L-'&RARy Pop s-/ METROPOLITAN BOROUGH OF POPLAR . ABRIDGED INTERIM REPORT on the health of the Borough during 1945 by G.O. MITCHELL, M.D., M.R.C.P., D.P.H., Acting Medical Officer of Health. : . Public Health Department, Poplar Town Hall, Bow Road, E.3. 1st July, 1946. To the Mayor, Aldermen aqd Councillors of the Metropolitan Borough of Poplar. Madam, Ladies and Gentlemen, In accordance with the Ministry of Health Circular 28/46 (England) this Roport like the reports for the years 1939-44, an abridged Interim Report. POPUIATIOIT. The Registrar-General's estimate of the civil population is 57,670, an increase over the previous year's figure (54,030). BIRTH. There was an increase in the number of live births and the birth rate (2l.2) is the second highest since 1926, displacing the figure for 1944 (20.7) from this position. STILLBIRTHS. The number of stillbirths fell, the rste per 1,000 total births (18.5) being'the lowost recorded since registration of stillbirths was introduced in 1930. DEATHS. The number of deaths at all ages was 844 and the death rate 14.6, the death rate for London as a whole being 13.8. Approximately one-eighth of the Poplar deaths were thoso of persons over 80 years of age. One death occurred from Measles, but again there were no deaths either from Diphtheria or Scarlet fever. MATERNAL MORTALITY. No actual death from puerporal causes occurred in the borough during the year, but one death which occurred outside the borough in 1944.was the subject of criminal proceedings and registration was delayed until 1945. There was virtually a nil rate for the first time in Poplar. INFANT MORTALITY. The infantile mortality rate was 47, a islightly higher figure than that recorded in 1944 but still satisfactory when compared with the London figure of 53. ,• INFECTIOUS DISEASE. During the year there was some increase in infectious disease, particularly Scarlet fever, Measles, Dysentery and Zymotic enteritis. TUBERCULOSIS. The number of new cases of pulmonary tuberculosis (125) is' tho lowest recorded in tho borough, but the number of new nonpulmonary cases (51) is the highest recorded since 1936. STAFF. It is with regret I havo to record the death of Mr. C. Hammond Williams, the Dental Surgeon at tho Council's Maternity and Child Welfare Clinics, and also the death through onemyaction of Sister Marjorie of the Nursing Sisters of St. John tho Divine. The following changes in staff occurred during the year:~ Resignations: Miss L. Mitchell, Shelter and Cleansing Station Attendant, 14th May, 1945. Mrs. G. I. Jones (formerly Miss G.I.Hill), Health Visitor, 20th Octobor, 1945. Mr. T.C.B.Rose, Sanitary Inspoctor, 30th Octobor,1945. Released from service with H.M.Forces: Miss E. Howlett,Health Visitor, General. During the year circulars on various matters were received from the Ministry of Health and other Government Departments and the necessary action has been taken. -2- In conclusion, I wish to thank the members of the council for their continued support during the year. I am, Madam, Ladies and Gentlemen, Your obedient Servant, G. O. MITCHELL Aoting Medical Officer of Health. STATISTICS AND SOCIAL CONDITIONS. . . AREA. 2,136 acres. POPULATION: Census 1931 155,089 Regsitrar-General's estimated Civilian Population 1944 57,670 The birth and death rates for the yoars 1938-44 wore given in last yoar's report. Below are-given the corresponding rates for the year 1944, the average for five years 1940-4, and for 1945. 1944. Average 1940-4. 1945. London 1945. Birth rate Live births 20.7 19.3 21.2 15.7 Stillbirths 0.48 0.44 0.40 0.40 Death rate, all causes 16.5 18.6 14.6 13.8 Tuberculosis death rate: of respiratory system 1.24 1.24 0.78 ? other forms 0.06 0.12 0.09 ? Total 1.30 1.36 0.87 ? Infantile Mortality rate per 1,000 births live 41 41 47 53 Meternal Mortality rate per l,000 total births 3.49 2.66 0.80 ? 1945. LIVE' BIRTHS. Total. Males. Females. Legitimate 1128 571 557 Birthn rate Illegitimate 95 55 40 per 1,000 population 1223 626 597 21.2 STILL BIRTHS. 23 12 11 Rate per 1,000 total births 18.5 DEATHS. 