NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
46
APPENDICES.
APPENDIX B.—Statement showing the number of vaccinations performed in
Municipal Towns and Notified Areas (to which Vaccination Act has been
extended) on children under one year of age (Paragraph 10), 1927-28—concld.
Towns.
(1)
Danubyu ...
Pyapôn ...
Kyaiklat ...
Thatôn ...
Kyaikto ...
Moulmein ...
Kawkareik ...
Tavoy ...
Mergui ...
Toungoo ...
Shwegyin ...
Pyu ...
Thayetmyo ...
Allanmyo ...
Minbu ...
Salin ...
Magwe ...
Taungdwingyi ...
Yenangyaung ...
Pakôkku ...
Mandalay ...
Maymyo ...
Kyauksè ...
Meiktila ...
Myingyan ...
Nyaung-u ...
Yamèthin ...
Pyinmana ...
Pyawbwè ...
Bhamo ...
Shwebo ...
Sagaing ...
Mônywa ...
Total ...
Number
of births
during the
year
1927-28.
(2)
148
199
203
514
147
1,649
286
870
557
422
145
189
241
220
172
231
478
388
433
523
7,614
705
232
310
571
173
273
502
159
177
511
427
339
36,053
Number
of deaths
among
children
under
one year
during
the year.
(3)
30
30
63
73
41
344
127
126
163
61
17
32
129
59
52
67
72
136
100
273
2,212
145
49
104
214
37
107
180
57
38
157
126
132
9,984
Number of
successful
operations
on children
under one
year during
the year
ending 31st
March 1928.
(4)
146
379
120
278
149
1,294
139
862
419
304
71
49
420
232
163
122
132
225
204
291
5,188
396
191
268
288
95
218
393
186
182
332
283
248
28,510
Date of extension of
Vaccination Act of 1880
into towns.
(5)
9th July 1909.
November 1904
15th Dec. 1904 ...
October 1891 ...
March 1897 ...
August 1885 ...
September 1914
December 1889
October 1891 ...
May 1889
January 1890 ...
January 1920 ...
May 1889 ...
May 1901 ...
March 1896 ...
March 1896 ...
10th March 1913
February 1893 ...
10th March 1913
April 1892 ...
August 1891 ...
October 1912 ...
May 1894 ...
June 1906 ...
September 1891
30th August 1921
February 1892 ...
November 1891...
May 1912.
26th October 1894
June 1894 ...
April 1894 ...
March 1893 ...
Date of extension of
Vaccination Law
Amendment Act of
1909.
(6)
29th March 1910.
Do.
Do.
Do.
Do.
17th Sept. 1914.
29th March 1910.
Do.
Do.
Do.
17th January 1920.
29th March 1910.
Do.
Do.
Do.
10th March 1913.
29th March 1910.
10th March 1913.
29th March 1910.
Do.
22nd October 1912.
29th March 1910.
31st July 1922.
29th March 1910.
30th August 1921.
29th March 1910.
Do.
29th March 1910.
Do.
Do.
Do
G.B.C.P.O.-No. 67, D.P.H., 13-9-1928-480.
PUBLIC HEALTH FROM No. 25.
APPENDIX C.
Diagram showing the Proportion of Population protected during the seven official years from 1921-22 to 1927-28 and the Death-rate from small-pox during the year 1927 in districts
where full registration is in force.
G.B.C.P.O.—No. 67, D.P.H.13 -0- 1928 . 4-8 0. L .
TRIENNIAL REPORT
ON
VACCINATION IN BURMA
FOR THE YEARS 1926-27 TO 1928-29
Rangoon
Supdt., Govt. Printing and Stationery, Burma
1929
Price, -Rs. 1-8 =2s. 3d.]
TRIENNIAL REPORT
ON
VACCINATION IN BURMA
FOR THE YEARS 1926-27 TO 1928-29
Rangoon
Supdt., Govt. Printing and Stationery, Burma
1929
LIST OF AGENTS FOR THE SALE OF
GOVERNMENT PUBLICATIONS.
