22
The cost of the establishment I have proposed for the Nágpúr district would be as fol-
lows :—
Eight Vaccinators
..
...
Native Superintendent at.. ..
Rs.
1,152
960
—Rs.2112
10. The registration of births in these Provinces is as yet too imperfect to be of much
value as a check upon the vaccination returns, nor does it afford us the means of forming a
correct estimate of the annual birth rate, but this is probably not very different from what
obtains in European countries, and I think the birth rate of Great Britain—33 per mille—will
fairly indicate the number of children born annually in any district. and, making an allowance
for the mortality at the early stages of infant life, we may estimate that to keep the population
of a district thoroughly protected against small-pox, the number of vaccine operations per-
formed annually should be nearly 30 per 1,000 of the population. We cannot yet count upon
vaccine operations keeping pace with births, but, considering that there must be a very large
number of children of a year old and upwards unprotected, I think we ought to obtain 30 vac-
cinations per 1,000 of those tracts in which vaccinators are employed.
11. At this rate the district vaccine establishment above proposed would yield 12,780
operations at a mean cost of 2 annas and 6 pies per operation.
The minimum rate at which public vaccinations can be contracted for in England under
the Vaccination Act is 18 pence per operation, paid from the poor rates, and to this the Trea-
sury adds one shilling for each successful case.
12. In the other districts of your Division the means will probably not be available for
carrying on operations so extensively as in Nágpúr, but in all it will be possible to bring a con-
siderable portion under vaccination, and I would recommend that the same plan of operation
be adopted. Each vaccinator should be limited to a defined circle, corresponding in extent with
one or more registration circles, and his returns should show the number of villages in which
he has operated and the number of operations in proportion to the population. In the districts
of Wardhá, Chandá, and Bhandára funds will probably not be available for carrying on vaccine
operations in more than the Sadar tahsil, and perhaps one circle in each of the other
tahils. Over this amount of work the Civil Medical Officers of those districts should be able to
bestow efficient supervision. They should first make sure that the normal vaccine disease has
been produced in each circle, and from time to time in the course of the season ascertain that
it has been kept up, and by verifying their returns in a certain number of villages in each
circle ascertain that the vaccinators are working honestly.
Copy of a letter from, the Commissioner, Nágpúr Division, to the Sanitary Commissioner,
Central Provinces,—No. 3743, dated 12th September 1870.
*No. 450, dated 5th September.
I have the honor to state, in reply to your letter* marginally noted, that I fully
concur in your views and arguments, which for convenience I sum-,
marise as follows:—
(1.)—We must recognise the necessity for systematically organising local vaccination in
the districts of this Division, and the advisability of working on some scheme which
can be extended so as to embrace the whole population.
* Thin computation includes all inhabitants except the
people of Nagpur and Kamthi, where the Municipalities
arrange separately for vaccination.
(2.)—We may reckon that if we vaccinate 30 per mille of the population yearly, that is,
about 13,000 out of the rural popu-
lation* of the Nágpúr district,—if
we can do this, then in a few years
the whole population will be effec-
tually protected from small-pox.
(3.)—We must admit that, if the population is to be protected at all, we ought to have a
regular establishment which shall do its work every year.
(4.) —The best way to effect our object will be to divide each district into circles, conter-
minous if possible with registration circles, each circle to contain about 60,000 souls