10
The slight increase in the cost per case is partly due to the employment of
additional Health Inspectors and vaccinators, and partly to decreases in the
number of successful vaccinations in certain districts.
The average cost per successful case varied from Re. 0-4-10 in Vizagapatam
to Re. 0-9-2 in Cuddapah district.
In municipal areas, the average cost ranged from a minimum of Re. 0-3-3
in Calicut to a maximum of Rs. 1-8-7 in Palacole. Attention has already been
drawn to the very unsatisfactory vaccination work done in Palacole, and the high
cost, which is a natural consequence of a low success-rate, was further enhanced
by the inclusion of the leave allowances of the vaccinator, for whom no substitute
was appointed.
The Director of the King Institute reports that he issued lymph for 2,063,925
cases to district boards and municipalities against 1,945,944 operations performed
in these areas. The difference of 117,981 represents a wastage of 5.7 per cent
which is only slightly above the permissible percentage.
23. (a) The number of vaccinated cases inspected by District Health Officers
ranged from 839 in Tanjore to 6,326 in South Arcot. Two District Health Officers
inspected less than 1,000 cases, 7 less than 2,000, 8 less than 3,000, 4 less than
4,000, 2 less than 5,000, 1 less than 6,000 and 1 less than 7,000 cases. The low
figure in Tanjore was entirely due to the continued prevalence of cholera in that
district.
(b) The inspection of vaccinated cases by Municipal Health Officers (exclu
ding Madras) ranged from 618 in Hindupur to 14,689 in Madura. The work of
seven Health Officers fell short of the prescribed minimum of 75 per cent and
their explanations have been called for.
(c) In the 45 municipalities where no Health Officers are employed, the
percentage of cases inspected by the Medical Officers in charge of vaccination
varied from 23.5 in Cannanore to 99.3 in Kodaikānal. Thirty-seven inspected
more than 75 per cent. One inspected less than 65 per cent and one less than 25
per cent, and the Surgeon General will be asked to obtain explanations from the
two officers concerned.
(d) District Medical Officers and Civil Surgeons inspected 7,979 cases as
compared with 10,802 in 1926-27.
(e) Two hundred and twelve Health Inspectors inspected more than 85
per cent of the cases and 53 failed to reach the prescribed minimum. Disciplinary
notice will be taken of those whose explanations are unsatisfactory.
24. The total deaths from smallpox during the last six years are as
follows:-
1922-23
...
...
...
...
...
...
...
...
1923-24
...
...
...
...
...
...
...
1924-25
...
...
...
...
...
...
...
1925-26
...
...
...
...
...
...
...
1926-27
...
...
...
...
...
...
...
1927-28
...
...
...
...
...
...
...
26,526
22,626
20,227
14,498
9,816
7,610
These figures constitute convincing proof that smallpox is a disease which
can be prevented by an efficient vaccination organization. Moreover, it must be
remembered that the annual saving of 20,000 lives is only one item on the credit
side of the account. No estimate in rupees, annas and pies can be made of the
tremendous amount of crippling, disfigurement and blindness which has also been
prevented. In the light of these facts, who can doubt that the new District
Health service has given full value for the money expended on it?
In G.O. No. 1372, P.H., dated 14th August 1923, the question of a general
introduction of compulsory revaccination was dropped, but in G.O. Mis. No.
1485, L. & M., dated 21st August 1923, the proposal of the Corporation of
Madras to introduce compulsory revaccination in the city was approved.
Continued enquiries made in infected areas have abundantly confirmed
previous experience that infection from smallpox is most commonly met with
amongt unprotected persons and amongst adults who have never been revacci-
nated. In order to reduce the incidence of the disease still further, it would be