IN BURMA.
AMERICAN BAPTIST MISSION PRESS, Rangoon.
BISWAS & Co., 30, Lewis Street, Rangoon.
BRITISH BURMA PRESS BRANCH, Rangoon.
BURMA BOOK CLUB, LTD., Post Box No. 1068, Rangoon.
INTERNATIONAL BUDDHIST BOOK DEPÔT. Post Box No. 971, Rangoon.
MODERN PUBLISHING HOUSE, LTD., Rangoon.
NEW LIGHT OF BURMA PRESS, 49, Phayre Street, Rangoon.
RANGOON TIMES PRESS, Rangoon.
MAUNG LU GALE, Law Book Depôt, 42, Ayo-o-gale, Mandalay.
CHAPPLE'S BUSINESS COLLEGE, 77, Lower Main Road, Moulmein.
IN INDIA.
BOOK Co., LTD., 4/4A, College Square, Calcutta.
BUTTERWORTH & Co. (India). LTD., Calcutta.
S. K. LAHIRI & Co., 56, College Street, Calcutta.
W. NEWMAN & Co., Calcutta.
THACKER, SPINK & Co., Calcutta and Simla.
D. B. TARAPOREVALA. SONS & Co., Bombay.
THACKER & Co., LTD., Bombay.
CITY BOOK CO., Post Box No. 283, Madras.
HIGGINBOTHAM & Co., Madras.
IN EUROPE.
The publications are obtainable either direct from the Office of the
HIGH COMMISSIONER FOR INDIA, 42, Grosvenor Gardens, London,
S.W. 1. or through any bookseller.
RESOLUTION
ON THE
Triennial Report on Vaccination in Burma
For the Years 1926-27 to 1928-29.
Extracts from the Proceedings of the Government of Burma, Public Health
Department,—No. 253829 (R.N. 505), dated the 30th September 1929.
READ—
The Triennial Report on Vaccination in Burma for the years 1926-27 to
1928-29.
RESOLVED THAT—
The Report be published.
By order.
F. H. STEAVENSON,
Secretary to the Government of Burma,
Education Department.
[The maximum limit of the body of the Report is eleven pages,]
TABLE OF CONTENTS.
TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS
1926-27 TO 1928-29.
General Review
...
...
...
...
...
Total Operations ... ... ... ...
Primary Vaccination ... ... ... ...
Successful Primary Operations ... ... ... ...
Revaccination
...
...
...
...
...
Vaccination in Towns ... ... ... ... ...
Revaccination in Towns ... ... ... ... ...
Infant Vaccination in Towns ... ... ... ... ... ...
Dispensary Vaccination ... ... ... ... ...
Jail Vaccination ... ... ... ... ... ...
Vaccination by Private Practitioners ... ... ...
Steamer Vaccination ... ... ... ... ... ...
Verification Work of Inspecting Officers
...
...
...
Establishment ... ... ... ... ... ...
Cost of the Department ... ... ... ... ...
Small-pox Inoculation ... ... ... ... ...
Prosecutions under Vaccination Act ... ... ... ...
Work of the Vaccine Depôt, Meiktila ... ... ... ...
Training Class ... ... ... ... ... ...
General remarks ... ... ... ... ... ...
PARA.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
PAGE
1
3
4
5
6
7
8
ib.
9
ib.
ib.
10
ib.
12
13
ib.
14
ib.
16
ib.
TRIENNIAL REPORT
ON
Vaccination in Burma
For the years 1926-27 to 1928-29.
Statement
General Review.—It is a hopeful sign that while the deaths from
small-pox in the Province during the triennium under report are less
than those recorded in the previous triennium, as will be seen from the
figures noted below, the output of vaccination recorded exceeded that
of the previous two periods :—
Years.
(1)
1923-24 ...
1924-25 ...
