NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
NOTES AND STATISTICS
ON
Vaccination in Burma
For the official year (April to March) 1932-33.
1. Establishment.—The following table compares the strength
of the vaccination staff employed in the Province during the year
1932-33 with that of the two preceding years :—
Vaccination Staff.
Year.
(1)
1930-31
1931-32
1932-33
Province or
State.
(2)
Burma ...
Shan States
Burma ...
Shan States
Burma ...
Shan States
District
Superin-
tendents
of Vacci-
nation
(3)
38
2
38
2
38
2
Part-time Supervising
Officers.
Sub-Assis-
tant Sur-
geons, etc.
(4)
32
...
32
...
32
...
Public
Health
Inspectors.
(5)
26
...
37
...
48
...
Inspec-
tors of
Vacci-
nation.
(6)
39
2
39
2
30
2
Head
Vacci-
nators.
(7)
3
...
3
...
3
Vacci-
nators.
(8)
354
42
355
42
351
43
BURMA.—During the year 1932-33, 351 vaccinators were employed,
compared with 355 during the previous year. There was a decrease of
2 in Prome district, 1 in Insein district and 1 in Mandalay Cantonment.
There were 30 inspectors of vaccination, compared with 39 in the
previous year. The 9 places were, however, filled by public health
inspectors who have a higher technical training. Government has
informed local bodies that a qualified public health inspector is to be
appointed in any future vacancy occurring in the post of inspector of
2
NOTES AND STATISTICS ON VACCINATION IN BURMA
vaccination. The number of public health inspectors rose from 37 to
48, while that of the sub-assistant surgeons, etc., supervising vacci-
nation work, remained the same.
In order to cope with local outbreaks of smallpox 41 temporary
vaccinators were entertained for various periods—20 in Rangoon town,
and 1 each in Pyawbwe, Moulmein, Pyinmana and Minbu towns, 3
each in Bassein and Tharrawaddy districts, 2 each in Magwe and
Shwebo districts, and 1 each in Henzada, Myaungmya, Hanthawaddy,
Minbu, Kyauksè, Bhamo and Mandalay districts.
SHAN STATES.—One additional vaccinator was employed in the
Federated Shan States. Otherwise the staff remained the same as in
the previous year.
Statement I.
2. General Review—Totals Vaccinated.—
BURMA.—A total of 1,138,145 persons are reported to have been
vaccinated, compared with 894,704 in the previous year—an increase of
243,441 persons.
This was mostly due to the higher incidence of smallpox. With an
increase in the prevalence of smallpox there was a corresponding greater
readiness on the part of people to get vaccinated. It is to be hoped
that with the spread of education it will not in the near future require
an unpleasant stimulus such as an epidemic to make the people
recognise the necessity of vaccination.
SHAN STATES.—The States report 120,969 persons, compared with
82,146 in 1931-32—an increase of 38,823 persons.
These figures exclude jail and ship vaccinations, but include dispen-
sary and private vaccinations.
Statement I.
3. Operations Performed.—
BURMA.—The total number of operations performed in Burma
during the year under report, excluding jail and ship but including
dispensary and private vaccinations, was 1,140,152 (637,649 primary and
502,503 revaccinations), compared with 896,080 (540,865 primary and
355,215 revaccinations) in 1931-32—an increase of 244,072 operations.
An increase is reported from 32 districts and a decrease from 5.
The largest increase is reported from Mandalay (+ 34,640) followed
by Bassein (+31,737), Myaungmya (+24,738), Tharrawaddy( + 21,793)
and Lower Chindwin (+20,133). Increases are also reported from
the districts of Thayetmyo ( + 14,963), Henzada ( + 14,412), Tavoy
( + 13,302), Yamèthin ( + 12,974), Magwe (+10,109), Prome (+9,931),
Myingyan (+9,693), Pyapôn (+8,314), Maubin (+8,137), Minbu
(+7,899), Pakôkku (+6,009), Meiktila (+5,842) and Kyauksè (+5,527).
Of the five districts reporting decreases Sagaing heads the list with
(-3,120), followed by Toungoo (-2,596), Akyab (-785), Salween
(-121)andThatôn(-72).
