NOTES AND STATISTICS ON VACCINATION IN BURMA FOR THE YEAR 1920-21.
3
Meiktila Division.—This division returns a deficit on the work of the pre-
vious years of 1,215 primary and 106,066 re-vaccinations. Yamèthin District had
the largest share in this decrease, viz. 3,234 primary and 102,610 re-vaccinations.
A very large proportion of the population, 55 per cent., was vaccinated or re-
vaccinated during the year 1919-20 in consequence of the vigorous propaganda
started by the Deputy Commissioner in 1918-19. It followed that there was a
smaller number of unprotected persons available, and a marked fall in the returns
was to be expected. Notwithstanding the number of operations performed
daring the year under review was 73,318, which greatly exceeds the total of any
other district in the Province.
Shan States.—In the Northern Shan States a decrease of 455 primary
operations, and an increase of 513 re-vaccination cases is recorded. The
Southern Shan States returned a total increase of 828 operations, of which 770
were primary cases.
4. New Plan of Work.—The usual method of distributing vaccinators has
been in the past to assign to each a separate area of the district to work in
throughout the year. Major Brayne, I.M.S., in 1913 showed that better results
could be obtained by concentrating a number of vaccinators to work in a limited
area, until every village therein had been visited, the Supervisor to follow eight days
later to verify results. This method has again been tried during the year under
review in the Prome, Pegu, Meiktila, Mandalay, and Myaungmya Districts. Prome,
Pegu, Mandalay, and Myaungmya showed an increase in total vaccination output
of 3,894, 4,794, 6,368 (figures for rural area only) and 3,785 cases, respec-
tively, as compared with the returns of last year, while the Meiktila District alone
returned a decrease of 1,552 cases. Other districts in the Province worked
on the older system and showing a marked increase were Amherst 16,495,
Thatôn 10,977, Lower Chindwin 2,818, and Kyaukpyu 2,267. In the first two
districts there was much small-pox. i he increase in the latter may be attributed
to better supervision.
In 1915 I applied the system of concentration of vaccinators to the Meiktila
District, but with no better results than in 1920-21. The failure in that instance
was due in a large measure to the untrustworthiness of the Burmese Supervisor,
but, also to the fact that the Civil Surgeon could not himself personally supervise
the work and did not succeed in any marked degree in obtaining the co-opera-
tion of the Burmese district officials.
Whatever method is adopted, good supervision is as essential for its
success as is the close co-operation of the district officials, but this should be
easier to ensure when the vaccinators are concentrated in a limited area,
and the results shown by the Prome, Pegu, Mandalay and Myaungmya vaccina-
tion staffs appear to justify an opinion that the method is one which can be
generally adopted with better results than attend the older plan of work under
normal conditions of freedom from epidemics.
5. Results of Vaccination.—Primary operations verified as successful
show an increase. on the previous year's returns of 5,029. They total
448,446 against 443,417 in 1919-20 and 397,720 in 1918-19. There were
11,796 failures, while the result remained unknown in 21,449 cases.
Successful re-vaccinations totalled 88,253 against 186,407 in 1919-20, a
decrease of 98,154. In 1918-19 the total successful re-vaccinations were 76,588.
The percentage of successful cases in which the results were verified is
97.48 in primary vaccinations and 55.70 in re-vaccinations as against 97.53
primary and 60.58 re-vaccinations in 1919-20. Lower Chindwin District in the
Sagaing Division heads the list with a percentage of 99.99 in primary cases.
Mergui District returns a low primary success ratio of 87.24 per cent. for
which no explanation is offered by the Civil Surgeon.
6. Vaccination in Towns.—In 59 towns in which vaccination has been
made compulsory by law, 35,952 primary and 36,216 re-vaccination opera-
tions were performed during the year under review, being a deficit of 2,827
primary and 54,426 re-vaccinations on the returns of the preceding year.
As in rural areas so also in towns the fall in the outturn of vaccination work was
attributable to the absence or less severity of small-pox outbreaks.