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Refresher Courses—In accordance with the rules of the Central
Midwives Board, two midwives attended Statutory Refresher
Courses during the year, each of one week's duration.
In addition, midwives were released for courses as under:—
11 for 1 day courses
6 for \ day courses
1 for 1 week (International Congress of Midwives—Berlin)
Observation Visits—During the year, 16 Student Nurses taking
an obstetric course were given the opportunity to observe the working
of the department's midwifery service.
Cervical Cytology
With the co-operation of Dr. Thomas, Consultant Pathologist
at Greenwich District Hospital, the five clinics established for
cervical cytology and staffed by general practitioner obstetricians
and nurses from the department were continued at various centres
during the year.
At these clinics, "well women' over the age of 25 years and
postnatal mothers had cervical smears taken and examined for the
detection of pre-malignant changes. Unfortunately, despite the
publicity given to this service, the impetus of attendance evident
during the early months of 1966 was not maintained throughout the
rest of the year. Further letters were sent to managers of local
factories and stores inviting them to enable their eligible employees
to participate in the scheme. In some cases where medical facilities
were available at the business premises, the 'cytology team' of doctor
and nurse with the necessary equipment carried out sessions at the
places of employment. Dr. Thomas was able to accept 100 (and later
120) specimens weekly for examination and by the end of the year,
65 women were undergoing examination each week.
Statistics are still too meagre for full comparisons to be made
but there were 8 deaths in the Borough from carcinoma of the
cervix uteri during 1966 giving a rate of 0.03 per 1,000 of the population
which compares very favourably with that for England and
Wales generally, viz. 0.10.
Of the 3,387 specimens examined by 31st December, 1966, 15
were found to require further investigation and 52 women were
referred for treatment of various gynaecological conditions followed
by re-examination of a cervical smear.