FOR THE OFFICIAL YEAR (APRIL TO MARCH) 1932-33.
3
SHAN STATES.—The total number of operations performed in the
Federated Shan States in the year under report was 120,969 (87,668
primary and 33,301 revaccinations), compared with 82,146 (65,080
primary and 17,066 revaccinations) in 1931-32—an increase of 38,823
operations.
Statement I.
4. Primary Vaccination.—
BURMA.—A total of 637,649 primary operations was recorded during
the year, compared with 540,865 during 1931-32—an increase of 96,784.
Out of 38 districts, 28 report increases and 10 decreases.
Large increases are reported from the districts of Bassein (+21,838),
Tharrawaddy ( + 15,126), Myaungmya ( + 14,601), Bhamo (+7,421),
Myingyan (+6,607) and Pyapôn ( + 6,414).
Decreases of over 1,000 are returned by the districts of Sagaing
(-2,161) and Akyab (-1,113).
SHAN STATES.—The number of primary vaccinations reported for
the year under report is 87,668, compared with 65,080 in the previous
year—an increase of 22,588.
Statement I.
5. Revaccination .—A total of 502,503 revaccinations is recorded
during the year, compared with 355,215 in 1931-32—an increase of
147,288. Increases are reported from 32 districts and decreases
from 6 districts.
Large increases are reported from the districts of Mandalay
( + 32,573), Lower Chindwin (+20,042), Shwebo (+15,021), Tavoy
(+14,184), Yamèthin (+12,810), Thayetmyo ( + 10,630), Henzada
(+10,579) and Prome ( + 10,551). Increases over five but below ten
thousand are returned from the districts of Tharrawaddy, Bassein,
Minbu, Magwe, Pakôkku, Kyauksè and Upper Chindwin. The general
increase is in keeping with the higher incidence of smallpox.
Decreases of over one thousand are reported from Rangoon (—65,781)
and the districts of Toungoo (-1,625) and Thaton (-1,054). In the
last two districts the travelling allowance of the vaccinators has been
fixed, instead of being paid according to the journeys performed,
and this is given as the cause of the falling off in the amount of
work done.
Statement I.
6. Results of Vaccination.—
BURMA.—Of the 637,649 primary operations (including those
performed by medical officers in charge of dispensaries and by private
practitioners) performed during the year under report, 572,668 are
reported as successful, compared with 498,023 in the previous year.
The results of 39,118 were unknown, compared with 27,275 in the
previous year. The number of failures therefore works out at 25,863,
compared with 15,567 during the previous year.
4
NOTES AND STATISTICS ON VACCINATION IN BURMA
Of the total of 572,668 successful vaccinations, 168,701 were on
infants under one year of age and 312,615 on children of one to six
years. The remaining 91,352 successful cases were on persons over
six years of age.
The percentage of success in primary vaccinations of which the
results were known is 95.68, compared with 96.97 in the previous year.
Success rates over 99 per cent. are returned by Kyauksè (99.56) and
Bhamo (99.85) districts and below 90 per cent. by Chin Hills (74.53),
Myingyan (88.97), Upper Chindwin (87.07) and Lower Chindwin
(89.95) districts. The remaining districts report success rates between
90 and 99 per cent.
Of the 502,503 revaccinations, 133,742 are reported as successful,
compared with 81,031 in the previous year. The percentage of success
in revaccinations of which the results were known is 33.25, compared
with 31.71 in the previous year.
SHAN STATES.—Of the total of 87,668 primary vaccinations per-
formed in the Federated Shan States, 70,225 are reported as successful,
compared with 58,775 in the previous year. The results of 16,465 were
unknown, compared with 4,551 in the previous year. The number of
failures therefore works out at 978, compared with 1,754.
Of the 33,301 revaccinations, 13,077 are reported as successful,
compared with 8,538 in the previous year.
The percentage of success amongst cases of which the results were
known is 98.62 in primary vaccinations and 52.09 in revaccinations.
Statement I.
