2
1916-17 the Corporation midwives attended 627 cases, and there were only
three maternal deaths, while the number of infantile deaths within ten days
after birth was 35. A system of periodical inspections of babies at their
homes by the Lady Health Visitors has also been introduced, and the fact that
there were only 19 deaths among 464 babies under observation justifies
the claim of the Chairman that the measure has some potential value in
the saving of infant lives.
5. Vital statistics.—The returns of vital statistics are admittedly defi-
cient, and it is unnecessary to dilate on this familiar fact. The usual verifica-
tion by inspectors and sub-inspectors of vaccination brought to light a slightly
larger proportion of omissions, viz., 3.3 per cent. of births and 2.3 per cent. of
deaths, than in the preceding year. The statistics are defective not only on
account of such omissions, but also through confusion as to the causes of
death.
The Sanitary Commissioner estimates that, even in the most
malarious districts, possibly only one quarter, or at the most one-third, of the
deaths entered under the head of fever are really due to malaria. " Kala-
azar accounts for a certain number of deaths in some districts ; enteric
fever is far more prevalent than is generally supposed ; and phthisis probably
accounts for at least 10 per cent. of the deaths recorded from fever." An
improvement has, however, been effected in some towns. The recorded birth-
rate in Asansol has been raised in two years from 6.02 to 30.5 per mille.
Dhulian, in Murshidabad, which last year headed the list with a birth-rate
of 31.4, has this year increased the rate to 43.6. Brahmanbaria and Madari-
pur also record rates of over 40, representing an increase of 16 and 12 per
mille, respectively. On the other hand, 14 municipalities record birth-rates
which are absurdly low, ranging from 7.6 per mille in Jhalakati to 14.8 per mille
in Mymensingh. These 14 municipalities include district headquarters and
populous towns, such as Suri, Burdwan, Bogra, Khulna, Titagarh and Bha-
dreswar, in which a better system of registration might be expected. It is
clear, as the Sanitary Commissioner remarks, that " in the majority of these
towns the lowness of the birth-rate merely signifies neglect on the part of
the local authorities to take steps to secure accurate registration."
6. Fever.—The number of deaths reported under this head was
882,768. There has been a steady decrease from the total of 1,064,159
registered in 1915, the annual diminution being 154,279 in 1916 and 27,112
in the year under review.
The decrease in 1917 was confined to rural areas, urban statistics
showing a slight increase, which the Sanitary Commissioner attributes to an
improvement in the registration of deaths.
Eastern Bengal, a region blessed with an abundant rainfall and great
rivers, which, as they spread over the land in flood, not only fertilize the soil,
but create conditions adverse to malaria, has, as usual, a comparatively
low death-rate.
Northern
Bengal, a land of dead and
dying rivers, in which the
drainage system is deranged,
is the most malarious part of
the Presidency, four districts in the Rajshahi Division heading the list with
the rates shown in the margin : the rates for the four least malarious
districts are shown in contraposition.
Dinajpur...
Rajshahi...
Jalpaiguri...
Rangpur...
Death-rate
per 1,000.
33.27
29.90
29.20
27.06
Dacca...
Tippera...
24-Parganas ...
Howrah...
Death-rate
per 1,000.
13.74
13.54
11.98
9.41
7. Anti-malarial measures.—Progress was made with the execution of
three of the four experimental anti-malarial schemes designed on lines
laid down by Dr. Bentley. The Meenglass scheme, which will carry under-
ground the ordinary flow of hill streams, was completed and came into
operation in the rains of 1917. It was not. however, found possible to con-
trol all the hill streams within the area of the experiment, and Government
have given an additional grant for further work. The Sanitary Commissioner
reports that, while a spleen census taken after the rains of 1917 suggests
that there has been some diminution in malaria, it will not be possible till
after the rains of 1918 to judge whether the area under control is likely to
be sufficient for the reduction of malaria. Progress was less satisfactory with
the scheme for surface drainage, combined with the flushing of streams, in the