4
the general public are beginning to realize that cholera is essentially a
preventible disease which can be properly controlled by the adoption of
effective sanitary measures. The provision of an adequate and pure water-
supply in rural and urban areas is obviously of primary importance in this
connection. At the same time the Director of Public Health lays very great
stress on the importance of taking preventive measures and of starting an
anti-cholera campaign on organized lines in order to check the spread of the
disease. As successful examples of measures of this kind he refers to the
effective steps taken by the District Board of the 24-Parganas to prevent the
occurrence of cholera at the last Ganga Saugor Mela, and the strenuous
efforts made by the District Boards of Bogra, Rajshahi and Pabna, assisted
by large bands of voluntary workers, for the prevention of cholera in areas
which suffered from devastating floods in the latter part of the year.
Enquiries made by the Director of Public Health have revealed that there
are special centres of infection in various parts of Bengal, and that there
are grounds for believing that cholera infection is often spread along lines
of communication from other provinces. As he has pointed out, it is within
the power of municipalities and district boards in Bengal to reduce cholera
mortality to a minimum at a very small expenditure. The experience
gained in anti-cholera work in several districts has shown that a reduction
in cholera mortality is almost automatically brought about by the appoint-
ment of a trained sanitary staff, and the Director of Public Health is
confident that not only would cholera mortality be almost entirely checked
if a small trained staff were provided for every thana in the province, but
that many other diseases of a like infectious nature would also eventually
be brought under control as a result of the establishment of an organization
of this kind in each district under the direct supervision of the District
Health Officer. The Minister for Local Self-Government trusts that this
suggestion will meet with careful consideration on the part of local bodies.
7. Small-pox.—In 1922 the mortality from small-pox remained
comparatively low, being 7,864 as compared with 8,157 in 1921, 36,190 in
1920 and 37,010 in 1919. This periodic decline may be followed in the
near future by a recrudescence of the disease, and the Director of Public
Health draws the attention of the local bodies to the need for carrying out
vaccination measures specially in areas where the infection appears to be
localized.
The total number of vaccinations reported in 1922-23 was 2,006,140 as
compared with 1,761,626 in 1921-22. Of the total operations, 1,526,385
were recorded as primary and 479,755 as re-vaccinations, against 1,266,551
primary and 495,075 re-vaccinations during the year 1921-22. There was
thus during the year 1922-23 an increase of 20.5 per cent. in primary and a
decrease of 3.02 per cent. in re-vaccination operations.
During 1922-23 out of 998,829 infants requiring vaccination 290,172
or 290.4 per mille were reported to have been successfully vaccinated in the
rural areas, as compared with 271.735 or 269.11 per mille during the previous
year. In nine districts, including Calcutta, the protection was said to have
been over 500 per mille. In municipal areas 553.3 per mille of the surviving
infants were protected in 1922-23 against 627.5 per mille during the
previous year.
Free vaccination has now been introduced all over the Presidency, but
for want of funds most of the local bodies were unable to appoint an
adequate staff of paid vaccinators. In several districts, licensed vaccinators
were also employed, while some district boards employed paid vaccinators
only for short periods. In the district of Dacca, some of the union boards
undertook to provide free vaccination and employed a few paid vaccinators.
In 1922-23 Government made a total grant of Rs. 25,000 to district boards
for free vaccination.
The Minister desires to call the attention of all local authorities to the
likelihood pointed out by the Director of Public Health of a recrudescence
of small-pox epidemic in the province in the course of the next 12 or 18
months and trusts that all early cases of small-pox will be carefully watched
and that every effort will be made to check the spread of infection by the
efficient vaccination of all contacts,