REPORT ON VACCINATION IN ASSAM.
27
be better off than others; but often the class of vaccinators found comprises those who are ex-inocula¬
tors, those who are wanting in intelligence to understand the plain instructions placed in their hands,
those who, though willing and active, lack a proper training; sometimes men who can neither read nor
write; men deficient in energy and truthfulness, making up for their laziness or ill success by plenty
of book-entered successes, with a tolerable sprinkling of good men who can be trusted, and these all
are the principal channels through which vaccination is brought to the people. If bad vaccination
is done no amount of supervision afterwards will remedy it.
4. To open out good prospects and encourage respectable men to engage in vaccination, there
might be apprentices on Rs. 5 per month; these, after passing, being appointed vaccinators on Rs. 10,
and, after showing themselves trustworthy, to be eligible as—
Vaccinator on
...
... ... ... ...
Head Vaccinators on
...
...
...
... ... ...
Inspectors of Vaccination on ... ... ... ... ... ...
Ditto
Ditto ... ... ... ...
Rs
12
15
25
30
with travelling allowance according to Assam rules, i.e., 6 annas per day while in the district, except
apprentices, and 7½ annas for Inspectors of Vaccination. Each district to be allowed one Inspector of
Vaccination, 1 head vaccinator, and 2 apprentices, with such proportion of ordinary vaccinators as
may be necessary.
5. The printed rules in English and the vernacular for performing vaccination would, if thoroughly
carried out, be ample to ensure good work, but unless thoroughly trained competent men are at work, these
rules are more or less disregarded; where there is a marked deficiency of good vaccinators some expe-
rienced men might be obtained from the Bengal vaccine circles, especially superior grades, as head
vaccinators and inspectors.
6. The Civil Surgeon occupies the position of Superintendent of Vaccination and the new class,
lately introduced, on Rs. 25 per month, called Superintendents, should be termed Inspectors of
Vaccination. A Superintendent of Vaccination in Bengal is a gazetted officer and the head of an
office.
7. As there is sometimes delay in starting the work of vaccination in the beginning of the season,
through supplies of lymph not being obtained early enough, it is suggested that early in September
an application should be made for a small supply of carefully-selected recently-filled tubes of
good lymph from the source which experience has taught as most reliable and suitable to the district,
three or four tubes would generally suffice. No crusts should be asked for or even used if it can be avoided.
In the meantime, the permanent vaccinator or the Hospital-Assistant should have sought in the localities
near and have a list of children unvaccinated, these should all be seen at their homes and selection
made of those to be vaccinated. First, healthy and robust infants under a year (about 4 to 8 months
old are most suitable, older children have a tendency to scratch or destroy the vesicle when vaccination
is done; the great importance of the preservation of the vesicle should be most particularly impressed
upon the parents: laving the vaccination sites with cold water several times a day cools the part
and lessons the itchy tendency, and the parents should be so instructed; a small money reward should
be offered when there is difficulty in securing good vesicles, to induce the parents to more carefully look
after the vesicle. If the lymph is good, properly engrafted, and propitious, the vaccination of a whole
district may now be set up by arm-to-arm vaccination, infants being again selected with similar
precautions. A good supply of lymph should be stored in capillary tubes from the selected cases.
When filling tubes that are to be used in a short time the ends should be stopped with sealing-wax,
instead of being hermetically sealed in the flame of a candle as less liable to damage the lymph.
8. The vaccinators should be present before end of September, and new candidates for appren-
ticeship should be appointed early. Men who had worked unsatisfactorily in past season should
not be re-engaged; former year's apprentices should take their place after due examination. A thorough
acquaintance with the rules for vaccination should be insisted on. No one should be engaged who
cannot write and read the vernacular well. The selected men should each have an appointment letter
from the Civil Surgeon given them and a parwana with seal of the Deputy-Commissioner.
9. Arrangements should be completed by this time for the supply of lancets, empty capillary
tubes, copies of printed rules, stationery, printed registers of diary and monthly return, printed forms
in the vernacular, &c., &c., to avoid delay in starting on 1st October for the district.
10. Only lymph stored in tubes or arm-to-arm vaccination should be used. Ivory points are
not trustworthy, and crusts are to be avoided. Spurious vaccination will never give lymph on the day-
week after vaccination; but crusts can be obtained from such spurious cases with which unfortunately
it may be continued; lymph-working vaccination requires fore thought and punctuality, and ill-trained,
careless men do not like to be tied to its use, but it is really the only virus to be depended upon
for good vaccination.
11. In Assam, where certain classes are bound by the authority of their religious teachers or
Gossains, every proper endeavour should be made beforehand to persuade them to permit their
followers being vaccinated, and, if possible, to obtain a genuine written authority for this.
12. The registers of vaccination should be printed books in the vernacular, similar to form in use
in Bengal circle of vaccination. They have columns for first and second vaccination. If suitable printed
registers and forms in the vernacular are not supplied to the vaccinators, they are tempted to place
some of the information on bits of paper and fill in the rest from memory ! when they have time
and inclination to rule and fill in the headings, &c. Blank books purchased in the bázár to serve
as registers cost almost as much as printed registers, and are without the convenience the latter afford.
A complete set, as samples, of all the printed forms of vaccination in use might readily be obtained
from the Superintendent of Vaccination, Bengal, and such as are suitable could be brought into use
in Assam.