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older and younger members of the family who cannot be inspected ; and, although
they are offered facilities for treatment by the local sanitary authority, there is no
means, other than persuasion, of ascertaining their condition or of bringing pressure
upon them to take advantage of the facilities. The school children who have been
treated return to homes where other members of the family are untreated and
re-infection is frequent.
In my last report measures taken to diffuse information concerning scabies
were given in detail. Further efforts at more intensive propaganda are under way.
Chronic invalidity
The school attendance department reports each month the names of children
who have been absent from school for three months or more on account of illness.
Each year the cases on the list for the month of November are analysed, and the result
gives the only index available of the causes of chronic invalidity in childhood.
Table 19 shows the number of children reported to have been out of school for
more than three months in November, 1938, and comparative figures for the three
preceding years.
The number of children (91) absent on account of rheumatism, chorea and
heart disease still forms a high proportion (25 per cent.) of the total, and proves
how largely this group of diseases is responsible for ill-health in childhood, especially
among girls, who account for half as many cases again compared with boys. These include
children who are being nursed at home, are in voluntary hospitals or institutions,
and in the Council's general hospitals. Since July, 1935, steps have been taken to
expedite the removal of such children as were in the Council's general hospitals,
where education is not provided, into the hospital schools, and the number not
receiving education is now 91, compared with 320 in 1934.
Nervous disorders (including 14 cases of epilepsy, and 5 of infantile paralysis)
accounted for 26 children. For the first time for many years there was not a single
case of encephalitis lethargica. Ringworm, formerly a chief cause of prolonged
absence from school, accounted for only 5 cases, compared with 129 in 1919. Since
the introduction of X-ray treatment for ringworm, the average length of absence has
steadily declined, and consequent upon the shorter period of infectivity, the danger of
the spread of the disease has likewise diminished.
Tuberculosis was the cause in 26 cases.
Among other ailments, respiratory diseases, other than tuberculosis, accounted
for 31 cases, and ear disease for 15.
The total invalidity among girls was greater during 1938 than among boys
(188 to 175). There were 1 boy cripple and 3 girl cripples. These are children with
spinal or lower limb disease who are either unable to walk or require assistance
in walking, and are returned by the attendance officers simply as " cripples."
Among the " other defects " is a small number of mentally defective children,
who, after ascertainment, at the moment of taking the census had not been placed in
special schools, though excluded from elementary school. No blind or deaf child was
reported as waiting admission to an appropriate school in November, 1938.