Mr. H. S. Wells, Secretary of the Department of Organisation, has left Geneva for the United States and Canada where he will study and report to the League on the methods of public health instruction employed by the American Red Cross and the Canadian Red Cross Societies. Mr. Wells has been asked by the American Red Cross to attend the Colombus Convention of October 8-10.

PUBLICATIONS OF THE LEAGUE

The following is a summary of the contents of the fifth number of the International Journal of Public Health, Vol. II:

Original articles. Strauss, Israel, and Wechsler, Israel, S.: Epidemic encephalitis (encephalitis lethargica). Rolleston, Humphry: The rôle of the medical profession in the prevention of tuberculosis. Benoît-Lévy, Georges: The Garden City.

– Yofé, Hillel : Proposals for anti-malaria work in Palestine. Winslow, C.-E. A.: Suggestions for a Red Cross health programme.

League Reports.

Resolution of the Medical Advisory Board.

Reviews. Venereal Diseases: The North European Red Cross Conference on Venereal Diseases. - Child Welfare and Nutrition: Fresh-air therapy and the school child. Communicable Diseases: The scientific basis of modern diphtheria prophylaxis (continued). Nursing: Rural Public Health Nursing.

-

French demography in 1920. Demographic Notes. demographical statistics in Poland.

Bibliography. Book reviews.

Selected bibliography.

LEAGUE FILMS

The Division of Popular Health Instruction has been informed by the Committee on Propaganda of the Belgian Red Cross Unit at Berchem (Antwerp) that the films dealing with venereal diseases, loaned to the Committee by the League, have met with great success. Popular demand to see these films was so great that six public meetings had to be organised. Both the civil and military authorities gave every possible support to the Red Cross organisations which were showing the films. Request has been made for other films, which have been supplied by the League.

The Schweizer Volkskino, with a view to organising a series of educational cinema performances to instruct the Swiss public in social welfare and general hygiene, as well as in the methods for combating tuberculosis and venereal diseases, applied to the League in July for the loan of films dealing with these subjects. The League has placed nine films at the disposal of the Schweizer Volkskino, which has already started its propaganda work. It has been arranged that 20% of the proceeds are to go to the Swiss Red Cross, 20 % to the Schweizer Volkskino and the balance to local organisations. This arrangement was endorsed by the Swiss Red Cross, which asked the League to assist the undertaking.

Two films on child welfare are being sent by the League to Strassburg at the request of Marquise de Leys Chandieu, chairman of the Alsatian Division of the Association des Dames de France. These films will be shown to the public by the Union Familiale Alsacienne.

୧୫:୨୭

GENERAL NEWS.

RED CROSS AND LABOUR.1

First Aid in Factories.

E

VEN in those countries where industrial hygiene has been most highly developed there is yet great scope for health education in the factory. The State has, in most cases, imposed by law the minimum health regulations necessary for safety, but there is a great gulf between this minimum and the good health and comfort of the workers, which alone ensures efficiency and economy. The Red Cross can help in two ways: (1) by educating employers to realise the necessity for an adequate ambulance service, and the economy such a service would mean in decreased compensation bills and increased production; and (2) by giving employees practical instruction in First Aid. That this is a real opportunity, is proved by the success of the American Red Cross, which reported in June, 1920, that " in addition to holding First Aid contests for the mines throughout the country, the Bureau of First Aid has supervised the First Aid contests, First Aid and Accident Prevention instruction and the standardisation of First Aid supplies for several large railroad systems, steel manufacturers, telephone companies, quarries and other industrial concerns during the past year. That this work is highly appreciated by both the employers and the industrial workers is shown by the increasing interest taken in the Red Cross First Aid work by both parties. An example of this interest is the case of the Bell Telephone Company (New Jersey Department) where 592 employees, or 40% of the entire force, voluntarily enlisted for the First Aid course.

The Red Cross, in approaching employers, should have before it a clear idea of the meaning of the words "an adequate ambulance service." The provision of ambulance accommodation is the first necessity. The need for it is proved by the fact that in 20 engineering factories in Great Britain, employing 42,700 workers, 9,393 cases were treated in one week approximately 22% of workers. In Great Britain an ambulance room is required, by order of the Home Office, in factories employing 500 or more, but every factory needs an ambulance room. In larger factories the accommodation should include surgery, rest-room, waiting-room, staff room and sanitary accommodation. The position should be central, quiet and easily accessible; a separate block is desirable, but not always to be obtained. The

1 The following article is in keeping with the policy outlined by Professor Rossi Doria in his article "Red Cross and Labour", published by the Bulletin in the March-April Number of this year.

following simple list of equipment is taken from "The Industrial Clinic", by Prof. Edgar L. Collis1, and may serve as a guide for adaptation to local conditions:

Surgery:

Writing table.

Necessary chairs.

Couch (height convenient for purposes of examination).

Fixed basin, with hot and cold water supply; taps so arranged that they can be worked by foot or elbow pressure.

Glazed sink with hot-water supply.

Dressing trolley of enamel and glass.

Glass shelves.

Instrument cupboard.

Cupboard for stock dressings.

Drug cupboard.

Instrument steriliser, gas or electric heating.

Water boiler or kettle.

