19

Doubts and difficulties with regard to the local training of second-class and proba-
tionary vaccinators cropped up in various districts and for the removal of these
a circular with a syllabus was drawn up in this office and issued by the Sanitary
Commissioner to all District Medical and Sanitary Officers with the concurrence
of the Surgeon-General with the Government of Madras on 23rd November 1918.
So between one thing and another, the new scheme cannot be said to be in
working order as yet. But there is not the slightest doubt that the scheme
has in it the nucleus of a great change for the better. It is yet in its infant
stage and requires to be carefully nurtured. The following are some of the
difficulties experienced in the working of it:—

(a) Vaccination not being compulsory in most areas and revenue influence
at a very low level, the vaccinator has to wander from door to door for getting
cases for vaccination often meeting with rebuffs and evasions. This the new
vaccinator—raw School Final man—is loth to do. He would rather prefer a less
toilsome job as a clerk in an office. As a matter of fact many new School Final
men who joined the department left it within three months of joining service. As in
most public offices the lowest clerk is now started on a salary of Rs. 20, he takes up
a clerk's appointment in preference to a vaccinator's post. The vaccinator's post
with its more toilsome work than quill-driving, in order to be attractive, the pay
must be more than what a School Final man will ordinarily start on as a clerk. I
would therefore suggest that the initial pay of second-class vaccinators may be fixed
at Rs. 25 and that of the qualified first-class vaccinators at Rs. 35. The scale may
be improved as follows :—

with the usual fixed travelling allowance of Rs. 10 per mensem. In the districts
where education is generally backward and where it is difficult to secure sufficient
number of " School Final" men, I would suggest that with the previous permis-
sion of the President, District Board, and the Sanitary Commissioner, the District
Medical and Sanitary Officer may be allowed to recruit the required number by
a selective examination held by him from among those who have a sufficient
knowledge to follow a course of lectures in Vaccination in English.

7.  Even in unions where vaccination is compulsory it is generally backward.
This is due to the lack of responsibility of the Union Chairmen in the matter.
Rules have been drawn up and submitted to the Sanitary Commissioner for Madras
for the improvement of vaccination and registration of vital statistics in unions.

8.  The total vaccination work performed during the past two years by all the
agencies in the Northern and Central Ranges is shown in the following table:—

There is thus a decrease of 18,100 operations in the Northern Range and
20,930 in the Central Range. It is hardly possible to compare the work of the
year under report with any of the previous years because of the several disturbing
elements at work during the past year. To begin with, the introduction of the
new scheme and the resulting changes in the staff seriously interfered with the
work for the whole of first half of the year. Then there was the inexperience of
the new men coming in, a good number of whom also went out without sufficient
notice after a short period of work. Then there was the discontent following
upon disappointment of the old vaccinators retained temporarily and last but not
least the prevalence of the pandemic of influenza for full two months, during
which time the work was practically at a standstill.

The prevalence of influenza was at its height from October to December 1918.
During this period alone in the districts of Ganjām, Vizagapatam, Gōdāvari,
Guntūr, Nellore, Anantapur, Bellary, Kurnool, Chittoor, North Arcot, Chingleput,