MlT 11 BOROUGH OF MITCHAM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1942 BOROUGH OF MITCHAM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1942 Mitcham: H. G. Mather, Caxton Works, Lower Green Borough of Mitcham HEALTH REPORT FOR 1942 To the Mayor, Aldermen and Councillors Sir, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1942. Freedom from enemy action has permitted a gradual return to more normal conditions and large numbers of evacuees have returned requiring increased welfare and other social services. The birth rate has increased and the death rate has decreased. The infant mortality rate has shown a satisfactory decrease, and is the lowest since 1939. In May, the Day Nursery established at Eagle House was opened with accommodation for 65 children. A second Nursery at Robinson Road has been approved for 50 children, which should meet the requirements of mothers in the Colliers Wood area of the Borough. The welfare and ante-natal clinics have again proved satisfactory and the number of sessions has been increased. The work of the voluntary helpers at the welfare centres has been of the highest value and has been greatly appreciated. The Woodlands Maternity Home continued to give satisfactory service, in spite of the difficulties associated with wartime conditions. There has been no serious outbreak of infectious disease, but the number of notifications of Scarlet Fever has considerably increased since last year. Diphtheria notifications, however, have shown a substantial fall; diphtheria immunisation has been urged with encouraging results. The treatment of scabies at the Baths has been very successful, and appears to have proved an effective factor in controlling the spread of this disease. I wish to thank the members of the staff for the loyal and able service they have given during 1942. I am, Ladies and Gentlemen, Yours obediently, A. ASHWORTH, Medical Officer of Health. Public Health Department, Mitcham Court, Mitcham. BOROUGH OF MITCHAM PUBLIC HEALTH COMMITTEE Chairman - - Councillor H. L. Gauntlett His Worship the Mayor (Alderman J. R. Beaumont, J.P.) Aldermen— E. J. D. Field, J.P. S. L. Gaston, J.P. Councillors — G. W. Cole W. F. Hill G. R. Madgwick G. W. Pearce Mrs. C. Randall Sir I. Wilson MATERNITY AND CHILD WELFARE COMMITTEE Chairman - - - Mrs. C. Randall His Worship the Mayor Councillors— S. E. Birch G. G. Cock H. Conway Miss G. D. Francombe Mrs. H. M. Hallowes J. E. Mahony T. A H. Murch Mrs. E. Watson Co-opted Members— Miss E. C. Chart Mrs. D. L. Chappell Miss K. Farewell-Jones Mrs. C. Norman Dr. G. Stoker REPRESENTATIVES ON WANDLE VALLEY JOINT HOSPITAL BOARD His Worship the Mayor (ex-officio) Aldermen— C. Woods A. H. Bailey W. Dalton REPRESENTATIVES ON WANDLE VALLEY JOINT SEWERAGE BOARD Chairman - - Alderman S. L. Gaston, J.P. His Worship the Mayor (ex-officio) Alderman W. Dalton Councillor A. T. Gidden STAFF Medical Officer of Health A. Ashworth, M.D., Ch.B., M.R.C.S., L.R.C.P., D.P.H., D.T.M. Assistant Medical Officer Florence M Parsons, M.R.C.S., L.R.C.P. Consulting Gynaecologist J. V. O'Sullivan, Esq., M.D., F.R.C.S. Consultant in Diseases of Infants N. L. Lloyd, Esq., M.B., M.R.C.P. Consultant in Ear Diseases W. H. B. Magauran, M.D., F.R.C.S. Consultant in Diseases of the Eye A. J. Cameron, F.R.C.S., D.O.M.S. Chief Sanitary and Meat Inspector. Petroleum Inapeotor Shops Act Inspector K. J. Gutteridge (1, 2) Assistant Sanitary and Meat Inspectors A. H. Riley (1, 2, 4) L. Gleed (1, 2, 3) Superintendent Health Visitor and Infant Life Proteotion Visitor Mrs. E. S. Wray (6, 7, 8, 9, 10, 11) Assistant Health Visitors Miss G. Russell-Harris (5, 6, 7) Miss D. Hinds (5, 6, 7) Miss E. Oakes (5, 6, 7) Miss P. Thompson (5, 6, 7) Matron of Eagle House Day Nursery (a) Miss J. E. Offer (5, 6, 12) Midwives Miss P. Gaunt (5, 6) Miss M. Monday (5, 6) Mrs. L. Papps (5, 6) Mrs. T. Davies (5, 6) (a) Appointed 9.3.42 Clerks J. B. A. Roodhouse and L. J. Bellingham, H.M. Forces Mrs. M. Odam Miss V. Valentine (temporary) (b) Mrs. H. Whitfield (temporary) (b) Engaged 20.4.42 1. Certificate Sanitary Inspectors' Board. 2. Certificate Meat and Foods R.S.I. 3. Smoke Inspector's Certificate. 4. Diploma Institute of Hygiene. 5. State Registered Nurse. 6. Certificate of Central Midwives' Board. 7. Health Visitor's Certificate R.S.I. 8. Health Visitor's Diploma. 9. Inspector of Nuisances. 10. Sanitary Inspector's Exam. Board. 11. Diploma Sanitary Science. 12. Sick Children's Registered Nurse. 8 REPORT STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,935 acres Population, Census 1921 35,119 1931 56,856 Registrar-General's estimate of population midyear, 1942 54,720 Number of inhabited houses, 1921 7,150 1931 13,187 1942 16,802 Rateable Value, 1942 £499,028 Sum represented by a 1d. rate £1,902 STATISTICS. Rate per 1,000 live Births. Total Male Female of population Legitimate 921 492 429 Illegitimate 39 20 19 Total 960 512 448 17.54 Rate per 1.000 still Births Total Male Female total births Legitimate 24 16 8 Illegitimate 2 2 - Total 26 18 8 26.37 Rate per 1,000 DEATHS. Total Male Female of population 537 269 268 9.81 Deaths from disease and accidents of pregnancy and childbirth:- Rate per 1,000 total births Prom puerperal sepsis - - Prom other puerperal causes 1 - Total 1 1.01 9 Deaths of infants under one year of age:- All infants per 1,000 live births 43.75 Legitimate infants per 1,000 live legitimate births 40.17 Illegitimate infants per 1,000 live illegitimate births 128.21 Deaths from:- Cancer (all ages) 104 Measles Nil Whooping cough (allages) 1 Diarrhoea (under two years of age) 5 Percentage of Births Occurring in Institutions Year Total births Births in hospitals, etc. Percentage of births occurring in institutions 1929 961 309 32.1 1930 1129 367 32.4 1931 1143 370 32.3 1932 1084 381 35.1 1933 1010 420 41.5 1934 982 428 43.5 1935 969 474 48.9 1936 1033 497 48.1 1937 976 501 51.3 1938 1028 569 56.3 1939 966 518 53.7 1940 854 453 53.0 1941 737 408 55.4 1942 986 518 52.5 Sfumber of births notified by midwives in 1942 694 „ „ „ doctors and others in 1942 292 The birth rates, death rates per 1,000 of population, and the infantile mortality rates for the years 1915-1942 are shown in the following table:- 10 Year Births per 1,000 population Deaths per 1,000 population Infant Mortality per 1,000 live births mitcham England & Wales mitcham England & Wales mitcham England & Wales 1915 28.9 21.8 12.7 15.7 78 110 1916 23.0 21.6 10.1 14.3 71 91 1917 18.0 17.8 11.8 14.2 75 96 1918 17.9 17.7 14.8 17.3 77 