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PART lII.—SCHOOL HYGIENE.

T have the honour to report on the work of the Division of School Hygiene for the year ended 31st March, 1939. Historical. Tn 1904: a scheme for the medical inspection of the New Zealand State school scholars was prepared under instructions from the Hon. Mr. McGowan, but although the scheme received the approval of the medical and educational authorities the Government of the day was unable to see its way to apportion the money necessary for its establishment. Had this scheme been put into operation then New Zealand would have been foremost in the matter of school medical inspection, for the English Act making provision for the medical inspection of public elementary schools was not passed until 1907. However, in 1912 authority for the compulsory medical inspection of children attending State schools was placed in the New Zealand statute-book. Previous to that time the only regular examinations that were made of school-children in New Zealand were in respect of scholars attending some of the larger secondary schools and private schools. At its inauguration the scheme was under the jurisdiction of the Education Department, but in 1921 the control of the School Medical Service passed to the Department of Health. The late Mr. George Hogben, M.A., then Director of Education, was the keenest advocate of universal medical inspection in schools and, with the School Medical Officer stationed in Wellington, gave much time and thought to the arranging and carrying-out of the scheme at its inception. The service began unpretentiously. The original staff consisted only of four officers (two men and two women) one stationed in each of the four main centres, and children in Standard ll—that is, children averaging eight to ten years of age —were selected for routine examination. The men did not remain long in the service, and their places were filled by the appointment of two more women. The two original women were Dr. Ada Paterson, who became Director of the Service in 1923, and Dr. Elizabeth Gunn, who was appointed Director after Dr. Paterson's death in 1937, and who still holds that position. The actual scheme of the School Medical Service, the putting of it into operation, the raising of it from obscurity to generally recognized importance was the privilege of four young medical women who controlled the scheme from North Cape to Stewart Island. The adventure of launching a new branch of State activity, very urgently needed, the satisfaction of converting suspicion into friendliness, the interest of exploring a new field of medicine was fascinating work. The travelling then was of the hardest—bad roads, slow trains, horses and traps, bicycles, or walking made heavy work, where now the travelling is done in a motor-car. Few women travelled then, and the country hotels made little or no arrangements'for their comfort. Many school-teachers and even Education Boards regarded the School Medical Officer as an interfering interloper whom they would have liked to order off the premises, and tact had to be used to enter the schools amicably, but when they came to understand the nature of the work and to realize that the School Medical Officer was there to help them in matters of cleanliness and sanitation and to advance preventive medicine the visits of the medical officers were demanded and welcomed. When this work commenced there was no office accommodation, no nurses, no clerks, yet during the year 1913, 333 primary schools were visited and 12,357 children medically examined ; of these children, 7,661 were pupils in Standard II taken at routine examination, and 4,696 were special cases thought by the teachers to be suffering from some defects. That year also the heights and weights of 17,000 children were observed and recorded. In 1916 the addition of seven school nurses to the School Medical Service was an important step. Besides assisting the medical officer at the inspection of the children, school nurses visited the parents and gave advice and assistance in connection with such matters as diet, clothing, and the treatment of minor ailments and injuries ; nurses also were able in a large number of oases to follow up the reports of the medical officers and by personal contact to persuade parents to obtain medical or dental treatment where this would otherwise have been neglected. By 1917 the medical staff had increased to seven and the nursing staff to ten, while in 1919 the medical staff numbered ten and the nursing staff fifteen. The number of schools visited in 1919 was 704, while the number of children completely examined was approximately 30,000, and a much larger number were partially examined. With the passing of the Health Act in 1920 the officers of the medical inspection of schools branch were transferred from the Education Department to the Department of Health. This transfer took place in 1921, when the branch came directly under the control of a Director appointed to take charge of the newly created Division of School Hygiene and the staff increased to thirteen School Medical Officers and twenty-seven nurses, distributed throughout the Dominion as follows : — Medical Officers. Nurses. North Auckland .. .. .. .. .. 1 2 Auckland Central . . .. .. .. .. 2 4 South Auckland .. .. .. .. .. 1 2 Wanganui and Taranaki . . . . . . . . 1 2 Hawke's Bay . . . . . . . . . . . . 1 2 Wellington .. . . .. .. .. .. .. 1 3 Nelson and Marlborough .. .. .. .. 1 2 Canterbury .. .. .. .. .. .. 2 6 Otago .. .. .. .. .. .. 2 3 Southland . . . . . . . . .. . . 1 I 13 27 In 1921, 1,356 schools were visited and 78,980 children examined completely or partially. 5 11. 31,

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