STE 49 LIBRARY METROPOLITAN BOROUGH OF STEPNEY ANNUAL REPORT or the Year 1944 (Abridged) of the MEDICAL OFFICER OF HEALTH AND ADMINISTRATIVE TUBERCULOSIS OFFICER F. R. O'SHIEL, L.R.C.P.I., L.M., D.P.H. together with a SUMMARY OF THE REPORT of the PUBLIC ANALYST. PUBLIC HEALTH DEPARTMENT, 43, White Horse Road, STEPNEY, E.l. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies and Gentlemen, I beg to present my annual report for the year 1944. The report is again abridged in accordance with the directions of the Ministry of Health. The Registrar-General's estimate of the population of the borough for the mid-year 1944 was 73,030. The population figures from the last more- war year were as follows:- 1938, 200,500; 1939, 197,200; 1940, 136,030; 1941, 75,010; 1942, 71,980; 1943, 72,920. The birth rate decreased from 18.8 in 1943 to 17.8 in 1944. The death rate was slightly higher than last year, 19.5 compared with 18.7. It is a pleasure to report that for the first time in the history of the borough there were no maternal deaths. The infantile mortality rate per 1000 live births was 56.6 compared with 53.2 last year. There was only one death from diphtheria and one from scarlet fever, nil from measles and 6 from whooping cough. Violent deaths rose from 51 in 1943 to 166 in 1944, largely due to flying bombs and rockets. Compared with last year there were 781 less cases of infectious diseases notified, mainly decreases in measles, scarlet fever and pneumonia. Notifications of measles decreased from 918 in 1943 to 201 in 1944, scarlet fever from 194 to 100 and pneumonia from 124 to 65. Whooping cough increased compared with last year from 142 to 245 and diphtheria from 45 to 47. There were no cases of smallpox or enteric fever. There were 2 cases of puerperal fever and 7 of puerperal pyrexia, all of which recovered. 185 cases of tuberculosis were notified during the year, being 83 less than last year, and 96 deaths, being 19 less than last year. An interesting special survey of the coloured persons in the borough will be found in the body of the report. All the health services continued throughout the year but the attendances at the war-time day nurseries and the diphtheria immunisation clinic were interfered with because of the flying bombs and rockets. The scabies clinic continued t be very busy throughout the year and I received much help from Dr.R.M.Orpwood and Dr.Tracy who undertook the diagnostic duties during the afternoon and evening sessions. The ruinruennial inspection of basement bakehouses under the factories Act 1937 was made in the early part of this year. Of the 69 basement bakehouses granted certificates in 1903/4 only 23 remain. (1) The Deputy Medical Officer of Health, Dr. J. W. Crawford, as called up for service in the R.A.M.C. on 22nd April and Dr. Susan M. Tracy commenced duty on 1st November in a temporary capacity as Assistant Medical Officer of Health during the absence of Dr.Crawford. The first flying bomb, which was also the first in London, fell in the borough on 13th Juno, and the first long-range rocket on 30th October. Altogether 36 flying bombs dropped on the borough and 8 rockets. The control of the casualty services for civil defence continued to occupy much of my time, and those sanitary inspector Clerical and other staff who helped to man the control centre wore actively engaged throughout the year. The Staff Officer for the Casualty Services and the officers in charge of the Light Rescue Services and First Aid Posts had onerous duties to perform I should like also to mention with gratitude those general practitioners in the borough who attended the wounded in the streets and the sick persons in the public shelters. The burden of food salvage fell on the food inspectors following enemy raids and largo Quantities of foodstuffs were recovered for human consumption. Those officers of this department and of the London Hospital who supervised and assisted at the emergency war mortuaries had a heavy year. The Air ended before the publication of this report and we look for ard to years of peace in which to reconstruct the borough ,nd improve its social services. It is not possible for me to mention all those who helped me throughout these difficult years, but I am most grateful to them and particularly to those members of the staff who did more than their share for the casualty and shelter services regardless of reward. To the Chairmen and members of the Committees associated with my ork and to the Civil Defence Controller, Mr.A.R.Beatfmont I tender my thanks for support and guidance, and to all the staff of the Department for their loyal co-operation, not only during this year but throughout the war period. I have the honour to bo, Your Worship, Ladies and Gentlemen, Your obedient servant, F. R. O'SHIEL. Medical Officer of Health. (2) METROPOLITAN BOROUGH OF STEPNEY ANNUAL REPORT (abridged) of the Medical Officer of Health for the Year 1944, I. STATISTICS AREA OF BOROUGH (in acres) 1902.766 POPULATION: The Registrar-General's Estimate for the raid-year 1944 73,030 LIVE BIRTH. Total M. E. Birth rate per Legitimate 1185 .609 576 1000 estimated Illegitimate 121 65 58 population Total Live Births: 1306 672 634 17.8 STILL BIRTH. 