( 2 )
in 20 districts during the past year. The increase is most striking in the
following districts:—
Midnapore ... ... ...
Cuttack ... ... ...
Balasore ... ... ...
Noakhali ... ... ...
Chittagong ... ... ...
Tributary States of Orissa ... ... ...
Bankura ... ... ...
Birbhum
...
...
...
35,325
28,702
19,894
19,865
14,286
12,097
10,301
9,634
The decrease is specially noticeable in the districts of Puri 11,029,
Rangpur 9,822, and Shahabad 9,210. An explanation of this is given below.
The cause of decrease in the Political States of Chota Nagpur 4,901, Rajshahi
3,962, Pabna 3,446, Saran 3,247, Sonthal Parganas 3,155, Darbhanga 2,875,
Jessore 2,421, Palamau 1,993, Bogra 1,985 and Jalpaiguri 1,953 is also given.
In Puri it is said to be principally due to (1) the negligence of the
District Inspector and the Sadar Sub-Inspector who have already been
punished; and (2) to the greater accuracy of the figures.
In Rangpur it is ascribed to the unusual prevalence of malaria in the
district during the first 3 months of the season, and also to the sickness of some
of the vaccinators.
The decrease in Shahabad, Saran and Darbhanga is said to be due to the
greater prevalence of plague in those districts during the past year; while in
Rajshahi, Pabna, Jessore, Jalpaiguri and Bogra it is ascribed, either to the
prevalence of malaria, cholera, etc., or to the sickness among the staff.
In the Political States of Chota Nagpur and Sonthal Parganas the
decrease occurred in revaccination, owing to less prevalence of small-pox
outbreaks.
A similar explanation applies to Palamau, where the decrease was chiefly
in revaccination.
As regards increase, which is most marked in the Districts of Midnapore,
Cuttack, Noakhali and Balasore, the Civil Surgeons of the first three
report it to be due to the active co-operation of the District Officers, while
the Civil Surgeon of Balasore attributes it to the re-introduction of the arm-
to-arm vaccination which had been practically stopped for some years. In
Chittagong and Birbhum the increase is mainly due to work in connection
with the stamping out of small-pox outbreaks. The Civil Surgeon of Bankura
ascribes it to the district having been more healthy. In the Tributary States
of Orissa, it was due, I think, to the systematic inspection of vaccination by
the Deputy Sanitary Commissioner, Captain Robertson Milne, I.M.S.
The causes that bring about fluctuation in the district returns year by
year are the following:—
Those that tend to aid vaccination—
(i) An epidemic of small-pox: this in most districts very much improves
the quantity of work; vaccinators, inspectors, executive
officers, all bestir themselves, and revaccinations greatly
increase. There is almost always a decrease in subsequent
years.
(ii) Improving the inspecting staff of any district, visits of Deputy
Sanitary Commissioners, pressure from head-quarters, etc.
Those that tend to hinder vaccination work—
(i) Epidemics of plague: this is a very important factor, if it is the
first epidemic. As the disease reappears regularly at certain
times, it affects the work less.
(ii) Unhealthy years generally,—vide this year's figures of Rangpur,
Rajahahi, Jessore, etc.
(iii) Years of scarcity and famine: the 2 anna fee is more of a
hardship than usual.
(iv) Advent of a new Inspector: this seems paradoxical, but it is not
at all uncommon to find that a change of staff produces an
increase in the actual work of the district, but a falling off in
the figures due to the new man putting a stop to the "cooking"
of returns by the Sub-Inspectors.