NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
2
5. Vaccinations performed by the special staff.
Statement I.—The vaccination staff performed 561,490
operations, of which 496,640 were primary and 64,850 were
re-vaccinations. As compared with the preceding year there
was a decrease of 20,774 operations (i.e., 3,021 in primary and
17,753 in re-vaccinations). The largest decrease was in Drug
district (5,383), then follow Balaghat with 4,671, Jubbulpore
4,236, Nagpur 2,817, Narsinghpur 1,804, Buldana 1,732 and
Raipur 1,170. In Drug district the decrease is due to ineffi-
ciency of vaccination staff and less children available for
vaccination than in the previous year ; in this connection the
Civil Surgeon sounds the following warning note :—" I am
afraid there will be a severe epidemic of small-pox this year
throughout the district and in Drug town as there are 4,431
children unprotected in scattered villages of the district and
249 children remain unvaccinated within Drug Municipal area "
In Balaghat the marked decrease in re-vaccinations is attri-
buted to the fact that during the year 1926-27 there was
small-pox in the mining camps at Tirodi and a large number
of re-vaccinations was performed there. In Jubbulpore there
was a large decrease in re-vaccinations while primary opera-
tions show a slight decrease and the Civil Surgeon states that
the decrease can rightly be attributed to the fact that vacci-
nation is not compulsory in rural areas. In Nagpur the
decrease is attributed to the prevalence of plague in Nagpur
City and in Katol, Kalmeshwar and Saoner circles. In
Narsinghpur the number of primary vaccinations shows a
decrease while re-vaccinations show an increase. In Rai¬
pur re-vaccinations show a decrease and the slackness on the
part of the vaccinators largely accounts for the decrease in
the work. In Buldana the fall is partly due to the decrease
in births and partly to sickness among children ; there was
also heavy showers of rain in the working season which im-
peded the movements of the staff.
6. There is a large number of children remaining
unvaccinated in several districts and it is hoped that Civil
Surgeons will adopt definite measures to have as many unpro-
tected children as possible vaccinated. The standard of
minimum number of operations to be performed by each
vaccinator has been fixed as 2,000 but the returns submitted
to this office show that many vaccinators did not attain this
standard. As already remarked in the previous years reports
every effort should be made to arrive at the prescribed
3
standard and the Civil Surgeons and District Councils will, it
is hoped, pay attention to this matter. The infliction of
adequate punishment on vaccinators for faulty work and
recruitment of suitable men in place of slack and unreliable
persons should be resorted to in such cases.
7. Re-vaccinations have decreased from 82,603 in the
previous year to 64,850 in 1927-28. It would be well for the
local bodies to take energetic action so that re-vaccination may
be pushed on as vigorously as possible to avoid severe epide-
mics of small-pox. The rule in the Public Health Manual
(paragraph 8 (b), chapter VI) regarding age-limit for re-vacci-
nation has been amended so as to allow of re-vaccination being
performed over the age of seven.
8. Dispensary vaccination and vaccination by
other agencies. Statement III.—During the year the
Government has sanctioned the proposal for the vaccination
of school children by the medical officers doing periodical
inspection of schools and the Civil Surgeons were asked to
give effect to it In accordance with these orders the medical
officers in some districts performed the vaccination of school
children and these were as follows:—Nagpur 87, Chanda 52,
Saugor 95, Hoshangabad 30, Yeotmal 74 and Akola 14.
The medical official in charge of the Jail hospital at
Nagpur performed 567 vaccinations, the medical subordinate
in charge Cantonment hospital, Pachmarhi, 481 and at the
Raipur Jail 268. The railway staff in Nagpur, Chanda and
Saugor performed 258 vaccinations, the mining agencies
Chhindwara, 2,241, the District Labour Association, Raipur,
3,757 and the Mission dispensary, Dhamtari 16.