97 1919 17.0 18.5 10.2 14.0 58 89 1920 27.8 25.4 9.2 12.4 50 80 1921 23.1 22.4 11.1 12.1 70 83 1922 20.9 20.6 11.0 12.8 61 77 1923 21.5 19.7 9.4 11.6 59 69 1924 20.3 18.8 9.2 12.2 55 75 1925 18.2 18.3 9.6 12.2 54 75 1926 21.5 17.8 9 9 11.6 63 70 1927 20.9 16.7 9.8 12.2 45 69 1928 20.4 16.7 8.8 11.7 48 65 1929 19.1 16.3 11.2 13.4 72 74 1930 19.3 16.3 8 2 11.4 49 60 1931 19.2 15.8 9.8 12.3 42 66 1932 18.0 15.3 8.4 12.0 43 65 1933 16.1 14.4 8.8 12.3 37.1 64 1934 15.6 14.8 9.1 11.8 51.6 59 1935 15.6 14.7 7.7 11.8 49.5 57 1936 15.4 14.8 9.1 12.1 48.0 59 1937 14.3 14.9 8.5 12.4 43.4 58 1938 15.1 15.1 8.3 11.6 38.0 53 1939 15.2 15.0 8.6 12.1 31.0 50 1940 15.4 14.6 11.8 14.3 46.0 55 1941 13.57 14.2 11.06 12.9 5 5.4 59 1942 17.54 15.8 9.81 11.6 43.75 49 11 Infant Mortality During the year 42 deaths were registered as occurring in infants under one year of age:- Males Females Total Legitimate 20 17 37 Illegitimate 2 3 5 Total 22 20 38 as compared with 35 deaths last year. Maternal Mortality During the year one death was registered as being due to:Obstetric shock cardiac failure. Eclampsia in pregnancy. Severe toxaemia in pregnancy. In 1941, four deaths were registered as being due to diseases or accidents of pregnancy. Inquests Inquests were held on 16 residents dying within the district and on 14 Mitcham residents who died outside the district, a total of 30. In addition, the coroner held 74 post-mortems without inquests. The following table shows the results of the findings of these inquests:- Deaths from natural causes 3 Accidental deaths 16 Deaths from misadventure 4 Suicides 5 Fracture of skull 1 Self-neglect 1 Total 30 12 Deaths Registered during the Year 1942 Cause or Death Males Females Total 1 Typhoid and paratyphoid fevers ... ... ... 2 Cerebro-spinal lever ... ... ... 3 Scarlet fever ... ... ... 4 Whooping cough ... 1 1 5 Diphtheria ... ... ... 6 Tuberculosis of respiratory system 17 19 86 7 Other forms of tuberculosis 5 ... 5 8 Syphilitic diseases 4 2 6 9 Influenza 2 1 3 10 Measles ... ... ... 11 Acute polio-myelitis and polio-encephalitis ... ... ... 12 Acute infectious encephalitis ... ... ... 13 Cancer of buccul cavity and oesophagus (m) and uterus (f) 6 9 15 14 Cancer of stomach and duodenum 10 8 18 15 Cancer of breast ... 11 11 16 Cancer of all other sites 34 26 60 17 Diabetes 1 2 3 18 Intra-oranial vascular lesions 23 36 59 19 Heart disease 56 67 123 20 Other diseases of circulatory system 11 9 20 21 Bronchitis 17 12 29 22 Pneumonia 16 11 27 23 Other respiratory diseases 2 2 4 24 Ulcer of stomach or duodenum 6 2 8 25 Diarrhoea (under two years) 3 2 5 26 Appendicitis ... ... ... 27 Other digestive diseases 6 7 13 28 Nephritis 1 3 4 29 Puerperal and post-abortive sepsis ... ... ... 30 Other maternal causes ... 1 1 31 Premature birth 10 6 16 32 Congenital malformations, birth injuries, infantile disease 4 3 7 33 Suicide 3 2 5 34 Road traffic accidents 3 ... 3 35 Other violent causes 11 5 16 36 All other causes 18 21 39 All causes 269 268 537 13 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1942. (Provisional figures based on weekly and quarterly returns.) England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Besident Populations 25,000 to 50,000 at 1931 census) London Administrative County Mitoham Rates per 1,000 civilian population Births— Live 15.8 17.3 18.4 14.0 17.5 Still 0.54 0.66 0.62 0.48 0.48 Deaths— All causes 11.6 13.3 12.1 13.9 9.81 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 - Searlet fever 0.00 0.00 0.00 0.00 - Whooping cough 0.02 0.03 0.02 0.04 0.02 Diphtheria 0.05 0.06 0.04 0.02 - Influenza 0.09 0.09 0.10 0.07 0.05 Smallpox - - - - - Measles 0 01 0.02 0.01 0.01 - Notifications— Typhoid fever 0.01 0.01 0.01 0.02 - Paratyphoid fever 0.01 0.01 0 01 0.01 - Cerebro-spinal fever 0.14 0.17 0.12 0.15 0.07 Scarlet fever 2.19 2.49 2.34 1.S6 3.20 Whooping cough. 1.73 1.97 1.58 2.72 2.94 Diphtheria 1.05 1.35 0.91 0.76 0 46 Erysipelas 0.30 0.36 0.26 0.43 0.13 Smallpox 0.00 0.00 - 0.00 - Measles 7.46 9.27 7.39 8.62 10.95 Pneumonia 1.07 1.30 0.94 0.94 0.37 Bates per 1,000 live births Deaths under one year of age 49 59 46 60 43 Deaths from diarrhoea and enteritis under two years of age 5.2 7.5 4.8 8.6 5.2 Rates per 1,000 total births (live and still) Maternal mortality (excluding abortion)- Puerperal infection (No.147) 0.42 Not available - Others 1.59 1.01 Total 2.01 1.01 Notifications— Puerperal fever 12.61 15.94 10.80 3.10 6.09 Puerperal pyrexia 17.69* * Including Puerperal fever. A dash (—) signifies that there were no deaths. 14 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 331 Sputa for tubercle 51 Total 382 AMBULANCES The Ambulance service for the district is quite adequate at present, and the following arrangements have been made:- For General and Accident Cases.—Two ambulances have been provided by the Council for the removal of general and accident cases. The total number of cases removed during the year was 1,338, of which 338 were accident cases, and 1,000 private removals. For Infectious Disease Cases.—The Wandle Valley Joint Hospital Board have provided two motor ambulances for the removal of cases of infectious disease to the Isolation Hospital. NURSING IN THE HOME There are three nursing associations in the Borough. The following are the returns from each association for year ended December 31st, 1942:- No. of Nurses No. of patients visited during 1942 No. of visits paid during 1942 St. Barnabas ... 1 108 4,029 South and East Wards 8* 424 10,055 Christchurch ... 2# 158 3,758 Totals 690 17,837 * One part time. 15 HOSPITALS. For General Cases.—The Wilson Hospital, which is a Voluntary Hospital situated within the district, receives accident and general cases. Other voluntary general hospitals available for the district are the Nelson Hospital (Merton), the Croydon General Hospital, and the South London Hospital for Women (Clapham). The large London hospitals are also within easy reach of the district. The Surrey County Council are the local hospital authority and the County Council hospitals provide hospital accommodation for Mitcham patients. For Infectious Diseases.—The Council is one of the constituent authorities forming the Wandle Valley Joint Hospital Board, and cases of infectious disease from this area are treated at their hospital situated at Beddington Corner, Mitcham Junction. For Small Pox Cases.—By an arrangement with the Surrey County Council cases of small pox are admitted to the Small Pox Hospital, Clandon. For Maternity Cases.