(J2 i - - /“V Jv“> « / ! V Ll -"•■• ,-f 1%^ ni-^ ■' \ L/*- I &L ,* Kf, / , .,/„ f/ 1/ 2 iS- ■{ o -Jp f If Library WEALD OF KENT HEALTH AREA 1943 PUBLIC HEALTH REPORT ’ by THE MEDICAL OFFICER OF HEALTH. A. V». GAYE, B.A., M.B., D.P.H. (Cantab.) it I 1. WEALD OF KENT HEALTH AREA To the WEALD OF KENT HEALTH COMMITTEE - Mr. Chairman and Members, I have pleasure in presenting the fourth Annual Report for the Weald of Kent Health Area. The Statutory Health Committee for the year was constituted as follows Chairman E. E. SELMES,~Esq., J.P. Tenterden Borough. Mrs. Adams. Dr. T. Martin. Cranbrook Rural District A. B. Burney, Esq. Mrs. Clayton-Jones . Miss A, D. Hindle. Clerk to the Committee Office Maidstene Rural District W. Day, Esq., J. B. Leaver, Esq. J. A. Raynham, Esq. Tenterden Rural District C. H. Brown, Esq, E. E. Selmes, Esq., J.P. - P. G. Banfield, Esq. - 5> East Hill, Tenterden. The population of the area has further declined from 41,437 to 40,610, though still showing an increase of 2,579 over the 1931 census figure. Whereas there is one house to eight acres in Tenterden Borough and the Maidstone Rural District, one to ten in the Cranbrook Rural District, it is only one to nineteen in the Tenterden Rural District; and the corresponding figures for population are two persons, three, and six to an acre respectively. There are roughly seven occupants for every two houses in the first three districts, but only six in the case of the last named. These figures bear out the comments made on the Housing position in the body of the Report. It is satisfactory to be able to record that the number of births increased from 637 in 1942 to 682 in 1943 with a further rise in the birth rate to 16.7 which compares favourably with l6«5 for England and Wales. The number of deaths (557) was increased by one, with a decimal increase only in the death rate of 13*6, which is higher than that for England and Wales at 12.1. There was one death in the area from puerperal sepsis. There were no infant deaths in two districts. 1109 cases of infectious disease were notified as compared with 863 in 1942. The increase was largely due to an epidemic of measles, especially severe in the two districts not involved in the epidemic of the previous year. There were outbreaks cf Sonne dysentery and diphtheria among children in Institutions. Scarlet Fever was more prevalent than for several years. Fortunately there was very little inf ectious disease in hep-pickers’ camps. The number of children under five immunised increased by the end of the year to I982, and to 4,110 in those over five. Of the children born during the year, three quarters were vaccinated. fM ■ ' ■ ■ ni < / c - There was a notable decrease in tuberculosis of the lungs, to three quarters of the average for five years. The Report is rather longer than in the other War years mainly due to the length of comments on infectious disease which proved of more than ordinary interest. Tables of defects investigated by the Sanitary Inspectors are given at the end of the Report. The number of drains that required cleansing is remarkable, being over J00 in one Rural District. I wish to express my thanks to all the Sanitary Inspectors for their willing co-operation during the year. I am, Sirs, Yours obediently, A. W. GAYE. Medical Officer of Health. ’'Yellowbois” , Cranbrook, Kent. : t ■ :: 'rc.' 3’ STATISTICS TEATERDEN CRANBROOK MAIDSTONE TEN TERDEN BOROUGH R.D • R.D. R.D. [REA (Acres) 8,946 41,315 34,708 38,379 MIEaBLE Vi-? LUE £23,858 £76,740 £90,924 £27,638 IJM represented bv a Id rate £95 £307.5s. £379.4. ica £119.0.5d, UMBER OF INHABITED HOUSES. 1,086 4,093 4,930 2,114 (end 1943) OPULATION Census 3,472 ■ 12,927 15,317 6,315 Mid-year 1943 3,675 14,010 16,740 6,185 For calculation 3,683 14,055 16,799 6,180 of death rate TTAL STATISTICS:- LIVE BIRTHS (M 29) 116) 13D 44) LEGITIMATE. ( ) 67 ) 217 ) 249 ) 92 (F 38) 101) 118) 48) (M 2) 9) 12) 7) ILLEGITIMATE ( ) 7 00 H ) 24 ) 8 (F 5) 9) 12) 1) Total 74 235 273 100 BIRTH RATE 20,09 16.72 16.25 16.18 STILL BIRTHS LEGITIMATE 2 7 11 2 ILLEGITIMATE 1 1 — 1 DEATHS M 20 9 5 103 51 F 35 102 103 48 TOTAL 5: ... . 197: 20(> -j f 99 DEATH BATE 14.96. 