2
TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS 1917-18 TO 1919-20.
Sagaing Division—Shows an increase of 6,696 primary and 27,582
re-vaccinations ; of the latter Sagaing itself supplied 16,947 cases, as the result of
a moderately severe outbreak of small-pox. The Lower Chindwin shows a
decrease of 1,427 primary cases, which is in part due to unwarrantable changes
made by the Civil Surgeon in the methods of distribution of the lymph.
Magwe Division.—Primary vaccinations in Thayetmyo District increased by
4,157 cases, but the other three districts, Pakôkku, Magwe and Minbu, showed a
slight falling off. There has been an increase of 36,203 re-vaccinations of which
the lion's share fell to Pakôkku 28,681.
Meiktila Division.—There has been a heavy falling off in Myingyan of
6,945 cases of primary vaccination. The reason appears to be, that practically
no touring has been done during the triennium by the Civil Surgeon. The present
Civil Surgeon has been too busy and the late Civil Surgeon too enfeebled by
illness to go on tour.
What can be done by vigorous action is well illustrated by the case of
Yamèthin. Finding his district threatened on several sides by an invasion of
small-pox, the Deputy Commissioner initiated a campaign for the protection of
the population by re-vaccination. This was begun in 1918-19 and continued with
great vigor throughout 1919-20. During the latter year 159,622 cases were
re-vaccinated, in addition to 19,540 cases of primary vaccinations, out of a total
population of 306,379. Nor was any enormous staff engaged for this work ; it
consisted of one Supervisor and seven vaccinators, so that each man vaccinated
over 22,000 cases in the year. This gives one furiously to think, and suggests
that both our organization and establishments are in need of revision. There
is no doubt the excellent results obtained were due to the energy of Lieutenant-
Colonel Bigg Wither, the Deputy Commissioner, who is described by the Civil
Surgeon Dr. Basu as being the " fountain head and back-bone" of the
campaign. The metaphor may be mixed but the inference is clear. All the
District officials contributed to the success of the work but the driving power
came from the Deputy Commissioner.
It was found that the best results were obtained by concentrating the staff
on a limited area, rather than by adopting the usual method of employing single
men scattered throughout the district.
The Civil Surgeon himself verified over 28 per cent. of the cases.
Shan States.—There was an increase of 17,443 in the Northern and decrease
of 17,161 in the Southern Shan States in primary vaccination work. The amount
of reliable inspection done in this part of the Province is very small and I do not
place much faith in the returns. The increase in the Northern Shan States is
said to be due to improved organization, but no explanation is furnished with
regard the decrease in the Southern Shan States.
Chin Hills—There has been a falling off to the extent of 1,090 primary
cases—probably due to the disturbed state of the Hills during part of the
triennium.
During the triennium the following percentage of the population was
primarily vaccinated in the different divisions.—
Tenasserim... ... ...
Irrawaddy... ... ...
Sagaing... ... ...
Magwe... ... ...
13.91
13.34
12.17
11.11
Pegu... ... ...
Arakan... ... ...
Meiktila... ... ...
Mandalay... ... ...
10.99
10.59
10.18
9.5
2. Small-pox and Vaccination.—Small-pox as is well known comes in cycles
lasting 2 or 3 years with intervals of 5 or 6 years between them. Epidemics in
Burma begin in Rangoon and Lower Burma, afterwards spreading to Upper
Burma. They are coincident with epidemics in India and probably due to them.
During 1919, 85 cases of small-pox in the eruptive stage were detected amongst
immigrants into Rangoon, and the number in whom the disease was in the
incubation stage and not therefore detectable, was probably very considerable.
The Vaccination Act of 1909 has failed to protect Rangoon and will continue to
fail until amended.
The failure lies in the definition of what constitutes an " unprotected person."
According to the Act any adult who has been successfully vaccinated at any