(3)
the mortality among infants under one year of age, the total number of infants
under one year available for vaccination is estimated at 2,443,096 against
2,460,228 in the preceding year ; and of these 508,615, or 208.18 per thousand,
were vaccinated, as compared with 498,979, or 202.81 per thousand in 1896-97.
As in the previous year, Malda, Darjeeling, and Lohardaga show the best results.
Patna is at the bottom of the list, and Puri, Shahabad, Gaya and the Tributary
States of Orissa also have very low percentages. The changes are small, and
the differences remain enormous. The range in the proportion of the vacci-
nation of infants born during the year is from 983 per mile in Malda to 54 in
Patna, and these prodigious differences are constant. Why has vaccination
become and continued so popular in Malda ? What can be done to establish
it in Patna ? Why should Puri average about 75, while its neighbour of
Balasore exceeds 200 ? These are obvious questions to which the Lieutenant-
Governor can find no answer in the Sanitary Commissioner's memorandum, and
he trusts that very special attention will be given to these backward districts
to ascertain the causes of their hostility to vaccination and to settle the best
methods of surmounting that hostility. All the three southern districts of
the Patna Division require the Sanitary Commissioner's special regard and the
serious co-operation of the Collectors.
5. Primary Operations.—The proportion of successful primary operations
for the whole Province is returned at 97.87 against 98.50. The slight decrease
is reported to be due to the inclusion for the first time of unknown cases in
calculating the ratio of successful operations. In previous years unknown cases
had been excluded. It is reported that orders are under issue for introducing
during the ensuing vaccination season the system (referred to in previous
resolutions) in force in the Punjab of making three punctures in each arm.
The draft of the instructions which it is proposed to issue on the subject has
lately been approved by Government.
6. Secondary Operations.—The number of secondary operations increased
from 70,527 to 76,443. There was an increase of 20,250 cases in rural areas,
while Calcutta and the mufassal municipalities and dispensaries show a decrease
of 7,852 and 6,482 cases, respectively. The percentage of successful cases was
64.36 against 60.23, excluding " unknown cases," and 52.59, including them in
1896-87, and the increase is attributed to a larger number of re-vaccinations
among adults.
7. Recess Work.—The number of operations performed during the recess
in connection with small-pox epidemics and the up-keep of lymph for emer-
gencies rose from 115,833 to 122,612, or by 6,779. The increase is attributed
partly to the greater prevalence of small-pox in some of the districts, and
partly to the relaxation of the rule prohibiting the grant of deputation allowance
to licensed vaccinators when employed within their own jurisdictions in
stamping out outbreaks of small-pox.
8. Vaccination at the expense of District Boards.—The number of vacci-
nators employed by the District Boards and paid from district funds was reduced
from 60 to 58, and the number of persons vaccinated by them fell from 58,722
to 55,937. The contributions made by District Boards for the purpose of giving
free vaccination in rural areas rose from Rs. 3,368 to Rs. 3,602. The largest
contribution of Rs. 1,322 was again made by the District Board of Puri.
A comparison of the work done by the Licensed, Government, District Board,
and. Municipal agencies shows that there was an increase in the number of
operations performed by the Licensed and Government agencies, and a
decrease in the number performed by the other agencies.
9. Cost of Vaccination.—The total cost of vaccination declined from
Rs. 2,06,204 to Rs. 1,81,480, and the average cost of each reported successful
vaccination from one anna and five pies to one anna and three pies. The large
decrease in the total cost is attributed to the abolition of the paid vaccination
system in Angul and also to the absence during the greater part of the year of
the Deputy Sanitary Commissioners, which effected a considerable saving in
their pay and travelling allowance. These two items alone represent a saving
of Rs. 23,000.
10. Death-rate from small-pox.—The diagram given in the report illustrates
the death-rate from small-pox in each district as compared with the proportion