37 _18 _19 Rate per 1000 Total Live & Still: 1543 690 663 DEATHS 1425 844 581 Death rate per 1000 estimated population DEATHS FROM PUERPERAL CAUSES: 19.5 Puerperal Sepsis Nil. Other puerperal causes Nil. Rate per 1000 total (live and still) births Nil. DEATH RATE OF INEANTS UNDER ONE YEAR OF AGE. All infants per 1000 live births 56.6 Legitimate infants per 1000 legitimate live births 57.3 Illegitimate infants per 1000 illegitimate live births 74.3 DEATHS from Cancer (all ages) 18 5 Measles " " Nil. Whooping Cough (all ages) 6 Diarrhoea (under 2 years of age) 8 COMPARATIVE RATES : England & Wales. London. Stepney. Live Births 17.6 15.0 17.8 Deaths 11.6 15.7 19.5 Infantile Mortality 46.0 61.0 56.6 Puerperal causes (death-rate) 1.93 (not available) Nil. II. PROVISION OP HEALTH SERVICES IN THE BOROUGH NURSING IN THE HOME). The Council's arrangements with the East London Nursing Society were continued for the nursing of Measles, Pneumonia following Measles, Ophthalmia Neonatorum, Puerperal Fever Puerperal Pyrexia, Pemphigus Neonatorum, also for all complications and illnesses arising out of childbirth. LABORATORY FACILITIES. The number of Bacteriological examinations carried out was as follows:- Positive. Negative. For Diphtheria bacilli 15 370 For Dysentery " - 2 INSULIN for persons suffering from Diabetes was provided free of cost to 16 patients of which 8 were new cases, under authority of Circular 2734 of the Ministry of Health, dated 4th January 1945. AGED & INFIRM PERSONS. Four persons were removed on Magistrates Orders to institutions during the year under Section 224 of the Public Health (London) Act, 1936. (3) TUBERCULOSIS. 185 notifications were received - 169 pulmonary and 16 nonpulmonary. 96 deaths occurred - 86 respiratory and 10 other forms. TUBERCULOSIS DISPENSARIES. To. of attendances at the Dispensary 4121 " " consultations with the medical practitioners: Personal 201 Other 568 " visits by Tuberculosis Officers to homes 323 " specimens of sputum examined (83 positive) 468 " X-Ray examinations (films 1213, screening 423) 1636 " children boarded out 15 " " visits by Tuberculosis Visitors to homes 4253 Artificial pneumo-thorax treatment was given by the Tuberculosis Officer to 32 patients, necessitating 436 re fills Artificial pneumo-thorax treatment was given by hospitals to 8 patients necessitating 115 refills. Fin sen Light treatment wis given to 3 patients necessitating 193 attendances. No. of patients recommended for Sanatorium treatment 263 No, of contacts examined 564 EXTRA NOURISHMENT to tuberculous patients : 289 grants were made to 83 patients, each grant being for a period of 28 days. TUBERCULOSIS FINANCIAL ALLOWANCES. " Total Cases considered during the year 561 (Of the above 76 were new cases) Total Cases accepted during the year 502 No. of patients in receipt of. allowances at the end of the year 59 MASS RADIOGRAPHY. During the year, the Ministry of Health's scheme for Mass Radiography was commenced. Only a small part of the total workers in Stepney were X-rayed under the Scheme. The work was carried out by the L.C.C. in co-operation with the Borough Council's Tuberculosis Officer. Complete figures of analyses are not, however, available 'from the London County Council as the first phase of the scheme will not be completed until 1945. The approximate number of persons X-rayed in 1944 was 300. A large majority of these were factory workers with a small percentage of office workers from the factories concerned. The Borough Council employees have not yet been included. TUBERCULOSIS CARE COMMITTEE. In spite of the Government's Scheme for financial assistance for certain patients during treatment, there are still numbers of patients to whom these benefits do not yet apply, and the Care Committee have had increasing demands on their services and the voluntary fund. In families burdened with the disability of tuberculosis many kinds of economic distress arise; extra warm clothing is needed, a separate bed for the patient, fares for him to be visited whilst at sanatorium, and in the case of the poorest patients, a weekly pocket money allowance for the small expenses which must be met even in a sanatorium. All these extra items occur at a time when the patient's earning capacity has temporarily ceased, and it is then that the Tuberculosis Care Committee can show its sympathy in a practical way. Clothes, fares and pocket money again constituted the chief requirements of patients and their families applying for assistance, and over £100 was expended on these items alone. The response