FOR THE TRIENNIAL PERIOD FROM 1893-94-1895-96.
3
cantonments that vaccination is compulsory. The statement printed in para-
graph 8 of the report shows that with a few exceptions vaccinations in muni-
cipal towns in Lower Burma keep pace with the accessions to the population of
the towns by births. A similar statement of much interest was furnished for
rural tracts in the last triennial report, and such a statement might with advantage
have been included in the present report. The Chief Commissioner will be glad
if this statement (i.e., for districts exclusive of municipal towns) is given
in future reports, and he requests also that statistics for the Upper Burma towns
in which births and deaths are registered, and in which the Vaccination Act is in
force, may be given in the statement for municipal towns.
4. Judged by the amount of work done by each vaccinator and the percent-
age of successful cases, the districts in which vaccination work seems to have been
pushed forward most vigorously during the year 1895-96 are Sandoway and
Hanthawaddy (inclusive of Rangoon) in Lower, and Mandalay, Meiktila, Sagaing
and the Chindwin districts in Upper, Burma. But the statement of inspections
(Statement V) leaves room for doubt as to the quality of the work in Hantha-
waddy. In the Toungoo, Salween, Mergui, Myingyan, Shwebo, and Katha dis-
tricts the vaccinators appear to have been industrious but somewhat unsuccessful.
The quality of the lymph-supply in these districts may be susceptible of improve-
ment. The least satisfactory results were those attained by the Akyab, Kyauk-
pyu, Bassein, and Myaungmya vaccinators in Lower Burma and in Myitkyina
and the Ruby Mines districts in Upper Burma. Special local causes may account
for the shortcomings in the quantity and quality of the work in Myitkyina and
the Ruby Mines. If so, the causes should have been reported. But in the case
of Akyab and Myaungmya, and also, though in a less degree, in the case of Bassein
and Kyaukpyu, Mr. Smeaton can only suppose that the vaccinators are lazy and
inefficient, and that the Civil Surgeons have been lacking in supervision. In Akyab
the results are specially unsatisfactory, seeing that the district only lately (in 1893)
recovered from a severe epidemic of small-pox.
Verification of results.
5. In most districts the work of the vaccinators was fairly inspected during
1895-96, but in some the verification of operations
was altogether inadequate. In this respect the re-
turns for the districts of the Arakan division are the worst. The Civil Surgeons
of these districts must devote much more attention to vaccination work in future.
The Native Superintendent in Akyab district inspected only 1.51 per cent. of the
vaccination cases. The Superintendent is requested to submit a special report on
this officer's work. In the Hanthawaddy district the great bulk of the inspection
work was done by the Native Superintendents: they reported 82.17 per cent. of the
cases inspected by them to be successful, a proportion very slightly less than that
claimed by the vaccinators themselves. But in the cases inspected by the Civil
Surgeon (only 6.41 per cent. of the aggregate number) the percentage of success-
ful instances was found to be only 34.99. This wide discrepancy casts grave
doubts on the accuracy of the Native Superintendents' returns and shows the need
of better supervision on the part of the Civil Surgeon. The Civil Surgeon's duties
at headquarters have been lightened by the appointment of a Resident Medical
Officer to the Rangoon General Hospital. He should in future be able to devote
more time to checking vaccination work in Hanthawaddy, especially in the