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13.
damage to the brain or from interference with its blood supply
before, during, or after birth.
It is well known that german measles contracted during
the first four months of pregnancy is liable to cause
congenital abnormalities in the child and extensive research
is now going on into the effect of similar virus diseases.
The Rhesus factor (incompatability of blood group between
mother and child), exposure of the pregnant woman to
irradiation, and premature birth from a multitude of causes
all tend to produce brain damaged' babies. Children of this
type form an increasing proportion of those now attending
special schools and constitute our greatest problem. Brain
damage is irreversible physiotherapy may prevent a spastic
child becoming a bedridden cripple but can never cure it.
The child with congenital perceptive deafness may be helped
by a hearing aid but nothing can restore its normal hearing.
Furthermore, brain damage tends to be multiple; typical is
a boy with such severe athetosis that his whole body goes
into writhing contortions in the effort to keep his hand
steady enough to write his name: his vision is poor and he
has to use a hearing aid. As one would expect, he is mentally
retarded as well. It is difficult to see what sort of education
could fit such a child to take his place in the world
or what work he would be capable of. Clearly he is
unemployable in the ordinary sense but the alternative of
dragging out his days house-bound in idle loneliness on
National Assistance does not bear thinking about.
There is a great need to create a few square holes for
such children. The Club for the Physically Handicapped held
on Monday evenings at the Margaret Brearley School goes some
way in providing occupation and companionship but is a poor
substitute for work. Could large employers of labour locally
be persuaded to carry a passenger? One firm did. A girl
paralysed from the waist down and confined to a wheelchair
was given a job out of charity. She is now working full time
on an assembly line besides doing the cooking and washing at
home for her father who is a widower. She is happy, and
proud of her job, but she might never have had the chance to
try.
Nowadays it is fashionable to compare the relative
importance of diseases not by the annual number of deaths they
cause but by the number of years of useful life lost' . Thus,
while strokes account for 14.2 per cent of all deaths and
congenital malformations with diseases of early infancy only
2.7 per cent the latter are more socially important since they