NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
TABLE OF CONTENTS.
TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS
1929-30 TO 1931-32.
General Review
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Total Operations ... ... ... ...
Primary Vaccination ... ... ... ...
Successful Primary Vaccination ... ... ...
Revaccination ... ... ... ...
Vaccination in Towns ... ... ... ...
Revaccination in Towns ... ... ... ...
Infant Vaccination in Towns ... ... ...
Dispensary Vaccination ... ... ... ...
Jail Vaccination ... ... ... ...
Vaccination by Private Practitioners ... ... ...
Ship Vaccination ... ... ... ...
Verification Work of Inspecting Officers ... ...
Establishment ...
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Cost of the Department ... ... ... ...
Illegal Inoculation against Small-pox ... ... ...
Prosecutions under the Vaccination Acts ... ...
Vaccine Depôt, Meiktila
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Training Class ... ... ... ...
General remarks ... ... ... ...
PARA.
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TRIENNIAL REPORT
ON
Vaccination in Burma
For the official years (April to March) 1929-30 to 1931-32.
GENERAL REVIEW—In the three years under review, good progress
in the work of the Vaccination Department in both the Province and
the Shan States was recorded. The number of vaccinations and revac-
cinations combined exceeded those of the previous triennium by
309,490. It is encouraging to note that the incidence of smallpox fell
during the same period. The following table illustrates this :—
Years.
(1)
1926-27 ...
1927-28 ...
1928-29 ...
Total ...
1929-30 ...
1930-31 ...
1931-32 ...
Total ...
Difference ...
Incidence of smallpox
Attacks.
(2)
5,035
8,282
7,137
20,454
4,748
3,334
4,790
12,872
- 7,582
Deaths.
(3)
2,233
2,452
2,419
7,104
1,686
837
1,113
3,636
- 3,468
Vaccinations performed
Primary.
(4)
515,359
556,522
615,519
1,687,400
628,785
616,477
605,945
1,851,207
+ 163,807
Revaccina-
tion.
(5)
210,377
323,110
333,203
866,690
356,459
283,633
372,281
1,012,373
+ 145,683
Total.
(6)
725,736
879,632
948,722
2,554,090
985,244
900,110
978,226
2,863,580
+ 309,490
An increase in the strength of the establishment was also recorded.
The Vaccination Acts of 1880 and 1909 were extended to the areas of
three district councils, viz. Lower Chindwin, Myingyan and Meiktila,
and to 6 notified areas, viz. Minbya, Chauk, Myitnge, Myitkyina, Ye-u
and Mawlaik. The Acts appear to have been more universally enforced
in the Province as several officers reported prosecutions. No serious
opposition to vaccination, however, was encountered. Compulsory
revaccination was introduced in 20 towns and in 8 district council areas.
These are shown in Appendix C.
2
TRIENNIAL REPORT ON VACCINATION IN BURMA
The presence of an epidemic of smallpox gives rise to an increased
number of vaccinations and revaccinations, as at that time the people
are more alive to the dangers of the disease and to the benefits of vacci-
nation. Thus, the vaccination figures for Akyab, Sagaing, Amherst
and Rangoon, each of which had an epidemic, show a marked increase.
It is pleasing however to note that an increase in vaccinations took
place in some districts without the unpleasant stimulus of an epidemic.
In these districts such a welcome improvement is to be ascribed to an
increased staff, a more rigid enforcement of the vaccination law and to
better co-operation on the part of district officials and local bodies.
Propaganda also has had its share in the success, as it has helped to
educate the people to understand how the scourge of smallpox can be
avoided. Continued and increased propaganda will be necessary to
gain the wide appreciation of the public regarding the benefit of
vaccination.
Statement I.
2. Total Operations—
BURMA—The total number of vaccinations performed in Burma
excluding the Shan States during the triennium shows an increase of
271,051 over the previous triennium, as shown below :—
Year.
1929-30 to 1931-32 ... ...
1926-27 to 1928-29 ... ...
Increase ... ... ...
Number of Operations.
Primary.
1,667,758
1,509,796
157,962
Revacci-
ation.
956,079
842,990
113,089
Total.
2,623,837
2,352,786
271,051
Out of the 38 districts in Burma proper, 26 reported an increase in
the combined rural and urban figures and 12 showed a decrease.
The highest increase was reported from Akyab district, where
52,282 more operations were done in this triennium. Of this increase
12,458 were primary operations. The presence of a smallpox epidemic
largely accounts for the higher figures.