7. Vaccination in Towns.—
BURMA.—In the 74 towns to which the Vaccination Acts have been
extended, a total of 230,276 operations were performed during the year,
compared with 239,005 in the previous year. Of the total operations,
61,002 were primary and 169,274 were revaccinations, compared with
59,240 and 179,765, respectively, in the previous year. This gives an
increase of 1,762 in primary and a decrease of 10,491 in revaccinations.
Of the 74 towns, 47 report an increase and 27 a decrease. The
highest increases are reported from Mandalay ( + 25,478), followed by
Tavoy ( + 6,266), Maymyo ( + 5,690), Henzada (+4,656), Akyab (+3,769),
Minbu ( + 3,750), Myingyan (+1,701), Sagaing (+1,555), Kyonpyaw
(+1,438), Syriam (+1,413), Gyobingauk ( + 1,239), Shwebo ( + 1,203)
and Thôngwa (+1,080). On the other hand, a large fall is reported by
Rangoon (-69,715), followed by Myitnge (-3,581), Letpadan (-3,182)
and Insein (—2,004), The large increase in Mandalay was attributed
to the higher incidence of smallpox and to better supervision, and the
large decrease in Rangoon was due to the fact that an abnormally large
number of operations was performed in the last three months of the
previous year when a severe outbreak of smallpox occurred.
FOR THE OFFICIAL YEAR (APRIL TO MARCH) 1932-33.
5
SHAN STATES.—A total of 4,962 operations were performed in the
three towns in the Shan States during the year under report, compared
with 2,170 in the previous year—an increase of 2,792.
Statement I.
8. Results of Vaccination in Towns.—
BURMA.—Out of 61,002 primary operations performed in the 74
towns, 55,497 were successful; out of 169,274 revaccinations 47,263
were successful. The percentage of successful cases to total known
cases is 97.63 in primary and 36.39 in revaccinations, compared with
97.99 and 35.03, respectively, in the previous year.
Of the 74 towns, 26 report 100 per cent primary successes and 41
report successes below 100 but over 90 per cent. Seven towns return
success rates below 90 per cent., viz. Kyaukpyu, Sandoway, Kawkareik,
Mergui, Myingyan, Pyawbwe and Mawlaik.
High success rates (ranging from 70 to 100) in revaccinations were
reported from Minbya, Pegu, Tharrawaddy, Thônzè, Nattalin,
Ngathainggyaung, Nyaung-U, Myitkyina and Mawlaik. Low success
rates, below 10 per cent., are reported from Syriam, Shwedaung,
Henzada, Maubin, Danubyu, Pyapôn and Myingyan.
SHAN STATES.—Of the 1,000 primary operations performed in towns
in the Federated Shan States during the year under report, 851 were
successful, compared with 837 in the previous year. Of the 3,962
revaccinations, 1,057 were successful, compared with 568 in the previous
year. The percentage of successful cases to total known cases is 98.84
per cent. in respect of primary operations and 46.38 in respect of
revaccinations, as against 98.12 and 47.49, respectively, during the
previous year.
Appendix B.
9. Infant Vaccination in Towns.—
BURMA.—Totals of 45,791 births and 12,177 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 33,614. During the year under report,
36,198 infants under one year were successfully vaccinated—2,584 in
excess of the recorded survivors.
The number of infants successfully vaccinated was in excess of
recorded survivors in 33 towns, and below, in 40 towns. In one town,
the figures were the same.
A large excess of infant vaccinations over survivors is reported from
Mandalay ( + 2,022), Chauk (+490), Pegu (+451), Insein (+376),
Myaungmya (+296) and Henzada ( + 287).
In seven towns, the number of infant vaccinations exceeded the
number of births. These are Pegu, Thingangyun, Henzada, Myaung-
mya, Maubin, Chauk and Myinmu.
6
NOTES AND STATISTICS ON VACCINATION IN BURMA
On the other hand, the number of infants successfully vaccinated
under one year was considerably below the number of survivors in
Rangoon (-1,293), Mergui (-194), Maymyo (-156), Prome (-138),
Pyu (-137), Toungoo (-122), Sagaing (-110) and Thatôn (-104).