1925-26 ...
Total ...
1926-27 ...
1927-28 ...
1928-29 ...
Total ...
Small-pox.
Attacks.
(2)
9,725
9,205
10,050
28,980
5,035
8,282
7,137
20,454
Deaths.
(3)
2,839
3,312
3,623
9,774
2,233
2,452
2,419
7,104
Output of vaccination.
Primary.
(4)
544,341
531,035
557,442
1,632,818
511,750
550,154
608,414
1,670,318
Revaccina-
tion
(5)
208,106
275,584
285,287
768,977
208,801
320,248
330,864
859,913
Total.
(6)
752,447
806,619
842,729
2,401,795
720,551
870,402
939,278
2,530,231
The incidence of small-pox during the present triennium is less than
in the previous triennium. Thus in 1926-27, 2,233 deaths from small-
pox were recorded. The deaths increased in the following year to
2,452 and in 1928-29 were slightly less than in the previous year
2,419 deaths. The output of vaccination work in the current triennium
rose steadily year by year as is shown in the above table. The most
satisfactory feature is that there is an increased output of both primary
and re-vaccinations every year of the triennium, establishing a record
during the year 1928-29.
The steady increase in the output during the six years (save 1926-27),
is partly due to the extension of compulsory Vaccination Acts to rural
areas and partly to better appreciation by the people of the benefits
conferred by vaccination. Nowhere is there serious opposition to
vaccination except in a few backward and primitive tracts and even in
these areas, the people willingly submit to vaccination when faced with
small-pox outbreaks. Several District Health Officers in Lower Burma
have reported that vaccinations and revaccinations are more appreciated
by Karens than by other classes ; and that parents, specially in the
2
2
TRIENNIAL REPORT ON VACCINATION IN BURMA
more remote areas are reluctant to have their children vaccinated
before the end of the first year. With the increasing propaganda work
now being carried out by the Public Health and Vaccination Staffs,
there is some prospect of vaccination improving still further, but more
efficient supervision of the work is greatly needed and must await the
urgently needed development of a rural public health service.
During the triennium, the Vaccination Acts were extended to two
more districts, viz. Mandalay from March 1927 and Shwebo from January
1929. These Acts have now been extended to the Lower Chindwin
District from April 1929 and it is hoped that the District Council of
Sagaing and others will follow suit. The beneficial results on deaths
from small-pox of the extension of the Vaccination Acts are clearly
brought out in the following table, which indicates the need for extension
of these Acts to those districts whose Councils have not yet adopted
compulsory primary vaccination and have therefore neglected to avail
themselves of the means at their disposal for checking the ravages of
this serious disease. Great credit is due to the District Councils of
Tharrawaddy and Thayetmyo for their pioneer work in this respect.
Districts where Vaccination Act was extended in 1923.
(Deaths from Small-pox).
Districts.
(1)
Tharrawaddy
Thayetmyo ...
5 years before
extension.
1919
(2)
11
105
1920.
(3)
12
144
Population—3,281,992
1921.
(4)
26
19
...
1922
(5)
23
11
...
1923.
(6)
16
121
...
Total.
(7)
88
400
488
Death rate.
(8)
...
...
.15
5 years after
extension.
1924
(9)
3
132
1925.
(10)
17
6
1926.
(11)
3
14
1927.
(12)
2
29
1928.
(13)
4
74
Population—3,412,095
Total.
(14)
29
255
284
Death rate.
(15)
...
...
.08
Districts where Vaccination Act was not extended.
(Deaths from Small-pox).
Kyaukpyu ...
Sandoway ...
Pakôkku
...
Meiktila ...
Myingyan ...
Yamèthin ...
Sagaing ...
9
4
74
57
362
7
259
32
31
30
36
130
22
49
...
12
5
26
53
...
31
99
41
...
...
22
1
21
Population—9,977,491 (5 years)
...
10
109
61
64
3
17
...
