View report page

throughout the country (of. Report of Medical Research Council, 1942).
Long hours, little opportunity Tor fresh air and well-regulated
leisure, black-out conditions and new environment are no doubt in no
small measure responsible. In children evacuation with accompanying
exposure to unaccustomed unpasteurised milk, is largely held to
blame.
ACCOMODATION FOR TREATMENT OF TUBERCULOSIS IN CHILDREN.
The lack of facilities for treating cases: of pulmonary tuberculosis
in children has been a source of great anxiety, particularly as
such cases have been on the increase since the war. Various sanatoria
on the East Coast are no longer available and local authorities who
have sanatoria for children have their beds filled to capacity with
their own cases and are, in consequence, unable to admit cases from
the Borough. It is to be hoped that the Ministry of Health will take
this matter in hand as a wait of three to six months for a case of
childhood tuberculosis may lead to disastrous results.
ACCOMMODATION FOR ADVANCED CASES.
This is still a vexed problem, and the position remains as outlined
in my report last year.
OCCUPATIONAL THERAPY.
The attendances at these classes are up to pre-war standard.
The difficulty In obtaining suitable materials is a handicap, but
in spite of restrictions, Miss Ross Smith has succeeded in maintaining
a high degree of enthusiasm among selected groups of our
patients. Close contact is kept with these patients in their homes
and they visit the Chest Clinic to receive supplies and continue,
in many cases, tho work they learnt at the Sanatorium. The standard
of work is so high that the donand far exceeds the supply. Our
contribution to the war effort is to try to make as many utility
products as possible, i.e., shopping bags (netting) baskets, etc.
and a certain amount of knitting,weaving, etc.,for the Forces. The
aim for these patients is to rehabilitate them through sheltered
workshops, where they can increase their working hours in a group
under medical supervision. The effect on the morale of these cases
In the knowledge that they are to some extent useful citizens, is
tremendous.
THE SOCIAL, ECONOMIC AND PSYCHOLOGICAL ASPECTS OF TUBERCULOSIS.
The importance of this aspect of our work and the value of keen
and enthusiastic home visiting by competent tuberculosis health
visitors cannot bo over-emphasised. Since Sister Mallon's departure
this side of our work has been carried out under the general direction
of Sister Williams to whose untiring efforts and devotion to
duty it is impossible to pay sufficient tribute. Now that we are
able to look forward to the much-needed return of a full staff of
tuberculosis health visitors, this aspect of our work should receive
even greater attention.
The family as the unit in treatment :For we must recognise
that we waste time and money if we treat the tuberculous patient
only and neglect the family. Moreover, the patient's mode of life
after he has left the sanatorium is a major problem.Our visiting
nurses regard the homes of the patients as a primary concern. The
After-care arrangements are equally important and, last but not
least, tho every-day economics of the home may deter early cases
from seeking treatment .We endeavour to deal with the psychological
make-up of the patient by trying to get him to appreciate that he
is going to have our help and not our interference. In this way
our visiting nurses soon become welcomed In the patients' homes,
not as public health officials, but as friend guide and counsellor.
As an illustration, an extremely aggressive and non co-operative
patient, suffering from active pulmonary tuberculosis, who had
refused all forms of treatment was, In spite of all forms of abuse,
continually visited by one of our Sisters. She was repeatedly subjected
to abuse, but was finally Invited indoors. After prolonged
discussions concerning the finances, work, family and conditions,
reason began to prevail. Ultimately the patient saw the light and
actually apologised to Sister for his behaviour, his own words
being "I could cut out my tongue for the way I spoke to you."Since
this incident a more co-operative patient would be impossible to find.
I am indebted to Dr. Palmer and all the members of the staff of
the Chest Clinic for their help and co-operation throughout the year
I am also indebted to Miss Webber of the Invalid Children's Aid
Association for her most helpful co-operation.
28.