68672 AC 4411(I) NALTHAMSTIW WAL70 BOROUGH of WALTHAMSTOW. EDUCATION COMMITTEE REPORT of the SCHOOL MEDICAL OFFICER for the year 1940 A.T.W.POWELL, M.C . ,M.B. ,B. S. ,M.R.C . S. ,L.R.C.P. ,D. P.H. 68672 CONTENTS Accommodation 4 Medical Treatment 8 After-care21 Mental Deficiency24 Attendance Officers 20 Milk Meals 19 Artificial Light Treatment. 17 Milk in Schools Scheme 20 Aural Clinic 10 Minor Ailments 6. 8 Blind School 22 Mumps 17 Boot Fun 20 N.S.P.C.C 21 Brookfield Hospital 24 Nursery School 24 Chicken Pox 17 Nutrition 5. 8 Child Guidance 24 Open Air Education 18 Clinics 4 " " School 22 Committee 2 Orthopaedic treatment 23 Convalescent Home treatm't.24 Orthoptic Clinic 9 Co-ordination 2 Parents, Co-operation of 20 Crippling 7.16 Parents, Payments by 25 Deaf School 22 Physical Training 18 Defective children 22 Population 4 Dental Defects 7.16 Re-inspections 5 Dental Treatment 7.16 Rheumatism 7.16 Diphtheria 17 Ringworm 17 Diphtheria Immunisation 18 Scabies 17 Ear Disease.7.10 Scarlet Fever 19 Employment of Children 25 School Journeys 18 Exclusion 17.22 School Camps 18 Eye Disease 6. 9 Secondary Schools 25 Following up 8 Skin Diseases 6. 8 Health flucation 25 Speech Therapy 24 Hearing 7.10 Staff 4eart Disease 7.16 Special Enquiries 25 Hospital Treatment 10 Statistics 26 Hygiene 4 Swimming 18.19 Iepetigo 17 Teachers, Co-operation of 20 Invalid Children's Aid Assc.2G Tonsils and Adenoids 7.10. Infectious Diseases 17 Tuberculosis 7 Introductions 5 Uncleanliness 6, 8 Meals, Provision of 19 Vaccination18 Medical Inspections 5 Vision 6. 9 Medical Examinations 26 Voluntary Bodies 20 Measles 17 Whooping Cough 17 1. EDUCATION COMMITTEE Chairman: Councillor S. N. Chaplin. Deputy Chairman: Alderman Mrs. C. McEntee, J.F. His Worshipful the Mayor, Councillor R.W.A.Russetl The Deputy Mayor, Alderman H. Frost, J.P. The Chairman, Finance Committee, Alderman Ross Wyld. Ald: Mrs. L.P.Bailey. Ald. Miss E.M.Pracy. Ald. A.G.Bottomley, O.B.E. Ald. W.H.Shaw. Ald. G. Gibbons, J.P. Coun. G.S.Mace Ald. W.B.Fitt. Coun. G.M.Page Ald: Mrs. 33.M, Miller. Coun. Mrs. E.A.Smith Co-optative Members: P. Aetin, Esq: J.P.,C.A. Rev: G.W.M.Laurence. Mrs. M.A.Gilman. E.J.Mumford, Esq: Mrs. E.M.Hsmond. Rt.Rev.Mgr.W.O'Grady, V.G. S.G.Haskins, Esq: E.C.C. S.A.Watson, Esq: A.J.D.Llewellyn, Esq: Director of Education and Chief Executive Officer: S.W.Burnell, Esq: LL.B.,B.Sc. (Retired August 1940) E.Gwyn Thomas, B.A.,Ph.D. (Appointed September 1940) 2. To the Chairman and Members of the WALTHAMSTO EDUCATION COMMITTEE Ladies and Gentlemen, I beg to present herewith c report upon the work of the School Medical Department for the year 1940. In comparing the findings with those of the previous year, the effect of evacuation should be borne in mind. A notable event was the opening of the new Handsworth Avenue School. In spite of the war the nutrition of children remaining in Walthamstow was maintained at a high level and, in fact, appeared to show a slight per centage improvement. There was some increase in uncleanliness and scabies - each inseparable from war conditions. In spite of so much shelter life, a kindly providence arranged for a low incidence of infectious disease. This may be partly explained by evacuation. In the case of Diphtheria however, the effects of the immunisation campaign are beginning to be felt. The work of the special schools continued as far as possible and also the loan of staff to the reception areas. once again I wish to acknowledge the consideration and help of your Committee and the good work of the Staff. I have the honour to be, Your obedient servant A.T.W.POWELL School Medical Officer 3. School Clinics-As for 1939. 1. STAFF OF SCHOOL MEDICAL DEPARTMENT. As for 1939. The services of the following were loaned to the areas specified for the period stated - BEDFORD FROM TO  Dr. M. C. Clarke, M.B.,B.Ch.,B.A.O. Sept:1939 Apri1 1940 Mr. G.P.L.Taylor, L.D.S.,R.C.S.(Eng). Sept:1939 May 1941 (when called up for military service) Miss D.E.Laidler, S.R.N.,S.C.M.H.V.Cert. Sept:1939 Feb:1940 Mrs. J. Morris, S.B.M.,S.B.M.,H.V.Cert. Sept:1939 Feb: 1940 Mrs. F. McWilliam, Dental Nurse. Sept:1939 Still awa NORTHANTS Miss E. McRaith, L.D.S.,R.C.S.(Eng) Oct:1939 May 1940. Miss Stuart, S.R.N.,S.C.M.,H.V.Cert. Sept:1939 Still awa Miss Waterman, Dental Attendant. Oct.19 39 May 1940. RUTLAND Mr. L.W.Elmer, L.D.S. ,R.C.S. (Eng) Sept:1939 Still awa Miss McCabe, S.R.N. ,H.V .Cert.(1919 ) Sept:1939 Still awa Miss Sanford, Dental attendant Sept:1939 Still awa ST.ALBANS Miss M.A.Young, S.R.N.,S.C.M.,H.V.Cert. Sept: 1939-May 1940. 2. CO - ORDINATION As given in the report for 1939. 3. THE SCHOOL MEDICAL SERVICE IN RELATION TO PUBLIC ELEMENTARY SCHOOLS. School Hygiene and accommodation:- The following table shows the number of schools in the Borough available during 1940 :- Boys Girls Ihfants. Mixed. Provided 5 5 17 14 Non-provided - 1 2 3 Special Mentally Defective. - - - 1 Myope Centre - - - 1 Open Air School - - - 1 Totals 5 6 19 20 1940 1939 1938 1937 1936 Number of children on Register, Dec. 31st 6270 15794 15980 16525 17265 Average attendance 4707.2 13943.4 14282.3 14909.1 15386.2 Percentage " 75.6 86.5 88.8 88.7 88.3 Population 109400 130800 131900 131900 133600 Percentage of School children to population. 5.7 12.07 12.1 12.5 12.9 School Hygiene - Mr. Frank H. Heaven, A.R.I.B.A., Architect to the Education Committee, reports as follows 4. New Buildings- Handsworth Avenue Senior Mixed School. The opening of this school was effected in May 1940 as a temporary mixed school for all ages. Its modern equipment consists of a large gymnasium with separate dressing rooms and showers for male and female staff and students. The sanitary accommodation, approached under cover from the school rooms, includes up-to-date combined flushing W.C.s, wash fountains in place of lavatory basins and electric face and hand driers. Large paved areas with a grass playfield of over seven acres provide ample space for physical training and organised games. Structural Alterations and additions. Air Raid Protection. Protection has been provided in practically every school and includes either hot water or electric heating, and where necessary chemieal closets. Blackout. In order to meet a demand for youth activities two halls have been specially blacked out with ventilator shutters. Renovations and Repairs. Interior renovations were deferred for economical reasons, with the exception of the lime whiting to outbuildings. Cooking and Dining Centres. Additional hot cupboards have been provided and improvements at the Central Kitchen effected. Heating. New stoker-fed boilers have been installed at two schools whilst supplementary heating by overhead electric panels and the repair of boilers and additional heating surfaces on existing hot water systems have been carried out. Sanitation. Defective cold water supplies have been renewed in four cases, one hot water supply installed and another renewed and repairs to cold and hot water services due to extreme frosts of the winter made good and sundry improvements effected. 