BMJ

The Shelter Problem In The East EndSource: The British Medical Journal, Vol. 2, No. 4171 (Dec. 14, 1940), p. 841Published by: BMJStable URL: http://www.jstor.org/stable/20318510 .

Accessed: 10/07/2014 18:15

Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at .http://www.jstor.org/page/info/about/policies/terms.jsp

.JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range ofcontent in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new formsof scholarship. For more information about JSTOR, please contact support@jstor.org.

.

Digitization of the British Medical Journal and its forerunners (1840-1996) was completed by the U.S. NationalLibrary of Medicine (NLM) in partnership with The Wellcome Trust and the Joint Information SystemsCommittee (JISC) in the UK. This content is also freely available on PubMed Central.

BMJ is collaborating with JSTOR to digitize, preserve and extend access to The British Medical Journal.

http://www.jstor.org

This content downloaded from 130.192.119.156 on Thu, 10 Jul 2014 18:15:00 PMAll use subject to JSTOR Terms and Conditions

DEC. 14, 1940 SHELTER PROBLEM IN EAST END MEDICBSRHAL 841

Orr's work and complaining that it was not well received by British surgeons. Winnett Orr asked me if I could do anything to put this right. I did so, first by suggesting that Dr. Trueta --should' have an opportunity of meeting a representative' gathering of 'the 'E.M.S. - This took place at the Royal Society of Medicine, with Sir Cuthbert

Wallace in the chair. And, further, I wrote an. introduc tion to Dr. Trueta's -book, in which I referred to. the

method employed by him as having been originated by Winnett Orr.

It is quite true to say that B6hler's method of treating open. fractures appears to be the very opposite to that of

Winnett Orr, but both methods have two important points in common-namely, immobilization and an avoidance of any, dressings. Bohler uses traction and leaves the wound with no covering, a' basin being placed under the limb into which the pus drips. Quite apart from matters of principle, it must be obvious that Bohler's

method is much more difficult to carry out, as it requires' hospitalization and is not adapted for transport.

THE SHELTER PROBLEM IN THE EAST END

From the survey of London shelters published last week (p. 796) the East End shelters were expressly omitted, the conditions in the East End being so dissimilar from those obtaining in the rest of London as to require separate treat ment. A number of East End shelters were visited unofficially by our investigator, but two local authorities refused a request for facilities for an investigation, and a third ignored. it. This negative attitude is in striking contrast to that of the other boroughs visited in Central, West, and North London, where in every' case the most willing co-operation was shown. The conditions of such East End shelters as were visited left very much indeed to be desired, and strongly sug gested that local government had failed in this unexampled emergency.: Admittedly the East End has had an exceptional problem to face with its immense population from multitudes of small houses. Moreover, it has few big solid buildings, like those in the City 'and Westminster, where proper base

ment shelters can bd constructed. But that is no excuse for neglect to make as comfortable and healthy 'as possible such

shelter accommodation as is at hand. At one very large shelter holding many thousands of people

whatever amenity it possessed at the time of our visit seemed to have been afforded by voluntary effort. The shelter was badly lighted, the shelterers for the most part had to sleep on the rough ground, the sanitary arrangements were deplor able, and the whole atmosphere so damp and cold that one

shuddered' to imagine what the conditions would be like in a London fog. In two smaller shelters, one of them a re

inforced' cellar,' the authority had overlaid the dampcourse with concrete, with the result that tlhe damp, instead of being con trolled, was creeping up the walls of the shelter. There were no first-aid equipment here and no visiting nurse; in the event of minor casualty or illness the marshal had to send to

the nearest wardens' post. The sanitary arrangements here .again were extremely primitive, and the shelterers themselves

were responsible for the cleaning. The worst " shelter " of all

seen in the East En,d was discovered under some railway arches,

each arch accommodating from seventy to one hundred people. Here the only lavatory accommodation was a couple of buckets for the women; the men had to manage outside. There was not a single water tap under the whole of the

