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but neither are they easily assimilated into the ordinary local society, partly
because they speak very little English and par11y because of their very different
customs. Thus they do not easily find girl friends, their wives are invariably
back home in Pakistan and they resort to local prostitutes. To get descriptions
from such patients was well nigh impossible. Apart from the language difficulty
they were extremely reticent and loath to discuss their personal affairs.
However a pattern of what was taking place soon became apparent. A girl would
go into one room of a man who would not have to pay and then the other men of
the house would come to her. leave money and depart. The room was probably dark
and the men would hardly see her. The prostitutes found this very easy and
lucrative. Soliciting as such was unnecessary and should anyone recognise the
girl, his limited command of English would debar him from describing her, even
if he wished to do so.
Because it seemed impossible to get descriptions of contacts from this
group of immigrants I decided to bring to the clinic the prostitutes who could
be seen around the area in the cafes and clubs mostly patronised by Pakistanis.
I felt that if I could gain the confidence of these girls I might be able to
persuade them to attend the clinic regularly for tests. I explained to them the
dangers of the infection to which they might be exposed and its damaging results if
left untreated.
Eight prostitutes from the area concerned were treated at the clinic for
infectious syphilis. These girls must have been the cause oof much of the
epidemic and seven of the eight had been approached by me. They may well, if not
treated, have infected hundreds of men. About this time I received a notification
from Copenhagen of aprostitute said to have infected a Dane with primary syphilis.
I called on this woman and brought her to the clinic and she was treated for
infectious syphilis.
The major aim of my work was to bring to treatment the sources of gonococcal
infection and thereby reduce the number of men attending the clinic with
gonorrhoea. 1963 was the last full year before active contact tracing was
carried out in the Whitechapel Clinic. In that year 1741 cases of men attending
with gonorrhoea were treated. In 1965, the first full year of active contact
tracing the number of male cases of gonorrhoea dropped ky 475 to 1266. This was a
a fal1 of 27.3%.
For the first year I shared the work with a part time colleague, Miss B.
Muspratt; but since 1966 have had a full time colleague, Mrs. D.M King. We
cover all clinics from 10 a.m. to 7 p.m. from Monday to Friday, only missing the
Saturday morning session. During these years of contact tracing the cases of
new men treated for gonorrhoea have dec]ined by 30%. In 1960 there were 1677 and
in 1969, 1171. The ratio of men patients to women has changed from 3.9 to 1 to
2.2 to 1. The decline in the total male and female cases of 20% is to be
compared with the national increase of 33%.
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