4. MEDICAL INSPECTION. The age groups of the children inspected have been those defined under the three code groups of the Board of Education. There has been no departure from the Board's schedule of medical inspection. The following table gives a summary of the returns :- A. Routine Medical Inspections - Entrants 1813 Second age group 268 Third age group 610 Total 2691 Qther routine inspections 114 Grand total 2805 B. Other Inspections- Number of Special inspections and re-inspections 22847 5. REVIEW OF THE FACTS DISCLOSED BY MEDICAL INSPECTION. (a) Nutrition - The statistical returns relating to nutritional findings at the medical inspections are given below in the form required by the Board's Administrative Memorandum issued on the 31st December, 1934. 5. Classification of the Nutrition of Children Inspected during the year in the routine age groups- No. of Children "A" . Excellent "B" Normal "C" slightly Subnormal "D" Bad  Entrants. 1813 67 2 37.06 1051 57.91 88 4.85 2 0.11 2nd Age Group 268 89 33.17 164 61.19 15 5.59 - - 3rd Age Group 610 320 52.45 269 44.09 21 3.44 - - Other Routine Inspection 114 48 42.10 59 51.75 7 6 .14 - - Totals 2303 1129 40.24 1543 55.00 131 4.67 2 0.07 The findings may be shown comparatively as follows A&B. C. D. 1940 95.2 4.67 0.07 1939 94.6 5.2 0.1 (b) Unoleaeliness:- No children were cleansed under arrangements by your Committee, nor rare any legal proceedings taken, The following table gives comparative figures for the past two years :- 1940 Up to 21st July, 1939  Average number of visits to schools. 5 3 Total examinations 16908 31194 Number of individual children found unclean 689 997 Percentage uncleanliness of average attendance 12.7 7.1 Cases of chronic uncleanliness are followed up in the home. (c) Minor Ailments and Skin Defects:- The following is the number of skin defects found during the year 1940 1939  Ringworm-Head 2 5 Body 3 12 Scabies 55 47 Impetigo 47 114 Other skin diseases 133 254 Total 245 432 (d) Visual Defects and External Eye Diseases:- The number of patients requiring treatment and observation was as follows :- 1940 1939  Treatmant. Observation. Treatment. Obdervstion Visual defects 58 3 257 31 Squint 20 - 44 4 External Eye Disease 151 - 357 3 6 (e) Nose and Throat Defects:- The number of patients requiring treatment and observation was as follows 1940 1939 Treat ment. Observation Treat ment. Observation Chronic Tonsillitis 91 48 125 272 Adenoids only 4 - 2 6 Chronic Tonsillitis and Adenoids 13 - 3 5 Other conditions 152 - 272 3 The 152 cases of other conditions are made up of sore throats and defects requiring diastello treatment. (f) Ear Disease and Defective Hearing:-Patients requiring treatment- 1940 1939 Defective hearing 11 69 Otitis Media 85 135 Other Ear Disease 2 44 (g) Dental Defects- Inspec -tion Requiring Treatment. Per Cent Actually Treated Fill ings Extract ions. General Anaesth etic Other Operations 1940 8793 7371 83.8 2945 5086 3387 1690 1592 1939 5721 4682 81.8 3415 3721 5048 2674 1150 Reference to dental inspection and treatment at Secondary and Technical schools is made in Section 16. (h) Orthopaedic & Postural Defects- A total of 46 deformities was found to require treatment. Nearly every cripple is being discovered under the Maternity and Child Welfare Scheme, and is receiving treatment either under your Authority's scheme, at one of the Metropolitan Hospitals; or from the family doctor. (i) Heart Disease and Rheumatism - The findings were as follows:- 1940 1939 Treat ment. Observetion Treat ment Observation Heart Disease- Organic 14 1 13 12 Functional 7 1 19 7 Anaemia 26 - 26 1 Total 47 2 58 20 (j) Tuberculosis - The same arrangements as for 1938. (k) Other Defects and Diseases-The following table shows the numbers of various other defects which were found:- 1940 1939 Requiring Treatment Observation Requiring Treatment Observation Enlarged Glands 19 - 76 - Speech 13 - 18 5 Bronchitis 70 8 28 - Epilepsy 4 -- 6 - Chorea 5 - 4 - Other defects 664 - 1180 71 7. 6. FOLLOWING UP. The school nurses paid a total of 1274 home visits during 1940. The visits are classified below External Eye Diseases 46 Mumps 2 Measles 146 Whooping Cough 6 Tonsils and Adenoids 49 Uncleanliness 109 Chicken Pox 103 Impetigo and Sores141 Vision 104 Dental failures 50 Otorrhoea 102 Ringworm 4 Sore Throat 16 Scabies 55 Various 301 Deafness 17 German Measles 22 Rheumatism 1 7. ARRANGEMENTS FOR TREATMENT. (a) Nutrition:- Treatment facilities as in 1939. The following shows the quantities of tonics supplied during 1939: Cod Liver Parrish's Syrup Lacto Cod Liver Oil Cod Liver Oil & Oil Food Phosphate and Malt Malt & Parrish's. 4 lbs 71 lbs 20 lbs 423 lbs 882 lbs (b) Uncleanliness. Facilities as for 1939. (c) Minor Ailments and Diseases of the Skin:- Treatment facilities as for 1939. Children suffering from ringworm of the scalp which does not readily respond to treatment are referred for X-ray treatment to the queens Hospital for Children. No cases were referred during 1940. Cases of scabies not responding to treatment are referred to the Public Assistance Committee for in-patient treatment. The work done at the school clinics is shown on the table given below Conditions FIRST INSPECTIONS inspections Number excluded under Art. 20 B Number not Excluded Boys Girls Boys Girls Boys Girls Ringworm 3 4 - 2 25 22 Scabie s 26 17 6 3 120 78 Rheumatism 1 - 20 27 85 127 Impetigo, Sores etc. 8 12 31 31 154 149 Skin 15 17 27 36 72 105 Verminous Head etc. 2 12 10 62 8 72 Sore Throat 7 15 — 2 3 11 Discharging Ears 1 2 100 110 211 275 Defective Vision - - 8 8 - - External Eye Disease 12 10 68 52 191 126 'Tonsils & Adenoids - - 3 4 - - iVarious 46 32 277 247 729 451 Totals 131 121 550 584 1598 1416 Number of children seen at first inspection 1386 Number of children sent by Attendances Officers 32 Number of attendances made by children 44 00' Number of children sent by Head Teachers 1141 Number of swabs taken 56 Number of specimens of hair examined for Ringworm 8 Number operated on for Tonsils and Adenoids 14 Number of children seen by Ophthalmic Surgeon-New cases 220 Prescribed for 281 Total inspections 1228 8. First attendances numbered 1386 against 3040 in 1939, and re-attendances 3014 against 9133. the total attendances being 4400 against 12173. (d) Visual Defects and External. Eye Disease. Treatment for the latter is given at the school clinics. Dr. Sheppara has kindly contributed the following account of the work done during 1940:- "There were 1358 attendances at the eye clinic during 1940. 