2
cases attended to by the staff was 4.2
per cent. as against 9.62 per cent.
among infants in the rest of the town.
Over a thousand dais were given ele-
mentary training by local bodies or
associations with the help of Govern-
ment grant, and the total number of
Exhibitions and Baby Weeks was more
than doubled (166 as against 67).
Cholera.—The year 1928 continued to
show a rise in the curve for mortality
from cholera with a rate for Bengal in
excess of that of any other province in
India and more than double the quin-
quennial average. The total number of
deaths was 136,245 in 1928 against
118,377 in 1927, showing an increase of
16.0 per cent. As in the previous year,
preventive measures taken comprised
inoculation, disinfection of water-sup-
plies, disinfection of infected houses and
of the patients' clothes. Eighteen medi-
cal officers and temporary staff of 5
Sub-Assistant Surgeons and 100 Sani-
tary Inspectors were deputed to assist
local bodies in checking outbreaks.
Propaganda work was carried on by
means of lectures and magic lantern
demonstration given by the Government
Publicity staff and the local sanitary
officers. Special measures were taken
to inoculate pilgrims for the Puri Ratha-
jatra and the Ganga Sagar Mela.
There was a further increase in
inoculations for cholera during the year
under review. 2,304,457 cubic centi-
meters of cholera vaccine were issued
during 1928 against 1,299,630 in 1927
and the number of inoculations performed
rose to 1,941,023 from 781,872 in 1927.
It is to be remembered that preventive
inoculation is a new measure in Bengal
so that high figures for cholera mortality
are likely to go hand in hand with
activity in inoculation against cholera
until the practice is sufficiently wide-
spread to be adopted beforehand in anti-
cipation of an epidemic.
Small-pox.—Even in the case of small-
pox the statistics for 1928 go to show
that the ideal of preventive efficiency in
which vaccination can preclude an epi-
demic is far from having been reached.
A quinquennial epidemic which had been
forecasted began in 1924. The curve
in 1928 was still rising, with 43,558
deaths as against 42,514 in 1925, and
5,567 in 1924 the zero year; and the one
district which attempted an organized
campaign of mass vaccination (Malda)
was that which returned the highest
ratio of small-pox mortality 3.27 per
thousand. The reason is obvious. In-
tensity of preventive action still follows,
rather than anticipates, an epidemic; and
this feature is further illustrated by the
statistics for vaccination in the province
as a whole. During the year under
review there were 5,281,419 vaccinations
of which 2,052,217 were primary vacci-
nations and 3,229,202 re-vaccinations,
successful vaccinations being 92.9 per
cent. and 56.5 per cent., respectively.
The number of successfully vaccinated
children under one year was 262,982
against 281,727 in the previous year,
while the total number of births, exclud-
ing infant deaths of 241,974 was
1,126,812 during the same period.
Protection was therefore given to only
about 24 per cent. of the surviving
infants. This was due to the unwilling-
ness of parents or guarians to have their
children vaccinated under the age of one
year.
The Director of Public Health reports
that district boards are actively engaged
in organising vaccination to counter the
further epidemic anticipated and Gov-
ernment have recently drawn their
attention to the necessity of taking
special steps for the purpose.
Malaria and kala-azar.—In contrast
to the increase in the two periodical
epidemics to which this province is
exposed it is satisfactory to find a very
definite decrease in mortality both from
malaria and kala-azar. Deaths from
malaria were reported at 368,691 as
against 429,143 in 1927 and 458,208 in
1926. Even after allowances are made
for the inevitable vagueness of returns
on which statistics are based a reduction
of over 24 per cent. in two years in
deaths from a disease which in its nature
is not liable to the sharply recurring
curves of small-pox and cholera does
seem to give grounds for hope that the
attention and expenditure devoted to
this cause by the Public Health Depart-
ment in the past few years are bearing
fruit. Similarly in the case of kala-azar
the decline which was noticed as a satis-
factory symptom in last year's report
still continued, 10,746 deaths being
reported as against 11,855 in 1927.
The total number of deaths from fever
752,007 as against 789,006 in 1927 repre-
sents a nondescript mortality, the im-
portance of the figure for the purpose of
statistics being chiefly in the fact that
the decrease precludes any idea that
mortality from malaria has been trans-
ferred to this head.