14
REPORT ON VACCINATION IN ASSAM.
Staff at work in the district.
72. The operations are on a modest scale. Beside the Civil Surgeon, there are
three dispensary vaccinators, two supported by Local Funds,
and one Hospital-Assistant. Mr Driberg of opinion that the
district should get a Superintendent, as the Civil Surgeon has too many other duties
to enable him thoroughly to inspect the work being done by subordinates There is,
no doubt, room for great improvement in the present indefinite way the work is carried
on; and certainly the absence of efficient inspection leads to many irregularities, and
is the cause of objections about the impotency of the protection afforded; an increase
to the staff might reasonably be asked from the Local Funds under the Deputy-Commis-
sioner's own guidance.
Statistics of 1883-84.
73. The results of the year are satisfactory. From 1873-74 to 1880-81 the
number of successful operations in this district barely
averaged 180 per annum. In 1881-82 they rose, "through
steady determination and the cordial aid of district officers," to 1,310, in 1882-83 to
2,109, and in 1883-84 to 2,610. This is encouraging if the success is real. No
ex-inoculators are employed, although from a remark in the report it would appear that
some of this class work in the villages either with vaccinia or with variola, according to
the fancies of the people.
Proposed additions to staff for 1884-85.
74. I hope the authorities will succeed in raising the staff of vaccinators to 10, and
have a Superintendent also. In this way the district can
be mapped out carefully,' and if the vaccination performed
is genuine and sufficient, the preference which, it is stated, the people now show for
inoculation, on account of its decided individual protection, will disappear.
Vaccination on tea-gardens not flourishing.
75. The work done on the tea-gardens is properly characterised as "quite in-
sufficient." The managers are under the impression that
vaccination is general among unprotected coolies at Dhubri,
but this is incorrect. Dr. Dobson states that 671 coolie children only were vaccinated
there this year for all Assam, and that the results were not known. Taking a favourable
estimate of 500 being successful, not more than 120 of them would be drafted into
the Nowgong gardens. The figure of operations by tea-garden agency for the year
was 69 successful out of 91 operations. The population of 22 gardens which furnished
returns is entered at 4,933; but the Deputy-Commissioner considers there are at
least 12,000 labourers employed. Managers should insist on the Medical Superintendent
or subordinate in charge posting in October a requisition on the Civil Surgeon
for a small supply of lymph tubes and crusts, and thereafter carrying on the work until
March.
Average cost of each case in the district
76. The cost of each successful vaccination is unusually high, viz., 3 annas 1 pie
for the district staff; the permanent vaccinator's average
being nearly twice that of the temporary. He is credited
with 569, and the extra men with less than 400 successful cases. This is a poor average
of the season.
Supplies of lymph and crusts.
77. The supply of lymph was the same as in other districts. The English lymph
failed; the supplies of human and bovine lymph from
Bengal were not reliable. The best store came from the
Deputy Sanitary Commissioner, North-Western Provinces.
General observations
78. The closing remarks of the late Mr. Hughes are valuable, as it is likely
few medical officers in Assam were better acquainted with
the people:—
" Inoculation is largely practised and thoroughly believed in by the people for its entire protection.
Direct mortality from inoculation rarely occurs; but indirectly, as the origin of village outbreaks,
the mortality is very heavy among unprotected young children."
79. Vaccination is nowhere compulsory in Nowgong under Act XIII. of 1880.
Local arrangement of work
80. Darrang.—There are only two centres from which vaccination is practised in this
large district, viz., the sadr station of Tezpur and the sub-
divisional township, Mangaldai. In the former the Civil
Surgeon superintends, and has under him three vaccinators, two of whom are paid by
Government and one by Local Funds; at Mangaldai the Hospital-Assistant and two vacci-
nators of the dispensary are the operators. No ex-inoculators are employed.
Advantages from experience.
81. Dr. R. Neil Campbell, who was appointed to the civil medical charge in August,
brought an experienced knowledge of vaccination, acquired
as Officiating Deputy Sanitary Commissioner, North-Western