WANS 8 BOROUGH OF WANSTEAD AND WOODFORD Annual Report of the MEDICAL OFFICER OF HEALTH For the Year Ending 31st December, 1943. MAYBANK PRESS LTD., PRINTERS, E.18. BOROUGH OF WANSTEAD AND WOODFORD Annual Report of the MEDICAL OFFICER OF HEALTH For the Year Ending 31st December, 1943. WANSTEAD & WOODFORD BOROUGH COUNCIL. Public Health Department, Municipal Offices, High Road, Woodford, E.l8. WITH THE COMPLIMENTS OF DR. R.P. VERE HODGE MEDICAL OFFICER OF HEALTH. Telephone - BUCkhurst 4464. PUBLIC HEALTH STAFF. Medical Officer of Health (part time), R. F. Vere Hodge, M.D., Cantab. Senior Sanitary Inspector, H. C. Howard, M.R.San.I., M.S.I.A. (a) (c). Deputy Senior Sanitary Inspector, E. Jackson, M.R.San.I., M.S.I.A. (b) (c) (d). Sanitary Inspectors, A. J. Storer, M.S.I.A. (b). Resumed 28th June, 1943. Health Visitors, Miss H. M. Hird, S.C.M. (e) Miss F. Smith, S.R.N., S.C.M. (e) (to 27th April, 1943) Mrs. O. A. Greedus, S.R.N., S.C.M. (e) (from 17th May, 1943) Midwives, Miss S. A. Jones, S.C.M. Mrs. M. Marlow, S.C.M. Miss I. Turner, S.C.M. Clerks, S. C. Hearson, Chief Clerk. (Joined R.A.O.C. 15th July, 1943) Miss A. E. Harrison. Mrs. M. Fotios (to 30th January, 1943) Mrs. D. A. White (from 3rd September, 1943) (a) Royal Sanitary Institute Certificate for Sanitary Inspector. (b) Royal Sanitary Institute and Sanitary Inspector's Examination Joint Board Certificate. (c) Royal Sanitary Institute Certificate of Meat and other Foods. (d) Royal Sanitary Institute Certificate for Sanitary Science as applied to Buildings and Public Works. (e) Royal Sanitary Institute Certificate for Health Visitor. WANSTEAD AND WOODFORD BOROUGH COUNCIL. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year Ending 31st December, 1943 In the year under review the public health of the district remained satisfactory and except for the prevalence of Scarlet Fever of a mild type, the incidence of infectious disease approximated to that of pre-war years The estimate of resident population for 1943 as given by the Registrar General shows a slight increase. The birth rate has increased from 16.1 in 1942 to 17.1, and the death rate from 11.2 in 1942 to 11.38 per thousand. Section A. Statistics and Social Conditions of the Area. Area (in acres) 3,824 Registrar-Generals estimate of resident population, 1943 50,010 Number of inhabited houses (end of 1943) according to Rate Books 16,652 Rateable value (end of 1943) £577,812 Sum represented by a penny rate (1943-1944) £2,260 Extracts from Vital Statistics of the Year. Live Births. Legitimate Males 420 Females 407 Total 827 Illegitimate Males 14 Females 16 Total 30 Total Males 434 Females 423 Total 857 Birth rate per 1,000 of the estimated resident population — 17.1. 4 Stillbirth: Legitimate Males 13 Females 4 Total 17 Illegitimate Males 0 Females 1 Total 1 Total Males 13 Females 5 Total 18 Rate per 1,000 total (live and still) births — 20.57. Deaths. Males — 273. Females — 310. Total — 583. Crude Death rate per 1,000 of the estimated resident population—11.65. Adjusted Death Rate — 11.38. Deaths from puerperal causes:— Puerperal and post-abortion sepsis nil Other maternal causes 3 Total 3 Rate per 1,000 total (live and still) births 4.57 Death Rate of Infants under one year of age:— All infants per 1,000 live births 43.17 Legitimate infants per 1,000 legitimate live births 41.11 Illegitimate infants per 1,000 illegitimate live births 100 Infantile Mortality. The infantile mortality during the year 1943 shows a definite rise. On analysis it is found that out of 37 deaths occurring in, or transferred into the Borough, 16 were due to bronchitis or pneumonia, 7 to premature birth, 3 to congenital abnormalities, 2 to atelectasis, 2 to cerebral haemorrhage, and 7 to other causes. Twenty-five deaths occurred within tour weeks of birth. Deaths from Cancer (all ages) 102 Deaths from Measles (all ages) nil Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age) 3 5 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1943. England and Wales, London, 126 Great Towns and 148 Smaller Towns. (Provisional Figures based on Weekly and Quarterly Returns) England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident populations 25,000 to 50,000 at 1931 Census) London