4
TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS 1899-1900-1901-1902.
waddy district, assigns various causes as contributing to the falling off, the
chief among them being that the figures for 1899-1900 and for the period April
to November 1900 are untrustworthy. The vaccinators worked directly under
the supervision of a Civil Assistant Surgeon for about a year, from Novem-
ber 1900, and there was therefore less opportunity for falsifying the returns. Ow-
ing to demands for Assistant Surgeons elsewhere, this officer had to be with-
drawn in November 1901, and I have not been able to replace him. The
decrease in the Tharrawaddy district is said to be due to no arm-to-arm vaccina-
tion being done, lymph being too dilute, and to more reliable returns. The Civil
Surgeon, Bassein district, attributes the decline to non-prevalence of small-pox,
paucity of subjects, and careless work done by district vaccinators coupled with
marked opposition on " the part of parents and often small officials." Two causes
are assigned for the decrease in the Amherst district, namely, (1) less small-pox
than the previous year and (2) inoculation, which the Civil Surgeon says, " has
''been more extensively carried out than in former years, and this has had a most
"injurious effect upon vaccination, several villages having taken to inoculation
" which in previous years readily accepted vaccination." In Upper Burma districts
the Civil Surgeons report that among other causes the falling off is mainly due to
want of regular supplies of lymph and paucity of subjects, the people not being
favourably disposed towards vaccination.
In only three districts has there been a steady increase in the outturn of
work—Henzada, Myaungmya and the Northern Shan States.
The percentage of success in primary vaccination has fallen considerably in
the last year of the triennium under review. In neither of the first two years of
this period did the percentage fall below 62 per cent., but in 1901-02, excluding
the Chin Hills, which has recently begun work in this direction, the percentage
has been reduced to 37.60 in the Salween district and 60.25 in the Rangoon Town
district. Six districts return a percentage of less than 80, in 13 districts the range
is between 80 and 89 per cent. and the remaining 19 districts return 90 per cent.
and over. In 1899-1900 no less than 35 districts returned a percentage of 90 per
cent. and over, and in the following year only 22 districts obtained similar
percentages. Various reasons are given in the reports received from Civil
Surgeons for the poor results obtained; the majority are disposed to blame the
lymph supplies, but when the officers are confronted with the reports received from
other districts of results obtained with material supplied from the same stock, they
seem disposed to blame the vaccinators for careless work. These are, I fear,
cases of bad workmen, who quarrel with their tools. The demand for a higher
criterion of success since the report for the year 1899-1900 [vide paragraph 15
(b), page 15] may have also contributed towards this decline.
9. Lymph supply.—Calf lymph is in general use throughout the Province
and arm-to-arm vaccination is only resorted to when the supply of animal vaccine
fails.
During the triennium the depôts at Taunggyi, Rangoon and Mandalay sup-
plied glycerinated or lanolinized calf lymph for district work generally. Animal
vaccination was also carried on at Moulmein, Akyab and Bassein, but only for
local use. Some Municipalities obtained their supplies from Bangalore and gener-
ally this lymph was found to be more active than that raised in the Province.
The reason of the Burma lymph being less effective I attributed to inexperience
of the depot establishments in the preparation and despatch of the vaccine. Captain
Williams, the Officiating Health Officer of the Rangoon Municipality, however, who
visited the Local Government Board Vaccine Establishment in London and studied
the methods observed there, is of opinion the fault lies with the Burman calf which
does not develop vesicles like its English congenere. A similar opinion is not
apparently entertained at any of the other stations where lymph is raised, the
calves, however, supplied in Rangoon are poor and generally in indifferent health,
which may possibly account for the difference in the quality of the lymph. This
question, will, however, be thoroughly worked out in the depôt recently opened at
Meiktila.