NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
FOR THE YEARS 1923-24 TO 1925-26.
5
Prome (99.34), Pegu and Myaungmya (99.26) and Magwe (99.22).
The district with the lowest successful rate was Minbu (88.34), the next
being the Hill District of Arakan (89.51). Other districts which returned
a success-rate of less than 95 per cent. were Shwebo (93.20), Salween
.(94.40), Mergui (93.43) and Bassein (94.80).
The low rates of Shwebo, Minbu, and Bassein Districts were
apparently due to bad technique on the part of vaccinators, whereas the
low rates in the Hill Districts of Arakan, Mergui and Salween District
may have been due to delay in transit of lymph from Meiktila. In the
remaining districts the percentage of successful cases varied from 95
to 98.
Statement I.
5. Re-vaccination.—The total number of re-vaccinations recorded
during the triennium was 768,977 cases, as compared with 524,326 for the
triennium 1920-21 to 1922-23, representing an increase of 244,651 opera-
tions. The district which performed the highest number of revaccina-
tions was Rangoon (112,724) showing an increase of 65,728 cases over
the figure for the previous triennium. Sixty-one thousand seven hundred
and thirteen cases were performed in Amherst District, 40,034 in Pakôkku
District, 38,448 in Sagaing District, 38,350 in Thatôn District, 33,656 in
Mandalay District and 31,274 in Myingyan District. Over 20,000 opera-
tions were returned from Pegu, Tharrawaddy, Bassein, Ma-ubin,
Magwe, Yamèthin, and Upper Chindwin Districts; over 15,000 from
Akyab, Hanthawaddy, Myaungmya, Toungoo, Thayetmyo, Kyauksè,
Shwebo and Lower Chindwin Districts; and over 10,000 from Insein.
Pyapôn, Minbu, Meiktila and Katha Districts. In all districts mentioned
above the output of re-vaccination showed an increase over the work
of the previous triennium, with the exception of the districts of
Yamèthin, Akyab and Lower Chindwin.
The percentage of success in re-vaccination was 42.21 in 1925-26. as
against 47.74 in 1924-25, and 46.76 in 1923-24. The successful rate
in each of the years of the previous triennium being 1920-21 (55.70),
1921-22 (58.46) and 1922-23 (53.68).
6. Vaccination in Towns.—In the 63 towns in which the Vaccination
Acts are in force, 363,414 operations were performed during the
triennium under report, of which 1.38,923 were primary and 224,491 were
re-vaccinations, as against 253,194 operations (viz. 119,403 primary, and
133,791 re-vaccinations) in the previous triennium. There was therefore
an increase in primary vaccination of 19,520 and in re-vaccination of
90,700 operations, making a total increase of 110,220 operations. The
percentage of success in primaries was 98.80, and in re-vaccinations
51.60 as compared with 98.67 and 56'99 respectively in the previous
triennium.
During the year 1925-26 altogether 112,755 operations were
performed in towns as compared with 154,754 in 1924-25 and 95,905 in
6
TRIENNIAL REPORT ON VACCINATION IN BURMA
1923-24. Thus there was a decrease of 41,999 operations over the out-
put of the previous year, but an increase over that of 1923-24 by 16,850
operations.
Of the total operations 46,565 were primary-and 66,190 re-vaccination
cases, the percentage success in primary being 98.60 and in re-vaccinations
46.88, as compared with 98.87 in primary and 52.89 in re-vaccination in
1924-25. In 31 towns the output shows an increase, and in 32 towns a
decrease. The towns which show a marked increase in primary
vaccination, work were Prome, Shwedaung, Paungdè, Moulmein, Mergui,
Pyu Thayetmyo, and Yamèthin.
