26
REPORT ON VACCINATION IN ASSAM.
has been but rarely carried out. The vaccinator states that the people often object to even two marks
being done, as the inoculators generally do one mark, and he has to comply with their prejudice in order
to have vaccination done. Many of the scars on the 41 persons were through scratching or other causes,
without the distinctive character that would without doubt indicate a true vaccine mark. The vac-
cine virus used is crusts. He does not appear to know how to properly select and perform vaccination
by lymph only, either arm to arm or from supply stored in tubes. I was able to see the recent vacci-
nation in various stages of five to seven days. These were mostly spurious, having dried-up crusts then.
The virus in use must be bad, and the so-called vaccination now being done by him must cease, as it
is not to be depended upon. His return to Nowgong is directed, and he should at once total up his
work of the season. There is no good virus now available. A telegram is now being sent in for despatch
to Dacca for a fresh supply of trustworthy lymph. Vaccinator states that he finds considerable difficul-
ty in places to persuade the people to be vaccinated. He states that the potter caste (Kuwar) will
not be vaccinated unless the Gossain, name unknown, who lives in Dibrugarh district, Halmora,
mauza Chamagurihuttra, will permit them; also the Hut Kulia, a caste whose Gossain is Peali of
Khola Katiahuttra, Nowgong district. Perhaps something may be done to move the Gossains to
permit their followers to be vaccinated in approaching cold weather. The work done is scattered
over large areas, a few here and there, and with difficulty found and examined. The vaccinator does
not keep up a proper diary, and has no printed register of vaccination.
13th to 15th March 1885.—Visited the area in which Hojai is appointed as vaccinator. Saw 89
persons on whom he had performed the vaccine operation. Of these, 42 had vaccine scars and 47 were
bad, principally complete failures. His vaccine virus is evidently bad, as those recently done are mostly
failures. He complains of difficulty experienced, the parents taking no care to prevent the
scratching of the sites vaccinated, people being unwilling in some parts. The virus in use by him
is crusts only, and he does not seem to know how to perform vaccination by lymph only. I have taken
a specimen of the virus. There is only a little with him tied up in a dirty rag. His lancet is quite
dirty and not sharp. This I have taken from him, as it is better that he should cease to trifle with the
work assigned him. No spare vaccination lancets are in store. He does not keep up a diary regularly.
He has not copied the names of those vaccinated during March into the book. He has them on loose
bits of paper without any regularity. He says he afterwards copies them into the book. I have had
him to sit down and copy them all now. He is not in possession of the printed rules in Assamese for
performing vaccinations: says he did not get a copy: says he has been at work for two seasons; but
to my mind he does not appear to be trustworthy. I have directed him to return to Nowgong, and
prepare his accounts for the season, as there is no good virus at hand now, and it will probably be
too late in the season to do much when a supply is available. I know from experience that unless
great care is taken towards the close of the vaccination season, especially when the weather is hot,
spurious vaccination occurs, and unless a vaccinator is a well-trained and trustworthy man, he may
be unable to detect it. Both these men, and from enquiry I believe all the vaccinators, fill in the
register of vaccinations thus: when a person is vaccinated, his name is entered in register on the
date on which performed, and if on the date of inspection, ten or fifteen days afterwards, the
operation is found to have failed, this result is entered opposite the name, and if then the operation
is repeated the person's name is again entered further down amongst those newly done on that
date, so that the register is practically one of operations attempted, rather than individuals. This,
though apparently in keeping with rules, makes a difficulty in filling up Statement I. of Vaccination
Report. The native superintendent, who accompanied me on this tour, informs me that good
vaccination has been done in Roha direction. I have introduced a better form of diary for him.
I have pointed out such faults as herein mentioned, and have given him full instructions about the
supervision required of him, and as the fresh lymph asked for by telegram has just arived, I have
shown him how to work from tubes with lymph. He seems willing and intelligent, but he was never
a vaccinator. He was promoted from compounder to native superintendent on the 20th October
1884. I question the entire capability of what seems a make-shift arrangement. I have personally
visited houses in Nowgong, and I see that there is objection expressed against vaccination. It is
much to be regretted that there should be so many failures; but I hope to remedy many of the
defects next season, though it. is too late to do much now. Primarily well-trained, efficient, trust-
worthy vaccinators are absolutely necessary.
APPENDIX C.
Memorandum on the difficulties and defects at times experienced in the work of vaccination.
MOST part of the difficulty encountered in the extension of vaccination, the ill-repute in which
it is at times held, and the disinclination to have it done which is evinced by the people in some
districts, are caused by bad vaccination, and this bad work occurs principally through inattention
to the instructions laid down for performing vaccination, ill-trained, careless, incompetent men being
appointed at times, and their unsuitableness not found out until harm has been done.
2. The want of good, well-trained vaccinators is in a measure owing to there being no system of
thorough training of apprentices in the art of vaccination, and the want of a superior supervising class
of head vaccinators and inspectors. In some districts a system of paid apprentices under training
seems very necessary to meet increasing requirements, and candidates, when accepted as such, should
receive a subsistence allowance of about Rs. 5 per month for three months at least. Only those who
can write and read, in good health, intelligent, and of the class suited to the district should be engaged.
Two or three new men per year per district would materially help.
3. To ensure good vaccination, trustworthy vaccinators and fresh selected good lymph are
absolutely necessary. Men who can be depended upon to keep and use good lymph only, who can
detect and avoid bad virus, and who will render a faithful account of their work. Some districts may