309 of these were submitted to retinoscopy, 236 being new cases. The following table shows the defects found in the new cases seen:- Under 7 yrs 7-11 yrs Over 11 yrs Secondary Schools Totals Bys Gls Bys Gls Bys Gls Bys Gls Bys Gls Hypermetropia 2 2 3 4 6 4 - - 11 10 Hypermetropic Astigmatism - 1 9 4 6 6 - 1 15 12 Myopic Astigmatism 1 2 4 5 2 6 - 1 7 14 Mixed Astigmatism - - 2 5 32 2 - 1 4 8 Myopia - 1 7 18 16 15 4 4 27 38 Various 9 15 18 i 15 14 12 - 7 41 49 Totals 12 21 43 51 46 45 4 14 105 131 The details of the group described as various are as follows Defects Boys Girls Total Squints 20 25 45 Headache, anaemia, styes, debility 12 21 33 Nystagmus 1 - 1 Corneal Ulcer - 1 1 Attending hospital 1 1 2 No visual defect 7 1 8 I have seen the children both at Hutton (6 children) and at Hale End (18 children) on several occasions. The Orthoptist has continued her work during the year with excellent results". The following report on the work of the Orthoptic Clinic has been given by Miss G.H.Montague-Smith, Orthoptist:- "The following table classified cases dealt with at the Special Squint clinic during the past year, For many children the course of treatment has temporarily ceased owing to evacuation, or failure to attend because of raids. The results therefore cannot compare with those of previous years when the course of treatment was carried on uninterruptedly. Number of attendances made 860 Number of children attending (Hew cases 33,Old cases 40) 73 Failed to attend 3 Evacueted 17 Left school 2 Moved away 4 Transferred 1 Unsuitable for orthoptics 2 Under observation 7 Cases treated for defective vision (1 cured, 1 still improving) 2 9. Cases treated with_orthoptic exercises- Discharged - Cured 4, 4 ) Cosmetic 2)- 8) Unresponsive 2) ) Evacuated after partial treatment 9) Rest from treatment 2) 30 Ceased attending because of raids 2) Still on treatment 9) Waiting list 5 (e) Nose and Throat Defects. The scheme for treatment remained the same as detailed in previous reports. The following table shows the number of cases treated:- Year At Connaught Hospital Privately Toto1 1940 14 3 17 1939 51 9 60 (f) Ear Disease and Defective Hearing. (i) Mastoid Disease No children were referred to the Prince of Wales General Hospital, Tottenham, for mastoid operation under your Committee's scheme, (ii) Ear Disease-Minor defects under this heading are treated at the minor ailments clinic, the numbers treated being given in the table relating to the work of these clinics. Ear Clinic-Dr. Francis Clarke reports as follows:- The following tables show the work done at the clinic during the year 1940. For explanatory notes on classification tables see 1939 report. "The Aural Clinic has been carried on during the whole of 1940 without any serious interruption, except that, arising during two or three periods of urgent evacuation, the attendances suffered accordingly, and a certain amount of disorganisation was inevitable. This was mostly felt in the special suction treatment for Tonsils. This, to a great extent , disorganised the special inquiry we were carrying out as to the value of suction in the curative treatment of diseased tonsils. The clinic however has been carried on, and one session a week and a good representative number of children with ear, nose and throat complaints attended and were satisfactorily treated. The net special tables of returns have been continued and we find them exceedingly helpful and informative in making our annual returns. The increasing number of infants and pre-school children now treated at the clinic is of special importance, and the results are satisfying,. It is the policy of the medical services to emphasise the early recognition and treatment of all affections of the ear, nose and throat in children of any age, and to have them promptly and adequately dealt with before they reach the chronic stage. In the case of acute otitis media (early middle ear inflammation) 29 infants or children under school age out of a total of 76 were treated at the clinic and 28 were cured, only one requiring hospital treatment. If these were neglected many of them would have drifted into the chronic stage with all its attendant dangers and disabilities. The number of chronic ear affections is steadily and relatively falling. Only a total of 33 cases were found during the year. This is largely due to insistent policy of efficient treatment in the early stages, and also the early recognition and treatment of nasal and throat defects which are generally the starting ground for later ear affections, The facilities of the clinic now extended to the treatment of nose and throat conditions as well as ear in infants and pre-school children is a valuable measure anc one to be strongly commended Special attention is being given to the conservative treatment of hypertrophied and diseased tonsils as against routine operation. The principal method used has been that of tonsil suction, referred to in our previous reports. In all, 73 cases received treatment as against 38 the previous year. Unfortunately, a considerable proportion of these 'lapsed' owing chiefly to evacuation, before the prescribed courses could be completed but in the great majority, even with part treatment, improvement was noticeable, and those who were able to complete the course were clear of all symptoms for which the treatment was undertaken, with definite reduction in the size of the consils. It will be noted in the figures of the returns the high numbers in the 'lapsed' columns. The great majority of these cases were evacuated under the urgent schemes last summer and autumn. It will also be noticed that the total number of children treated for nose and throat conditions exceeds the total for purely ear affections. This is on the right lines as it is in the early recognition and treatment of these nose and throat defects that the majority of later ear and hearing troubles are prevented. Proets displacement method in nasal sinus affections has established itself as a definitely valuable diagnostic and therapeutic measure. Zinc ionisation ha s b een retained as the method of choice as the most efficient treatment of chronic Otorrhoea. A steady improvement in the regularity of attendances and appreciation by the parents is noticeable, following an intensified 'follow up' system by the school medical department, but owing to war conditions a number of lapses is inevitable. The following are the Tables of classification 11. 