to the annual appeal for funds through the medium of the Christmas Seal Sale shows that the Committee's work is appreciated, this year's result being the highest yet, £200 being raised at a time when many demands are being made for war-time charities. The Care Committee greatly appreciate the response which is made locally for the tuberculosis patients in Stepney. (4) The "Xmas Seal Sale" is now well known, and apart from the donations sent by many people, the kind note of encouragement which often accompanies it make the Care Committee feel that the work they are doing is 'ell worth while. The Care Committee are grateful to all those whose willing help enaoled them to lighten the lot of those afflicted with this long and often tragic illness. DELTAL CLINIC Maternity Tuberculosis. Child Welfare. Total attendances 82 450 No. of new patients 4 68 No. of dentures supplies 16 60 MATERNITY & CHILD WELFARE No. of Health Visitors employed: Municipal 10. Voluntary 6. No. of all Health Visitors' visits to expectant mothers: First visits 902. Total 2250. " " " " " " to children under one year: Hirst visits 1170. Total 9694. " " " " " " to children between 1 & 5 years : Total 18165. to. of Infant Welfare Centres on 31st December: Municipal 7. Voluntary 3. Total 10. Ho. of children at first attendance: Under. 1 year old 1144. Between 1 and 5 years 255. Ho. of children attending at the end of the year: Under 1 year, 919. Over 1 year old, 2070. Total 2989. Total number of visits made during the year for all purposes by the Health Visitors: Municipal 24,900. Voluntary 18,147. AHTE & POST NATAL CLINICS. No. of Clinics: Municipal 2. Voluntary 3. Total number of women who attended 1086. SUPPLY OH MILK AND VITAMINS. Under the national Scheme, the following welfare foods were distributed: FOOD Infant Welfare Centres Day Nurseries Institutions. Hood Office TOTAL Milk, full cream 16500 pkts 278 pkts 373 pkts 889 pkts 18,040 " half " 1040 " 24 198 " 205 " 1,467 Orange Juice 53896 bots 1318 bots 432 bots 1620 " 57,266 Cod liver Oil 5536 " 503 " 24 " 177 6,240 A & D Capsules 1203 - - 72 1,275 THE CARE OF PREMATURE INFANTS (Cire. 20/44 and 174/44). 1. Information of all premature and underweight infants (5½ lbs. and under at birth) is supplied to the Medical Officer of Health on the birth notification cards. 2. Premature and underweight infants so notified 61. " " " " born in Stepney 42. " " " " " outside Stepney 19. 3. Of the total 61 infants:- (a) Number who died before the end of one month 23. (b) Percentage of deaths " " " " " 37.7% 4. Of the 42 born in Stepney:- (a) Born at home 15. (b) Born in Hospital 27. (5) 5. Of the 15 born at hone in Stepney:- (a) Died during the first 24 hours 3 (b) Died after the first 24 hours but before the end of first month — (c) Survived at end of first month 11. (11 of the 15 were nursed entirely at home). 6. Of the 27 infanta born in hospital in Stepney:- (a) Died during the first 24 hours 5. (b) Died after the first 24 hours but before the end of first month 1. (c) Survived at end of first month 21. 7. Special, equipment for premature infants born at home is supplied by the London County Council to their domiciliary midwives and to the district midwives of the London Hospital and East London Nursing Association who undertake domiciliary midwifery for the L.C.C. 8. Expressed breast-milk is obtained by the L.C.C. from Queen Charlotte's Hospital when necessary. 9. The services of a paediatrician are available at the London Hospital and the L.C.C. hospitals in the Borough. 10. Following up of the infant after discharge from hospital, or, in the case of those born at home, after the midwife leaves the house, is undertaken by the Health Visitor of the district concerned. 11. Home helps are not at present available. 12. Special wards or special premature infant units in local L.C.C. and voluntary hospitals are not provided at present, but those infants receive special care and attention in screened cots in the normal infant units. 13. The standard proposed in Circular 20/44 of one specially trained nurse to 1½ premature infants is not possible at the present time. 14. Specially designed or newly built institutional accommodation for premature infants is not possible at the present time, but the Borough Council have had a scheme under consideration for such provision at a future date. 15. Special transport for the conveyance of premature infants to hospital:- These infants are conveyed by the London County Council normal ambulance service, with hot ater bottles, blankets, etc. Nurse accompanies. ILLEGITIMATE INFANTS (Circilar 174/44 and 2866 (revised) ). 