HEALTH WEEK.

Otago Daily Times, Issue 18991, 12 October 1923, Page 4

HEALTH WEEK.

WELFARE OE THE INFANT. VALUE OF ANTE-NATAL AND POST-NATAL CARE. MEDICAL INSPECTION OF SCHOOLS. EFFECT OF GARDENING ON HEALTH.

In the Health Week campaign, being so Rigorously prosecuted hero just now, yesterday was largely devoted to infant welfare topics, addresses by experts in various subjects being given in the afternoon and evening. Demonstration to Girls. The programme for the day opened with a most successful demonstration in tho Burns Hall to Fifth and Sixth Standard girls brought from all over the city and suburbs and from as far as Mosgiel. Inc demonstration of how to care for a baby was given, bv Aliss R. A. Buisson, matron of tho Karitane Hospital, am! nurses from that hospital. The girls crowded every part of the building and watched with intense interest all that was done by_ these highly skilled experts. After a brief introductory talk had been given, the nurses took a baby, and with it went through all tho processes of dressing and undressing, bathing, and feeding. They also showed exactly how a baby’s oot should be made. While these demonstrations were being given another of the nurses explained to all the watching girls exactly what was being done. Finally, Nurse i Mntheson gave them a practical talk on physical exercises and their value to health. This most instructive and novel gathering lasted only a little over an hour, and conveyed to the girls a great deal of valuable Information that will not be quickly forgotten. AFTERNOON MEETING. Airs J. A. Johnstone presided at the jfteriioon session, at which there was a .airly good attendance of women. Ante-natal and Natal Care. The first speaker was Dr Russell Ritchie, uid his subject was “The_ Importance of Anle-natal and Natal Skill in tho Preservation of Infant Life.” At the outset he explained that ante-natal meant before birth, and referred to the whole period of pregnancy, while natal meant during birti. or the time of confinement. The object of his few remarks was to show how very important is the proper care and supervision of the expectant mother at these times in order to primarily preserve _her health and life, to prevent complications before or at her confinement, and by so tloing to ensure the birth of a mature, healthy child. The toll of human life was greatest during the first 12 months after birth, and it was only fair and right that wa should attempt to give the new-born infant a chance by seeing that it was not born in an injured—congenitally, disabled, or premature state. In this respect he was convinced that a great deal could be done by ante-natal supervision just as surely as post-natal caro could help to protect its life after birth. Largely owing to the great work that had been done by Dr Truby King and the Plunket Society the death rate of infants under one year was now, he believed, the lowest in the world, and during the last 10 years had fallen from 51 per 1000 to about .42 .per, 1000.-c. . >Ve., must not forget, however," that the' birth rate in New Zealand had been gradually falling from 41 per 1000 in 1878 to 23 per 1000, or nearly half, in 1922, and that it was usually found that countries with a low birth rate had a correspondingly low death rate. This decreasing birth rale was at the present time a problem in many countries, and many were the ways that had been recommended to combat it, so far without any great success, but there was no doubt that ante-natal wmk had helped and was going to help still further in staying this alarming decrease. Prevention was always better than cure, and for some years now preventive measures had occupied a prominent position in all branches of medicine. In the words of Sir George Newman, a pioneer in this work, preventive medicine sought to reduce and, if possible, abolish invalidism and physical disability and to postpone the event of death. Ante-natal hospitals, or clinics, were now universally recognised as a most essential, if not the most essential; part of a maternity hospital, and were to be found attached to most of the maternity institutions ail the world over.- Here in Dunedin we had two such departments, one at St. Helens Hospital, under the supervision of Dr Siedeberg, and the other at the Batchelor Hospital in Forth street—the hospital the late Dr Batchelor did so much for and succeeded by his efforts in establishing some 15 years ago. At tho Batchelor Hospital, to which he was attached, an ante-natal clinic was held every week, when expectant mothers come for examination and advice. Their general health was investigated, they were given simple advice by himself or the matron in health matters, and the importance of careful living, fresh air, exercise, baths, drinking of water, avoidance of alcohol, care of the teeth, etc., was stressed. Special examinations were made with a view to finding symptoms ol trouble that plight be prevented. They were given printed instructions, explaining the importance of certain symptoms and urging them to at once notify the hospital or_ a doctor if such symptoms appeared. They were also told to come back at stated intervals for further examination. .If it was found at any of these visits that symptoms requiring treatment