Suitable supply of jugs, lotion bowls, instrument trays, and mesures.

Covered pails for soiled dressings.

Suitable supply of instruments, varying with the scope of work undertaken. Arm and leg baths.

Foot rests.

Rest room:

Couch.

Rugs and pillows.

Hot-water bottles.

Easy chair.

Staff Room:

Table.

Easy chair.

Wardrobe or cupboard for clothes.

Cupboard with shelves.

Cabinet with record cards.

Waiting Room:

Chairs or fixed benches round walls.

The question of staff will depend on the size of the factory and on local conditions. Where the whole-time medical officer is not available, arrangements should be made for a visiting officer at regular hours. A trained nurse in charge of the ambulance room is essential in a factory of any considerable size, but where an employer objects to the expense involved, it might be possible to arrange for the nurse's services to be shared by several adjoining factories, in telephonic communication. The doctor and nurse can be greatly assisted by First Aid workers throughout the factory. The Home Office of Great Britain requires that in every factory employing 25 persons and over, First Aid boxes shall be provided at the rate of 1 to every 150 persons. This represents a minimum. A practical working scheme is to have a squad of workers trained in First Aid in each shop or department, of whom one in each shift should be in charge. This worker would have

1 American Red Cross, Annual Report, Year ending June, 1920.

access to the First Aid Box, stretcher, etc., would give the necessary emergency treatment with the aid of other members of the squad, and would then send the patient to the ambulance room. Only small wounds should be treated at First Aid Posts, and a special rule must be made forbidding treatment of eye cases. Washing of wounds should not be included in First Aid treatment, which in most cases would simply mean application of iodine and sterilised dressings.

The Red Cross, in co-operation with employers, would have ample scope for adapting First Aid principles to the particular needs of any factory, and in offering specialised instruction to meet such needs. The whole ambulance scheme should be worked out in close co-operation with employers, medical and nursing staff, welfare workers, and the factory staff themselves. The formation of an ambulance committee among the workers is the best guarantee of obtaining their active interest and help; and this interest could be kept up by drills, parades, First Aid competitions, health talks, and inspection of First Aid Posts by Red Cross officers. Most factories have a recreation room where lectures and drills could be arranged. The degree to which the Red Cross can assume responsibility for the orgnisation of a factory ambulance service must necessarily depend apart from the goodwill of the employer on the existing health facilities in the factory. In large plants where a medical officer is in charge and an organised health service already exists, the services which the Red Cross can render will probably be limited to First Aid instruction and drills, the First Aid unit so formed being, if possible, affiliated to the local Red Cross chapter or detachment. Assistance in this direction will probaly be welcomed by a busy factory medical officer, as it will leave him more time for technical duties. In small factories, however, where no organised health service exists, the field of the Red Cross is unlimited. Here First Aid will be only the forerunner of other health activities - the ambulance room, the trained nurse, the visiting medical officer, the dental clinic should all follow. The Red Cross will be merely the channel through which this help is introduced, with the double object in view of the welfare of the workers, and economy to the employer, who depends for success upon the good health and efficiency of his factory staff.

A TRAVELLING CHILDREN'S CLINIC IN SLOVAKIA.

A feature of the child welfare unit, which the Lady Muriel Paget Mission in

Czecho-Slovakia is operating in conjunction with the League, is the automobile clinic which travels through the country. This clinic, or travelling dispensary, began its work last May and in three months covered over 3,000 miles, serving eleven villages, where about 2,000 children have been treated.

The staff is kept as small as possible and consists of one Czechoslovak and two English sisters, a Slovak interpreter and the driver. The clinic is held by the local doctor, or, in cases where there is none, by the doctor from the nearest village.

The following description is taken from a report by Dr. R. P. Stewart, of the League of Red Cross Societies, who is in charge of the infant welfare scheme of the Paget Mission 1 :

"At last we near the village where the clinic is to be held. We pass on all sides mothers in their picturesque Slovakian costumes, with their babies on their backs, and leading one or two older children by the hand. We reach the schoolroom where the clinic is usually held, and find many more weary mothers waiting round it, besides the universal beggar and gipsies, who always collect at any function. The mothers, who have tramped many miles over hills, receive the lorry with a quiet, patient smile of welcome. Then the unloading begins. The schoolroom is transformed as quickly as possible into a waiting and weighing room and a doctor's room and dispensary, by means of the screens, tables, medicine trays, etc., all carried on board by the lorry. The mothers are ranged sitting at long tables, with baskets hanging from the tables in front of them, and soon their babies, wrapped up like little mummies in their mattresses and many ribbons, are slowly unswathed on the table, the clothes going into the respective baskets and so kept apart. The babies, one by one, are then carried kicking and struggling after their long confinement, to the weighing machine. They enjoy the release, for they have frequently been carried for 15 miles on their mothers' backs and have not been unwrapped for six hours. After being weighed, the mothers carry them into the doctor's room with their weight charts, and the doctor orders them what he wishes in the way of milk or medicine, and has a talk with each mother. Then they are taken back to undergo the same process of mummification again, and their long pilgrimage over the hills starts once more. "

1 See Bulletin of the League of Red Cross Societies, Vol. II, No. 6-7, Page 218.