REPORT
ON THE
UNSATISFACTORY STATE OF THE ARRANGEMENTS FOR VACCINATION AS
PRACTISED UNDER THE MUNICIPALITIES OTHER THAN THOSE
OF THE TOWN AND SUBURBS OF CALCUTTA.
Inefficiency of Municipality Vaccinators.
1. Under recent arrangements the various newly formed municipalities have under-
taken the support of one or more vaccinators.
The great difficulty in the way of the successful
working of public vaccination through small municipalities, consists in making efficient
provision for the professional supervision of the work done by the vaccinators. It is
exactly of the same kind as that which has been long felt in the case of the vaccinators
who used to be attached to the various Government Dispensaries. The municipality can
pay the vaccinators, and they can supply them with lancets, but they cannot insure that
protection from small-pox is provided to the people who are operated on. The consequences
of any system of vaccination which falls short of fulfilling this requirement are most
fatal to the ultimate acceptance of vaccination by the people as a prophylactic against
small-pox. They cannot appreciate the difference between a pimple or other form of irrita-
tion caused by a vaccinator and the true vaccine vesicle which alone protects from small-pox.
Having been operated on by a vaccinator constitutes, in their minds, vaccination, and
any person who has been so operated on and subsequently dies of small-pox furnishes to
their minds only another instance of the inefficiency of vaccination to protect against
small-pox.
Two causes, leading to this.
2. There are two circumstances which go far to explain how it is that worthless vaccina-
tion is so often met with when performed by vacci-
nators working independently of control. On the
one hand, the difficulty of finding men who have been carefully taught to vaccinate,
or of teaching them thoroughly, is a great one, and ignorance regarding vaccination is a
fruitful source of the failure to protect by such vaccinators. On the other hand, while
working away from close supervision, the vaccinators grow careless, and whenever they
know that their work will not be subjected to close inspection, they almost invariably
become lax and indifferent as to the character of the vaccinations which they practise, and a
large amount of unprotective vaccination thus results.
Instruction of Municipal Vaccinators.
3. The difficulty as regards careful teaching would be in part got over if the
various municipalities could be induced to send
their vaccinators to Calcutta to be instructed in
the work. As this could be done without any additional expense, beyond the cost of
travelling, being incurred, the proposal seems to be one which might be carried out without
much difficulty.
During the months of June, July, and August the municipal vaccinators remain at
present idle, and if they were sent to Calcutta arrangements could be made for their
instruction by one of the Superintendents of Vaccination in the town. Their education
would not be merely of a theoretical nature, but as vaccination is always being carried on
in some of the emigrant depôts, they could have opportunities also of receiving practical
instruction.
By being year by year subjected to such a training, it might justly be expected that
not only would they become more efficient at the time, but be kept up year by year to an
advanced standard.
Supervision over Municipal Vaccinators.
4. It seems hopeless to attempt for the present to introduce the requisite amount of
supervision over this class of municipality vacci-
nators, as they are so scattered that the greater
part of the time of any Superintendent who might be appointed to this duty would
so much be occupied in moving from one municipality to another that but a small part of
his time could be devoted to the duty of inspection.
16