( 3 )
of all persons passing through contractors' depôts (which description till the end of last
year included not only contractors' but also the bulk of sardári coolies) not already protected
from small-pox. And thus the unprotected population on the plantations should consist
only of free labourers, and of the children of contract coolies born in the Province. From
what he has seen on his tours among the tea-gardens, Mr. Elliott believes that planters
are already fully alive to the advantage of thoroughly carrying out vaccination on their
gardens, an advantage which is of the most direct kind, as a small-pox outbreak would
seriously interfere with the efficiency of their labour force ; and he has found vaccination
practised wherever he has enquired into the subject. He cannot, therefore, altogether
accept Dr. Clarke's view (paragraph 10 of the report) that the matter has been neglected
by tea-planters; and he has no doubt that if facilities are afforded them for obtaining lymph
from successful cases already established in the district, they will do all in their power to
spread vaccination among the people in their employ. It is, he thinks, too much to
expect that planters should import their own lymph, except where gardens are in charge
of European Doctors, who are aware of the sources of supply and the procedure to be
adopted for procuring it. But all Civil Surgeons should, on application, arrange for the
Hospital-Assistant on each garden where the manager desires it being supplied with virus
from some properly established vesicle in the neighbourhood.
Proportion of success attained.
8. Turning now to the success attained by the different classes of operators, the
Chief Commissioner finds that of the primary vaccinations
(including tea-garden cases), 44,230 in number, 38,741, or
87.5 per cent., are returned as successful. Of re-vaccinations, 1,181 in number, the unusually
large proportion of 1,118, or 94.6 per cent., were successful. Last year the figures were
87.6 for primary vaccinations ; none of the re-vaccinations in 1880-81, 12 in number,
were successful.
The table below shows the proportion of success attained by each class of operators
with primary vaccinations:—
Civil Surgeons ........................
Hospital-Assistants ................
Government Vaccinators ................
Municipal „ ................
Ex-inoculators ........................
Tea-garden Doctors ........................
Number of operations.
1,075
3,495
16,225
2,443
15,890
5,102
44,230
Successful.
870
2,925
14,065
2,003
14,835
4,043
38,741
Percentage.
80.9
83.7
86.6
81.9
93.3
79.2
87.5
It is obvious from the above figures that the proportion of success said to have been
attained by the ex-inoculators is untrustworthy; and this was only to be expected from
the impossibility of adequately supervising them or testing their work. The figure for
the Government vaccinators, also, is suspiciously high, when the result of vaccination in
the hands of Civil Surgeons and Hospital-Assistants, where approximate certainty is
attainable, is considered. This affords the strongest reason for discouraging resort to
an agency which cannot be controlled and checked. It cannot be too often repeated that
defective vaccination is worse than none, since it not only fails to protect, but discredits
the cause, and renders people unwilling to avail themselves of the prophylactic. The
Chief Commissioner has heard too much of work of this kind in the Province. In his
review of the Gáro Hills Administration Report for 1881-82, published in June last, one
instance is quoted, which goes to show that of the population vaccinated in that district
(where till lately the agency of ex-inoculators was largely employed), a considerable number
are not effectually protected against small-pox. He has heard of another case in which a
mauzadár was induced by great persuasion to have his child vaccinated ; the lymph was
believed to have been taken from the arm of a child suffering from small-pox, and the infant
vaccinated caught the infection and died. One such case, if true, shakes the public confi-
dence to its foundations; and, if untrue, the Civil Surgeon, who can hardly have failed to
hear of it, should have noticed and reported it. It was to guard against the possibility
of such cases arising, that the necessity of restricting vaccination to areas where efficient
inspection can be carried out (except in very special cases) was strongly insisted on by
Sir Steuart Bayley and the present Chief Commissioner in their orders on the reports of
1879-80 and 1880-81 ; and Mr. Elliott hopes that the Sanitary Commissioner will inculcate
even more strictly than at present the primary duty incumbent on Civil Surgeons of seeing
personally that the work is properly done, and not fudged in the returns, or insufficiently
performed on the patients vaccinated.
Inspection by Civil Surgeons.
9. The Chief Commissioner is glad to notice that the number of cases inspected
and verified has increased from 2,515 in 1880-81 to 5,048,
or almost exactly double the number, in 1881-82. He is
gratified to find that the proportion of success in the cases inspected was as high as 87.2
per cent., the best districts being Darrang and the Khási and Gáro Hills, and the worst the