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94
Dr. Beatrice Smithies, one of the medical officers at the hospital, has supplied
a report giving detailed accounts of London school children attended to at the
hospital, and its sub-centres, during the present season. Of 1,172 hop-pickers who
attended the hospital, 258 were children under five and 388 children between five
and fourteen. The conditions for which the latter required treatment were burns
and scalds 12, casualties 84, conjunctivitis and "hop-ey" 11, dermatitis and "hoprash"
13, constipation 25, enteritis 30, sepsis 117, infectious disease 35, ear-aches
and otorrhcea 6, teeth 21, pneumonia 5. In her general notes on the above conditions
Dr. Smithies refers to many points of great interest.
Owing to the marvellous weather pneumonia was less frequent than usual,
and burns and scalds were fewer, owing to the less need for fires for drying purposes,
and outdoor cooking was practised very generally. The frequency with which
children suffered from constipation is partly due to the insufficient, and often filthy,
latrine accommodation which existed in some of the camps. Many cases of enteritis
were caused by unsuitable food and to food actually unfit for human consumption.
A number of others were caused by eating unripe fruit, especially apples and wild
fruits gathered from hedgerows. Some of this illness might be avoided if definite
instruction on the subject were given in the schools before hop-picking began.
"Hop-rash" and "hop-eye" occur chiefly among women and children. Both
appear to be of the nature of a protein sensitiveness such as is seen in the cutaneoreactions
and ophthalmo-reactions used in the diagnosis of hay-fever and its allied
conditions. The rash comes up rapidly within a few hours as an intense papular
erythema. If untreated this stage may be followed by pustulation which requires
very active treatment. General constitutional disturbance may be a marked
feature, the patient complaining chiefly of extreme drowsiness. "Hop-eye"
appears to be an acute conjunctivitis associated, in some cases, with considerable
oedema of the eyelids. The oedema without the conjunctivitis has also been seen.
In those cases investigated it appears to have occurred rapidly after the eyes have
been rubbed with fingers dirty from hop-picking. The pain, which is smarting in
character, rapidly becomes worse. In a previously healthy eye the conjunctivitis
is readily amenable to the usual treatment, and the oedema subsides in a couple of
days with the use of cold compresses.
The hop gardens, during the picking season, were visited independently by two
members of the Council's medical staff, viz., Dr. E. J. Boome, who accompanied the
deputy Medical Officer of Health of Kent, on visits to farms in relation to some of
which there had been complaints, and Dr. Dorrit Waterfield, who visited with the
local sanitary inspector in a "good" area. Their reports gave much information
as to the actual conditions. All accounts, whether obtained on the hop gardens
themselves or from the hop-pickers on their return to London confirm the remarks
and opinions of Dr. A. Greenwood cited at the commencement of this section.
The conclusions which the available evidence in this enquiry warrant are:—
(i.) In a favourable season the hop-picking exodus gives an opportunity for
an enjoyable country holiday attended by general improvement in health to a large
number of children from the most crowded central districts of London.
(ii.) Wholesale condemnation of the conditions in the hop gardens is unwarrantable,
but there are many farms and areas in which not as much is done as
is desirable to secure healthy conditions for the hop-pickers, and in some cases the
conditions are very bad.
(iii.) General improvement has taken place in the hop-gardens during recent
years; this is to be ascribed:—(1) To the adoption and enforcement of by-laws by
some of the rural councils. (2) To the example shown by the more public spirited
hop-growers. (3) To the improvement in education and behaviour of the hoppickers
themselves. (Many growers assert that the conditions are largely in the
control of the hop-pickers, and to some extent this is true. Dr. Waterfield's report