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105
Although the cleansing scheme was clearly achieving satisfactory results, the number
of pupils cleansed each year was still too great to permit of close investigation of every
case. Early in 1953, however, it was decided that the numbers had dropped sufficiently
to make it possible to consider whether the existing procedure could be effectively
supplemented with a view to securing an even more rapid decline in the incidence of
uncleanliness. Hitherto, the cleansing scheme for school-children has been operated by
school nursing sisters. The integration of the health visiting and school nursing services
should facilitate a more intensive investigation into each case and its linking with
existing information on the particular family already in the possession of the health
visitor. By approaching the problem at the level of the family, more intensive work
might be possible. Accordingly it was decided that if a pupil was found by the school
nurse to be dirty, the advice card would be delivered at the home by the health visitor,
and that no statutory notice would be issued by the Education Department unless the
health visitor requested such action. If the health visitor suspected that adults in the home
were verminous, and were the source of the trouble in the school pupil, then, if necessary,
she would consult the borough sanitary inspector.
It will, of course, be some time before it is possible to assess and report more fully
on the results of this more intensive attack on the problem of uncleanliness in school
pupils.
Comprehensive hygiene inspections
The school nursing sisters' personal hygiene inspections of all school pupils each term
are primarily concerned with the detection of lice or nits, and therefore can be carried
out fairly rapidly, about 50 pupils being seen in an hour. The Ministry of Education
suggested to the Council that these inspections should be of a more comprehensive
nature, and conducted at a rate of only 20 cases an hour. Accordingly, for a period of
twelve months, an experiment was carried out in three of the nine health divisions of
the county.
The nurses carrying out this comprehensive inspection were given the following
notes of guidance as to what they should look for when examining the pupils :
(1) Skin—taking care to have clothing turned back from neck, shoulder and arms,
presence of rash or vermin, etc., condition of nails.
(2) Ears—presence of discharge.
(3) Eyes—any blepharitis, conjunctivitis, squint or evident abnormality.
(4) Nose and throat—evidence of obstruction other than that caused by acute
infection.
(5) Orthopaedic—any evidence of orthopaedic defect.
(6) Nervous—clear evidence of nervous disease or psychological upset.
(7) Mouth and teeth—condition and, in young children, stage of dentition.
(8) Head vermin, etc.,—condition—whether clean or uncared for or ' nitty ' or
verminous.
(9) Clothing and footwear—general standard and suitability.
(10) Frequent absence—If the class register shows frequent or prolonged absences not
satisfactorily explained, the need for treatment may be brought to light.
(11) Any other defect.
Pupils for whom further medical care is needed are referred for a special medical
examination in school, or for medical examination at a minor ailment or special investigation
centre.