121 illegitimate infants were born during the year, 63 males and 58 females. The death rate of these infants was 74.3 per 1000 illegitimate, live births. During the year conferences were held between the London County Council and the Borough Councils as a result of which it was decided that each borough should contribute a block grant to the voluntary moral welfare societies operating in the area, according to the rateable value of the borough. On this basis Stepney Borough Council contributes £143, which is distributed on an agreed basis to the moral welfare societies concerned, through the Metropolitan Boroughs Standing Joint Committee. The Health Visitors and the officers of the local moral welfare societies co-operate in all cases. The number of illegitimate infants born during the year and looked after by their own mothers in their own homes was 88. Looked after by individual foster mothers 4. Looked after in voluntary homos and institutions run for private profit 4. (6) Looked after in L. C. C. institutions 5. The number of premises in the Borough exempted wholly or partially from inspection is Nil. The notifications received of births of the illegitimate infants whoso mothers normally reside outside the Borough wore transferred at once to the welfare authority in which the mothers normally resided. Ten of such notifications were transferred. Approximately twelve cases were untraced. CHILD LIFE. PROTECTION. Number of persons who were receiving children for reward at the end of the year 3. Number of children at ,end of the year 3. Lumber, of Child Protection Visitors: Health Visitors 10. " " " " : others 1. Visits, made by above to Homes of foster mothers 9. " " " " " " children 7. Proceedings taken during the year under Part XIII of the Public Health (London) Act 1936, Section 23.9 (a) NIL. WAR TIME DAY NURSERIES. There are three war-time Day Nuraeries for the children of paid working mothers and one voluntary Day ilursery. Queen Elizabeth Hospital. (Shadwell) Old Church Road. Vallance Rd, (Robert Montefiore School) Beaumont Grove Girls Club (Voluntary) Accommodati on: 0-2 years 16(incl. 6 infants) 30(incl. 10 infants) 30(incl. 10 infants) - 2-5 34 30 30 20 Total 50 60 60 20 Average Attendances per day: 0-2 years 15 18 19 — 2-5 17 21 21 11 Total 32 39 40 11 Highest average attendances in any one day: 0-2 years 23 33 32 — 2-5 30 33 34 — Total 53 66 66 — NOTE: The attack on the Borough by flying bombs tended to decrease the attendances at the war-time day nurseries. Great difficulty has been experienced in obtaining staff for the nurseries. In this respect probably the east-end boroughs in London suffer more than those in residential areas. The remuneration does not encourage parents to allow their daughters to undertake work of this kind in districts where it is difficult to obtain lodgings. The Council has two small hostels for nurses with accommodation for 10, but one of these must soon close. Hostels for Nursery Nurses. 35 Stepney Green. Total accommodation 6. Queen Elizabeth Hospital. Total accommodation 4. (7) III. SANITARY CIRCUMSTANCES OF AREA. SANITARY INSPECTION The following is a summary of the inspections carried out by the nine District Sanitary Inspectors:To houses and other premises (relating to Complaints, Nuisances, Infectious Diseases, Resaurants, Lodging houses, etc. 7179. Miscellaneous Inspections 10609. To Factories, Workshops and outworkers premises 1483. Number of Revisits 8553. Number of Intimations served 2838. " " Statutory Notices 573. " 11 Summonses taken out 3. " visits to air-raid shelters 906. " visits to Rest and Feeding Centres 15. " visits to Canteens 38. Note: Eight of the Council's Sanitary Inspectors are still seconded to War Damage and are not available to the Public Health Department. A summary of sanitary work carried out as a result of notices served is as follows:- Repairs to roofs, gutters and rain-water pipes 985. Cleansing or repairs to drains, water-closets, sinks, baths and lavatory wastes 3317. Miscellaneous repairs 2523. Dampness in premises, remedied and rooms cleansed 1717. Drains tested 253, of which 24 were defective. RAT CONTROL. The District Sanitary Inspectors continue to co-operate with the Council's Rodent Officer and Rat Catchers in the Borough Engineer's Department on the control of rat infestation. During the year 630 complaints were received as to nuisances for rats and mice. Drains were tested where necessary and 493 complaints were forwarded to the Borough Engineer and Surveyor so that the Council's rat-catchers could call and assist the tenants concerned. IV. HOUSING. INSPECTION. Number of houses inspected for housing defects 6174. " inspections made for such purposes 6844. " houses not reasonably fit 2304. " houses rendered fit informally 1731. " houses in respect of which notices were served 573. " houses in which defects wore remedied after service of formal notice 573. OVERCROWDING-. Houses in which the rooms were measured and the permitted number ascertained 30. Number of visits to the above 38. " " houses in which the information has been supplied to owners and occupiers 28. HOUSING ACCOMMODATION AND THE EFFECTS OF THE WAR. The housing accommodation in the Borough was seriously interfered with as a result of enemy action by piloted and pilotless aircraft and long range rockets during the war. Prior to the war there were approximately 34,600 dwellings in the Borough. The appended figures, which are approximate only and liable to adjustment, show how drastically this accommodation was reduced. (8) The War Damage 'Department of the Council have since executed repairs on a most extensive scale to hundreds of the repairable properties, and the following figures do not therefore represent the present position, which has, of course, very considerably improved and continues to improve. 