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is very low indeed, living rooms counting in the same way as bedrooms, a child under 10 counting as a half a
unit and children under one year not being counted at all. In these circumstances two rooms measuring
over 110 sq. ft. each would not be statutorily overcrowded if they contained three adults, or, alternatively,
one adult, four children under 10 and twin babies under one year. Furthermore, consideration must be
given to the fact that 128 tuberculous persons did not sleep in separate rooms.
We feel, therefore, that we are justified in maintaining that overcrowding exists in a large proportion
of cases. We would hold that where the circumstances are such that there is insufficient accommodation
for a person suffering from tuberculosis to have at least a sleeping room to himself, there is overcrowding which
is dangerous and injurious to health—not so much to the patient himself, but to those with whom he shares
the room.
The worst case of overcrowding was that of a husband and wife and five children who occupied two
rooms. Three members of this family, father and two children, were notified cases of pulmonary tuberculosis.
Furthermore, the rooms they occupied were underground rooms within the meaning of the Housing Act,
1936, and did not comply with the regulations thereof as to fitness for human habitation. This family had
recently applied to be re-housed, and a recommendation for urgent priority was made.
42 patients had accommodation which included basement rooms, but the number of cases where
accommodation consisted entirely of basement rooms was 15.
Lighting and ventilation was inadequate in 15 cases.
A menities.
In 193 out of the 242 dwellings visited a separate water supply was available. 110 families had the
use of their own water closet ; 61 the use of a separate bath. In 52 cases the family had the use of a bath
together with other persons. In 129 dwellings there was no bath provided. It will be seen, therefore, that
in 49 families where there was a case of tuberculosis, water supply was shared with another family, and in
132 cases there was also sharing of a water closet. It is not suggested that tuberculosis is spread by the
sharing of a water supply, a water closet or a bath with another family. The point is that the cure of
tuberculosis and the prevention of spread of the disease is best secured where the patient is provided with
every modern convenience of hygiene and sanitation.
Housing.
Whilst the above facts give some indication of the conditions which we have found in the homes of
those suffering from tuberculosis, it gives little idea of what the Public Health Department has achieved to
improve these conditions. The fact that a recommendation has been made for re-housing does not mean
the conditions can be ameliorated immediately, for there are approximately 10,000 families awaiting re-housing
in St. Pancras, many in urgent need of priority, and the total building allocation for the whole Borough for
the year 1950 is approximately 250 housing units.
Service of Sanitary Notices.
Seventy-nine sanitary notices were served during the year in connection with the above 242 dwellings.
These notices dealt with absence of a proper food cupboard, dampness from whatsoever cause, inadequacy
of water supply, defective plaster, need for redecoration, and the like.
Improvements.
What has been achieved as a result of the visits of the sanitary inspectors during the year 1949 ?
It would give us great pleasure if we could report that adequate housing accommodation and proper
environmental conditions had been provided in every case.
Unfortunately this is far from being so, and we can only express the hope that the time may not be
far distant when this ideal may be attained. In the meanwhile the Public Health Department has achieved
much to improve the conditions under which those we have visited are living, and possibly have succeeded
in part in preventing some spread of infeccion.
Positive achievements which we car record include the removal of the cause, and remedy of dampness
in 25 cases, in some of which it was necessary to repair the roof. Furthermore, in 41 cases we secured general
repair and redecoration of the premises. The drainage system was repaired in seven cases, the water closet
apartment in nine, an additional water supply was made available in seven premises, and ventilated food
cupboards provided in nine. Thirty-three general sanitary defects were also remedied.
The above does not take into consideration the conditions improved as a result of simple advice and
measures which the patient himself could take, as, for instance, the opening of windows which we found fixed,
the cleansing of rooms and removal of conditions likely to favour the spread of infection, for which no notice
was necessary. It is easy to under-estimate the good effect of such advice resulting quite often from friendly
conversation between the inspector and the patient and his family. Very often a separate bedroom for the
patient is achieved and furniture so re-arranged or removed that the conditions under which the patient can
be treated prior to admission to hospital or sanatorium are entirely different from those met with at the
first visit of the Inspector. We would add that the combination of the visit of the Tuberculosis Health
Visitor and the Sanitary Inspector, working in harmony, one directed primarily towards treatment and
nursing and the other to the removal of adverse environmental factors, constitutes no small contribution to
the prevention of the spread of infection and the recovery of the patient.