[Maximum Limit of Narrative Portion of the Report—8 Pages.]
TRIENNIAL REPORT ON VACCINATION IN ASSAM FOR THE YEARS
1923-24. 1924-25 AND 1925-26.
1. Introductory.—Major J. B. Hanafin, I.M.S., held charge of the Department
from 5th April to 4th December 1925 and myself for the remaining part of the year
1925-26.
The report deals particularly with the returns for the year 1925-26 and generally
with the vaccination work performed during the triennium ending the 31st March 1926.
2. Vaccination agencies.—The total number of vaccinators employed during the
year 1925-26 was 434 as compared with 432 in 1924-25, 425 in 1923-24 and 444, the,
annual average of the preceding triennium. The average number of persons vaccinated
by each vaccinator was 1,013 in 1925-26, as compared with 878 in 1924-25, 849 in 1923-
24 and 821, the annual average of the preceding triennium. In 1925-23, the average
number of operations per vaccinator was 1,314 in the Sylhet district while in other
plains districts it varied from 919 in Sibsagar to 733 in Lakhimpur. There is no reason
why a vaccinator should not perform 1,500 operations in a season. A certain minimum
of operations per month should be insisted on and vaccinators failing to work up to that
minimum should be dealt with and informed that this fact will be taken into considera-
tion when reappointing them during the next season. The inspecting staff should check
the work of the vaccinators much more closely and see that irregularities are reduced to
a minimum.
3. Total number of operations.—The number of vaccination operations performed
during the year 1925-26 was 501,351 with 347,254 primary operations and 154,097
re-vaccinations, as compared with 418,359 operations with 326,031 primary and 92,328
re-vaccinations in 1924-25 and 385,579 operations with 313,594 primary and 71,985
re-vaccinations in 1923-24. The total number of operations performed in the trienn-
ium under report was . 1,305,289 as compared with 1,162,931 in the preceding trienn-
ium showing an increase of 142,358 which was due mainly to larger number of
re-vaccinations performed in the years 1924-25 and 1925-26 in order to combat out-
breaks of small-pox in several districts and also to less number of vaccination
operations performed in the last two years of the last triennium due to non-co-
operation movement.
4. Death from small-pox. —The provincial ratio of the mortality from small-pox
per 1,000 of population in the year 1925-26 was .45 as compared with .22 in 1924-25
and .40 in 1923-24 and .32 the annual average of the preceding triennium. The highest
mortality rate of 2 99 per mille of population was recorded in the Sibsagar district
in the year 1925-26 followed by Kamrup (.69), Goalpara (.30), Darrang (.22) and
Lakhimpur (.14). Certain sections of people—Mahapurushias in the Sibsagar
and Kamrup, Cacharies in Darrang and Bhateas in Goalpara districts are much
opposed to vaccination. Small-pox generally breaks out in the areas inhabited by
these people and spreads from there to other parts. The prevailing custom of hiding
cases helps the spread of the disease. Special regulations making vaccination compul-
sory in rural areas where small-pox is prevalent and opposition to vaccination is pre-
sent have been framed under Government Notification No. 1873L.S.-G., dated the
11th May 1925, and this has proved to be of great value in suppressing epidemics.
These regulations were framed temporarily for one year and have been retained for
another year. They were extended to 14 mauzas in Sibsagar, one village in Kam-
rup, 12 villages in Cachar, 24 villages in Sylhet, 5 mauzas in Lakhimpur and 4 villa-
ges in Sadiya Frontier Tract. The co-operation of District Officers has resulted in
almost all unprotected persons in these villages being vaccinated. These regulations
should be made permanent. Public Health Propaganda work has now been extended
to schools where booklets written in a conversational style in the local vernacular have
been prescribed. In addition magic lantern demonstrations on the subject are being-
given to the masses. These measures will prove of great educative value. The epi-
demic which broke out in the Sibsagar district in December 1924 persisted through-
out the year 1925-26 in severe epidemic form and still persists. The number of
villages reported to have been affected was 258. There is evidence to show that a
large number of these villages were not reported as small-pox infected. Attempts to
hide cases as well as opposition to vaccination when offered has made it difficult to
satisfactorily undertake remedial measures. Vaccinations and re-vaccinations were