3
work is not great, but what is absolutely necessary is reliability, so the Civil
Surgeon's services cannot be wholly dispensed with, and several instances have
lately come to notice where the withdrawal of this trustworthy supervision has
been fraught with most undesirable consequences.
Assistant Superintendents of Vaccination were out on tour for 3,784 days
against 3,585 days in the previous year and inspected 253,796 primary and 24,710
re-vaccinations in 18,815 villages against 260,254 primary and 22,535 re-vaccina-
tions in 20,302 villages in the year 1910-11. The prevalence of plague and
discontinuance of the practice of collecting children for inspection accounts no
doubt for the fall in the inspections, but in some districts the amount of touring
done by these men is quite unsatisfactory and must be considerably increased.
For instance, in Narsinghpur the Assistant Superintendent was out on tour for only
87 days during the season and for only 65 days in 1910-11. His case as well as
those of Nagpur and Betul require explanation. These men seem to have
spent much of their time at head-quarters without going out on inspection duty.
As a rule, every Assistant Superintendent ought to spend at least 135 days
(from 1st November to 15th March) in every season on inspection tours and
Civil Surgeons should see that time is not wasted at head-quarters but that
Assistant Superintendents make out definite programmes, carry them out and
inspect as large a percentage of the total work done as possible. Mr. Napier
suggests the appointment of an additional Assistant Superintendent for Drug.
This case as well as that of Amraoti will be considered.
Percentage of success.
8. The percentage of success in primary vaccinations recorded by vaccinators
was 99.02 against 98.50 and 98.25 found on inspection
by Civil Surgeons and Assistant and Superintendents. In
none of the districts have the vaccinators claimed a cent per cent success and
this is due to taking into account secondary or repeated operations, which, until
recently, were ignored. In re-vaccination the success recorded was 75.12 per cent,
while the Civil Surgeons and Assistant Superintendents found 53.79 and 54.40.
In the Feudatory States 98.19 per cent of primary vaccinations are reported
successful. The figure 98.10 per cent representing the re-vaccination results is
certainly not to be accepted as Civil Surgeons, at their inspections, found only
79.99 for the former and 59.37 for the latter and other inspecting officers found
86.40 and 65.67 only. Lack of supervision is the cause of such unsatisfactory
work in the States.
Inspection by the Sanitary
Commissioner.
9. In many of the towns vaccination work was so disorganized by plague
that it was impossible to form any opinion of how it was
progressing. In twelve of the principal ones, however, an
average of 20 per cent of the total work done was examined and there can be no
doubt that although in a few towns (Bhandara, Raipur, Burhanpur) the work is
carefully and well done, in the majority there is much room for improvement.
The commonest defects are lack of system in keeping registers and issuing
certificates, want of a more intimate knowledge of the clauses of the Act,
irregular and incomplete checking of results instead of making it an object to
inspect the mature vesicle and lastly absence of prompt dealing with defaulters.
Inspection of school-boys.
10. During the year systematic inspection of school-boys in all dispensary
towns was started, as a result of a proposal submitted
to the Commissioners' Conference by me last year for
improving rural sanitation. So far, the method has not been very throughly applied
but there can be no doubt of its possibilities and the subject is mentioned in
most of the district reports. Itis amazing to find 12 per cent of the boys examined
in one important town entirely unprotected, another 20 per cent badly pock-marked
and perhaps 3—4 eyes permanently damaged or lost in a municipality where
vaccination is legally compulsory. Captain Fraser suggests vaccination being
made compulsory for school-going boys, but such a procedure is unnecessary
as the existing rules in the Education Manual appear sufficient, provided they are
carefully observed by the educational authorities. It appears probable that the best
way to raise the standard of public opinion in this respect is by interesting
the schoolmaster in the subject of health during his normal school career rather
than by coercive measures. Both in Raipur and in Mandla active opposition
on the part of schoolmasters is reported and is being enquired into. The
whole question of hygiene in its relation to schools is daily assuming larger