7. Re-vaccination in Towns.—In 30 places the output of re-vaccin-
ation shows an increase and in 33 places a decrease. The towns which
show an appreciable increase in the number of operations performed
are Yamèthin (+824), Nyaunglebin (+523), Toungoo (+516), Nyaungu
(+373), Minbu ( + 171), and Pyu (+160). A marked decrease in
re-vaccination is noted at Thatôn (—3,937), Mandalay (—1,978),
Pyinmana (-1,901), Sagaing (-1,362), Bassein (—1,081), Kyauksè
(-998), Moulmein (-979), Insein (-823), Syriam (-674), Akyab
-559), Meiktila (-538) Kyaukpyu (-419) and Pegu (-404).
Appendix B.
8. Infant Vaccination.—In the 63 towns of the Province 33,595 births
were registered in 1925-26 and of these 9,395 infants under one year of
age died thus leaving 24,200 survivors available for vaccination. The
total number of children of this age vaccinated was 28,412, an excess of
4,212 over the survivors. In 33 towns the number of infants successfully
vaccinated was less than the survivors, but in 30 it was more. The main
reason for this latter discrepancy is the defective birth registration,—
many childern being vaccinated whose births have not been recorded
while the careless upkeep of vaccination registers is a contributory factor.
It is also a common practice for parents from rural areas to have their
children vaccinated during a visit to a town, thus swelling the urban
figures. The excess in Mandalay ,Pegu and Nyaunglebin has been
attributed to this latter cause by the Health Officers concerned. The
figures for Nyaungu Town are so obviously fallacious as to call for
special comment. Actually 170 births were recorded while 148
children under one year of age died—thus leaving only 22 available for
vaccination while the number of children successsfully vaccinated :was
88 or 66 more than the survivors. It is extremely unlikely that 66
children had been brought to the town from other places or that the
infantile mortality could have been as high as 870.
Regarding towns in which the number of infants vaccinated
was less than the number of survivors available, the following are
included : Sandoway, Thônzè, Syriam, Shwedaung, Paungdè, Ngathaing-
gyaung, Kyônpyaw, Wakèma, Kyaikto, Shwegyin, Maymyo and
Myingyan. Here unfitness for vaccination owing to sickness or skin
FOR THE YEARS ,1923-24 TO 1925-26.
7
disease, death before vaccination, or departure from the locality were
among the reasons given for the, discrepancy. It would appear that in
these, places no children .could have come into the town from outside,
or that if any did come they must have escaped the notice of the
vaccinating authorities.
Statement
III.
9. Dispensary Vaccination.—During the triennium under report 23,884
operations were performed in various hospitals and dispensaries in the
Province, of which 14,474 were primary and 9,410 re-vaccinations.
The figures for the previous triennium totalled 14,683 operations, with
8,500 primary and 6,183 re-vaccinations. Thus there has been a decided
increase in dispensary vaccination during the present triennium, the
excess recorded being 9,201 operations.
During the year 1925-26 only 19 districts returned reports of
dispensary vaccination whereas during the year 1924-25,—22 districts
reported on such work. In Pyapôn, Pakôkku and Shwebo districts
181, 97 and 13 dispensary vaccinations were performed during
1924-25 respectively, whereas during this year no operations were
reported from these districts. The amount of work done in 12 districts
shows a decrease, and in 7 districts an increase, as compared with the
previous year. Bassein District, which reported 4,475 dispensary
vaccinations last year, reported only 581 cases during this year.
10. Jail Vaccination.—Out of an average daily population of 19,463
in 36 jails and subsidiary jails, 31,063 persons were vaccinated, of whom
1,282 were primary and 29,781 re-vaccination cases. Of primary cases,
1,087 (or 84.79 per cent.) were reported as successful, and of re-
vaccinations 15,469 (or 51.94 per cent).
11. Vaccination by " Other Agencies".—In the four places from which
returns for vaccination done by private practitioners were received only
730 persons were reported to have been protected by them. Of these
287 were primary and 443 were re-vaccinations. The rate of success in
primary cases was. 98.11 and in re-vaccinations 79.53 per cent. In the
previous year 537 primary and 1,656 re-vaccinations were performed by
private practitioners. It is only to be expected that with the increase in
facilities for free vaccination by the public vaccination staff, the work
performed by private practitioners should show a corresponding decrease.