84 500 344 Death rate per per 1,000 population 14.6 DEATHS FROM PUERPERAL CAUSES. Puerperal sepsis 1) Rate per 1,000 Other maternal causes - ) total births 0.80 -3- INFANTILE MORTALITY RATE. All Infants per 1,000 live births 47 Legitimate infants per 1,000 legitimate births 45 Illegitimate infants per 1,000 Illegltimnte births 74 CAUSES OF DEATH AT ALL AGES. The 844 deaths at all ages were classified by the Eegistrar-General as follows;- Cerebrospinal fever 3; Tuberculosis (a) of respiratory system 45; (b) other' forms 5; syphilitic diseafce 13; influenza 1; Measles 1; Acute infectious encephalitis 2; Cancer of (a) buccal cavity and oesophagus 7; uterus 7; stomach, and duodenum 33; breast 7; all other sites 102; Diabetes 4; Intracranial vascular lesions 55; Heart diseases 200; other diseases bf circulatory system 45; Bronchitis 69; Pneumonia 41; other respiratory diseases 6; Ulcer of stomach or duodenum 17; Diarrhoea (under 2 years of age) 9; Appendicitis 1; other digestive diseases 23; Nephritis 5; puerperal and post-abortive sepsis 1; Premature birth 13; Congenital malformations, etc. 18; Suicide 5; Bond traffic Occidents 9; other violent causes 49; all other causes 48. TOTAL 844. INFANTILE DEATHS. There were 58 deaths of infants. under one year of age, t'he causes,of death being as follows:- Cerebrospinal fever 2; Tuberculosis (a) of respiratory system 1; (b) other forms 1; Influenza 1; Measles 1; other diseases of circulatory system 1; Bronchitis 1: Pneumonia 9; Diarrhoea 9; Premature birth 13; Congenital malformditionc, etc. 15; other Violent causes 1; all other causes 3. Total 58. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. NURSING IN THE HOME. Grants are made to two Nursing Societies. The number of visits paid by Nurses from these associations was 2,604. WELFARE CENTRES. a. Tuberculosis Dispensary - see page 8. b. Maternity and Child Welfare Clinics at 31st December, 1945 1. Borough Council: Ruston Street Ante-natal: Tuesdays 10.30-l2.30 & 2-4. Wednesdays & Fridays 2-4. Infant Consultations: Thursdays 10.30-12.30 and 2-4. 'Sunlight: Mondays, Wednesdays and Fridays 9.30-12.30 and Fridays 2-4. Wellington Way Dental: Tuesdays & Wednesdays 10-12. 134 Poplar High Street Infant Consultations: Mondays 2-4. 54 West Ferry Rd. Ante-natal: Thursdays & Fridays 2-4. Infant consultations: Wednesdays 1.30-3.30. 2. Royal College of St. Katharine: All Hallows Infant Consultations: Tuesdays 2-4. St. Michael's Infant Consultations: Mondays 8-4. Trinity Hall Ante-natal: Thursdays 10.30-12.30. Infant Consultations: Wednesdays 10.30-12.30 -4-" The numbers of attendances at the Maternity and Child welfare Clinics were:- Borough Council Royal College of St. Katharine. Total. 17,058 6,783 23,841 CLINIC ACCOMMODATION. Proposals were submitted to the Committee for (1) the re-establishment of Maternity and. Child welfare work at Wellington Way, (2) the taking over of 154 Poplfcp High street vice Simpsons Road clinic which was badly damaged by fenemy action, and (3) the adaptation of the First Aid Post at Galbraith Street as a Maternity and Child, Welfare Centre. The proposals were agreed to and approval of the Minister of Health of items (1) and (2) obtained. With regard to (3) plans and estimates are being prepared for submission to the Minister. VISITS PAID BY HEALTH VISITORS. The number of visits paid by the .Health Visitors were:- Borough Council, Royal College of st. Katharine. Total. 21,886 21,068 42,954 CARE OF PREMATURE INFANTS. (M.H.C.20/44). The arrangements for the care of premature infants outlined in last year's report continue to operate. Equipment loaned to mothers of premature infants included 6 treasure cots with detachable linings; 3 hot water bottles; and 1 weighing scales. 