12. TABLE A ACUTE OTITIS MEDIA. (i) Children over 5. Diagnosis Total (Ears) Tonsils & Adenoids TREATMENT RESULT Zinc Ionisation Anti septic Treatment Tonsils & Adenoids Conservative:Nasal Diastolisation. Tonsils & Adenoids Operation. Cured Improved Still under Treatment or Observation Left or Treatment Lapsed. Referred to Hospital for Operation Declined Treatment. Acute non-suppurative otitis media 13 4 Operation before Clinic - 3 - - 4 - - - - - 9 No Operation - 9 - - 7 - - 2 - - Acute non-suppurative otitis media with Nasal conditions: Enlarged Tonsils and Adenoids. 12 1 Operation before Clinic - 1 1 - 1 - - - -- -- X(1) 11 No Operation - 11 10 - 9 - - 2 - - Acute suppurative Otitis Media 17 6 Operation before Clinic - 6 - - 6 - - - - - X(2) 11 No Operation - 11 1 - 9 - - 2 - - Acute Suppurative Otitis Media with Nasal conditions: Enlarged Tonsils & Adenoids. 5 2 Operation before Clinic - 2 2 - 2 - - - - - 3 No Operation 1 3 2 2 1 Totals 47 44 16 40 - - 7 - - 13. TABLE A. ACUTE OTITIS MEDIA (ii) Children under 5 Total (Ears). Tonsils and Adenoids TREATMENT ii RESULT Zinc Ionisation Antiseptic treatment Tonsils & Adenoids Conservat ive:Na sal Diastolisation Tonsils & Adenoids Operation Cured Improved Still under Treatment or Observation Left or Treatment Lapsed Referred to Hospital for Operation Declined Treatment. Acute non-suppurative Otitis Media 12 - Operation before Clinic - - - - - - - - - - X(2) 12 No Operation - 12 - - 12 - - - - - Acute Suppurative Otitis Media - 14 - Operation before Clinic - - - - - - - - - - X(2) 14 No Operation - 14 - - 13 - - 1 - - Acute Suppurative Otitis Media with Nasal conditions: Enlarged Tonsils & Adenoids 3 - Operation before Clinic - - - - - - - - - - 8 No Operation - 3 2 - 3 - - - - - Totals 29 -" 29 2 - 28 - - 1 - - X The figures in brackets indicate the number of cases with Bi-lateral Otorrhoea. 14 ' TABLE B.- CHRONIC SUPPURATIVE OTITIS MEDIA. DIAGN0SIS. Totals (Ears) DIAGNOSIS TONSILS AND ADENOIDS. TREATMENT RESULT. (Children over 5.) Chronic Tympanic Sepsis. Complicated by:- Granulations: Simple Polyp. Mas toid Disease. | Enlarged Tonsils and Adenoids. Nasal Catarrh: Rhinitis:Sinusitie External Otitis: Exzema. Primary (Ear) Collateral (Nose & Throat.) Cured. Improved . Still Under Treatment or Observation Left or Lapsed Treatment. Referred to Hospital for Ope ration. Declined Treatment Old Operation No Operation. Zinc Ionisation. Antiseptic Treatment or Cautery. Tonsils & Adenoids. Conservative: Nasal: Diastolisation. Tonsils & Adenoids Op; Granulations: Simple Polypi. 3 1 - - - - - Operation Before Clinic. 1 - - - 1 - - 1 - - 1 _ — 1 _ _ No Operation. 1 1 — 1 1 1 i - — Mastoid Disease. 6 X(2) - 1 - - - - Operati on Before §linic. 1 - - - 1 - - - — 2 3 - - - No Operation. 3 4 - - - 1 4 - - Enlarged Tonsils and Adenoids. 3 - - - - Operation Before Clinic. - - - - - - - - - - | - 3 - No Operation. 1 3 3 - 1 2 - - Nasal Catarrh:Rhinitis or Sinusitis. 3 X(1) _ _ _ _ Operation Before Clinic. _ _ _ _ — _ - 1 _ _ - - - 3 - No Operation. 2 1 - - 1 - | - 2 ! - - External Otitis. Eczema. 3 1 - - - - Operation Before Clinic. - - - - - - - j - 2 - - - - 1 No Operation. 2 1 - - 3 - - i - TOTALS: 18 4 3 3 I 4 3 1 11 10 g 1 8 2 - | 9 1 - - Chronic Suppurative Otitis Media solely. (Tympanic Sepsis only) 13 X(3) Children over' 5 years. 8 Operation Beforp 01ini n. 6 2 - - 5 1 1 - - 5 No Operation. 4 1 - - 3 -I 1 1 - - Chronic Suppurative Otitis Media with Nasal Conditions; Tonsils & Adenoids. 2 Children unde: 5 years. - Op-eration Before Clinic. - - - - _| - - - - 2 No operation. - 2 - - — — - 2 — — GRAND TOTALS: 33 21 15 3 1 1§ 2 1 L 13 - - I - The figures in breokets indicate the number of cases with ;Bi-lateral Otorrhoea. 15. TABLE C. NOSE AND THROAT CONDITIONS. (i) Children over 5. Diagnosis (Primary) Total TONSILS AND ADENOIDS. Secondary Conditions. TREATMENT RESULT Deafness Nasal Catarrh Enlarged Tonsils & Adenoids Diastolisaticn Aijti septic Treatment Frcetz Displecement Tonsils & Adenoids. Chared Improved Still under Treatment or Observation Left or Treatment Lapsed. Referred to Hospital for Operation Declined Treatment Conservative Treatment Operative Treatment Sinusitis: Rhinitis. 4 Operation Before Clinic. - - - - - - - - 7 - - - - - - No operation. 4 - 2 1 3 3 2 — — 1 - - 1 2 - Nasal Obstruction. Rhinitis. 11 Operation Before Clinic. 3 - - - 2 1 - - - 1 1 - - 1 - No. Operation. 6 - 1 8 7 3 - 2 - 4 - 1 4 - -' Nasal Catarrh. 37 Operation Before Clinic. 7 2 - - 7 1 - - - 5 - 1 1 - - No operation. 30 5 1 25 5 - - - 21 2 2 4 - - Enlarge Tonsils & Adenoids. 73 Operation Before Clinic. - - - - - - - - - - - - - - No Operation. 73 2 21 31 17 8 2 50 2 26 4 5 39 - - TOTALS: 125 125 9 24 41 61 21 2 52 2 58 7 9 48 3 - (ii) CHILDREN UNDER 5. Nasal Catarrh. 3 Operation Before Clinic. - - - - - - - - - - - - - - - No operation. 3 - - - 2 1 - - - 3 - - - - - Enlarged Tonsils' & Adenoids. 4 Ope ration Before Clinic, - - - - - - - - - - - - - - - No operation. 4 - 1 2 1 - - 3 1 2 - 1 1 - - GRAND TOTALS: 132 132 9 25 43 64 22 2 55 3 63 7 10 49 3 - TABLE L Miscellaneous cases Diagnosis Total Treatment Result Cured No change Wax in the Ear 15 Removed 15 - Furuncle 2 Antiseptic 2 - Epistaxis 2 Gauteri sed 2 - Deafness, Speech etc. (nerve lesions) 5 Physica1 Electrical. 2 3 Totals 24 21 3 (g) Dental Defects-Treatment of Secondary and Technical PupilsThe work done for the Essex County Council is shown below and is not included in Table IT at the end of the report. INSPECTIONS 11 Yrs 12 Yrs 13 Yrs 14 Yrs 15 Yrs 16 Yrs Total No.offered treatment. % Requiring treatment. 