9. Cost of department. Statement II.—The total
cost of the department was Rs. 2,04,204-6-7 against
Rs. 2,06,470-9-10 in the preceding year. The cost of each
successful case was annas 7 and pies 3 against annas 6 and
pies 6 in the preceding year. Excluding the expenditure
incurred in connection with the Vaccine Institute, Nagpur,
the cost per successful case stands at annas 6 and pies 6
against annas 5 and pies 9 in 1926-27.
10. Supply of lymph.—Glycerinated calf lymph
prepared at the Vaccine Institute was used and the supply
was reported to be satisfactory and the lymph good. As an
experiment chloroformed lymph was prepared and sent out but
the results were not satisfactory due to vaccinators in the
4
moffusil not taking proper care of it and the rapid deteriora-
tion of it when exposed to heat and delay in transit; the
chloroforming of lymph was therefore stopped.
II. The report for the year 1927-28 as submitted by
the Superintendent of the Vaccine Institute, Dr. Edibam ,
M.B.B.S., Dr. P. H, (Amer.) is reproduced below:—
"119 animals—112 bovine and 3 buffalo calves, and
4 rabbits—against 214 last year were operated on.
Of
these
5 were rejected due to unsatisfactory
results.
The whole of the abdominal area was
scarified by special fork shaped scarificator. The average
out-put of lymph was 76.57 grammes per bovine calf,
138.84 grammes per buffalo calf and 1.71 grammes per
rabbit. The total yield of pulp was 8,619.67 grammes
equivalent to 36,778 c. c. lymph or 735,560 doses, against
8,263.43 grammes equivalent to 37,892 c. c. lymph or 757,840
doses of last year. Cost of lymph per dose works out at
4 pies per dose against 5 pies of last year. The average
purchase price per calf was Rs. 12 and the sale price was
Rs. 9 in round figures. Six calves were sold without being
operated on for the following reasons :—
1 for Anæmia.
4 for Piroplasmosis.
1 for dry gangrene of the tail.
"The whole province of 22 districts, the Feudatory States
of Raigarh, Sirguja and Bhopal, Military Bodies, Railways,
Jails, Labour Associations and Mission Hospitals were
supplied with lymph on indents. Total supply of lymph
to the whole province was 650,490 doses against 684,720 doses
of last year; of these 576,690 doses were supplied to the
vaccinators serving the various local bodies and 73,800 to the
Feudatory States, Railways, Military authorities and Private
Practitioners, etc.
" Balance of lymph on hand on 31st March 1928 was
19,732¼ c. c, i.e., 394,645 doses.
" Result of the working of lymph :—
Primary vaccination ...
Re-vaccination ...
Case success.
Per cent.
97 against
99 of last year.
57 against
58 of last year.
Insertion success.
Per cent.
89 against
92 of last year.
44 against
45 of last year.
5
" This slight lowering of percentages in case success
and insertion success was due to indifferent results from
about 30 brews which were sent out chloroformed. As the
vaccinators in the moffusil could not use this lymph within
the prescribed three days after receipt and as chloroformed
lymph deteriorates rapidly the chloroforming process was
stopped and the results improved.
" The total expenditure during the year was
Rs. 19,241-8-9 against Rs. 25,051-3-3 of last year. Of this
Rs. 10,477-7-0 was spent on salaries and travelling allowances
and the rest Rs. 8,764-1-9 on contingencies. This reduction
in expenditure was due partly to the new method of operations
introduced since January 1927 and partly to the lower salary
of the Superintendent.
"The total receipts amounted to Rs. 23,936-11-9 as
detailed below:—
Sale of calves ... ...
Sale of lymph ... ...
Sale of rabbits ... ...
Miscellaneous ... ...
Total ...
Rs.
1,050
22,653
11
221
23,936
a.
12
7
8
0
11
p.
0
0
0
9
9
" 26 vaccinators—out of which four were private students
and one from Kanker State, 12 School teachers and three
Assistant Superintendents were trained and given certificates
of efficiency after examination. The trainirg class was
conducted by the Assistant Superintendent Maroty Ram¬
krishna. Magic lantern lectures on all epidemic diseases were
given to the classes by Dr. R. K. Mehta, Health Publicity
Officer.