Administrative County Borough of WANSTEAD and WOODFORD Rates per 1,000 Civilian Population Births: Live 16.5 18.6 19.4 15.8 17.1 Still 0.51 0.63 0.61 0.45 0.36 Heaths : All Causes 12.1 14.2 12.7 15.0 11.65 Section B. General Provisions of Health Services for the Area. 1. (1) Public Health Officers of the Authority:— Particulars are given on page 2, at the beginning of this report. (2) fa) Laboratory facilities:— All pathological and bacteriological services are provided by the Essex County Council, the work being done at the Pathological Laboratory, St. Margaret's Hospital, Epping. The analysis of water, milk and food is carried out by Dr. Bernard Dyer and Mr. George Taylor, Public Analysts for the Borough. (b) Ambulance facilities:— (i) For infectious diseases. All cases requiring removal to hospital are conveyed by the ambulances attached to the hospitals. (ii) For non-infectious and accident cases. Cases of this class are taken to hospital by either of the two ambulances belonging to the Borough Council. A satisfactory service is maintained throughout the district. (c) Nursing in the home:— Home nursing is carried out:— (i) By private nurses; (ii) By district nurses working under a Committee and supported by voluntary contributions and receipts from patients. 6 (D) Clinics and Treatment Centres:— Child Welfare Centres. There are five centres in the district: — (i) St. Barnabas Church Hall, Snakes Lane. (ii) Fuller's Road Sunday School. • (iii) Baptist Church Hall, Aldersbrook. (iv) Ashton Playing Fields Pavilion. Chigwell Road. These are supported and directed by the Borough Council. (v) Holy Trinity Church Hall, Hermon Hill. This is under the direction of a voluntary committee, but is subsidised by the Council. The following treatment centres in the district are under the control of the County Council:— (i) The Tuberculosis Dispensary. (ii) The School Clinic. (iii) The Orthopaedic Clinic. (Conjointly with the British Red Cross Society). These all find accommodation at The Shrubberies, High Road. South Woodford. (e) Hospitals. Public and Voluntary:— Maternity.—There are no maternity hospitals in the district. There has been a greatly increased demand for maternity beds in hospitals. This is due partly to the change of outlook on the part of the mothers in favour of hospital treatment, and partly to the number of expectant mothers who are living under conditions where there are no facilities for a confinement at home. During the year 1943, by the courtesy of the Essex County Council, we were able to make arrangements for 68 cases to be received at St. Margaret's Hospital, Epping. Cases were also sent to Queen Mary's Hospital, Stratford, Danbury Park Hospital, Chelmsford, and the Mothers' Hospital, Hackney. In all cases the fees payable by the patient were assessed according to scale. Cases of Puerperal Pyrexia requiring hospital treatment are sent to the Waltham Joint Hospital. Children.—There is a children's ward of five beds at the Woodford Jubilee Hospital. Infectious Diseases.—Cases of infectious diseases in Wanstead and Woodford, which required removal, were taken to the Waltham Joint Hospital, under the control of the Waltham Joint Hospital Board. Since November, 1936, the Waltham Joint Hospital Board have been willing to admit, in addition to Scarlet Fever and Diphtheria, cases of the following diseases:— Complicated cases of Measles, Whooping Cough, Influenza and Pneumonia; 7 The acute infectious diseases of the nervous system, Meningitis. Poliomyelitis and Encephalitis; Typhoid and Paratyphoid Fevers; Dysentery, Erysipelas and Ophthalmia Neonatorum; Puerperal Pyrexia. Smallpox.—The London County Council are prepared to receive cases of Smallpox from this area into the London Smallpox Hospital so long as they have sufficient accommodation available 2. Maternity and Child Welfare:— (1) Midwifery and Maternity Services.— No changes have been made in the personnel of the service. We have three Municipal Midwives working in the district. Except for ante-natal visiting they devote the whole of their time to midwifery. The number of cases attended by them was as follows: (a) As Midwives 188 (b) As Maternity Nurses 27 Number of visits paid by these Midwives:— (a) Number of cases 215 (b) Ante-natal visits 1,167 (c) Nursing visits 3,612 Ante-natal Supervision.