102 109 126 73 28 2 440 357 81.2 TREATMENT No. of Children Attend ances. Extractions Anaesthetics Fillings Perm: Teeth Other Operations . Ferm.Teeth Temp. Teeth Perm. Teeth Local General 94 208 - 61 - 53 165 78 (h) Orthopaedic and Postural Defects. Details of the work done under the scheme are given in the section dealing with Defective Children. (i) Heart Disease and Rheumatism. Dr. Sheldon contributes the following report on the work of the Rheumatism Clinic during 1940:- RHEUMATISM CLINIC 1940 Number of sessions 25 " " attendances 306 " " new cases 59 " old cases 247 " discharged 52 " still under treatment 71 " of new cases with rheumatic or cardiac defect 20 " Referred to Hospital as In-patient 1 Out-patient 1 " " for tonsils and adenoids operation 8 " " " dental treatment 3 " " to Physically Defectice Centre 2 " excluded from school " " half time school 2 " " from games and exercises 5 " to begin games and exercises 3 " seen after scarlet fever 2 " " " diphtheria 6 " with cardiac defect after scarlet fever " " " " " diphtheria 1 " referred for convalescent home treatment 5 " sent away 5 (j) Tuberculosis. The number of school children examined during the year was - boys 18 and girls 19, of which 2 boys and 5 girls were referred by the school medical staff. 16 of the cases were sent by private practitioners, and 14 were examined as contacts. At the end of the year the live register of notified cases of school age was-Pulmonary 34, Non-pulmonary 53. 16. (k) Artificial Sunlight Treatment. The arrangements with the Connaught Hospital detailed in the 1936 report were continued. One child of school age was referred for treatment, and a total of 20 treatments was given at a cost of £2.0.0. 8. INFECTIOUS DISEASES. Control is on the lines detailed in the Board's "Memorandum of Closure of and Exclusion from School, 1930." Notification in the 5-15 years age group during 1940 were as follows (1939 cases shown in parenthesis)-scarlet fever 49 (123) diphtheria 6, (26), bacillary dysentery Nil, (2), Pneumonia 4 (14), erysipelas Nil (1), cerobro-spinal meningitis 2 (Nil), measles 28, whooping cough 4. The last two named diseases were made notifiable in October 1939. Among the cases discovered by the medical staff and included above were scarlet fever 1, non-clinical diphtheria 2. Non-notifiable infectious diseases is chiefly brought to light by the weekly returns made by Head Teachers under the local "Regulations as to Infectious Diseases in Schools." The monthly figures were as follows:- Sore Throat Measles Whooping Cough. Mumps Chicken Pox Ringworm & Scabies Impetigo Sores etc. January - - - - - - February - - - - - - - March - - - - - - - April - - - - - - - May - 34 1 - 1 1 - June - 12 1 - 9 - -- July 1 3 - - 13 - 1 August - - - - 3 - - September - - - - 16 - -- October - - - - 19 - 3 November 1 - - - 4 - - December - - 29 - - Total 2 49 2 1 94 1 4 Infectious Disease Clinic - Follow up arrangements as detailed in 1939 report. Sore Throat Follow-up scheme - Detailed in previous reports. 24 children had appointments but only 14 were kept. No child was referred to the Rheumatism clinic. The following table shows the work done at the infectious disease clinic No. of clinics held in connection with Infectious diseases and immunisation 53 Number of attendances made 696 Average attendances per session 13.1 No. of children recommended to rheumatism clinic 8 Number of children recommended to Ear clinic 12 17 The following are the weekly average numbers of children away from sohool owing to exclusions and the non-notifiable infectious and other diseases named Exclu sions Chicken Pox Meas les. Whoop -ing Cough Sore Throat Influ enza. Mps. Ring worm Scab ies. Var ious Totals 1940 9 25 24 2 10 6 - - 3 211 292 1939 44 52 20 149 33 120 4 2 7 531 964 Diphtheria Immunisation:- Immunisation was carried out at the weekly clinic on Tuesdays, but was discontinued at Infants schools owing to war conditions until recommenced towards the end of the year. The following summarises the work done Total number of immunisations completed during 1940- School Age 129 Pre-school age 220 Over school age - 349 Number not completing immunisation or left district - Number of Schick tests following immunisation 5 Number of attendances made at Clinic for immunisation 540 Immunisation at schools (included above) Number completely immunised 31 Number partly immunised Number having extra dose immunised in previous years. 12 Vaccination-The vaccinal condition of each child examined at routine medical inspection was noted, and a summary shows the following:- Number Examined No. found to be vaccinated Percentage Vaccinated Entrants Boys 887 183 20.6 Girls 926 157 16.9 2nd Age Group Boys 114 20 17.5 Girls 154 57 37.0 3rd Age Groups Boys 262 64 24.4 Girls 348 110 31.6 Total 2691 591 21.2 Action under Article 20(b) (Exclusion-of individual children) At Medical Inspection - At School Clinics 252 Action under Article 22 (School closure ) Nil. Action under Article 23(b) (i.e.,attendance below 60% of number on Register Nil. 9. OPEN AIR EDUCATION School .journeys. There were no school journeys during the year. School Camps:- Arrangements were made for a limited number of boys and girls to attend at the Manor House, Sandown, Isle of Wight. Two contingents completed their stay in the hotel but in accordance with instructions from the Board of Education it was necessary to recall the 3rd party. Swimming. Swimming instruction was given to the boys on Tuesdays and Thursdays and to the girls on Mondays and Wednesdays. 10. PHYSICAL TRAINING The following extracts have been taken from a report submitted to your Committee by the P.T.Organisers, Miss Hawkes and Mr. Last. "The chief factors which have hindered the maintenance of the pre-war standard are:- (i) Curtailment of the time devoted to physical education owing to the reduction of school hours and the interruption of the lessons by air-raids. 18. (2) Staffing Problems, i.e., the lack of specialist teachers due to evacuation and the loss of young men to H.M.Forces. (3) Absence of suitable conditions and equipment for the development of senior work where senior children now attend prewar junior schools. (4) Cessation of visits to playing fields because of the danger from air raids. (5) Curtailment of playground space and damage to playground surfaces owing to their use by Civil Defence Services (much has now been done to restore the normal peace time facilities). (6) Difficulties attending the resumption of the accepted prewar practice of changing into special gymnastic clothing due to (a) The rising costs of this clothing to parents. (b) The delay in taking cover, which this practice might involve in cases where the dressing cannot be carried out in the school shelters or where children use home shelters (under present conditions many children do not change into night clothes and the Association of desirable hygienic habits with physical exercise is therefore particularly important). Whilst agreeing that the long hours spent under poor hygienic conditions combined with the emotional stress caused by air raids have not resulted in any widespread or dangerous epidemics, or seriously