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to go again as the conditions were "too rough". Similar complaints were made in
other cases.
As a number of the children who had been to the hop gardens were not present
at the doctor's visit after the return, it is possible that some were absent on account
of illness contracted while away. So far as possible, therefore, enquiries were made
into the causes of absence. It was found that there were 31 further children who
were absent for conditions of ill health which may have been connected with their
visit to the hop gardens. These included children who had not returned to school
owing to infection 13, sepsis 4, chorea 2, stomach trouble 2, bronchitis 2, ear
trouble 2, meningitis 1, broken arm 1, neuralgia and toothache 2, bad eyes 1.
The bringing together in a crowded encampment of families derived from many
of the poorer districts of London gives special opportunity for the spread of infectious
disease, and, as a result, the return of the hop-pickers to London is the signal for the
outbreak of infection in new centres. Several of the children who failed to appear
for their re-inspection were away from school, excluded on this account. This year
for the first time smallpox was a danger, and an outbreak amongst the hop-pickers
was followed by the appearance of the disease in new schools in London, in the first
place amongst children who had been away hopping. Of 31 cases of smallpox
occurring in London between 26th July and 18th October,twelve cases (10 in Lambeth,
1 in Poplar and 1 in Southwark) were infected in connection with the hop gardens
at Marden, Kent. The first case came to notice when a girl, aged 14, living in North
street, Lambeth, was diagnosed as suffering from smallpox in the out patient's
department of St. Thomas's Hospital on the 6th September. Enquiries revealed
that she had returned from Marden that day and that the rest of her family was
still in the hop gardens. It was also ascertained that her brother, aged 3 years
had had a rash before the family left London. On 8th September this brother and
a sister aged 5, were removed to South Wharf from Marden, as suffering from smallpox.
About 2,000 hoppers returned to London from Marden on 12th September
and were followed up as contacts of smallpox. As stated above, 9 further cases of
smallpox have resulted from this source.
There are two chief conditions which stand out in the reports of the social
workers in London in regard to their enquiries after the return of the children calling
for comment. There are (1) the prevalence of overcrowding in huts, and (2) the
difficulty in obtaining adequate water supply and facilities for cleaning. It is clear
from the enquiries made that farms and districts differ widely in these respects.
In some areas the number of persons per hut appears to have been rigorously regulated,
while in others no supervision existed or rule was obeyed. It was not possible, of
course, to obtain any idea of the amount of cubic space per person in the sleeping
quarters, but dividing the returns into two categories (1) five persons or less to one
hut, and (2) more than five persons to one hut, 36 per cent, of the cases fall in the
second category of probable overcrowding. Thirty-two per cent, of the children
returned as improved in health slept under presumably overcrowded conditions,
while 42 per cent, of those not improved slept more than 5 to a hut. A bad feature
in very many cases was the fact that the huts were totally without windows or
provision for ventilation other than the door.
Spontaneous complaints of latrine accommodation were frequently made, and
it is clear that in many instances, conditions were very bad in this respect. Water
supply to the encampments was very unequal. Many had water laid on to taps in
the immediate vicinity of the hutments ; in other cases tanks of water were provided
and the supply renewed daily by the growers; many unfortunate ones had no
specific water supply and had to rely upon streams and ponds, and many had to carry
their water themselves from sources at a distance of, in some cases, half a mile.
The danger of burns and fire was very real. The hutments are often of wood
and the bedding of loose straw on the floor. Even when a cook-house was provided