89 premature babies were born during 1945, 14 at home and 75 in hospital, Of those born at home 2 died during the first 24 hours and 12 survived at the end of one month; and of those bbrn in hospital 8 died during the first 24 hours and 57 survived at the end of one month. CHILD LIFE PROTECTION. Visits to foster mothers and children 11 Foster mothers under supervision during 1945 1 " children " " " " 1 ADDITIONAL INSTITUTI0NAL MATERNITY ACCOMMODATION. The allocation of seven maternity beds in Poplar General Hospital referred to in last year's report, was cancelled by the london County Council as no patients bad been referred to the Hospital by the Borough Counci1 and it was not anticipated the beds would be required by us. EMERGENCY OBSTETRIC SERVICE. During, the year this service was called upon once by a medical practitioner, the fee of £5. 5s. being paid by the Borough Council. STERILE MATERNITY OUTFITS. Two outfits were sold during the year. OBSTETRIC CONSULTANTS. It was not necessary to call in a Consultant to any case during the year, CONVALESCENT TRETMENT. 5 cases were sent away during the year through the agency of the Invalid Children's Aid Association. SUPPLY OF SHEETS FOR EXPECTANT MOTHERS (M.H.C. 154/44). Arrangements were made in 1944 for the issue of priority dockets to expectant mothers and during 1945 380 dockets were issued. MILK SCHEME (Maternity and Child Welfare). Five applications were received and were granted. Orders for 22lb. of dried milk were issued. In addition 438 packets of dried milk were sold at cost price. DISTRIBUTION OF COD LIVER'OIL AND FRUIT JUICES. The arrangements made in 1941 with the local Deputy Food Officer were continued. -5- DAY NURSERY. The Day Nursery in Tidey Street continued to function tlarougliout the year, the highest attendance on any one day being 41 At the end of the year there were 48 children on the register. DOMESTIC HELP. No "Home Help" service had previously been provided toy the Borough Council and serious consideration was given to Ministry of Health Ciroular 179/44 on the subject. SO far as could be ascertained at the time there was little demand for a service of Domestic Helps, and, although holding out little hope, the local Employment Exchange promised to do what was possible to fill vacancies should the Council set up a scheme. The matter was, therefore, deferred for six months. Later, however, a letter was received from the Employment Exchange stating it had been decided to obtain as much local publicity as possible with c view to recruitment of Home Helps. It was then agreed to co-operate with the Ministry of Labour in this and when a suitable person (who had been introduced by the Ministry) was appointed c scheme was formulated to be reviewed at the end of six months. Up to the end of the year there was one application for domestic help which was provided for approximately four hours per day from 13th December to 4th January. The Committee reviewed the scheme im January and decided to carry on for another six months. GOVERNMENT EVACUATION SCHEME. The Health Visitors co-operated with . the Ministry of Health in visiting prospective homes before arrangements were made for the return of children. Of 59 children referred to us 43 could return home, 3 were recommended for further investigation, and 13 could not return home because of special difficulties. Of the 43 that returned 40 required bedding which was requisitioned from the Ministry of Health. SANITARY CIRCUTMSTACES OF THE AREA. SANITARY INSPECTORS WORK. The total number of inspections and reinspections carried out by the District and Lady Sanitary Inspectors was 21,837. 22 air raid shelters were visited and 47 inspections were made. 1,485 intimations, 491 statutory notices and 171 final notices were served, and nuisances were abated in 1,378 instances. Legal proceedings were taken in three cases where owners failed to comply with notices. DISINFESTATION. Total number of inspections and visits 1,940. The number of rooms disinfested was 1,070 and the number of articles disinfested 3,742. Disinfestation by HON was done in one case. Treatment of Scabies is referred to on a later page. REHOUSING AND DISINFEDTATION. In order to minimise the risk of infestation of temporary bungalows, etc. a scheme was arranged for the inspection of present accommodation, bedding and furniture of prospective tenants. Disinfestation