—Cases requiring hospital treatment are admitted to the County Council Hospitals or the London Voluntary Hospitals. DOMICILIARY MIDWIFERY Four municipal midwives have been appointed for this Borough, the Borough Council acting as agents for the Surrey County Council, who are the local supervising authority. WOODLANDS MATERNITY HOME The Borough Maternity Home has accommodation for 15 cases. All patients must be Mitcham residents, and those who wish may book their own medical attendant for the confinement. CLINICS AND TREATMENT CENTRES Welfare Clinics Infant Welfare Centres are held at the following places:- 16 Sunshine Hall, Park Road.—Sessions are held every Monday afternoon. St. Barnabas Church Hall, Gorringe Park Avenue.—Sessions are held every Tuesday afternoon. Sherwood House, Commonside East.—Sessions are held every Thursday morning. Church Road Centre.—Sessions are held every Thursday afternoon. Dr. Parsons attends all sessions. Ante-Natal Clinics Ante-natal clinics are held at the following places: — Woodlands Maternity Home.—Sessions are held on Friday and Monday mornings for patients who have booked for the Woodlands Maternity Home. Mitcham Court.—Sessions are held on every Tuesday morning. The municipal midwives also hold a clinic at Mitcham Court on Wednesday afternoons. Post-Natal Clinic A post-natal clinic is now held at Mitcham Court on the fourth Tuesday of each month. School Clinic The Surrey County Council is the Local Education Authority. Medical and dental services are provided at the School Clinic, London Road. Diphtheria Immunisation Clinic Diphtheria Immunisation Clinics are held every Wednesday morning at Mitcham Court. Scabies Clinic A Clinic for the diagnosis of this condition is held by the Medical Officer of Health at Mitcham Court every morning. 17 Tuberculosis Clinic The Surrey County Council is the authority responsible for diagnosis and treatment of tuberculosis. Dispensaries are held at the London Road J.B. School as follows:- First, third and fifth Tuesday of month at 1.30 p.m. Each Thursday at 1 p.m., and third Saturday at 1.30 p.m. Venereal Diseases Clinics The Surrey County Council is the responsible authority for venereal diseases in this area and is a member of the London and Home Counties Scheme. The arrangements provide for the free diagnosis and treatment of these diseases at the Croydon General Hospital, Royal Surrey County Hospital, Guildford, East Surrey Hospital, Redhill, and at hospitals under the London and Home Counties Scheme. Disinfection The disinfection of houses is undertaken by the Council. Disinfection of bedding, etc., is done by the Wandle Valley Isolation Hospital. Charges are made for disinfection which is not in the interests of the public health. REPORT ON MATERNITY AND CHILD WELFARE SERVICES Child Welfare Child Welfare Sessions are held at four centres, thus serving every part of the Borough. Every centre is held weekly. The total number of attendances at the infant welfare centres was 16,509, as compared with 9,555 in 1941. Of these, 994 were new cases, 820 being infants under one year of age, and 174 being children over one but under five years of age. The total number of attendances of infants under one year was 11,821, and of children between one and five years of age, 4,688. 18 At the end of the year there were 716 infants under one year and 1,426 children between one and five years of age attending the centres, making a total of 2,142. The average attendance at each individual centre was:Park Road 73.2 Church Road 75.5 Sherwood Park 83.8 St. Barnabas 84.6 The percentage of infants under one year of age attending the centres for the first time was 85.4 per cent. of the total number of live births. General Remarks The nutrition, clothing and cleanliness of the children continued to be of a high standard, and the children attended the centres very regularly. Sunlight Treatment Arrangements have been made with the Wilson Hospital for giving sunlight treatment. No patients were sent during the year. Orthopaedic Clinic Arrangements have been made with the Wilson Hospital, Mitcham, for children in need of orthopaedic treatment to attend the orthopaedic clinic of this hospital. During the year 58 cases were referred to this clinic, as compared with 24 cases in 1941. Dental Treatment Dental treatment is available to children under five years of age and to expectant and nursing mothers. Patients are referred from the infant welfare, ante-natal and post-natal clinics to the British Dental Hospital, Tooting. Attendances for treatment were as follows:- Expectant mothers, 15; nursing mothers, 1; children under five, 4. 19 Health Visiting There are five health visitors employed in visiting the mothers and children in this district. The Superintendent Health Visitor is responsible for the general supervision of the welfare centres, ante-natal clinics, etc., and also does the visiting of tuberculous patients and acts as Infant Life Protection Visitor. Attendances at Infant Welfare Centres, 1942 Particulars Park Road St. Barnabas Church Boad Sherwood House Total Number of new cases registered during year of— Children under one year of age 168 210 221 221 820 Children over one year and under five years of age 50 57 36 31 174 Number of children in attendance at end of year— Under one year of age 147 193 199 177 716 Over one and under five years of age 253 499 386 288 1426 Total attendances of children under one year of age 2520 3012 3086 3203 11821 Total attendances of children over one year of age 1067 1390 988 1243 4688 Total attendances at centres 3587 4402 4074 4446 16509 Average attendances at centres 73.2 84.6 75.5 83.8 79.2 Percentage of infants under one year of age attending centres of the total live births ... ... ... ... 