The second highest increase was reported from Meiktila district,
34,825 more operations being performed during the triennium. These
were almost all revaccinations. As there were only a few smallpox
cases, the officers and staff deserve credit for this good work.
The third highest increase was reported from Sagaing, 29,961
more operations having been carried out. This district suffers from the
failure of the District Council to extend the Vaccination Acts and it is
regrettable to have to relate that smallpox was prevalent all through
the triennium, just as it was during the previous three years.
FOR THE YEARS 1929-30 TO 1931-32.
3
Other districts returning a considerable increase are Amherst
(+25,731), Mandalay ( + 22,233), Bassein ( +15,650), Insein ( + 15,480),
Rangoon (+15,164), Pyapon ( + 14,802), Myaungmya ( + 12,665) and
Mergui (+10,422).
The increase in Amherst and Rangoon was mainly due to the
presence of a smallpox epidemic. In Mandalay special efforts were
made by the municipal health staff in 1930-31 to get the population
vaccinated. The District Health Officer, Bassein, reports that a
prediction was made by local Burmese sages that a severe outbreak of
smallpox would occur in 1930-31 and this unusual reason accounts for
the increased numbers who resorted to vaccination. In Insein district
good vaccination work by the Hlegu Health Unit helped towards
increased figures. There were a few cases of smallpox in Pyapon during
the triennium, but none in Myaungmya. The increase in vaccination in
these two districts is largely due to the appointment of wholetime
Health Officers. Mergui district having been free from smallpox, the
increase in vaccination speaks for the good work done by the District
Health Officer and his staff.
Of the 12 districts reporting a decrease, Magwe (—21,799), shows
the biggest reduction, followed by Minbu (—9,085), Shwebo (-7,822)
and Toungoo (—6,884). The absence of severe smallpox in these dis-
tricts largely accounts for the reduced vaccinations. It is regrettable that
the vaccination figures fall on this account for it only means that the
people are being lulled into a false sense of security and when next
smallpox raises its head in these districts there will be many unfortu-
nate people unable to resist its attack.
SHAN STATES—The total number of vaccinations performed in the
Shan States during the triennium shows an increase of 38,439. A total
of 239,743 operations were performed during the triennium compared
with 201,304 in the previous triennium.
Statement I.
3. Primary Vaccination—
BURMA—A total of 1,667,758 primary operations was recorded
compared with 1,509,796 during the last triennium—an increase of
157,962 operations.
An increase in rural and urban figures combined over those of the
previous triennium was reported from 27 districts and a decrease from
11.
Of the 27 districts, the following 7 districts reported large
increases :—Prome ( + 14,245), Bassein ( + 14,152), Myingyan ( + 12,939),
Amherst ( + 12,680), Akyab ( + 12,458), Sagaing ( + 12,103), and Insein
(+10,045). Considerable increases ranging between 5,000 and 10,000
were reported from 8 districts, viz., Mergui, Yamethin, Myaungmya,
Chin Hills, Shwebo, Pyapon, Pegu and Upper Chindwin, the remaining
12 districts reporting increases below 5,000.
4
TRIENNIAL REPORT ON VACCINATION IN BURMA
Of the 11 districts reporting decreases only Minbu district (—8,799)
reported a decrease exceeding 5,000 operations.
SHAN STATES.—In the Federated Shan States, 183,449 primary-
operations were performed during the triennium compared with
177,604 during the last triennium—an increase of 5,845.
Statement I.
4. Successful Primary Vaccination—
BURMA—Out of a total of 1,583,504 primary verified operations in
the triennium, 1,532,817 were reported as successful (the total primary
operations being 1,667,758, and the non-verified cases 84,254). Out of
a total of 1,430,041 verified operations in the previous triennium,
1,361,350 were reported as successful (the total operations being
1,509,796 and non-verified operations 79,755). The percentage of
success in primary known cases is therefore 96.80 for this triennium
compared with 95.20 in the last.
A success rate of over 99 per cent in the year 1931-32 was recorded
in Rangoon (99.29) and in the districts of Tharrawaddy (99.90), Prome
(99.18), Henzada (100), Maubin (99.68), Kyaukse (99.31), and Bhamo
(100). In the same year a success rate below 90 per cent was
reported from the Hill District of Arakan (84.17), Kyaukpyu, (87.60),
the Upper Chindwin (89.59) and the Lower Chindwin (89.20). The
low success rate is to be ascribed to the length of time it takes
the lymph to reach the vaccinators in the last named districts and the
resulting loss of potency of the lymph.
