NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
24
APPENDIX B.—Statement showing the annual mortality from small-pox
during each of the
Year.
1
1921-22.
1922-23.
1923-24.
1924-25.
1925-26.
1926-27.
1927-28.
—
2
Annual mortality from small-pox . ...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox ...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox ...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox ...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox ...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox ...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox ...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Nagpur.
3
109
32.62
33
32.14
3
36.11
4
38.02
118
45.11
299
41.65
55
37.75
Bhandara.
4
130
24.80
26
30.59
20
33.92
6
34.49
42
35.13
199
37.21
40
33.96
Wardha.
5
43
35.33
6
34.89
...
33.19
3
37.56
290
36.05
342
40.07
16
30.55
25
for seven years and the annual proportion of persons protected by vaccination
the seven years.
Chanda.
6
56
20.39
...
20.61
6
25.02
21
32.41
43
31.68
268
32.76
370
29.37
Balaghat.
7
58
23.68
...
25.86
6
31.68
4
31.49
...
30.52
15
34.97
2
28.19
Jubbulpore.
8
98
21.24
5
29.08
5
26.96
...
29.33
16
31.58
148
30.44
108
23.52
Saugor.
9
...
28.55
1
25.28
3
33.02
37
33.38
45
35.96
145
36.23
57
34.65
Damoh.
10
61
31.95
9
35.46
...
36.49
...
34.79
6
37.19
296
32.97
73
27.66
Seoni.
11
69
16.01
9
23.81
13
28.14
6
29.88
60
38.18
100
37.37
194
38.88
Mandla.
12
244
22.64
4
20.34
...
36.69
...
39.81
...
33.56
29
38.17
136
34.26
Hosh-
ang-
abad.
13
6
30.58
2
27.53
36
34.94
47
30.47
42
33.01
49
34.31
35
3.08
26
APPENDIX B.—Statement showing the annual mortality from small-pox
during each of
Year.
1
1921-22.
1922-23.
1923-24.
1924-25.
1925-26.
1926-27.
1927-28.
—
2
Annual mortality from small-pox
..
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox
..
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox
...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox ..
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox
...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox
...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Nimar.
14
6
34.33
14
35.17
47
40.75
116
37.36
3
38.45
105
42.03
183
36.99
Narsing¬
pur.
15
17
21.81
24
32.75
4
36.44
8
29.02
4
32.90
120
29.43
218
21.43
Betul.
16
3
27.56
...
26.10
4
31.92
19
35.75
33
27.92
13
35.84
7
34.85
27
for seven years and the annual proportion of persons protected by vaccination
the seven years.—(Concld.)
Chhindwara.
17
4
29.05
1
28.07
...
39.89
2
44.36
25
38.83
16
38.99
10
35.07
Raipur.
18
120
26.93
25
26.06
6
34.79
4
34.17
3
34.40
29
35.19
30
33.73
Bilaspur.
19
70
25.76
48
29.58
...
30.50
48
33.87
33
33.26
91
36.87
63
33.08
Drug.
20
40
22.77
14
27.27
1
36.24
7
36.57
28
42.46
216
46.36
248
39.01
Amraoti.
21
12
26.47
58
30.81
26
32.28
578
32.58
900
35.05
252
38.32
13
33.27
Yeotmal.
22
41
26.11
11
29.60
22
30.41
24
31.37
311
31.37
527
30.87
87
31.95
Akola.
23
15
26.84
58
23.79
158
30.90
660
31.21
599
32.96
85
32.72
32
26.06
Buldana.
24
14
28.49
35
27.32
60
33.79
317
33.12
337
34.82
212
38.79
198
30.39
Govt. Press, Nagpur:—No. 651, Dir. of P. H.—23-7-28.—319.
Triennial Report on Vaccination
in the Central Provinces and
Berar for the years 1926-27,
1927-28 and 1928-29
(For the triennial period ending 31st
March 1929)
NAGPUR:
PRINTED AT THE GOVERNMENT PRESS
1929
[Price—Re. 1-8-0.]
Triennial Report on Vaccination
in the Central Provinces and
Berar for the years 1926-27,
1927-28 and 1928-29
(For the triennial period ending 31st
March 1929)
NAGPUR:
PRINTED AT THE GOVERNMENT PRESS
1929
Agents for the sale of publications issued by the Central Provinces
Government.
