View report page

87
A dispensary should further work by bringing skilled influence to bear on the
home conditions in the direction of hygienic and dietetic improvement; both for
the direct benefit of the actual sufferer, and for the better protection of the
contacts. Here the importance of having a properly trained visiting nurse is
obvious. She must have knowledge of the social difficulties of the district and
tactful resource in advancing the claims of hygiene. An acquaintance with the
various charitable agencies working in the district is a necessary part of her
equipment and she should be able to fill an important place on the committee of
an After-care association.
Under present conditions a certain amount of the medical treatment is
rather an important function of the dispensary, at any rate in the eyes of the
patients, but it is hoped that in the course of time more strictly hygienic methods
may be adopted on a larger scale.
It is to be deplored that the structural limitations of so many of the homes
renders anything approaching "sanatorium" conditions exceedingly difficult
to arrange short of sending the patients away. Beds at the disposal of the
Borough at sanatoria or hospitals are badly needed, and the provision of open-air
schools under the auspices of the London County Council will be a measure
of the greatest assistance to tuberculosis dispensaries.
It is desirable that an After-Care Committee should be formed in Shoreditch
to assist patients after their discharge from a sanatorium and to co-operate with
the several charitable organisations in dealing with the more promising cases.
The Dispensary at the Royal Hospital for Diseases of the Chest, City Road,
is at present open for the attendance of patients on four afternoons a week, and
also on Monday and Thursday evenings, at 8 p.m., for the convenience of those
who are at work during the day and who can ill afford to lose the time which an
afternoon visit entails. These two nights are usually busy ones, so that the
evening attendance seems to meet a definite need.
During the past year "contacts" have been examined at the hospital and not
at the homes of the patients. This plan has certain definite advantages, though
it may not always be conducive to the accumulation of large figures. It should be
noted that contacts are not examined of those cases sent by medical practitioners
for an opinion only and not for treatment. Contacts are kept under observation
and examined again and again at intervals and their records carefully filed ; in
this way the earliest manifestations of the disease will be detected.
The official arrangements with the Borough Council regarding the work of
the Dispensary in relation to Shoreditch cases is to take effect from April 1st,
1913, but in submitting a statistical report it will be found convenient to give the
figures relating to the whole of the year 1913.
New cases 413
Total attendances 2,948
Visits paid to homes 1,205