14.02 12.26 16.02 INFANT DEATHS LEGITIMATE Nil 6 11 Nil ILLEGITIMATE Nil 3 2 Nil TOTAL - c > V > DErtTH RuTE OF INFANTS - 38.29 47.62 - DEaTHS from CANCER (all sees) 8 28 27 21 D IARRHOEa (und e r Digitized by the Internet Archive in 2018 with funding from Wellcome Library https://archive.org/details/b30241133 k)PUL**TION BIRTHS DEATHS Comments on the Statistics The estimated population shows a further decrease in all four districts. The return home of evacuees and the continued calling up of men and women for military and industrial work are factors which have had effect upon the figures. In the Tenterden Rural District, the population shows a slight decrease as compared with that at the census of 1931? or, allowing for the factors mentioned above, a small increase only. In all except the Cranbrook Rural District (in which the number is the same as the previous year) increase in the number of births is continued, with a corresponding rise in the birthrate, especially marked in Tenterden Borough. In all except the Maidstone Rural District (in which there was a decrease both in the number of deaths and the death rate), the number of' deaths and the death rates have increased, especially in the Tenterden Rural District. There^were no infant deaths in either the Tenterden Rural District or the Borough, and in the latter there have been none for two successive years. There was an increase in these deaths in the Cranbrook and Maidstone Rural Districts with a rise in the death rate of approximately 33% and 25% respectively. The number of deaths from cancer remains relatively high in the Tenterden Rural District. Water Supplies SANITARY CIRCUMSTANCES There was no change in the supplies in any of the four districts. The following samples were taken* TENTERDEN BOROUGH CRANBROOK R.D. MAIDSTONE R.D. TENTERDEN R.D. Good Bad Good Bad Good Bad Good Bad MAINS 6 - 11 11 36 1 WELLS - 1 11 - - 1 6 The mains water is consistently good, and usually sufficient, though strained at times by supply to the military. Two thirds to five sixths of the houses are on mains supply, with very few standpipes. Well supplies are consistently bad. From the public health point of view, mains supply should be extended so that all houses are included. Routine samples are taken by all the Companies, both of the raw and treated water. These were satisfactory except in the case of the raw water from Ewell Manor, which is unsatisfactory from time to time. continued ■ ■ 5 SEWERAGE and DRAINAGE No change took place during'the year in any of the districts. Cesspools continue to cause nuisances from time to time. Improved methods of disposal of human excreta and sullage are needed in many parts of the Rural Districts, especially in those parts of the area where mains water and drainage are not available. Collection of refuse should be extended to all parishes. HOUSING Housing accommodation continues to be an acute problem in the whole area, with waiting lists for applicants for Council houses. The difficulty is less acute in the Tenterden Rural District. Deterioration in house property owing to lack of maintenance has become more evident. Overcrowding is considerable in the Maidstone Rural District, in part caused originally by influx of people from bombed areas. MILK SUPPLIES. TENTERDEN BOROUGH CRANBROOK R.D. MAIDSTONE R.D. TENTERDEN R.D, Number Bad Number Bad Number Bad Number Bad Schools - 23 3 12 4 6 Ordinary 1 6 2 3 1 4 1 Designated 11 4 99 23 27 9 50 20 For Tuberculosis -——-—— 3 7 - 4 1 _ 9 h. Samples of ’designated’ milks and mixed milk for tuberculosis are taken by the Sanitary Inspectors on request from the County Authority. Sampling of school milk is arranged by the County, through the school attendance officers. Between a quarter and a third of the samples of designated milk (’’accredited" and ’’tuberculin tested”) were found unsatisfactory. The number of unsatisfactory samples was greater during the warmer months of the year. Very few samples of ordinary milk were taken, not because it does not need to be subject to routine examination, but because, with the present staff, it is not possible for the Sanitary Inspectors to do it with the many calls upon their time through War time duties. The fourteen samples of ordinary milk were taken owing to special need or following the receipt of complaints; but the number of unsatisfactory samples (though expected to be found bad in the circumstances which made the sampling necessary) was much the same as with the designated milks. No reports upon school milk in the Tenterden Borough were received during the year. SLAUGHTER-HOUSES No slaughtering took place in the area during the year except under special licence from the Food Office. The Ministry slaughter-house in the Cranbrook District is closed. . ■ " , . 