—This is given to all women attended by the Municipal Midwives and in every case one or more examinations are made and if necessary treatment is given by a doctor of the patient's choice. In necessitous cases the fees for the medical services are paid by the Council. In 1943 payments were made to medical practitioners in 9 cases. Consultant.—Mr. Alan Brews. F.R.C.S., is the Consulting Obstetric Surgeon to the Borough. (2) Institutional Provision for Mothers or Children.—Over 50 per cent. 660 out of 958 — births in Wanstead and Woodford occurred in private nursing homes. A substantial proportion of the mothers coming to these maternity homes belong to other districts, and the births are transferable. (3) Health Visitors.—Miss F. Smith resigned on 27th April. Mrs. O. A. Greedus took up her appointment on 17th May. The following particulars of the work done by the Health Visitors are taken from Form M.C.W.96 (Revised), which was sent to the Ministry of Health in advance of this report. Number of visits paid during the year by the Health Visitors:— (a) To children under one year of age:— First visits 984 Total visits 2,030 (b) To children between the ages of one and five years:— Total visits 3,046 8 Infant Welfare Centres. The following attendances were recorded at the five Centres serving the Wanstead and Woodford residents:— (a) Children under one year of age 14,552 (b) Children between the ages of one and five years 5,597 4. Child Life Protection.—The Health Visitors are appointed Child Life Protection Visitors under Part VII of the Public Health Act, 1936 There were ten foster-mothers and twelve foster-children on the Register at the end of the year. A total of 52 visits were paid by the Visitors. 5. (a) Arrangements for Dental Cases.—Arrangements were made with the local dentists in 1937 to undertake the dental treatment of expectant and nursing mothers and children under school age. Their charges are on an agreed scale and the fees payable by the patients are assessed according to their means, on a scale similar to that of the Essex County Council. During the year 1943, six mothers and three children were treated under this Scheme. (b) Arrangements for Orthopaedic cases.—There is an orthopaedic clinic at the Shrubberies, High Road, South Woodford, directed conjointly by the British Red Cross Society and the Essex County Council. Section C. Sanitary Circumstances of the Area. 1. (1) Water Supply.—The water service throughout the district is supplied by the Metropolitan Water Board. (2) Drainage and Sewerage.—There have been no important extensions of sewerage or improvements made in the arrangements for drainage, sewerage and sewage disposal. 2. Rivers and Streams.— The results of the analyses of samples of effluent from the three sewage works were satisfactory. 3. (1) Closet Accommodation.—With the exception of four isolated dwellings, house drainage throughout the district is conducted on the water carriage system. (2) Public Cleansing.—The collection and disposal of house refuse has continued to be carried out under contract requiring the maintenance of a weekly collection throughout the district and the disposal of the refuse under controlled tipping conditions, subject to prevailing salvage operations. Kitchen waste is collected and delivered to the County Borough of East Ham for processing for the purposes of animal food, in accordance with the Ministry of Supply direction. (3) Sanitary Inspection of the Area.—The Report of the Senior Sanitary Inspector is included at the end of this Section. (4) Shops and Offices.— Under the provisions of the Shops Acts, 9 1934, a total of forty-three shop inspections were recorded. Improvements with regard to ventilation and temperature of shops and to sanitary conveniences were effected upon one premises. Shops (Hours of Closing) Act, 1928.—Under the provisions of Defence Regulations. 1939, earlier closing hours operated during the winter months and normal closing hours were resumed between March and November. It was unnecessary to warn shopkeepers against any contraventions. (5) Eradication of Bed Bugs.