2                                  Nos. 715, 716 L., 25TH JULY 1902.

                                   GOVERNMENT OF MADRAS.
                         LOCAL AND MUNICIPAL DEPARTMENT.

READ—the following paper :—

Letter from Lieutenant-Colonel W. G. KING, C. I.E., I.M.S., Sanitary Com-
missioner for Madras, No. 700-V., dated 21st June 1902.

ABSTRACT.—Forwarding the Annual Vaccination Report for 1901-1902.

ORDER—No. 715, L., dated 25th July 1902.

This report deals with the work done by the vaccination staff during the three
years which ended on the 31st March 1902 and except that there was in the last
year a decrease of ten in the number of vaccinators, the progress made in the term
was satisfactory. Owing to exceptional circumstances caused by the prevalence
of plague in 1898-99 there was a marked decline in that year in the number of
cases vaccinated, and the position reached in 1897-98 was not retrieved until
1901-02. The Government propose therefore, to examine the statistics for a more
lengthened period in order to ascertain whether the staff is adequate in numbers
and efficiency and whether, having regard to all the circumstances, the progress
made is all that could reasonably be expected.

Staff.

2. Ten years ago the supervision of the Vaccination department was, as now,
entrusted to the Deputy Sanitary Commissioner, but
he had then more time for this work. A Provincial
Health Officer will, however, be appointed shortly and the Deputy Sanitary
Commissioner will then be relieved of the duties at the Medical College which now
keep him in Madras for a great part of the year. The number of Deputy Inspectors
has increased from 58 to 63 in the ten years, but the number of vaccinators
(excluding probationers) in the Madras Presidency proper has advanced by ten
only since 1892-93, and now stands at 688. Taking the birth-rate at only 40 per
mille per annum and the infant mortality at 25 per cent., and assuming further that
two-thirds of the infant deaths occur in the first six months of life, the number of
children who survive that period and should, therefore, be vaccinated in one year
is 1,275,000. This gives an average to each vaccinator of 1850 cases of infant
vaccination alone. It also appears that in most districts there is no reserve from
which men can be drawn to supply the places of those who are absent on leave,
and this has, in many cases, been given as the explanation of a reduced outturn
of work. It seems clear, therefore, that the staff is seriously inadequate and the
Sanitary Commissioner should accordingly examine the circumstances of each
district and municipal town and submit proposals for strengthening the estab-
lishments.

Quantity and quality of vaccination.

3. The population has increased during the ten years by 7¼ per cent., but
though the total number of primary and secondary
vaccinations has increased by 11.6 per cent., the
advance in the number of successful cases is only 5.2 per cent. In the case of
towns the position is even more unsatisfactory, as the increase in the number of
successful cases is only 4.7 per cent. while the population has grown by 15.3 per-
cent. It is clear, therefore, that in the presidency as a whole, and more parti-
cularly in towns, the staff has not even succeeded in keeping pace with the growth
of population. In districts the ratio of all kinds of successful vaccination to
population was 28.1 per mille in 1901-02. This ratio was noticeably low in North
Arcot (21.1), Cuddapah (22.1), Nellore (24.1), Chingleput (24.3), and South Arcot
(24.6). There was a satisfactory improvement in Malabar, but the average number