undermined the health of bur children, our observations indicate that these conditions are nevertheless adversely affecting health and physique. Too many children are very pale, they show obvious signs of fatigue, and their posture and movement lack vitality. A vigorous daily physical training lesson, taken in the open air whenever possible, would do much to counteract the ill effects of long hours spent in a vitiated atmosphere under cramped conditions with little or no scope for any freedom of movement. Swimming. The absence of many teachers particularly interested in and capable of rendering valuable swimming instruction was keenly felt, but in spite of all difficulties some very good work was done, and attendance was remarkably good. The Committee's decision not to cancel the swimming programme was fully justified for nowhere could more healthy relaxation and joyous carefree effort be seen than at the swimming bath, where the lessons provide a real physical and mental tonic. Prevailing conditions made it quite impossible to organise the usual annual gala and the valuable stimulus provided by this important function was certainly missed. The majority of schools conducted at least one series of tests but. owing to the sudden cancelling of visits early in September the results obtained were very incomplete and there is no point in reproducing the usual table of records. 11. PROVISION OF MEALS (i) Mid-day Meals-The number of meals provided was as follows- Year Number of children Number of Meals Average Meals per child 1940 462 25,042 54.2 1939 790 67,788 85.8 1938 797 94,990 119.2 1937 801 93,791 117.1 1936 732 91,133 124.5 (2) Milk Meals. 486188 milk meals were supplied to children on medical grounds on the recommendation of the medical staff. The number of meals supplied during the preceding year was 1,028,595. 19. (3) Milk in Schools Scheme - The arrangements detailed in former reports were continued in 1940, all the milk supplied being pasteurised milk sold under licence. During the Easter vacation 16 Centres were opened for the supply of milk meals. The number supplied was as follows:- Voluntary. 1/3 pts. 1078 Official. ½ pts. 1937 Total. 3015 12 (a)- CO-OPERATION OF PARENTS. The following table shows the attendance of parents during 1940:- Boys. No. Inspected. No. of Parents. Percent. 1940. Percent. 1939. Entrants 887 789 88.9 90.0 2nd. Age Group 114 101 88.5 72.8 3rd. Age Group 262 142 54.2 49.8 Totals: 1263 1032 81.7 74.9 Girls. Entrants. 926 854 92.2 92.9 2nd.Age Group 154 100 64.9 83.1 3rd.Age Group 348 204 58.6 65.0 Totals: 1428 1158 81.0 78.7 Grand Total. 2691 2190 81.3 72.1. 12 (b) - CO-OPERATION OF TEACHERS. Renewed and grateful acknowledgment for the co-operation of Head Teachers and their staffs must be made. Generous help and co-operation has invariably been experienced. (c) - CO-OPERATION OF SCHOOL ATTENDANCE OFFICERS. The Superintendent Attendance Officer and his staff have again co-operated with the work of the School Medical Service,and there is almost daily proof of the advantage resulting from it. (d) - CO-OPERATION OF VOLUNTARY BODIES. (a) The Invalid Childrens Aid Association:- Miss Lewis, the Secretary, has kindly contributed the following report:- "Convalescent home treatment touched a very low figure but there was no evidence that this means of treatment was being refused. In the Autumn it almost stopped, the children left at home being obviously of parents who would not let them go away well or ill. There was no appearance, as might have been expected of children suffering from nervous affections caused by the 'Blitz' or from exposure in shelters. In fact, Dr. Sheldon's notes on M.B. whose home was destroyed, shows that in common with most of the children attending his clinic she put on 4½lbs in weight between July and the time he saw her after the bombing. "New Cases (in addition to re-applications) were referred by:- Over 5 yrs. Under 5 yrs. Medical Men, Hospitals and Dispensaries. 27 10 Medical Officer of Health and Infant Welfare Centres 6 6 Education Committees and School Medical Officers 11 1 Local Authorities under Schemes for (1) Rheumatism 6 1 (2) Orthopaedic care 127 44 Invalid Children's Aid Association 1 1 Totals: 178 63 20. Classification of cases:- Anaemia and debility 11 6 After infectious illness 2 1 Marasmus and Malnutrition 1 l Rheumatism, Chorea and Heart 6 - Heart (congenital) - - Diseases of Lungs (non T.B. ) (a) Bronchitis, Pneumonia etc 7 3 (b) Asthma 1 - Glands (Non T.B.) 3 - Diseases of bones (Non T.b.) 94 29 Diseases of digestive organs 3 1 Paralysis 4 - Nervous conditions 6 - Congenital deformities 29 18 Accidents 2 - Air Raids 3 l Hernia 2 2 Various 4 1 Help given to Old and New cases (all ages) Old New Sent to Special Hospitals and Convalescent Homes 17 35 Extension from previous years - 26 Provided with surgical boots and appliances 42 27 Provided with massage and exercises - 12 Referred for visiting and advice 133 188 Clothes - 7 Number of visits paid 970 Average length of stay in Convalescent home 19 weeks Children sent away from rheumatism clinic 5 (b) National Society for the Prevention of Cruelty to ChildrenThe following summary of the work done in Walthamstow during 1940: Nature of Offence How dealt with Neglect 43 Warned or advised 63 Advice sought 12 Illtreatment 4 Other wrongs 4 63 63 Number of children dealt with over five years of age, boys 33, girls 30. Number of children under 5 years of age, 68. 276 supervisory visits were made during the year, and 86 miscellaneous visits were made. (c) Central Boot Fund Committee. The Honorary Secretary, Mr. A.J. Blackhall has very kindly sent the following account of the work of the boot fund during 1940:- "During the 12 months ended 31st December 1940, approximately 600 pairs of boots were distributed at a cost of £200. The decrease in distribution is accounted for by reason of the number of children evacuated to the reception area. (d) The Mental Welfare and After Care Committee. The activities of this Committee were suspended during 1940. 21. 