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153
Report of the Medical Officer (Education).
This station has already effected a considerable improvement in the children attending the
schools in the neighbourhood, and one of the encouraging signs is the fact that on a second examination
the same children are not always found to be verminous. There are a few who are always infected,
but the greater number of children found verminous are new cases. The head teachers remark on
the increasing cleanliness of the children. The working of the scheme has, however, been hindered
to a considerable extent by the necessity for serving the statutory notice under the Children Act upon
the fathers of the children, who are frequently not at home except at midnight.
The custom has grown up prior to the powers obtained under the London County Council
(General Powers) Act, 1907, of having school children cleansed at borough cleansing stations when
the local authorities were willing to assist. In the borough of Camberwell, which maintains a
station under the Cleansing of Persons Act, 1897, the cleansing of school children has always been
well attended to. as indeed it has been in several boroughs.
Sanitary
Authorities.
The question of providing means for cleansing children with verminous clothing or bodies has been
under almost continuous consideration, and in December, 1910, the Council decided that some provision
should be made for the whole of London. A scheme was therefore devised by which children will be
picked out in school by the school nurse and, if not cleansed by their parents, will, after due warning,
be taken by a nurse acting under the Children Act to one of 23 cleansing centres. There the
child's clothing will be removed and exposed for ten minutes to boiling temperature moist steam,
then thoroughly dried and brushed. Meanwhile the child will be washed with soft soap and hot water
and given a hot bath. The hair will also be treated with paraffin and if necessary portions cut.
Arrangements for one year have been made to use the cleansing stations of thirteen borough councils
on payment by the Council. The boroughs which have made such arrangements are Battersea,
Bermondsey, Camberwell, Greenwich, Hackney, Hampstead, Poplar, St. Marylebone, St. Pancras,
Southwark, Stoke Newington, Woolwich, and the City of Westminster. The City of London has made
arrangements for the cleansing of its own school children without payment from the Council.
Certain districts are not served by these centres and it is therefore proposed to establish centres
to be worked by the Council in the vicinity of Fountain-road (Wandsworth), Frankham-street (Deptford),
Hackford-road (Brixton), Halford-road (Fulham), Lauriston-road (Hackney, S.), Pakeman-street
(Islington, E.), and Sirdar-road (Kensington, N.), in addition to the already existing centres. Each
centre will serve a district within a mile radius. The cleansing of the child at a centre is ineffective
whilst the home is untouched and so a mechanism is arranged whereby the unclean child in the
school will be followed up in its home by the sanitary authorities and cleansing of the home achieved.
The borough ocuncils will be paid two shillings a head for cleansing the children. The cleansings
will be as many as are required, but only one payment will be made for any number of cleansings up
to the end of the month following that in which the first cleansing is done.
The arrangement of cleansing stations has justified itself in the work as set out above. Neither
the existing stations nor those projected should be looked on as other than temporary measures till the
cleansing scheme for verminous bodies and clothing is fully developed. The present provision is
merely for the treatment of a most obtrusive symptom, but when the relations of this symptom to
the conditions of the houses and the want of domestic opportunity for ordinary cleansing are considered,
the whole question of school baths as a sanitary and educational requirement will have to be
gone into and provision may prove to be necessary on a larger and more substantial scale than any
cleansing which has yet been considered.
Following the practice of former years the school nurses assisted the Committee ot this fund
by examining for the detection of any infectious disease (e.g., ringworm) or any form of uncleanliness
the children whom it was proposed to send to the country so soon as the summer vacation
began. These children were examined on two occasions. The parents of children found to be in an
unsatisfactory condition at the first examination were warned that, if the condition were not
remedied, the children would not be sent on the holiday ; and cases found to be unsatisfactory at
the second examination were rejected. There appears to have been a lack of co-operation on the
part of the voluntary workers in carrying out the scheme for the examination of these children, but
much good work was done and in many instances the school nurses, in their leisure time, assisted
the voluntary workers by visiting the parents and advising as to the steps to be taken for the
relief of unclean conditions.
Children's
Country
Holidays
Fund.
Mr. Harinan has investigated cases where "blight" has appeared in the Ackmar-road,
Canal-road, and "Dockhead" schools. So far as his experience goes the teachers are competent
to detect true "blight" and the description already given in the rules for their guidance is sufficient.
On the appearance of cases in a school the use of towels should be suspended immediately, any
washing that is considered necessary should be done under direct supervision of a teacher and washing
of the face at school must be forbidden. The school doctor, on being advised of the cases, should
make enquiry with a view to ascertaining the out of school causes contributing to the spread of
disease and the steps necessary to combat any such causes. Some system of treatment should be
undertaken in these cases as with efficient treatment they can be cured in a very short time and much
loss of attendance thereby obviated. In a recent outbreak 27 children were absent for various periods
exceeding a fortnight, 17 of them with an aggregate of 144 weeks or an average of two months
apiece. As an alternative to excluding these cases an experiment might be tried of allocating certain
desks apart in the class to such cases and expecting the children ten minutes after the others and dismissing
them ten minutes earlier. It is evident that the disease which is a particular infection can only
be dealt with by official supervision. The recording of all such cases on a suitable card index, and
the following up of each case to recovery is highly desirable. The cases could be safely diagnosed
in the first instance by the school nurses.
Ophthalmia.
5716
L.