HEALTH PROBLEM.

Taranaki Daily News, 11 May 1923, Page 6

HEALTH PROBLEM.

CHILDREN IN HOSPITAL. NUMBERS CAUSE ANXIETY. INVESTIGATING THE REASONS. AN IMPORTANT CONFERENCE. The large number of schoolchildren in hospital has been exertising the minds of the Taranaki Hospital Board and the Taranaki Education Board for some time past, and, with the desire to discover the reasons for representatives of these two bodies met at New Plymouth yesterday to discuss this important problem of health. The profitable discussion that ensued, bringing to light as it did many of the probable causes of infectious diseases, should form a solid basis for investigation into a matter that so vitally concerns the welLbeing of schoolchildren, with a view tc the imposition of preventative measures which will minimise as much as possible the danger of infection. The chairman of the Hospital Board (Mr. M. Fraser), who has always taken a keen interest in this subject, presided. Other hospital board representatives present were Messrs. Vickers and E. Gilmour (members) and Ek Holden (general manager). Messrs. P. J. H. White, S. G. Smith, M.P. (members), and H. W. Insuil (secretary) were the Education Board delegates, while the inspector of health for the Taranaki district (Mr. F. W. Swindells) was present by invitation. Owing to indisposition, the chairman of the Education Board (Mr. A. Lees) was unable to attend. “I suppose I am primarily responsible for the many reflections that have been made upon the very large number of children coming to the hospital,” said the chairman, in opening the discussion. Mr. Fraser explained that for 27 years he had lived close to the Central School and had met the children two or three times a day; therefore, he had taken some interest in their welfare, especially as he had afterwards seen some of these same children in hospital. Six years ago, when he egme to the board, table, he had noticed the large number of children coming to the hospital. This had prompted him to investigate the conditions in the Old Country, and he found that great stress had been laid on the value of open-air schools. The foundation of the health of a district, he believed, began with the schools in that district, but the ventilation of some schools was terrible. EPIDEMIC IN SCHOOLS. The Taranaki hospital district contained over 30,000 people, proceeded the speaker. How many of these were schoolchildren he did not know. In such an extensive district children were coming into the hospital from all directions. Quoting the figures for the month of April, the chairman said there were in hospital 51 schoolchildren (30 boys and 21 girls), or, in other words, more than half of the number of patients in hospital were schoolchildren. Mr. Fraser recalled the scarletina epidemic that occurred at the Fitzroy school. On that occasion someone had been very much to blame. The school had been closed on account of the epidemic, and a few days later many of the children attended a picture show. Consequently, 17 cases had to be sent to hospital. That meant that isolation had to be provided. It meant also that nurses in that ward had to work 12 hours at a stretch, and under such work it was no wonder they generally “broke down.” Schools should be very particular when an epidemic broke out to see that the school was isolated and the children stopped from going to the pictures, to church, to Sunday-school, or other places in a crowd. Health considerations must come first. During the summer holidays, 28 children were operated upon for tonsils and adenoids in the New Plymouth hospital, proceeded Mr. Fraser. These were chiefly New Ply mouth schoolchildren. This was a very painful operation, and all efforts should be made to ensure that children did not fall into a position necessitating the operation. Asked for his opinion, the medical superintendent at the hospital (Dr. G. Home) had replied: “The prevalence of adenoids and toiyjil enlargements in New Plymouth is largely due to conditions of atmospheric moisture, whereby there is a tendency for moisture to remain in the upper air passages instead of being more dried out as they would be in a higher and drier locality. This extra secretion in the nose and throat acts as a culture medium for any germs which happen to arrive in it, and repeated mild infections, not any one of them perhaps serious enough to call for treatment, cause an enlargement of the ring of filtering lymphatic tissue at the back of the nose. This enlargement constitutes adenoids and generally it requires surgical removal, for it is so placed as to seriously interfere with the passage of the breath through the nose. The condition is certainly aggravated, and the chances of extra infection greatly increased, by crowding children together in any not very adequately-spaced or ventilated room. The nose and mouth are the portals of entry of nearly all diseases due to microbes, and they would resist quite a large number of microbe invasions if kept healthy. Supply of fresh air, day and night, is the most important means of keeping them healthy. Decayed teeth are a fearfully common cause of unhealthiness of the tonsils and throat, and from these of the body generally.” PHYSIQUE OF CHILDREN. “The conditions of the schools require drastic changes,” said Mr. Fraser, in urging that on hot days especially the children should be taken out in the open air fof lessons for an hour, in order to let the rooms ventilate. The speaker said he was not dictating to the Education Board, but the fact remained that in December last 28 operations for adenoids had been performed in hospital. As soon as the schools closed for the holidays the children seemed to be sent in for the operation. The British Educational Department had set up a consultative committee to.go into the very question of the health of school children. Their report stated: “It was recognised that girls in general are not so strong physically as boys, and are more highly strung and liable to nervous strain. Medical statistics indicate that there is a higher percentage among girl pupils of cases of anaemia, spinal curvature, defective .eyesight and minor physical defects. It appears that the time given to domestic subjects does

