Report of the Director-General of Public Health, New South Wales.
- New South Wales. Department of Public Health
- Date:
- [1925]
Licence: Public Domain Mark
Credit: Report of the Director-General of Public Health, New South Wales. Source: Wellcome Collection.
158/244 page 126
![12G It lias been found that when a child has recovered and is returned to its home, the mother, in certain cases, is so indifferent in her care that the child returns to the hospital in a short time as ill as before. So glaring have been certain of these instances that the Medical Superintendent has been compelled to inform the mother that the child would not be admitted into hospital again for the same complaint. Partly owing to the demands for hospital accommodation and partly owing to parents not seeking treatment early enough, the serum treatment of this (?) bacillary dysentery has not been markedly successful. The earlier the serum can be administered the greater the prospects of success, and in cases where the serum is given within twenty-four or thirty-six hours of onset, good results have been obtained. Still another difficulty confronts the hospital when gastro-intestinal infections are prevalent, namely the impossibility of obtaining trained nurses for a few months’ work in the summer time. In order to meet this difficulty I tentatively arranged with Dr. Kneebone (Medical Superintendent) to send three additional nurses to Broken Hill during the summer and autumn months should he desire them. These nurses will work under his supervision and control, will be accommodated at the hospital, but will be deputed exclusively to the ward for gastro-intestinal cases. By such intensive efforts and co-operation it is hoped that infant mortality will be considerably reduced. It should he distinctly understood, however, that these efforts will prove futile unless supported by a scheme for general sanitary improvement which must proceed concurrently. If this latter scheme cannot be instituted, the expense involved in sending extra nurses to Broken Hill cannot be justified. 6. Co-operation with Doctors and Midwives.—During my visit I arranged, through the helpful courtesy of Dr. McGillivray, a meeting at the Baby Health Centre of all the medical men in the city. The whole problem of maternal and infant mortality was discussed. It is pleasing to note that a most harmonious understanding exists between the profession and the nurses of the Baby Health Centres. It was unanimously agreed at this meeting that the next essential step is a sanitary “ spring-cleaning.” There are about thirty midwives in actual practice at Broken Hill. AVith a few exceptions they are all untrained women. The Baby Health Centre nurses, at my request, arranged an afternoon meeting to which they were all invited. About twenty accepted the invitation, and I addressed them on their responsibility and their opportunities for assisting in this work. There is little doubt that such meetings are of the greatest value in securing the co-operation of the midwife and enlisting her support in the movement generally. It is perhaps worthy of record that within a day or so of my address some of the midwives brought specimens of patients’ urine to the Baby Health Centres to be examined by the nurses. In all probability this is the first occasion on which these midwives have ever had such tests carried out, and is an indication of the value of educational propaganda. This is all the more important when it is recognised that a large proportion, if not the majority, of midwifery cases, are attended without a doctor. The co-operation which exists between the hospital and the Baby Health Centres is excellent. The hospital notifies the centres of the discharge of any infant who is in need of dietetic supervision, and the nurses get into touch with the case at once. 7. Educational Propaganda,—This is necessary not only in Broken Hill but also throughout the State and it is unfortunate that so far it has not been possible, owing to official delay, to commence a publicity campaign. Once this campaign is in full swing it will give an impetus to the movement and will eliminate much of the ignorance and passive indifference which are the great obstacles to progress. The editors of both local papers (Barrier Truth and Barrier Miner) assured me that they would devote as much space as possible to publish any facts or propaganda supplied to them, and would periodically support our efforts with leading articles. Since my return certain classes of school girls at Broken Hill have been given demonstrations at the Baby Health Centres and it is hoped to continue these in the future and also to institute similar classes wherever possible, throughout the State. Summary. (a) Broken Hill and the Western Division of New South Wales have an excessive infant mortality w'hich constitutes a problem of the greatest magnitude. (b) This mortality must be reduced if New South Wales is to compare favourably with other States and countries. (c) The chief cause of this excessive mortality is probably bacillary dysentery. (d) Baby Health Centres alone cannot solve the problem. Improvement of the general sanitation is an urgent necessity and of vital importance. (e) 70 per cent, of total annual babies in Broken Hill come under the influence of the Baby Health Centres, but 75 per cent, of the total mortality occurs among those babies (30 per cent.) who do not attend the centres. (/) Ignorance and indifference on the part of mothers may not necessarily be followed by fatal results, but owing to the peculiar local conditions they tend to exact a certain and very heavy toll of infant life in Broken Hill. J (g) Pre-natal causes of infant mortality are no greater, perhaps not so great, than in the State as a whole. (h) Intensive efforts during the late summer and autumn, especially in co-operation with the local hospital, give prospects of improving the situation. (?) ( o-operation between the Baby Health Centres, doctors and midwives is satisfactory. {]) Educational propaganda and publicity is extremely necessary. Recommendations. 1. That a sanitary inspector of this Department be sent at once to Broken Hill, where he should remain for several months. Every effort to bring about an improvement of sanitation should be made by him, so^far as possible in co-operation with the local authority, but if necessary independently of it. 2. If (1) be approved {but only in the case of approval), special nurses should be detailed to assist in combating gastro-intestinal infections during late summer and autumn. 3. That laboratory facilities be provided (along the lines of special report) to carry out, inter alia, investigations concerning gastro-intestinal infections.](https://iiif.wellcomecollection.org/image/b31485169_0158.jp2/full/800%2C/0/default.jpg)