6 NURSING HOMES Tenterden Borough Cranbrook R.D. Maidstone R.D. WEALD OF KMT HEALTH AREA. One Home was closed and one was exempted from registration in the Cranbrook District. All the Nursing Homes were visited periodically during the year and the conditions found were satisfactory. One Nursing Home was found to have no resident registered nurse, but obtained one when it was pointed cut that this was not in accordance with the previsions of the Bye-laws under the Public Health Act 193&* Special visits were paid and investigations made at Kench Hill and St. Faiths Nursing Hemes following cases of infectious disease or suspected infectious disease. Number Maternity Other Registered Beds Beds 1 15 25 (20 Emergency 5 ll 27 2 30 5 8 56 57 INFECTIOUS DISEASE Tenterden Borough Cranbrook R.D. Maidstone R.D. Tenterden R.D. Weald of Kent Area Scarlet Fever 9 37 48 6 100 Diphtheria - 10 3 Mt 13 tfhooping Cough 2 28 46 29 105 Hie as les 164 159 137 310 770 Pneumonia 3 32 25 ! 60 Cerebro-spinal Fever - tal 4 1 5 Erysipelas - 2 5 •mm* 7 • Encephalitis Lethargies - 1 — - 1 ! Puerperal Pyrexia - 1 10 . - 11 Dysentery (Sonne) - 30 1 2 33 • Enteritis(B.Aertryche) 2 1 - 3 Opthalmia Neonatorum - — 1 — l TOTAL 180 301 280 3+8 1109 The following deaths from infectious disease were recorded Pneumonia 4- n 16 3 34 Influenza 5 ll 2 3 21 Diphtheria - l *•4 - l Cerebro-spinal Fever - — 11 1 . ' ■ INFECTIOUS DISEASE - continued. The Military sent notifications as follows: Scarlet Fever - 2 Malaria - 1 Diphtheria - 2 Whooping Cough - 1 Chicken Pox - 3 J aundice - 12 Measles - 2 Mumps - 2 Pneumonia - 4 Influenza - 2 Tonsilitis - 1 Salmons 11a Infection (Gaertner) - 1 Scarlet Fever Scarlet Fever was more prevalent than for several years, the number notified being more than twice those in 194-2 in the Cranbrook Rural District and more than four times in the Maidstone Rural District. One child was in hospital with scarlet fever and chicken pox at the same time, having contracted both from her sister returned from hospital. Several children becajne infected about a fortnight after the return home from hospital of a brother or sister. The brother of a child, who was notified on May 7th and was nursed at home, developed the disease on July 10th and was admitted to hospital. This may have been fortuitous after so long a period, but it is known that the causal organism may be carried in the naso-pharynx for a considerable time after the patient has recovered from the disease. Alternatively the organism may have been carried by the mother, but that does not explain the long period between the two. Diphtheria Diphtheria was much less prevalent * The ten cases in the Cranbrook Rural District occurred in September in a Home for children convalescing from Surgical Tuberculosis. There were three clinical cases, the remainder being bacteriological, the organism being proved virulent. The first case, a clinical one for whom immunisation had been refused by the mother, was of moderate severity. The other two clinical cases, who had been immunised, were very mild. The remainder had all been immunised though two of them only within a month of the outbreak. The infection was introduced by a child admitted from hospital at Chatham. Measles. There was a severe epidemic of measles mainly in the months cf February to June, involving all four districts, the incidence, being highest in the Tenterden Rural District which had escaped the epidemic of the previous year, as had also Tenterden Borough. Attenuating serum was used with benefit in a small residential school in the Cranbrook Rural District, as well as in seme cases for very young children in all districts. _ < One case cf measles was admitted to hospital with osteomyelitis.. Pneumonia Pneumonia was increased in the Cranbrook district, especially in December in association with influenza, which became very prevalent,, and the majority of the deaths occurred then. Puerperal Pyrexia Eight of the cases of puerperal pyrexia occurred at St. Faiths Home Maidstone Rural District. Full enquiry was made but the source of infection was not traced. The probability is that one of the girls was carrying the germ when admitted. Investigations were also made at Kench Hill Nursing Home, Tenterden Borough following a suspected case of infectious disease. bLXA soO i. 6 t:3if aifT . .. ’ i-: '3- - ■ 8 INFECTIOUS DISEASE - continued !Dysentery. There was an outbreak of Sonne dysentery among 47 children then resident