were present thov were admitted to the hospital at once or were given advice as regards treatment in their own homes. It may bo asked: “What was gained by all this examination?” If a patient was found fit and well with no signs of trouble or complications, surely it must be some comfort to such a person to know this, and to bo assured that all was well. Undoubtedly peace of mind at this time was ot tho greatest importance to her. Then on tho other hand conditions might bo discovered which could bo easily and often successfully treated, but which if unrecognised or left too late might cause severe illness or even the death of both -mother ruid child. Again, there was no doubt that *4ire and supervision during pregnancy ensured in many cases an easier confinement, prevented complications, limited the risk of infection, and of other complications after confinement. It also helped to prevent miscarriages, premataive births and still births, and reduced the number of unfit and con"enitably disabled babies. Recent statistics in Now Zealand showed that although the infant death rate is low,' far too many babies died from congenital causes—that was, causes present before and at birth. In 1922 in New Zealand over 60 per cent, of the babies lost died in the first month of life from congenital conditions. Surely ante-natal care could do something for this slate of affairs. The chief problem which faces doctors was to convince women of the necessity of early examination and care. AI any would not reabso its importance, and too often the doctor was called in late when troubles had arisen which were difficult to treat. Alanv gocined to wait until serious symptoms compelled them to send for assistance, and thev appeared to take no notice of warning symptoms which were nearly always present Another difficulty was that many expectant mothers lived in out-of-the-way districts and could not spare the time or money to obtain advice in the earlier months, and were too often seen for the fir=t time at their confinement, I'or such people much could be done by the provision of' a cottage home with t rained mat emit,v nurses in tho nearest township. If such provision could be made by the various hospital boards all over the country a great saving could be effected in material and infant disability and loss. It ought to bo possible in this country for every expectant mother and her unborn chid to receive proper ante-natal care either from her own doctor or through maternity hospitals and homes. In conclusion, he again urged that these matters bo more fully ventilated by suitable propaganda in order to educate dm public to their importance, for it was only bv so doing that a reduction of maternal ami infant loss would he effected, which was so essential in a young and growing country like New Zealand.

Post-natal Care. Dr E. Williams spoke on the subject of “Infant Welfare; the Plunket Society; Tho Value of System in Post-natal Care.” Ho said wo had been witnessing for some years tho wonderful results of the organised education of public opinion in tho proper caro of infant life. The Plunket Society started nearly 17 years ago as the result of the enthusiasm and driving power of Dr Trnby King, and its success had been largely due to the simplicity of the principles involved and tho enthusiasm with which Dr King was able to inspire others. What were the important points about this society's work? It began with the institution of a small creche with such wonderful results that it was followed by the founding of the Karitane Hospital at Anderson’s Bay, which bad steadily grown ever since. Ihe objects of tho institution wove numerous. It was for iho caro of sick babies needing special attention. It was also designed to he an educational centre for mothers and girls who might some day become mothers. Tho great majority of school girls showed an obvious interest in babies. A baby was a very complex piece of machinery, and it required quite a lot of attention. Why should it not be common for girls to learn about the peculiarities of their friends’ babies? In time theie would be provision made at Karitane for tho care of perfectly normal and well babies so that people might be taught about them. A third object of tho Karitane Hospital was the training of nurses, a work the importance of which had been recognised by various countries far beyond New Zealand, which had sent nurses to be trained hero, Plunket nurses were expected to tench mothers the simple points in mothercraft and to make them able to recognise illness. They always advocated, and even urged, tho importance of breast feeding. In country districts particularly the Plunket nurses were of the greatest value, and their activities were a great factor in the reduction of infant dealths. The department working under the Infant Life Protection Act. arranging for the boarding-out of babids who would not otherwise obtain proper care, was another organisation that did much to reduce the death rate. Congenital defects accounted for a considerable proportion of the deaths that occurred during the first year. There was no doubt whatever that ante-natal care might prevent many cases of illness now included under the .hooding of congenital debility. Prematurity was