REPORT ON VACCINATION IN ASSAM.
11
pox before he was found out. And then there is the question of a fee. The people may-
or may not fee the Government vaccinators, but they must fee the private inoculators ;
and this frequently amounts to extortion after a successful attendance in a well-to-do
family.
Small-pox was not either prevalent or very
fatal.
45. The prevalence of small-pox during 1884 was very slight. Only 267 deaths
in the whole district were registered, compared with 613 in
1883. Dr. Dobson gives a table of the mortality in each
sub-divisional outpost. In Sidli, Salmara, Rungjuli, Fakiragram, and Bugribari vaccina-
tion had not been allowed by the inhabitants in 1883-84 ; and in these outposts 250
out of the 285 deaths occurred. In Dhubri town, Agomoni, Jemadarhat, Sukchar,
Manicachar, and Lakhipur, where there had been ample vaccination, not a single death was
reported. In both 1883 and 1884 8 out of 23 outposts had no death ; on the other
hand, Goálpára town, which is most obstructive, was also free of the disease. Among
11 deaths in Dhubri thána, 8 were imported cases among immigrants.
Lymph generally good.
46. The supply of lymph was, on the whole, good; it was chiefly obtained from the
Sanitary Commissioner of Bengal in periodical fresh supplies.
Dr. Dobson states the vaccinators in his district work chiefly
with crusts, because these are easily collected and carried; and parents object to arm-to-arm
vaccination. His vaccinators also find it difficult to collect lymph in tubes, as the vesicle
is ordinarily picked by the child. It is strange that in the neighbouring district of the
Gáro Hills, Mr. McNaught, equally painstaking and observant, insists on arm-to-arm,
ivory points, and tubes being essential to genuine vaccination. On my inspection tour
in December 1884 I saw over 100 children in a large village near Manicachar, in nearly
all of whom the vesicle was destroyed. I did not see five uninjured, and these were in
the early stage, about the sixth day, and would probably be picked in the next twenty-four
hours.
Value of ex-inoculators' work considered.
47. The report deals very fully with the question of ex-inoculators, whose work has
been repeatedly questioned, both as to genuine character and
reliability of figures ; and the Chief Commisssoner's Resolu-
tion on the Report of 1883-84, paragraph 10, passed positive orders that this class of
operators are not to be employed unless they can be properly supervised. The number
who were granted licenses in Goálpára during the present season was only 8, and they
appear to have had that supervision which was conditional to their employment. Dr.
Dobson unhesitatingly favours them under such circumstances. He writes—
"I believe more in the unpaid vaccinators than those that are paid. The suspicion expressed
as to their work I believe to be due to their being styled 'ex-inoculators'; as a matter of fact, not a
single man employed in this district during the past two years was ever an inoculator. From
personal experience I find these unpaid vaccinators the best workers ; every operation means at least
2 annas to them ; some of them keep an assistant and give him Rs. 50 at the end of the season.
Inspection soon shows the unpaid man has gone about his circle most and knows all about it.
Unpaid vaccinators, will not, as a rule, take paid appointments ; the lazy men come for these. I am
almost inclined to advise doing away with the paid men ; but constant supervision is necessary;
without it vaccination is useless."
These remarks, being founded on experience and good judgment, deserve considera-
tion. Practically, there is no difference of opinion. Neither the Sanitary Commissioner
nor the Chief Commissioner stopped unpaid vaccinators altogether; the objection was
taken to ex-inoculators working an entire sub-division like Barpeta without any super-
vision; diffusing either vaccinia or variola indiscriminately according to the fancies of their
customers; and returning 100 per cent. of their work as successful. If the Civil Surgeons,
as Superintendents, will take care that these grave defects are obviated, their employment
may be continued, and their title changed to " licensed private vaccinators." In the
beginning , however, the term ex-inoculator was perfectly accurate.
Expenditure of the season.
48. The cost of these extended operations is really trifling The total charges of
the season came to Rs. 600; of which only Rs. 120, the pay
of one permanent vaccinator, is debited to provincial revenues.
Hence, the average cost of 5,783 successful operations by paid assistants is one anna
eight pies only ; and if credit be given for the unpaid vaccination work, which has been
largely inspected by both the Civil Surgeon and native inspector, 15,982 cases were
successfully performed at an average of 71/6 pies. The average cost of 353,010 operations
in the Central Provinces in 1881-82 was 1 anna 9¼ pies, and in no single district was
the average less than 10½ pies. In Bengal Proper the lowest average is 7½ pies for 293,526
operations in 1880-81; and in the Hyderabad Assigned Districts the lowest average
cost of 18,205 successes in Akola is 2 annas 11 pies. The municipality at Goálpára
made no grant for vaccination, and altogether there were only 55 operations in the town.