85.4 Visits Paid by Health Visitors Particulars No. Primary ante-natal visits 171 Subsequent ante-natal visits 90 Primary birth visits 847 Subsequent visits to infants 2,362 Visits to children over one and under five years of age 4,355 Visits re stillbirths 18 Visits re deaths of infants under one year of age 24 Visits re cases of ophthalmia neonatorum 8 Visits re eases of puerperal pyrexia 4 Primary visits to cases of tuberculosis 116 Subsequent visits to cases of tuberculosis 344 Special visits, and infant life protection visits 277 Infectious disease visits 238 Total 8,854 20 Supply of Food and Medicines Dried food, cod liver oil emulsion, Virol and Parrish's Food, were sold at the centres, and in necessitous cases supplied free. Arrangements were such that necessitous children needing dried food other than that supplied at the clinics could obtain this free. Liquid or National Dried Milk is supplied free in necessitous cases on application to the local Food Office. Vitamins are supplied to children under two years of age at Welfare Centres, the Food Office and at British Restaurants. Arrangements were also made for necessitous nursing and expectant mothers to receive free meals. Ante-Natal Centres One ante-natal clinic is held each week at Mitcham Court and two clinics each week in connection with Woodlands Maternity Home. A clinic for cases booked by the mid wives is held each Tuesday at Mitcham Court. Average Attendance at Each Centre Number of expectant Number of Average mothers attendances attendance Woodlands (two clinics) 261 2.627 53.6 Mitcham Court 265 1,566 30.1 Midwives' Clinic 358 1,597 30.7 Total 884 5,790 38.1 Of the total number of registered births, 89.6 per cent. of the mothers had attended the ante-natal centres. The number of expectant mothers who attended the antenatal centres and were evacuated for their confinements was 120. General Remarks The clinics were reserved, as in previous years, for those cases entering Woodlands, hospital, or for evacuation, or who 21 were to be confined in their own homes and attended by midwives. Any patient who was to be attended by her own doctor was advised to attend him for her ante-natal supervision. Any patient found to be suffering from any serious pathological condition was referred to her own doctor or to hospital, a letter giving details of the conditions present accompanying the patient in either case. Letters were sent to midwives who referred patients to the clinics, and midwives were welcomed at the centres, the patients' ante-natal notes being available for their perusal. Cod liver oil emulsion, Virol or Parrish's Food, and extra nourishment were supplied free to necessitous and debilitated patients. X-Ray Examinations Arrangements have been made with the Wilson Hospital, Mitcham, for theX-ray examination of women attending the antenatal clinics. The majority of the examinations are made to determine the presentation of the child in doubtful cases, and also to confirm the diagnosis of twins. During the year 26 women attended for this examination, as compared with 26 last year. Post-Natal Centre A Post-Natal Centre is held at Mitcham Court each month. Leaflets are given to the patients when they leave Woodlands Maternity Home and to the patients attending the various antenatal clinics giving them information about this clinic and the purpose for which it is intended. The total number of women who attended the post-natal clinic was 146, the average attendance being 12.1. WOODLANDS MATERNITY HOME The Woodlands Maternity Home, Devonshire Road, Colliers Wood, was established by the Council in 1924. 22 Staff The staff consists of a matron, two sisters, two staff nurses and five pupil midwives. All the staff are State registered nurses and, with the exception of the pupil midwives, hold the certificate of the Central Midwives' Board. The Home is recognised as a Part II. training school for midwives. Home The Home can accommodate 15 patients at a time, but bookings are limited to 26 patients per month. The following table shows the number of births which has occurred in each year since the opening of the Home:- Number of births 1924 (August to December) 42 1925 129 1926 240 1927 (10 months) 177 1928 265 1929 298 1980 318 1931 259 1982 289 1933 285 1934 285 1935 299 1936 814 1937 309 1938 297 1939 254 1940 239 1941 215 1942 263 Number of maternity beds in the institution (exclusive of isolation and labour beds), 15. Number of maternity cases admitted during the year, 263. Average duration of stay, 14 days. 23 Number of cases delivered by (a) midwives, 231; (b) doctors, 32. Number of cases in which medical assistance was sought by a midwife in emergency, 25 Number of cases notified as (a) puerperal fever, nil; (b) puerperal pyrexia, 2. Number of cases of pemphigus neonatorum, nil. Number of infants not entirely breast-fed while in the institution, 4. Number of cases notified as ophthalmia neonatorum, nil. Number of maternal deaths, nil. Number of stillbirths, 6. Number of infants' deaths within 10 days of birth, 2. An ante-natal clinic is held every Monday and Friday at the Home, and patients who have booked are expected to attend. Infant Life Protection The Superintendent Health Visitor has been appointed the Infant Life Protection Visitor for this district. Frequent visits during the year are paid to the homes of the foster children. A strict supervision is kept on these homes, and no cause was found to remove any infant from the care of the foster mother during the year. The following are the number of foster mothers and children on the register:- Number of foster mothers on register, December 31, 1942 20 Number of children on register, December 31, 1942 18 Number of children who have died during the year - Number of children on whom inquests were held - 24 Number of registrations withdrawn - Number of prosecutions - Number of visits paid by the Infant Life Protection Visitor 91 National Society for Prevention of Cruelty to Children The Society does very valuable work in the Borough and there is very close co-operation between the officials of the Public Health Department and the officers of the Society. War-time Nursery During May, Eagle House, London Road, was opened as a War-time Day Nursery. The house was adapted to accommodate 65 children, and the register was almost immediately filled by children of full-time war workers, preference being given to mothers of only children. The children admitted have made very good progress, both physically and mentally, and have shown the benefit to health of regular hours, good food and fresh air. No serious epidemic of infectious disease has occurred, any cases or suspected cases being immediately isolated, and removed to hospital if necessary. At the end of the year a long waiting list existed, and approval has been given for the establishment of a nursery for 50 children at 63, Robinson Road. This nursery will serve the Colliers Wood district, and will probably relieve the waiting list at Eagle House. The average daily attendance at Eagle House was:- Under two 16.07 Two—five 31.58 Total 47.65 25 SANITARY CIRCUMSTANCES OF THE AREA WATER SUPPLY With the exception of eight houses in Goat Road, the whole of the Borough is supplied by the mains of the Metropolitan Water