" The Institute has been self supporting for several years
past. This year it shows a profit of Rs. 4,695-3-0 ".
12. Inspection of vaccination. Statement V.—
During the year the Civil Surgeons inspected 9.15 per cent
of the primary and 5.27 per cent of the re-vaccinations against
8.55 and 4.30, respectively, in 1926-27. Some of the Civil
Surgeons have devoted more time to this important part of
their duties
Balaghat 55 days, Nimar 52 days, Drug 52
days, Damoh 46 days, Chhindwara 42 days and Wardha
41 days. In Nagpur and Jubbulpore the Civil Surgeons
6
could not as usual do much touring for inspection purposes
owing to work at headquarters. In Hoshangabad the less
touring is attributed to the transfers of Civil Surgeons. In
several districts it is noticed that the prescribed period of
vaccination tour, viz., six weeks was not maintained and it
is hoped that Civil Surgeons will see that the rules allotting
six weeks for vaccination touring will not be overlooked in
future.
13. The Assistant Superintendents and others such as
the Assistants to Civil Surgeons, epidemic dispensary Assistant
Medical Officers and Sanitary Inspectors in municipal towns
inspected 56.46 per cent of the primary and 24.88 of the
re-vaccinations as against 58.50 and 27.62 in the preceding
year. In some districts the amount of touring done by the
Assistant Superintendents of Vaccination is not satisfactory
and must be considerably increased; as for instance in
Hoshangabad the Assistant Superintendent of Vaccination
was on tour for 93 days and it is stated that the man being of
very advanced age is unable to tour properly ; in Nimar the
Assistant Superintendent of Vaccination toured for 88 days;
in Damoh 121 days ; in Yeotmal one of the Assistant
Superintendents of Vaccination was on tour for 128 days.
As a rule every Assistant Superintendent of Vaccination
ought to spend at least 135 days in every vaccination season
on inspection tours and the Civil Surgeons should see that
these orders are rigidly enforced.
14. Percentage of success in primary and re¬
vaccination.—The percentage of success recorded by
vaccinators was 90.40 for primary and 50.12 for re-vaccina-
tions against 98.21 and 54.28, respectively, in 1926-27. The
Civil Surgeons and Assistant Superintendents during their
inspections found 90.91 and 87.63 success for primary and
44.57 and 42.14 for re-vaccinations against 96.96 and 94.65
for primary and 35.51 and 43.12 for re-vaccinations in the
preceding year. The less percentage during the year is due
to the fact that in accordance with the instructions issued by
my predecessor children with 1 and 2 marks have been
classified as unsuccessful while in previous years they were
classified as successful.
15. Vaccination performed in municipal towns.—
In 1927-28 the births registered in municipal towns and
7
notified areas were 53,153 and deaths among children under
one year of age were 11,344. Thus 41,809 children were
available for vaccination and of this 30,000 or 72 per cent
were successfully vaccinated which is less than the percentage
vaccinated in 1926-27, viz., 88. In several towns there is
a large balance of unprotected children which is dangerous
and the need for taking prompt action to get the balance
cleared off is urgently called for. I hope the municipal
committees will take energetic action to clear off the balance
of unprotected children as early as possible.
16. During the year my predecessor examined the
vaccination records of all municipal towns and notified areas he
visited and brought the irregularities to the notice of the local
bodies concerned. Besides this, he inspected 1,100 primary
and 87 re-vaccinations in six municipal towns and 53 villages.
17. Deaths from small-pox —Deaths from small-pox
numbered 2,175 against 3,556 in the previous year. All the
districts were infected with small-pox ; among the badly in-
fected districts, Chanda returned the largest number (370).
