Rom 16 LIBRARY BOROUGH OF ROMFORD HEALTH DEPARTMENT. INTERIM ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH For the Year 1941. JAMES B. SAMSON, m.d., d.p.h., Medical Officer of Health. W. & W. LTD. BOROUGH OF ROMFORD HEALTH DEPARTMENT. INTERIM ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH For the Year 1941. JAMES B. SAMSON, m.d., d.p.h., Medical Officer of Health. 2 BOROUGH OF ROMFORD MEMBERS OF THE COUNCIL (As at 31st December, 1941). His Worship The Mayor: Councillor J. Butterfield, J.P. Deputy Mayor: Alderman W. M. Goldsmith, J.P. Aldermen: Alderman C. H. Barney. Alderman H. W. Hole, J.P. „ F. L. J. Cole, C.C. „ W. J. Russell. „ R. A. Forge, J.P. „ C. E. Smart. Councillors: Councillor A. E. Blane. Councillor D. P. Hartnett. „ R. G. L. Bowyer. „ W. D. Hill. „ A. J. Brian. „ Mrs. L. A. Irons. „ G. W. Butcher. „ L. A. Lucas. „ G. F. Chaplin. „ A. Needham. „ Mrs. I. J. Coates. „ C. A. Osborn. „ H. F. Davenport. „ G. E. C. Quartermaine. A. J. Dyer, O.B.E. „ E. W. Smith. „ N. Eyre. „ G. A. Stafford. „ A. E. Fruitnight, C.C. „ L. S. Webb. 3 BOROUGH OF ROMFORD PUBLIC HEALTH COMMITTEE (At at 31st December, 1941). His Worship The Mayor: Councillor J. Butterfield, J.P. (Ex-officio member). Deputy Mayor: Alderman W. M. Goldsmith, J.P. (Ex-officio member). Chairman: Alderman F. L. J. Cole, C.C. Vice-Chairman: Vacant. Alderman C. H. Barney. Councillor G. W. Butcher. „ R. A. Forge, J.P. „ Mrs. I. J. Coates. „ W. J. Russell. „ H. F. Davenport. „ C. E. Smart. „ Mrs. L. A. Irons. Councillor A. E. Blane. „ G. E. C. Quartermaine. „ A. J. Brian. „ L. S. Webb. Maternity and Child. Welfare Committee. As above with the addition of— Mrs. G. Bignold. Mrs. A. Damant. Mrs. L. Fox. Mrs. B. Hollingsworth. 4 Maternity, etc., Cases Sub-Committee. Chairman: Councillor Mrs. I. J. Coates. Councillor Mrs. L. A. Irons. Mrs. L. Fox. Mrs. G. Bignold. Mrs. B. Hollingsworth. Mrs. A. Damant. Day Nursery Sub-Commitee. Chairman: Alderman F. L. J. Cole, C.C. Councillor J. Butterfield, J.P. Councillor Mrs. L. A. Irons. (Mayor). Mrs. A. Damant. „ A. J. Brian. Mrs. L. Fox. Mrs. I. J. Coates. HEALTH DEPARTMENT. Public Health Staff. Medical Officer of Health. J. B. Samson, M.D., Ch.B., D.P.H. Assistant Medical Officer of Health. Elizabeth N. Christie, M.B., Ch.B., D.P.H. Sanitary Inspectors. (a) W. S. Gent, Chief Sanitary Inspector; Certificate of the Royal Sanitary Institute; Certificate of the University of Liverpool School of Hygiene for Meat and Foods. (b) H. C. Boswell, Certificate of the Royal Sanitary Institute; Certificate of the Royal Sanitary Institute for Meat and Foods. (c) R. Martin, Certificate of the Royal Sanitary Institute; Certificate of the Royal Sanitary Institute for Meat and Foods. (Reported for Military Service 13th May, 1940). 5 Health Visitors. (a) Mrs. E. J. Bingham, State Registered Nurse; State Certified Midwife. (b) Miss M. Roberts, State Registered Nurse; State Certified Midwife; Health Visitor's Certificate. (c) Miss F. K. Wells, State Registered Nurse; State Certified Midwife ; Health Visitor's Certificate. Council Midwives. (a) Miss C. M. Kerr, State Registered Nurse; State Certified Midwife. (b) Mrs. G. E. Sexton, State Registered Nurse; State Certified Midwife;. Queen's Certificate for District Nursing. (c) Mrs. D. Shaddick, State Registered Sick Children's Nurse; State Certified Midwife. (d) Mrs. A. P. Shuttleworth, State Registered Nurse; State Certified Midwife. (e) Mrs. J. Thompson, State Registered Nurse; State Certified Midwife. Clerks. (1) Permanent. (a) E. W. Gowers, Senior Clerk to the Medical Officer of Health. (Reported for Military Service 20th February, 1941). (b) S. Adams, Clerk to the Medical Officer of Health. (Reported for Military Service 25th August, 1940). (c) C. G. Humberston, Clerk to the Sanitary Inspectors. (Reported for Military Service 20th November, 1940). (d) Miss M. E. Pollitt, Clerk to the Medical Officer of Health. (2) Temporary. (a) L. Goold, Clerk to the Medical Officer of Health. (b) M. J. Cole, Clerk to the Sanitary Inspectors. (c) Miss D. E. Powell, Clerk to the Medical Officer of Health. (Resigned 20th July, 1941). (d) Miss S. J. Rose, Clerk to the Medical Officer of Health. (Commenced Duties 25th June, 1941). 