View report page

- 126 -
The many and varied problems which large scale immigration bring are now
becoming well known but those which particularly involve the Health and Welfare departments
of a local authority are as follows:-
The main difficulties of the environmental health services are connected with
insanitary conditions; work not complying with bye-lawsetc; complaints of noise and cooking
smells, plus the ever present danger due to oil heaters, both summer and winter. In view
of the largenumbers of immigrants from many countries engaged in food handling we devised
a set of simple instructions relating to food hygiene. These have been translated into eleven
languages and copies in the appropriate language are supplied wherever necessary.
On the housing side there are instances of "Rachmanism", of ten a coloured landlord
as well as tenants; multiple occupation and all its associated problems, overcrowding
and over-occupation. Approximately 50 per cent, of all cases of overcrowding brought to
official attention concern coloured immigrants.
The personal health services encounter difficulties in connection with illicit
child-minding and the heavy demand for day nursery places; nearly half of all our day nursery
places are occupied by coloured children. However, although coloured immigrants
normally need no persuading to attend clinics, whether ante- or post-natal, infant welfare
and immunisation, there is difficulty in arranging to have their coloured infants adopted or
fostered. Simple health education has to be constantly used by all workers to overcome the
differences in education, language, customs and, particularly, diet. The poor housing conditions
under which many immigrants live render hospital confinements essential. This
throws a great strain on hospital maternity services.
Problems are also found in the school health service, notably that many children
appear to be more backward than they really are due to lack of previous educational opportunities
and language difficulties.
With regard to specific diseases we have no evidence that rickets isoccurring or
that many persons are carriers of various tropical worms, but a survey carried out a few years
ago did show that many of the children were anaemic. With regard to venereal disease, I
am informed that in one clinic, covering the northern part of the borough, the number of
coloured men attending for gonorrhoea has dropped by about 10 per cent, over the last three
years with a less marked fall in the number of coloured women. The number of Asians of
both sexes is not large and has remained almost unchanged. Notifications of tuberculosis
(the other disease always associated with immigration) show that approximately 20 per cent,
occur in immigrants and of these 30 per cent, either had the disease on arrival or contracted
it within one year.
In January, 1965, the Ministry of Health arranged that in future all long stay
immigrants were given at ports and airports of arrival, a handout printed in their own language
stressing the importance of registering with a G.P., who in turn would arrange for a
chest X-ray. At the same time their destination address would be forwarded to the appropriate
Medical Officer of Health so that they might be visited and persuaded to act on the
advice of the handout.
In the quarter April 1st to July 1st, 393 such immigrants settled in the borough,
412 in the next quarter and 333 in the final one. By July it had become obvious that the
public health inspectors and the health visitors, already understaffed, were too heavily
committed to continue this visiting. It was therefore decided to discontinue these visits
and to write to each immigrant stressing the importance of registering with a doctor and
enclosing a 5-page summary of all the important health, welfare and other social services
in the borough. Also attached was a post card which asked that the name and address of
the G.P. be inserted and returned to the department. In the last quarter when this scheme
was fully in operation, at least one-third had apparently registered.
All this however, is very far from the scheme recommended by the B.M A.
Working Party who stressed that a medical examination and X-ray should be performed in
the immigrant's country of origin.
Immigration, with all its problems, is obviously with us for the foreseeable
future and it is up to all concerned, whether at national, local or personal level, to try and
see that the various social andcultural groups become absorbed into our national way of life.