140
98
218
180
631
33
377
1677
...
...
...
...
...
...
...
.17
...
47
89
96
192
28
144
33
11
94
151
613
88
284
...
12
36
21
550
20
80
...
....
44
22
83
20
44
1
6
56
8
100
87
100
Population—10,269,144
(5 years).
34
76
319
298
1538
243
652
3160
...
...
...
...
...
...
...
.31
4
TRIENNIAL REPORT ON VACCINATION IN BURMA
in 1926-27 to 43,021 in 1927-28. In the last year of the triennium:
1928-29 the out break subsided, only 51 deaths being registered and
simultaneously the output of vaccination went down to 27,693.
Of the 18 districts which recorded a decrease, Pakôkku topped the
list with a deficit of 23,004. The reasons furnished by the District
Health Officer were a reduced incidence of small-pox and non-employ-
ment of additional temporary staff, whereas in the previous triennium
small-pox was more prevalent and additional temporary staff was
entertained to cope with it. The steady decline in this district since
1924-25 up to 1927-28 requires further elucidation. In 1923-24, the
output recorded was 34,351 ; it went down to 26,914 in 1924-25 and
from this year onwards the decline is continuous up to 1927-28. In
1925-26 the output was 24,822, in 1926-27, 20,780 and in 1927-28,
20,477. There was only a slight rise in 1928-29, viz. 21,826 or an increase
of 1,349 over the previous year's output. A very unsatisfactory feature
is the reduction in primary vaccination.
The next district which returned a large deficit is Upper Chindwin—
20,358 fewer operations were recorded. Absence of serious outbreak
of small-pox, economy exercised in lymph supply, difficulties of commu-
nications and of transport and unwillingness on the part of the people to
submit to vaccination during non-epidemic years are stated to be the
main causes of the decline ; but as stated in the Notes and Statistics on
Vaccination in Burma for 1927-28 and as pointed out by the District
Health Officer and the Deputy Commissioner the inadequacy of Vacci-
nation Staff may be another reason for the unsatisfactory state of
vaccination work in this district. The area of the district is large,
some 16,000 square miles, communication is very difficult and most
of the people ignorant and backward. Here also there has been a
falling off of primary vaccination as well, since the serious small-pox
epidemic of 1925-26.
The other districts which recorded large deficits are Myingyan
(—14,796) (mainly in re-vaccinations), Sagaing (—14,715) Minbu
(-14,635) Ma-ubin (—9,983), Thatôn (—9,294) (all re-vaccinations—
primary vaccinations showing an increase), Kyaukpyu (—7,394), Insein
(-7,207), Kyauksè (—6,859) and Sandoway (-5,460); but it is encour-
aging to note that in nearly all these districts the output in the year
1928-29 was more than that of either of the previous years of the
triennium. The deficit in other districts calls for no comment.
Statement I.
3. Primary Vaccination.—A total of 1,670,318 primary vacci-
nations was recorded during the triennium under report, as
compared with 1,632,818 in the previous triennium or an increase of
37,500 operations. In 24 districts there is an increase and in 17 districts
a decrease. In four districts only a marked increase occurred, viz.,
Prome (+ 19,394), Southern Shan States (+ 10,965), Toungoo
(+ 10,273) and Amherst (+ 9,580). An increase of over 5,000 primary-
FOR THE YEARS 1926-27 TO 1928-29.
5
operations was registered in the Chin Hills and Katha districts, In the
remaining 18 districts the increase is not marked. The increase
recorded in the Southern Shan States is commendable, in view of the
fact that people in this area are very ignorant, there are difficulties in
communication and the villages are widely scattered.