[NOTE.—Appointments of all official Agents in the United
Kingdom and on the Continent for the sale of Government
Publications have been terminated with effect from the 1st April
1925.
All publications in future are obtainable either direct from
the High Commissioner for India, 42, Grosvenor Gardens,
London, S. W. 1, or through any bookseller.]
INDIA.
AKOLA:
The Proprietor, Shri Ramdas
Stores, Tajnapeth.
ALLAHABAD:
Mr. Ram Narain Lal, Publisher,
etc., 1, Bank Road
The Superintendent, Nazair Kanun
Hind Press.
AMRAOTI:
Thakur & Co., Booksellers.
BILASPUR:
Mr. M. A. Subhan, Bookseller
and Publisher.
BOMBAY:
D. B. Taraporevala, Sons & Co.,
190, Hornby Road, Fort.
Radhabai Atmaram Sagoor.
Sunder Pandurang, 25, Kalbadevi
Road.
Thacker & Co., Ltd.
CALCUTTA:
The
Book
Company, 4/4-A,
College Street.
Butterworth & Co. (India), Ltd.,
8-2, Hastings Street.
The Indian School Supply Depôt.
M. C. Sircar & Sons., 75,
Harrison Road.
Newman & Co.
R. Cambray & Co.
S. K. Lahiri & Co.
Thacker, Spink & Co.
COOCH BEHAR:
Babu S. C. Taluqdar, Proprietor,
Students & Co.
DELHI:
The Oxford Book and Stationery
Co.
JUBBULPORE:
The Manager, General
Book
Depôt.
KARACHI:
The Standard Bookstall.
LAHORE:
Rai Sahib M. Gulab Singh &
Sons.
LUCKNOW :
The Proprietor, Newal Kishore
Press.
The
Upper
India
Publishing
House, Ltd., 41, Aminabad
Park.
MADRAS:
Higginbotham & Co.
S. Murthy & Co., Post Box
No. 152.
NAGPUR:
Aidan Binzani, Proprietors, Kar-
mavir Book Depôt, Manal
Mr. G. G. Khot, Walker Road.
Mr. G. A. Shastri, Bookseller and
Publisher, Hislop College Road.
The Manager, General Book
Depôt.
The Manager, "The Hitavada".
PATNA:
The Patna Law Press Co.
POONA.
The Proprietors, New Kitabkhana.
RANGOON:
The Superintendent, American
Baptist Mission Press.
SIMLA:
Thacker, Spink & Co.
No. 9626-689-IX.
GOVERNMENT OF THE CENTRAL PROVINCES.
MEDICAL ADMINISTRATION AND PUBLIC
HEALTH DEPARTMENT.
Nagpur, the 5th December 1929.
READ—
Triennial Report on Vaccination in the Central Provinces and
Berar for the years 1926-27, 1927-28 and 1928-29.
RESOLUTION.
The period under review is the second triennium
during which the administrative and executive control of
the vaccination staff has been exercised by local bodies.
The reports show considerable variations in the amount
of interest taken. Some local bodies have shown com-
mendable zeal, while others have failed to realize the full
implications of their responsibilities in this respect. The
total number of operations performed in the province
rose from 1,585,946 during the previous triennium to
1,746,145, all districts except three contributing to the
increase. Although the figures show a welcome increase
over those of the previous period, they still only equal
approximately the standard reached some 14 years ago,
and there is still obvious scope for wide improvement.
In many districts large numbers of children still remain
unvaccinated, and are a source of public danger, which
is reflected in the increase in the number of deaths from
small-pox during the triennium. In the Nagpur district
the report shows that the percentage of population
protected has fallen considerably, and the matter re-
quires the early attention of the district council. The
danger is not, moreover, confined only to the areas under
district councils, where vaccination is still optional, but
also to municipalities, where compulsion has been intro-
duced. It is unsatisfactory to read that the percentage of
2
children successfully vaccinated fell from 88 per cent in
1926-27 to 68 per cent in 1928-29 and to learn that the
decrease was mainly caused by the apathy of the local
bodies and their lack of supervision over their vaccinat-
ing agency. For instance, in Jubbulpore, only 19 per
cent of the vaccinations performed in the town have been
inspected by the Health Officer's staff.