The increase in small-pox is due to the fact that year after year
a large number of children are left unvaccinated and in order
to check this preventable waste of infant life, it is extremely
important to secure as complete vaccination as possible every
year.
18. General.—The relations between the Civil Surgeons
and the District Councils have continued to be cordial.
19. As usual cases of opposition to vaccination in rural
areas were common during the year. It is satisfactory to note
that orders have been passed on the proposal for making
vaccination compulsory in rural areas which was under the
consideration of Government for some time past and the District
Councils have been asked to submit definite proposals for
making vaccination compulsory in selected rural areas.
20. The proposal to amend section 9 of the Vaccina-
tion Act making vaccination for children compulsory after the
beginning of third month of age is under the consideration of
Government.
21. In order to provide for the compulsory and imme-
diate reporting of the occurrence of small-pox cases in muni-
cipal areas, temporary regulations called '' The Small-pox Pre-
vention Regulations " were issued by Government in April
8
1927 for all municipal towns in Nerbudda Division and in
August 1927 for municipal towns in Narsinghpur district.
The Civil Surgeon, Narsinghpur, states that so far as Nar-
singhpur Municipality is concerned the application of these
Regulations had no influence on the spread or otherwise of
small-pox for which the fault lies in the fact that the municipal
committee has no reporting agency worth the name. In this
connection the Deputy Commssioner, Narsinghpur, remarks
that these Regulations have been rarely enforced and that
there are no sufficient data to judge whether they were
efficacious in preventing the out-break or spread of the
disease. In Nimar and Chhindwara districts the application
of these Regulations was not found necessary.
22. Under the scheme sanctioned by Government for
the training of Schoolmasters in Berar in vaccination, some
Schoolmasters have been trained. Thirteen trained teachers
were employed for vaccination work in Amraoti district, 6 in
Akola, 9 in Buldana and 4 in Yeotmal. The figures of
vaccination work performed by these men are included in State-
ment No I. With regard to the work of these School
teachers the Civil Surgeon, Amraoti, remarks "I am not per-
sonally much impressed with any great advantage that their
employment entails. They certainly have not the experience
of ordinary vaccinators and their results as entered by them
are much more at fault than in the case of vaccinators." It
is proposed to extend this experiment to the Central Provinces
districts and the opinions of the District Councils have been
called for in the matter.
23. The Civil Surgeon, Wardha, says that the appoint-
ment of Assistant Superintendent of Vaccination should be
provincialized while the Civil Surgeon, Raipur, suggests that
an Assistant Medical Officer be appointed as a District
Vaccination Officer to supervise the work of Assistant
Superintendents and the Vaccinators.
J. NORMAN WALKER, COL., I.M.S.,
NAGPUR:
The 5th June 1928.
Offg. Director of Public Health,
Central Provinces.
STATISTICAL STATEMENTS.
APPENDIX.
STATISTICAL STATEMENTS.
STATEMENT NO. I.—Showing particulars of vaccination
in the Central Provinces and Berar,
during the year 1927-28.
STATEMENT No. II.—Showing the cost of the department
in the Central Provinces and Berar,
during the year 1927-28.
STATEMENT No. III.—-Showing the dispensary vaccination in
the Central Provinces and Berar,
during the year 1927-28.
STATEMENT NO. IV.—Showing the number
of persons
primarily vaccinated and the num-
ber of those persons who were
successfully
vaccinated in the
Central Provinces and Berar since
1917-18.
STATEMENT No. V.—Showing particulars of vaccination
verified by Inspecting Officers during
the year 1927-28.
APPENDIX A.—Showing the number of vaccinations performed
in municipal towns on children
under one year of age in 1927-28.
APPENDIX B.—Showing the annual mortality from small-pox
for seven years and the annual
proportion of persons protected by
vaccination during each of the
seven years.
APPENDIX C.— Diagram showing the death-rate arom small-
pox per 10,000 of popu—tion during
the year 1927-28, the average rate
of mortality from small-pox per
10,000 of population for the five
years ending 19 26-27, and the
proportion of persons successfully
vaccinated during the year 1927-28
and the preceding six years in
each district of the Central Provin-
ces and Berar,
PAGES.