— The means employed for eradication of the bed bug as outlined in previous reports has been continued with satisfactory results. The number of premises disinfested was 41; 4 Council owned houses were disinfested. The insecticides used were Fuminol and Zaldecide preparations. Spraying and steam disinfestation is carried out by the staff of the Public Health Department. 4. Schools.— One Public School, one Secondary School and eight Elementary Schools are situated in the district. There are several private schools. The sanitary condition and water supply remained satisfactory. SANITARY INSPECTION OF THE AREA. Report of the Senior Sanitary Inspector. In accordance with Article 27(18) of the Sanitary Officers' (Outside London) Regulations, 1935, I beg to submit the following particulars with regard to the work accomplished by the Sanitary Inspectors during the year 1943. Owing to war time conditions a considerable amount of time was taken up in connection with the following matters:— Arrangements for the treatment and disposal of foodstuffs contaminated by gas. Civilian war deaths. Underground shelters. War damaged premises (drains and sanitary arrangements). Summary of the various inspections made by the Sanitary Inspectors:— Dwelling Houses— On complaint and other causes 583 Infectious disease enquiries 216 Scabies Order enquiries 27 Food poisoning enquiries 7 Premises measured for purposes of Part IV of the Housing Act, 1936 (abatement of overcrowding) 11 Number of rooms measured in these premises 42 Rent Restriction Act enquiries 2 Total number of re-inspections for all purposes 1,611 10 Other Premises— Schools 19 Factories 39 Meat distributing centre 324 Butchers' shops and provisions stores 244 Bakehouses 43 Fishshops 52 Dairies and Milkshops 34 Massage Establishments 11 Other Food premises 154 Rat infestations (Inspectors) 426 Rat infestation (Rat-Catcher) 176 Verminous premises 5 Petroleum installations 72 Shops Act 43 Premises where animals are kept 22 Van Dwellings 3 Bombed Sites 11 For Requisitioning purposes 51 Miscellaneous inspections, including visits due to war circumstances 387 Total number of inspections and re-inspections 4,500 Drainage— Renewed or repaired, including war damaged drains 64 Notices served— Informal:— Housing Act, 1936 72 Public Health Acts 89 Statutory:— Public Health Act, 1936, Section 24 15 „ 39 3 „ 83 1 Housing Act, 1936, Section 9 21 Factories Act, 1937.—The total number of factories registered at the close of the year was (1) Power Factories—83, (2) Non-power factories—46. These included fourteen bakehouses, two being underground bakehouses. Informal notices were served and satisfactory results obtained in respect of 5 factories with regard to cleanliness of premises, improvement or repair to sanitary arrangements, as well as improved ventilation. Rent and Mortgage Interest Restrictions Acts, 1920 to 1939.—A few enquiries were made by occupiers of premises with regard to their position under the Act, but notices served in respect of the conditions referred to usually had the desired effect. No certificates were granted. 11 Rats and Mice (Destruction) Act, 1919.—Four hundred and twenty-six visits were paid to premises by Sanitary Inspectors in connection with complaints received. The bulk of these visits formed preparatory work in connection with Infestation Order, 1943, and pre-baiting and baiting with both Zinc Phosphide and Barium Carbonate was set in motion in December throughout the more heavily-infested areas in the Borough, including relevant sewer lengths. The initial survey revealed only one "Major Infestation" and this was the subject of special attention. A Rat-catcher was appointed in October and made 176 visits to the end of the year. Petroleum (Regulation) Acts, 1928 and 1936.—A total of forty-eight licences were renewed at the beginning of the year and included two licences for the storage of cellulose. The total storage capacity under licences amounted to 63,580 gallons for petroleum, 150 gallons cellulose, and 100 gallons rubber solution. Game Licences.—Three licences to deal in game were renewed. Section D, Housing. No houses were erected during 1943. 