SHAN STATES.—In the three notified towns, where the Vaccination
Acts are in force, 571 births and 104 infant deaths were recorded. The
number of recorded survivors was therefore 467, of which 367 were
successfully vaccinated.
Statement I
(Summary).
10. Dispensary Vaccination.—
BURMA.—Dispensary vaccinations were performed in thirteen
districts in Burma during the year, which is the same number as the
previous year.
During the year 2,020 primary vaccinations and 6,241 revaccinations
were performed, compared with 2,660 and 4,286 operations, respectively,
during the previous year.
Out of 2,020 primary operations, 420 are reported as successful and
1,555 as unknown ; out of 6,241 revaccinations 953 are returned as
successful and 2,246 as unknown. The percentage of successful cases
to total known cases is 90.32 per cent. in primary and 23.85 per cent. in
revaccination.
SHAN STATES.—These report 866 primary operations and 1,790
revaccinations, compared with 372 and 386, respectively, during the
preceding year.
11. Jail Vaccination.—
BURMA.—In the jails 45,280 prisoners were vaccinated in the year
under report, compared with 44,836 in the previous year. Of the 1,833
primary cases, 1,083 were successful and of the 43,447 revaccinations
14,265 were successful. The percentage of success in primary cases
is 59.08 and in revaccinations 32.83.
SHAN STATES.—There is no jail in the Shan States.
Statement I
(Summary).
12. Vaccination by Private Practitioners.—During the
year private medical practitioners performed a total of 3,535 primary
and 3,203 revaccinations. The percentage of success amongst the
verified cases is 38.66 in primary operations and 28.24 in revaccinations.
The total number of infants under one year of age successfully
vaccinated, was 480 ; between one and six years, the figure was 1,550.
13. 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, 173,025 ship vaccinations were performed in
the ports of Rangoon and Akyab during the year 1932-33, compared
with 165,990 in the previous year. Rangoon port reported 158,215
(156,537) and Akyab port 14,810 (9,453).
FOR THE OFFICIAL YEAR (APRIL TO MARCH) 1932-33.
7
Statement IV.
14. Verification Work of Inspecting Officers.—
BURMA.—Of the total number of 1,138,145 persons vaccinated and
revaccinated in Burma during the year under report, District and
Assistant District Health Officers and Municipal Health Officers
inspected the results of 107,425 or 9.44 per cent., compared with 86,157
or 9.63 per cent. in the previous year.
Of the total number of 635,692 primary vaccinations, Inspectors of
Vaccination, Public Health Inspectors and Sub-Assistant Surgeons
verified the results of 372,149 or 58.54 per cent, compared with 325,216
or 60.28 per cent in the previous year ; of the total of 502,453 revaccina-
tions they verified 221,103 persons or 44.00 per cent., compared with
152,616 or 42.97 per cent., in the previous year.
SHAN STATES.—Of the 120,969 persons vaccinated and revacci-
nated in the Federated Shan States during the year under report, the
District Health Officers verified the results of 4,737 or 3.92 per cent.,
compared with 5,680 cr 6.91 per cent. in the previous year.
The percentage of verification work carried out by the Inspectors of
Vaccination and Head Vaccinators was 32.03 per cent. in primary and
15.70 per cent. in revaccinations, compared with 60.96 per cent. and
23.30 per cent., respectively, in the previous year.
Statement II.
15. Cost of the Department.—The total cost of the Depart-
ment, as shown in Statement II, was Rs. 4,33,526-9-7, compared
with Rs. 4,26,707-6-8 in 1931-32. The average cost of each successful
case of vaccination is Re. 0-9-10, compared with Re. 0-11-10 in the
previous year. The lower cost was due to the larger number of
vaccinations performed during the year.
If, however, the sum of Rs. 48,008-8-0 credited to Government, on
account of the sale in Burma of vaccine lymph, be deducted from the
total expenditure of Rs. 4,33,526-9-7, the net cost of the Department is
reduced to Rs. 3,85,518-1-7, compared with Rs. 3,90,562-1-8 in the
previous year. The average cost of each successful case is therefore
proportionately reduced to Re. 0-8-9, compared with Re. 0-10-10 in
1931-32.
