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50
"Secondly, the full value of the personal instructions
indicated above cannot be realised unless vigorous efforts are
made to prevent the accumulation in or in the vicinity of the
house of decomposing animal and vegetable matter. It is not
necessary to do more than mention the importance of
efficient scavenging, or frequent and, if practicable, daily
removal of house and stable refuse, of domestic cleanliness,
and of keeping all food properly protected. The Council may
consider it advisable during the next few weeks to divert the
sanitary inspectors from less urgent work, and to instruct them
to make rapid visits with a view to securing efficient sanitation,
especially in and about the houses of the working classes."
"Thirdly, it is important that the Council should promptly
ascertain in which parts of their district diarrhoea is especially
prevalent, and should devote close attention to street and
court scavenging and to the removal of stable and domestic
refuse in these areas. Without waiting for the weekly death
returns, efforts should be made to obtain information of cases
of diarrhoea from Health Visitors and others who make domestic
visits; and to impress upon parents the importance and
immediate treatment of infantile diarrhoea. Apart from the
medical notification of cases of epidemic diarrhoea in children,
the visits of Health Visitors can be utilised for impressing upon
parents the seriousness of diarrhoea amongst young children
and the desirability of information being given to the Medical
Officer of Health should a case of diarrhoea occur.''
This letter was received during the summer recess of the
Council, but it was immediately handed to me to take such action
in accordance with the suggestions of the Local Government Board
as I was authorised to take, and I beg herewith, in compliance
with the special desire of the Local Government Board, "to set out
the course of action taken in the district to prevent diarrhoea and
child mortality generally in the special circumstances "of the past
summer.