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At one of the Lewisham nurseries, a special unit for nine severely subnormal children
under five years of age continued its success, both in maintaining attendances and in the
response of these small children to the care and training given. At the end of the year it was
agreed to install a similar unit in a Camberwell nursery.
Tuberculosis—During the year a tuberculosis incident at a large comprehensive school
with a roll of some 1,400 boys occupied the attention of divisional medical, nursing and
clerical staff, in co-operation with the chest physician and chest clinic staff and the mass
X-ray unit. In view of the extent and interest of the whole incident, an outline of its development
is given.
On 1 and 6 March, 1963 two boys from one family were notified as having tuberculosis.
The elder boy of 16 years had an adult type of tuberculosis with cavitation and positive
sputum; he had been attending school regularly and was referred to the chest clinic by his
family doctor. As is usual in cases of tuberculosis occurring in school children, close
contacts were followed up in school and the staff (teaching and other) were X-rayed.
The follow-up was complicated by the system of tutorship, by which boys of different
ages had come in close contact with the original case; examinations also were in progress
and it was not till early July that skin-testing was carried out. Before that, in June, the mass
X-ray unit visited the school to X-ray the teaching staff (100+) and any kitchen staff,
school keepers, etc. An elderly meals helper was picked up in this way and notified. Between
the first notifications and the skin-testing in July one further 12-year-old boy was notified.
As the result of skin-testing 392 boys, 197 were given B.C.G. vaccine; of the remaining
195 boys, 38 were new positives and 137 had previously had B.C.G. and therefore were
expected to react.
During July and August large parties of pupils went abroad to the U.S.A. and on
'adventure courses'; it was therefore necessary to postpone X-ray of the mantoux
positive boys until early September when term started. By the middle of November seven
boys had been notified, four having been picked up by X-ray after positive skin-reactions
in July. In view of this disturbing situation the whole school was skin-tested. The positive
reactors were X-rayed (mobile vans were stationed in the school car park) and the negative
reactors were given B.C.G. As a result 14 boys were notified; the seven mentioned in the
previous paragraph, a further three from the July investigation and four from that in
December. As a further precaution the whole school will be X-rayed again by the mass
X-ray unit.
Dover Lodge hostel for girls—During the year the full complement of 13 residents was
attained, although numbers fluctuated from time to time. The hostel proved a valuable
training and habit forming centre in enabling subnormal girls to settle down to regular
work and to take their own place in the community. Regular case conferences were held
at the hostel, attended by medical staff and social workers, to discuss all aspects of the
girls' health and welfare, and to give help and guidance to the warden.
Day centres for mentally ill persons—Two part-time day centres, one in Camberwell
and one in Lewisham, were started as an extension of the domiciliary occupational therapy
for mentally ill persons. The centres enabled the therapists to use their time more economically,
in that they could supervise several persons at the same time and a greater variety of
activities was provided for the patients, as in addition to handicrafts outwork of a simple
nature was carried out for local firms. The aim was to reach chronic schizophrenics who
do not fit into an industrial centre and housewives who after hospital treatment are
depressed and inadequate. The patients benefitted by having a regular meeting place in a
pleasant social atmosphere and by receiving a small ex-gratia payment for the work they
performed; their fares were paid and occasional outings to places of local interest were
organised. The mental health social workers were able to see their patients who attended
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