12. Steamer Vaccination.—Under the provisions of section 9 of the
Burma Vaccination Law Amendment Act of 1909, 41,169 labourers
were vaccinated op arrival at the Port of Rangoon by the Vaccination
staff,of the Corporation of Rangoon under the supervision of the Port
Health Authorities, during 1925-26,—a striking increase when contrasted
with,a return of 30,202 in 1924-25 and 27,155 in 1923-24. The results
of none of these cases however could be verified, as these people
proceeded to their destinations as soon as they had been vaccinated.
8
TRIENNIAL REPORT ON VACCINATION IN BURMA
Statement V.
13. Verification Work of Inspecting Officers.—Of the total number of
848,891 persons vaccinated in 1925-26, District Health Officers and
Assistant District Health Officers claim to have inspected the results of
80,095 (or 9.44 per cent.) of the total number vaccinated, as against
58,676 (or 7.19 per cent.) in 1924-25 and 65,282 (or 8.61 per cent.) in
1923-24. Thus there is some improvement in the inspection work of
these officers in comparison with the work of the previous two years.
Of primary cases 60,569 (or 10.81 per cent.) and of re-vaccinations
19,526 (or 6.76 per cent.) were inspected.
The districts which claimed large percentages in order of pre-
cedence were Meiktila 81.89 per cent. of primary and 22'60 per cent. of
re-vaccination, Chin Hills 68.44 per cent. of primary and 55'20 per cent.
of re-vaccination, Pegu, 49.90 per cent. in primary, 3.52 in re-vaccination;
Kyauksè, 39.48 per cent. in primary and 5.63 in re-vaccination ;
Tavoy, 39.30 per cent. in primary and 4.73 per cent. for re-vaccination ;
Sandoway, 38.88 per cent. in primary and 30.04 per cent. in re-
vaccination ; and Upper Chindwin, 38.87 per cent. in primary and
24.42 in re-vaccinaiton.
The districts in which very little inspection work was performed
were Akyab, where 0.12 per cent. in primary and nil in re-vaccination
were inspected; Southern Shan States, 0'43 per cent. in primary and
nil in re-vaccination; Bassein, 1.27 per cent. in primary and 0.99 per
cent. in re-vaccination; Magwe, 1.79 per cent. in primary and 1.87 per
cent. in re-vaccination; Myaungmya, 1.83 per cent. in primary and 1.66
per cent. in re-vaccination; and Insein, 1.94 per cent. in primary and
1.65 per cent. in re-vaccination.
The total number of persons inspected by Inspectors of Vaccination
and other Inspecting Officers was 424,054 or 49.95 per cent. as compared
with 431,743 or 52.92 per cent. in 1924-25, and 376,871 or 49.73 per
cent. in 1923-24. The Inspectors in Pegu District claim to have
verified the results of 91.17 per cent. in primary and 89.59 per cent. in re-
vaccination cases, in Kyauksé, primary 93.09 and re-vaccination 77.17
per cent.; Pyapôn, primary 91.56 and re-vaccination 56.20 percent.;
Rangoon, primary 90.13 and re-vaccination 72.38 per cent.; Meiktila,
primary 83.66 and re-vaccination 67.34 per cent.; Ma-ubin, primary
83.53 and re-vaccination 69.02 per cent.; Tharrawaddy, primary 73.66
and re-vaccination 49.91 per cent. and Tavoy, primary 72.19 and re-
vaccination 61.45 per cent.
Other districts showing over 60 per cent. of primary cases inspected
were Akyab, Insein, Thayetmyo, Sagaing and Southern Shan States ;
and over 50 per cent. Sandoway, Hanthwaddy, Myaungmya, Mergui,
Toungoo, Mandalay, Katha and Lower Chindwin. In these districts a
fairly large number of re-vaccination cases were also inspected.
