Health > Memorandum relating to the enquiries into the causes and prevention of still-births and mortality during the first year of life

— 20 —
At Cassel, the chief municipal medical officer, with the help of the principal medical officer
of an infant welfare centre, directed the enquiry. A visiting nurse was specially employed
for house visiting.
In both towns the medical officers of the health services, infant welfare centres and all
other similar institutions willingly gave their assistance.
At Lippe, the Director of the Government Health Service directed the enquiry himself,
with the help of the senior visiting nurse of the district and of the visiting nurses under her.
Owing to the particularly favourable circumstances obtaining in the three German districts
mentioned above, it was possible to carry out the enquiry under excellent conditions, although
the work was somewhat hampered in the urban districts on account of the women investigators
being greatly overworked.
At Mecklenburg^-Strelitz, on the other hand, the enquiry was very difficult to organise
owing to the lack of a child welfare service in the rural part of the district; consequently, it
was no easy matter to obtain information, and the difficulties were increased by the defective
means of communication. For these reasons, the medical diagnoses for this district are not
always very accurate, and the other information is not altogether complete. The enquiry
was co-ordinated by the medical adviser to the Ministry with the help of a nurse. Two other
visiting nurses had to be specially engaged for the enquiry. Their work was made very difficult
both on account of the lack of communications and of the distances they had to travel. These
difficulties were aggravated by the exceptionally wet weather which prevailed during the year
of the enquiry.
Great Britain.
The enquiry covered four districts —two urban districts, Sunderland and Croydon,
and two rural districts in Oxfordshire and Staffordshire.
The enquiry was conducted by Dame Janet Campbell.
In this country the medical officers of health in the various districts gave every assistance
in their power and obtained the information from their colleagues and from visiting nurses.
They also organised special lectures to explain the purpose of the enquiry to medical practi¬
tioners and thus obtained their help and that of the directors of hospitals and other important
institutions. A highly qualified specialist in children’s diseases gave his advice and assistance
in checking the medical diagnoses, so that a uniform interpretation of the results was ensured.
At Sunderland, the enquiry was conducted by the principal medical officer of health in
that town.
At Croydon, the medical officer of health was in charge of the enquiry, which was carried
out by one of his colleagues with the assistance of visiting nurses.
In Staffordshire, the medical officer of health for the county directed the enquiry and
was mainly assisted by two chief visiting nurses, inspectors of midwives.
In Oxfordshire, the enquiry was conducted by the medical officer of health for the county,
while a large number of personal investigations were undertaken by the principal public health
nurse, with the help of the staff under her.
Thanks to the efficient organisation of the enquiry and to the competence of the investiga¬
tors, who contributed to the value of the results by their special knowledge of the living
conditions of many of the families, and also to the uniform manner in which the diagnoses
were verified from the pediatric standpoint, the data collected were very complete and are
therefore of special value.