2. Cases of opposition to vaccination in rural areas
are becoming more frequent, and the report states that it is
now more generally realized that Government has no
powers of compulsion. The question of extending
compulsory vaccination in selected rural areas is now
engaging the attention of the Local Government, but
before any measure of compulsion can be fully effective,
it must be supported by a healthy public opinion. The
Director of Public Health attributes the unsatisfactory
state of affairs in rural areas to the slackness of the
vaccination staff. The Local Government, however,
considers that the root of the difficulty lies not so much
with the agency employed as with the local bodies
themselves. Until a measure of compulsion can be
introduced, the progress of vaccination must depend
upon the interest evinced and the supervision exercised
by the local bodies, and unless local bodies generally
bestir themselves to awaken a proper public feeling
among the less educated sections of the people in regard
to this important matter, progress is bound to be slow.
In this respect the example of the District Council,
Seoni, where it is reported that 90 per cent of the
school-going children are now protected, is commended
to the notice of other district councils as an object lesson
of what can be achieved by keenness and co-operation.
Apathy in the public is possibly to be expected, but
apathy in the local bodies cannot be excused. The local
Government trusts that all local authorities will realize
their responsibilities in this matter and will endeavour
not only to keep their staff up to the mark but also to
take active steps to educate public opinion generally
as to the value of the protection offered and the dangers
of failure to adopt it. In this connection Government
also wishes to emphasize the necessity for adequate
touring by Civil Surgeons and others responsible for
the inspection of vaccination work.
3
3. The scheme for the training of schoolmasters
in Berar sanctioned previously has continued during
the triennium. The results have been somewhat diverse
in the various districts, and there is an increasing
measure of doubt as to whether it is wise to entrust to
this agency work that is so entirely foreign to their
ordinary duties. The Yeotmal District Council has
determined to send no more teachers for training, and
the Akola District Council considers that the scheme is
a dangerous one, but on the other hand good results
have again been achieved in Buldana. Further trial of
the experiment will be made, but at the same time
Government commends to the notice of district councils
the remarks of the Director of Public Health suggesting
the alternative employment of schoolmasters as advisers
and instructors of the people in their local areas. The
work of the vaccinators will be both easier and more
rapid if the path is made smooth for them in advance,
and the work of preparation and propaganda is perhaps
more likely to be suited to this agency than that of the
actual performance of the operations.
ORDER—Ordered that a copy of this Resolution be
forwarded to the Director of Public Health, Central
Provinces, for information and guidance; also, that it be
published in the supplement to the Central Provinces
Gazette.
By order of the Government
(Ministry of Medical Administration and Public Health),
E. GORDON,
Revenue Secretary to Government,
Central Provinces.
GPN-2141-RS-10-12-29-331.
TABLE OF CONTENTS.
Introductory ...
Administration ...
Area and population ...
Establishment ...
Total vaccinations ...
Vaccination by special staff ...
Re-vaccinations ...
Dispensary vaccination and vaccination by other
agencies ...
Cost of the department ...
Supply of lymph and working of the Institute ...
Inspection of vaccination ...
Percentage of success in primary and re-vaccination...
Vaccination performed in municipal towns ...
Deaths from small-pox ...
Temporary Small-pox Prevention Regulations ...
General ...
PARAS.
1
2
3
4-5
6-7
8-13
14-15
16-17
18
19-20
21-23
24-25
26-27
28
29
30-32
TRIENNIAL REPORT ON VACCINATION IN THE
CENTRAL PROVINCES AND BERAR FOR THE
YEARS 1926-27, 1927-28 AND 1928-29.
1. Introductory.—This report deals with the work
performed during the triennial period ending 1928-29.
2. Administration.—Lieutenant-Colonel H. G. Stiles
Webb, I.M.S., was in charge of the department till the
1st May 1928 except for the period from 4th June to 23rd
September 1927 when he was on leave and Lieutenant-
Colonel W. J. Powell, I.M.S., was in charge. On the 2nd
May 1928 Lieutenant-Colonel Stiles Webb, I.M.S., pro-
ceeded on long leave and Colonel J. Norman Walker,
I.M.S. took over from him and remained in charge till
the 1st January 1929 when I succeeded him.
3. Area and population.—There was no change in
the area and the population of the province during the
triennium, the area being 99,823 square miles with a
population of 13,912,760. From the 1st April 1926 four
villages of Akola district were added to the Buldana dis-
trict, with the result that the area of Akola district was
reduced, while that of Buldana district increased from
that year.