at Babies Castle, Hawkhurst. The first case occurred towards I the end of October. Twenty seven cases were notified including one iiamong the staff. In eight, the causal organism was isolated from the faeces early, and in some of the others, a month or more later. One case remained negative though her illness continued six weeks, ii The symptoms were abdominal pains and diarrhoea with mushroom soup or spongy stools. The member of the staff attacked, aged l6, had a very mild attack, being unwell two days only. The children were all under five years of age, the majority of cases (nineteen) occurring in those under three, six being less than one year, the youngest only four months old. ; There were two deaths, one, the first case notified, aged seven months, the other, four months. The latter's faeces, however, were negative bacteriologically. Examinations were made of the faeces of all the ; children and of all the staff. This did not produce any evidence to show the source of infection, which was probably from a child who was t admitted to the Home on August 28th and had a mild enteritis on September 14th. This recurred later and she was notified with others as with an onset on November 17th, but the organism was not isolated from her faeces and she left the Home on November 27th apparently in good health; in twenty two cases, the onset was between the l6th and 19th November. Three cases also occurred in the Parish of Hawkhurst at the end of the first week in December. Two were breast fed babies, four and five months old respectively; neither the source of infection, nor any connection with the outbreak at Babies Castle could be traced either through contact with inmates or staff. Enteritis Three cases of infection by a germ of the food poisoning group (B.Aertryche) occurred, but the infection could not be traced, though enquiries were made as to foods eaten and some were submitted for bacteriological examination. An investigation was made into cases of gastro-enteritis which occurred at Biddenden. Repeated attacks occurred off and on during a year. No organism was isolated from the faeces and the water for drinking purposes was found satisfactory. The attacks appeared to cease when a change of milk was made. A germ which sometimes causes gastrointestinal irritation was discovered in a sample of milk, but the milk was in bulk and on enquiry it was found that there were some 3 different farms from which the supply might have come. One curious feature was that the attacks - in one household anyway - usually occurred at the week-end. This would appear to connect up with the Sunday joint, but no meat left ever after an attack was obtained for examination. Trichinosis, A case of trichinosis was diagnosed after the patient had been admitted to hospital, and the infection was considered definitely due to infected pork, but this could net be traced to the farms in the district.suspected. Hop-Picking Gamps There were not many cases of infectious disease among hcp-pickers. One case of pneumonia, and five of scarlet fever (all in one family) were notified from camps in the Cranbrook Rural District, and three scarlet fever, two diphtheria, two cerebro-spinal fever, one whooping cough, three measles and one pneumonia in the Maidstone Rural District. •. > ... * t:o '> j*; '.hn.s'-bf'Z S . 9* INFECTIOUS DISEi.SE - continued Immunisation against Diphtheria The table below gives the numbers immunised during the year and previously, and the percentages of the estimated child population protected at the end of the year. Tenterden Borough Cranbrook R.D. Maidstone R.D. Tenterden R.D. Age Groups i-5 5-15 1-5 5-15 1-5 5-15 i-5 5-15 Immunised 57 16 218 138 289 -117 94 39 Immunised previously l6o 331 374 1,278 58** 1,553 210 638 TOTAL IMMUNISED 217 3 *7 592 1,416 869 1,670 304 677 Estimated percentages 97% 793 66% 77% 83% 793 81% 88% Estimated percentages (l - 15) j 34% 73% 1 8 OO 1 86% There were 11 cases of diphtheria in children under lj. 7 of them had been immunised, and of these two were clinical cases and the attacks were mild. Vaccination. Below is given the percentage of children vaccinated against smallpox among those born in 19^3.