13. BLIND, DEAF, DEFECTIVE & EPILEPTIC CHILDREN. (i) Blind School:- The following table shows the classification of children attending the school at the end of 1940:- Walthamstow Blind Partially Blind Boys 1 7 Girls - 10 Evacuated to Hutton L.C.C. Residential School Boys 1 2 Girls - 3 The Head Teacher, Miss M.L.Balis, has kindly sent the following report:- "Despite the difficulties of war conditions, the Walthamstow Education Authorities continue to maintain the school for Blind ana Partially Blind children. During the period from January 1st 1940 and March 31st 1940, the Blind and Myope Centre remained at the Reception area at Hutton L.C.C. Residential School. On April 1st, however, owing to the number of children who had returned to Walthamstow, two classes were opened and are still functioning under the ideal conditions existing at the Education Committees Open Air School at Hale End Road. Here, there exists a very adequate air raid shelter in which during raids the children can continue to learn their lessons in safety and comfort. Consequently the work of the Centre continues as normally as shorter hours, air raids and changed conditions will allow. On 31st December 1940, the school consisted of 18 children at Hale End Open Air school, 6 at Hutton L.C.C. Residential school and 15 privately evacuated with their families. During the year ended 31st December 1940, three boys and three girls left the school and are all in employment suited to their capacities, and designed to preserve their sight. In conclusion may I thank the Education Committee and its administrative staff for the continued help and interest shown to the school, despite their extra work in the town owing to wartime conditions, and also the medical department, the doctors and nurses of which, despite the extra labour evacuated conditions have thrown upon them, have, with undiminished care and attention carried out the periodic inspection of the Children's eyes and general health both in Walthamstow and at the reception area". (ii) Deaf School. This school has been evacuated since the outbreak of war. (iii) Open Air School. Miss Thompson, the Head Teacher, reports as follows "In January 1940, there were still some 68 children of the Hale End Open Air school at the camp at eymouth. The severe winter had brought no worse troubles than chilblains, which however were very trying in many cases. Otherwise the health of the children was wonderful. So well did the children appear, that on a visit by a L.C.C. school medical officer it was decided to examine with a view to discharge and some 20 were considered fit to be transferred to private billets. Of these, 9 only went into Weymouth the rest returning to their parents. This made Walthamstow school one of the smallest in the camp. The parents visits were arranged by the Authorities once a month and each time a few withdrawals were made. 22 The Education Committee decided to re-open the school at Hale End Road in August and the staff was recalled, one teacher only remaining at Weymouth. As other schools are occupying the premises the numbers are necessarily small. At the end of the year there were in attendance, 9 orthopaedic, 3 cardiac and 8 debilitated. (iv) Orthopaedic Scheme. The arrangements whereby the Superintendent Health Visitor and the Welfare Masseuse attended each clinic was continued. The close liaison has proved very valuable. A total of 12 consultant sessions were held in 1940. The scheme is under the clinical charge of Mr. B. Whitchurch Howell, F.R.C.S., Consulting Orthopaedic Surgeon. The following tables show the work done at the clinic:- ORTHOPAEDIC SCHEME 5-16 yrs . BOYS Under 5 yrs Over 16 yrs 5-16 yrs. GIRLS Under 5 yrs Over 16 yrs Anterior Poliomyelitis 4 1 1 5 - 9 Scoliosis, Kyphosis Lordosis 1 - - 3 - - Surgical Tuberculosis Rickets:- 1 - - 1 - - (a ) Genu Varum - 13 - 1 9 - (b) Genu Valgum 7 9 - 2 9 - Pes Plano Valgus 63 9 1 26 5 - Spastic Paralysis 5 1 - 2 2 - Arthritis - - 1 1 - 1 Talipes:- (a) Equino Varus 6 1 1 1 4 - (b) Equino Valgus - - - 2 4 - (c) Pes Cavus - - - 2 - - (d) Calcaneo Valgus - 1 - - 1 - Torticollis 1 1 - 4 3 - Ataxia 1 - - - - - Osteomyelitis 1 - - - - - Amputation of leg - - - 1 - - Congenital dislocation of Hip - 1 - 4 1 - Hallux Valgus 1 - - 2 - - Hammer Toe - - - 2 - - Perthe's Disease - - - 1 - - Congenital defects 1 - - 2 3 - Miscellaneous 5 - - 2 2 — Totals 97 37 4 64 43 10 Number of cases seen by burgeon- From Physically Defective School 17 From other schools 91 Over school age 32 Under school age 80 Total 220 New cases seen by Surgeon:- School age 83 Under school age 49 Total 132 23 Total number of examinations by Surgeon 352 Total number of cases discharged by Surgeon 21 Average number of examinations made per session 27.1 Number of attendances for orthopaedic & massage treatment. 1015 Average number of attendances per sessions 5.2 Number of sessions held - Inspection 13 Treatment 196 Total number of visits by instrument maker 25 Number of children known to be evacuated 108 Defects seen at Orthopaedic Clinic in Children under 5 years of age Anterior Poliomyelitis 1 Rickets- (a) Genu Varum 22 (b) Genu Valgum 18 Pes Piano Valgus 14 Spastic Paralysis 3 Talipes 11 Torticollis 4 Congenital dislocation of Hip 2 Congenital defects 3 Miscellaneous 2 (v) Brookfield Orthopaedic Hospital:- This hospital has been closed since the outbreak of war. (vi) Mental Deficiency. Ascertainment Ascertainment has proceeded along the lines detailed in previous years. Certification. The school medical officer and two of the assistant school medical officers are recognised by the Board of Education as certifying officers. A summary of the work done under this heading during the year is given below:- Not Mentally Defective, or Dull and Backward 6 Mentally Deficient. 4 (vii) Child Guidance. No cases were referred during 1940. (viii) Speech Therapy. The speech therapy clinic has been discontinued since the outbreak of war. Convalescent Home Treatment. 48 children were sent away for treatment during 1940. There were 23 children remaining in convalescent homes and hospital schools on December 31st 1940. The conditions for which children were sent included the following - Debility 14, Heart 5, Rheumatism 2, Malnutrition 1, Bronchitis 4, Asthma 1, Anaemia 3, Nervousness 4, Chorea 3, after infectious illness 1, Various 10. A total of 10 children were sent to convalescent homes or heart homes from the rheumatism clinic. The average length of stay in all homes has been 19 weeks. 14. FULL-TIME COURSES OF HIGHER EDUCATION FOR BLIND, DEAF, DEFECTIVE & EPILEPTIC STUDENTS. The Authority for the provision of such courses is the Essex County Council. 15. NURSERY SCHOOL This school has been evacuated since the outbreak of war. 24 16. SECONDARY SCHOOLS The Authority for the provision of Secondary Schools in Walthamstow is the Essex County Council. (a) Dental Inspection & Treatment - Reference has been made in Section 7 (g) to the dental inspection and treatment of pupils attending Secondary and Technical Schools. (b) The following table shows the findings at Medical inspection. Number inspected- Entrants 55 12 years old 48 - Total 122. 