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104
On this last point, a large question is raised. It is a common
occurrence to find cases who definitely appear to have been infected by
their fellow workers. Girls working in close contact in workrooms,
clerks who may be working directly opposite to an infected individual,
etc.
The difficulties arising in such cases are very obvious. One cannot
turn the breadwinner out of a position in which he may be infecting
his fellows, and yet in the case of food carriers, the Ministry provide
for their removal and compensation, although it is doubtful if they do
any more harm to the community than the cases mentioned above, but
there is a sentimental aspect, as food is implicated.
The vicious circle is continued further, for owing to the intensive
campaign against tuberculosis, employers of labour have a very wholesome
fear of the dangers of infection. Landladies, and even fellow
lodgers in the same house, regard the suspected case with aversion, with
the result that when it is known that a person is tuberculous he finds
difficulty in obtaining either work or lodging.
This state of affairs tends, not unreasonably, to a dislike of the
individual to be notified, to a dislike to visits from the Health Department,
and finally to the patient leaving the district in an endeavour to
remove himself from the stigma. It also, in all probability, tends to
the patient avoiding a doctor in the future in his new surroundings for
fear of a renewed notification and a recurrence of his troubles.
All these facts make it a very difficult problem, and it is a case of
the State v. the individual; but it would seem ethically that if the
action of the State makes the life of the individual more difficult,
he should be entitled to consideration in that respect.
Until these larger problems are attacked we might well concentrate
on the delicate and doubtful children. I would also advocate the
institution of convalescent homes for tuberculous patients, where the
patient who has had sanatorium treatment, and who is doing
satisfactorily, might be sent for three weeks or a month when he
begins to flag.
Mention has already been made of the relative attendances during
the past years.
The number of potential contacts, and percentage of same
examined during the last five years is as follows:—