3
Chhittagong Divisision.
Tippera is the only district in this Division which records an increase in the
number of operations of this triennium over the last. The total has steadily risen
from 69,000 in 1905-06 to 98,000 in 1910-11.
In Noakhali, although there is a decrease of 19,000, the work has on the
whole been satisfactory.
Chittagong, however, shows a remarkable decrease of 111,412 in the number
of operations of the last three years, compared with that of the former period. Last
year's operations only numbered 61,000 and there has been a steady decline from
134,000 in 1905-06, with the exception of a slight rise in 1909-10. The decrease
of 8,000 which occurred this season has, I consider, been largely due to want of energy
on the part of the inspecting staff, and there has also been apparently some diffi-
culty in recruiting vaccinators locally, which may have had some share in causing the
deficit. A decided effort will have to be made next season to bring the standard
back to its original strength.
In all the districts of this Division, the Civil Surgeons complain of the difficulty
in realizing the vaccinators' fees. In Chittagong they sometimes have to wait 3
or 4 months for them, and then are often unable to realize the full amount due.
Rajshahi Division.
In four of the districts of this Division a considerable increase is recorded in
the number of operations of the past three years, viz., in Dinajpur, Rangpur, Bogra
and Malda, chiefly owing to the impetus given to the work by a sharp outbreak
of small-pox in 1909-10. In Rajshahi this year owing to a severe outbreak of
small-pox, which was no doubt the remnant of the wave which spread over the
Division the previous year, there was a large increase in the number of revaccina-
tions. Strong opposition was offered by the Ruffadin Muhammadans, and the Civil
Surgeon comments on the great assistance which was given him by the sub-
divisional officers in overcoming it.
In Pabna, the decrease of 20,000 operations which occurred in 1909-10 owing
to a severe outbreak of malaria, has been more than made good, and credit is
due to the staff; and in Malda though there is a decrease of 5,600 in the number
of operations, compared with the number recorded last year, the total is still higher
than any year of past decade (except 1909-10). The Civil Surgeon considers the
decrease is partly due to emigration from the villages which were destroyed by
the Ganges, and partly to a change in jurisdiction by which some villages were
transferred to Purnia.
Assam Valley Districts—
In all the districts of the Assam Valley except Kamrup and Goalpara, the
number of vaccinations has fallen, chiefly in Sibsagar, Nowgong and Darrang. Even
in Kamrup though the triennial total is higher than the last, there has been a gradual
fall from 33,600 to 26,500 during the last three years, which is not satisfactory.
Moreover, the Civil Surgeon states that no Mahapuruahyas were vaccinated. This
is the chief community in the district who refuse vaccination' and considering the
efforts which have been made of recent years to get them to accept it, and with
considerable success, it is disappointing. The Civil Surgeon gives no reason or
explanation of his statement.
In Darrang between the years 1905 and 1909 the number of operations
fell from 14,300 to 8,100. Last year it increased again to 11,000 owing to the
efforts of the staff.
In Nowgong also, after long period of depression, in which the number fell from
12,000 to 5,000, thanks to the assistance of the Deputy Commissioner to overcome
the objections of the people, it has again increased to 8,500, the first rise for 6
years. The mortality from small-pox this year (3.05) and last (3.49) as the result
of years of indifferent vaccination, is the highest in the decade.
Hill Districts.
In the Garo Hills there is a fall of nearly 4,000 operations, and the number
(13,900) performed last year was lower than in any year since 1905. The
Civil Surgeon remarks that '' the population are so well protected that there is
very little fear of an outbreak of small-pox". The statement is not altogether