another cause of numerous deaths. A premature baby was making very little heat and expending a great deal of heat. There was provision at Karitane for caring for premature babies, and as a result of the caro they got there they had survived and grown into comparatively normal infanta. If such infants were sent there they must be sent with duo care taken for their welfare on the journey. With regard to tho known congenital causes of death, such as pneumonia, measles, whooping cough, etc., tho babies suffering from these diseases were frequently sem. to a hospital in order that they might get satisfactory attention. It was essential that all large hospitals should have a children’s departments where the services of a nurse who had had a special training in infant welfare would be available. Otherwise there was a risk that infants .plight fail to get the attention that was necessary. Before the inception of the Plunket Society gaslro-entcritis loomed very large in New Zealand as a cause of the death of infants, but at present the number of certified deaths due to that trouble was very low, especially in Dunedin. The spread of knowledge amongst mothers and householders generally had 1 had the effect of avoiding diseases which in nearly all cases were due to carelessness or want of knowledge in the preparation of food. Tho Plunket Society would always show* the best way to look after the milk for an infant. This had undoubtedly been tho cause of an extraordinary and gratifying drop in what was. formerly a fatal disease amongst infants. In the next few years the people would see greater strides made than had been witnessed so far, but many changes would be necessary before perfection was reached. During tho afternoon Mrs Birch Johnston sang a song featuring “ The Plaint of the Little Bisque Doll,” and a sketch entitled “The Antiseptic Baby” was given by Miss E. Holland. Both items were well received, and the performers were accorded hearty applause. At the close of this meeting a maternity lecture demonstration to women onlv was given by Miss Holford, matron fet. Helens Hospital, and Alisa R. Every, matron of tho Forth Street Hospital. Evening Meeting. There was a large attendance at Burns Hidl ot the evening meeting, over which Air E. Sincock presided. The two speakers of the evening wore Dr Emma Irwin, school medical officer, and Dr F. Truby King, C.AI.G., director of child welfare. The proceedings were varied by an exceb lent gramophone selection and by songs from Miss Jessie Miller (“Charming Chios”) and Air Douglas Craigie (“From Oboron in Fairyland”). Aliss Craigie provided the accompaniments. Medical Inspection of Schools. In the course of a brief address on “The Aledical Inspection of Schools,” Dr E. Irwin, school medical officer, explained that in making an inspection of school children they .sought to determine the physical needs of the children, and they tried to make suggestions for the remedy of any defects that were discovered. By the accumulation of statistics they were able to make contrasts between children in different environment and in different parts of the country. The object of medical inspection was the iiltimate hope that disease might be minimised and children made more physically fit, so that the amount of crime, insanity, and physical degeneration might eventually be reduced. In the physical development of children much depended on the instructions in tho service of the Education Department. These people carried on a valuable work in a most efficient manner, at least so far as Otago was concerned. The speaker proceeded to illustrate what tho physical instructors had done in the direction oi remedying defects of the body. It was realised that the instructors were under a groat disadvantage in some cases. Much labour would bo lost altogether in seeking to correct some of the deformities to which she had referred. Clothing was a very important matter to be considered in relation to ehildren, and parents should remember that if they_ wanted physical perfection in their offspring they must pay special attention to the looseness of their garments. She had paid special attention to this matter, and had examined a great many’ children, both in the town and the country. It was frequently found that the condition of affairs in this respect was very serious. In regard to ailments tho question of goitre had been considered, and she hud examined the children m the schools hi half the Otago district. She bad prepared statistics with the object of ascertaining whether any particular locality suffered more from goitre, than another. Her investigations had led her to the conclusion that there was a greater incidence of goitre round Balchitba than in rile 'other schools which she had examined. _ She had approached the Government with a view to securing free treatment for one year for the children of the Balelnlha School, and her suggestion had been agreed to. Tho treatment was commenced about three weeks ago. The mirenls of 412 pupils out of 460 had agreed to treatment on preventive lines for goitre. By means of a number of lantern slides Dr Irwin illustrated a number of defects in children, and showed what had been accomplished in tho way of remedial measures in many cases.

