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85
In the early days of the enquiry, it was realised that the
standard of weight for height could not be used as a hard and fast
rule, but that the general physical condition of the child must be
taken into account. We therefore began to include children who
showed symptoms of fatigue, anaemia, enlarged glands in the neck,
and other signs of debility.
All the children who are being provided with meals and
milk, as well as all the school children who are considered to be
undernourished, are weighed and measured at the Clinic once each
month. Certain children have been added to those on the list of
free meals from time to time, and in certain cases we have had to
waive altogether the weight for height standard, and provide meals
for the children temporarily, where they were obviously needed
owing to lack of money in the home.
Six months after the first examination and the commencement
of school meals, the children were all examined again and any
progress noted. Many of the children on free meals belong to a
floating population as they discontinue school meals when home
circumstances improve.
We have chosen for special mention children who were under
our care continuously during the first 6 months after the scheme
came into operation. There were 80 such children receiving free
meals and milk. In addition 2 received meals only, and 11 received
milk only. 67 of these children had gained in weight satisfactorily
and were better in every way.
During the August holiday, 15 children actually lost weight,
but one month after recommencing meals they had all gained
weight.
4 of the children had not gained weight at all. One of these
suffered from a severe form of heart disease and in spite of his
failure to gain there was a definite general improvement. No cause
for the stationary condition could be found in the other 3 but they
still went to bed far too late and fatigue was probably the cause
of the failure to gain.
9 children continued to lose weight, and the reason appeared
in most cases. 3 of them were obviously neglected. They
small children who were sent to school in a dirty and ragged
condition and there was no home care. Another girl who was in
general condition was found to return home after her school
dinner in order to run errands, and she was kept at home one day
weekly for housework. Her mouth and teeth were in a very bad
condition, and the mother refused dental treatment. The homes
were visited and the children kept under stricter supervision, and
wall cases some improvement resulted.