5
The proportion of persons successfully vaccinated per 1,000 of population
was 39.99 against 38.33 (worked on the census population of 1911) in the
previous year. The usual diagram is appended.
General.
15. In this note an attempt has been made to summarise the existing state
of affairs and the measures that were or are being taken
to improve them. The Deputy Commissioner, Bhan¬
dara, suggests that vaccinators should be provided with travelling cases
for their instruments, etc. This is a matter on which I would lay great
stress. In Nagpur Municipality vaccinators were provided with small tin
cases (obtained from England) in which they kept their instruments. The
case was not only handy but had a sterilizing apparatus inside. It would be
well if Civil Surgeons were to move the local bodies to supply such cases
to their vaccinators. A very serviceable scratcher has been introduced by
Colonel Buchanan and has been recommended to Civil Surgeons. It is easily
kept sharp and by its use all bleeding is avoided. Many of the Civil Surgeons,
Deputy Commissioners and also Commissioners comment unfavourably on the
rate of pay allowed to vaccinators in these Provinces, which they say is too low.
The vaccinator's salary is certainly not a handsome one, but it must be remembered
that he receives it in full all the year round, whereas the working season lasts for
six months only, as a rule. The pay of vaccinators in these Provinces compares
favourably with the scale employed in the Punjab and United Provinces but is
considerably lower than that in vogue in Bombay, where, however, the rôle of the
vaccinator is somewhat different. As the scale was only recently drawn up, it
is thought inexpendient to revise it again pending proof that the cost of living
here is greater than in those Provinces with which it can fairly be compared.
A proposal is at present being considered to bring the vaccinator up to the
Bombay standard and employ him fully in the non-working season, under
which circumstances his pay would have to be reconsidered.
The Civil Surgeon, Saugor, draws attention to the apathy of the Great
Indian Peninsula Railway Company in the matter of protecting their staff, and
the Deputy Commissioner remarks that it is extraordinarily difficult to come to
terms with them over medical arrangements. It is not clear why such an atti-
tude, which may not only cost them dear but affects the community at large,
should be adopted.
The assistance of schoolmasters and tahsildars should be freely used
in rural areas, and in towns Municipal authorities must be more active, lending
their support and influence to aid the vaccinator instead of leaving him severely
alone as is so commonly the case at present.
The subject of re-vaccination is calling loudly for further recognition and
the recent epidemic in Nagpur showed many instances of the disastrous results
of neglecting it
The immunity conferred by infant vaccination gradually
decreases and it is found that at the age of 15 or so it has ceased to exist,
the chances of being attacked by small-pox then becoming practically equal to
those of the unprotected. If this is made known to vaccinators and to the general
public it would be a step towards controlling such outbreaks as we have recently
experienced. In Amraoti and Nagpur, great efforts have been made to raise the
standard of work and put the staff on a more satisfactory footing. The reports
from Balaghat and Bhandara show very efficient work, but in Buldana there is a
considerable falling-off which demands attention.
The writing up of exempted cases on the back of village forms, originally
started in Nimar, is a useful procedure, as is also the furnishing of the vaccin-
ator's programme for the ensuing week on the back of each weekly return. These
are recommended for general adoption.
The Civil Surgeon, Yeotmal, is very anxious to re-introduce the old Berar
system of granting certificates to patels and patwaris for assisting in vaccination
work. I think it would be a useful adjunct, and we are badly in need of some
form of stimulus—the schoolmasters might well be included. Further enquiries
on this point are necessary.
NAGPUR:
The 10th June 1912.
The 12th July 1912.
T. G. N. STOKES, M. B., MAJOR, I. M. S.,
Sanitary Commissioner,
Central Provinces.