No. 5396-V.

FROM

                              LIEUT-COL. T.W. IRVINE, M.B., C.M, F.R.C.S.E, D.P.H, I. M. S,

                                                                              Sanitary Commissioner,

                                                                                          North-West Frontier Province,

To

                              E. H. KEALY, ESQUIRE, I. C. S,

                                                Secretary to the Hon'ble the Chief Commissioner,

                                                                                          North-West Frontier Province.

                                                                     Dated Peshawar, the 15th September 1917.

SIR,

      I HAVE the honour to forward, for the information of the Hon'ble the
Chief Commissioner, the Annual Return on the working of the Vaccination
Department in the North-West Frontier Province for the season 1916-17, and
to offer the following remarks thereon.

Administration.

2. I held charge of the Vaccination Department from the 1st April
1916 to the 17th May 1916, and again
from the 20th November 1916 to the
31st March 1917, Major Crossle having held charge of the Department for the
intervening period, viz., from the 18th May to the 19th November 1916.

Statement No.I.— Strength of Vaccination establish-
ment.

3. The establishment employed during the year was 2 Divisional
Inspectors, 6 Superintendents and
37 Vaccinators, which number in-
cludes one Military Sub-Assistant.
Surgeon attached to the Cantonment General Hospital, Nowshera. The
decrease of one Vaccinator when compared with the previous year is due to the
services of one of the Vaccinators in the Chitral Sub-Agency having been
dispensed with in May 1916 on account of the closure of the Mastuj Dispensary
as a result of the reversion to military duty of the Military Sub-Assistant
Surgeon in charge.

During the year under report the Peshawar Cantonment Committee
undertook the management of the Cantonment vaccination.

Statement No.I.— Number of vaccinations per-
formed by all establishments.

4. During the triennial period 1914—1917 the total number of opera-
tions performed by all establishments
was 456,105 as compared with 451,395
during the preceding triennial period.
This represents an increase of 18,374 primary vaccinations and a decrease of
13,664 re-vaccinations. On the whole it may be said that the work during
this period, which has been an exceptionally trying one, has been satisfac-
tory specially in regard to primary vaccinations.

Of the total number of primary operations performed in the Province
during this period nearly half was contributed by the Peshawar and Hazara
districts, the figures for the former being 117.669, and for the latter 107,319.
As already pointed out in previous reports, the value of secondary operations
in certain parts of the Province is not quite understood nor fully appreciated
by the poorer classes, to whose apathy and indifference is mainly attributed
the falling off under this head. In Hazara and Bannu districts no less
than 28,506 and 9,406 secondary operations respectively have been performed