In the 17 districts from which a deficit is returned in primary
operations, Mandalay stands at the top of the list with 9,095 fewer
operations followed by the Upper Chindwin with a deficit of 7,685. A
deficit of over 5,000 is reported from Insein and Henzada, over 4,000
from Kyaukpyu, Myaungmya and Ma-ubin and over 3,000 from Sando-
way, Myingyan and Sagaing. The decrease in primary cases in
Myaungmya, Pyapôn, Mergui and Lower Chindwin is covered by the
increase in re-vaccination cases in these districts. In the remaining
districts there is a decrease under both classes of vaccinations and these
are the same districts in which a large deficit in total operations is
recorded, as noted in paragraph 2 above.
Statement I.
4. Successful Primary Operations.—During the triennium, 1,509,029
successful primary operations were recorded as compared with 1,538,221
in the previous period—a deficit of 29,192 successes. The decrease was
solely due to unsatisfactory results obtained in 1927-28 in which year only
92.16 per cent. of primary cases were reported as successful.
With the exception of Akyab, Rangoon, Thatôn, Meiktila and
Southern Shan States, the same districts which returned a decrease in
primary operations also returned a decrease in successful cases. Akyab
district which returned an increase of 2,473 in primary operations
during the triennium, recorded a deficit of 2.834 in primary successes.
Similarly Rangoon which recorded an increase of 196 in primary opera-
tions showed a deficit of 2,461 successes. Thatôn follows the above
two places but the loss in successful cases is only 93. In the case of
Minbu, a gain of 1,663 successes was recorded in contrast with a loss in
primary operations of 2,186. Meiktila and Southern Shan States show
fairly large deficits. The loss sustained in primary successes in the
former district was 1,858 and in the latter 6,015.
The provincial percentage of success in primary cases in 1928-29
was 97.11, as compared with 92.16 in 1927-28 and 96.63 in 1926-27.
With the exception of a few distant places, such as the Hill District of
Arakan, Sandoway, Mergui and Chin Hills, the percentages of success
recorded in the remaining districts in 1928-29 compare very favourably
with those recorded in 1927-28. Myaungmya district returned cent. per
cent. primary successes, closely followed by Tharrawaddy with 99.98
per cent. and Ma-ubin with 99.88 per cent. Other districts which
recorded over 99 per cent. success rate are Prome, Henzada, Pyapôn,
Amherst, Toungoo and Kyauksè. Over 98 per cent. of successes were
reported from Rangoon, Bassein, Magwe, Sagaing, Katha and Northern
6
TRIENNIAL REPORT ON VACCINATION IN BURMA
Shan States and a success rate below 98 per cent. but above 95 per cent.
was recorded in Hanthawaddy, Insein, Thatôn, Tavôy, Minbu,
Mandalay, Myingyan, Yamèthin, Shwebo and Southern Shan States. In
the remaining districts which are not mentioned here, the success rates
vary between 90 and 95 per cent. On the whole, the success rate obtained
in 1928-29 in all the districts, with the exception of the four remote ones
mentioned above, is very satisfactory.
The district which reported the lowest success rate is Chin Hills
(82.75 per cent.), but the lymph takes ten days to reach there from
Meiktila and hence the potency is partly lost during transit. The low
success rate of 86.35 per cent. in Sandoway District is partly due to poor
communications and partly to unwillingness on the part of the people to
have three insertions on the arms of the children. The matter is receiv-
ing the attention of this Department and an Epidemic Sub-Assistant
Surgeon has been detailed to the district to carry out vaccination pro-
paganda work and also to supervise the work of vaccinators. Mergui
also reported a low success rate of 85.76 per cent. Here also com-
munications are bad.
Statement I.
5. Re-vaccination.—The total number of re-vaccinations recorded during
the triennium was 859,913 as against 768,977 in the previous period—
an increase of 90,936. Judging from this increase in spite of lessened
incidence of small-pox during the period under report, it may be con-
cluded that the people in general are beginning to realize the benefit of
double vaccination—once at infancy and again at the age of about ten
years,—as a means of protection from small-pox throughout life.