1. Houses or separate duellings in Stepney before the war 34,600. 2. Damaged beyond repair 8,600. 3. Damaged seriously 5,400. 4. Damaged slightly 15,000. 5. Total damaged 29,000. CERTIFICATES OF ESSENTIALITY FOE REPAIR OF PROPERTY. In October 1943 the Ministry issued Circular 2871 which dealt with the general scheme for the repair of houses and provided for the issue of certificates of essentiality by the Local Authority to serve for evidence in procuring building licences from the Ministry of Works and for the contractor to present to the Ministry of Labour as protection of. the labour engaged on the work against transfer. The circular aims at securing the maximum improvement in housing conditions and defines the work which comes within the scheme. The Medical Officer of Health reports upon applications received and makes recommendations to the Town Clerk as to the. issuing of certificates. During the year 276 applications were recommended and 20 not recommended. Number of premises surveyed by the Sanitary Inspectors for such purposes was 454. LICENCES FOR REPAIR OF PROPERTY & REPAIR OF C(b) HOUSES (War Damage). The Medica1 Officer of Health reports upon applications received for above and makes recommendations to the Town Clerk as to the issuing of licences for those properties which are, to be repaired by the owners. This necessitated many inspections by the 'Sanitary Inspectors. V. INSPECTION AND SUPERVISION OF FOOD. Total number of inspections and re-inspections made by the four Inspectors engaged in the supervision and inspection of food amount to 8206. Legal Proceedings were taken out in 35 instances. The quantity of foodstuffs dealt with as unfit for human consumption during the year amounted to 220 tons under the Public Health (imported Food) regulations, and 161 tons under the Public Health (London) Act, 1936 (see also Analyst's Report). 1479 samples of food and drugs and 28 other sample's were submitted for analysis. Assistance was also rendered by these Inspectors to the Food Control Committee on Food Salvage, new registrations, etc. BASEMENT BAKEHOUSES. In the year ending on 30th June 1939 and in every fifth year subsequently, inspections of basement bakehouses must be made under the Factories Act 1937. I accordingly made a quinquennial examination of the remaining basement bakehouses in the early part of 1944, and reported to the Committee that, of the 69 which were certified in 1903/4 under the Factory and Workshop Act 1901, only 23 remained open. I further reported that, of the latter, 12 were unfit to retain their certificates. Owing to the war and the shortage of suitable bakehouse accommodation and the doubtful survival, owing to enemy bombing, of those existing, it was decided to take no action to close unsuitable bakehouses at the present time. VI. PREVALENCE AND CONTROL OVER INFECTIOUS DISEASE. NOTIFICATION OF INFECTIOUS DISEASES .(Other than Tuberculosis). 766 notifications were received during the year: Scarlet Fever, 100; Diphtheria, 47; Puerperal Pyrexia, 7; Puerperal Fever, 2; Erysipelas, 31; Cerebro-Spinal Fever, 7; Ophthalmia Neonatorum, 8; (9) Polio-Myelitis, 1; Malaria, 3; Measles, 201; Pneumonia, 6 5; Whooping Cough, 245; Dysentery, 43; Pood Poisoning, 4; Enteric, 0; Smallpox, 0. Of the above 766 notifications, 65 cases removed to hospital were found not to be suffering from the disease notified. These referred to. Scarlet Fever, 9; Diphtheria, 25; Cerebrospinal Fever,, 3;. Polio-Myelitis, .1; Measles, 16; Whooping Cough', 7; Dysentery, 4. DEATHS FROM INFECTIOUS DISEASES. There were 87 deaths, i.e. Scarlet Fever, 1; Diphtheria, 1; Cerebro-Spinal Fever, 3; Pneumonia, 76; Whooping Cough, 6. DIPHTHERIA IMMUNISATION. The number of attendances at the diphtheria immunisation clinics decreased considerably this year. This was no doubt partly-due to the disturbance caused by the flying bombs and long range rockets. In addition to the diphtheria immunisation clinic every Friday afternoon at 35, Stepney Green, E.I., facilities have now been provided at most of the Infant welfare Centres for those pre-' school children who attend them. B.C. L.C.C. TOTAL Und.5 Over 5. Und.5 Ovr.5. | Number of Sessions held 51 – – 51 Number of Post Schick Tests 424 14 – – 438 Number of Immunisation Certificates given. 