Board. The houses in Goat Road are supplied from the Sutton Water Company. RIVERS AND STREAMS Twenty visits have been paid to all works suspected of discharging effluent into surface water sewers. CLOSET ACCOMMODATION With very few exceptions the whole of the district is on the water carriage system, the houses being drained to the public sewer. At the end of the year there were three pail closets and one cesspool in use. PUBLIC CLEANSING A fortnightly collection of house refuse is carried out by direct labour. Four dust collection vehicles are in use. A fortnightly collection of salvage is also made, two vehicles being used for this purpose. ERADICATION OF BED BUGS Number of Council houses found infested during year 91 Number of other houses found infested during the year 15 Number of houses disinfected during the year 106 Number of Council houses disinfected by Council staff 91 Number of requisitioned, etc., houses disinfected by Council staff 15 Number of Council houses disinfested by Contractors nil Methods employed:— 100 rooms treated with sulphur dioxide (Cescones). 203 room treated with insecticide spray (Lethane) (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. 26 Number of private houses disinfected by owners or occupiers after notice 24 SCHOOLS The supervision of the public elementary schools is under the control of the Education Department of the Surrey County Council. The sanitary fittings, etc., however, are inspected periodically by the sanitary inspector. All schools have a constant supply of water from the mains of the Metropolitan Water Board. Medical Inspection.—The medical inspection of school children is carried out by the Education Department of the Surrey County Council. Closure of Schools.—No school has been closed by the local authority during the year. Injections Diseases.—Scholars in contact with a case of infectious disease are excluded from school, the period of the exclusion being that set out in the memorandum of the County School Medical Officer to the Surrey Education Committee. The head teacher of the school concerned is always notified of this exclusion and the reason for same. THE ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR To the Mayor, Aldermen and Councillors of Mitcham Sir, Ladies and Gentlemen, I beg to submit a summary of the visits and works carried out in the Borough by myself and the District Sanitary Inspectors:— Total number of visits paid 6,566 Complaints received and investigated 431 Visits re complaints and sundries 1,563 Revisits 945 Houses inspected for defects 940 Number of rooms measured for permitted numbers 98 Number of nuisances discovered 611 27 Number of intimatory notices served 439 Number of nuisances abated without reports 410 Number of statutory notices served 107 Number of nuisances abated after reports 90 Visits to butchers and other food shops 362 Visits to factories 133 Visits to piggeries 71 Visits to refuse dumps 12 Visits re infectious disease 234 Details of visits to other premises are enumerated in other sections of the report. Character of Work Done Roofs repaired 135 Rainwater gutters and piping repaired or renewed 52 Ventilation under floors provided or improved 1 Dampness to ground floor rooms remedied 38 Water service pipes repaired 15 Waterclosets: repairs to roof, walls, doors and seats 29 Flushing apparatus repaired or renewed 39 Water storage cisterns cleansed or covered 14 Water supply to houses reinstated 14 Back yards and sculleries paved or repaired 9 Flooring of rooms repaired 26 Rooms cleansed and redecorated 107 Repairs to internal plastering of walls and ceilings 6 Repairs to sinks and waste pipes 39 Window frames and sashes repaired 49 Windows made to open 1 Sashcords provided 18 Drains tested 31 Drains repaired and cleansed 39 New watercloset pans and traps provided 21 Repairs to firegrates 13 New dustbins provided 54 Accumulations removed 22 Rooms disinfected, after infectious disease 218 Repairs to chimney eaves 1 Sundries 127 28 All ponds and ditches in the Borough where mosquito breeding was possible were sprayed with paraffin twice early in the year. Petroleum (Consolidation) Act, 1928.—Seventy-five licences to store petroleum and cellulose solutions were granted, totalling 137,760 gallons. A licence was also issued for 20 cwt. of carbide of calcium to be stored. Unsound Food Dealt With. Beef 2371 lbs. Eggs 115 Mutton 298 ,, Butter Beans 60 lbs. Pork 171 „ Soya Flour 2½ tons Veal 50 „ Baking powder 3½ ,, Offal 1357 ,, Butter 44½ lbs. Fish 84 „ Bacon 75 „ Whelks 1 cwt. Corned Pork 1823 „ Cheese 68 lbs. Turkeys 3 Potatoes 273 lbs. Number of visits to Meat Depot 20 576 Yours obediently, K. J. GUTTERIDGE, Chief Sanitary Inspector. Housing Statistics I. Inspection of Dwelling Houses during the Year.— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 940 (b) Number of inspections made for the purposes 1,009 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 410 29 3. Action under Statutory Powers during the Year:— Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which notices were served requiring repairs nil (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) By owners nil (b) By local authority in default of owners nil INSPECTION AND SUPERVISION OF FOOD FOOD AND DRUGS ACT, 1938 Formal Samples. 46 formal samples were taken, as follows :— Milk 37 Butter 2 Baking powder 5 Margarine 2 Informal Samples. 32 informal samples were taken, as follows:— Cocoa 2 Custard powder 2 Meat Paste 2 Beef cubes 1 Sausage Meat 1 Flour mixtures 2 Jam 1 Beef suet 2 Baking powders and Vinegar 4 self-raising powders 6 Whiskey 1 Almond flavouring 1 Salad oil 2 Castor oil 1 Camphorated oil 1 Egg powder 3 One warning letter was sent to a supplier of one sample below standard. 30 Proceedings were taken under the above Act on one occasion during 1942. Analysis of a sample of baking powder revealed that it contained arsenic to the extent of five parts per million and fluorine to the extent of 3,000 parts per million. The impurities were due to the use in the manufacture of the baking powder of impure monamonium phosphate. Although the firm agreed that the arsenic and fluorine content were injurious to health the case was dismissed on legal grounds. The firm, however, surrendered their stocks of baking powder, some 3½ tons in all, which were sent for salvage. MILK (SPECIAL DESIGNATION) ORDER, 1936 During the year the Council granted the following number of licences under the above named Order:— Tuberculin Tested 6 Pasteurised 8 Pasteurising Plant 1 Supplementary Licences— Pasteurised 4 Tuberculin Tested 5 BAKEHOUSES The number of bakehouses in the district is 14. Twenty-seven visits have been paid. DAIRIES AND COWSHEDS There are 28 registered premises within the district, of which 27 are dairies and one cowshed. During the year 63 visits of inspection were paid. PIGGERIES There are 23 piggeries in the Borough. Seventy-one visits were paid during the year. OTHER FOOD PREPARING PLACES There are four other premises in which food is prepared for human consumption. All of these have been systematically visited. 