Report on Vaccination in the North-West Frontier Province for
                              the year 1919-20.

            REVIEW BY THE CHIEF COMMISSIONER.

THE Deputy Sanitary Commissioner, Major Stiles-Webb, I. M. S., is to
be congratulated on having lent a touch of colour to what is usually a mere
congeries of statistics by introducing a brief, but most interesting, review of
small-pox and vaccination from the earliest times.

The figures for primary operations show a certain recovery: there were
9,911 more such operations than in 1918-19, the figures for which year, however,
were lower by no less than 15,837 than those for the year before. The cause
of that heavy decline was the influenza epidemic, but in the absence of any
such cause during the year under review the Chief Commissioner cannot
yet consider the results as fully satisfactory. He is, however, glad to note an
increase of 7,818 over the previous year's excellent figures for secondary
operations.

The unsettled conditions throughout Agency areas caused a still further
decrease in the number of operations performed there.

The Deputy Sanitary Commissioner notes the interesting fact that the
work done since the formation of the province has nearly doubled.

There was again the curious phenomenon of an excess of primary vacci-
nations over births registered. As the report points out, however, this was not
entirely due to defective registration, but also to the practice of the trans-
frontier migratory population having their children vaccinated while they are
passing through our districts.

Small-pox appeared in epidemic form in almost every district through-
out the province, and this fact no doubt to some extent accounts for the
increased number of operations recorded. There is no religious prejudice
against vaccination, but apparently until the fear of an epidemic is upon them
most of the people are unwilling to undertake the slight trouble of revacci-
nation.

Charge of the Vaccination Department was held by the late Major
Crossle till the forenoon of 29th September 1919, when he was relieved by
Lieutenant-Colonel J. H. Hugo.