In Pi aise of Gardening. Dr King’s subject was “Gardens and Gardening in Relation to Personal and National Health.” At the outset lie said lie owed something of an apology for pattiim- this subject before a Dunedin audience, as it was like bringing coals to Newcastle. It was widely recognised that Dunedin was essentially a city of the best conducted Amenities Society and cult of gardening that there is in this dominion. 'J.his Dunedin owed mainly to the enthusiasm and labours of Mr Bathgate and Mr ’lannock. The lecture, as a matter of fact, had not boon prepared for Dunedin but for Wellington Health W 7 eek. Anyhow, it was a change from speaking to a Dunedin audience about child welfare and tho Blanket Society.— (Daughter.) Child welfare was his raison d’etre, but gardening and farming were his hobbies, and he supposed a man was entitled to speak of his hobbies sometimes. Ho prefaced his pictures by drawing attention to the great advantage possessed by the ovo over the ear as a medium of instruction and interest. Lnquostionably farming and gardening and such open-air pursuits weie tho most natural occupation of man and' tho most healthy for the race. Nevertheless inere was the groat tendency to aggregate into cities, and so wo had to make the conditions there as closely approximating us possible to the conditions of the country. Every city dweller should have a section large enough to keep him in fvilit and vegetables all the year round and that was a perfectly possible ideal. Ihose could bo grown on a very small area particularly such vegetables as mustard and cress, which could be grown even in a window garden. It was wonderful what people did even in tho blast End of London m this way. It did tho man of the house a world of good to have a lot of his time m the garden instead of watching sports teams and doing nothing himself. This was one of tlie ies ■ features of tho gardening cult, that it took a man home to his wife and family and to the highest joys. There was no excuse for them in Dunedin not having good gaiclens with tho aid and example of » m«n a. Mr Tatmock. who was envied them bv all the rest of the dominion. The first of the pictures thrown on die screen illustrated the wonderful ments made on Dr King s teraki chiefly by the use of mauam , glass. Bv a judicious use of the forces o. Nature and the provision of shelter to begin with a wonderful growth of yogeUtion had been obtained. Many of the scone V n J? n * 111 own garden there were very dm min . I paid a high tribute to the work of Mr Bathgate in beautifying and reclaiming barren areas, and illustrated from his own experience how loyally school chddion wmill care for the beautifying of their schoo "rounds if they wore properly treated and put on their honour. When he went to Wellington he was faced witn the position of having cither io buy his fruit and vegetables from Chinamen or to grow his own His yard was a most sterile niece ot ground over-run with the roots of pinus insignia from neighbouring sections. lie made war on those roots, and a photo taken nine months later showed scarlet runner beans 12ft high, rhubarb, vegetable marrows. tomatoes, Indian com, and other vegetables and fruits growing with extraordinary vigour. Another senes of photographs showed tho remarkable beautifying work carried out recently on a steep hill in Wellington which had long been allowed to remain as an eyesore. Then followed a charming series of pictures of the Dunedin Botanical Gardens, of which the lecturer was enthusiast io in his praise. Several photographs illustrated the great wealth ot roots possessed by tho asparagus, and the lecturer accompanied these by some valuable practical advice on tho growth of asparagus. Nature was so prodigal m her giving that the wonder was that vegetables were so clear. Raw carrots and raw turnips were really admirable foods if they were properly chewed and aided digestion. In closing ho drew' attention to the wmndrous prodigality of Nature in providing for tho continuity of the race and the handing on of the, lamp of life. Any nation which did the right thing in regard to tho next generation could not be far wrong in its religion. He suggested that at the coming Exhibition Mr Tannock might be asked to repeat a most valuable exhibit lie gave some years ago of the right and wrong methods of dealing with baby plants. On the motion of the chairman, the audience carried by hearty acclamation votes of thanks to both tho speakers. Rotary Club Luncheon. ADDRESS BY DR ABKIBBIN. There was a fairly good attendance at the Rotary Club luncheon, which was held in the Savoy yesterday. Sir George Fenwick occupied the chair, and the speaker for tho day was Dr ABKibbiu (District Health Officer), who delivered ii short address on tho aims and objects of Health Week. In the course ol his remarks Dr M'Kibbin said ho took it for grunted that Rolarians were out to help them to that higher plane of civilisation and of health to which Ilygeia pointed and to leave this dominion better than they found it. It was a tribute to the noble tenets of the practising profession of medicine that one of their number had let a salaried health officer loose upon his fellow Rolarians. The traditions of medicine were noble even though her methods for