4. Establishment.—During the triennium under
report the number of Assistant Superintendents of
Vaccination remained the same, viz., 36. For the districts
of Saugor and Mandla it has been urged that one Assist-
ant Superintendent of Vaccination for each of these dis-
tricts cannot efficiently supervise the work of all the
vaccinators, and in order to maintain strict supervision,
the entertainment of a second Assistant Superintendent of
Vaccination is necessary. Although this has been em-
phasized every year, the District Councils have not seen
their way to sanction these appointments. The District
Council, Mandla, has, however, sanctioned the appoint-
ment of one Assistant Superintendent of Vaccination for
six months, i.e., for the vaccination season only. The
Civil Surgeon, Betul, also remarks that it is practically
impossible for one Assistant Superintendent of Vaccina-
tion to properly supervise the work of the district and
2
considers that two such appointments are absolutely essen-
tial. In Chanda district one post of the Assistant Super-
intendent of Vaccination remained vacant for about 10
months during the year 1928-29. It is undesirable that
these posts should be allowed to remain vacant for such
long periods to the detriment of vaccination inspection.
5. At the end of the previous triennium there were
in all 306 vaccinators. This number was increased by
eleven in the districts of Nagpur, Bhandara, Wardha,
Chanda, Betul, Chhindwara, Akola and Yeotmal. The
increase was largely due to some Municipal Committees
entertaining independent vaccinators in their towns. The
District Council, Raipur, sanctioned the post of vaccina-
tion clerk from June 1926. The Civil Surgeon, Yeotmal,
thinks that the pay of the vaccinators be increased so as to
attract right type of men. The Civil Surgeon, Akola,
suggests that the District Council should make provision
for two reserve vaccinators. It is hoped the District
Councils would pay attention to the recommendation made
by the Civil Surgeons.
6. Total operations performed.—The following table
illustrates the progress of vaccination during the triennium
as compared with the previous triennium : —
Establishment.
By vaccinators ...
By
Sub-Assistant
Surgeons attached
to dispensaries.
By other agencies ...
Total ...
Triennial period ending 1928-29.
1926-27.
582,264
1,727
6,699
590,690
1927-28.
561,490
1,668
6,272
569,430
1928-29.
579,615
1,653
4,757
586,025
Total.
1,723,369
5,048
17,728
1,746,145
Triennial period ending 1925-26.
1923-24
500,806
110
482
501,398
1921-25.
519,991
402
723
521,116
1925-26.
555,941
2,849
4,642
563,432
Total.
1,576,738
3,361
5,847
1,585,946
Difference
+ 146,631
+1,687
+ 11,881
+160,199
From the above it will be seen that as compared with
the previous triennium, the total number of operations
increased by 160,199. During each of the years of the
triennium under report the total number of operations per-
formed remained fairly constant.
3
7. During the triennium ending 1919-20 as many as
1,616,431 operations were performed, but during the next
triennium ending 1922-23 there was a considerable
decrease, the number being only 1,279,167. This was
ascribed to a large extent to the non-co-operation
movement. There has been a steady increase from the
year 1922-23 onwards, and it is satisfactory to note that
the vaccination work for the triennium under report shows
an increase of 129,714 operations over the triennial period
ending 1919-20 and approximates to the standard obtained
in the triennium ending 1916-17.
8. Vaccination performed by the special staff. State-
ment I.—The total number of operations performed by the
vaccinators during the triennium was 1,723,369, of which
1,502,970 were primary and 220,399 revaccinations
(499,661 primary and 82,603 revaccinations in 1926-
27, 496,640 and 64,850 in 1927-28 and 506,669 and 72,946
in 1928-29). As compared with the previous triennium,
146,631 more operations were performed by the vaccina-
tion staff, and the increase is contributed by all the districts
except Damoh, Hoshangabad and Narsinghpur.
9. During the triennium under report Bilaspur
headed the list with an increase of 20,648 operations
followed by Amraoti (17,032), Chanda (13,153), Drug
(10,687), Saugor (10,308), Seoni (10,062), Jubbulpore
(9,139), Raipur (9,038), Bhandara (7,819), Buldana
(7,248), Nagpur (6,955), Betul (5,825), Nimar (5,816),
Mandla (4,943), Wardha (4,885), Akola (4,655), Yeotmal
(3,087), Balaghat (451) and Chhindwara (22). In Nar-
singhpur, Hoshangabad and Damoh there has been a
decrease in the number of operations performed during
the triennium under report, amounting to 2,298, 1,700
and 1,144, respectively.
