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100
I have given considerable attention to the figures for 1938
and previous years. As I have already stated the classification is
carried out at the request of the Board of Education, but I am
afraid that I cannot ask the Committee to come to any conclusion
based on these figures as to the nutrition of the children of Enfield.
It has been my experience that they differ very widely as between
doctor and doctor.
Nutrition is something which it is impossible to define. It
depends, admittedly, to a large extent on food. On the other hand
it is possible to find children whom one cannot classify as either " A "
or " B " yet whose standard of living and whose supply of food is
both adequate and satisfactory. Apart from the fact that exercise,
home environment, sleep, rest, and freedom from noise and worry are
factors of importance, there must be considered, furthermore, the
question of heredity. I mention these facts lest the Committee
should consider that since there were 884 children classified as
slightly sub-normal and 24 as nutritionally bad, there is an immediate
need to supply all these children with extra milk and/or meals. It
is quite possible that many of them are being adequately fed at home,
and that the cause of their nutritional deficiency lies other than in
inadequacy of food in quality or quantity.
During 1939, should time permit, I hope to correlate more
closely the question of nutrition with that of the provision of milk
and/or meals, for at the present moment the latter is carried out
largely on a family income basis. This may be criticisable, but
looked at from a preventive point of view there is much to be said
for feeding and giving milk to children from homes where the family
income is low, even though nutritionally these children appear to be
well-nourished. Unless these preventive measures are taken,
malnutrition will arise in due course. Rightly or wrongly it has
been, in most cases, on the suggestion of the head teachers, confirmed
by the School Medical Department, that free milk and meals have
been provided, and I rather feel that the recommendations from the
teachers have been based verv largely on their own knowledge
of family hardship.
It is hoped to institute nutrition surveys very shortlv, but these
cannot be carried out with the existing medical staff.
Skin Diseases.—Twenty-two cases were seen; all required
treatment.
Ear Disease.—Thirteen cases of middle ear disease were found;
also twenty-nine cases of defective hearing. All these cases were
referred to the Aural Clinic for treatment.