( 2 )
3. Operations.—The total number of operations performed was 2,293,655
in 1896-97, 2,319,536 in 1897-98, and 2,147,452 in 1898-99, giving an increase
for the triennial average, as compared with that of the preceding period, of
155,053.
In 1898-99 the six-puncture system of vaccination was introduced, and
the novelty, being unfortunately synchronous with the plague inoculation scare,
appears to have been generally regarded as indicating some sinister intention on
the part of Government. Consequently there was a decrease in the number of
operations for the year as compared with the previous year which extended
to 35 out of 49 districts. The general increase, however, in the triennial
average is satisfactory and shows that progress is being made. It extends to 33
districts out of 49 as against a decrease in 16. The Lieutenant-Governor
is inclined to ascribe the instances of decrease not so much to the special causes
noted by the Civil Surgeons as to the defects in the constitution of the vacci-
nating staff, on which the Sanitary Commissioner remarks in another part of his
report, and to the want of effective supervision. The advantages of vaccination
are, except in Orissa, believed to be very fairly recognised by the people of
Bengal, and the conscientious objector is consequently not a factor to be
seriously reckoned with. Such passive opposition to vaccination as does exist,
originates partly, no doubt, in natural impatience of Government interference
in family matters, but principally in a reluctance to pay the fees demanded
for the operation, which again is consistent with other experiences of domestic
life. If the operators are compelled to devote time to realising their fees, which
would otherwise be spent in operating, there is of course diminished outturn.
To establish, however, a system of paid vaccinators is beyond the resources of
this province, and there is in the alternative system of licensed vaccinators an
advantage of its own, which gave it a preponderating weight with the adminis-
trators of Bengal. When the vaccinators have to support themselves on the fees
they have to recover, there is a powerful stimulus to thoroughly good, careful, and
tactful work, and the improvement which can be attained under these conditions,
by increased diligence and attention, is illustrated this year by several instances;
and particularly by the case of Gaya, to the backwardness of which attention
was specially called in last year's Resolution. Its figures for 1898-99 show
an increase on the previous year of no less than 11,000. The Lieutenant-
Governor, has also to admit that the progress of the department was seriously
hampered by the absence of proper assistance to the Sanitary Commissioner.
War and plague made so great a drain on the medical service that throughout
nearly the whole of this triennial period, it was impossible to attach to the
Sanitary Commissioner a single Deputy. This defect it is hoped to remedy
next winter.
The districts which show the most noticeable increase in the triennial
average are Cuttack (26,568), Backergunge (25,881), Mymensingh (15,311),
Balasore (14,367), Gaya (12,627), and Patna (11,541). The largest decreases
are in Angul (11,057), Noakhali (8,449), and Dacca (8,083). There can be little
doubt that the large decrease in Angul is due, not to the stereotyped explanation
given by the Civil Surgeon that the number of available subjects for vaccina-
tion is no longer sufficient to maintain the previous standard, but to the
wilful slackness of the newly-introduced licensed vaccinators, which was noticed
by the Sanitary Commissioner in last year's report. With regard to Dacca
and Noakhali, it is to be regretted that work among the Ferazi Muhammadans
has not been up to the level of the previous years. The same explanation
is offered as in the case of Angul, but its incorrectness is exposed by the
figures given in another portion of the report, which show that in each case
there has been a diminution in the proportion of infant vaccinations to the
number of births recorded.
4. Protection afforded to infants.—For the purpose of comparison the Sani-
tary Commissioner gives a table showing the proportion of infants successfully
vaccinated in 1898-99 as compared with 1895-96, the year previous to the
period under review. Taking the estimated births at 40 per cent. of the
population shown in the census of 1891, and deducting the recorded deaths
among infants under one year of age, the result arrived at for the whole
Province is that 203.88 infants per mille were successfully vaccinated as
against 169.19 in 1895-96. The increase is satisfactory, but would be still more
so if it were accompanied by a levelling up of the striking differences