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8. Vaccination work in different districts.—Eight districts show an increase in
the number of operations performed during the year under report, as compared with
the preceding year. The most marked increase is reported from the districts of Sibsagar
(+7,310), Kamrup (+5,382), Khasi and Jaintia Hills (+3,031) and Nowgong
(+2,539). The increase in Sibsagar was due to there being no opposition on account of
the non-co-operation movement. In this district two vaccinators were dismissed for
unsatisfactory work. In Kamrup and Nowgong districts the increase was due to the
prevalence of small-pox in an epidemic form which resulted in a larger number of
persons being vaccinated. In Nowgong two additional vaccinators were appointed who
worked throughout the year. In both districts Civil Surgeons have gratefully acknow-
ledged the help given them by their respective Deputy Commissioners. Had it not been
for this assistance, it would have been extremely difficult to check the spread of the
disease in the districts. Both Civil Surgeons are in favour of the extension of the com-
pulsory Vaccination Act to selected rural circles where the inhabitants offer resistance
to vaccination. An increase of 3,031 operations in the Khasi and Jaintia Hills district
is satisfactory. A fall of 2,175 operations in the district of Cachar is attributed to the
reduction of 5 temporary vaccinators by the Silchar Local Board. A fall of 2,625
operations in Garo Hills with low percentage of success in primary operations (88.62),
unreliably high percentage of success in revaccination (85.43) and a high percentage
of unknown cases (8.82 in primary and 10.77 in revaccination) show a lack of super-
vision over the vaccinators' work. It would appear that the newly appointed Sub-
Inspector of Vaccination has not yet mastered his duties. The attention of the Civil
Surgeon is being drawn to these defects with a view to improving matters in the future.
On the vaccination work of the Manipur State in which there is a decrease of 3,940
operations the Political Agent remarks that " there has been a slight falling off in
regard to the quantity of vaccinations performed. Of the quality of the work it is not
possible to judge, as the medical officer has been remiss in his inspection work ".
9. Composition and strength of the inspecting staff.—There was no change under
this head during the year.
10. Verification by Inspecting Officers.—The Civil Surgeons, Subdivisional Assistant
Surgeons and Assistant Surgeons on kala-azar duty inspected 15,433 primary operations
and 2,924 revaccinations or 5.21 per cent. and 4.37 per cent., respectively, of the total
number of operations of each class performed during the year. This shows a slight
improvement over the corresponding ratios of the preceding year, which were 3.20 and
4.35 respectively. The Director of Public Health and his Assistant also inspected
vaccination while on tour but the number of operations inspected by them is not avail-
able. The subordinate inspecting staff inspected 5665 per cent. of the primary and
44.15 per cent of the revaccinations against 49.02 and 38.34, respectively in 1922-23.
Percentages of inspections of primary operations in Goalpara (27.87), Garo Hills (29.67)
and Lushai Hills (35.87) were low, and steps will be taken to stimulate the staff to
more activity in this branch of their duties.
11. Vaccination in compulsory areas.—Out of 4,309 infants under one year of
age available for vaccination in urban compulsory areas in the year 1923-24, 1,970 or
45.72 per cent. were successfully vaccinated, as compared with 41.13 per cent. in the
preceding year. In Tezpur, Nowgong, Silchar and Shillong almost all available infants,
except those who were exempted on account of illness, were vaccinated. In the
Sunamganj Municipality out of 119 infants available, none was vaccinated and in the
Karimganj Municipality the percentage is as low as 4.59. An explanation will be
called for from the Sub-Inspectors of Vaccination concerned and from the Health
Officer of the Karimganj Municipality. Nineteen per cent. of the available infants
were vaccinated in the Gauhati Municipality. In this Municipality 78 persons were
prosecuted and 50 convicted. In the Barpeta Municipality many cases were vaccinat-
ed after being prosecuted and warned by the Magistrate. The working of the com-
pulsory Vaccination Act in the villages in the districts of Sylhet and Sibsagar to which
it has been extended, is not satisfactory and measures for its improvement are under
consideration. In rural compulsory areas in the Sylhet district, 2,532 operations were
performed and in such areas in the Sibsagar district, 545 operations were performed.
The Civil Surgeon, Sibsagar, suggests that instead of temporary vaccinators permanent
ones should be allotted to rural compulsory areas so that they may work through-
out the year, as they have to serve notices before vaccination is done under the provi-
sions of the Act, and consequently a considerable time is taken in finishing a village.
The Civil Surgeon is being asked to communicate his suggestion to the Chairmen of
the Local Boards concerned.