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31 cases seen at first visit and referred to the proper channel for treatment
as not coming under the definition of minor ailments, included dental caries 11,
anaemia 5, constipation 3, rheumatism 3, nits 2, bronchial catarrh 2, vomiting 1,
debility 1, chorea 1, cough 1, ganglion 1. The 36 cases of infectious diseases sent
up as minor ailments comprised 32 cases of mumps and 4 cases of chicken-pox.
The above long category of diseases serves to illustrate the multitude of ills
that beset the path of the humble dweller in the town. Dr. Chaikin remarks upon
the rarity of acute corneal ulcer, which formerly was so common, and ascribes this
to improved nutrition. In 391 cases (16.7 per cent.) the children were excluded
from school on account of the infectivity of the condition of disease observed. Of
the 129 cuts and wounds, 94 occurred in boys and of the 71 burns and scalds 38
occurred in girls, an interesting sidelight on the occupation risks of the two
sexes.
Following-up and re-inspections.
A review of the results of the school medical work over the years 1913-1923
lleads to the conviction that the mountain of disability and suffering which the school
medical service at its inception had to face has indeed begun to move. Independent
observers in a position to know state that the London child is now a different being.
Not only is the improvement marked as a whole, but analysis shows a steady advance
year by year at each age and in each sex in a most consistent way.
The question inevitably arises whether the rate of improvement is as rapid as
it could or should be. That there are conditions that heavily handicap progress
is very clear. The improvement which has taken place is largely due to the untiring
efforts of voluntary workers who devote themselves unstintingly to the work of
alleviation. Amongst the voluntary workers are to be included a great number of
the teachers. There are still, however, in London, schools and districts where
insufficient help is forthcoming and where the standard of care committee attainment
is much below the average.
In some cases the vexed question of attendance marks hinders the medical
work, and complaints have been received from many quarters on this score. Measures
have been taken to remove as far as possible this handicap. The attendance of
children at the centres is recorded, and at the end of the year, the total of attendances
is credited to each school department. Many teachers complained that requisitions
were apportioned on the uncorrected attendance figures, and, therefore, schools
most eagerly co-operating were penalised by being allowed smaller quantities of
materials. This difficulty was removed during the past year by the agreement
of the Council to apportion materials requisitioned by the head teachers on the
basis of average roll in place of that of average attendance.
Complaints still arise, however, on the score that, if as a result of medical or
dental treatment the child remains out of school for several attendances, only the
actual attendances at the centre are recorded, and the remainder is a total loss.
It is where schools stand near the point upon which they will be regraded on any
fall of average attendance that this trouble is most acute. In these schools, too, there
is diificulty in obtaining the co-operation of the head teachers in the work of sending
children away for convalescence whether to the camp schools or otherwise, and in
ascertaining which children would benefit by attending open-air schools. This is
a real difficulty, and the cure for it does not appear obvious.
The greatest difficulty of all, however, is the ignorance and apathy of some of the
parents. Much of the work is educational, it involves the establishment of a higher
ideal of hygienic excellence than has hitherto been reached, and means a change of
habit and custom amongst a class of the populace notoriously conservative in
regard to such matters. There are parents who can be shown only with difficulty
the need of attention to early dental defects in their children, and also others
who are instinctively hostile to any sort of interference in their affairs.