6 BOROUGH OF ROMFORD. To His Worship the Mayor, Aldermen, and Councillors of the Borough of Romford. Mr. Mayor, Ladies, and Gentlemen, I have the honour, herewith, to present to you this, my Annual Report on the Health of the district for the year 1941. This is the Eighth Report in the series, since I was appointed your Medical Officer of Health, and it is drawn up in accordance with the requirements of Articles 6 (3) and 17 (5) of the Sanitary Officers (Outside London) Regulations, 1935, as modified by Circular 2604 of the Ministry of Health, dated 24th March, 1942. This Circular states that the Report should again be an Interim one. At the same time careful preservation is being made of all records, which, in normal times, would have appeared in this publication, so that, at some future date, these can be reported upon. In spite of war conditions, with added difficulties and responsibilities, the Department has continued to function to the best of its ability, and, in fact, has participated in new schemes, and I trust that this Report, short though it may be, will show that the supervision of the health of the district is being well maintained. In the course of the year the permanent staff was still further depleted, and the vacancies were again filled by temporary personnel. As before, my best thanks go to all the members of my staff who, each in his or her own sphere, have assisted in the compilation of this Report, to my fellow officials for their kind assistance throughout the year, and to all the members of the Council, who have shown continued interest in the health of the inhabitants of the town. I am, Mr. Mayor, Ladies, and Gentlemen, Your obedient servant, JAMES B. SAMSON, Public Health Department, Medical Officer of Health. Town Hall, Romford. April, 1942. 7 1.—GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. (i) Public Health Officers of the Authority. For particulars of these, see the list at the beginning of this Report. (ii) Laboratory Facilities. During the year, we continued to avail ourselves of the services of the Counties Public Health Laboratories for the major part of our requirements, and, owing to the fact that the laboratory had to take up new quarters, transferring from London to Romford by reason of air raid damage to their premises in London, we found the change to be to our advantage. As regards the Emergency Laboratory Service, organised by the Medical Research Council, this transferred to St. Margaret's Emergency Hospital, Epping, and we made use of this laboratory for the provision of Diphtheria Immunisation material, Measles Serum for prophylaxis, and Typhoid-Paratyphoid vaccine. (iii) Nursing in the Home. (a) Midwives. Our scheme for a domiciliary service of salaried midwives continued on the lines previously reported. In addition to the 5 Council Midwives, there are 3 Midwives in independent practice in the District, and also 4 District Nurse Midwives. Five Midwives, resident outside the Borough, also undertook cases in the District during the year. (iv) Hospitals: Public and Voluntary. (a) Infectious Diseases. (b) Maternity. (c) Children. (d) Other Cases. There is nothing new to report in either of these sections, except in the case of Victoria Hospital, which has now taken up quarters in. the new building. This Hospital can now accommodate 50 patients, and its various services have been extended and improved. In addition, a Resident Medical Officer has been appointed. During 1941, the Romford Council again granted a subscription of 10 guineas to this Hospital, 8 2.