3
during the past few years, as remarked by Mr. Standen, have been responsible
for the epidemic. The district is lightly staffed and I hope the district authorities
will give their early attention to the matter. In the northern districts, Seoni
recorded 361 deaths and Jubbulpore 115.
Frequent evacuation on account of plague and the consequent disorganization
of vaccination is probably largely accountable for the epidemic and special efforts
are therefore being made everywhere to stamp out the disease.
General.
12. Several improvements have been effected during
the year, viz.—
1. In certain districts, where there was much dissatisfaction among the
staff, local allowances have been sanctioned, e. g., Nagpur, Amraoti
Akola. In Khandwa the District Council is unnecessarily dilatory
in responding to the requirements of the situation.
2. The clauses of the Vaccination Act have received much more attention
in Municipal towns and the system of notices and prosecutions has
been enforced, especially in Nagpur, with good results.
3. Instrument cases have been supplied to the staff in some districts
4. An effort has been made to improve the diagnosis of small-pox by
issuing leaflets which have been pasted into the Kotwar's village
note-book and by the issue of a leaflet (in the press) on epidemic
diseases through the Director of Public Instruction to all school-
masters.
5. The introduction of a system of tour programmes for the staff, so that
it may be known where they are working.
13. The real difficulty to be tackled is the improvement of the staff. In
many districts men are hardly to be obtained at all and generally the class of
man is much below what is required.
Better salaries will have to be offered by District Councils and a better
stamp of man obtained both for work and supervision. It would be then possible
to train the staff in checking vital statistics, the recognition and treatment of
epidemics and the method of self-protection. At present the vaccinator is
ignorant, his records and work unreliable and he not infrequently succumbs to the
epidemic disease which circumstances have necessitated that he should be sent
to control.
More co-operation between the vaccinator and the executive district staff
is required and much help has recently been given by schoolmasters. In this
connection it would be well to introduce generally the excellent example of
Narsinghpur where certificates were granted by the Deputy Commissioner to
masters who gave assistance. This would, I think, be more valuable in practice
than the grant of monetary rewards to them or of holidays to re-vaccinated
children.
School inspections have done much to assist vaccination and the Civil
Surgeon, Nagpur, finds this method extremely useful, but it is wise to temper the
recommendation with the caution that the parents of children should be informed
before children are vaccinated. It is to be regretted that the old condition in
the Education Manual 59 (h) for a grant-in-aid has recently been deleted. To
make vaccination a condition seemed a harmless and wholesome sanitary provision.
14. On the whole the year's work has been good in spite of difficulties
arising from cholera: in Balaghat and Narsinghpur especially good work and
results have been obtained. The forms in use for annual statements will be
examined with a view to simplification.
T. G. N. STOKES, M. B., MAJOR, I. M. S.,
Sanitary Commissioner,
Central Provinces.