2
to the required standard by hurrying on from village to village. Unfor-
tunately, in their attempts at rapid movement, they not only leave the work in
the villages they visit unfinished, but also fail in their endeavours to secure the
prescribed standard. In many cases they have failed to reach even a minimum
standard of 2,000. Some Civil Surgeons say that their " vaccinators vaccinated
almost all the available children in their districts without being able to reach the
minimum standard ", and some plead that " the conditions obtaining in their dis-
tricts do not allow of their vaccinators exerting themselves more than what they
have been doing"; these are frivolous arguments. In the former case, the
number of vaccinators employed, is more than is needed and may safely be
reduced as proposed in the Betul district, while in the latter case, I do not think
that the conditions existing in these Provinces are so bad as those in the North-
West Frontier Province, where the average per man ranged from 3,500 to 6,000.
When 5,000 to 6,000 operations could be done by some vaccinators in the hilly
and jungly districts of Chhindwara and Yeotmal, I do not understand why the
vaccinators working in the plains having thickly populated villages, should not
be expected to attain this number. I am of opinion that supervision and general
organization require bracing up in many parts of the Province, and this is a
matter Civil Surgeons and local bodies can remedy if they care to exert them-
selves.
It is strange that there is no 4th grade or spare vaccinator in the Balaghat
district to take the place of men on the regular staff on leave or otherwise absent.
The Civil Surgeons of Drug and Mandla suggest Patels and Kotwars being
made responsible for having all children in their villages vaccinated. This would
very much lessen the troubles not only of the vaccinators but also
of the Revenue Officers (Tahsildars, etc.) who are off and on called on
to advise those refusing vaccination, but as vaccination is not compulsory in
rural tracts, it is doubtful if such an order can be issued.
6. I congratulate Mr. Clarke, the Deputy Commissioner of Nagpur, and
Lieutenant-Colonels Buchanan and Kenrick, Civil Surgeons of Saugor and Jub-
bulpore, on the excellent results obtained through their exertions. Mr. Clarke's
circulars and instructions to District Councils and Municipal Committees were
so sound and thorough that in spite of the severe epidemic of plague, which
raged all over the district throughout the vaccination season, more than four-fifths
of the available children in the Nagpur district were successfully vaccinated
in 1916-17. Lieutenant-Colonels Buchanan's and Kenrick's endeavours kept the
districts of Saugor and Jubbulpore absolutely free from small-pox during the
past two years.
Vaccination by others than
the special staff.
7. No work was done by the Sub-Assistant Surgeons attached to dispen-
saries as no emergency arose. The Jail and Railway
Medical staff performed 4,861 operations, of which 951
were primary and 3,910 revaccinations.
Cost of the Department.
STATEMENT II.
8. The total cost of the Department was Rs. 3,36,559-1-1 against
Rs. 2,19,719-4-11 in the previous triennium, and the
cost per each successful vaccination, which averaged
Re. 0-2-1 in the past triennial period, rose to Re. 0-3-2 during the period under
report, the chief causes of the increase being the establishment of the Central
Vaccine Depôt at Nagpur, the improvement in the pay of the vaccination staff,
grant of conveyance allowance to the Assistant Superintendents of Vaccination
and the introduction of the village vaccination registers.
9. Statement IV does not call for any remarks.
Inspection of vaccination.
STATEMENT V.
10. In spite of the prevalence of plague, a satisfactory amount of inspection
was done by Civil Surgeons. They inspected 10.80
per cent of the primary vaccinations performed in
1914-15 and 9.35 of the revaccinations. In the following year, the percentage
inspected was 11.31 for primary and 8.19 for revaccinations, while in 1916-17
only 8.45 of the primary and 12.41 of the revaccinations were inspected, as