A low percentage of verification of vaccination work by Inspectors
of Vaccination was returned by the districts of Kyaukpyu, Prome,
Thatôn, Amherst, Magwe, Pakôkku and Shwebo.
FOR THE YEARS 1923-24 TO 1925-26.
9
14. Establishment.—The following table contrasts the strength of the Statement II.
Vaccination Establishment in each year of the two triennial periods :—
Years.
1920-21...
1921-22...
1922-23...
Average...
1923-24...
1924-25...
1925-26...
Average...
Part time Supervising Staff.
Civil
Surgeons
41
41
41
41
41
41
41
41
Sub-Assistant
Surgeons.
29
35
31
32
36
27
27
30
Public Health
Inspectors.
...
...
...
...
...
6
8
5
Inspectors
of
Vaccination.
46
46
43
45
44
43
44
44
Head
Vacci-
nators.
3
3
1
2
1
1
1
1
Vacci-
nators.
347
337
336
340
339
342
365
349
The number of Sub-Assistant Surgeons receiving vaccination allowance
or otherwise employed in the Vaccination Department as part time
supervising officers in 1925-26 was the same as last year. The cadre of
Inspectors of Vaccination was increased by one. due to appointment of an
additional Inspector of Vaccination in Mergui District to supervise the
work of additional vaccinators employed consequent on the extension
of the Vaccination Acts to this district. The cadre of vaccinators was
augmented by the appointment of nine additional Registrar-Vaccinators
in the Corporation of Rangoon, one vaccinator each in Letpadan, Zigôn,
Kyônpyaw and Thatôn towns, one in Tharrawaddy and Thônze towns
jointly, one each in Akyab, Bassein and Kyauksè Districts, and three each
in Mergui District and Southern Shan States, all totalling a net increase
of 23 vaccinators. Nine vaccinators, one each in Akyab, Bassein,
Minbu, Pakôkku and Shwebo, two each in Pyapôn and Amherst
Districts, were either removed or dismissed from the service for
falsification of returns and diaries ; whilst the services of three vacci-
nators (two in Meiktila and one in Lower Chindwin Districts) were
dispensed with for the same offence. Seven vaccinators resigned their
appointments and three died. Ten additional temporary vaccinators for
a period ranging from one to six months were employed in Kyaukpyu,
Insein, Prome, Shwebo, Sagaing and Lower Chindwin Districts to cope
with outbreaks of small-pox.
Statement II.
15. Cost of the Department.—The total cost of the department during
1925-26 was Rs. 3,74,109-1-9 as compared with Rs. 3,57,956-4-0 in
1924-25 and Rs. 3,43,262-0-10 in 1923-24. There was thus an increase of
Rs. 16,152-13-9 over the previous year and Rs. 30,847-0-11 over that of
1923-24. The increase over the previous year under the head " Pay of
the Establishment" was Rs. 3,629-10-8 and under the head " Travelling
Allowance " Rs. 5,027-8-5. The increase under these two heads is natural
10
TRIENNIAL REPORT ON VACCINATION IN BURMA
as the staff is on the time-scale of pay; The increase under the head
"Contingencies" was due to the increased expenditure under this item at
theVaccine Depôt , Meiktila.
The average cost per successful case of vaccination during the year
was Rs. 0-9-7 as compared with Re. 0-9-6 in 1924-25 and Re. 0-9-3 in
1923-24. The districts which returned high rates for each successful
case in 1924-25 with the exception of Mergui also returned a high rate
during 1925-26, viz., Hill Districts of Arakan (Re. 1-12-3), Pakôkku
Hill Tracts (Re. 1-5-2), and Myitkyina (Re. 1-1-2). In Mergui the
average rate of Re. 1-6-9 in 1924-25 was reduced to Re. 0-13-0 in
1925-26. In Tavoy District the rate was also high, viz., Re. 1-2-4, but
was slightly less than that of the previous year Re. 1-2-9. The
high rate in Insein District (Re. 1-1-11) was due to the inclusion
of pay and allowances drawn by the Sanitary Inspectors who do
vaccination-inspection work in the district. In 17 districts the rates
were higher than the Provincial average rate and in 24 districts they
were lower.