2—7
8—11
12 & 13
14-17
18 & 19
20—23
24—27
2
A.—VACCINATION
STATEMENT No. I .— Showing the particulars of Vaccination in the
Num-
ber.
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
District.
2
Nagpur Division.
Nagpur ... ...
Bhandara ... ...
Wardha ... ...
Chanda ... ...
Balaghat ... ...
Total ...
Jubulpore Division.
Jubbulpore ... ...
Saugor
...
...
Damoh ... ...
Seoni
...
...
Mandla ... ...
Total ...
Nerbudda Division.
Hoshangabad
...
...
Nimar ... ...
Narsinghpur ... ...
Betul ... ...
Chhindwara ... ...
Total ...
Chhattisgarh Division.
Raipur
...
...
Bilaspur ... ...
Drug
...
...
Total ...
Berar Divition.
Amraoti
...
...
Yeotmal
...
...
Akola ... ...
Buldana ... ...
Total ...
Total District Vaccination ...
Total Dispensary Vaccination ...
Py other Agencies ...
Total British Districts Centra
Provinces and Berar.
Population of
district according
to census of 1921.
3
792,521
717,747
463,696
660,630
511,634
3,146,228
748,685
528,380
287,126
348,871
386,446
2,296,508
440,733
396,554
315,162
363,737
491,835
2,013,021
1,406,676
1,231,765
743,246
3,381,687
828,384
748,959
794,623
703.350
3,075,316
13,912,760
...
...
13,912,760
Average popula-
tion per square
mile.
4
206.71
198.11
190.51
70.94
140.84
138.23
190.61
113.36
101.89
108.48
76.42
121.09
121.09
93.81
159.49
93.94
106.20
109.48
143.73
161.69
160.01
153.56
176.10
143.89
104.28
187.36
173.23
139.30
...
...
139.30
Average
number of
vaccinators
employed
throughout
the year.
5
20
14
11
14
8
67
18
12
7
9
11
57
11
0
8
9
11
48
26
24
17
67
15
11
16
14
56
295
...
...
295
NOTE.—(1) Column 13, " Re-vaccination", includes the vaccination of all persons who bear marks
(2) Difference of 4.347 between the number of primary vaccinations and re-vaccinations
represents secondary
(3) Figures for vaccination work in Berar districts include primary vaccinations and
3
DEPARTMENT.
Central Provinces and Berar during the year 1927-28.
Total number of persons
vaccinated.
6
Males.
24,998
15,349
11,318
13,240
8,994
73,899
13,021
13,656
6,300
8,332
8,254
49,563
9,239
9,352
5,857
7,903
11,014
43,415
26,592
27,014
17,058
70,664
20,876
15,067
16,300
16,626
68,869
306,410
...
...
...
Females.
15,351
13,594
8,668
11,748
7,075
56,436
11,474
9,709
4,932
6,653
6,657
39,425
7,570
7,859
4,478
6,981
10,904
37,812
24,610
21,820
15,357
61,787
15,099
13,153
14,121
12,899
55,273
250,733
...
...
...
40,349
28,943
19,986
24,988
16,069
130,335
24,495
23,365
11,232
14,985
14,911
88,988
16,809
17,211
10,305
14,904
21,968
81,227
51,202
48,831
32,415
132,451
35,975
28,220
30,120
29,525
124,142
557,143
1,668
6,272
565,083
Average
number of
persons
vaccinated
by each
vaccinator.
7
2,017
2,067
1,817
1,785
2,008
1,945
1,360
1,947
1,604
1,665
1,356
1,561
1,528
1,912
1,292
1,656
1,997
1,692
1,969
2,035
1,906
1,977
2,237
2,506
1,854
1,915
2,217
1,889
...
...
1,889
Primary vaccination.
Total.
