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53
Fulham has always been conspicuous by a high diarrhoeal
mortality, and last year was the first in which
the diarrhoeal death-rate has been lower in the borough
than in the County of London, the respective rates
being 14 deaths per 1,000 births in Fulham and 16 per
1,000 in London. The decline in diarrhoeal mortality
last year was remarkable, as weather conditions were,
if anything, more favourable to a high diarrhoeal
death-rate than in any year since 1911, as although
the mean temperature of the summer quarter was not
above the normal, there was a long spell of hot, dry
weather during the second half of August and the first
half of September, the usual period of the maximum
intensity of the disease, while the conditions resulting,
from the breakdown of the service for refuse removal,
were certainly most favourable to its prevalence. It
is possible that the extensive use of dried milk for
feeding infants, in place of the more or less dirty milk
too often given to them, may have had some influence
in preventing the disease.
Reviewing the Maternity and Child Welfare scheme
as a whole, it may be claimed that the attempt to link
up the work of the voluntary societies with that of the
Council has been fairly successful. With workers
dealing with the same problem, but serving under different
bodies, some friction will at times arise, and
there must be a certain waste of energy in securing the
necessary co-ordination; but the importance of retaining
the cordial co-operation of voluntary social workers
in so vital a matter is so great that a continuance of
present methods is, at any rate for a time, advisable,
and progress should be attempted on existing lines.
The chief points calling for attention at present
are
1. The Appointment of additional Health Visitors.—
In their memorandum of August, 1918, the Local
Government Board said "that if the various duties of
a Health Visitor are to be fully performed, a district
with about 400 births a year will be as much as one
Health Visitor can undertake." If the increase of
births shown in the last quarter of 1919 is maintained,
d