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3
Certain other decisions and work require to be mentioned in connection with
the year 1943. Included are the following items:—
In January I was authorised to supply insulin to poor inhabitants of the borough
suffering from diabetes. In the same month it was decided to appoint two full-time
home helps in addition to any part time homo helps remaining on the panel. In
April it was agreed to institute an evening antenatal clinic. In May I was authorised
to enter into negotiations with voluntary hospitals for the provision of extra beds
for maternity cases, any agreements to contain a clause stating that no woman be
refused admission for reason only that she is unmarried. (This problem of extra
beds was later in the year settled by the L.C.C. arranging to set aside up to five beds
for us at St. Bartholomew's.) In May the scale for dinners for mothers and toddlers
was modified by being made more generous. An additional foot clinic session was
instituted and it was decided to appoint a whole-time chiropodist in addition to one
of the part-time workers. In that month also the committee recommended
for adoption some standards submitted for reconditioning selected houses. In
August the compulsory notification of scabies came into force. In that month too
the health committee and the housing committee decided to set up a joint committee
to deal with the requisitioning and reconditioning of houses to mitigate housing
difficulties. In September the health shelter in Reeves Place was closed, arrangements
having been made with Bethnal Green for the use of their health shelter if
required. In November a Rodent Officer was appointed and shortly afterwards
started work with a small staff ; by the end of the year the first of two intensive
treatments had been applied to the whole sewer system.
In the matter of civil defence only a few incidents occurred during the year
and the medical services showed commendable keenness in all their work and
exercises. Disinfection and disinfestation of bedding used by firewatchers and
other A.R.P. workers continued and the mobile hot-air disinfector was of great
assistance. Altogether during the year nearly 88,000 articles were treated by this
means.
A word should be added about the new table included on the back page of this
report and described as Reproductive Wastage. This table demonstrates some interesting
points. The reproductive wastage rate attempts to show the number of
pregnancies per thousand live births which do not result in the birth of a child who
lives beyond the age of one year. It includes therefore the number of still births
and the number of babies dying within the first year of life. It should also strictly
include the number of abortions, but as these are not notifiable and as the vast
majority of them occur within the first month or two of pregnancy they may be
regarded as of less account than children dying any time between the sixth month
of pregnancy and the end of the first year of life. The total reproductive wastage
rate, as can be seen, is gradually diminishing, but is still too high. It remained up
last year owing to the increase in still-births, and in neo-natal deaths—a serious
statement in itself as possibly, among other things, indicating lowered nutrition in
the mother. Further interesting points are the neo-natal death rate, that is, the
number of babies dying in the first month of life per thousand live births, and the
rate of deaths during the rest of the first year of life. It will be seen that the neo-natal
rate has fallen from 36 in the years 1905-9 to 22 in the years 1940-43, that is, a
drop of 39 per cent., whereas the rest of the first year rate has fallen from 117 to 36
in the same period, which is equivalent to a drop of no less than 70 per cent. The
figures for 1943 alone are striking, although too small to be reliable. They show that
for the second time on record (1943 and 1942) the rate of deaths from the first month
to the end of the first year was less than the rate of deaths during the first month.