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132
Blindness of the Union of Counties' Associations for the Blind forms a suitable basis for action. The
Model Scheme set out in the Circular includes—
(1) The notification of persons threatened with blindness.
(2) Systematic visiting of persons ascertained to be threatened with blindness to secure that
they avail themselves of the facilities provided for expert treatment and supervision.
(3) The provision of treatment for the prevention of blindness to persons so threatened either
as in-patients or as out-patients at hospital dispensaries, clinics or other approved places
or otherwise.
(4) The provision of financial or other assistance to cases where necessary to enable them to
take advantage of the facilities for treatment.
(5) Recovery of whole or part of the cost of treatment according to the circumstances of the
patient.
(6) The dissemination of literature or information regarding the prevention of blindness.
Pre-School and School Children.
Children under five years of age and children attending Willesden Public Elementary Schools
threatened with blindness are already dealt with so far as they come to knowledge under the Maternity
and Child Welfare Scheme or the School Medical Service Scheme of the Local Authority.
Ante-natal Work and the Prevention of Blindness.
It should be observed, however, that the child of a pregnant woman who is suffering from a
vaginal discharge or syphilis is in fact threatened with blindness. The Minister in Circular 1474,
dated 9th April, 1935, called attention to the need for the better linking up of the ante-natal services
with the treatment of such discharges and the treatment for syphilis. This is again emphasised in
Circular 1621 on the Prevention of Blindness, which is now before the Health Committee.
The Prevention of Blindness Committee above referred to has had this matter under consideration
and in connection with it have issued the following statement which appears in the Report on
the Prevention of Blindness by the Standing Committee on the Prevention of Blindness of the Union
of Counties' Associations for the Blind published in 1936:—
"63. The development of ante-natal services and of the means of securing early treatment
in cases where venereal disease is present or suspected, should do much to secure for the newborn
child a greater measure of immunity than formerly from the diseases or infections which threaten
eyesight in the early days of life.
"The Annual Report of the Chief Medical Officer of the Ministry of Health for 1932 referred
to the special arrangements made 'at a number of Maternity and Child Welfare Centres for the
diagnosis and treatment of gonorrhœa and syphilis in their patients,' and emphasised the value
of ante-natal treatment in the prevention of gonorrhceal ophthalmia and congenital syphilis,
and the Annual Report for 1933 recorded that 'a number of Local Authorities have not yet
given serious consideration to the co-ordination of ante-natal work with that for venereal disease.'
We hope that the importance of arranging and maintaining close liaison between the ante-natal
work of an authority and the centres or clinics for the treatment of venereal disease will become
generally realised as time goes on. We recognise, however, the difficulties of establishing a
satisfactory link between the Maternity and Child Welfare Department and the Venereal Disease
Department in areas where the population is scattered and where the only available treatment
centre for venereal disease is a considerable distance away, but we consider that no effort should
be spared in arranging for adequate ante-natal supervision and providing the best treatment
possible in the circumstances. An examination of the various methods employed by the Public
Health Authorities has led us to the conclusion that where it is possible to arrange for women
and children to receive treatment for venereal disease at a clinic in association with a Maternity
and Child Welfare Clinic, such an arrangement is desirable, and its success has been demonstrated
by far greater willingness on the part of the patient to make the necessary attendances. The
Ministry of Health recommend the provision of treatment on such lines in their Circular 1474,
issued 9th April, 1935."
In connection with the above it should be observed that with a view to the prevention of
blindness it is necessary to treat patients suffering from vaginal discharge or syphilis.
Vaginal Discharges.
There is very great difficulty in dealing with the vaginal discharges of patients. The bulk
of such discharges are not of venereal origin, but whatever the origin they should have a course of
treatment for their cure. It is invidious to send such patients to a venereal department of a hospital,
and of those so referred from the ante-natal clinics of this Authority some go, but many do not. In
addition, of those who do go few continue their treatment at these clinics on account of the time and
distance and the possible stigma which may be attached to attendance at such clinics. The Royal
Free Hospital runs a special ante-natal clinic for such cases and some of the Kilburn expectant mothers
attend there, but speaking generally, this clinic is too far away for Willesden women. The only
satisfactory solution of this problem in Willesden would be for clinics to be held regularly at the
Health Centres with a medical officer in attendance with special knowledge of these conditions.