( 3 )
between the percentages of different districts which were commented on by
Government in their Resolution last year. These differences range from a
proportion of 856.55 per mille in Malda to one of 24.29 in Puri, and emphasise
the conclusion drawn in the preceding paragraph that there is a very wide
difference between the amount of attention given to vaccination in different
districts. Of districts which have been previously noticed as exceptionally
backward, the increase in Gaya from 39.72 to 227.07 is particularly noticeable,
while Patna, which in 1895-96 was at the bottom of the list with 26.52, has
risen to 85.72. The average in Puri is, however, the lowest on record, and
the improvement in Shahabad is trifling. The backwardness of vaccination
in Puri has attracted the special attention of the Sanitary Commissioner, and
he has arrived at very radical conclusions which must be separately discussed.
In the meantime the opening of a training school for vaccinators at Cuttack.
should be undertaken as soon as possible, and the Commissioner will be asked
to use his influence with the Chiefs of the Tributary States to entertain trained
and respectable men. As regards the other backward districts of the Province,
Sir John Woodburn would call the special attention of the Civil Surgeons
concerned to the example of Gaya; and hopes that in the near future a more
uniformly high average may be attained.
It may be noted that in compiling this table an average birth rate of 40
per mille has been assumed. In the Sanitary Report the accepted estimate of
50 per mille has been taken as the basis of calculation throughout, and it would
be as well for the sake of uniformity if that estimate were adopted for the
future in the Vaccination Report also.
5. Primary operations.—There was an increase of 130,006 primary vaccina-
tions during the period under review as compared with the previous triennial
period. The percentage of successful operations is given as 97.92 as against
98.29. The Sanitary Commissioner, however, ascribes this high ratio to the
habitual falsification of returns by vaccinators, who include even absolute failures
as successful cases; and points out that this practice can only be put a stop to by
stricter supervision on the part of Civil Surgeons and the inspecting staff.
The system of six-puncture vaccination has, in spite of considerable opposition,
which has not yet altogether ceased, been generally introduced into the
Province, and satisfactory results are now being obtained. It is hoped that the
existing prejudice against it, which has no doubt been due to the plague
inoculation scare, will in a short time vanish altogether.
6. Revaccinations.—The average number of revaccinations increased from
43,998 in the preceding period to 69,045, and the ratio of successful operations
rose from 36.99 to 61.22. The increase in numbers is satisfactory, but the high
ratio of successful cases must be regarded with suspicion.
7. Recess work.—The average number of operations performed during the
recess rose from 110,541 in the previous period to 113,601. The average in
Calcutta has, however, declined by almost one-half, the explanation given being
that extensive recess operations were rendered unnecessary by the absence of
small-pox in an epidemic form.
8. Cost of vaccination.—There has been a continuous decrease in the cost of
vaccination, the average annual expenditure having fallen from Rs. 1,94,966 to
Rs. 1,87,186, and the cost of each successful operation from Re. 0-1-6 to
Re. 0-1-4.
The saving has been effected by the absence of Deputy Sanitary Commis-
sioners during the greater part of 1897-98 and 1898-99 and by the reduction in
the number of paid vaccinators.
9. Protection from small-pox.—The usual diagrams are appended showing
side by side the death-rate from small-pox, district by district, for each
of the three years under review, and the degree of protection afforded by
vaccination during the seven preceding years. With a view to arriving
at more definite conclusions as to the actual effect of vaccination on the death-
rate, the Sanitary Commissioner has prepared a detailed statement comparing
the death-rate from small-pox since the introduction of vaccination in five
districts chosen at random with that during the five preceding years.
Both sets of figures, however, while interesting, are inconclusive in
detail. The diagrams naturally do not render it possible to lay down any
harda nd-fast rule by which the amount of protection afforded by vaccination
can be disclosed. The fortuitous occurrence of a small-pox epidemic among