arches; if the shelterers wanted a drink of water they had to

bring it with them. The ligh'ting also was very poor, the people supplementing it from candles. In wet weather the water percolated all over this shelter, and there was not a dry

spot. The, only help afforded was by the students of the

London Hospital, who come 'every night to give whatever

assistance they can, and by a local vicar who distributes cups

of cocoa. If the shelter "dictator " whom we suggested in our last

issue is appointed he should make his way with all haste east

of Aidgate. It is fortunate for the East End that evacuation has taken place there to a much greater extent than from the rest of London. We were informed of areas from which half the population has gone.- Moreover, many of the. people who

make a nightLy dormitory of the Tube stations further west (where there is light; warmth, and some nursing attendance, though the bunks are slow in coming and, the -stinking lava tories slow in being replaced)- are East-Enders, who have travelled anything up to five miles -to sleep. In the'East End shelters there is, fortunately, a relative absence of children and of mothers with young children. But it needs to be .borne in mind how vital is this -area at the gate of dockland, where many of the men find their work, and amid factories where large numbers of the wo'men are employed, a 'consider able proportion of whom, both men and women,' find in the shelters at present their only home.

THE MEDICAL RESEARCH COUNCIL OF IRELAND

The Medical Research Council of Ireland has made the following awards: Mr.-John Breen, whole-time grant for one year from January 1, 1941, to undertake an investigation of the organo-metallic compounds of calcium, magnesium, and potassium in living organisms-a study of their possible isolation and constitution; and to assist in the study of the intimate structure of cell membrane and of the manner in which calchirm and magnesium gain admission and the special purposes they may serve. 'The work is to be carried out in the biochemistry department, University College, Dublin, under the direction of Prof.' E. J. Conway. Dr. William Hayes, part-time grant for six months from January 1, 1941, to undertake an' investigation to devise a simple, rapid, and accurate method for groupinig haemo lytic streptococci, the work to be carried out in the School

of Pathology, Trinity College, Dublin, under the direction of Dr. R. A. Q. O'Meara. Dr. J. D. H. Widdess, grant-in aid to enable him to employ a technician to carry out the serial sectioning of blocks.

Whole-time grants have been renewed for further periods as follows: Mr. R. P. Cooke, six months; Mr. P. J. Boyle, one year; Dr. T. G. Brady, one year; and Miss E. M. Mason, one year.

Part-time grants renewed are: Dr. Oliver FitzGerald, one year; Mr. Martifl G. A. Little, one year; and' Dr. D. K.

O'Donovan, one year.

The grant-in-aid awarded to Prof. J. F. Donegan has been renewed for one year, as has that awarded to Dr. N.

Falkiner. Dr. R. A. Q. O'Meara relinquishes his whole-time grant

as from November 1, 1940, and a grast-in-aid' has been awarded him for one year.

The latest annual report of the medical services of Sierra Leone, presented- to the Colonial Office by Dr. W. P. H. Light body, who was recently promoted director of the services, records a satisfactory state of general health among a popula tion of some 100,000 and an absence of major epidemics.

Nutrition in the undisturbed tribal communities is described as fairly satisfactory, but in Freetown, the capital, with its

population of 55,000, and the adjacent villages there is some

evidence of qualitative defects in diet, mainly an insufficiency of protein. Tables are given showing the health of Euro

peans., Among the 250 European officials resident the average annual sick time per resident was '6.46 days, almost exactly the same as that of the 1.000 African officials. Three Euro

pean officials were invalided home during the year. Among the 495 European non-officials resident, the total number who

wvere on sick leave was seventy-three. Three European officials and ten residei!ts who were not officials were invalided home. The most frequent cause of death among the popula tion in Freetown is malaria, which causes nearly twice as many deaths as tuberculosis, the second largest cause of mortality.

Malaria also accouints for 43 per cent. of the hospital cases in the colony.

This content downloaded from 130.192.119.156 on Thu, 10 Jul 2014 18:15:00 PMAll use subject to JSTOR Terms and Conditions