31 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of notifications received during the year was 1,021. Contacts, Suspects, Etc. The Medical Officer of Health may be called in consultation by medical practitioners to see patients in their homes. Visits Made by No. Sanitary Inspectors 234 Health Visitors 238 Total 472 The monthly incidence of infectious disease was:— Small Pox. Scarlet Fever Diphtheria Typhoid Fever Erysipelas Pneumonia Puerperal Pyrexia Ophthalmia Neonatorum Dysentery Cerebro-spinal Meningitis Poliomyelitis Measles Whooping Congh Food Poisoning Encephalitis Letchargica Totals January ... 6 4 ... ... 5 2 1 ... ... ... 6 11 ... ... 35 February ... 5 ... ... ... 2 ... ... ... 1 ... 71 10 ... ... 89 March ... 6 3 ... 1 3 ... 2 ... 1 ... 23 10 ... ... 49 April ... 2 5 ... ... 1 ... ... ... 1 ... 29 11 ... ... 49 May ... ... ... ... ... 2 1 ... ... 2 ... 98 4 ... ... 107 June ... 6 2 ... ... ... 2 ... ... ... ... 113 6 ... ... 129 July ... 4 2 ... ... 1 ... 1 ... ... ... 189 11 ... ... 208 August ... 4 1 ... 1 ... ... 1 ... 1 ... 43 4 ... ... 56 September ... 14 2 ... ... ... ... 1 ... ... ... 13 14 1 ... 45 October ... | 46 2 ... 4 ... ... ... ... ... ... 4 26 10 ... 92 November ... 36 3 ... ... 2 ... 4 ... ... ... 7 25 ... ... 77 December ... 46 1 ... 1 4 1 ... ... ... ... 3 29 ... ... 85 Totals ... 175 25 ... 7 20 6 10 ... 6 ... 599 161 11 1 1021 32 Infectious Disease Notifications, 1922-42. Disease 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 ] Small Pox ... ... ... ... ... ... 9 7 ... 4 1 ... ... ... ... ... ... ... ... ... ... Scarlet Fever 178 110 81 106 104 145 102 134 113 105 174 240 392 143 171 192 150 61 48 75 175 Diphtheria 84 35 59 201 87 76 75 133 129 49 32 40 83 80 104 89 64 27 36 72 26 Typhoid Fever 1 2 1 4 2 6 3 4 9 2 3 3 ... 3 5 ... 1 ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 3 2 1 5 6 9 4 6 1 7 5 1 1 2 2 1 ... ... ... ... ... Anthrax ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-spinal 1 ... 6 ... ... 2 1 4 ... ... 1 4 1 1 3 1 2 1 13 12 6 Meningitis Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 13 15 11 10 13 14 10 22 22 17 11 31 30 20 22 16 8 19 17 19 7 Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 301 194 599 Acute Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Chicken Pox 26 91 35 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Poliomyelitis ... 4 ... ... 1 2 ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... Ophthalmia Neonatorum 3 6 7 5 12 10 3 3 1 3 4 2 2 4 3 1 3 3 1 3 10 Polio-encephalitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis ... ... ... 2 2 ... ... ... 2 1 1 1 ... ... ... ... ... ... ... 1 Lethargica Pneumonia 30 19 39 42 30 62 54 57 35 45 52 37 45 35 36 32 43 ... 30 22 20 Malaria 8 3 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Pyrexia ... ... ... ... 1 14 9 5 6 9 4 9 6 1 11 5 4 7 2 2 6 Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 16 186 161 Food Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 6 11 Totals 347 287 246 376 259 340 270 375 319 242 288 368 560 293 357 338 275 125 468 591 1021 33 Small Pox No case of small pox was notified during the year 1942. Scarlet Fever The number of cases of scarlet fever notified during the year was 175, as compared with 75 in 1941, equivalent to a case rate of three per 1,000 population. The disease has been generally mild in character and no deaths due to this cause were recorded. Of the total number of cases notified 128 were treated in hospital, and 47 cases were treated at home. There were seven cases which were known to be "return cases," representing 3.1 per cent. of the cases treated in hospital, and 6.4 per cent. of cases treated at home. The patient's home was disinfected after his removal to hospital or his release from isolation, but steam disinfection of the bedding has been discontinued as a routine procedure. Diphtheria Twenty-five cases were notified during the year and all the cases were removed to hospital for treatment. All the contacts are swabbed as a routine measure, and school contacts supervised by the staff of the school medical service. Diphtheria Immunisation During the year further efforts have been made to encourage parents to have their children protected against diphtheria. Every school-child has been offered immunisation at school. A large number of school-children, however, state that they have been immunised whilst they were evacuated, but we have no record of this. The probability is that a considerably greater percentage of school-children are immunised than our figure would suggest, as no child is regarded as immunised unless the details are available and confirmed. The success of immunisation depends on the number of children between one and two years of age who are immunised. Every child on its first birthday has received a birthday greeting and an appointment at the clinic for immunisation. The 34 names and addresses of all children under five years of age have been obtained from the Food Office, and the Health Visitors have visited every child and urged the mother to have the child protected. Special appeals have been made to the mothers attending the Infant Welfare Centres. The following figures show the number of children immunised during the year. Under five 933 Five—15 940 Over 15 5 Total 1,878 The following figures show the percentage of the child population considered immunised at 31st December, 1942:— Under five 39.43% Five—15 41.45% The number of birthday greetings sent in 1942 was 120. Seventy-five mothers took advantage of this offer. Typhoid Fever No case was notified during the year. Diarrhœa and Enteritis Under Two Years of Age Five deaths were registered during the year. Encephalitis Lethargica One case was notified during the year. Chicken Pox Two hundred and fifty-four cases of chicken pox were notified by the head teachers of the schools in the district. Mumps Four hundred and eighty-nine cases of mumps were notified by the head teachers of the schools in the district. 