5
compared with the previous year. This increase is due to the following
reasons : —
(1) The post of Assistant Director of Public Health, Vaccination, was
held by a whole-time Officer during the year under review in-
stead of by an officer holding it as a collateral charge in the
year previous.
(2) The appointment of Assistant Director of Public Health, Ambala'
was held by a non-service officer during 1922-23 while
it was held by an Indian Medical Service officer drawing a
higher rate of salary during the year 1923-24.
(3) The post of Assistant Director of Public Health, Rawalpindi, was
created during the year.
(4) Grade promotions of the members of the vaccination staff.
Cost of each suc-
cessful case. State¬
ment No. II.
11. During the year under review the average cost of each successful
vaccination was Re. 0-5-2 as compared with Re. 0-5-4 in the previous year.
This reduction in the cost of each successful case in spite of the increase in the
total cost of vaccination operations is mainly due to the increase in the total
number of successful vaccinations. The cost of each successful vaccina-
tion in Municipal towns and rural areas varied from Re. 0-2-5 in Hoshiar¬
pur District to Re. 1-1-6 in Simla. The average cost of each successful
vaccination in the districts of the Province was Re. 0-3-8 whilst the average
cost of each successful vaccination performed by the Special Staff was Re. 0-11-2
in 1923-24 as compared with Re. 0-9-2 in the previous year.
Inspection work.
Statement No, IV.
12. The Director of Public Health, Punjab, inspected 900 primary
and 100 re-vaccinations. The percentage of success being 94.44 in primary
and 50.00 in re-vaccinations. The Assistant Director of Public Health
(Technical), Epidemiology, inspected 3,225 primary and 947 re-vaccinations in
the districts of Amritsar, Jullundur, Ludhiana, Karnal and Ferozepore. The
case success in primary vaccinations was 96.4 and 64.6 in re-vaccinations.
The Assistant Director of Public Health, Ambala Circle, visited 70 villages in
Simla Hill States and 15 towns and 68 villages in the plains where 5,565
primary and 1,093 re-vaccinations were inspected with the result that 91.02
per cent. of the primary vaccinations and 53.61 per cent. of re-vaccinations
were found to have been successful. The Assistant Director of Public Health,
Rawalpindi Circle, visited 23 villages in Attock and Rawalpindi Districts and
31 villages in Jhang District. The percentage of success in 778 primary vac-
cinations was 97.43.
The total number of vaccinations inspected by Civil Surgeons, Medical
Officers of Health and Assistant Epidemiologists during the year under report
amounted to 73,400 primary and 19,832 re-vaccinations. The percentage of
success being 92.65 in the former and 54.59 in the latter. The Superintend-
ents of Vaccination inspected 430,724 primary and 131,594 re-vaccinations,
with the result that 96.14 per cent. of the primary and 67.11 per cent. of re¬
vaccinations were reported to have been successful. The percentage of success
reported by vaccinators was 97.78 in the case of primary and 70.62 in the case
of re-vaccinations as compared with 98.67 and 69.38 respectively during the
previous year.
Vaccination
in
Municipal towns.
13. There are 103 Municipalities and 106 Notified Areas in the Punjab,
but only 84 Municipalities and 21 Notified Areas have adopted the
Vaccination Act. It is disappointing to have to record, in spite of special
efforts to persuade all Municipalities and Notified Areas to adopt the Act, that
only two Notified Areas adopted the Act during the year under report. Special
importance is attached to vaccination in Municipal towns since it has been
shown that the small-pox death-rate is higher in Municipalities than in rural
areas. Of the total number of people under one year of age born in the
Municipal towns in which the Vaccination Act is enforced, 82 per cent. are re-
ported to have been successfully vaccinated, but there is reason to believe that
in many of these towns the " Vaccination Index " is unduly low and that the
Vaccination Act in many of the large cities and towns of the Province is
rarely enforced. The Medical Officer of Health, Jullundur, for example,