• Tenterden Borough Cranbrook R.D. Maidstone R.D. Tenterden R.D. Weald of Kent Births in 194-3 74 235 273 100 682 Vaccinated in 194-3 64 167 198 86 515 Percentage vaccinated 86% 71% 72% $ 00 75% Venereal Disease. On behalf of the four districts, the Medical Officer of Health attended a conference on venereal diseases held in London in February. In brief, the main point shown was the urgent need for increased publicity. As a result, posters, stressing the necessity for early and continued treatment for these diseases, were supplied by the Ministry of Information and posted in the three Rural Districts. In Tenterden Borough, approach to the problem was made through the Youth Clubs, Women’s Guilds, etc. and a public meeting was held in the Town Hall. b 10 0 TUBERCULOSIS The table below shows the number of notifications, deaths and recoveries during the year. NET W CASES DEATHS RECOVERIES Rihnon- ary Non- Pulmon- ary Total Pulmcn- ary Non- FLlmon- ary Totai P NP T District. M F M F M F M F Tenterden Borough 1 2 - 3 - - - - Nil 1 - 1 Cranbrook R.D. 1 2 1 3 7 - 2 1 - 3 - Nil Maidstone R.D. 6 3 4 1 14 2 3 1 - 6 1 3 4 Tenterden R.D. 2 2 1 - 5 •—m - - Nil - 1 1 Weald of Kent ^ Area ( 30 9 6 4 2 '5 2 M 2 4 19 1 i LO 29 1 / 7 2 9 6 Non-Civilian cases were notified as follows Tenterden Borough - Nil Cranbrook R.D. - 5 Maidstone R.D* - 1 Tenterden R.D. - 2 There is a decrease in the number of cases notified by 50% in the Cranbrook R.D. and 30% in the Maidstone R.D. The figures for the preceding four years are:- 1939 j 1940 1941 1942 Average P NP T 1 p NP T p NP T P NP T 4 yrs . Tenterden B. 3 2 5 1 2 1 3 l 1 2 2 2 3 Cranbrook R.D. 5 4 9 5 2 7 8 4 12 9 7 16 11 Maidstone R.D. 24 4 1 281 13 3 16 14 -\ 17 14 8 22 23 Tenterden R.D. 4 2 6| 2 1 3 7 4 11 6 1 7 7 Weald of Kent Area 36 12 48 22 7 29 30 12 42 31 16 45* 41 - * 1942 - 2 cases were both pulmonary and non-pulmonary. The decrease is in the number of pulmonary cases - HOP-PICKING Preliminary visits were paid to selected camps by doctors from the Ministry of Health. These were followed by several days visits to Cranbrook and Maidstone Rurdl Districts and a half day inspection of camps in the Tenterden Rural District. The half day proposed in Tenterden Borough was abandoned owing to the Surveyor being preoccupied with recent War damage. The defects found were dirty and dilapidated latrines, some leaky huts and in some cases generally untidy and insanitary camps. Notices were sent to the farmers in the usual way, but it was realised that difficulties in supply of materials and labour would delay repairs. Overcrowding was evident in some camps due to overflow of pickers from other districts. A Dispensary was established by the Red Cross in the Bedgebury area and proved its usefulness. It was open from J.lJ to 6.30 p.m. from Mondays to Fridays. I give below copies of letters received from the Ministry "I am directed by the Minister of Health to state that he has considered the report made by Dr. Harvey following his visits during the hop-picking season of 1943 to camps for hop-pickers situated in Cranbrook Rural District. The Minister notes with satisfaction that despite the calls made by war-time duties on the time of the Council’s Officers, supervision of these camps has been maintained. At the same time he desires to call attention to:- „ (1) the poor standard of maintenance of latrine accommodation in many camps-. (2) the poor standard of ventilation which has been accepted in new huts built under present byelaws; and (3) the poor standard of lighting found in many lodgings. Special attention is called to the many defects found at Little Pixhall, Hawkhurst, and at High Tilt, Cranbrook. The Common Room and clothes washing room provided at Castle Farm, Cranbrook, is noted as a most interesting advance in camp amenities. I am to express the Minister’s appreciation of the assistance given by the Council’s Officers to Dr. Harvey during his visits." "I am directed by the Minister of Health to state that he has considered the report made by Dr. Butler after visits made during the Hop-picking Season for 1943 to a number of camps for hop-pickers situated in the Maidstone Rural District. The Minister notes with satisfaction that despite the calls on the time of the Council's Officers made by ’War-time duties, supervision of these camps has been maintained and has resulted in some improvements . It is hoped that future efforts of the Local Authority and their Officers will continue to result in improvement in the general standard of lodging and accommodation provided for hop-pickers in Maidstone Rural District. The Minister appreciates the assistance given by the Council's Officers to Dr. Butler during his visits." ' . r j,, .. rj V. 12, HOP-PICKING - continued MI am directed