TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS 1914-15 TO 1916-17.
3
Burma in the second year from their onset in the coastal districts, which is usually
the third year from their commencement in Rangoon.
Statement I.
3. Comparative study of vaccination operations :—
Arakan Division.—The deficiency of 36,838 operations in the Arakan Division
in the triennium under review is subject to a simple explanation which leaves no
room for doubt. This deficiency includes 27,248 primary and 9,590 revaccinations.
The decrease in primary operations affects principally the returns of Kyaukpyu
and Sandoway Districts, but there is also a deficit of 534 primary operations in
Northern Arakan District, Akyab District showing an increase for the last trien-
nial period of 3,717 primary operations.
The deficiency in the Kyaukpyu District returns is wholly dependent upon
the almost complete absence of small-pox mortality in that district during the
last triennium whereas there were two serious outbreaks of the disease in 1911
and 1913 respectively; the latter, which was the more severe, accounted for 405
registered deaths. To cope with the epidemic the permanent establishment of
six vaccinators was augmented by six additional temporary employees for a period
of some months. The combined establishment claimed to have performed during
the twelve months 19,861 primary operations, with 18,872 known successes;
and 1,128 revaccinations with 673 successes. Only 3,431 (17.3 per cent.)
primary operations and 88 (7.8 per cent.) revaccinations were inspected by the
Civil Surgeon and can be accepted as absolutely authentic operations. Serious
doubt is thrown upon the genuineness of the returns of this district for the whole
triennial period, which claim 44,366 primary operations, amounting to the whole
census population of the district up to the age of 10 years. An abnormally large
staff was employed in 1913-14, proportionally to population at least double that of
any district of Burma proper.
For Sandoway District the decrease in the number of primary operations
amounting to 4,258 or 29.6 per cent. on the returns of the previous triennium is
explained by the late Civil Surgeon Dr. Maung Tha Noo, himself an Arakanese,
as being largely due to the ignorance, backwardness, and apathy, of the rural
population, in the absence of the stimulus created by small-pox mortality. Only
two deaths from this disease have been reported in the district during the past
triennium.
Pegu Division.—A total increase in the last triennium of 26,966 (14.63 per
cent.) primary operations and 13,161 (10.14 per cent.) revaccinations is returned
for this Division. Insein and Hanthawaddy Districts each return between 10,000
and 11,000 primary operations in excess of the previous triennium. The vacci-
nation establishments of these two districts are under one Civil Surgeon and their
work may be reviewed as for the conjoined district, which was a single adminis-
trative unit in 1911-12. Starting with the 7,279 primary operations performed in
the whole area in that year, and 8,563 in 1912-13, the great advance has been made
to 21,612 in 1916-17. The last serious epidemic of small-pox in the district
occurred in 1912, so that the whole of the progress has been made without the
stimulus of small-pox prevalence.
In the triennial report for 1911-12 to 1913-14 it was stated that the excess
primary operations in this conjoint district over the work of the previous triennium
amounted to 96.68 per cent. In the triennium under review the further advance
of 60.81 per cent. was achieved.
Pegu District returns show a deficit of 2,118 primary operations, and Rangoon
Town District of 3,677. The output of work in Pegu District reached its maximum
in 1913-14, stimulated perhaps by the considerable small-pox mortality of the two
previous years, and has shown a rather sudden drop to pre-epidemic conditions
in the triennium under review. Rangoon returns showed a falling off in primary-
vaccination from 1911-12, an epidemic year, with 10,428 primary operations, to
6,621 in 1914-15 and has to some extent recovered in 1916-17 to 8,052 in face
of another, though much less severe, outbreak of small-pox. In this town 108,593
revaccinations were performed during the last triennium, an excess of 9,490 on
the preceding period ; and of this total 56,541 or more than 50 per cent. were
carried out in 1916-17.
Next to the advance made in the vaccination work of the Insein-cum-Han-
thawaddy District that of the Prome District calls for encomium. Throughout the
preceding triennium primary vaccination had steadily declined in this district to
9,689 operations in 1913-14. During the triennium under report it has as steadily
risen to 13,919 primary operations in 1916-17, ; the excess work for the last trien-
nium is 7,597 primary operations (25.31 per cent.) and 6,241 revaccinations
52.95 per cent. It is understood that this progress owes much to the active
support of the Deputy Commissioner Mr. C. S. Pennell, I.C.S., who has
personally interested himself in improving the condition of vaccination in his district.
The Civil Surgeon, Major Nolan, I.S.M.D., is also to be congratulated.