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30
In many sanitary districts, systematic efforts are made each summer to remove
nuisances and other conditions, which favour excessive mortality amongst children, but
the Board suggested the following lines along which it was most important that action
should be taken.
Such is, of course, not intended to cover the whole field of precautions, supplementary
action being probably necessary to meet the special needs of individual districts.
" Firstly, it is important that advice should be given as to the feeding and manage"
ment of children, and more generally as to preventing the exposure of their food to
" contamination from decomposing organic matter. The distribution of clearly worded
" leaflets is useful in this connection ; but even more important are personal visits and
" the offer of practical advice to the mothers of babies born within the last twelve
" months. Exact and simple instructions are most likely to be followed, if given
" during a period of special danger. In districts and towns, in -which the Notification
" of Births Act has been adopted, the records obtained under that Act will give
" valuable information in selecting the homes to which visits are now most urgently
" required.
" Secondly, the full value of the personal instructions indicated above cannot be
" realised, unless vigorous efforts are made to prevent the accumulation in, or in
" the vicinity of the house of the decomposing animal and vegetable matter. It is
" not necessary to do more than mention the importance of efficient scavenging, of
" frequent and, if practicable, daily removal of house and stable refuse, of domestic
'' cleanliness, and of keeping all food properly protected. The Council may consider
" it advisable, during the next few weeks, to divert the sanitary inspectors from less
" urgent work, and to instruct them to make rapid visits with a view to securing
" efficient sanitation, especially in and about the houses of the working classes.
" Thirdly, it is important that the Council should promptly ascertain in which parts
" of their district diarrhoea is especially prevalent, and should devote close attention to
" street and court scavenging, and to the removal of stable and domestic refuse in those
" areas. Without waiting for the weekly death returns, efforts should be made to
" obtain information of cases of diarrhoea from health visitors and others who make
" domestic visits, to impress upon parents the importance of immediate treatment of
" infantile diarrhoea. Apart from the medical notification of cases of epidemic diarrhoea
" in children, the visits of health visitors can be utilised for impressing upon parents
the seriousness of diarrhoea amongst young children, and the desirability of information
" being given to the Medical Officer of Health should a case of diarrhoea occur."
In my opinion, the diversion of the Sanitary Inspectors from their statutory duties
is undesirable, and so far as the City is concerned, unnecessary, but with this exception,
all the suggestions outlined above are carried out by your Officers as routine.
The Corporation take special precautions, not only in the summer months, but
during all periods of the year, to minimise as much as possible the excessive infantile
mortality with which all civilised countries are afflicted, and for this purpose have
retained the services of a Woman Sanitary Inspector, who devotes practically the whole
of her time to this object.
In 1902, when this Officer was appointed, the deaths of children under one year
of age, to 1,000 births, was 124, and this figure has since steadily fallen, until for the year