not relieve the strain on girls. There is evidence that girls are much less able to protect themselves against over-pressure than boys, who have, as a rule, a habit of healthy idleness, whereas girls are more conscientious. If you give a girl too much to do, she breaks down. If you give a boy too much to do, he simply does not do it. The committee conclude that the predisposition of girls to nervous overstrain is one of the most important features of female education. The greatest liability of girls to fatigue should be taken into account on arranging the curriculum in mixed schools.”

“It is for the Education Board to say whether or not the Hospital Board is right in its contention that there is not sufficient fresh air in the schools,” proceeded Mr. Fraser, in pointing out the opinion of Dr. Elizabeth Gunn (school medical officer) that the number of children in hospital was in part attributable to overcrowding in schools. The speaker thought that the proper care of the teeth safeguarded children’s health, for he had noticed that since the inauguration of Dr. Gunn’s scheme there had been less trouble. “I have not made these remarks in a faultfinding spirit,” concluded Mr. Fraser, “but in recognition of the value of the health of children.” BIG STRIDES MADE. “I am sure the representatives of the Education Board are very pleased to meet the Hospital Board, as nothing but good can come from the discussion on this important subject,” said Mr. White. The Education Board was anxious that the very best conditions should prevail for the children while they were at school. The matter raised was vital. The conditions under which the children were now taught were to some extent an improvement on the conditions of a few years ago, but they could be still further improved. Big strides had been made in the last seven or eight years, not only in the sanitary conditions and the system of ventilation, but also, he believed, in the knowledge both teachers and children had on points of health (clean teeth, diet, etc.). This work should be continued on right lines. Mr. White said that, of the children in hospital, comparatively few seemed to be from New Plymouth itself.

Mr. Fraser: The figures are for one month only. We will be able to supply you with other reports from time to time. Continuing, Mr. White said the Education Board regretted to know of the scarletina outbreak at Fitzroy and the subsequent visit paid by the children to the pictures, but the board had no control over it. In any ease, it was quite a moot question as to whether it was advisable to close schools during the progress &f an epidemic. How could a layman decide when medical men differed ? In the towns, when the schools were ordered to be closed, the children generally played round indiscriminately. In the country it was different, because settlement was scattered and the children usually remained on the farm. The Education Board had tried to make the sanitary conditions of the schools as good as the money allowed, but it was most difficult to keep track of everything. He believed Mr. Fraser had touched onia vital point in stressing the importance of diet and the care of the teeth, the neglect of which caused so many cases of adenoids. As a knowledge of the care of the teeth extended, so he believed would the number of cases of sickness among children diminish. SHOULD SCHOOLS BE CLOSED. “We are very much obliged to you, Mr. Fraser, for your interest in this matter, and for the valuable information you have given us,” said Mr. Smith. Touching oh the references made to the closing of the fitzroy school, the speaker said he ha*d heard two doctors having a discussion on the advisability of such a procedure. It had been shown conclusively by one of them that, under proper supervision, very little value attached to the closing of schools during the course of an epidemic. During recent times great progress had been made in the conditions of schools. Dr. Gunn attached value to open-air schools and he believed there was something in ■her contentions. For eleven years the Central School had suffered because the central authorities in Wellington would do nothing until last year, when the board was allowed to remodel the building out of the special rebuilding fund. These alterations had not been made to accommodate one extra pupil, but to provide better facilities for the passage of fresh air through the school. The new infants’ school at Courtenay -Street, from the point of view of light and fresh air, was, he believed, one of •the most modern schools in New Zealand.