16. Small-pox Inoculation.—Instances of small-pox inoculation were
reported from Southern Shan States, Yamèthin, Shwebo, Minbu,
Myaungmya, Magwe, Meiktila and Kyauksè Districts. In the Southern
Shan States and Myaungmya inoculators and inoculated were punished
severely when caught, but no action was taken in Shwebo, Yamèthin,
Magwe and Minbu Districts as the' Burma Prohibition of Inoculation
and Licensing of Vaccinators Act was not in force at that time. In
Meiktila District the parents of inoculated children were let off with
nominal fines.
17. Work of the Vaccine Depôt, Meiktila during 1924-25.—Structural.—
No addition or important alteration to the building was made during
the year. Some minor improvements were carried out. The overhead
pipes for cooling the calf shed were renewed.
Calves.— As was the case last year, great difficulty was experienced
in-obtaining a regular supply of calves, arid during the cold weather
when it is necessary to lay in a stock of lymph to meet indents during
the hot months none could be obtained. Fortunately the Depôt was
able to carry on, but it was found necessary to order lymph from King's
Institute, Guindy, Madras, in December at a cost of Rs. 2,190-6-0.
Eventually a contract was effected with a dealer to supply calves at the
rate of Rs. 15-8-0 per calf and the supply is at present satisfactory, but
the problem of the disposal of vaccinated calves still remains. For
many years no difficulty had been experienced in selling them locally
but latterly there have been no buyers and at times a large number of
calves has accumulated at the Depôt all of which had to be fed. A
camp has now been formed in a Forest Reserve some nine miles from
Meiktila where grazing rights have been obtained from the Forest
FOR THE YEARS 1923-24 TO 1925-26.
11
Department as it is hoped that after grazing calves for 18 months or 2
years a market for them may open. The scheme has met with misfortune
after misfortune. Foot and mouth disease broke out in the camp as
soon as it was opened. This was followed by rinderpest, then a forest
fire nearly destroyed the whole camp and a very large part of the
grazing ground was burnt. Later' haemorrhagic septicaemia broke out.
Up-to-date 59 calves have been lost through disease.
The number of unvaccinated calves remaining at the Depôt' on the
1st April 1925 was 4 and 431 calves were purchased during the year
making a total of 435, of which 421 were inoculated and 4 died,—thus
leaving a balance of 10 on the 31st March 1926. The number of
vaccinated calves at present on the grazing ground is 256.
Lymph Output.—Four hundred and one calves were successfully
vaccinated 'during the year ; 20 calves either failed to take or yielded
lymph of such poor quality that it had to be rejected. A comparative
statement showing the output and issue of lymph during the year under
report and the two previous years is given below :—
Year.
(1)
1923-24...
1924-25...
1925-26...
Number of
calves
scraped.
(2)
334
344
401
Total yield.
(3)
Oz.
325.66
377.12
364.55
Grams.
9,277
10,743
10,335
Average yield per calf.
(4)
Grains.
468.5
529.6
397.7
Grams.
27.63
31.23
25.77
Doses issued.
(5)
982,404
1,072,701
1,100,167
From the above table it will be seen that there was a drop in the
yield per calf, which was due to the shortage of calves during the cold
season when the yield is generally at its maximum.
Ten thousand and thirty-five grammes were issued during the year
leaving a balance of 250 grammes on the 1st April 1926 which is about
30,000 doses i.e., sufficient for fifteen days.
Technique.—Throughout the year the phenol method of lymph treat-
ment was followed. As a result of a careful revision1 of technique the
average bacterial counts has been greatly reduced.
