22
REPORT ON VACCINATION IN ASSAM.
Statistics.
131. The gross outcome of the year by 36 operators is 18,818 cases and 18,341
successful, or 97.46 per cent. There were 78 re-vaccinations,
and 61, or 78.2 per cent., successful. In 1883-84 the working
staff comprised 35 persons, the returns showed 22,993 cases, and 22,068 and 95.98
per cent. successful.
Distribution.
132. The detail of the vaccination in Statement II. shows that the work chiefly
fell on ten provincial vaccinators in the sadr division.
These men performed, on an average, 1,084 cases each, with a
reported success of 99.61 per cent. The next highest average is one local fund vaccinator
in Habiganj 823 and 98.84 per cent., and three local vaccinators in Maulavi Bázár who
reached an average of 793 and 96.8 per cent. In Sunámganj, Balaganj, and Karimganj
the local and municipal vaccinators did 500 or less. The Civil Surgeon, native inspector,
assistant inspector, the several Hospital-Assistants and municipal vaccinators, did nothing
specially deserving record.
Inspection.
133. Inspection of 10,299 cases is reported, and the proportion of successful is given
as 99.52. Of these the Civil Surgeon saw 830 and the
native inspectors 9,469. On this subject Dr. Macnamara
writes—
" The percentage of successful cases may seem high; but as a child is vaccinated in most in-
stances until he takes, and is shown only once in the total, unsuccessful means insusceptible."
and again—
" My experience is that an unsuccessful case on inspection is rare; unless the vaccinator is intelli-
gent, he rarely brings one to a house to see a single unsuccessful case; there is nothing to see."
I regret exceedingly to find a medical officer of Surgeon Macnamara's education and
experience giving expression to opinions which, if they mean anything, mean that he is
being led by his subordinates. The inspection should be much more searching: on
arrival at a village the registers should be examined; and the cases called up to the inspect-
ing officer's order, quite irrespective of the vaccinator's lead. And unless both the Civil
Surgeon and the inspectors learn that inspection is not merely to ascertain whether
vaccination has taken, but to prove the lymph used is good, the resulting pock genuine,
and the protection sufficient, their practice is calculated to bring discredit on vaccination
altogether, and their employment is entirely superfluous.
Tea-gardens
134. Statement IV. gives the number vaccinated on tea-gardens to have been 1,972,
and 567 of them successful, but both the Civil Surgeon and
the Deputy-Commissioner complain of the incompleteness
of tea-garden reports, — " as their submission is not prescribed by law, no compulsion is
possible."
Expenditure.
135. The total cost is the largest of all the distrcts. In 1883-84 it amounted to
Rs. 1,904, and the average of each successful operation was
1 anna 9 pie, in 1884-85 it rose to Rs. 2,086 and average
1 anna 11 ¼ pies for each so-called success. Looking through the detail of accounts, it is
observable that the municipal vaccinator, who is paid for the whole year, has again
only 221 successful vaccinations, and an average cost of 8 annas 8 ¼ pie for each. This
is not a good example of what Dr. Macnamara promises if all the operators are paid
permanently. Another unsatisfactory feature in the report is that no prosecution was insti-
tuted in Sylhet under the Vaccination Act of 1880. The practice is compulsory within the
municipal area, but practically the law remains a dead letter. The Hospital-Assistant
in charge of the sadr dispensary received Rs. 150 from the municipality in remuneration
as an Inspector of Vaccination. The Hospital-Assistant is himself a member of the
municipality, and I think the inspection is likely to be more efficient if a Superintendent
with more time at his disposal were appointed. Dr. Macnamara is wrong in stating that
no small-pox epidemic occurred during the year. There were 17 deaths in the municipal
area and 194 in the sadr thána.
Conclusion.
136. Altogether, the impression left in my mind is that the increase of past years
would have been shown in the current year also, if the same
zeal and energy had been continued.
CACHAR.
Annual Report.
137. The annual report is prepared by Dr. T. D'O. Partridge, who was in charge
for a short period only at the close of the season. The
increased success of past years has not been maintained.