High rates of average cost are reported from the following districts,
viz., Arakan Hill Tracts (Rs. 1-12-9), Salween (Rs. 1-5-2) and Sandoway
(Rs. 1-0-1). The cost reported for Rangoon is Rs. 2-9-6.
SHAN STATES.—The total cost of the Vaccination Department in
the Federated Shan States, as shown in Statement II, was Rs. 36,728-
15-0, compared with Rs. 39,114-11-0 in 1931-32. The cost per success-
ful case of vaccination works out at Re. 0-7-2, compared with Re. 0-9-4.
The decrease was due to the larger number of vaccinations performed
during the year.
8
NOTES AND STATISTICS ON VACCINATION IN BURMA
16. Illegal Inoculation.—Forty-seven and thirty cases of
inoculations were detected in Henzada and Thatôn districts, respectively.
Various fines were inflicted on the culprits in Henzada, while the
inoculator in Thatôn was reported to have disappeared. In Thatôn
district, six parents performed arm to arm vaccination on their children.
Each was fined Rs. 2 by the Township Magistrate, Thatôn. The
practice of inoculation was also detected in Magwe district, but the
matter was still under enquiry at the time of report.
17. Prosecutions under the Vaccination Acts.—Rangoon
reports six prosecutions, of which two were successful, one was closed
and the other three were still pending in court at the end of the year.
Fifty-four parents in Amherst and three in Thatôn were reported to
magistrates for refusal to submit their children to vaccination and by
the orders of these courts, the children were subsequently vaccinated.
In Minbu 240 persons were prosecuted and some were fined. One
prosecution made in Kawkareik town is still pending in court.
18. Vaccine Depot, Meiktila.—The new operation theatre and
operation stable were brought into use in July. They facilitate the
manufacture of an increased quantity of lymph under more satisfactory
working conditions. It is now possible to manufacture 4,000 grammes
of lymph per month which is about four times the demand when
smallpox is not present in epidemic form. There is thus ample
provision for an emergency and little danger of our supply of lymph
running short.
One of the water reservoirs was replaced by a new one and a second
Roturbo pump was installed.
OUTPUT OF LYMPH.—Two hundred and forty-one cow calves and
17 buffalo calves were vaccinated during 1932-33. Three cow calves
failed to take.
The following table contrasts the output and issue of lymph during
the year with that of the two previous years:—
Years.
(1)
1930-31
1931-32
1932-33
No. of calves
and buffaloes
scraped.
(2)
223 calves
22 buffaloes
180 calves
13 buffaloes
241 calves
17 buffaloes
Total yield.
Oz.
(3)
382.36
97.56
355.87
58.48
435.24
120.31
Grms.
(4)
10,840
2,766
10,089
1,658
12,399
3,411
Average yield per
calf and buffalo.
Grains.
(5)
749.89
1,940.11
86496
1,967.06
793.82
3,096.43
Grms.
(6)
48.61
125.72
56.05
127.54
51.45
200.65
Doses
issued.
(7)
1,219,197
1,352,382
1,578,108
FOR THE OFFICIAL YEAR (APRIL TO MARCH) 1932-33.
9
The average yield per cow calf decreased from 56.05 to 51.45
grammes. An outbreak of foot and mouth disease to some extent
accounted for the decrease. The average yield per buffalo calf
increased from 127.54 grammes to 200.65 grammes.
There was an opening balance of 3,500 grammes of lymph carried
over from the previous year, and 15,810 grammes were manufactured
during the year. Of this total of 19,310 grammes, 14,386 grammes were
issued during the year, 1,132 grammes were used as seed lymph and a
closing balance of 3,792 grammes has been carried over to the year
1933-34.
TECHNIQUE.—Ten rabbits were used for rejuvenating the seed
lymph. As in previous years, seed lymph was passed through the
modified Nijland cycle throughout the year (rabbit—cow calf—buffalo
calf—rabbit). All lymph issued was subjected to Cunningham's
potency test on cow calves and the Calmette Guerin potency test on
rabbits. In addition, each lymph was tried on at least three children,
before the lymph was issued, and an insertion success of 100 per cent.
was obtained.