35 Impetigo Twenty-five cases of impetigo occurred in school-children during the year. Rubella Sixteen cases of rubella were notified among school-children. Ringworm Five cases of ringworm were notified among school-children. Dermatitis Two cases were notified among school-children. Infective Jaundice Two cases were notified among school-children. Erysipelas Seven cases were notified. Five cases were removed to hospital. No deaths from this disease were registered. Puerperal Pyrexia Six cases were notified during the year. Pneumonia Twenty cases of primary pneumonia were notified during the year. The number of deaths from all forms of pneumonia, some of which are not notifiable, was 27, of which 16 were males and 11 females. Cerebro Spinai. Fever Six cases occurred during 1942, and there were no deaths. Influenza During the year three deaths from influenza were recorded. Two were males and one female. The previous year thirteen deaths were registered. 36 Prevention of Blindness By an arrangement with the London County Council cases of ophthalmia neonatorum can be treated at Whiteoaks Hospital, Swanley Junction, Kent. Blind children are looked after by the Surrey Voluntary Association for the Blind. Ophthalmia Neonatorum During the year ten cases of ophthalmia neonatorum were notified:— Cases Notified Treated Vision Unimpaired Vision Impaired Total Blindness Deaths At Home In Hospital 10 4 6 9 1* nil. nil. *Child has small scar on left cornea. School Notifications The school intimation notices of infectious disease are always compared with the notifications received from the medical practitioners. If any case on the school return is found to be unnotified, investigations are made in order to find out if the patient is receiving medical attention. The school notices also give fairly accurate estimate of the prevalence of non-notifiable infectious disease, such as chicken pox, mumps, etc. The numbers so notified are reported on under various diseases mentioned earlier in this report. Cancer. The number of deaths from cancer registered during the year was 104, of which .50 were males and 54 were females. Cancer is mainly a disease of the digestive system, with the exception of its preference for the generative system in females. The site distribution for 1942 was as follows:— Digestive organs 18 cases Genito-urinary organs 9 „ Breast 11 „ Other sites 66 „ Total 104 „ 37 The following table shows the number of deaths from cancer, together with the death rate as compared with England and Wales: — Year Number of Deaths Death Rate per 1,000 of population Mitcham England and Wales 1915 26 .77 1.22 1916 21 .63 1.16 1917 17 .50 1.19 1918 25 .72 1.19 1919 31 .89 1.18 1920 34 .94 1.16 1921 31 .87 1.21 1922 34 .94 1.22 1923 33 .90 1.26 1924 42 1.11 1.29 1926 48 1.29 1.33 1926 44 1.14 1.36 1927 46 1.13 1.37 1928 58 1.27 1.42 1929 66 1.33 1.43 1930 73 1.25 1.45 1931 81 1.41 1.48 1932 68 1.0 1.51 1933 52 .86 1.52 1934 70 1.1 1.56 1935 61 1.0 1.58 1936 80 1.2 1.61 1937 76 1.1 1.63 1938 103 1.5 1.66 1939 73 1.12 1.64 1940 94 1.55 1.66 1941 84 1.6 1.67 1942 104 1.9 1.698 Tuberculosis During the year 85 new cases of tuberculosis were notified, viz.:— 38 Males Females Total Pulmonary 42 25 67 Non-Pulmonary 10 8 18 Total 52 33 85 The total number of deaths registered as occurring from tuberculosis was viz.:— Males Females Total Pulmonary 17 19 36 Non-Pulmonary 5 — 5 Total 22 19 41 England and Wales Mitcham Death rate from respiratory tuberculosis per 1,000 population 0.506 0.66 Death rate from non-pulmonary tuberculosis per 1,000 population 0.11 0.09 The following table shows the number of new cases, the type of disease and the deaths from tuberculosis during the year. Age Periods new Cases Deaths Respiratory NonRespiratory Respiratory Non- Respiratory M. F. M. F. M. F. M. F. Under 1 year ... ... ... ... ... ... ... ... 1 year to 5 years ... ... 3 ... ... ... 1 ... 5 years ,, 10 „ 2 1 1 2 ... ... ... ... 10 „ „ 10 „ 2 ... 1 1 ... ... 1 ... 16 „ „ 20 „ 4 2 ... ... ... 1 1 ... 20 „ „ 35 „ 19 18 2 3 3 9 1 ... 35 „ „ 45 „ 4 ... 1 ... 6 6 ... ... 45 „ „ 65 „ 11 2 2 2 8 3 1 ... 65 „ and upwards ... 2 ... ... ... ... ... ... Totals 42 25 10 8 17 19 5 ... 39 New cases coming to the knowledge of the Medical Officer of Health during the year through (a) Death returns; (b) Posthumous notifications:— Age Periods 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total Pulmonary: males ... ... ... ... ... 1 1 ... ... 2 ... 4 Pulmonary : females ... ... ... ... ... ... ... 1 1 1 ... 3 Non-Pulmonary: males ... 1 ... ... ... ... ... ... ... 1 ... 2 Non-Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... The sources from which information as to the above mentioned cases was obtained are as follows:— No. of Cases Pulmonary NonPulmonary Death return., (a) From Local Registers 1 ... (b) Transferable deaths from Registrar General ... ... Posthumous notifications 6 2 Number of cases removed from register during 1942:— Reason Pulmonary Non Pulmonary Total Cases Males Females Total Males Females Total Withdrawal of notification 2 ... 2 ... ... ... 2 Recovery from disease 1 ... 1 1 1 2 3 Death ... 17 19 36 5 ... 5 41 Otherwise 10 8 18 3 6 9 27 40 The ratio of non-notified tuberculosis deaths to the total tuberculosis deaths is as follows :— Non-notified tuberculosis deaths 9 Notified tuberculosis deaths 32 Percentage of non-notified T.B. deaths (all forms) 22 per cent. Percentage of non-notified pulmonary T.B. deaths 19.4 ,, Treatment for cases of tuberculosis is under the control of the Surrey County Council. A dispensary has been established at London Road School, Mitcham. Arrangements have been made by this Borough for the examination of sputa from cases or suspected cases of tuberculosis, and during the year 51 such examinations have been made. Tuberculosis Care Committee The Mitcham Tuberculosis Dispensary area comprises the Boroughs of Mitcham and Beddington and Wallington. Functions of the Committee 1. To alleviate want or distress amongst tuberculous people, providing, where necessary, extra nourishment, clothing, bedding, coal, surgical appliances, travelling expenses and help in the home. 2. To care for the families of patients in sanatoria so that their changed economic circumstances shall not result in impaired health, and that the sufferer shall not be harassed by undue anxiety. Assistance to Patients—1942 Number of persons assisted 173 Receiving supplies of milk, butter, eggs, continuously