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paid off when the ship arrived. The medical officers of health of the areas concerned would
then normally follow up these cases and arrange for them to be examined at the Chest Clinic.
"In another case a notification from a hospital management committee revealed the existence
of a wanderer who had been wandering from ship to ship, and who normally lived in lodging houses
when he is ashore, particularly one in the borough of Stepney, or alternatively another one in
Cardiff. We got the health authorities of Stepney and Cardiff to trace the man and tried to secure
his attendance at Chest Clinics, but our success was not 100% because this particular man had
the habit of attending the clinic once or twice and then disappearing again.
"My last case is one of which we are particularly proud. It occurred on a ship where there was
no ship's surgeon and where the Master had put in a clean Declaration of Health. It is our practice
when there is no ship's surgeon to demand a crew list and a crew muster, and fortunately
our vigilant boarding medical officer noticed that the crew muster was one short of the crew list.
This led him to ascertain that there was in fact a sick man in the crews quarters, and when we
followed up this case we found he had pulmonary tuberculosis. Meanwhile the ship had proceeded
to Bristol, but thanks to information from us, the Port Health Authority there secured the mass
radiography of 61 ratings. These were re-called for re-examination, and one was discovered to be
suffering from active Tuberculosis with extensive cavitation. The appropriate forward notices
were sent from Bristol to Manchester, the next port of call, which again illustrates the co-operation
between different ports and towns in the Port Health and Public Health Service of this
country.
"You may ask what is the size of the problem? Well, in the Port of London, this works out at
an average of 42 cases of pulmonary tuberculosis known to be coming into the Port of London
every year and it must be very seldom that we miss any cases. Unfortunately I cannot fromthat
figure work out a case incidence because I cannot obtain any figures as to the numbers of crew
coming to the Port for the first time in any one year. I have a figure of 671,177 by courtesy of
H.M. Customs, but this includes seafarers who have come in more than once in the year on
repeated voyages. I should have liked to have a figure to compare with that for England and
Wales, namely 131 per million population of all groups and ages, (vide Annual Report of Ministry
of Health 1955).
"I conclude with a quotation from the published papers of Wade Frost, which I humbly suggest
does set forth principles that we are trying to follow in the Port Health Service
"The soundest principle to follow seems to me that, as the cases become fewer and fewer,
preventive measures should be centred more and more upon the open cases; that the protection
thrown around these infective cases and their immediate contacts be not relaxed, but
steadily and progressively increased. This is a sound principle of epidemiology, for it is
to be expected that, as the prevalence of tubercle bacillus in the general environment is
diminished, infection and disease will become more distinctly focalized. In fact, there is
already evidence of increasingly wide differentiation between the most sheltered and the
most exposed groups of our population; and even now we should take more cognizance of
this in directing our efforts."
ASSISTANCE TO THE SEAFARING COMMUNITY
The Port Health Authority is at all times ready to render medical assistance to the seafaring
community and the Boarding Medical Officers have always co-operated to the full in rendering
this valuable service.
An example of this occurred on the 9th March, 1957 last when a deckhand from the tug "SUN XI"
was recovered by the Pilot cutter from the River after five minutes immersion. Resuscitation was
carried out on board the "HOWARD DEIGHTON" and the boy was able to go home in good condition.
Helpful co-operation of another kind is shown by the following letter of appreciation received
from the Ministry of Transport and Civil Aviation.
Ministry of Transport and Civil Aviation,
Berkeley Square, London, W.l.
22nd March, 1957.
"Dear Dr. Greenwood Wilson
Medical Advice by Radio to Ships at Sea.
Since the inception, more than 30 years ago, of the system whereby messages received
by General Post Office coast radio stations from ships at sea, requesting medical advice,
were forwarded to local Medical authorities in the vicinity of the coast stations, the number
of British and foreign vessels using the service has steadily increased year by year.
We are informed by the General Post Office that 289 requests for medical advice were
received last year involving 921 messages between ships and the medical authorities ashore.
These included 129 requests from foreign ships. These figures indicate a considerable
increase over those given for the preceding year and, in general, the statistics provided by
the General Post Office for recent years indicate a growing demand for the service.
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