( 4 )
The percentages of inspections by the Civil Surgeons of the total
number vaccinated was 2.07 primary and 6.42 re-vaccinations and those
by the Divisional Inspectors and Superintendents were 23.90 and 74.46
primary and 21.36 and 73.00 re-vaccination respectively.
Inspections by Deputy Sanitary
Commissioner.
The Deputy Sanitary Commissioner personally inspected Vaccina-
tion in 4 towns and 13 villages. The total number
of children inspected and verified was 405 and
the number of vaccination and re-vaccinations
carried out by him, or under his immediate supervision was 34.
He corrected the methods of certain Vaccinators explaining at the
time the reasons for so doing.
Appendix A.—Vaccination in
Municipal towns.
16. In Appendix A are shown for the Municipal towns and notified
Areas, in the province, the number of children
under one year of age available for vaccination
and the number of vaccinations performed on
them in 1919-20. The excess of primary vaccinations over births regis¬
tered in some of them, as noted in previous reports, is due to defective
registration and to the floating population composed of transfrontier tribes
submitting their children for vaccination while passing through these
centres on their way to and from independent Territory. In Peshawar
City and in the Notified areas of Nowshera, Kalan, Backet Gunj, Khwaja
Gunj and Lakki the provisions of the Vaccination Act are not in force.
Appendix B.—Case success and
annual ratio of deaths from Small-
pox.
17. It will be observed that the Small-pox broke out in epidemic
form in almost every district throughout the
province. The following number of deaths were
recorded in the following details. In the Hazara
district 325 deaths, Peshawar district 828 deaths including 269 deaths in
the Mardan Sub-Division, Kohat district 118 deaths, Bannu district 99
deaths, and in Dera Ismail Khan district 302 deaths. I note that the
mortality from Small-pox is 0.81 per thousand deaths for the whole
province.
Particulars of Lymph used.
18. All vaccination operations were performed with Glycerinated
choloroformed lymph obtained from the Punjab
Vaccine Institute, which has been punctual in
complying with indents sent from this province. The lymph received
was of good quality and gave satisfactory results.
Attitude of the people towards
Vaccination.
19. The people of the province are on the whole in favour of
Vaccination, but not so in the case of re-vaccination
which is unpopular, except when Small-pox prevails
in epidemic form. No religious prejudice against vaccination exists.
Summary and Conclusions.
20. The Deputy Sanitary Commissioner reports that he has seen
cases of reputed Small-pox in vaccinated and re-
vaccinated adults in this Province.
He saw
similar cases in East Africa, and is of the opinion that these cases constitute
a disease comparable to Pyosis Corletti, which is Staphylococcic in origin,
rather than an instance of pure Small-pox. In fact they may approximate
to the African variety I have mentioned in para 2.
21. I am indebted to Major Stiles Webb, I. M. S., Deputy Sanitary
Commissioner for the compilation of this Report.
I have the honour to be,
SIR,
Your most obedient servant,
G. TATE, LIEUT.-COLONEL, I.M.S.,
Sanitary
Commissioner,
North-West Frontier Province.