by the Minister of Health to state that he has considered the report made by Dr, Harvey following his visit during the hop-picking season of 1943 to camps for hop-pickers situated in Tenterden Rural District. The Minister notes, with satisfaction that, despite the calls made on the time of the Council’s Officers by War-time duties, supervision t cf these camps has been maintained. At the same time attention is called tc the low standard of latrine accommodation provided generally, and the neglect in maintenance which results in the development of offensive conditions. The siting of the camp at Bishopsdale calls for consider- ! ation as regards dampness, and the finding of a privy closet with overflow direct into a stream is a matter calling for attention. It is hoped that when the present national emergency is over the Council will give consideration to the adoption of a more up-to-date set of bye-laws. I am to express the Minister’s appreciation of the help given by the Council’s Officers to Dr. Harvey during his visit.” Various schools occupied camps in July and August tc help farmers with the harvest. At one camp, the water supply was from a well next to a pond - the water being raised by a crude hand pump which required priming (with dirty water in a tin), and as the covering was defective, dirty water from the roof could drain back into the well. This water was found unsatisfactory for drinking purposes unless previously boiled. On the whole, the conditions when occupied by harvest workers or Girl Guides was considerably better than when occupied by pickers, but due allowance must be made for the fact that numbers were very much smaller in the former case. EVACUATION. Almost all the evacuees, who came after the bombing of London, had left the area by the end of the year, but still a large number remained from the coastal towns. CIVIL DEFENCE. Teams from both the Tenterden & Cranbrook Joint and Maidstone Rural A.R.P. areas, selected by practical tests, entered for a competition organised by the Region. The teams acquitted themselves well, though not successful in getting through more than one round. A lot of keenness was also shown in competitions held locally in several parts &f the area. . : * t, _ . _%fl« **?»'! • ■ - . 13 INSPECTION BY SANITARY INSPECTORS Bakehouses Dairies Slaughter-houses Registered Licenced Other Food Preparing Places Factories Workshops and Workplaces ances gnd Defects remedied (other than above) Overcrowding Keeping of Animals Hop-Pickers Camps Sanitary Accommodation - insufficient defective Drainage - reconstructed - repaired - cleansed Cesspools - abolished - repaired Offensive Accumulations Refuse Receptacles Tents, Vans and Sheds Yard Paving Dampness Roofs and Rainwater Pipes Floors ^ 1 Is and Ceilings Windows and Ventilation Baths, Lavatory Basins, and Dinks Water Supplies Miscellaneous TENTERDEN BOROUGH CRANBROOK R.D. MAIDSTONE R.D. TENTERDEN R.D. 1 _ 39 — 1 6 - 2 26 l8 6 • 14 1 1 3 30 22 . 8 16 2 1 7 22 12 - 31 515 34 6 — - 16 20 2 1 — 20 - 1 12 6 — 1 5 2 j? 17 9 1 18 16 10 18 12 2 21 21 4 3? 34 2 16 22 - - 14 19 1 10 8 3? 10 31 32 16 .J 14 FOOD CGi\Dj^1IniKD PUKING IKK YLKR Tenterden Borough Cranbrook R.D, Maidstone R-.D-* Tenterden R.D-. Tons cwts * qts• Tons Cwts. Cgts. Tbs* cwts. qts. lbs-. qts . lbs. 3 10 2 2 10 16 2 12 3 10 The amount of food that needed to be condemned was increased in all districts except Tenterden Rural* In Cranbrook Rural District the carcases of three animals were rendered unfit for human consumption by injury owing to enemy action. TOTAL NUMBER OF INSPECTIONS BY THE SANITARY INSPECTORS 2,003 2,124 894 There was a decrease in the number of bakeries and dairies and visits paid in Tenterden Borough.- During the last two or three years, there has been an increase in cowsheds and dairies in the Cranbrook and Tenterden Rural Districts. In the former, visits paid increased from 411 in 1942 to $02 in the current year. In the Maidstone Rural District, attention was paid to twice the number of complaints of over-crowding as compared with the previous year, while floors needing repair were 21 compared with 12; and drains cleansed reached the figure of S15. In three districts,, the total inspections made were less than in the previous year, though this is not surprising in view of the amount of the Sanitary Inspectors4, time taken up by duties in connection with the War*. ir:, : cf! ;.v'i't I fil ,/> ■$ i; ^ ■ .lA-ff*. - r *4- ^ -*.v . ' ; 1W>#Q &iij