In 23 districts, there was an increase in re-vaccinations and in 18 a
decrease. The increase in Akyab was the greatest in the Province,
amounting to 54,286 cases. In this district the number of re-vaccina-
tions rose from 3,525 in 1926-27 to 25,858 in 1927-28 and to 40,075 in
1928-29, making a total for the triennium of 69,458 as against only 15,172
in the previous period. The other districts which returned substantial
increases are Rangoon with an excess of 24,822, Magwe (+21,522),
Shwebo (+12,678), Toungoo (+12,301), Prome ( + 11,931), Yamèthin
(+11,490), Amherst (+11,043) and Pegu ( + 9,999). An increase of over
8,000 cases was reported from Southern Shan States, over 7,000 from
Northern Shan States, over 6,000 from Myaungmya and over 5,000 from
Salween districts.
Of the 18 districts in which a reduction in re-vaccinations is recorded
in the triennium, Pakkôku stands first, 20,295 fewer cases being reported.
As the low output of work as a whole in this district has already been
commented upon above, it is unnecessary here to make further comments.
The deficit in other districts in order of sequence is Upper Chindwin
(-12,673), Minbu (-12,449), Thatôn (-12,127), Sagaing (-11,120),
Myingyan (-11,110), Kyauksè(-8,775), Katha (-6,195) and Ma-ubin
FOR THE YEARS 1926-27 TO 1928-29.
7
(=5,630). In the above districts, with the exception of Thatôn and
Myingyan, the prevalence of small-pox was low and hence the reduction
in re-vaccination.
In Thatôn district, although the number of deaths from small-pox
recorded during the current triennium is slightly higher than that
recorded in the previous period; re-vaccination work shows a marked
decline.
In Myingyan district, the incidence of small-pox during the two
periods is about the same, but re-vaccination work shows a serious
falling off, with the result that the disease has apparently gained a
strong foothold and is still prevalent, both in town and district. The
Vaccination Acts are not in force in this district and the Local
Authorities are reluctant to extend them, although the necessity for
doing so has been urged on them by this Department. The District
Council, in my opinion, must bear a share of responsibility for the serious
outbreak of small-pox which has recently occurred.
The percentage of success in re-vaccination in 1928-29 was 36.22
as compared with 39.88 in 1927-28 and 35.97 in 1926-27. A high per-
centage of successful re-vaccinations was reported from Bassein town
95.80. It may be noted that in the Northern Shan States, vaccination
work is carried out for only six months in the year from October to
March. The District Health Officer suggests altering this system.
6. Vaccination in Towns.—In the 73 towns to which the Vaccination
Acts have now been extended, as compared with 63 towns in the last
triennium, a total of,401,691 operations was performed during the
triennium. This compares with 363,414 in the previous period. Of the
total operations, 148,217 were primary and 253,474 re-vaccinations, as
against 138,923 and 224,491 respectively, in the previous triennium.
The increase in primary vaccination was not very large, amounting to
9,294 operations, but in re-vaccination, an excess of 28,983 operations
was recorded over that of the previous period. The percentage of
success for the triennium in primary vaccinations was 95.20 and in
re-vaccination 44.35, as compared with 98.80 and 51.60 respectively in
the previous period.
The total number of operations performed in towns during 1928-29
was 130,705, i.e., 42,985 fewer operations were performed than in
1927-28. Only in 29 towns was there an increase. The decrease in
the output during 1928-29 was chiefly due to a great falling off in
re-vaccination work in Rangoon town, where only 29,253 re-vaccinations
were done as against 82,992 in 1927-28 or a decrease of 53,739. The
towns which showed a decrease in the output other than Rangoon
in order of sequence were Moulmein (—2,083), Toungoo (—2,025),
Taungdwingyi (-1,666), Syriam (-1,489) and Pegu (-1,274). In
Moulmein and Syriam, the deficit was wholly due to fewer re-vaccina-
tions. In Toungoo, Taungdwingyi and Pegu, the deficit is noticeable
under both classes of vaccinations.