3
During the year under report 162,182 primary operations and 228,630
re-vaccinations were performed as compared with 177,286 and 294,729
respectively, in the previous year.
6. Protection of infants.—During the year under report, the number of
children under one year available for vaccination was 1,109,602 and the num-
ber of successful operations was 388,998 equal to 350 per thousand against
417,112 or 386 per thousand successful operations out of 1,080,668 children
available during the previous year. The protection of infants in municipali-
ties is separately shown in statement VII. It gives a ratio of 572 per thousand
of the surviving infant population as compared with 540 in the previous year.
These figures are unsatisfactory inasmuch as they show that far more than
half of the total number of operations is performed on children over one year
of age. Civil Surgeons and Assistant Directors of Public Health are unanimous
in attributing the opposition to vaccination to be concerned more with the age
of the child than with the operation itself, as there is a strong prejudice,
against vaccination of infants at an early age. The advantages in retaining
the limit of age for compulsory primary vaccination as it now stands are
obvious, but prejudices in India die hard and it will take years of education
to dispsel this one.
7. Incidence and mortality of small-pox.—During the last ten years, the
total number of deaths from small-pox in the districts of this province has been
149,154.
During the first quinquennium, the number of deaths was 51,699 and
during the second 97,455. In each of the last five years the mortality was
as follows:— 3,893, 8,345, 22,748, 35,626 and 26,843.
The provincial ratios of the mortality from small-pox per thousand of
population during the last five years have been 0.11, 0.24, 0.67, 1.05 and 0.79.
As indicated in the report for 1926-27 the epidemic of small-pox reached
its height in 1926. There was a considerable decrease in the incidence of the
disease and in the total number of deaths in 1927-28. This reduction is being
maintained and it is fairly safe to predict a normal case incidence and death
rate from this disease for the next few years.
8. Prevention of small-pox.—The statistics given in the previous paragraph
indicate the insufficiency and inefficiency of the existing arrangements for vac-
cination, and it almost appears as if we relied more on natural causes to eventu-
ally arrest an epidemic, than in our efforts at prevention by vaccination.
Small-pox is a preventible disease and vaccination can prevent it, as it
has in countries where it is properly carried out. In the light of this know-
ledge and in face of the above facts there is a great necessity for a stronger
and more complete vaccination policy.
The question of compulsory vaccination throughout the province has been
under consideration for some time and primary vaccination has been and is
being extended to whole districts and areas in districts. Difficulty is still being
experienced in certain areas and amongst certain classes notably the Brahmans,
Rajputs and Bunniahs and in some cases the Muhammadans, of almost every
district, and where these difficulties become acute, the Vaccination Act is
extended on application from the district officials.
But the process is a slow one, and the time has now come when vaccina-
tion should be made compulsory throughout the province and should be free.
Compulsory primary vaccination alone, although it will be beneficial, will not
solve the difficulty completely. The immunity conferred by vaccination in
infancy is by no means lifelong, and if it is seriously desired that small-pox
should be eradicated, re-vaccination will also have to be compulsory, until
such time as the people themselves come to appreciate the benefits of it.
9. Inspection of work.—During the year under report the Assistant
Directors of Public Health inspected 73,090 primary vaccinations as against
78,083 in the previous year.