Report of the Medical Officer of Health / Municipality of Colombo.

  • Colombo (Sri Lanka). Public Health Department.
Date:
[1925]
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Medical Officer of Health / Municipality of Colombo. Source: Wellcome Collection.

    21/74 (page 51)
    (b) Rates per 1,000 Births. 1908 1909 1910 1911 1912 Average, 1908-1912 1913 1914 1915 1916 1917 Average, 1913-1917 1918 1919 1920 1921 1922 Average, 1918-1922 1923 1924 1925 Developmental. Pneumonia and 89 70 67 72 73 74 71 67 77 80 98 78 96 100 69 81 88 86 96 90 78 Bronchitis ... 54 55 46 51 52 51 53 37 33 28 31 36 51 37 32 36 36 38 37 31 31 Digestive 55 43 48 44 38 45 46 39 40 30 37 38 32 34 31 32 33 32 37 34 29 Convulsions ... Tetanus Neo- 109 83 82 91 91 91 83 84 85 70 69 78 62 71 82 69 60 69 68 59 56 natorum 29 38 31 27 18 28 9 5 5 3 4 5 5 3 2 2 2 3 1 3 2 Tuberculosis ... 4 4 4 1 1 3 — 0-2 0'4 05 0-5 0-3 1 1 1 2 1 1 1 0-6 03 Infectious 2 1 0-2 1 1 1 — 1 2 05 07 1 0-3 05 1 1 0-6 0-6 1 01 0-4 Syphilis 2 3 3 4 4 3 4 5 3 3 3 4 5 6 5 4 6 5 8 5 5 The most noteworthy points in the foregoing statement are the reduction in mortality from tetanus neonatorum, from 29 per 1,000 in 1908 to 9 per 1,000 in 1913 and only 2 per 1,000 in 1925. This improvement is, without doubt, attributable to the work of the Municipal midwives, a branch of the Public Health Department which was initiated in 1905. A progressive improve¬ ment is also recorded in the mortality from digestive diseases and convulsions, much of which latter is also probably due to improper feeding ; pneumonia also shows some improvement, as the result probably of more intelligent care of infants ; all of which reflects credit upon the teaching conducted by the Health Visitors, a branch of the Public Health Department which was initiated in 1910. The one outstanding exception to this record of improvement is in the case of “ develop¬ mental diseases,” an important group which includes premature birth, atelectasis, atrophy, debility, and wasting diseases generally (marasmus), all of which are by some authorities included under the term “immaturity.” As Sir Geo. Newman has said “it is evident that if infants die within a few days or hours of birth, or, even if dying later, show unmistakable signs of being unequal to the calls of bare physical existence, that there must be something more than external conditions or food or management which is working to their hurt. The explanation is clearly to be found in ante-natal conditions.” To combat these amongst other conditions the now world-wide Child Welfare movement was evolved. At this stage of the Child Welfare movement in Colombo, when the Municipal Council has just appointed a specially trained Lady Assistant Medical Officer to take charge of and reorganize the Child Welfare branch, it will be of special interest to observe the progress made in respect of infant mortality during the next few years. It is confidently anticipated that, barring accidents, such as an outbreak of influenza or the occurrence of unusually adverse climatic conditions, the infant mortality will show a further improvement during the next few years. Although, as previously stated, the infant death-rate from all causes in 1925 was the lowest on record, this good result was not anticipated during the first-half of the year, for the reason that the number of infant deaths recorded during that period was considerably greater than the average for the previous year. It is, therefore, interesting to ascertain when and in what respects the improvement occurred during the year. This is disclosed by the quarterly statement given below which shows that the improvement was a progressive one, but was most marked during the second quarter, the chief reason for this improvement being the great reduction in the number of deaths from atrophy and debility. There can be no doubt that but for the unfortunate outbreak of influenza in May-July, the infant death-rate for the year as a whole would have been even more markedly below the record than it was {vide Diagram No. 1 (5)). Developmental Respiratory (16) Infant Deaths during each I. Quarter in 1925. II. III. IV. Atrophy and Debility 175 101 90 92 Premature birth 39 19 34 26 Bronchitis 25 17 9 8 Pneumonia ... 42 50 46 44 Diarrhoeal 50 66 66 38 Convulsions ... 107 99 98 ... 122 Total ... 438 352 343 330 Local Incidence of Infant Mortality. In view of the fact that Child Welfare work is being carried on in certain wards of the- town and not in others, the local incidence of infant mortality as recorded in the statement below is of special interest.