:mi-:du'ai. ixsim-x'tiun of sciuxils. ^^^y 



governing the procedure in certain i)iiljlic health (|nestions. These 

 difficuhies one can meet with ])atience. fortified by the reflection 

 that thie service is new in this country, and thiat Sottth Africa as 

 yet does not possess a pnbhc heahh con>cience in the true sense 

 of the term. ( )nce this latter mentor is aroused, the ])ul)lic will 

 not tolerate a state of things that allows the ( iovernment to 

 make game ])reser\atii n and forest conservanc\- matters of 

 more vitallx' national inii)ortancc than the Ivalth of itf. citiz.~ns. 



With regard to the second essential, it is ])ro|)osed to deal 

 -with defects discovered at routine ex;uninati(jn as ])rom])tl\- and 

 as ade(|uatel}" as otir somewhat limited means allow. We have 

 no hosjiitals in the Iuu"oi)ean sense of tlie term in this cotmtrv ; 

 our institutions for the sick are either nursing homes for pa\ing 

 jjatients or patiper asylitms analogous to the nutch-maligned and 

 itnpopular " infirmaries " in Ivngland. A child whose ])arents 

 cannot ahord to i)a\' toi- medical or surgical treatment — and 

 please remember that such inabilit\- to pa\- does not mean ])atiper- 

 isni in the sense that it imjflies in Kngland, where the rates 

 charged for such treatment are far lower than here — must at 

 present he either lett uiureated or nuist a])])lv to the magistrate 

 for treatment as a pau])er. Add to this the fact that our hos- 

 l)itals do not ])ossess otu-patient departments which are worthy 

 of the name, and th.'it they serve white and colotu"ed jiatients at 

 the same time, hor obviotts reasons I refrain from discussing 

 the subject of the e.^cienc\' of these instittuions. Mv point is 

 merely that if it is i)racticall\ unsound to send defective school 

 children to hos])itals in Rngland — a matter on which there 

 exists almost tinanimit\- ot o])inion — it is still less sound to send 

 them to hos])itals here. In l^ngland and in Atistralia — where 

 hos])ital facilities are better than the\- are here — this ])roblem 

 of the treatment of defective children has been sohed, 1 believe, 

 on economically sound lines, and certainh- on a. basis that is ])rac- 

 ticall} ettective — by the establishnient of school clinics and tra- 

 velling -school hos])itals. The same alternative to hosi)ital treat- 

 ment ])resents itself here, and in the scheme for school medical 

 ins])ection in the Transvaal i^-ovision is made for the establish- 

 ment of school clinics, travelling dental clinics, and probal)lv a 

 travelling hospital. hA-en at ])resent the medical inspector is 

 forced to take with him a su])])l\- of drtigs and tonics, and the 

 school lutrse a su])])i\- of dressings and nn'nor essentials, to deal 

 with urgent cases on the spot. .School clinics, while ])racticable 

 for the larger centres, are out of the (|uestion for small rural 

 areas; in such Ave must have a iravelling hos])ilal, i)eregrinating 

 around its area once every year, and dealing with all defective 

 children within that area who cannot att'ord ])rivate treatment or 

 — and tliis is a ])oin.t I would lay some stress ujion — who prefer, 

 for |)a\-ment, to be treated by the s])ecialists attached to the hos- 

 pital. Concentra.tion u])on this important (juestion of treatment 

 is most desirable in view of the grave defects that arise through 

 neglect of such defects, and jiersonally I should much prefer to 

 see the facilities for treating defective children extended to see- 



