16
REPORT ON VACCINATION IN BENGAL
in check by vaccination and the isolation of the affected persons. It has not become epidemic
in any instance.
" Attitude of the people towards vaccination.—Except in the south of the Rungpore dis-
trict the attitude of the people towards vaccination was one of strong opposition, and to obtain
lymph afterwards was always difficult and at times quite impossible. Matters are much
complicated, and difficulties greatly increased, by the employment of a double agency to carry
on vaccination. Civil Surgeons are encouraged to train inoculators as vaccinators. These
are turned out of dispensaries with instruments and lymph, and wander about the country
generally without any supervision, saying they are Government vaccinators. They have to
wait on the pleasure of the people; vaccinate when and how they please, and never employ
the method of arm-to-arm transmission of lymph; when the real Government vaccinators come
they are met with numerous objections with regard to their mode of working, and much delay
and embarassment result. It is a mistake to employ two agencies to carry out one sanitary
measure. It should be left entirely with regard to districts in the hands of the Vaccine Depart-
ment, leaving the civil stations under charge of Civil Surgeons with municipal vaccinators under
them. The officers in charge of outlying dispensaries should be restricted to such operations as
they can themselves perform, and be forbidden to employ any subordinates to carry on vaccina-
tion, as these gradually slip away from the immediate vicinity of the dispensaries and remain
entirely without supervision. The cicatrices I examined this season were of the worst character,
many persons nominally vaccinated having none at all. These had all been operated on by
men licensed from dispensaries. There were some men practising vaccination on their own
account and passing themselves off as Government vaccinators with forged or stolen purwa-
nahs. One was caught and made over to the Magistrate; several are still at large. They
give much trouble, as they misrepresent the facts concerning vaccination to the people,
and discredit the Government mode of working. They also prevent a district being properly
protected from small-pox.
" It would be most unfair to hold the Vaccine Department responsible for the state of
protection afforded to the greater part of Rungpore, as much of it is not the work of the
department and has been carried on in a way of which the department entirely disapproves.
" Inspections of the Superintendent and Deputy Superintendent.—The inspections of the
Superintendent were continued throughout the cold weather in the district of Rungpore, and
in the Darjeeling Hills during the hot and rainy seasons with the exception of July
and August. He verified the returns of 32,389 cases which gave a percentage of success
of 98.66. He visited 768 villages in Rungpore. Great opposition was constantly
offered during the course of the inspection, and much difficulty encountered in seeing
the persons who had been vaccinated. The people showed much suspicion and distrust,
and in one thana, Borolari, some mischief-maker had spread the report that vaccine scars
were the marks put upon children, two boat loads of whom were to be sacrified at the site of
an imagined railway bridge over the Teesta, and that the Superintendent was coming round
when inspecting to select suitable victims.
" Though inspection is welcomed among the educated classes harm is often done by it
to the cause of vaccination among the ignorant, and this latter constitute the majority among
the people of Northern Bengal. It is very harassing to the vaccinators at times.
" The Deputy Superintendent was active and verified the returns of 34,215 cases, which
gave a percentage of success of 97.88, a trifling difference of less than one per cent. from
the result obtained by the Superintendent. As the Superintendent and Deputy Superin-
tendent made a point of going over separate ground and not seeing the same cases twice,
their inspections cover more than one out of every three cases vaccinated throughout the
season. More than this it would be impossible to undertake, and less would be amply
sufficient as a test of the work done under officers of experience.
" Every gang of vaccinators was visited twice by the Superintendent and some three
times.
" Small-pox and Inoculation.—The hot weather and rains of 1878 afforded cases of small-
pox in Rungpore, Darjeeling, Julpigoree, Dinagepore, and Purneah; but in the last four districts
the outbreaks were unimportant and were quickly suppressed, except in Purneah, where
vaccination was carried on under great opposition. In Rungpore, however, although active
steps were taken for its suppression, it continued to crop up again and again, and was found
in the cold season in places all over the district by the vaccinators and effectually stamped
out as their operations progressed. As the Bagdogra sub-division was, however, beyond the
scene of the season's work, it was in the thanas comprising it that the disease gradually
spread to a serious extent, although vaccinators were first sent in January and more in Feb-
ruary and March, till in April, with few exceptions, the whole establishment was employed
in this one jurisdiction. The police continued to report the increase of small-pox which,
considering the efforts of the vaccinators, was most unusual. An explanation has since been
afforded, however, by investigation, as it was found that inoculation was being extensively
practised in the sub-division over large areas and by strong bodies, of inoculators, and as
soon as vaccinators appeared in one plaee, the inoculators changed their ground and kept on
working. Not a whisper of this was ever uttered by the police, though the coming of the
vaccinators had been proclaimed in Prumbari and Durwani thanas by notices distributed
by the Magistrate through the police. Not a vaccinator has ever been informed by them of
the proceedings of the inoculators, which they carefully ignore till small-pox is present in
an epidemic form. It was so actively propagated by inoculation that 108 cases with 7