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170
Annual Report of the London County Council, 1910.
An intermediate scheme.—Even if it were decided to limit admission to initially non-infectious
cases provision for care and disinfection would still be required, since any one might develop a
cough or become infectious. The increased space would still be required, daily inspection would be
advisable till the trend of the experiment was evident, and at least two nurses would be required.
The curriculum would have to be susceptible of modification to fit the individual child and his daily
changes and to be subordinated to medical requirements.
If all the children were tuberculous greater demands would undoubtedly be made by the Board
of Education. Local authorities and neighbouring interests would be keener in their restrictions.
With such a carefully selected type of child, although tuberculous, the risk of infection may
be reduced to a minimum. If it were understood that any child would be removed on becoming infectious
the provision for sterilising materials could be materially reduced and no special attendant be
necessary. The buildings could be simpler and the nursing staff reduced. Regular medical inspection
would be required almost daily, at least until the experimental stage was passed.
In the early days of the school all the arrangements would require to be elastic and subject
to constant revision under medical advice. Such an experimental school might be started first on
a small scale, with adapted premises on a rented site, not too far from the county, and with initially
non-infective cases, to gain data for a later and permanent school, in a more suitable situation.
A multitude of unsuspected factors are constantly being revealed in relation to sanatoria, and
it is probable that equally valuable lessons will be found in the tuberculosis school.
No children 's sanatorium on the proposed scale exists in this country, so that on many points in
regard to work, play, rest and medical arrangements the data are insufficient, and conclusions formed
in advance might be found later to be erroneous.
Kensal House
Tuberculosis
School.
The school known as Kensal House School for Tuberculous Children has now been organised.
It originated with a proposal made to the Council by the Paddington and Kensington Dispensary
for the Prevention of Consumption. The original scheme was a school in which
children coming from a tuberculous environment might be educated in the particular hygienic
precautions needed to avoid danger. Perhaps this is rather an elaborate idea and one in which
the result is scarcely attainable. It was not, however, possible to put it to test, as under the Act of
1899 the Board of Education required to be satisfied that every child admitted was actually suffering
from tuberculosis. The Paddington Dispensary Committee suggested a day school in the district
rather than a residential country school as being more likely to influence the parents and the homes
in regard to the principles of open air, and to show that open windows and fresh air are as applicable
in London as in the distant country. The Dispensary deals with whole families, not merely with individuals.
Having found one member of a family tuberculous they examine all the others. The
doctor and nurse visit the home of every patient, and having supervised the patient's surroundings
the further control of the children in school is being attempted. The Kensal House School is intended
to do more for a child with tubercle than the ordinary open-air school; by the co-ordination of
the Council and Dispensary the child will be under continuous observation by a doctor who knows
the circumstances of its family, home and school. Beyond this observation and the open-air methods
it was intended that the school should not depart materially from the ordinary school. The strenuous
inculcation, of the need of cleanliness, of plenty of fresh air, and of the avoidance of fatigue are the
main novelties of the school. The Dispensary did not wish school feeding, as part of their campaign
is to educate the members of affected families to proper home feeding. The visiting members of the
Dispensary are always ready to give advice as to choice and preparation of suitable food. It is, however,
likely that it will be necessary to institute regular meals if the school is to attain its full usefulness. Suitable
clothing is necessary for a phthisical child, and yet from the nature of the case it is to be expected that
many of these children will come from slums, where warm clothing is scarce. At the Dispensary it
is made known that only well-clothed and well-fed children will be admitted; parents who could not
so provide for their children are handed over to the Charity Organisation Society so that the family
may be dealt with as a whole. The children were selected entirely from the patients of the Dispensary.
They live within walking distance of the school and are able to go home for the mid-day
meal. The factors taken into account in their selection are, in addition to definite evidence of pulmonary
tuberculosis, the clothing and cleanliness of the child, the apparent possibility of its receiving
sufficient food, and the keenness and earnestness of its parent. Kensal House is in the Queen's Park
district lying between the Canal and Harrow-road. It is a private house with a big garden space around.
The ground floor forms three classrooms, a head teacher's room and offices. There is a large kitchen
and a workroom on the same floor. The second floor, reached by a broad stone staircase, has two
school rooms. Above this are various rooms for the teachers, nurse, doctor and caretaker, but none
are used for teaching. Ordinary windows are provided, the educational effect of ordinary open windows
being greater than any special ventilating arrangements. For the same reason heating is entirely
by open fireplaces. Electric light is used throughout.
Curriculum.—The school hours are 9 to 12 and 1.30 to 4 p.m. There is a rest period before
going home to dinner and again on returning. The school work is light and well broken up by intervals
in which breathing and other physical exercises are taken, or free play or organised games. The classes
are held outdoors as far as this can possibly be done. For wet weather a lean-to shelter has been placed
in one corner of the garden. The children are taught to take an interest in gardening and given a
small plot to care for. The school was opened early in 1911, and it is impossible as yet to state any results
such as the gain in weight at the open-air schools.