was carried out where necessary on the day of removal. All second-hand bedding received by the Women's Voluntary Service was disinfested before reissue. DESTRUCTION OF MOTHS. A letter was received from the Board of Trade asking the local authority to assist members of the public in the destruction of moths by offering the use of the disinfecting plant. The Committee agreed that anyrequests should be dealt with and reported to the Committee with a statement as to the cost incurrod for the Committee to decide what charge, if any, should be made. Four requests were dealt with and in each case the Committee decided to make no charge. -6- WATER SUPPLY. Generally, this service is provided by the Metropolitan Water Board directnfrom the mains and examinations are carried out by the Board. No complaints were made to the Public Health Department during the year. WATER CERTIFICATES (Public Health (London) Act, 1936, section 95.) Certificates were issued in respect of 614 new dwellings (541 Borough Council and 73 London County Council) RENT etc. RESTRICTION ACTS. Certificates under these Acts were issued as follows:- to Tenants 74 to Owners 30 RODENT CONTROL. Contributory Scheme. In October, 1943, the Council authorised the organisation of a contributory scheme for rodent control similar to that in force in the Port of London. At the end of 1945 there were 100 films participating in respect of 119 premises. During the year 901 treatments were applied resulting in the recovery of the bodies of 3722 brown rats, 1757 black rate and 357 mice. The treatments applied were in accordance with the standard procedure laid down by the Ministry of Food, whose help and guidance have always been, available when required. The full establishment of 6 rat-catchers has been employed. Good progress with this work has been made, particularly in the Isle of Dogs area, where, during the year, the 39 premises treated have shown marked freedom from rats for considerable periods of time. Inspections were made and treatments applied at frequent intervals in order to minimise the effects of possible re-invasion of the premises by rats from river-borne traffic. The remaining 80 premises are in Poplar, Bow and Old Ford, and it is believed that all premises in Poplar and Bow known to harbour rats are under observation and treatment, either by the Public Health department or by service companies specialising in this work. The application of block control methods throughout the Borough has been found to be the most economic and efficient method and great strides have been made in the Poplar and Bow areas as a result. Complaints. During the year 228 complaints relating to 176 dwelling-houses were investigated. The results may be list.ed as follows:- 138 premises found to be infested with rats. 9 " " " " " " mice. 29 complaints not substantiated. Of the justifiable complaints causation was as follows:- 48 defective drains 2 defective sewer connections. 44 instances of rats gaining access to house through war 37 instances of rats coming from uncleared debris. (damage. 16 instances of rats coming from industrial premises. A total of 643 rodents were found dead; 414 brown rate, 164 black rats and 65 mice. There were also 22 complaints, 6 relating to business premises which have since entered the contributory scheme, 2 relating to air raid shelters, 9 relating to small shops and licensed premises, 4 relating to Poplar Borough Council premises and 1 to a London County Council school. 