1. Inspection of Dwelling-houses during the Year:— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 518 (b) Number of inspections made for the purpose 2,129 (2) (a) Number of dwelling-houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 Nil (b) Number of inspections made for the purpose Nil (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 201 2. Remedy of Defects during the Year without Service of formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 196 3. Action under Statutory Powers during the Year:— (a) Proceedings under sections 9, 10 and 16 of the Housing Act, 1936: 12 (1) Number of dwelling-houses in respect of which notices were served requiring repairs 21 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 9 (b) By Local Authority in default of owners 6 (b) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 19 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 9 (b) By Local Authority in default of owners 19 (c) Proceedings under sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil 4. Housing Act, 1936.—Part IV.—Overcrowding:— (a) (1) Number of dwellings overcrowded at the end of the year 13 (2) Number of families dwelling therein 13 (3) Number of persons dwelling therein 85 (b) Number of new cases of overcrowding reported during the year Nil (c) (1) Number of cases of overcrowding relieved during the year Nil (2) Number of persons concerned in such cases Nil (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report Nil 13 FACTORY AND WORKSHOP ACT, 1901, AND THE FACTORIES ACT, 1937. 1. Inspections for the purposes of provisions as to health. Including Inspections made by Sanitary Inspectors. Premises Number of Inspections. Written Notices. Occupiers Prosecuted. Factories with mechanical power 13 ... ... Factories without mechanical power 23 ... ... Other premises (other than Outworkers' premises) 3 ... ... Total 39 ... ... 2. Defects found. Particulars Number of Defects. Number of defects in respect of which Prosecutions were instituted. Found. Remedied. Referred to H.M. Inspector. Want of Cleanliness 1 1 ... ... Overcrowding ... ... ... ... Unreasonable temperature ... ... ... ... Inadequate Ventilation 1 1 ... ... Ineffective drainage of floors ... ... ... ... Sanitary Conveniences:— 1. Insufficient 1 1 ... ... 2. Unsuitable or defective 1 1 ... ... 3. Not separate for sexes ... ... ... ... Other Offences ... ... ... ... Total 4 4 ... ... 14 Section E. Inspection and Supervision of Food. (a) Milk Supply.—Milk is not produced within the district for the purpose of sale. The number of persons and premises registered for the sale of milk within the district are as follows:— Premises registered as Dairies and Milkshops 9 Persons registered as retail purveyors of milk in sealed bottles 11 Persons registered as retail purveyors of milk whose premises are situated outside the district 7 Number of inspections 34 The premises concerned were generally well maintained; minor infringements of the Regulations were abated promptly. "Designated" Milk.—The number of licences granted for the sale of designated milk under the Milk (Special Designations) Order, 1936, are as follows:— Designation. Licences Supplementary Licences. Tuberculin Tested 7 3 Accredited ... 1 Pasteurised 13 5 (b) Food and Drugs Act, 1938.—Thirty-two samples of food, including 14 samples of milk were obtained for analysis. All the samples were reported by the Public Analyst as being genuine. (c) Meat and Other Foods.—The Government meat distributing depot was under constant supervision during the year, and a total of 324 inspections were made. The total quantity of meat, including offal, condemned as unfit for human consumption amounted to one ton, eleven hundredweights, five pounds. Canned meat condemned at the depot weighed 13 cwt. 1 qr. Food examined upon other premises and surrendered as unfit for human 15 consumption included the following:— 123 tins etc. mixed Meat Products; 58 lbs. Bacon; 10 Rabbits; 78 tins etc. mixed Fish Products; 10 stone Coley Fillets; 1 box Herrings; 233 tins mixed Milk Products; 9½ lbs. Cheese; 82 tins etc. mixed Vegetable Products; 3 cwt. mixed Vegetables; 94 tins etc. mixed Fruit Products; 83 1 -lb. jars etc. mixed Jams; 192 tins etc. Soup; 28 lbs. Sugar; 70 lbs. Biscuits; 88 pkts. etc. miscellaneous Groceries. As a result of War Damage, chiefly by glass and plaster, an additional 387 pkts. etc. mixed Groceries were condemned as unfit for human consumption. Returned to Ministry of Food as salvageable were 882 pkts. etc. mixed Groceries, including 97 lbs. Bacon and 168 lbs. Cheese. Registration of Food Premises.