20
REPORT ON VACCINATION IN ASSAM.
Working staff.
115. The staff consisted of the Civil Surgeon for the time being, who operated
fifteen times with ten successes; two Provincial vaccinators,
one permanent, and one employed for six months, who
together return 3,022 operations with 2,600 successes; a vaccinator at Mauphláng
dispensary paid by Government, whose work was very small, being 185 cases and 136
successes; and three Hospital-Assistants engaged in and near Shillong, who performed
323 operations and had 280 successful. There are no ex-inoculators in this district.
Lymph supply generally good.
116. The lymph was obtained in the beginning by four tubes from England supplied
from this office; and on six other occasions during the
season from the Sanitary Commissioner of Bengal, being
two each of vaccine, humanised vaccine, and bovine lymph. The humanised vaccine
lymph was a partial failure; but all the rest was found good and efficient.
Expenses very great;
117. The cost remains very large, the average of each successful operation,
notwithstanding the increased numbers reported, being 4
annas 10 pies, 7 pies more than in 1883-84. This is partly
accounted for by the higher rate of pay, Rs. 16; but the chief expense is in the travelling
allowance bills, which amount to Rs. 440-11. This, with Rs. 363-3-2, salaries of
Government employés, brings the total cost to Government for the season to Rs. 803-14-2,
and proves the urgent need of inspection. The municipal grant was Rs. 150, but of this
only Rs. 64 appears to have been expended in the pay of a man during the non-vaccinating
season; and the balance is said to be deposited in the savings bank.
and ought to be reduced.
118. Notwithstanding the great increase of work which is reported to have been
done, the actual results in the absence of efficient inspection
by superior authority cannot be accepted as genuine; and
it is certainly most desirable that the travelling allowances should be reduced. There
is apparently no check on the amount claimed under this head.
Annual report is meagre and the results
are not reliable.
119. The annual report contains nothing interesting except the second-hand
information about small-pox in the Khási villages. So long
as the civil medical duties are additional to the military and
there is no district inspection, the real progress of vaccination in its protective value must
remain open to grave doubts.
GÁRO HILLS.
Continued progress reported.
120. It will be remembered that progress in this district, which had been retarded
by great sickness among the operators in 1882-83, made
a very extraordinary advance in the season of 1883-84.
The total rose from 2,432 to 7,263; and of successes from 1,973 to 6,938. In the
present year the increase, although less marked, is still very satisfactory ; the total has
now reached 8,683, with 8,464, or 97.47 per cent., of successful operations.
Distribution of the work.
121. Vaccination began in Tura on the 12th September with good lymph in tubes
from Dacca and Darjeeling ; and on the 1st October the
vaccinators began their tour into the district; two new men,
who had been first carefully trained, forming part of the staff of six. They travelled in
pairs and worked a given area until every village had been visited. Among the hill
Gáros little or no opposition was met with ; but in the plains the refusal to accept
vaccination was occasionally invincible.
Protection is now fairly general.
122. The report mentions that the Gáros are now fairly protected, with the
exception of a small area west of Tura. The adult popula-
tion are generally scarred after inoculation, but this is now
dying out, and vaccination preferred. During the past ten years, 39,784 successful cases
have been reported ; and although, as Captain Maxwell points out, a very large proportion
is only what the medical subordinates tell us, yet there is reason to believe that under the
careful training of the operators, the rigid selection of good lymph, and the close
inspection instituted and maintained by Mr. McNaught, the results have been fairly
protective. For example, during the present season, out of 1,370 cases which were
personally inspected, Mr. McNaught himself found 1,320, or 96.35 per cent., good, and
how particular he is may be inferred from his paper on the subject printed as an appendix
to this report. Again, Dr. Gupta, who succeeded Mr. McNaught in medical charge of the
district in February 1885, made a tour of inspection in March, and saw 533 cases, and
found only 7 unsuccessful. This gives even a higher percentage of 98.68 ; and his
testimony is the more valuable, because he particularly mentions that he saw the
vaccination principally in its later degree, and that from the excellent type of the scars, he
considered the vaccination to be " eminently satisfactory." I would, however, mention
that when I visited Tura itself in November 1884, I examined half a dozen children at
hazard in the police lines, and found not one of them with a good scar, although all were
said to have been vaccinated.