TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS 1917-18 TO 1919-20.
7
children for vaccination at the summons of the Thugyi. The urgency of that
summons and the degree of compliance with it depends entirely on the status
and influence of the officer who has invoked the aid of the Thugyi.
Compulsory vaccination would in practice be on exactly the same lines, but
the position of the various officials concerned would be regularized and
strengthened.
It is a disconcerting paradox that the very success of vaccination in
preventing small-pox increases the unwillingness of the people to submit to it.
An outbreak of small-pox occurs in a village followed by a vigorous vaccination
and re-vaccination campaign. In consequence the village remains free from
small-pox until a non-immune population has grown up. Past experience is
forgotten—there has been no small-pox for years, why should they take the
trouble of having their children vaccinated ? This topsy-turvy mentality is very
difficult to deal with especially on a voluntary basis.
Inoculation as a preventive of small-pox is widespread especially in Pegu,
Tenasserim and Irrawaddy Divisions. It is less common but by no means unknown
in Upper Burma, and epidemics have time after time been traced to this source.
Apart from its being a time honoured practice, I believe the chief cause of its
popularity is the absence in the majority of cases of any troublesome symptoms,
such as sometimes follow vaccination under insanitary conditions. The inoculated
child may of course develop generalized small-pox and die, this risk is clearly
recognized, but accepted, because in the majority of cases the after-effects are
almost nil. A small pock with perhaps 2 or 3 still smaller ones round it, is the
usual course of an inoculation, and the children require little if any attention.
That the inoculated child may spread infection and give rise to a severe epidemic
of small-pox, is either not recognized, or else considered outside the sphere
of human action and fittingly left in the hands of Providence.
To increase the popularity of vaccination all officers concerned lay stress on
the importance of the after treatment of the sores, and this point will receive more
attention in future. I should like to present the mother of each vaccinated child
with a collapsible tube of some antiseptic ointment, to be applied to the vesicle
after it has ruptured, but fear the expense would be prohibitive. Some officers
both here and in India advocate painting the arm with Iodine before vaccination.
They claim that this treatment greatly diminishes the severity of undesirable after-
effects. This is quite true, but unfortunately the iodine, while it diminishes
undesirable after-effects, also to the same degree diminishes and sometimes com-
pletely prevents the desired after-effect, i.e., the formation of a large typical
vesicle, and its use should never be permitted. I would suggest that more
official notice be taken of Thugyis and other Officers, who take an interest in,
and help vaccination work. No doubt there have been cases, but I have
personally never known one, where a Thugyi has been given some decoration
or reward for good work of this kind. Yet it is surely as important as helping
the Police, Forest Department or Recruiting.
12. Cost of the Department.—The annual expenditure increased during
triennium by Rs. 43,156-2-4 from Rs. 6,54,416-6-9 to Rs. 6,97,572-9-1. The
increase on Establishment was Rs. 18,320-11-0, on Contingencies Rs. 22,185-12-3
and on travelling allowance Rs. 2,649-11-1. Under Contingencies there is a total
increase of Rs. 22,185-12-3, the Vaccine Depôt, Meiktila, accounts for
Rs. 15,847-5-2 of this, the balance is enhanced expenditure on increased establish-
ment (Rs. 18,320-11-0) and travelling allowance (Rs. 2,649-11-1).
The average cost of each successful operation during the triennium was
Re. 0-7-4 as compared with Re. 0-8-7 in the previous triennium or a decrease of
Re. 0-1-3.
During 1919-20 the average cost per successful case was annas six and pies
four only which was the lowest for several years past. The districts showing
highest cost per successful case were Northern Arakan Hill Tracts (Rs. 1-15-10)
and Ruby Mines (Rs. 1-6-3). The lowest was returned by Yamèthin District, only
ten pies per case.
Other districts which returned a low cost were Sagaing
(Re. 0-2-8), Katha (Re. 0-3-6), Amherst (Re. 0-4-5), Tharrawaddy (Re. 0-4-6),
Bassein (Re. 0-4-7), Magwe and Thatôn (Re. 0-4-11). The cost in Ma-ubin,