-—No additional certificates were granted under Section 34 of the Food and Drug Act, 1938, for the purpose of carrying on the business of a wholesale dealer in margarine. Bakehouses.—There are fourteen bakehouses in the district; two of these are underground bakehouses. Forty-three inspections were made and the provisions of the Bakehouse Regulations were observed satisfactorily. Section F. Prevalence of, and Control over, Infectious and other Diseases. 1. (a) Scarlet Fever.—Two hundred and two cases were notified. No deaths occurred. (b) Diphtheria.—Nine cases were notified. No deaths occurred. Diphtheria Immunisation.—The numbers of completed inoculations made during the year were:—Children under 5 years, 513; children over 5 years but under 15 years, 344. Estimated percentage immunised at the end of 1943:—Under 5 years, 76.6%, 5 to 15 years, 89.6%. 16 (c) Puerperal Pyrexia.—Twelve eases were notified, eleven of these occurred in the district; nine were removed to the Waltham Joint Hospital, one was nursed at Essex County Hospital, and the other at the Maycroft Nursing Home, one case was notified from a hospital in the Metropolitan area. No deaths occurred. (d) Typhoid and Paratyphoid Fevers.—No cases of paratyphoid were notified. (e) Dysentery.—Two cases were notified. There were no deaths. (f) Cerebro-Spinal Fever.—One case was notified as occurring in the district, and was removed to the Waltham Joint Hospital. Particulars of the incidence of notifiable diseases during 1943 are contained in an accompanying table. 2. (a) Disinfection and Disinfestation.—The disinfection of bedding and similar articles is done by the saturated steam process in a cylindrical horizontal steel " Thresh " disinfector; infected premises are sprayed with formalin and fumigated by burning formalin tablets. Number of rooms disinfected 291 Number of verminous rooms disinfested 59 Loads of bedding disinfected 328 Loads of bedding disinfected for Chigwell U.D.C. 4 Number of School classrooms disinfected 26 (c) Tuberculosis.—Public Health (Prevention of Tuberculosis) Regulations, 1925, and the Public Health Act, 1936, section 172. No action was necessary with regard to persons suffering from pulmonary tuberculosis employed in the milk trade. 3. Tuberculosis.—Particulars of new cases of tuberculosis and mortality from the disease during 1943:— 38 Pulmonary and 14 non-Pulmonary cases were notified for the first time during the year. 6 cases were transferred into the district. 19 Pulmonary cases and 5 non-Pulmonary cases died during the year. 7 deaths occurred from non-notified cases of tuberculosis. 5 cases were restored to the register. 31 other cases were removed from the register. 252 cases remained on the register at the close of the year. 17 County Tuberculosis Scheme— Dr. W. A. Bullough, Chief Tuberculosis Officer of the Essex County Council, has kindly furnished me with the following particulars of Wanstead and Woodford patients sent to institutions for treatment during 1943:— Pulmonary. Non-Pulmonary. Total. M. F. M. F. Adults 23 8 5 5 41 Children 3 1 4 6 14 18 NOTIFICATION OF INFECTIOUS DISEASE. Small Pox Scarlet Fever Diphtheria Typhoid including Paratyphoid Erysipelas Tuberculosis Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebro-spinal Fever Acute Poliomyelitis Measles Whooping Cough Other diseases Pulmonary Other Forms 1939 0 52 22 3 10 28 9 8 3 28 0 0 2 1940 0 24 8 1 13 24 7 7 1 31 12 0 95 4 4 1941 0 85 21 Typhoid 0 Paratyp'd 8 10 46 15 3 0 41 8 1 586 280 0 1942 0 81 3 l 11 42 21 12 2 31 7 0 523 176 9 1943 0 202 9 0 9 38 14 12 1 55 1 0 372 118 2 19 VITAL STATISTICS OF WHOLE DISTRICT DURING PREVIOUS YEARS. Year. Population. Births. Deaths. Infantile Mortality. Number. Rate. Number. Rate. Number Rate per 1000 Births. 1939 55,880 763 13.7 555 10.4 28 37.8 1940 48,620 611 12.6 653 13.4 18 31.8 1941 46,640 566 12.1 551 11.1 15 30.24 1942 49,850 803 16.1 572 11.47 21 26.15 1943 50,010 857 17.1 583 11.65 37 43.17