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52
WOMEN HEALTH VISITORS.
The following observations, being an excerpt from my fifth monthly report (May 24th,
1900, page 50) deal with an interesting question that will probably be deemed deserving of the
attention of the Council—
" The practice of employing women in sanitary administration, originated by the late
Vestiy in respect to inspection of workshops, laundries, etc., wrhere women and children are
employed, has undergone interesting development by the appointment by certain provincial
sanitary authorities of ' women health visitors.' Manchester led the way, and in 1899 Birmingham
adopted the system. The duties of the visitors are sufficiently indicated by the directions
given to those (four in number) appointed by the Corporation of Birmingham, as follows: —
' To visit from house-to-house ill such localities as the Medical Officer of Health shall direct.
To carry with them disinfectant powder, and use it when required. To direct the
attention of those they visit to the evils of bad smells, want of fresh air, and dirty
conditions of all kinds. To give hints to mothers on the feeding and clothing of their
children, and to use their influence in getting children sent regularly to school. In cases
of sickness, to assist in promoting the comfort of the invalid by advice and personal
help. To urge, on all possible occasions, the importance of cleanliness, thrift, and
temperance.
" The visitors are instructed to note
' (1) The general sanitary condition of the house, (a) The number of rooms and of occupants.
(6) The existence of bad smells, and whether they arise from deficient ventilation, from
bad drainage, or from accumulations of filth, (c) The state of the walls and floors;
whether dirty from the tenant's or landlord's neglect, or in need of repair. (2) The general
mode of living, particularly with regard to personal and domestic cleanliness. (3) The
feeding and clothing of children, especially of those under two years old. Whether the
baby is nursed by the mother or fed by hand j if the latter, what it is fed upon.
(4) Any cases of illness in the house, (o) Nature of the disease. (6) Whether there is
a medical man in attendance, (e) How far the necessary sanitary precautions are being
carried out.'
" A hand-bill relating to cleanliness, ventilation, etc., is distributed, containing advice
to householders—(a) as to the house, (b) as to the yard, closets, dust-bins, etc., and (c) as to
food. Naturally the poorest streets receive the attention of the visitors, who, to the end of
1899, had visited nearly 12,000 houses with excellent effect. The medical officer of health
concludes his observations on the subject, in the annual report for 1899, by stating that it is
' the unanimous opinion of all who are brought into contact with the visitors that the work
they do is urgently needed and has already proved very beneficial.' He adds that ' the general
uplifting of the life of the very poor has been obtained '—and assuming this to be a correct
statement of the result of the movement in the capital of the Midlands, there can be no doubt
that the moderate expenditure entailed by the appointment of the visitors has been amply
justified. The movement may be expected to extend; and, personally, I should be gratified should
your Vestry (or the Kensington Council of the near future) see fit to appoint women, with the
status of sanitary inspectors, to do the work of ' health visitors.' The matter, I may mention, is
receiving attention from an organisation recently formed in London, one of whose meetings I
was lately privileged to attend. On that occasion I ventured to express the opinion that it
would be well to impress on school boards and the managers of other primary schools the
importance of adding to their subjects of teaching, elementary information on matters relating
to health, sanitation, and domestic management, cookery, etc. The best hope of bringing home
to the minds of the next generation of men and women the hygienic importance of cleanliness,
would be to teach the children of to-day the evils of uncleanliness. Needless perhaps to add
that it would be well to inculcate the happiness which attends good management, in the
attainment of a well-ordered and healthy home."
The consideration of the report led to an interesting debate at the meeting of the late
Vestry held on the 18th July, but the proposal to appoint two health visitors was negatived.
PUBLIC HEALTH (LONDON) ACT, 1891.
The need of amendments to this Act is recognised, and it was expected that the County
Council would have introduced a Bill for the purpose during the ordinary session of 1900. In
February, 1899, a letter was received by the late Vestry, from the Public Health Committee of the
Council, asking for information as to any amendments, which, in their opinion, should be made.
The communication was referred to a sub-committee of the sanitary committee, together with
reports by the vestry clerk, the surveyor, and the medical officer of health; and also a communication
from the Society of Medical Officers of Health, embodying suggestions for amendments and additions
to the Act. The sub-committee made suggestions for amendment of section 2, especially for the
definition of " overcrowding," corresponding to the provisions of the Borough Council's second
bye-law for registered houses. They also proposed that section 5 should be amended, so as to
enable the sanitary authority, upon obtaining a closing order, to evict the tenants. Other proposed