disease prevention were not yet model. Some men thought _ that Health Week was a preaching campaign to exhort and instruct slum dwellers and poor people in personal and household cleanliness. It had been said that if they pulled down the skims and built a few decent collages they would not need a Health Week. Other advice was extend the sewers—see the doctor earlier—build more public hospitals, have campaigns in the schools and train the young idea, for tho adults are hopeless. Health Week was not for tho slum dweller or the working man. It was for all —the ruler, tho statesman, the politician, the local body representative, the thinking public, and the health officer. We Now Zealanders were lucky. Wo lived in a hind of milk and honey, of wide open spaces and sparse population. Wo therefore had good general vitality, a low death rate, and a very low infant death rale. This was only in relatively small measure duo to our foresight and our work. We could point to individual examples of zeal in preventive medicine, to a few men who had earned fame in the prevention of disease, bo it infant or adult. We could justly claim that wo were advanced, even lavish, in the provision of hospital beds, that many of our municipalities had registered records in the reticulation of drains, and high pressure water supplies; but for the most part our good health state was a form of greatness that had been thrust upon ns. We hoped to increase tho population of our dominion. With that increase, be it natural, or acquired by importation, ' our troubles would begin. But first and foremost, why should that increase not ho natural. In the seventies the human birth rate in Now Zealand was 41 per 1000 of population, whereas last year it was only 23, and last year a substantial proportion of those births even were illegitimate. Marriage, where it occurred, was in considerable measure enforced, not optional. Healthy, virile youth abounded in the dominion. Gould wo not, as a democracy, do more io make marriage easy and assist more in the maintenance of large families. If wo did that we would approach tho solution of our two most important problems--viz., the normal, natural increase of our population and the reduction in the incidence of two comagious diseases that caused more devastation than any other pathological condition and constituted tho chief cause of ill-health, premature old age, crippling, and death in civilised countries. Our cities were growing older and larger. Under democracy we wore given tho opportunity to plan the development of city, town, and village in tho interests of the community as a whole. Wc should set about it both for health and for economic reasons. Wo -were faced also with the. problem of insufficient and unsuitable house accommodation. Insanitary houses and overcrowding of persons in houses were far more harmful to health than overcrowding of houses on space. r f li is had been definitely proved time and time again. Common acute infectious disease such as tuberculosis, diphtheria, and measles wore more fatal and more frequent where houses were overcrowded ami unhealthy. Yet given a. good dwelling, filthy and unhygienic conditions might still exist, brought about usually by acquired or hereditary disease of one or both parents, usually prevontiblo disease. We were forced to consider the younger inmates and also the effect of such disease centres on the health of the general population. We should vigorously attack all preventable disease? rather than wait to cure thorn. Although the span of man’s life had been prolonged and the incidence of some infectious diseases was steadily decreasing, tuberculosis, influenza, measles, and acute rheumatism were still prevalent and with venereal disease led lo much disablement and mortality. Yet in the whole of Otago and Southland, with a population of over 200,000, there were only three medical practitioners (one medical officer of health and two.school medical officers) definitely employed to prevent disease. All others were primarily curative and wo did not pay them to prevent. In England from 30.000 to 50,000 persons comprised a health district for a full-time medical officer of health and there was a school medical

officer to each 40,000 of the general population. Systematic disease prevention then was only iu its infancy. Had they not noticed tho surprise and consternation of the public when the medical examination of school children revealed a substantial degree of physical and mental impairment? The real marvel was that the children aro not worse. On tho whole they were bettor iu Now Zealand than in most other lands. The primary purpose of a Health Week then was to convince each and every citizen that if not from choice then from necessity ho was his brother’s keeper. We had ahead of us a lengthy policy or platform which could only find fulfilment hy degrees. They had started at the beginning, which was education. Then they must pursue their course with foresight and circumspection, with open mindedness and forward looking thought, and always with tile consent and understanding of the community. On the motion of Dir P. 11. Sargood a hearty vote of thanks was accorded Dr M.'Kihbin. Subsequently a few remarks on town planning were made hy Mr J, L. Salmond.