329 17 – – 346 Number of attendances of children for Schick or immunisation. 1615 52 – – 166 7 Number of children who completed the full course of immunisation. 477 11 58 216 762 WHOOPING COUGH IMMUNISATION. In addition to the whooping cough immunisation clinic held in conjunction with the diphtheria immunisation clinic every Friday afternoon at 35 Stepney Green, facilities have now been provided at most of the infant welfare centres. 376 children were immunised during the year. The immunising agent used is alum-pre cipitatec. (pertussis) Vaccine (Glaxo) containing 20,000'million cells per cub. centimetre. Throe doaes are given of 0.5 c.c. at intervals of 2 weeks. BUG ERADICATION. During the year, the Housing Committee decided to resume the practice of disinfecting with Hydrogen Cyanide the furniture and effects of all families, before admission as tenants to the Council's housing estates. In the year 1941 the Committee temporarily stopped this disinfestation, since when infestation of tho Council's estates was found to increase. 2538 inspections and re-inspections of premises were carried out by the Inspectors on bug eradication. 470 premises, 975 rooms and 143 shelters were sprayed during the year. During this year 70 of the families rehoused by the Housing Department to Stepney Borough Council flats had their furniture and other household articles treated with H.C.N. 34 of the families rehoused by Civil Defence had their furniture and other household articles and goods treated with H.C.N, prior to removal to other premises. All bedding is separately disinfected with steam. CLEANSING AND DISINFECTION. 406 rooms were disinfected because of infectious disease and 50 because of pulmonary tuberculosis. 70,526 articles of clothing and bedding were steam disinfected. (10) SMALLPOX AND VACCINATION. To cases of smallpox were notified. 488 children were successfully vaccinated. 365 Statutory declarations were received. In addition, 372 children who were registered outside the Borough were successfully vaccinated. The total number of children vaccinated was 860. SCABIES (Scabies Order 1941). Ho. of cases notified Formally 1155. - Informally 521. Diagnostic Clinic. Men. Women. Children TOTAL. No. of Sessions 104. " persons who attended 661 1123 630 2414. " " found positive (39%) 220 455 267 942. Total number of attendances 737 1232 686 2655 Branch Road Treatment Centre. Persons bathed and clothing disinfected 217 318 118 653. No. of baths and treatments given 456 662 243 1361. London Hospital Treatment Centre. Persons bathed and clothing disinfected 268 467 313 1048. L.C.C. School Treatment Centre. Pre — school children - - 12 12. No. of baths and treatments given - - 36 36. Statutory Action under Scabies Order 1941. Ho. of Inspection of promises notices served 13. " Medical Examination notices served 282. " Medical Treatment notices served 2. " Cases in which legal proceedings were taken 1. VERMINOUS PERSONS. Branch Road Cleansing Centre. Men. Women. Children. TOTAL No. of persons bathed and clothing disinfected 257 126 34 417. baths and treatments given 265 135 36 436. L.C. C. (Pre — School children) - - 11 n. HEAD LICE. (Ministry of Health Circular 2831. ) Special attention is being given to this matter by the Council's Health Visitors at the Infant Welfare Centres and when visiting the homes. Kit combs and Lethane Oil are supplied free or at cost price at the Infant Welfare Centres. Leaflets have been widely distributed. 11 coloured persons in stepney. a special survey During the latter part of 1943 a special Survey was made of the groups of coloured persons in Stepney by investigators working for a local committee in co-ope ration with the welfare Department of the Colonial Office. This as an original and most useful piece of work and I desire to express my gratitude for permission given me to quote some of the facts and figures of the Survey. The fact that the investigation as undertaken in the midst of the war does, not mean that the matter is a war-time one. It is true the War intensified the difficulties of the coloured people in many ways and temporarily added to their number coloured visitors serving in the Forces, many U.S.A. negroes spending periods of their leave amidst the coloured people in the Borough. But the question existed for several years before- the war and is likely to continue in an area such as Stepney which is closely associated with shipping and the docks. The coloured persons in Stepney tend, at present, to confine themselves to a more or less limited area of just under one square mile in the south-westerly part of the Borough. In- this area in 1943 approximately 698 coloured people could be found on any given day. Of the 698, some 400 were residents in the area and 298 were a floating population, of whom about 150 v/ere casual visitors to the district, the latter mostly United States negro soldiers on leave. (1) tie resident coloured parsons About 400 coloured persons have homes in Stepney in the area described above. These consist of 252 men, 12 women and 136 children. The men are mostly Indians from the East Indies but there are many coloured "colonials". The proportions, worked out from the known origin of 150 of the men, were as follows:- Indians 49.2% Colonials 45.2% Other origins 4.4% The "colonials" originated as follows :- Vest Africans 69.4% British West Indians 17.0% Ceylon, Malaya, Aden 13.6% with a few others from the Soudan, South Africa, '/est Africa, French . Africa and Egypt. 