15 " " 19 Parents present 103 Number referred for treatment (excluding dental & uncleanliness) 37 Number referred for observation 15 Number referred for treatment (excluding vision, dental & uncleanliness) 31 Nutrition - A 51 B 62 C 9 D - Defects found- Skin - Requiring treatment 6 Blepharitis - " " 1 Defective "Vision (excluding squint) Requiring treatment 6 " observation 9 Enlarged Tonsils - requiring observation 9 Teeth - Requiring treatment 6 Deformities - Requiring treatment 14 Other diseases and defects 10 17 PARENTS PAYMENTS The approved scales for the recovery of fees in respect of treatment is the same as given in the 1938 report. 18 HEALTH EDUCATION As for 1938. 19. SPECIAL ENQUIRIES As for 1938. 20. MISCELLANEOUS (i) Employment of Children and Young Persons. Mr. R. Dempsey, the Juvenile Employment Officer, gives the following report on the work of the Bureau:- "The upheaval in schools necessitated the suspension of all advisory work as to choice of employment among school leavers. 25 I During the first four months of the War the Walthamstow employers were at a standstill, and the numbers of unemployed at the Bureau were larger than usual at that time of the year, hut in January indications of greater activity in the works became evident With the factories in full swing, unemployed boys and girls and scholars who had reached their 14th birthday presented themselves a the factories and were immediately engaged without reference to the Bureau. Employers always had plenty of juvenile labour waiting at the gates and had no occasion to notify vacancies to the Bureau while thus lost many placings in employment, With the resumption of compulsory attendance at school ½n April 1940, the usual procedure of linking up the school leaver with the Bureau was re-established. Throughout the year, as in the previous year, employment in the City of London, on which so many Walthamstow Secondary and Central School pupils depend,was scarcely available owing to the evacuation of offices and the general reduction of office staffs. Large numbers of "placings in other districts" were tnus lost to the Bureau, and many boys and girls who would have found their future in the City, were forced to take local employment, frequently in jobs which offered good money but no future. The suspension of the provisions of the Factory Acts regarding overtime was, in the case of the juveniles, most unfortunate, if necessary at the time. Boys were able to draw very high wages. In many cases boys refused jobs which did not offer the high wages of a previous job. Compared with the previous year registrations at the Bureau were 167 less, placings in employment 353 less. The following figures indicate the increase or decrease on the previous year:- (a) Registrations 167 (b) Placings in employment 353 (c) Unemployment Insurance Claims to benefit 153 Amount paid £139 New Insurance Books issued 387 Annual exchange of books 93 (d) School Leavers- Registrations- Boys 711 Girls 633 1344 — 49 Placings in employment- Boys 432 Girls 325 757 — 178 (ii) Employment of Children. 40 children were examined by the medical staff. All were passed fit for employment. (iii) Employment of Children in Public Entertainments. No children were examined under these regulations. (iv) Medical Examinations. The following examinations were made during 1940 by the medical staff:- Teachers 42 Others 15 21. STATISTICAL TABLES. The statistical tables required by the Board of Education follow:- 26 TABLE I. Medical Inspections of children attending Elementary Schools. A. Routine Inspections Number of inspections in the prescribed groups- Entrants. 1813 Second age group 268 Third Age group 610 Total 2691 Number of other routine inspections 114 Grand total 2805 B. Other Inspections. lumber of special inspections and Re-inspections £2847. TABLE II. Classification of the Nutrition of Children Inspected during the year in the Routine Age Groups. Age Groups No. of children inspected. A Excellent B Normal C Slightly Sub-normal D Bad No. % No. % No. % No % Entrants 1813 672 37.06 1051 57.97 88 4.85 2 0.11 2nd age group 268 89 33.17 164 61.19 15 5.59 - - 3rd age group 610 320 52.45 269 44.09 21 3.44 - - Other routine inspections 114 48 42.10 59 51.75 7 6.14 - - Total 2805 1129 40.24 1543 55.00 131 4.67 2 0.07 table III. Group 1. Treatment of Minor Ailments (excluding uncleanliness, for which see Table V. Total number of defects treated or under treatment during the year under the Authority's scheme 1529 Group 11. Treatment of Defective Vision and Squint (excluding Minor Eye defects treated as Minor Ailments-group 1.) No. of defects dealt with Under the Authority's Scheme Otherwise. Total Errors of Refraction (including squint) 191 - 191 Other defect or disease of the eyes 45 - 45 Total 236 - 236 No. of children for whom spectacles were- Prescribed. 309 - 309 Obtained 309 - 309 27 \ Group III. Treatment of Defects of Nose and Throat. Number of Defects Received Operative Treatment Received other forms of Treatm't Total Under the Authority's scheme, in Clinic or Hospital By Private Practitioner or Hospital 19 1 151 171 TABLE IV DENTAL INSPECTION & TREATMENT (i) Number of children inspected by the Dentist (a) Routine age groups. Age 5 6 7 8 9 10 11 12 13 14 Total Number 585 535 845 874 888 999 939 894 983 251 7793 (b) Specials 1000 (c) Total (routine and Special) 8793 (2) Number found to require treatment 7371 (3) Number actually treated 2945 (4) Attendances made by children for treatment 7071 (5) Half days devoted to (7) Extractions Inspection 58 Permanent teeth 725 Treatment 1015 Temporary teeth, 2662 (6) Fillings (8) Administrations of general Permanent teeth 2922 anaesthetics for extractions. l6 Temporary teeth 2164 (9) Other Operations Permanent teeth 960 Temporary teeth 632 TABLE V VERMINOUS CONDITIONS Average number of visits per school made during the year by the School Nurses 5 Total number of examinations of children in the schools by School Nurses 16908 Number of individual children found unclean 689 TABLE VI BLIND AND DEAF CHILDREN Number of totally or almost totally blind and deaf children who are NOT at the present time receiving education suitable for their special needs NIL MENTALLY DEFECTIVE CHILDREN Total number of children notified during the year ended 31st December 1940, by the local Education Authority to the Local Mental Deficiency Authority, under the Mental Deficiency (Notification of Children) Regulations, 1928 3 28