SUPPLY OF LYMPH.—Of the 1,578,108 doses of lymph issued,
1,522,929 were supplied to local bodies on payment and the balance
of 55,179 doses were issued to Government institutions free of charge
as follows :—4,956 to Military, 38,037 to Jails, 11,460 to Government
vaccinators in Chin Hills District and 726 to the Borstal Training
School, Thayetmyo.
QUALITY OF LYMPH.—Of 266,423 cases of primary vaccinations
in 1932-33, the results of which were reported to the Depôt, a success
rate of 92.9 per cent. was obtained, compared with 95.82 per cent. in
1931-32. For 118,915 revaccinations reported, the percentage of success
was 41.5, compared with 36.32 in the previous year.
DRY LYMPH.—Further experiments with dry lymph during the
year confirmed the previous finding that the process of drying destroys
a large amount of the virus. It was also found that after a year's
storage dry lymph produced very weak and small vesicles and that it is
about four times more costly to produce than glycerine lymph.
FINANCE.—The total maintenance expenditure of the Depôt for the
year 1932-33, was Rs. 32,972-3-0 and the total net income was 53,415-1-0,
including Rs. 6,871-7-0, balance of the sale proceeds of vaccine lymph
outstanding on the 31st March 1932, but excluding Rs. 7,158-4-0 balance
of the sale proceeds of lymph outstanding on the 31st March 1933.
The excess of income over expenditure during the year is therefore,
after adjustment, Rs. 20,729-11-0.
Of the total expenditure of Rs. 32,972-3-0, a sum of Rs. 16,842-14-0
was expended on establishment, Rs. 7,574-0-0 on contingencies,
Rs. 4,377-8-6 on medicines and instruments, Rs. 2,148-0-0 on the hire
10
NOTES AND STATISTICS ON VACCINATION IN BURMA
FOR THE OFFICIAL YEAR (APRIL TO MARCH) 1932-33.
of calves, Rs. 1,127-12-0 on feeding of calves and rabbits, Rs. 809-5-6
on service postage and telegrams and Rs. 92-11-0 on petty construction
and repairs.
19. Training Class.—Owing to there being already a sufficient
number of trained vaccinators in the Province no student vaccinators
were trained at the Vaccine Depôt during the year 1932-33.
Ninteen students undergoing the course of training for Public Health
Inspectors were, however, given training in vaccination at the Depôt
and seventeen passed the qualifying examination.
20. General Remarks.—Mr. G. H. Blaker, I.M.D., and U Myat
Maung continued to hold charge of the duties of Director and Assistant
Director, respectively, of the Depôt. The Depôt was visited during the
year by Lieut.-Col. G. Jolly, C.I.E., I.M.S., Director of Public Health,
Burma, and by Dr. J. F. Kendrick, M.D., Director, Rural Health
Unit, Hlegu.
E. COTTER, Major, I.M.S.,
RANGOON, 21st August 1933.
Offg. Director of Public Health, Burma.
APPENDICES.
STATEMENT I.—Showing particulars of vaccination in the Province of
Burma during the year 1932-33.
STATEMENT II —Showing the cost of Vaccination Department in the
Province of Burma during the year 1932-33.
STATEMENT III.—Showing the number of persons primarily vaccinated
and the number of those persons who were successfully
vaccinated in the Province of Kurma in each of the
official years 1923-24 to 1932-33.
STATEMENT IV.—Showing particulars of vaccination verified by Inspecting
Officers during the year 1932-33.
APPENDIX A.—Showing the ratio per 10,000 successfully vaccinated and
the mortality 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—Showing local areas in which revaccination rules were
in force.
APPENDIX D.—Graphs showing the vaccinations performed and the
deaths from small-pox in Burma (excluding Backward-
Tracts) since the year 1922-23.
APPENDIX E.—Diagram showing the proportion of population protected
during the seven official years 1926-27 to 1932-33. and
death-rate from small-pox during the calendar year
1932 in districts where full registration of vital
statistics is in force.
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