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

— 26 —
Emmen. — A large Dutch district consisting mainly of peat-bogs and to some extent
agricultural; a large number of unemployed ; social conditions and housing in many cases very
bad ; very high birth rate ; breast-feeding very common ; child welfare centres and clinics for
pre-natal supervision only now being organised.
3. Districts with a High Infant Mortality.
Pays de Caux. — A French district in Normandy, mainly agricultural; peasant population,
often suspicious and superstitious; very backward as regards hygienic conditions; living
conditions frequently bad among agricultural workers ; drunkenness fairly common ; the peasant
women are overworked ; no pre-natal supervision in 50 per cent of the cases ; much harm done
by untrained midwives ; child welfare organisation undeveloped ; feeding of infants defective.
Hoensbroek.—A Dutch district, almost exclusively mining ; rapidly expanding economically;
housing conditions favourable, but intellectual level of the population not on a par with those
conditions ; many young married couples ; population partly foreign , consulting clinics for
infants exist but are little used ; doctors and midwives overworked.
4. Districts with a Very High Infant Mortality.
Pays de Bray. — French district in Normandy, almost entirely agricultural (dairy industry);
fairly prosperous ; general conditions similar to those in the Pays de Caux , fewer small towns
than in that district ; population less able to benefit by urban medical organisations.
Mecklenburg-Strelitz. — A German agricultural district ; communications defective ;
many large, old properties ; population mainly consists of labourers, employees and servants
living under bad conditions ; rural hygiene defective ; attitude of population frequently sullen ,
child welfare centres exist in only a few towns ; female labour common ; pre-natal supervision
rare.
Gmunden. — A mountainous Austrian district, mainly agricultural ; communications very
difficult ; a population of small farmers and indigent agricultural labourers ; social and economic
conditions mainly bad ; housing poor ; women’s work excessive ; child welfare centres exist
but are run under difficult conditions ; a very high percentage of illegitimate births ; feeding
usually artificial.
Schdrding and Engelhartszell. — An Austrian district, mainly agricultural and forest
land ; communications particularly difficult ; intellectual level of the population below the
average ; housing conditions poor ; social conditions rather or very bad ; work of peasant
women often excessive during pregnancy ; hygienic conditions bad; no child welfare organisation
in the rural part of the district ; a very high percentage of illegitimate children ; midwives’
qualifications particularly poor ; feeding of infants defective.
B. Urban Districts.
1. Districts with a Low Infant Mortality.
Leyden. — A commercial and industrial town in the Netherlands ; conditions for all classes
of the population satisfactory ; housing and social conditions good or moderately good (as a
rule one house for each family) ; hygienic conditions good ; numerous and exceedingly well-run
medical institutions ; breast-feeding very common.
Dordrecht. — A very prosperous Netherlands town ; conditions almost identical with
those at Leyden ; infant welfare clinics extremely well organised and very popular ; breast¬
feeding very common.