3

9. The Assistant Superintendents of Vaccination inspected 237,887 or
46.34 per cent of the primary and 21,902 or 25.55 per cent of the re-vaccinations
in 17,214 villages. In the previous year, they inspected 263,148 primary and
21,218 re-vaccinations. The fewer number of operations inspected during the
past year is due to the more detailed inspections required and the restrictions
placed on their movements in accordance with the suggestions made in para-
graph 11 of the last Report on Vaccination.

Vaccination in Municipal
towns.

10. The remarks in the Provincial Reports and in the Resolutions of
the Hon'ble the Chief Commissioner have improved
vaccination work in many Municipal towns. During
the past year 28,516 or 93 per cent of the available infants were successfully
vaccinated, but in many Municipal towns, e. g., those of Nagpur, Bhandara,
Wardha, Hoshangabad, Betul, Raipur, Amraoti and Akola, there are
still a large proportion of unprotected children, and unless the Municipal
authorities take an active interest and do their duty to the community, it is
useless to expect any improvement in the number of protected children.

Some of these Municipal authorities ignore the advice and instructions of
Civil Surgeons and the Sanitary Commissioner : the Vaccination Act and the
rules framed thereon require the establishment of vaccination stations at different
centres, but in many Municipal towns there are no such stations, and even where
they are established, steps are not taken to have children regularly sent to them
for vaccination and inspection purposes. The consequence is that the vacci-
nator has to go from house to house with all his numerous registers and equipment,
and beg the parents to allow their children to be vaccinated. This entails
unnecessary and heavy work on the vaccinator and leads often to his neglecting
his prime duty, i. e., of sterilising his lancets before each operation. Such
instances have been reported from Wardha, Balaghat and Bhandara in the
last of which only six children were brought to the vaccination station during
the whole season. Notices signed by responsible officials have no
effect as prosecutions are very rare. Prosecution and heavy fines in a few
selected cases, as has been done in Hinganghat (where a Marwari was fined
Rs. 50 for not having his child vaccinated), are the only ways to improve
matters. I would also recommend the appointment of female vaccinators in
places where purdah nashin ladies wish to have their children vaccinated at
their houses. The Municipal Committee might charge a small fee in such
cases. A Vaccination Post in charge of a female vaccinator at every Dufferin
Hospital would be useful. To carry out this suggestion suitable candidates as
vaccinators would have to be carefully selected and trained. Perhaps some
Municipality will adopt this system.

Deaths from small-pox.

11. 981 deaths from small-pox were reported during the year against 292
in the previous year. The largest number of deaths was
reported from Buldana District where, as has been stated
before, vaccination work has not been satisfactory of late. Raipur, Bilaspur
and Akola also reported a good number and unless special measures are taken
I fear that sooner or later there will be a severe epidemic.

General.

12. Primary vaccination has on the whole been satisfactory, but re-vaccina-
tion is calling loudly for more recognition. It would be
well if re-vaccination is enforced in schools. The Civil
Surgeon, Balaghat, suggests vaccinators being allowed to inspect school children
and record their inspection notes in the Visitors' Book, but I think the procedure
would create friction.

I regret that the report is delayed this year and hope it will not occur
next.

                     C. R. M. GREEN, M.D., F.R.C.S., D.P.H., COL., I.M.S.,