivered by doctors. 13. No. of cases of puerperal pyrexia. 1. No. of infants not entirely breast fed. 2. No. of still births. 5. Wandle Valley Isolation Hospital. 151 cases were admitted during the year. British Dental Hospital. No. of attendances during the year: Women 57 Children 35 Total 92. 8. The Annual Report of the Chief Sanitary Inspector. To the Mayor, Aldermen and Councillors of Mitcham. Sir, Ladies and Gentlemen, I bog to submit a summary of the visits and works carried out in the Borough by myself and the District Sanitary Inspectors:- Number of complaints received and investigated 426 Number of premises inspected 1259 Number of premises revisited 585 Number of houses measured for permitted numbers, Housing Act, 1936 24 Number of nuisances discovered 348 Number of nuisances abated without reports 243 Number of nuisances abated after reports 26 Number of intimatory notices served 112 Visits to butchers and other food shops 127 Visits to factories 53 Visits to marine stores 9 Visits to stables 25 Visits to refuse dumps 20 Details of visits to other premises are enumerated in other sections of the report. Character of Work done to abate nuisances. Roofs repaired 34 Rainwater gutters and piping repaired or renewed 14 Ventilation under floors provided or improved 5 Dampness to ground floor rooms remedied 15 Water service pipes repaired 8 Ventilation of watercloset compartments provided 1 Waterclosets: repairs to roof, walls, doors and seats 17 Flushing apparatus repaired or renewed 21 Water storage cisterns cleansed or covered 14 Water supply to houses reinstated 6 Back yards and sculleries paved or repaired 5 Flooring of rooms repaired 7 Rooms cleansed and redecoated 135 Repairs to internal plastering of walls and ceilings 146 New scullery sinks provided 2 Repairs to sinks and waste pipes 20 Walls round sinks rendered 4 Window frames and sashes repaired 55 Windows made to open 10 Sashcords provided 16 Drains tested 8 Drains repaired and cleansed 143 New watercloset pans and traps provided 12 Repairs to firegrates 5 Repairs to washing coppers 3 New dustbins provided 43 Accumulations removed 17 Rooms disinfected after infectious disease 187 Repairs to chimney eaves 4 All ponds and ditches in the Borough whore mosquito breeding was possible, were sprayed with paraffin twice early in the year. Petroleum (Consolidation) Act, 1928. - Seventy-four licences to store petroleum and cellulose solutions were granted, totalling 119,320 gallons. A licence was also issued for 8 cwt. of carbide of calcium to be stored. 9 Housing Stactistics Total number of dwalling houses inspected for housing defects (under Public Health or Housing Acts) 461 Number of inspections made for the purpose 523 Number of defective dwelling houses rendered fit in consequence of informal action by the local authority or their officers 112 Number of dwelling houses in which defects were remedied after service of formal notices 16 Eradication of Bed Bugs. No. of Council houses found infested during year 65 No. of other houses found infested during the year 27 No. of houses disinfested during the year 92 No. of Council houses disinfested by Council staff 65 No. of Council houses disinfested by Contractors nil Methods employed:- 8l rooms treated with sulphur dioxide (Cescones). 158 rooms treated with insecticide sprays (Lethane or Solitox) (inclusive of rooms treated on more than one occasion). No private houses are treated by the Council staff, but advice is given and material supplied at cost price on request. No. of private houses disinfested by owners or occupiers after notice 27 Inspection and Supervision of Food Food & Drugs Act. 1938. Formal Samples - 48 as follows: Milk 46. Chocolate roll 1. Butter 1. Informal Samples - 32 as follows: Margarine 7. Pork sausage 5. Cocoa 4. Fish paste 3. Chocolate roll 2. Salmon 1. Beef dripping 1. Chopped lamb 1. Coffee 1. Soup powder 1. Jam 1. Tinned peas 1. Castor oil 2. Seidlitz powder 1. Gregory powder 1. Seven warning letters were sent to suppliers of samples slightly below standard. Proceedings were taken in one case of milk reported by the Public Analyst to be deficient in solids not fat. Case dismissed on technical error in service of summons. 10. Milk (Special Designation) Order 1936. During the year the Council granted the following number of licences under the above orders Tuberculin Tested. 5. Pasteurised. 7. Pasteurising Plant. 1. Supplementary licences Pasteurised. 7. Tuberculin Tested. 5. No. of visits made to Meat Depot 20. - 444. Unsound food dealt with. Beef. 2978 lbs. Mutton. 2787 „ Veal. 275 „ Offal. 10433 „ Sheeps heads. 963. Fish, shellfish. 336 „ Rabbits 51. Butter and margarine. 384 ¾„ Bacon. 10 „ Jellied veal. 42 „ K. J. GUTTERIDGE Chief Sanitary Inspector.