—MATERNITY AND CHILD WELFARE. (i) Ante-natal Clinics. During the year an extra session was opened, so that 2 sessions are now being held at the Centre in Marks Road, and 2 at the Centre in Collier Row. A Consultative Ante-natal Clinic continues to be held at Oldchurch County Hospital, and this, once more, has proved a valuable adjunct to our own services. During the year 1941, 907 individual expectant mothers attended the Clinics. In addition, 22 mothers attended for post-natal advice. In all, 195 sessions were held during the year. The total number of attendances of the 929 mothers mentioned above was 3,324, giving an average of 35 attendances per patient. The average number attending at each session was 17.0. (ii) Infant Welfare Clinics. Seven sessions were held weekly during 1941, spread over 5 Centres, and all facilities, reported in the past, have continued in operation. The National Milk Scheme of the Ministry of Food was again used to advantage, and, for this purpose, close co-operation was maintained with the Local Food Office. During the month of December, a scheme for the supply of Vitamin preparations in the form of Black-currant Syrup, Blackcurrant Puree, and Cod Liver Oil, was introduced by the Ministry of Food, and distribution was arranged from each of the 5 Child Welfare Centres, in addition to distribution from the Town Hall and the Food Office. Dental arrangements under our Maternity and Child Welfare Scheme were carried out according to the annual rota, but, in the absence of one of the practitioners on military service, the others on the rota shared the work on behalf of their colleagues. During 1941, an additional service was introduced, viz., cooperation in the facilities of a Cardiac Clinic established at Oldchurch County Hospital. This Clinic is under the supervision of Dr. William Evans, F.R.C.P., and is for the purpose of obtaining expert investigation and advice on obscure and difficult heart conditions, so that a definite decision can be reached as to whether the condition is organic or functional, and so that suitable advice, as to exercises, etc., can be given. Each case referred from our Clinics is charged at the rate of 10/6. 9 Regarding the provision of Dried Milk and other preparations, there were 305 applications received during the year, 108 had to pay a proportion of the cost, and the remaining 197 received free grants. During 1941, 359 Child Welfare Sessions were held, and the following table gives a summary of the attendances:— Table 1. Individual Children attending 2,740 Children attending for the first time 958 Medical Consultations 7,041 Attendances of Children under 1 year 10,864 Attendances of Children between the ages of 1 and 5 years 4,769 Average attendance per session 43.5 Table 2 relates to the Home Visits paid by the Health Visitors. Table 2. (a) To Expectant Mothers. First Visits 26 Total Visits 33 (b) To Children under One Year of age. First Visits 942 Total Visits 2,596 (c) To Children between the Ages of 1 and 5 years. Total Visits 5,889 (iii) Child Life Protection. In Romford, each Health Visitor also holds the appointment of Child Protection Visitor under Sections 206 to 220 of the Public Health Act, 1936. Table 3. (a) Number of persons who were receiving children for reward at the end of the year 37 (b) Number of Children:— (1) At the end of the year 71 (2) Who died during the year 0 (3) On whom inquests were held during the year 0 10 (c) Number of Child Protection Visitors at the end of the year who were:— (1) Health Visitors 3 (2) Female, other than Health Visitors 0 (3) Male 0 (d) Number of persons (in addition to or in lieu of Visitors under (c) above) or Societies authorised to visit under the proviso to Section 209 ( 2) of the Public Health Act, 1936 0 (e) Proceedings taken during the year:— (1) Number of Cases 0 (2) Act and Section under which proceedings were taken — (iv) Midwives Act, 1936. The following gives a summary of the cases attended by the Council Midwives, as Midwives, and as Maternity Nurses during 1941:— As Midwives 412 As Maternity Nurses 64 (v) Inspection of Nursing Homes, Etc. Two Nursing Homes in the District are Registered by the Essex County Council under Section 187 of the Public Health Act, 1936. One of these is Registered for the