3
I issued the following Circular to all Civil Surgeons in September 1895, for
their information and guidance :—
During the past year the Divisional Inspectors of Vaccination brought to notice
many grave irregularities in the work of the Vaccination Staff; and Vaccinators in
almost every district of the Province have either been fined or degraded for negligence,
carelessness or other misconduct. I have gone through all the cases that have come
before me carefully, and, after the inquiries that I personally instituted during my
tour last winter, I am satisfied that irregularities, such as not checking the birth entries
in the Chaukidárs' Memo. Books, entering false results of vaccination and falsifying
returns, are due in great measure to the system of conducting vaccine operations at
present in force in the Province.
2. Vaccinators now go out in pairs to different parts of their districts, and are
in many instances quite away from the control of the Native Supervisor. They can thus
absent themselves from their work without their absence being known, and it has come
to my knowledge that it is no infrequent practice for one man to remain while the other
goes to his home or elsewhere. The Native Supervisor either closes his eyes to such
irregularities, or is unaware of them ; but in either case the work suffers, and the returns
are consequently frequently untrustworthy. I have therefore come to the conclusion,
not only in the interests of vaccination work generally, but for the convenience of the
people, and to facilitate careful supervision of the men themselves both with regard to
work and conduct, to abolish the system of working apart in pairs, and to substitute
for it the method now adopted by the Special Staff working under the Deputy Sanitary
Commissioner, that is, working in bodies, beginning work from one centre followed and
directly controlled by the Native Supervisor, who will be held responsible for the entire
management of the operations. By this plan the Native Supervisor will be able to have
thorough control over his men, and irregularities such as those noticed in paragraph 18,
page 5, of my Vaccination Report for 1894-95, reduced to a minimum. I accordingly
direct that, in supersession of all previous orders on the subject, vaccination work this
year be carried on from one centre until the whole district is traversed. It will be con-
venient perhaps to do the work tahsíl by tahsíl, beginning at the Sadr, but Civil Surgeons
can make any arrangement that is most convenient, so long as the system is not departed
from.
3. This method has the additional advantage of enabling the Civil Surgeon to
follow the men and note their work during his vaccination and sanitation inspection tours.
Hitherto the work in districts has been carried out in such a scattered fashion that the
Medical Officer could not systematically control it, and was more or less obliged to accept
the results and excuses reported and made by the Vaccinators or the Native Supervisor;
but by working in bodies they will be brought directly under his notice in all respects,
and it is hoped this will result in more trustworthy returns and better work.
4. Although the system now introduced is to be followed as a general rule, it is
not intended to interfere with the discretion of Civil Surgeons in cases of emergency, such
as an outbreak of small-pox in any particular locality, &c., when it may be neccessary to
detach a party of men rapidly to deal with it, but is intended to bring the District Staff
more immediately under his observation, and to enable him to deal more efficiently wíth
neglect of duty or carelessness on the part of either the Native Supervisor or the
Vaccinators.
Result of vaccinations
performed under the new
system fairly satisfactory.
11. The vaccination work therefore in 1895-96 was carried on under
the new system; and although I anticipated a larger
increase in numbers than the returns show, I believe that
what has been done has been better and more efficient.
In December 1895 I had to call upon several Civil Surgeons to explain the
cause of the falling-off in work in October and November in their districts,
and in almost every instance I was told that the Native Supervisors attributed
it to the introduction of the new system. As I knew the orders were not
likely to be appreciated by men who had formerly been able to do just as they
pleased, I was fully prepared for this, and I accordingly issued stringent instruc-
tions to Civil Surgeons to warn the Native Supervisors and the Vaccinators
that, if they did not pull up the work by the end of the vaccinating season,
serious notice would be taken of their conduct. These warnings had a salutary
effect, the result being that the deficiencies in October, November and December
were more than made up, and there is no doubt that had the men worked
properly at the beginning of the season on the new plan, a great many more
vaccinations would have been performed; but next year I anticipate very
considerable augmentation in the numbers, as I have impressed upon the Civil
Surgeons the importance of exercising as strict supervision as possible over the
District Staff, and enjoined them to personally verify the Vaccination Returns
whenever they can, noting particularly whether cases entered as successful
in the Vaccination Returns are so or not, and I am glad to record that these
instructions have been carefully carried out by the majority of these officers.