9
the number of vaccinators has been increased by two making a total of one
Superintendent and six vaccinators but this number is still insufficient to meet
requirements. The number of vaccinations performed during the year was
16,352 as compared with 12,337 in the previous year. This increase in the
number of vaccinations is however mainly attributable to special measures
taken to combat a severe epidemic of smallpox. The "Vaccination Index"
was 95.0
In Amritsar City (population 157,031) there is at present no Superin-
tendent of Vaccination— a defect which I hope the Committee will shortly
remedy and there are only three vaccinators, which is inadequate for so large
a city. Vaccination stations, of which there are three, are all located
within the city and there are at present no arrangements for the vaccin-
ation of the inhabitants living in the suburbs that have recently sprung up
outside the city. The "Vaccination Index" was 84.4.
In Multan
(population
89,162) a third vaccination
station
was opened during the year but there was a serious decline in primary vacci-
nation which is mainly attributable to the fact that plague prevailed in
epidemic form throughout the greater part of the period under review. The
"Vaccination Index" was consequently extremely low being 36.36.
In Jullundur (population 59,085), where there are three vaccination
stations and three vaccinators, the Medical Officer of Health reports that the
Vaccination by-laws, which previously were a dead letter, are now observed.
The number of children available for vaccination was 3,105 out of which
2,729 were vaccinated ("Vaccination Index" 87.89).
In Sialkot (population 56,018) there are three vaccinators but no
Superintendent of Vaccination. There are seven vaccination stations but
these are not located in suitable buildings nor are they provided with any
equipment but action has been taken with a view to remedy these defects.
The number of primary vaccinations was 2,271, as compared with 2,588 in the
previous year. The "Vaccination Index" was 86.7.
In Rawalpindi (population 55,251) there is no Superintendent of
vaccination and only two vaccinators. The total number of children avail-
able for vaccination was 2,030 of whom 1,643 were vaccinated. The "Vacci-
nation Index" was 80.9.
In Ambala (population 28,581), where there is only one vaccinator,
vaccination is reported to be in a neglected state. It appears that the
vaccinator has been dismissed for bad work on three occasions by different
Civil Surgeons but each time he has been reinstated by the Committee.
As
the result of this action the Civil Surgeon refuses to accept any further
responsibility for the efficiency of vaccination in this town. No "vaccination
index " can be calculated.
The vaccination arrangements in the smaller Municipal towns in
many cases are markedly defective and it is clear from the remarks of
Deputy Commissioners and others that the efforts made to rouse the interests
of Local Bodies in vaccination has so far not led to any appreciable improve-
ment. During the year under report 9,918 operations were carried out by
means of house to house visitations as compared with 5,594 in the previous
year. This method of carrying out vaccination is of value provided it is not
used to replace vaccination at vaccination stations. It should be reserved for
use in connection with the vaccination of children whose parents do not
desire that they should be brought to public vaccination stations.
Vaccination in rural
areas.
15. The thoroughness of vaccination in rural areas varied consider-
ably. The number of persons vaccinated per 1,000 of population was highest
in Mianwali and Kangra Districts, the figures being 55.27 and 50.57 respec-
tively. The lowest figures were reported from Lahore District (26.55) and
Sheikhupura (27.07). The following districts showed a marked increase in
the percentage of successful vaccinations performed during the year as
compared with the corresponding figure for the previous three years : —
Attock and Gurgaon (+ 10) ; Jhelum (+ 9); Dera Ghazi Khan
and Ambala (+ 8); Ludhiana (+ 7); and Kangra (+ 6), whilst the follow-
ing districts show a considerable decrease : —
Karnal, Lahore, Gujranwala, Sheikhupura, Lyallpur, Jhang and Multan,