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42
because the facilities became better known or were more taken advantage
of than any actual increase of incidence, 1,701 persons attended in
1942 and 2,178 in 1943. In the latter part of 1944 most of the first aid
posts were closed, leaving only the two. The reduction in facilities
may have accounted at least in part for the slightly smaller number of
attendances, namely 1,915 in 1944.
The return of persons from abroad, particularly from those districts
subject to the full blast of war provides a means of introduction of
infections to which we in this country are not ordinarily subject. One
of these diseases is smallpox. Up to the present the nearest the district
has been to this infection was in 1944 when numbers of its residents
became contacts of a Service patient at Mount Vernon Hospital or
contacts of those who contracted infection from this patient. An increasing
number of notifications is received in respect of Service- or
Ex-Servicemen suffering from a relapse of malaria contracted abroad.
Typhus fever is one of the diseases liable to be introduced, and some
cases have in fact developed amongst those who have returned to this
country, though this district has as yet escaped.
Summarizing the position then, as far as can be ascertained from
the notification rates : tuberculosis has increased ; there was a short
period increase of paratyphoid infection, while it is understood that
general experience is that the incidence of venereal diseases is rising.
Beyond these, those infections which might have increased in war conditions
have not done so. Some might conclude perhaps with justification
that the public health organisation is on sufficiently sound lines
that it has been able to withstand and overcome these tests and trials
to which it has been subjected. But while this may be accepted as
the position, it must not be inferred that it is maintained that the health
of the community has not suffered. It is just that there is no means of
knowing of or estimating the prevalence of those such very common
conditions, whether rheumatic, digestive, dermatological or nervous
which cause the sufferers to be far short of fit, and, while not in any
sense real invalids, nevertheless so very far removed from the class
enjoying perfect health. It is feared that such disabilities might now
be much more prevalent.
General Environmental Conditions.
Drainage: The district has been fortunate in that enemy action
resulted in so little damage to drains or sewers, and only for a short
period was any inconvenience suffered, while there was never any risk
to health.
Water Supplies: Damage to mains with consequent risk of
pollution was one of the hazards feared from enemy action. Precautionary
measures taken would probably have ensured safety even in the
event of far greater damage than the district sustained.
Scavenging and Cleansing: Labour difficulties resulted in less
attention being paid to street cleansing and also necessitated less
frequent collections of house refuse. The lengthened intervals probably
contributed to the prevalence of flies of which complaints were received.