39
During the cold weather of 1901-02 there had been outbreaks of plague in the
• districts of Jullundur, Hoshiárpur, Gurdáspur, Siálkot, Ludhiána, Lahore, Ambala,
Ferozepore, Shahpur, Gujránwala, Karnál, Amritsar, Gujrát, Jhang and Mooltan, and
imported cases had occurred in the Delhi, Mooltan, Hissar, Kángra, Ráwalpindi,
Montgomery, Miánwáli and Dera Gházi Khan Districts.
It was not considered likely that the people of the Mooltan District, in which but
a small outbreak of plague had been limited to a single village, or of those districts in which
imported cases had occurred, would submit to inoculation, or indeed that except in the case
of the city of Delhi, where for special reasons it was considered desirable to make arrange-
ments for inoculation, that it was necessary to include these districts for the present in any
special scheme of inoculation operations.
The people of the Karnál District had not availed themselves of such facilities for
inoculation as had been afforded to them during the recent epidemic, and had displayed
an attitude which rendered their acceptance of the measure unlikely ; it was therefore not
considered necessary to make any special provision for inoculation in this district. This
left 13 districts and the city of Delhi to be provided for.
In these 13 districts there were 14 towns of over 150,000 inhabitants, the population of
which with that of the city of Delhi amounted to about 1,011,000 persons, for the inoculation
of about 500,000 of whom it was deemed advisable to make arrangements. Exclusive of that
of larger towns, the population of the 13 districts mentioned amounted to about 10,000,000,
of whom it was desired to inoculate 6,500,000 between September 1902 and January 1903.
Arrangements had therefore to be made for the inoculation of 7,000,000 persons in five
months.
Supply of prophylactic.
59. Before proceeding any further with the enquiry into the arrangements for a
scheme of such magnitude it became necessary
to ascertain whether the necessay supplies of
prophylactic would be forthcoming.
The Chief Plague Medical Officer when visiting Bombay in May 1902 informally
consulted Mr. Haffkine, the Director-in-Chief, Plague Research Laboratory, as to the
possibility of his supplying from the beginning of September onwards about 70,000 doses of
prophylactic daily, and Mr. Haffkine had given his opinion that he could meet this demand
provided that he were given sufficient notice.
On June 17th Mr. Haffkine, in reply to a telegram in which the same enquiry was
made, stated as the result of careful enquiries that compliance with the full requirements
of the Punjab was contingent only upon a sufficient supply of flasks being obtained by
him from Europe, and that in case of a scarcity of flasks he could supply half the
number of doses required, i.e. 35,000 doses daily, from September 1st, with daily
increments. This assurance with regard to the minimum supply of prophylactic rendered it
possible to proceed with the consideration of the scheme in detail.
Staff ; arrangements and estimates.
60. The number of Medical Officers necessary for the performance of 6,500,000 inocula-
tions in five months had to be determined, the
method for inducing: the voluntary acceptance
of inoculation by so large a proportion of the population had to be considered, plans for
carrying" out operations on a scale of such magnitude had to be formulated, estimates had to be
framed of the number of syringes and other instruments and accessories required in connec-
tion with the performance of the operation of inoculation. Further, the records required,
the methods of their maintenance, the establishment necessary, the number of the various
forms and registers required had to be decided upon, and the manner of providing the
staff and establishments with accommodation had to be considered, and finally an estimate
had to be prepared of the cost of the undertaking.
Preaching of inoculation.
61. The first problem to be considered was the method of inducing: the people to be
inoculated, and it was considered that the best
means for doing this was to depute selected
Assistant Commissioners and Extra Assistant Commissioners to infected districts to preach
inoculation, that is to say, to expound the benefits of the measure and to do all in their power
to persuade the people to accept it. It was estimated that 20 such officers would be
necessary, though it was expected that all district officers would share their work.
Medical staff required.
62. The strength of the medical staff re-
quired had then to be estimated.
On the basis of previous experience it was calculated that the number of inoculations
which a Medical Officer could be expected to perform daily was 700, and that therefore on
this estimate of 24 working days per month the number of full-time inoculators required to
perform 6,500,000 operations in five months was 77. This applied to rural areas only-
It was considered that Civil Surgeons and their assistants could perform all inoculations
required in the towns with the help of only two other operators.