SHAN STATES—Out of a total of 60,529 known operations in the
Shan States in 1931-32, 58,775 cases, or 97.10 per cent, were reported
as successful, compared with 96.99 per cent in 1930-31 and 97.99 per
cent in 1929-30.
Statement I.
5. Revaccination—
BURMA—A total of 956,079 revaccinations was recorded during the
triennium, compared with 842,990 during the previous triennium—an
increase of 113,089 revaccinations. While this is to be regarded as
satisfactory, there is still much room for improvement. The law which
makes revaccination compulsory applies at present to only 8 districts.
Until it is universally applicable and enforced we will be without one of
the great defences against the recurrence of smallpox epidemics, which
continue to beset this province.
An increase was reported from 21 districts and a decrease from 17.
The biggest increases were in the districts of Akyab ( + 39,824), Meiktila
(+33,490), Mandalay(+22,026), Sagaing ( + 17,858), Rangoon (+14,968)
and Amherst (+13,051). The reasons for the increase in these places
have been given in section 2. A large decrease was returned from the
districts of Magwe (-21,407) and Shwebo (-14,150), the smaller
incidence of smallpox being, as already stated, the cause of the fall.
FOR THE YEARS1929-30 TO 1931-32.
5
SHAN STATES—In the Federated Shan States, 56,294 revaccinations
were performed compared with 23,700—an increase of 32,594 operations.
The health staff are to be congratulated on this.
6. Vaccination in Towns—
BURMA—In the 74 towns to which the Vaccination Acts have been
extended (there were 71 towns in the previous triennium), a total of
489,019 operations was performed compared with 400,450 in the
previous three years. Of the total operations, 158,367 were primary and
330,652 revaccinations, compared with 147,536 and 252,914respectively
in the previous triennium. Therefore there was an increase of 10,831
in primary operations and of 77,738 in revaccinations during the trien-
nium under review. The percentage of success for the triennium in
primary vaccinations was 97.54 and in revaccinations 35.09, compared
with 95.25 and 44.35 respectively in the previous three years.
In the year 1931-32, a total of 239,005 operations were performed,
compared with 121,617 in 1930-31 and 128,397 in 1929-30. Of the 74
towns, 51 reported an increase and 23 a decrease in the year. The
highest increase was reported from Rangoon (+103,392), followed by
Insein ( + 3,557) and Letpadan (+3,434). On the other hand, Mandalay
reported a large fall (—10,125), followed by Syriam (—1,670), Moulmein
( — 808), Kawkareik (—541) and Pyapon ( —432). The decreases mainly
occurred in revaccinations. Rangoon's large increase was the result of
the severe outbreak of smallpox at the beginning of 1932, when many
revaccinations were done.
Of the 239,005 operations, 59,240 were primary and 179,765 were
revaccinations, and out of the total increase of 117,388, 10,300 were
primary and 107,088 were revaccinations.
The percentage of successful cases in primary vaccination was 97.99
and in revaccination 35.03, compared with 97.78 and 36.67 respectively
in the previous year.
SHAN STATES—A total of 2,170 operations were performed in the
three towns in the Shan States in 1931-32, compared with 1,602 in
the previous year. The percentage of successful cases to total verified
cases is 98.12 in primary and 47.49 in revaccinations.
Appendix C.
7. Revaccination in Towns—
BURMA—It is gratifying to note that 20 towns out of the 74 in which
the Vaccination Acts are in force have framed revaccination rules
under Section 12A of the Burma Vaccination Law Amendment Act,
1909, as amended by the Burma Act IV of 1928.
SHAN STATES—Taunggyi and Lashio reported an increase in revac-
cination during the year 1931-32, while Kalaw returned a decrease.
The net increase for the States as a whole was 179.
6
TRIENNIAL REPORT ON VACCINATION IN BURMA
Appendix B
8. Infant Vaccination in Towns—
BURMA—In the year 1931-32, a total of 42,205 births and 11,527
deaths among infants under one year of age were registered in the 74
towns in which the Vaccination Acts are in force. The number of
survivors according to these records is therefore 30,678. During the
year, 33,290 infants under one year were successfully vaccinated—2,612
in excess of the recorded survivors.
The number of infants successfully vaccinated was in excess of the
recorded survivors in 34 and below in 38 towns. In two towns the
figures were the same.
A large excess of infant vaccinations over the available survivors was
reported from Rangoon ( + 1,006), Pegu (+585), Mandalay (+529),
Insein (+456) and Thayetmyo ( + 211).
The excess in Rangoon was partly due to the vaccination of 1,164
infants left unvaccinated below the survivors of the previous year.