Lymph Supply.—The total number of doses issued from the Depot
during the year was 1,100,167, of which 924,831 doses were sent to
Municipalities and districts and to others as follows :—
Army 7,776 doses, Railway Medical Officers 10,728 doses,
Corporation of Rangoon 146,286 doses, Industrial Companies 252 dose,
Private Practitioners 2,990 doses and to Têngyüeh in China 7,304 doses.
Results.—Out of 403,911 cases of primary vaccination, concerning
which results were reported, there was a percentage of success of 98.18
against 97.93 last year. Out of 182,491 cases of re-vaccination the
percentage success was 46.04 as compared with 50.02 of the previous
year.
12
TRIENNIAL REPORT ON VACCINATION IN BURMA
FOR THE YEARS 1923-24 TO 1925-26.
Finance.—The net expenditure of the Depôt was Rs. 19,915-14-2 as
compared with Rs. 15,672-5-9 in the year 1924-25 and Rs. 17,936-8-4 in
1923-24, thus there was an increase of Rs. 4,243-8-5 over that of last year
and Rs. 1,979-5-10 in excess of the figure for the year before that.
The increase was chiefly attributed to the head " Purchase of European
Medicine and Instruments," and partly also to increased expenditure in
purchase and feeding of calves.
A sum of Rs. 6,634-10-6 was realized from sale of lymph, and
Rs. 1,237-8-0 from the sale of vaccinated calves. In addition, at the
close of the year, a sum of Rs. 774-2-9 was still outstanding from the
sale of lymph. If Rs. 2,261 (the value of live-stock,—266 calves) is.
added to these amounts the net income at the credit of the Depôt will
be Rs. 10,907-5-3. Of this total sum of Rs. 6,634-10-6 from the sale of
lymph, Rs. 5,237-13-0 were credited into the Rangoon Treasury and.
Rs. 1,396-13-6 into the local treasury.
18. Training Class.—Fifty-six apprentice vaccinators as against 34
last year were trained at the Depôt and all passed out with the exception.
of one who absconded. Thirteen Public Health Inspectors began
their course of training in vaccination on the 22nd April 1926.
19. General Remarks.—Major Jones, D.S.O., I.M.S., was in charge
of the Depôt until September 1925 when Dr. H. H. Lynsdale, I.M.D.,
took over. Dr. U Thaw Zan remained as Assistant Director throughout
the year.
I desire to draw attention to the excellent work done by all the
staff of the Vaccine Depôt and to the keenness which has resulted in
the production of lymph sufficient for the needs of the Province and of
a very satisfactory quality in the face of great difficulties.
E. BISSET, Lieut.-Col., I.M.S.,
Director of Public Health, Burma.
Rangoon, 30th June 1926.
APPENDICES.
STATEMENT No. I—Showing particulars of Vaccination in the Province of
Burma during the year 1925-26 ... ... ...
STATEMENT No. II—Showing the cost of Vaccination Department in the Province
of Burma during the year 1925-26 ... ... ...
STATEMENT No. III—Showing Dispensary Vaccination in the Province of Burma
for the year 1925-26 ... ... ... ...
STATEMENT No. IV—Showing the number of persons primarily vaccinated and
the number of those persons who were successfully
vaccinated in the Province of Burma in each of the official
years 1916-17 to 1925-26... ... ...
STATEMENT No. V—Showing particulars of Vaccination verified by Inspecting
Officers during the year 1925-26 ... ... ...... ...
APPENDIX A.—Showing the ratio per 10.000 successfully vaccinated and the mort-
ality from small-pox by quinquennial periods... ... ... ...
APPENDIX B.—Statistics relating to the number of children under one year of age
in towns available for vaccination and the number of successful
operations performed on them ... ... ... ...
APPENDIX C—Diagram showing the proportion of population protected during
the seven official years 1919-20 to 1925-26 and the death-rate
from small-pox during the calendar year 1925 in districts where
registration of vital statistics is in force ... ... ... ...
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