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22
1941 was described by Dr. Powell in an abbreviated unprinted
report as dictated by the economy standards of the time. The
population, due to evacuation and other effects of war. had fallen
to 94,170 (it had been 130,000 in 1939). The birthrate was
nevertheless maintained at 13.8 with the death-rate 13.3. The
infant mortality rate showed only slight improvement over the past
decade at 44.8 (56 in 1981) - it actually showed an increase of 1940
as did the Maternal Mortality Rate at 6.7 due no doubt to the
inevitable interference of war conditions with the maternity servicss,
Infectious Disease still played a major role in diminishing the
health of the community; during the year 2,036 cases occurred as
shown below, but most of the apparent increase was due to the
inclusion of measles, accounting for more than half the total.
TABLE IV

In 1951 normal peace-time conditions were reported, the
population was 120,900 and both the birth and death rates were very
low at 13.5 and 10.8 respectively (National averages were 15.5 and
12.5). Not a single case of diphtheria occurred and Dr. Powell
wrote:-
"It is now estimated that if a non-immunised child
catches diphtheria, the chances of dying from the disease
are seven times greater than those of the immunised child.
The need still remains to concentrate on the immunisation
of as many babies as possible on reaching the age of nine
months. At present about 40 per cent of the babies born
annually are immunised before reaching the age of one year,
but the target still remains at 75 per cent."
This is equally true today when rather more than 50 per cent of
babies are immunised in their first year. Immunisation had already
dramatically reduced the morbidity and mortality from diphtheria but
other infectious diseases were still prevalent though the case
mortality rate had in all cases been greatly reduced, as shown in
Table V. With only 37 deaths the case mortality rate of tuberculosis
had fallen from 50 per cent to just over 30 per cent.