75 of the coloured men residing more or less permanently in the area live with or are married to women by whom they have children. 32 of these men are indians, 39 colonials and 4 other origins. The children number 136, and most of these have been born within the last 10 years, as the following figures show:- 6 children between the age of 15 and 16. 19 " " " " " 10 " 15. 33 " " " " " 5 " 10. 78 " under the age of 5 years. (12) All but 20 of those children have white, mothers. Only 12 of the mothers are coloured, 2 of these being ha11-caste. There are 75 families. 61 of the children have Indian fathers (33 families), 71 Colonial (39 families), and 4, fathers of other origin. 12 of the Colonial children are pure-bred and are 7 West African and 4 Malayan. Employment of the Resident Coloured Persons. Of the 252 resident coloured men, 80% are seamen or are working in .connection with local cafes run for the coloured population. 20% work for the building trade and other occupations such as tailoring and stokers in factories and gasworks. The -coloured seamen work in ships' engine rooms as firemen, greasers, donkey-men, etc.' It is said they are good workers. In peace-time a number of resident coloured men obtained casual employment in "crowd" scenes in film studios in ana around London. A small number were and are still employed in restaurants in the "Test End, more obtained employment in Stepney as messengers and carriers for tailoring firms. Others, usually of tho Sikh tribe, took up hawking on their own account and travelled the country with suit-cases of "Indian" scarves, shawls, stockings, etc., or were employed by small firms to do this work. During the war this trade has temporarily ceased. (2) THE FLOATING COLOURED POPULATION The floating population of coloured men depends on the number of ships in tho docks, recently, owing to the war, less than the normal number. At the time of this survey the average daily floating population numbered approximately 298 but 150 of these were U.S.A. negro soldiers on leave from camps in England, and a few coloured men from Dutch 3hips who spent their free time here. Employment of Floating Coloured Population. Tho floating population of coloured men are usually employed as seamen and work in ships' engine rooms as firemen, greasers, donkey-men, etc. Sometimes, often following prolcged absence from duty because of sickness, these men cease to act as seamen and become absorbed into the resident coloured population. (3) HOSTELS, CAFES AND CLUBS Hostels, caf6s and clubs exist in the area and are patronised both by resident and casual coloured men. Hostels. Of tho seven licenced hostels for seamen in the neighbourhood, three only are used by the coloured men to any extent. The latter are small hostels and have little accommodation. They are used by not more than 50 Indians and 15 coloured Colonials. A few coloured men stay in common lodging houses, but the majority live with the resident coloured population in various rooms and small houses in the area under review. Cafes. There are about 32 cafes patronised by resident and casual coloured men (including U.S.A. negroes on leave), nearly all in the south-western area of the Borough. The coloured men use these cafes not only for meals, but as resting places during the day and ths evening, Sometimes, though no often, rooms over the cafe premises are used for sleeping. The coloured cafc-s are features of the neighbourhood that cannot be missed by anyone walking through the district. They are usually run by coloured men or men from Malta who live abd work in close contact with the coloured population. The coloured men use (13) thorn to sit in and while away the hours drinking tea and listening to the radio. Though they are poor places they are comparatively comfortable and warm and the food is usually good. To some extent therefore they serve as clubs and social centres for these men and the women who associate with them. As a rule, Muslims go to one cafe and negroes to another. Clubs. Coloured men are not as a rule heavy drinkers, though they frequent the local public, houses in moderation. There is one small West Indian club in the neighbourhood Which has a licence to sell alcoholic