2
The Medical Officers mentioned are expected to make repeated and minute
inspections in their respective districts, and are to a great extent responsible for
the character of the work done and the general accuracy of the returns. Their
reports are given in extenso.
8. The local establishments, as the designation would indicate, are entertain-
ed by the Local District authorities, and are of varying strength according to the
local means of payment, and the importance attached to the operation by persons
voting or apportioning the Local and Municipal funds.
These are under the Civil Surgeons of the districts, and their work is chiefly
confined as a rule to small areas in the neighbourhood of Sadar and branch dis-
pensaries, where the operators are supposed to be overlooked by the Medical
Officer and the several Hospital Assistants.
9. The establishment at Nagpur is intermediate in character. There is a
2nd Class Hospital Assistant as Native Superintendent, half of whose salary
(being the pay of his rank) is paid by Government, the remainder being dis-
bursed from Local Funds. The Vaccinators are paid entirely from Local and
Municipal funds. These work all over the district, but the Civil Surgeon's time
is too fully occupied to admit of his making inspection tours, and he can only
see the work carried on in the City and Station and that brought before him on
his periodical visits to outlying dispensaries. The reports and returns are for-
warded by the Native Superintendent direct to this Office, and the establishment
is under my control. During the time that I am at head-quarters I make weekly
inspections of the work done, and when on my tours examine the villages
en route.
The work is very fairly examined by the Native Superintendent, and this
year I have incorporated the returns with those of the regular establishment
working at Seoni, Chhindwara and Betul.
10. There are two or more Vaccinators employed for certain months of
the year in every district of the Province but that of the Upper Godavari, but
the services of Superintendents have been dispensed with at Balaghat and
Chanda.
These Local Vaccinators work under the direction of the Civil Medical
Officers who, however, have only limited powers as to their employment. This
was shown in the Sagar district, where at the suggestion of my predecessor,
Dr. Townsend, a Vaccinator was temporarily removed from Kurai to the Sadar
Station, but the Municipality of the former place refused (and I think with some
justice) to pay for his services during the time that he was away from their
immediate neighbourhood.
11. All the Vaccinators in the Province are attached during the non-work-
ing season to one or other of the Civil Dispensaries in order that they may
become familiar with the more ordinary forms of disease and injury, and their
appropriate treatment, and so in a position to give advice and assistance in
remote villages far away from regular professional aid.
12. In numerous instances individual Vaccinators have called my attention
or that of their immediate superiors to the insanitary state of certain towns,
villages or dwellings and I have directed that all when submitting their
periodical returns should note against each town or village in which they have
been working, the more striking sanitary or insanitary conditions and prevalence
of any form of disease. They are to be encouraged to point out to Malguzars
and Patels any glaring defects, but are not to give orders of any kind. It will
rest with the Civil burgeon to either visit the spot himself or bring to the notice
of the District authorities any reports that may appear to call for attention.