Pegu reported an excess of 146 in 1930-31 and 585 in 1931-32. One
reason given for the latter excess is that owing to the rebellion there
was a large influx of people into the town from the surrounding rural
areas. Mandalay reported an excess of 1,077 last year and 529 this
year. It was stated that the number of primary vaccinations included
not only children born in Mandalay but also outside, who happened to
come into the town. Insein reported an excess of 169 last year and
456 this year. Probably refugees from disturbed areas accounted for
this year's excess. The excess in Thayetmyo was probably due to the
same reason.
In eleven towns the number of infant vaccinations exceeded the
number of births. These were Pegu, Insein, Thingangyun, Kanbe,
Kamayut, Kyangin, Thayetmyo, Chauk, Myitnge, Yamethin and Myinmu.
This excess is probably due to defective birth registration and in the
cases of Pegu, Insein and Thayetmyo to the influx of families from the
country districts during the rebellion.
On the other hand, the number of infants successfully vaccinated
under one year was considerably below the number of recorded survivors
in Myingyan (—259), Toungoo (—196), Mergui (—172),Pyu (—131),
Thongwa (—122), Shwegyin (—120), Pakôkku (—102) and Thaton
( — 100). No satisfactory reasons were given except in the case of
Toungoo where 123 infants were reported to have left the town. The
vaccination state of these towns can only be considered as unsatisfactory
when all these children remained unprotected at the end of the
year.
SHAN STATES—In the 3 notified towns, where the Vaccination Acts
are in force, 571 births and 108 deaths were recorded. The number of
FOR THE YEARS 1929-30 TO 1931-32
7
recorded survivors was therefore 463, compared with a figure of 340
shown as successfully vaccinated.
9. Dispensary Vaccination—
BURMA—A total of 19,308 vaccinations were performed in hospitals
and dispensaries (10,818 primary and 8,490 revaccinations) during the
triennium, compared with 20,207 operations (14,321 primary and 5,886
revaccinations) during the previous triennium.
Summary of
Statement I.
During the year 1931-32, a total of 2,660 primary and 4,286 revacci-
nations were performed compared with 3,810 and 1,004 in the previous
year and 4,348 and 3,200 in 1929-30. Of the 2,660 primary cases, 1,200
were reported as successful and 1,354 as " result of unknown"; out of
4,286 revaccinations, 824 were returned as successful and 468 as
unknown. The highest number of dispensary vaccinations was
reported from Mandalay town (3,859), followed by Myitkyina district
(1,312), Bassein district (364), Hill District of Arakan(343) and Tharra-
waddy district (324).
SHAN STATES—A total of 2,593 vaccinations were reported from
dispensaries in the Shan States for this triennium as against 3,652 in the
last triennium.
Of 372 primary vaccinations done in 1931-32, 262 were reported as
successful and 104 as unknown ; out of 386 revaccinations in the same
year, 221 were reported as successful and 151 as unknown.
10. Jail Vaccination—
BURMA—In the Jails 44,836 prisoners were vaccinated in 1931-32,
compared with 32,378 in the previous year and 30,386 in 1929-30. Of
the 44,836 vaccinations, 1,970 were primary and 42,866 were revacci-
nations. Of the primary cases, 1,680 were successful, and of the revac-
cinations, 16,700 were successful. The percentage of success obtained
in primary vaccination was therefore 85.28 and in revaccination 38.96
compared with 84.67 and 43.93 per cent respectively in the previous
year and 70.44 and 49.77 per cent respectively in 1929-30.
SHAN STATES—No jail vaccination was reported from the Shan
States for 1931-32.
Summary of
Statement I.
11. Vaccination by Private Practitioners—
BURMA—During the year 1931-32 medical practitioners performed
7,574 vaccinations in Burma, compared with 332 in 1930-31 and 877 in
1929-30. The very big increase is due to the epidemic in Rangoon
which prevailed during the last three months of 1932, and in that time
private practitioners performed a large number of vaccinations.
8
TRIENNIAL REPORT ON VACCINATION IN BURMA
Of the 7,574 operations, 736 were primary and 6,838 were revacci-
nations ; the percentage of success was 99.30 with primary and 46.81
with verified revaccination cases.
The total number of infants under one year successfully vaccinated
by private practitioners was 179 ; between one and six years the
figure was 409.
SHAN STATES—Thirty-two primary vaccinations and 1 revaccination
were reported as performed by private practitioners in the Shan States,
compared with nil last year. All the primary cases were reported as
successful.
