6
Dr. Roe, late of Siálkot, and his Assistant Surgeon, 3,477, Mr. J. Connor of
Muzaffargarh 2,547, Assistant Surgeon Juswunt Roy of Rohtak 3,712. The system
of checking returns by comparing the vaccinated children with the copy of the
vaccination registers left in the villages, continues to work satisfactorily in the
Jhang district.
"In not a single instance during the year," says the Civil
Surgeon, "was any false entry detected in the returns either by the Supervisor
or by the Civil Surgeon."
Districts in which
there was little or no
inspection of vaccina-
tions.
16. The district of Jhelum shows not a single case of vaccination inspect-
ed by the Civil Surgeon, Kángra only 8, Dera Ismail Khan 7,
Pesháwar 44, Umballa 161. In districts in which Civil Surgeons
hold joint medical charge of the civil and military populations,
as well as in those in. which the duties at the head stations take
up almost all the time of the Medical Officer, much inspection work cannot be
expected. But the statement clearly shows, that in several instances the Civil
Surgeons have not paid much attention to this important part of their duties.
The success of vaccination depends greatly upon the genuineness of the opera-
tions performed by the Vaccinators, and unless the quality of work done is tested
by the Civil Surgeons by personal inspection, no great reliance can be placed on
the figures shown in the statement.
The necessity of in-
spection.
17. The necessity for a close examination of the vaccination work on the
part of Civil Surgeons is amply proved by the results of inspection
embodied in the following extract from Dr. Roe's report:—
It will be observed that the percentage of successful cases recorded
by the Native Supervisor is 97.51 whilst that verified by the Civil Surgeon
only amounts to 81.24, but I may state that my first day's inspection in the
Daska Tahsíl showed me very plainly that this man* could not be depended
upon, every case being reported as successful. I will therefore discard his
reports, and state the results of my personal inspections. I examined 2,405
cases of which I found 1,978 successful, 187 unsuccessful, and 243 irregular, and
these results may, I think, betaken as a fair representation of the success of the
operations generally in the district, as the children I saw were taken from 117 towns
and villages in the various tahsíls. These numbers show failure to the extent of 7f
per cent., and 10 per cent. of irregular vaccinations, in which it was extremely
doubtful if any protection was at all afforded. This, in my opinion, is unsatisfac-
tory and is undoubtedly the results of carelessness on the part of the operators
when it is remembered that with good lymph and the observation of all proper
precautions, an expert vaccinator should not fail of success once in 150 times
(Marsun), but in the cases I am now writing about, it was quite evident that two mat-
ters of primary importance were neglected, (1) the state of health of the individual
vaccinated, and (2) the thorough insertion of the lymph. With regard to the
first of these, in many cases I found the children covered with cutaneous disease
of the vesicular type, and secondly I found the method of vaccination universally
followed to be that by puncture which in numerous cases quite suitable for
operation was so hastily and perfunctorily performed as to fail altogether. It will
thus be seen that the Vaccinators in order to swell the numbers, indiscriminately
operated upon every child whether it was a suitable subject or not, and in order to
save themselves the trouble followed the method of simple puncture without
taking care that the point of the lancet was properly charged before insertion,
proceedings which undoubtedly tend to bring the operation into disrepute."
Inspection of vacci-
nation by Native Super-
visors.
18. In several districts, as will be seen on reference to the statement given
on the preceding page, the operations inspected by the Native
Supervisors are comparatively very small. To inspect vaccina-
tions is the most important, I should say, the only duty of the
Native Supervisor. Any laxity in this work will in future be severely dealt with.
Inspection of vaccin-
ation by Dr. Doyle.
19. Dr. Doyle, the Deputy Sanitary Commissioner, Western Circle, in-
spected 1,055 children belonging to 67 towns and villages in
the Montgomery district, 957 children in the Dera Gházi
Khan district, and 971 children in the Mooltan district. It appears from the
report furnished by him that he found the results generally satisfactory.
Success of the new
organized scheme of
district vaccination.
20. It is gratifiying to observe the marked success which the new sys-
tem has achieved in almost all the districts under the ener-
getic supervision of the Civil Surgeons combined with the
ready assistance rendered by the District officers. Vaccina¬
* He has since been transferred to another district.