50 black rats and 59 brown rats were found dead ??? a result of treatments applied. The amount of work done in respect of complaints from the general public has increased enormously, but the employment of six rat-catchers has made it possible to deal quickly with these complaints as they arise, and it is felt that the degree of success achieved is very satisfactory in view of the large amount of war damage in the -7- borough, which has favoured the movement of rats from sewers and industrial premises to dwelling houses. Sewer treatments. The continuance of enemy air attack in the early part of the year and the acute man-power shortage made it impossible to arrange the full maintenance treatment that was felt desirable; preparatory work was carried out however for a treatment in January, 1946. Limited sewer treatments were carried out in 4 instances, baiting being done at a total of 112 manholes, resulting in 27 dead rats being recovered. Interpretation of results of treatments. Although in the above notes the numbers of dead rodents found as a result of treatment are recorded, these numbers give only a partial index of the success achieved, since the total kill is in all cases estimated to be . considerably more than the dead rodents recovered. INSPECTION AND SUPERVISION OF FOOD. The Meat and Food Inspectors made 3,594 inspections of premises where food is prepared, stored or sold. REPORT OF THE PUBLIC ANALYSTS. The number of samples examined was 727 and the number found to be adulterated was 33 (4,54 per cent). During the ten years 1936-45 the average number examined was 717 and the percentage adulterated was 3.6. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. The number of cases notified (corrected for "altered diagnosis" cases) and the number of deaths were:- Cases. Deaths. Scarlet fever 153 • Diphtheric 12 • Typhoid and paratyphoid fevers 3 • Erysipelas 23 Puerperal fever 2 1 a Puerperal pyrexia 8 • Cerebrospinal fever 5 3 Ophthalmia neonatorum 4 • Measles 640 • Whooping cough 58 • Primary pneumonia 80 8 b Influenzal pneumonia 10 • Dysentery 80 2 c Zymotic enteritis 33 9 Malaria 3 d • Acute poliomyelitis 3/1117 Scabies 754 1871 Notes. a. Not notified, occurred outside the borough in 1944 but death not registered until 1945. b. Notified cases only. c. Not notified - inmates of mental hospitals outside London. d. 2 non-civilian cases and 1 induced therapeutically. Encephalitis lethargica - 3 deaths occurred of chronic cases one of whom also had Tuberculosis. DIPHTHERIA PROPHYLAXIS. (M.H.C. 170/44). Consideration was given to the Ministry of Health Circular and the following action taken:(a) Medical practitioners were reminded of the arrangements for immunisation, and the fee to private practitioners for immunising pre-school children was increased from 5/s. to 6/s. -8- (b) the London County Council was asked to continue to co-operate through its school organisation. (c) advertisements, were issued in the local Press. (d) Social Clubs and other organisations in the borough were asked to, co-operate. The immunisation clinics at the council's Tuberculosis Dispensary and the Maternity, and Child Welfare Clinic at 54 West Ferry Road functioned throughout the year. Summary of all immunisations:- a. at Borough council clinics 724 b. at London County Council centres 182 c. by Private Practitioners 41 947 ASSISTANCE TO HOUSEHOLDERS IN THE EVENT OF AN EPIDMIC. (M.H.C. 196/1945) After conferring with veirious local organisations (nursing and social) a scheme was prepared but, fortunately, circumstances did not arise to require it to be put into Operation. TUBERCULO SIS. Dispensary Clinics; Mondays 6 p.m. Tuesdays 2 p.m. Thursdays 10 a.m. and 2 p.m. Fridays 10 a.m. Number of new cases examined 306; contacts 194 = 500 (Tuberculous 110; non-tuberculous 364; diagnosis inconplete 26) Number of attendances at the Dispensary 3099 Number of visits to hones by Health Visitors 552l Number of sputum specimens examined 342 Number of X-ray examinations at St. Andrew's Hosp. 593 Additional Statistics. In addition to the 5521 visits paid by the Health Visitors for Dispensary purposes 159 non-Dispensary visits wore paid under the Public Health (Tuberculosis) Regulations. 