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11
After some initial experience, the nurses were instructed to bring before the
school doctors for special examination every child amongst the infants who was
four kilogrammes, and, amongst the juniors, who was five kilogrammes, below the
average for his height.
The importance of the scheme will, however, only be fully felt when second and
third weighings reveal the progress of each individual child, and children will be
brought before the doctor not only because they are below the usual measurements
but also because they are not making satisfactory progress.
Another proposal in connection with the watch on the nutritional state of the
children, which has aroused great interest, is the establishment of nutrition centres
where the condition of children found in school not to make satisfactory physical
progress can be intensively studied (see page 20).
Cleanliness.
After nutritional state, personal hygiene. This being the second of three great c
indices—nutrition, cleanliness, clothing—by which social conditions and their
improvement can be assessed.
In 1935 the percentage of children in the three prescribed age groups found free
from even traces of nits or pediculi in the hair was 97.0 compared with 96.5 in the
previous year. This is the best result ever obtained. For some years past the condition
of the hair of the 12-year-old girls has been taken as the criterion of cleanliness,
and it has been pointed out that there has been a gradual improvement from 67.2
per cent, free from all traces of vermin in 1913 to 75 per cent, in 1923, 91.9 per cent,
in 1930, and 93.5 per cent, in 1931. This figure was still further improved in 1932,
when the high level of 95.8 per cent, was obtained.
Unfortunately the percentage in this group, which has always been chosen as
the index group, fell back one unit in 1933 to 94.8, a disappointing result when the
condition of the other groups was better in this respect than ever before. The reason
why the 12-year-old girls were chosen as an index is that they have always given the
worst result of all the groups, for mothers expect the older girls to look after their
personal cleanliness themselves.
In the year 1934 the percentage of 11-year-old girls (who now take the place of
the 12-year-old group) entirely free from vermin was 94.8, being exactly the same
as that of the 12-year-old girls in the previous year. This percentage has been
raised to 95.1 during 1935.
It must be remembered that the parents are warned of the medical inspections
upon which these figures are based, and the children appear spick and span for the
occasion. The figures given in these results are therefore better than would be the
case at surprise inspections, such as those carried out by the nurses in their rota visits
to the schools.
It is, however, impossible for the parents to eradicate at short notice the traces
of persistent neglect. It is a pleasure to record that the mothers of the children,
often harassed by household cares and financial worry, have responded so bravely
to the persistent advice of the school nurses.
It is now very rare for the school doctor to find a child actually infested with
body vermin; a condition which 3 to 4 per cent, of the elementary school children
exhibited in the early days of medical inspection. Only 82 children were found in
the statutory age groups to be affected by body vermin in 1935, out of 135,994
examined.
The remarkable progress since the inauguration of the school medical service in
freeing the children of the elementary schools from parasitic infestation has been
accompanied by the raising of the general level of care, of tidiness and of happiness,
and forms by no means the least of the benefits which the school medical service
has brought to the schools, the teachers, and the population generally.