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60
Cleanliness.
One of the chief concerns of the School Medical Service is the preservation and
improvement of the personal hygiene of the children in the schools. The steady fight
which has been maintained by the school nurses, aided by the teachers and the school
doctors during the last twenty years against dirt and verminous conditions, has been
rewarded by a considerable measure of success. In the earlier years the fight was
with conditions of gross infestation. Officers and teachers old in the service all
remember that when medical inspection was first established, the conditions revealed
when the children were undressed in school were indescribable. Child after
child was found whose underclothing had been "sewn up for the winter," was never
taken off and was grossly infested by body vermin. In 1913, when a comprehensive
series of figures was first compiled, there were still two per cent. of the children who
were infested with body vermin. The establishment of cleansing stations, the progressive
application of the cleansing scheme to every school, the promotion of bathing
facilities and the steady pressure of educational methods and of public opinion,
which had already in 1913 produced a pretty high standard of cleanliness, have now
resulted in the reduction of the cases of body vermin found to the small proportion
of two in a thousand of the children examined. In other words, fewer children are
found in school to be suffering from body vermin than are found to be suffering from,
say, tuberculosis. This is not only a physical, but a moral success, the results of which
cannot fail to be far reaching in their effects upon the well-being and comfort of the
people generally. So successful has been the campaign against dirt and dirt
diseases that the basis of the struggle has now been fundamentally altered and its
aim shifted.
The one outstanding evil now is the slighter cases of infestation of the hair of the
girls. This condition is much more difficult to tackle than the grosser infections
which have been mainly overcome. The accidental incidence of a single louse upon
the head of a girl will produce in a night evidences which it may take the mother
months to eradicate. Until the last year or two the only known means to effect this
eradication was the cutting away of all infected hair, and the patient school nurses
charged with the duty of effecting this procedure were naturally exposed to much
obloquy and abuse. Yet the legal processes necessary made such measures inevitable.
So great was the resentment of parents that riots and assaults became
fairly frequent. Fortunately for the success of the Council's scheme, however,
the inventiveness of science was not exhausted, and, as has been recounted in previous
reports, by the introduction of special medicaments and appliances, the Council's
nurses are now able to cleanse the heads of the infected girls at one operation without
resorting to the cutting of the hair. By steady work the percentage of girls in school
who were free from all traces of verminous infestation was raised from 67 per cent.
in 1913 to over 75 per cent. in 1920. In the latter year the methods were fundamentally
altered, as has been explained. In 1921 for the first time there appeared
a set-back and the number of girls with clean heads showed a falling off. The new
methods, however, were steadily persevered with and eight of the ten additional head
cleansing stations agreed to by the Council were brought one after another into action.
The result has been not only to wipe out the relapse of 1921 but to produce quite a
noteworthy improvement. The percentage of 8 year old girls with perfectly clean
heads being 79.3 in 1922 as against 74.9 in 1921 and 76.5 in 1920, the best before
recorded, while a closely corresponding condition was established in relation to the
12 year old group. It is good to note also the disappearance of the acute
opposition on the part of the parents which formerly marred the Council's
cleansing scheme.
Dental
conditions.
Gratifying indeed are the results of the measures taken by the Council to provide
facilities for attention to the condition of the teeth of the children in the schools.
The widespread incidence of dental caries is again demonstrated by the figures given
in the tables in the Appendix.
At entrance to school in 1922, already 42.6 per cent. of the infant boys and 43.7