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remedy, and with deep, warmed, well-appointed shelters they would disappear.
A great step in the direction of better health could be taken in the evacuation of all
children, and of all women not directly engaged on productive war work. It may have
been remarked that lack of food was not amongst the depressing factors mentioned
above. This is because the food situation at present hardly gives rise to anxiety.
Even with an intensification of the blockade, a government policy based on the good
physiological and agricultural advice which is available could prevent any serious
adverse effect on nutrition. Large-scale evacuation may even stimulate communal
feeding of those who remain, and this would be, whether in peace or war, of considerable
benefit. In September of this year, communal cooking of one meal a day was
started for those who could not, owing to enemy action, cook at home. It is possible
that this initial experiment may have far-reaching results.
At this period of time, when one tends to be depressed by the present, one can
play more easily with hopes and memories. For the latter, the year 1939 was remarkable
not merely in the lowness of the maternal mortality rate but in the (possibly
more important) infantile mortality rate which fell to a figure which is easily a low
record. The rate was 31 per 1,000 live births, as against the previous year's
figure of G4, and an average for the last ten years of 71. It also compares with
a figure of 48 for London and 50 for England and Wales. It was apparent during
the first part of the year that, provided we avoided -a bad autumn quarter, the
figure would be very low ; the result, however (possibly helped, but by no means
decided, by evacuation), exceeded expectations. It will serve as an excellent
incentive to future peace-time efforts.
Basement bakehouses, a continual source of hygienic trouble for very many years,
were tackled during 1939 as a result of the powers given under the Factories Act.
The number of basement bakehouses inspected in accordance with the act was 27.
Of these, eight had not been in use for a period exceeding 12 months and thus automatically
ceased to be usable as bakehouses again. Certificates of unsuitability were
served in respect of 11 bakehouses, and in the remaining eight consideration was
deferred for a schedule of works to be carried out.
It is impossible to close these introductory remarks without referring to the
establishment of a " convalescent " home for children aged two to five with subnormal
health. After a considerable amount of discussion, the approval of the
Ministry of Health was obtained in spite of some earlier opposition of the County
Council, and premises were acquired at Mayfield, near Tunbridge Wells, Sussex,
which had previously been used as a convalescent home for mothers and babies.
These were opened at the end of May, 1939. There is accommodation at Mayfield
for 15 toddlers, and the staff consists of a matron, staff nurse, nursery-trained nurse
and four probationers, together with domestic assistance. It was hoped that Mayfield
would serve as one of the corners of a triangular scheme for the care of young children
apart from ordinary welfare work, the other corners of the triangle being the dietetic
wards at the Model Welfare Centre, and a day nursery, for which a site had been
obtained in the centre of the borough. The war, of course, put a temporary stop to
this as the wards were closed down at the outbreak, and day nursery children were
at first, and should continuously be, evacuated from inner London.