beverages and which is much frequented by the coloured Colonials and their friends. One similar club has recently been licenced in the area. These Clubs have some facilities for music and dancing. —o — Prom the above summary of the Survey, it will be seen that the coloured population of stepney is not great in number. In a dock-side, borough there will always' be a drift of coloured persons to and from the sea, and it is realised that whilst residents of the Borough their welfare and health should be cared for as for their white neighbours. (14 ) METROPOLITAN BOROUGH OF STEPNEY LIBRARY Public Health Department, 43 White house Road, E.l. Medical Officer of health's Annual Report for the Year 1944. Please note the following correction :- Pane- 15 - The headings below should be substituted for those appearing at the head of the Table of "Causes of Death'' :- TOTAL Under 1 Year 1-5 5-15 15-45 45-65 65 & over — F. R. O'SHIEL Medical Officer of Health. 0 CAUSES OF ALL DEATHS DURING THE YEAR 1944. CAUSES OF DEATHS TOTAL Under 1 Year. 1-2. 2-5. 5-15 15 -45 45-65 65 & over. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Typhoid and paratyphoid fevers. – – – – – – – – – – – – – – – – Cerebro-Spinal Fever 2 1 – – 2 - — — — 1 — _ — — — Scarlet Fever — 1 – – – 1 '/hooping Cough 6 — 5 – 1 — — - i — — — — — — — Diphtheria 1 – – – – — — — 1 — — — — _ — mm Tub. of Resp. System 65 21 1 1 — 3 — — 27 10 25 4 12 3 _ mm Other forms of tub. 7 3 — _ 2 2 1 — 2 1 1 _ 1 _ — mm Syphilitic disease. 20 10 1 1 — — — 1 1 7 6 11 2 mm mm Influenza 4 4 — 1 2 1 2 2 mm mm Measles – – – – – – – – – – – – – – – – Ac. polio-myel. & polio, ence^h. – – – – – – – – – – – – – – – – Ac. inf. enceph. 3 1 – – – – – – 3 1 – – – – – – Cancer of buc. cav. & Oeso^h. 17 – – – – – – – – – 3 – 14 – – – Cancer of Uterus. – 7 — — – _ — — – 1 – 5 _ 1 mm mm " of Stomach & duodenum. 22 17 – – – – – – 3 2 11 8 8 7 – – of breast. - 35 – – – – – – — 1 – 9 _ 5 _ mm of all other sites. 68 30 – – – – – – 5 3 28 15 35 21 – – Diabete s. 3 8 – – – – – – – – 1 3 2 5 – – Intral-cranial vascular lesions. 52 43 – – – – – – – – 20 18 32 25 – – Heart Disease. L76 163 — — _ — 1 8 12 40 33 128 117 – – Other diseases of the circ. system. 34 18 – – – – – – 2 — 9 4 23 14 — mm Eronchitis. 80 31 2 - - - — — 6 1 23 7 49 23 mm mm Pneumonia. 43 33 5 6 2 — — 1 4 6 10 4 22 16 mm Other Resp. diseases 11 3 — — — — im — 2 — 5 2 4 1 mm mm Ulcer of Stomach or duodenum 10 1 – – – – – – 1 – 5 1 4 – – – Diarrhoea 3 5 3 5 — — – – — — – – – – – – Ap-oend icitis. 1 1 — – 1 _ – – 1 – – – – – – Other Digestive diseases. 19 14 1 2 – 1 1 – 2 – 5 5 10 6 – – Nephritis. 29 7 — — — — mm' mm 6 1 10 2 13 4 – – Puerperal and postabortive sepsis. – – – – – – – – – – – – – – – – Other maternal causes – – – – – – – – – – – – – – – – Premature births. 12 11 12 11 – – – – – – – – – – – – Congenital mabirth injury, inf. disease. 8 6 7 2 – 1 – – – 2 1 – – 1 – – Suicide. 6 4 – – – – – – 1 1 2 3 3 – – – Road Traffic accidents 6 5 — — — _ 1 – 2 – – 3 3 2 – – Other violent causes. 91 75 4 2 2 — 12 7 28 21 26 24 19 21 – – All other causes. 45 34 4 1 – – – – 4 7 15 12 22 14 - - TOTAL 844.581 45.32 10 8 15 9 108 73 249.169 417.290 – – 1425 77 18 24 181 418 707 - 15 21st ANNUAL REPORT Summary of Borough analyst's Quarterly Reports for the year 1944. 1,621 samples were submitted for analysis. Of these 1,591 samples were taken under the Food & Drugs Act. The remaining 30 samples were received from Borough Departments. Samples taken under the Food & Drugs Act. Tota1 samples 659 samples wore taken formally. 932 samples wore taken informally. Foods (taken under the Act) Foods (private samples) Drugs (taken under the Act) Other private samples 1223 27 368 3 1,6 2l Out of 1,250 samples of food, including private samples 67 or 5.4 per cent were adulterated and out of 368 samples of drugs 10 or 2.7 per cent were adulterated, making a total of 1,618 foods and drugs out of which 77 or 4.8 per cent wore adulterated. MILK 572 samples wore examined. The average composition including 3 adulterated samples was;- Fat. 3.64 por cent and solids-not-fat 8.72 por cent. ADULTERATED SAMPLES (including other offences) Nature Adulterated, etc. prosecutions Cautioned. Informal Formal . Private. FOODS Meat paste 1 — — — — Egg Sub.pdr. 3 - — — — Oatmeal 1 1 — — 1 Milk - 3 — 2 1 Buttered Rolls 20 4 - 2 2 Soya Flour 2 1 — 1 - Fruit Drinks 7 3 - 2 1 Vinegar 5 1 - 1 - Baking Pdr. 3 3 - - 3 Wine - 3 - 3 - Cloves 1 - - - — PRIVATE FOODS Rice — _ 1 — — Semolina — — 1 — — Blanc-mange — - 1 — - Milk — - . 1 - — Lemonade — — 1 — — DRUGS Paregoric Tabs — 1 — — 1 Boracic Lint 1 — — — — Precipitated Chalk 1 1 — — 1 Anti-gas Oint. 3 X — - — - Tartaric Acid 1 — - — — Time of Iodiro 1 - - - — ??? 1 — — — — X Reported to factory. Total fines and costs £131. 17. 0 Poor quality samples 16 samples were reported as being of inferior grade or doubtful quality. D.HENVILLE. Borough Analyst.