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school children are concerned, I have not had one instance reported
to me. Assessments of nutrition are difficult to make on statistical
or scientific bases. Attempts have been made to determine the
state of nutrition of individual children or groups of children by
assessment of heights and weights, by a comparison of a heightweight
ratio, and by blood tests, but I am not satisfied that any of
these tests have received general acceptance. Children vary in
height and weight as do adults, and the thin child is not always the
unhealthy child. Personally, I know of only one way of assessing
nutrition, and that is to rely upon the eye of the experienced observer.
There are many members of the Education Committee who, from this
point of view, are as fit to judge of the health of our school children
as I am, and I think they will agree with me that our children are
as fine looking, as upright, and as healthy as in pre-war years.
Only eight children suffered from Diphtheria, and I believe
this to be about the lowest figure ever recorded in the district.
There must be many residents who can remember when Diphtheria
was endemic in Enfield ; when our cases were numbered in hundreds,
and when there was a definite mortality from this disease every
year. It is not my duty, nor would it be wise for me to prophesy
for the future, but I think I may say with confidence that if the
children of Enfield continue to obtain immunisation from this
disease as they have in the past two or three years, there should
be little reason for us to fear a return of Diphtheria in epidemic
form.
There are two new services which have been given much
consideration by the Education Committee, namely, the Orthopaedic
service and the Speech Therapy service. The Committee authorised
me to make arrangements for the organisation of an Orthopaedic
Clinic, and to appoint the appropriate staff. Unfortunately, I was
unable to obtain the services of an orthopaedic specialist. I have,
therefore, in the first place, dealt with the orthopaedic cases myself
in conjunction with the assistant school medical officers, but I have
had considerable hospital assistance and arrangements are now
reasonably well in hand for the care of children suffering from
orthopaedic defects.
In the latter months of the year a school Speech Therapy
Clinic was commenced under the supervision of Miss E. Richnell,
who holds the appropriate certificates. At this stage it is too early
for me to speak of results. Let it suffice that, in Enfield, we have
recognised the necessity for dealing with children suffering from
defects of speech, and that we have commenced an organisation to
deal with them. The clinic is held twice weekly and has an average
attendance of about ten. Miss Richnell receives assistance from
one of the school nurses, and there is already a long waiting list of