9
season opened each vaccinator was at his post with an ample supply. In this
district the number of infants vaccinated exceeded 7,000. In Wardha it was
only 2,811.
The Civil Surgeon and Native Superintendent have done a large amount of
inspection work and report very favourably on what they saw. The Hospital Assist-
ants with the exception of those at Sironcha and Allapili have done well; the general
result is very creditable to Mr. Craggs the Civil Surgeon, and his establishment.
The cost per case was only one anna and two pies. The vaccinator attached to
the Sironcha sub-division has shown only 709 successful vaccinations.
39. Balaghat.—For years this district had been conspicuous for the ineffi-
ciency of its vaccination. This was brought to the notice of the Civil Medical
Officer in successive annual reports and in letters addressed specially to this
officer. Matters, however, reached a climax in 1877-78, when the average number
of operations per vaccinator reached 751 only. I therefore reduced the Super-
intendent to a vaccinator, promoted a good man in his room, made changes in the
establishment, and informed the Civil Medical Officer that a recurrence of such
inefficiency would necessitate special measures being adopted. The result was that
each vaccinator performed on an average 1,369 operations during the year under
review.
Hospital Assistants' work is still very unsatisfactory; five men performed
only 261 operations.
40. Bhandara.—There has been a great decrease in the number of opera-
tions performed in this district with respect to the previous year. The Civil
Medical Officer ascribes it chiefly to mortality from small-pox during the previous
season; this does not account for it at all ; for whilst the decrease in vaccinated
persons reached 6,319, the total number of deaths of all ages from small-pox
only numbered 2,481. The Civil Medical Officer states that the people are not
in the least opposed to vaccination in this district, and the impression left on my
mind after a tour of inspection there during the past cold season coincides with
this view. The Civil Medical Officer considers the year's work good ; but in a
district where the people have accepted vaccination, and where abundance of
subjects exist, an average of 1,408 operations per man is very unsatisfactory in
my judgment; I do not think the number should be less than 2,000, and shall
ask the Civil Medical Officer to accept this view of the matter ; he will perceive
that in the adjoining district, Chanda, vaccinators performed upwards of 2,300 on
an average. The percentage of success as given by vaccinators is 95; that actually
ascertained on inspection by the Civil Medical Officer and Superintendent was 92.
My inspections confirm the correctness of those figures.
41. Raipur.—In this district also small-pox was very prevalent; 2 277 deaths
were reported, whilst cholera carried off upwards of 24,000 persons. There would
thus be fewer infants-for operation in 1878-79 than during the previous year;
still, considering that the vaccine establishment is unable to reach all those avail-
able, there remained sufficient for the vaccinators to operate on. I find, however,
that there has been a falling off of upwards of 4,000, whilst vaccinators performed
on an average 1,450 operations each against just 1,800 during the previous year.
I have in paragraph 107 of the Sanitary report explained that the establishment
at work in this district is too weak and unable to protect the total number of
annual additions to the population. Thus whilst a large mumber are protected
annually there remain a considerable number unvaccinated, those with infants too
young for vaccination are liable to be swept away when small-pox breaks out,
I found also that children of less than one year old are not considered suitable for
operation. The returns show that of those vaccinated 7 per cent only were
infants.
The Civil Surgeon was only unable to make a few inspections in the neigh-
bourhood of Raipur; the results of my inspections in that district do not differ
materially from the percentages returned by vaccinators,