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children, who would not otherwise have had a holiday, were sent to Broadstairs
for two weeks during the summer for the usual annual school journey.
Under this scheme, the children, who are accompanied by their teachers,
continue with their lessons, but as these largely take the form of nature
study, practically all their time is spent in the open air. While it would be
difficult to demonstrate any immediate and tangible evidence of benefit, such
as marked increase in weight or improvement in the physical signs of disease,
I am satisfied that school journeys have a beneficial influence on the general
health of the children. In addition to the school journey, four children
received a school holiday at Margate, while three boys, whose general health
was not satisfactory, were sent to the Victoria Home, Broadstairs, for three
months.
During the year 13 children were transferred to elementary schools,
treatment in an open-air school being considered no longer necessary, while
10 children were discharged as fit for work and placed in employment by
the School Care Committee.
In addition to open-air schools for tuberculous children there are, throughout
London, a number of other open-air schools for non-tuberculous delicate
children. Both classes of schools, I am certain, play a very useful part in
the treatment and prevention of tuberculosis.
Among other essentials these schools ensure :—
1. A healthy environment with abundance of fresh air for the greater
part of the day.
2. Greater freedom from the risk of infection or re-infection. As many
of the children come from infected homes there is considerably less
exposure to prolonged and massive doses of infection. The risk of
bovine infection is obviated by sterilisation of the school milk supply.
3. A higher standard of cleanliness than it is possible to maintain in the
ordinary elementary school. Bathing facilities are available at
Stormont House for those needing them, dental hygiene is supervised
and cleanliness of the heads of children rigidly enforced.
4. A hygienic mode of living is instilled into the child, which it carries
into the home and probably never quite loses for the remainder of its life.
5. More immediate means for the treatment of diseases other than tuberculosis,
and the prevention of the spread of infectious diseases.
With weekly observation and frequent routine examination it is often
possible for the Medical Officer to detect disease in its incipient stage and to
ensure immediate treatment. Likewise the daily attendance of the nurse,
who takes the temperature of the children morning and evening and reports
as to the presence or otherwise of a rash or sore throat in any child with a
rise in temperature, has frequently resulted in the immediate exclusion of an
early case of infectious disease. Naturally, we have had, at Stormont House,
isolated cases of measles, diphtheria, and scarlet fever contracted elsewhere,
but thanks to the vigilance of the nurse there has not been a single incidence
of the spread of the infection to other children in the school since it was
opened 15 years ago.
The scheme introduced by the London County Council in 1922, which
aimed at closer working arrangements between the school medical service
and the Dispensary and a reduction in the number of children attending the
Tuberculosis Dispensary, is still being carried out. All healthy contacts and
those who after a period of observation at the Dispensary show no definite
evidence of tuberculosis, together with other children whose health is not
entirely satisfactory, are transferred to the school medical department.
The Tuberculosis Officer sends a report on each case to the School Medical
Officer, who provides special observation for such cases, arranging periodic
examinations and the keeping of accurate records of weight, etc. Should
the School Medical Officer later suspect tuberculosis in any of these children
they are immediately referred back to the Dispensary for further investigation.