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231
owing to the bulk of the routine work to get through, and the
limited time and means that can be directed towards it. It is
debatable whether routine medical inspection, as now carried out,
could not be modified with benefit, though it must always remain
the basis of the work for, obviously, before causes can be investigated
their effects must be noted, and this can only be done by
a medical inspection.
The average attendance of scholars in the Elementary Schools
throughout the year was 90 per cent., the same as in 1930. No
widespread epidemic occurred, though Chicken Pox and Mumps
gave some trouble. Measles, as was expected, did not figure
largely in the cases of Infectious Diseases. The year was a
satisfactory one as regards the general level of health in school
children. Although the actual number of cases of verminous
or dirty children are not large, the increase shown in 1931 on
1930 is disquieting. As was mentioned in my report for 1930,
certain schools, and certain families whose children attend those
schools, are mainly responsible for uncleanliness findings. The
majority of the schools maintain a commendably high level of
cleanliness. In this connection, the cloakroom provision must
be considered, and it certainly seems desirable, more particularly
in schools drawing children from unsatisfactory districts, that the
cloakroom arrangements should be such that coats and hats
should not touch when hanging, there should be a free circulation
of air all round the clothes with means, also, for drying wet
clothes and boots or shoes.
The chief causes necessitating the exclusion of children from
school on medical grounds, were the common infectious diseases,
which constituted 65% of the total. Impetigo and verminous
conditions between them formed 19.4% of the exclusions, and
both showed a rise on 1930, when the combined percentage was
ten. In connection with cleanliness of scholars the school nurses
paid 503 visits to the schools and examined during the year 64,755
children, of whom 3,281 were found unclean at the first inspection
and 1,652 at subsequent following-up inspections. In addition
218 visits were paid to children's homes for the same reason.
The presence of the habitually dirty child is a very real source of
anxiety to teachers and to the parents of clean children, and
Persistent efforts have been made to keep the incidence of uncleanliness
as low as possible. Although unsatisfactory housing conditions
may have an influence on some of the disabilities from
which children suffer, it certainlv does not necessarily play anv
conspicuous role in the cause of uncleanliness; for dirty children