for 12 months 8 ,, „ ,, for 6-9 months 7 ,, „ „ under 6 months 23 Fares for family to visit sanatorium 4 41 Clothing, bedding (Bundles for Britain), supplied through the medium of Committee 100 Tuberculous persons who have received special consideration re housing 1 Fares for children (contacts) for Summer holiday 2 Pees for instruction 1 Payment for holiday 1 Christmas Gift, 5s. per head 26 Scabies The Scabies Order, 1041, provided for the diagnosis and treatment of scabies. A clinic for the diagnosis of this condition has been held by the Medical Officer of Health each morning at Mitcham Court. Efforts have been made to obtain the co-operation, not only of the patient, but of the whole family, and all have been treated when possible. As Mitcham has no cleansing centre, arrangements for the treatment of scabies were made at the Mitcham Public Baths. A part of the baths formerly used for foam baths was partitioned off and isolated from the public baths, so that a separate entrance was available. Usually treatment was with benzyl benzoate lotion 25 per cent., and this has given very good results. Female patients have been treated by a nurse on the First Aid Post staff, and the men have been treated by a baths attendant who has received special training. Treatment at the public baths has had the advantage of a constant supply of hot water, suitably heated premises and a competent male attendant, but it is not open on Tuesdays, Thursdays and Sundays, nor other days after 6 p.m., and those members of the family who are at work are loth to lose time from work for treatment, especially if they have few or no symptoms. No disinfection of clothing or bedding, other than washing, has been recommended, and the results have justified the adoption of this course. 42 Visits paid, 73. Attendances at clinic, 192 persons; representing 99 families. Treated at baths, 122 persons; representing 52 families. Number of baths given, 409. Supplied with lotion or ointment (for home treatment), 58 persons; representing 32 families. Admitted to hospital, 1. Food Poisoning A small outbreak of acute food poisoning occurred during the year amongst the members of the National Fire Service. Some 16 cases of acute diarrhoea and vomiting were reported and several cases required hospital treatment. Examination of specimens from the patients and of food still available proved negative. A temporary canteen was in use at the time and the suspected cause of the outbreak was a staphyloccal infection of gravy, but as none was available for examination this could not be confirmed. 43 WANDLE VALLEY JOINT HOSPITAL BOARD Cases admitted to the hospital during the year ended December 31, 1942. Disease Beddington & Wallington Coulsdon & Purley Merton & Morden Mitcham Cases Deaths Coses Deaths Cases Deaths Cases Deaths Diphtheria 7 ... 10 1 12 1 24 ... Scarlet Fever 64 ... 42 ... 174 1‡ 128 ... Erysipelas ... ... 1 ... 2 ... 3 ... Tonsilitis 1 ... ... ... 3 ... 3 ... Measles 2 5 ... 14 ... 20 ... Influenza ... ... 2 ... 4 ... 1 ... Whooping Cough ... ... 2 ... 6 ... 16 1† Rubella ... ... ... ... 5 ... 3 ... Chicken Pox ... ... 1 ... 1 ... 2 ... Meningitis 1 ... 2 1‡ 9 3 7 ... Poliomyelitis ... ... 2 ... 2 ... ... ... Puerperal Fever 5 ... 2 ... 5 1* 2 ... With mother 3 ... 1 ... 4 ... 2 ... Minor injury 1 ... ... ... ... ... ... ... T.B. Meningitis 1 ... ... ... 1 ... 1 l Cerebral Tumour ... ... ... ... ... ... 1 ... Rheumatism 1 ... ... ... 1 ... ... ... Pemphigus 1 ... ... ... 1 ... 4 ... Lung Abscess ... ... ... ... ... ... 1 1 Thrush 1 ... ... ... ... ... 1 ... Enteritis 1 ... ... ... 2 ... ... ... Admitted with baby 1 ... ... ... ... ... 1 ... Endocarditis and Pericarditis ... ... ... ... ... ... 1 l Pneumonia ... ... 1 ... ... ... 1 ... Glandular Fever ... ... ... ... ... ... 1 ... Hemiplegia ... ... ... ... ... ... 1 ... Pheno-Barbitone Poisoning 1 ... ... ... ... ... ... ... Ulceration of Mouth ... ... ... ... ... ... 1 ... Psycho-Neurosis ... ... ... ... ... ... 1 ... Erythema ... ... ... ... 1 ... ... ... 91 1 71 2 247 8 226 4 *Puerperal Fever and Cerebral Embolus, †Whooping Cough and Convulsions. ‡Broncho Pneumonia. 44 INDEX Ambulances 14 Analysis of Mortality 13 Ante-Natal Clinics 16, 20 Area 8 Bakehouses 30 Bed Bugs, Eradication of 25 Birth Rates 9, 10, 13 Births, Live 8 — Illegitimate 8 — In Institutions 9 — Still 8 Blindness, Prevention of 36 Cancer 36 — Deaths from 37 Causes of Deaths 13 Cerebro-Spinal Fever 35 Chicken Pox 34 Child Welfare 17 Clinics 15-17 Dairies and Cowsheds 30 Death Rates 10, 13 Deaths 8, 9, 12 Dental Treatment 18 Dermatitis 35 Diarrhoea and Enteritis 34 — Deaths from 9 Diphtheria 33 Immunisation 33 — — Clinic 16 Disinfection 17 Encephalitis Lethargica 34 Eradication of Bed Bugs 25 Erysipelas 35 Food and Drugs Act (1938) 29 — and Medicine, Supply of 20 — Inspection and Supervision of 29 — Poisoning 42 45 page General Provision of Health Services tor the Area 14 Health, Visiting 19 — Visitors, Visits by 19 Hospitals 15 Housing Statistics 28 Impetigo 35 Infantile Mortality 9, 10, 11 Infant Life Protection 23 Infant Welfare Centres, Attendances 19 Infectious Disease, Cases notified 33 — — Case rates 13 — — Contacts 31 — — Incidence of 31 — Prevalence of and Control over 31 — — Notifications 32, 35 — — School 36 Influenza 35 Inhabited Houses 8 Inquests 11 Inspection and Supervision of Food 29 Jaundice, Infective 35 Laboratory Facilities 14 Maternal Mortality 11, 13 Maternity and Child Welfare Services, Report on 17 — Home 15, 21 Midwifery, Domiciliary 15 Milk (Special Designation) Order (1936) 30 Mortality, Analysis of 13 Infant 9, 10, 11 Maternal 11, 13 Mumps 34 N.S.P.C.C. 24 Nursing in the Home 14 Ophthalmia Neonatorum 36 Orthopaedic Clinic 18 Patients Admitted to Hospital 43 Personnel, Committee 5 — Staff 6 46 page Piggeries 30 Pneumonia 35 Population 8 Post-natal Clinic 16 — Centre 21 Prevention of Blindness 36 Puerperal Pyrexia 35 Rateable Value 8 Ringworm 35 Rubella 35 Samples, Food 29 Sanitary Circumstances of the Area 25 Sanitary Inspector's Report 26 Scabies 41 — Clinic 16 Scarlet Fever 33 School Clinic 16 Schools 26 Small Pox 33 Social Conditions » Statistics 8 Statistics, Housing 28 — Vital 8 Still Births 8 Sunlight Treatment 18 Tuberculosis 37 Care Committee 40 — Clinic 17 Typhoid Fever 34 Venereal Diseases Clinics 17 Vital Statistics 8 Wandle Valley Hospital 43 War-time Nursery 24 Welfare Clinics 15-17 — — Attendance at 19 Whooping Cough, Deaths from 9 Woodlands Maternity Home 15, 21 X-Ray Examinations 21