3

11.   Vaccination in compulsory areas.—During the year under report, out of an
estimated number of 3,602 infants available for vaccination in the towns in which
vaccination is compulsory, 1,935 infants or 53 per cent. were successfully vaccinated,
as compared with 56 per cent. in 1916-17. The degree of protection afforded to
infants by successful vaccination appears satisfactory in the towns of Nowgong,
Nazira, Jorhat, Goalpara, and Tezpur, in which almost all available infants were vacci-
nated. In Dhubri though the percentage of 47 is very low, the history of all children
whose births were registered has been carefully followed by the Civil Surgeon. The
ratio was very low in all towns in the Surma Valley Division—Sunamganj 25, Karim-
ganj 25, Sylhet 26, Silchar 38, Habiganj 45 and Maulvi Bazar 55 and the administra-
tion of the compulsory Act in these towns is lax. The unsatisfactory state of vaccina-
tion in Sylhet called for adverse comment on the occasion of my inspection of the town
and since the close of the year, active steps have been taken to improve matters. In
the Assam Valley Division the lowest rate of 19 per cent. was recorded in Barpeta
town, but here we are intentionally proceeding with caution, as there are religious
scruples to be overcome. In the town of Dibrugarh (51 per cent.) negligent adminis-
tration of the Act by the Sanitary Inspector who is responsible to the Civil Surgeon
for its working, was brought to notice in my last inspection.

12.   Vaccine Depôt.—The number of capillary tubes loaded during the year 1917-
18 was 561,854 as compared with 668, 559 in the preceding year. The number of
calves inoculated during the year was 402, and lymph was taken from 316 calves, 86
calves being rejected for unsatisfactory vesicles and other reasons. The average
number of tubes filled per calf was 1,778 against 1,726 in 1916-17.

13.   Cost of the Department.—The total cost of the Department was Rs. 55,000-
11-10 against Rs. 52,636-11-9 in the previous year, i.e., an excess of Rs. 2,364-0-1 due
to increased expenditure on the pay of vaccinators. The cost per successful vaccina-
tion was three annas and two pies in 1917-18 against two annas and nine pies in 1916-
17. One notes that in Cachar there were two vaccinators less than in last year but
some Rs. 300 more was disbursed in pay, and that the travelling allowance drawn is
almost the same as last year, viz., Rs. 1,348, although the vaccination inspecting staff
inspected only 10,702 primary operations as against 15,084 primary operations
inspected in 1916-17. In Nowgong with the same strength of inspecting staff, 10,134
inspections were performed, and the travelling allowance drawn was Rs. 503. In
Kamrup with a larger population to serve and with double the number of vaccinators,
double the number of operations, and double the number of inspections, the travelling
allowance drawn was Rs. 404 only. In this district the vaccination arrangements
receive close attention from the Civil Surgeon.

The conclusion to be drawn is that the Cachar travelling allowance should be
reduced to a reasonable figure by more careful scrutiny of the travelling allowance
bills by the Civil Surgeon,who is responsible for checking the travelling allowance
bills, not only of the inspecting staff but of the vaccinators, by the rules framed under
the Local Self-Government Act.

The increase in the cost per successful operations is due to the reduction in the
number of operations performed in Cachar, Sylhet and Sibsagar, and to the unusually
large number of failures in October.

14.   General.—During the year 28,927 vaccination operations were reported to
have been performed in tea estates, against 35,618 in 1916-17. Reporting of vaccina-
tion in tea estates is very irregular and it appears that the number of vaccinations
actually done in tea estates is in excess of the number reported. Some improvement
in reporting took place in 1916-17 as a result of the issue of a circular, but it appears
that matters have relapsed to their former condition. One is inclined to think that if
Civil Surgeons of planting districts were to press the matter, they could secure more
complete returns than are at present received.

The record of work for the year is somewhat disappointing. The number of
operations performed has decreased and the expenditure has somewhat increased as
compared with last year. The explanation probably lies to some extent in the fact
that closer supervision in so far as it has been possible to exercise it, has decreased the
extent to which falsification is practised, while the absence on military duty of so many
of our permanent Civil Surgeons is an undoubted handicap which the good work done
in Nowgong and Kamrup by the officiating Civil Surgeons cannot wholly neutralise.
As was remarked in last year's report the number of vaccinators employed is in most
districts insufficient The question of increasing their numbers has been taken up in
detail with district Civil Surgeons but pressure of other work has delayed the submis-
sion of my proposals in this connection, which will however shortly be available.

                                             T. C. McCOMBIE YOUNG, Major, I. M.S.,

                                                                        Sanitary Commissioner, Assam.