1930. Reports to Chairmen of Medical Boards 31 Patients sent away for institutional treatment 176 Patients in receipt of extra nourishment from Dispensary during the year 68 Patients in receipt of extra nourishment from Dispensary at 31st December 31 Reports on child contacts to Divisional School Medical Officers 56 Letters to General Practitioners concerning patients 269 Reports to General Practitioners on official forms 43 Progress reports fron General Practitioners 1 Clinical reports to London County Council 128 Reports to Ministry of Pensions 7 Shelters on loan during the year 0 Shelters on loan on 31st December 0 Beds and. bedding on loan during the year 6 Beds and bedding on loan at 31st December 4 During the year 6 children were boarded out under the London County Council contact scheme. During the year 25 new cases and 22 old cases have attended Brompton, Colindale, London Chest and St, Andrew's Hospitals for 622 artificial pneumothorax refills. 9 Dental Treatment at st. Andrew's Hospital. Five cases were deferred to St. Andrew's Hospital for dental treatment during the year. One of the patients refused treatment. Tuberculosis Allowances. The Government scheme for the provision of allowances for persons giving up work to undergo treatment of pulmonary tuberculosis has continued to operate as part of the Dispensary service. Sessions held by Tuberculosis Assessment Officer 51 Adjudicatipns made 473 New applications 60 Cases reviewed 413 Patients in receipt of allowances on 31/12/45 55 The question of inadequate allowances was considered by the Committee and was referred to the Metropolitan Boroughs Standing Joint Committee with the object of making representations to the Minister of Health. In view of a statement made in the House of Commons however, the matter was hot proceeded with by the Standing Joint Committee. NUMBER OF NEW CASES AND DEATHS. The numbers of new cases and deaths reported during the year were:- New cases. Deaths. Death rate per 1000 population. Pulmonary 125 a 45 a 0.78 Other forms 51 b 5 n 0.09 176 50 a 0.87 a. lowest recorded. b. Highest since 1926. The death rates for the years 1938-44 were given on page 8 of last year's report. The percentage of non-notified cases to total deaths was 8.0. The number of cases on the Tuberculosis Register at 31st December was 609. The number of cases on the Tuberculosis Dispensary Register at 31st December was: Definitely tuberculous 465 (T.B. plus 216) Diagnosis not completed 29 494 MASS MINIATURE RADIOGRAPHY. As mentioned in last year's report the London County Council installed a mobile unit in Hackney. The following is a summary of the results:- Number of employers who co-operated 22 Number of trades, etc. represented 16 Number of volunteers in lists sent to the County Council 1176 Number of volunteers examined 954 Number of volunteers conveyed to the Centre by the L.C.C. 818 Cost of conveyance charged to the Borough council £97. 14s. 2d. (11 firms provided all or part transport for their employees) Results of examinations as reported by the L.C.tC. Number examined Referred for large films Did not re-attend No abnormolity Calcified lesions N.F.A. Referred to G.P's. Probably T.B. Others. Men 465 26 3 8 2 8 5 Women 489 20 5 8 1 5 1 Totals 954 46 8 16 3 13 6 -10- SCABIBS. 754 cases of Scabies were notified during the year. The number of visits "by the Lady Sanitary Inspector cad the seconded. Health Visitor wa»> 1,053. • • ' " 1 ' • , 4 , . , 2,805 treatments were given at the Council's Cleansing Station. Of these, 119 were given at 50 evening sessions. Adults 798 7273 males; 525 females) ■ Children 2007 (947 " ; 1060 ' ■ : » )- ' : 38 premises'and 39,838 articles were disinfested. CLSaNSING- OF VEEHINOUS PEBSONS AND CHILD RM. i:' I • - J • •. • The total.number of cleansings carried out at the Counoil'i Cleansing station was 9'5b. •' '' ,• ,r -• • i n •• - ! ? Adult's 73 ( 43 males; .30 females) Children . 877 (819 * ; 658 » ) PUBLIC EDUCATION IIT HEilLTH. 215 lectures were given at 15 centres and the total attendances were 11,319. ' 7 r - * ) , < : ' 1 h J . - i. VlEflSKEAL DISEASES - Educational Campaign (M.H.C's. 42/45 and 92/45) " ■ , " " "" ■ ' ' • At the request of the London County Council posters were reissued for. display at; all the buildings under the Council's control, Photographic displays VlQre offered to factories, and letters were sent to the larger firms in the Borough urging them to arrange displays for their employees. • . A * ' ' • ' 'I v, .-