reception of 5 Maternity or Medical Patients, and an annex to this Home is. Registered for 5 Maternity Patients. The other is Registered for 2 Maternity Patients. The third, referred to in last year's report, was discontinued during the year. Quarterly inspections of the two Homes were carried out on behalf of the Essex County Council as before, and investigations were again made in respect of Maternal Deaths, Cases of Puerperal Pyrexia, Eye Discharges of Infants, and Liability of the Midwives to be a Source of Infection, etc., which occurred generally throughout the District. (vii) Day Nursery. During the latter part of the year, arrangements were being made for the establishment of a War-time Nursery in this area. A house near the centre of the town was selected for this purpose, and, at the end of the year, sanction had been received from the Ministry of Health for the necessary adaptations and appointment of staff. It is anticipated that this Nursery will be in working order early in 1942. 11 3.—INSPECTION AND SUPERVISION OF FOOD. Meat and Other Foods. The Sanitary Inspectors have again carried out numerous duties in connection with the inspection of meat and other foods at the Regional Slaughterhouse, the Meat Depot, Butchers' Shops, Stalls, etc. Altogether, 542 visits were paid. At the Slaughterhouse alone 21,326 carcases were inspected. 4.—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. (i) Notifiable Diseases. (a) There was no increased prevalence of these diseases during the year, although, during the month of December, there was a slight rise in the number of cases of Scarlet Fever. This disease, however, maintained the mild features which have been characteristic of it now for many years. (b) Diphtheria Immunisation. Considerable propaganda was given throughout the year to the advantages to be obtained from Immunisation against Diphtheria, and the material used for this purpose, viz., Alum Precipitated Toxoid, was provided free of charge by the Emergency Laboratory Service. A course consists of 2 injections—a primary dose of 0.1 c.c. being followed in 4 weeks by a second dose of 0.3 c.c. Sessions have been arranged following each Child Welfare Clinic, and also at all the schools. The following statistics apply, since the inauguration of this scheme in Romford in 1935, till the end of 1941:— Table 4. Number of Immunisation injections given at Clinics 12,874 Number of Individuals who have received injections at Clinics 5,344 Number of Sets given to Practitioners 1,068 Total Number of Individuals who have received Immunisation Injections 6,412 Number of Schick Test injections given, including control injections 7,629 Number of Individuals who have been Schick tested 3,832 Percentage found to be Immune after course of treatment 96.2 12 (c) Prophylaxis against Typhoid-Paratyphoid Fevers. As recommended by the Ministry of Health, arrangements were made at the beginning of 1941 for the immunisation against organisms of the Typhoid Group of those members of the A.R.P. and Police Services who wished to avail themselves of this treatment, and, altogether, 311 personnel were given a first injection of 0.2 c.c. of T.A.B.C. Vaccine, and 286 of these were given a second injection, after an interval of four weeks, of 0.5 c.c. As with the material for Diphtheria Immunisation, so also was this Vaccine provided free of cost by the Emergency Laboratory Service. (ii) Non-Notifiable Diseases. The relative prevalence of these is set out below:— Table 5. Rubella 38 cases Chickenpox 220 „ 5.—SUPPLEMENTARY. Air Raid Precautions. During the earlier part of the year, the Casualty Services were again in action, and, as previously, carried out their duties in a manner which brought forth congratulations from all quarters. Once more I take this opportunity of expressing my thanks to the members of the staff of the Public Health Department, who, in conjunction with those in other Departments, have given so much of their own time to duties in the Report Centre, and elsewhere.