View report page

8
security given by the deeper shelters. In this district the Anderson
shelter is difficult to make satisfactory. Even if acceptable in
summer its disadvantages will probably always in winter outweigh
the advantages, being as they are, damp and cold and difficult to
ventilate. There remains the question of strengthening a room
or part of a room in every house. This would go a long way to
removing many difficulties which arise under arrangements in
which there is herding of people, e.g., those present because of
patients suffering from temporary acute illness, whether infectious
or not, who cannot be removed to hospital and also the case of
the tuberculous patient who should not be in a public shelter.
Of course for that matter for the open case of tuberculosis to be
in any shelter with his family is contrary to the teachings of all
tuberculosis authorities who have for these years continued to
stress the necessity for such patients having separate sleeping
accommodation. The congregation of large numbers, even though
the sanitation of the shelters were satisfactory would still afford
a risk of the spread of infection greater than that to which the
community is ordinarily exposed. Not unnaturally the medical
profession would be looked to to minimise this risk. In the
latter part of the year the Metropolitan Boroughs were authorised
to engage medical men, in the case of the largest shelters, as
full-time medical officers of the shelters, but, in the case of other
shelters holding 500 persons, to pay a regular nightly visit and be
on call, or, in the case of the smallest shelters to be on call only.
In the last weeks of the year these provisions were extended to
this district, though in point of fact, because of the limited use
made of the shelters it was necessary to take advantage only of
the provision by which a medical man could be summoned at the
cost of the authority to attend to a patient in any of the public
shelters. While such authority is undoubtedly of advantage to
those in charge of the shelters, although the doctors summoned
will have an opportunity of advising the shelterers on matters
of hygiene, too much, if anything at all, must not be expected
that by this means the risk of infection can materially be lessened.
Many infections are spread by carriers, healthy persons who
harbour the organism unknown to themselves or to others. Many
others are most infectious in the very often unrecognised, and,
for all practical purposes, unrecognisable, stage. Few enough
are the occasions when an infection is brought home to any offending
individual. From the point of view of reducing the spread of
infection all that can be done is to appeal to the shelterers to
present themselves for medical examination at the onset of any
symptoms which might be precursors to any infection. For such
a step to be of any real advantage, however, it would be necessary
to have some place in which such persons can be housed where
they will not be a risk to others. In the case of declared diseases
for which hospital provision is ordinarily made, if the patients