10. Although the vaccination work done shows an
improvement there still remain a large number of children
unvaccinated in several districts each year. As remarked
in previous reports, this is mainly due to the slackness
of the vaccination staff. Moreover the rural population
is generally coming to realize that vaccination is optional
and there are no laws to compel it. This, as the Civil
Surgeon, Jubbulpore, remarks, may be due to a lazv
4
vaccinator complaining that people were unwilling to
submit to vaccination. The balance thus left is a danger,
and it is hoped that the Civil Surgeons will take necessary
measures to clear off this arrears.
11. The minimum number of vaccinations prescrib-
ed for each vaccinator is 2,000, but the returns show that
the standard was attained in very few districts. In
Hoshangabad district the average number of vaccinations
performed by a vaccinator during the year ending 1928-29
was only 1,280. The average of Narsinghpur, Jubbul¬
pore, Damoh, Betul and Wardha is also disappointing, the
number being 1,341, 1,529, 1,575, 1,600 and 1,607 respec-
tively. The Civil Surgeons and the Local Bodies, parti-
cularly of the above districts, should therefore pay
attention to this matter and see that the vaccinator gives
a sufficient outturn of work. The infliction of adequate
punishment on vaccinators for bad work and recruitment
of suitable men in place of slack and unreliable persons
should be resorted to in such cases and it is of the extreme
importance that the District Councils should give due
weight to the recommendations of the Civil Surgeons in
this matter. I quote an instance of the apathy shown by
the Jubbulpore District Council. The Civil Surgeon
recommended the dismissal of a vaccinator whose
work was hopelessly bad, but the District Council
failed to take any adequate disciplinary action against the
man. In this connection the Commissioner, Jubbulpore
Division, remarks: —
"Apart from the apathy of the people, the vaccination staff
is controlled by Local Bodies which are not infrequently worse
than apathetic. The case of the Vaccinator Khanderao referred
to by the Deputy Commissioner is a glaring instance of this
attitude; a 'Vaccinator' who refused to do any vaccinations at
all was not only retained in his appointment, but was paid full
pay for the time he was under suspension, though all the facts
were admitted, with the result presumably that the children of
his circle were left unprotected with small-pox rife in the district.
I agree that the only logical step is compulsory vaccination; but
in addition, if this measure is taken, the vaccinators must be
placed definitely for discipline under the Department of Public
Health."
12. Cases of opposition to vaccination in rural areas
are frequent. These were sent to the Deputy Commis-
sioners for necessary action. In the absence of legislation,
the Revenue Authorities cannot do more than give a few
5
words of advice. In this connection the Civil Surgeon,
Jubbulpore, remarks: —
"During the year 1,502 persons were reported to the Deputy
Commissioner for action. Out of these only 5 were vaccinated.
As the law stands, it seems pure waste of time to make these
notifications as there are no legal powers to enforce compliance."
13. The scheme for making vaccination compulsory
in selected rural areas is under the consideration of
the Government.
14. Revaccinations.—During the year 1928-29 the
number of revaccinations performed was 72,946 against
64,850 in 1927-28 and 82,603 in 1926-27. As compared
with the previous triennium, this work shows an increase
amounting to 65,512. The largest number of revaccinations
(8,404) during the year 1928-29 were performed in
Bilaspur. Labour recruited from that place is mainly
responsible for this increase. In Seoni district 4,055
revaccinations were performed in 1928-29 as compared
with 1,456 in the previous year. This increase is due to
the fact that the Chairman, District Council, issued orders
to all the school masters in the district for getting all the
school boys revaccinated. The Civil Surgeon in his report
states that as a result of this about 90 per cent of all school-
going children have been revaccinated. In Mandla district
there was an increase of 3,199 revaccinations and in
Raipur 2,373. Narsinghpur, Nimar and Hoshangabad
recorded very few revaccinations during the year 1928-29.
Results achieved in Seoni show that considerable
improvement can be effected by the active co-operation
of the members of the Local Bodies, and it is hoped that
the District Council members would use their influence
and help the vaccination staff so that revaccination work
is done on a larger scale to avoid severe epidemics of
small-pox.
15. The rule in the Public Health Manual
[paragraph 8 (b), Chapter VI] regarding age limit for
revaccination has been amended in 1927-28 so as to
allow of revaccination being performed over the age of
seven.
16. Dispensary vaccination and vaccination by other
agencies. Statement III.—During the year 1928-29 vacci-
nations performed in Nagpur Jail and Raipur Jail number-
ed 418 and 850, respectively. The medical subordinate