2
Yeotmal showed 16,390 more vaccinations, Raipur 15,453, Chanda 13,555,
Amraoti 11,025, Bhandara 10,964 and Narsinghpur 10,097. In other districts
the increase ranged between 1,500 and 10,000, while in Jubbulpore, Mandla,
Nimar, Akola and Nagpur less work was done and no satisfactory explanation is
forthcoming.
Of the 1,534,901 primary operations 1,485,243 were successful, of which
latter 1,206,021 were among children under one year and 179,823 among those
between one and six years of age. It is not clear why a separate column for
primary vaccinations between the ages of one and six years is required.
The number of successful re-vaccinations was 144,612.
6. As far as figures go, the above results indicate fair general progress
except in the five districts mentioned, but a study of the average work done per
Vaccinator reveals some unsatisfactory features. The highest average per man
was 3,015 in Yeotmal, while in Damoh the average was 1,501 last season and
always is low. The Civil Surgeon explains this figure in various ways but, even
making allowance for harvest time and scarcity, I am inclined to attribute it
more to a local custom on the part of the Vaccinators, and the incompleteness
of the town vaccination there seems to lend colour to this explanation. In the
North-West Frontier Province, where conditions are not particularly easy, the
average per man in 1912-13 ranged from 3,462 to 6,535, and this suggests the
idea that supervision and general organization requires bracing up in parts of
this province.
Many of the reports show that from 20 to 30 per cent of the infants born
remain unprotected, and it is for the local authorities to devise a means of reduc-
ing this figure. This can only be done by first making an accurate calculation of
children available, a matter about which some confusion prevails. The number
available may be taken to be the number of births registered minus the deaths
under one year. It is often objected that the figure thus obtained will include
many children of too tender an age to be vaccinated, but if this view is taken one-
quarter to one-half of the children will remain unprotected each year.
As a matter of fact these very young infants should, in making the calcula-
tion, be ignored because they are compensated for by a similar balance from the
previous year which should be kept on the books by the Vaccinator.
The Vaccinator should note by name all cases of exemption in the village
record and should submit his weekly and monthly returns of work done, with a
programme of his next week's tour, regularly to the Civil Surgeon's office where
it should be tabulated. Steps should be taken to see that the work is kept
up-to-date in all circles.
Similarly, the movements of the Assistant Superintendent of Vaccination
require supervision.
It has been suggested to substitute a Village Vaccination Register for
the present detached form which is frequently lost and is never forthcom-
ing for past years; steps will be taken to consider how this may be
introduced. The district of Saugor appears to illustrate the extent to which
immunity may be attained by properly directed effort, for the Civil Surgeon reports
that small-pox has practically reached the vanishing point and this, in spite of a
staff so poor that, as is remarked in the Jubbulpore report, " it would seem the
Vaccinator should apologise for his existence." The introduction of new rules and
standardised lymph will give a stimulus to better work, but the details of supervision
must be sharpened up and the vaccinator instructed to show himself instead of run-
ning to earth on the approach of District Officers.
Cost of the Department.
STATEMENT II.
7. The total cost of the Department was Rs. 2,19,719-4-11 against
Rs. 1,89,462-10-11 in the previous triennium. The rise
is due to the increase of staff, the grant of local allowance
to Vaccinators in some districts and to the establishment of the Provincial Vaccine
Depôt at Nagpur. For the same reasons the cost per successful vaccination,
which averaged Re. 0-1-11 during the triennium ending 1910-11,rose to Re. 0-2-1
during the period under report, but in calculating the average cost the expenditure
incurred at the depôt has been omitted.