( 5 )
the population protected for all India is 28.74 per mille, compared with 24.01 for Assam.
The Assam Valley districts are distinctly in advance of the Surma Valley, both in the
proportion of the people protected and in the industry of the vaccinators. For the first time,
it is shown how thoroughly backward and unprotected Sylhet is; the proportion of
successful vaccinations being only 13 per thousand, compared with 35 in Cachar, and an
average of 31 in the six Assam Valley districts. If vaccination were as forward in
Sylhet as it is in Darrang, or even in Lakhimpur, the number of operations in the season
should be 75,000, instead of 25,000. There is likewise a great contrast between 650
vaccinations performed by each Local Fund vaccinator in Sylhet and 1,023 credited to
each of that class in Cachar. Dr. Macnamara should organise licensed vaccinators
on the principle of payment by private fees, as is being so successfully worked in Goálpára
by Dr. Dobson.

Abstract Statement No. I.

15. The complicated statistics of Statement I. are reformed as an abstract in a
smaller table, No. 1A., to follow. This is chiefly useful, as
showing the success which has attended each class of
operators. The percentage of primary successful vaccination varies from 83.20 per cent.
of Hospital-Assistants to 97.44 of the Native Inspectors; while the 91.72 per cent. for
all is fairly representative and adequate. The figure for India generally in 1886 was
94.43.

Statement No. II.

16. In General Statement No. II. the cost of the department is given in a much
more readable and concise form than in the table hitherto
presented in the body of the report, and now expunged.
The total cost of the department was only Rs. 13,356-14-5, towards which provincial
funds contributed Rs. 6,164 11-6, Local Funds Rs. 6,537-0-5, and Municipalities
Rs. 655-2-6. The average cost of each successful operation varied from As. 15-6 in
Goálpára to As. 1-7½ in Sibságar. But these sums cover the paid operations only, and
under them Goálpára is unfairly represented. Taking all the vaccinations into account,
the average cost is reduced to 1 anna 10 pies for each successful case, and this is the correct
view, as all the unpaid operations are under inspection and administration by paid officers.
The vaccination at Manipur was initiative, and the cost unproportional. Next season a
paid vaccinator will be at work.

Statement No. III.

17. This return, which is required by the Government of India in the orders quoted in
paragraph 12, is not applicable to Assam. Hospital-Assist-
ants are required to assist in vaccination within the ordinary
limits of their medical duties, but they have no special dispensary attendance for that
purpose.

Statement No. IV.

18. In General Statement No. IV. the progress of vaccination in Assam for the past
ten years is figured. While the total at foot exhibits a fair
improvement, the details afford some grounds for criticism.
Notwithstanding the large increase to the immigrant population of all ages and both
sexes, vaccination is not being cared for as it should be. Managers have apparently drifted
into the notion that it may be left to Government agency, and the district reports by
medical officers make mention of difficulties thrown in the way even when assistance by
Government agency has been proffered. The truth I suspect to be that the rules have not
been enforced, and so neglect has spread. A circular on the subject has been issued, and
will, it is hoped, remind managers of their duty. It is possible, however, that the figures
do not represent the vaccination really performed, as no return is required by law, and
the information is entirely voluntary. The vaccinations performed by Provincial
operators may be said to have made no advance, at all since 1883-84, the same of
Municipal operators since 1884-85, while the Local Funds operators have not advanced,
compared with the increase to their number in 1885-86. The only satisfactory figures
in the table are those of licensed vaccinators, who give 19,807 operations, with 92.71
per cent. of successes, at practically no cost at all. Subject to thorough inspection, as is
being given in Goálpára, it is highly desirable that a beginning on the same principles
of payment by private fees should be authorised in each district. It seems strange that
Dr. Dobson in Goálpára cannot get vaccinators to accept Government employment, while
Sylhet and Cachar are wholly reliant on paid agency. A beginning should be made.

Vaccination in Manipur.

19. Last season vaccination was begun in Manipur. It has long been supposed
that the rigid caste prejudices of the people presented an
insuperable bar to any protection except through Brahmin
inoculators. Colonel J. Johnstone, when Political Agent, proposed bovine lymph only,

                                                                                                            C