12. Ship Vaccination—
Under the provisions of Section 9 of the Burma Vaccination Law
Amendment Act of 1909, as amended by Burma Act IV of 1928, 165,990
ship vaccinations were performed in the ports of Rangoon and Akyab
during the year 1931-32 compared with 194,534 in the previous year
and 219,072 in 1929-30. The decrease is due to the smaller number of
immigrants.
Rangoon port reported 156,537 and Akyab port 9,453 vaccinations.
The results of these cannot be recorded, as passengers are allowed to
proceed to their different destinations at once. There is no doubt that
this large number of vaccinations at the ports goes a long way towards
reducing the incidence of smallpox in Burma.
Statement IV
13. Verification Work of Inspecting Officers—
BURMA—Of the total number of 894,704 persons vaccinated and
revaccinated in Burma in the year 1931-32, the District and Assistant
District Health Officers and Municipal Health Officers inspected the
results of 86,157 or 9.63 per cent, compared with 12.89 per cent in
1930-31 and 11.33 per cent in 1929-30.
Of the total number of 539,503 primary vaccinations in 1931-32,
inspectors of vaccination and other inspecting officers verified the result
of 325,216 or 60.28 per cent, compared with 56.54 per cent in 1930-31
and 54.42 per cent in 1929-30 ; of a total of 355,201 revaccinations, they
verified 152,616 persons or 42.97 per cent. compared with 49.38 per cent
in 1930-31 and 44.66 per cent in 1929-30.
SHAN STATES—Of the 82,146 persons vaccinated and revaccinated
in the Shan States during 1931-32, the District Health Officers verified
the result of 5,680 or 6.91 per cent, compared with 7.14 per cent in
1930-31 and 14.55 per cent in 1929-30.
The percentages of verification work carried out by Inspectors of
Vaccination and Head Vaccinators were 60.96 per cent in primary and
23.30 per cent in re-vaccinations, compared with 63.18 per cent and
45.00 per cent respectively in 1930-31 and 65.07 per cent and 26.49
per cent in 1929-30.
FOR THE YEARS1929-30 TO1931-32.
9
14. Establishment—The strength of the vaccination staff
employed during the years of the last two triennial periods is shown in
the table below:—
Year.
(1)
1926-27 ...
1927-28 ...
1928-29 ...
Average ..
1929-30 ...
1930-31...
1931-32 ...
Average...
Province or
State.
(2)
Burma ...
Shan States
Burma ...
Shan States ...
Burma ...
Shan States
Burma ...
Shan States
Burma ...
Shan States
Burma ...
Shan States
Burma ...
Shan States
Burma ...
Shan Slates
District
Superin-
tendents
of
Vaccina-
tion.
(3)
39
2
39
2
39
2
39
2
39
2
38
2
38
2
38
2
Part-time Super
vising Officers.
Sub-
Assistant
Sur-
geons.
(4)
28
...
28
...
31
...
29
...
31
...
32
...
32
...
32
...
Public
Health
In-
spectors.
(5)
9
...
11
...
13
...
11
...
13
...
26
...
37
...
25
...
Inspec-
tors of
Vaccina-
tion
(6)
41
1
42
1
41
1
41
1
38
2
39
2
39
2
39
2
Head
Vaccina-
tors.
(7)
...
1
...
1
...
3
...
2
...
3
...
3
...
3
...
3
Vaccina-
tors.
(8)
337
40
344
40
343
42
341
41
350
42
354
42
355
42
353
42
It will be noted from this table that the staff has increased in the
triennium.
The number of Sub-Assistant Surgeons receiving an allowance for
supervision of vaccination remained the same in 1931-32 as in the
previous year. The number of Public Health Inspectors supervising
vaccination increased by 11—one each in the towns of Kyaukpyu,
Maubin, Minbu, Salin, Kyauksè and Pyawbwè, six in the districts of
Insein, less one in the district of Toungoo. The increase in the Insein
district was due to the inclusion of four Public Health Inspectors
employed in the Hlegu Rural Health Unit area and to the employment
of two Public Health Inspectors in the rest of the district on verification
duty in addition to their ordinary sanitary duties.
There was an increase of one in the number of vaccinators.
To cope with epidemics of smallpox, 20 temporary vaccinators were
employed by the Corporation of Rangoon during the latter part of
1931-32, one by the Akyab Municipal Committee for one month, one by
the Moulmein Municipal Committee, one in Kyauksè district for one
month and one in Hanthawaddy district for one month.
SHAN STATES—The Staff in the Shan States in 1931-32 remained the
same as in the year 1930-31.