As a result of the improvements in the school buildings the health of the children had noticeably improved, continued Mr. Smith. Regarding the number of children attended during the Christmas holidays, this was caused by he fact that parents were anxious that children should not miss school. Mr. Fraser: That is very wrong. If the Hospital Board could let the Education Board have periodically a list of the children in hospital and the localities they came from, Mr. Smith suggested that this would give the Education Board the opportunity to make personal investigations, in company with representatives of the Hospital Board and others whom it might be desirable to co-oiperate with. These investigations should not be confined to the New Plymouth district, but should extend over the whole of the Taranaki education district. As a result of the publicity given to the importance of the matter, the Education Board would do its best to get to the root of the trouble and minimise the causes as far as it could. He did not agree entirely with the authorities quoted by the chairman, as they dealt largely with conditions obtaining in big industrial centres of England. The conditions here, except in isolated capes, could hardly be the same. “DISGRACEFUL -CONDITIONS.” The Taranaki Education Board was imbued with the desire to build good schools with plenty of floor and air space. It had been the habit of teachers to take the children outside for lessons, hut the real difficulty was the central authorities in Wellington. At one school he had visited there were 59 children and the school was not big enough to hold them all. Consequently some had to be accommodated in the shelter shed, while on wet days they had to be sent home because of the lack of accommodation. The Wellington authorities had suggested closing the school altogether and making the children go to some other school. While the speaker thought the scheme of consolidation was good, the children at Kent Road should not have to be taught un*

der disgraceful conditions because of that theory. A great deal of good, he was sure, would result from the publicity given to the investigations being made into the question of the children’s health, and the Education Board w-ould co-operate whole-heartedly in an effort to lessen the hospital population by bringing about better conditions for the children.

“In blaming the central authorities you must remember that Mr. Parr, who ds Minister both of Health and of Education, has, during his term, given £1,500,000 more than the £3,000,000 allocated for schools,” said the chairman. “Whatever the trouble with the authorities, I feel sure it’s not Mr. Parr’s fault.”

■Mr. Smith: My remarks wer.e not intended to wholly blame the Minister. Mr. Fraser said he felt the work being done by Dr. Gunn was not appreciated to the extent it should be. His own opinion was that the schools were particularly fortunate in having an officer of such ability. “The district is too large for her,” said Mr. Smith. “Last year she spent only two months in Taranaki and ten months in the Wanganui district.’ The disgraceful conditions prevailing at the Kent Road school was emphasised by Mr. Gilmour, who recalled seeing children housed out in the shelter-shed i the rain. “If ever a school wanted attention, it does,” he said. Mr. White mentioned that both the board and the department were* now dealing with the matter. IMPURE DRINKING WATER. Appreciation of what the Education Board members had said was expressed by Mr. Vickers, who thought the two boards could do something to locate the evils that existed. He recognised that the department had been fairly liberal in the expenditure on schools, while the Ikiueation Board members had done their utmost and would continue to do so. A solution of the question would mean much to the rising generation. Doubts as to the purity of the drinking water in some school tanks were mentioned by the speaker, who said he J had taken samples of water. In sum-mer-time, especially,, the water in the tanks was totally unfit for human consumption at all, 'but some children drank the water when in a state most likely to give infection. The sanitary arrangements at some schools were also far from satisfactory. If the inspector of health for the district cauld furnish a report on some of the schools, the speaker felt this would help to get at the root of the trouble. Ho further suggested that sprays should be provided for use on the walls and floors of some very old schools, where dust and germs collected. All tanks should be fitted with filters. Mr. Smith: That has been tried. Mr. Vickers said tht? effort should not be given up. In some cases well water could be procured quite close to the school. All that was necessary was to cover the top over in cement and fit the well with a suction pump and tank. HOW DISEASE SPREADS. A desire being expressed to hear the views of the health inspector, Mr. Swindells said the health department was concerned more particularly with infectious diseases. In investigating these it was generally found that other conditions led up to these diseases. In 'his district, he was pleased to say, the number of infectious cases had decreased considerably, as the following figures showed: 1916, 261; 1917, 203; 1918, 472 (influenza epidemic); 1919, 275; 1920, 895 (recurrence of epidemic in mild type); 1921, 233; and 1922, 188. All school children came into contact with conditions which made them suffer in consequence. The teachers had full powers to exclude children Who were

suffering from infectious diseases but, as it was, salaries were based on average attendance. If the method of capitation by paying on attendance was altered, then some good might result, as a teacher would not hesitate to send a child home that was infected. Again, some school committees were apathetic, principally in the country districts where the teachers had practically to manage the whole of school affairs. Further, children not well born, owing to their weakened condition, were liable to catch any infectious diseases that were prevalent. As regarded the Fitzroy case, referred to by previous speakers, since the precautions taken in the use of plasticene, disease had diminished considerably, as was also the case at Tikorangi. amount of disinfectant in plasticene was so small mat it was practically of no use. As it was, the plasticene, used as common property among the children and passed from one to the

other, spread disease. There were other articles used in common in schools, a practice that should be discontinued. The general .practice of closing schools during epidemics had no value, particularly in towns, where the children played about together. The actual contacts should, of course, be isolated. On behalf of the Education Board, Mr. Smith thanked Mr. Fraser and his colleagues for the opportunity given of meeting together. The conference had been well worth while, and he believed it would result in great good to the community as a whole.