TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS 1890-91 TO 1892-93.
3
*Akyab.
Kyaukpyu.
Hanthawaddy.
Pegu.
Prome.
Thôngwa.
Bassein.
Henzada.
Thayetmyo.
Mergui.
Toungoo.
Comparing the work of 1889-90 with that done in 1890-91, an improvement
is noticeable in all districts in the number of operations performed during the
latter year, except Sandoway, Henzada, Toungoo, and Salween. This decrease
was referred to in the brief report forwarded with the annual statements for that
year. Looking to district figures for the three past years, it will be observed
that in 11* out of the 18 districts the operations for
1891-92 were less than for 1890-91. In the Kyauk-
pyu district the decrease was slight (65 less). In
Bassein the falling off was only apparent, not real,
and was due to the exclusion of operations in the jail
as explained in the notes accompanying the state-
ments for that year. The causes which led to the diminution in the other dis-
tricts were also noticed at the time.
Since then an improvement has taken place in all districts except Pegu,
Prome, Thôngwa, Amherst, and Salween Hill Tracts. In Pegu and Thôngwa the
decrease has been considerable and steady for the past two years. In Prome the
difference between the figures of the two last years is trifling (52). In Amherst
and the Salween Hill Tracts the operations performed in 1892-93 were less than
those for the previous year by 2,289 and 379 respectively.
The decrease in the Pegu district is due to the presence of a large number
of private vaccinators. These men qualify themselves as vaccinators by working
for a time under the Health Officer, Rangoon Municipality, and when they obtain
a certificate that they are competent to vaccinate, they go into the district and
oftener than not practise inoculation under the guise of vaccination. Pegu, Thôn-
gwa, and Henzada seem to be the most favoured districts, Pegu pre-eminently so,
as frequent applications are made to me for permits to practise there. At first
permission was given on the understanding that the applicants would obtain their
supplies of lymph through the Civil Surgeon of the district and furnish that
officer occasionally with a list showing the number and names of those operated
on in order that he might verify the cases. This they entirely omitted to do, and
District Medical Officers invariably report that, armed with these permits and
the original certificates of qualification, these vaccinators resort to inoculation. I
received a strong representation on this subject from the Civil Surgeon, Pegu, last
year, but as the practice of inoculation cannot be interdicted, nothing can be done.
The people themselves favour inoculators and screen them as much as possible. In
Thôngwa the decrease was due to the indifferent work of the vaccinators. There
were three changes in the appointment of town vaccinator at Ma-ubin during the
year owing to unsatisfactory work, and in the district the Pantanaw vaccinator,
who was removed in May, was not replaced till the month of December. In the
Amherst district, though the number of cases vaccinated was less in 1892-93
than for the previous year, which was unusually high, the number of operations by
each vaccinator gives an average of over 2,200. In the previous year small-pox
was more prevalent, and 7 calves had been vaccinated and conveyed to thickly
populated neighbourhoods in response to applications for vaccination. Only 4
calves were so sent in 1892-93. In the Salween Hill Tracts district, owing to
the presence of small-pox in the district, the hill tribes refused to allow any stranger
into their villages for fear of infection. This is in marked contrast to the atti-
tude of Karens in the settled districts, who eagerly accept the prophylactic,
especially when small-pox is in the neighbourhood. The percentage of successes
in primary vaccinations was 86.65 in 1892-93 as against 85.21 in 1891-92 and
85.38 in 1890-91. The percentage of success in re-vaccinations was 47.79 in
1892-93 as compared with 61.03 and 57.19 for the two previous years. In con-
nection with the smaller number of secondary operations the Civil Surgeon, Ran-
goon, remarks that the reason is the adoption in previous years of a faulty method
of classification, whereby large numbers of children successfully vaccinated for
the first time have been treated as re-vaccinated simply because they did not re-
spond to the first operation. To call such cases re-vaccinations was both an error
in judgment and an oversight of the instructions. In the following statement the
average number of successful operations performed in towns on children under
one year of age during the past three years and the number of births for a similar