8
31,906
24,224
17,761
23,826
14,255
111,972
23,226
18,307
10,407
13,529
12,99l
78,460
15,339
16,640
8,691
13,184
17,553
71,415
48,898
43,191
28,687
120,776
30,940
26,912
30,269
25,896
114,017
496,640
480
2,631
499,751
Successful.
Under one
year.
9
23,906
18,176
14,899
13,068
10,842
80,091
15,179
14,751
5,482
10,946
9,224
55,585
11,185
12,498
5,131
11,056
13,608
53,478
16,975
28,621
22,137
87,733
22,768
17,893
15,966
14,736
71,363
349,050
191
2,032
351,273
One and
under six
years.
10
3,726
4,084
3,588
4,021
2,859
18,178
2,260
1,299
2,155
1,588
2,423
9,728
2,300
1,768
995
964
1,275
7,302
9,149
10,380
4,369
23,898
3,011
5,138
3,904
5,324
17,377
76,483
57
200
76,740
of previous vaccination or of small-pox.
performed (total of columns 8 and 13) and the total number of persons vaccinated (total in column 6)
operations.
re-vaccinations, etc., performed by the schoolmasters.
4
A.—VACCINATION
STATEMENT No. I.—Showing the particulars of Vaccination in the
Num-
ber.
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
District.
2
Nagpur
Division.
Nagpur ... ...
Bhandara
...
...
Wardha ... ...
Chanda ... ...
Balaghat ... ...
Total ...
Jubulpore
Division.
Jubbulpore
...
...
Saugor ... ...
Damoh
...
...
Seoni ... ...
Mandla ... ...
Total ...
Nerbudda
Division.
Hoshangabad ... ...
Nimar ... ...
Narsinghpur ... ...
Betul ... ...
Chhindwara ... ...
Total ...
Chhattisgarh
Division
Raipur ... ...
Bilaspur ... ...
Drug ... ...
Total ...
Berar
Division.
Amraoti ... ...
Yeotmal ... ...
Akola
...
...
Buldana ... ...
Total ...
Total District Vaccination ...
Total Dispensary Vaccination ...
By other Agencies ...
Total
British Districts,
Centra
Provinces and Berar.
Primary vaccination.
Successful.
Total of
all ages.
11
27,792
22,295
17,487
18,423
13,701
99,698
17,457
16,135
7,637
12,534
11,767
65,530
13,508
14,300
6,126
12,032
14,884
60,853
46,406
39,248
26,506
112,160
25,904
23,031
20,304
20,355
89,644
427,885
337
2,232
430,454
Un-
known.
12
1,793
163
235
2,092
419
4,702
3,614
960
1,116
394
468
6,552
656
113
1,008
417
1,045
3,239
1,418
775
1,814
4,007
664
1,115
2,356
683
4,818
23,318
84
125
23,527
Re-vaccination.
Total.
13
8,447
4,724
2,225
1,797
1,814
19,007
1,473
5,070
825
1,456
1,920
10,741
1,527
937
1,826
1,950
4,415
10,655
2,385
5,643
3,743
11,771
5,556
1,574
1,456
4,087
12,673
64,850
1,188
3,641
69,679
Successful.
14
2,124
2,079
853
978
724
6,758
82
2,174
304
1,029
1,471
5,060
426
366
609
644
2,365
4,430
1,006
1,501
2,489
5,026
1,656
890
459
901
3,914
25,188
436
3,500
29,124
Un-
known.
15
2,417
994
444
417
419
4,691
328
1,111
283
172
88
1,982
396
86
366
325
540
1,713
467
3,140
742
4,649
622
314
303
320
1,559
14,594
483
99
15,176
NOTE.—(1) Column 13 " Re vaccination", includes the vaccination of all persons who bear marks
(2) Difference of 4,347 between the number of primary vaccinations and re-vaccinations
represents secondry
(3) Figures for vaccination work in Berar districts include primary vaccinations and