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periods there have been in Shoreditch marked decreases in the numbers of infants
dying from prematurity, debility at birth, wasting and the effects of injudicious
feeding, also from bronchitis and from suffocation in bed in a lesser degree.
These causes of death are amongst those likely to be first affected as the results of
increase of knowledge as to the care of infants. These decreases have taken place
during a period when there has been an increasing amount of attention given to
the subject of infantile mortality, and is not unreasonable to assume that to some
extent they are directly or indirectly attributable to it. In this connection,
without including that of a general practitioner, mention may be made of the
large amount of work done for the infants of Shoreditch by the Queen's Hospital
for Children, and other similar institutions in the Metropolis, by the Mission in
Harman Street and the Babies' Home in Brunswick Place, also during the past
three years by the Council's Health Visitors. This must have been the means of
spreading both directly and indirectly knowledge as to the care and management
of infants, and it is suggested that it has materially assisted in the reduction of the
infantile mortality of the Borough to which attention has been directed. The
decrease of the number of infants suffocated in bed also may be specially noted as
an indication of more thought and less neglect ; and on the whole the outlook is
encouraging, and it may reasonably be expected that with increased activity and
proper co-ordination of the work there is every likelihood of a still more marked
reduction in the infantile mortality of the Borough. Upon this, Dr. Addision may
be quoted; his suggestion is "a methodical campaign covering the whole of the
"Borough in which the aid of voluntary workers and associations is enlisted
"and brought into orderly relationship, in which the arrangements are facilitated
"for the supplies of suitable milk and for the necessary assistance and advice
"being available for nursing mothers and for infants who stand in need of it."
He believes that "such a campaign can only be carried on with efficiency and full
"success with the co-operation, direction, and supervision of the Medical Officer
"of Health and the Sanitary Authorities." He further suggests "a determined
"campaign to improve the housing conditions of the people, to provide increased
" sanitary conveniences, and to abate the evils arising from overcrowding."
In commenting upon the above suggestions, I may remind your Committee
that the question of the adequacy of the sanitary staff for the needs of the Borough
came under your consideration in May, 1912, and was carefully gone into at that
time, and upon your recommendation the Council increased the staff by two
sanitary inspectors, a health visitor, and a clerk, and in December, 1912, the
additional staff commenced work. The sanitary staff of the Borough was thereby
increased in strength by approximately 43 per cent. It need hardly be pointed
out that it is much too early to say anything as to the effect of this addition
beyond stating that the amount both of sanitary inspection and health visiting
has been greatly increased. The increase in the number of health visitors has
enabled the Committee to take certain steps which may be regarded as being in
the right direction towards the proper co-ordination of the work : the Borough
has been divided into two districts for the purpose of health visiting, namely,