ABSTRACTS OF REPORTS FROM CIVIL SURGEONS.                           69

Ex-inoculators.

" One hundred and sixty-seven of these men applied for perwannahs to enable them to
vaccinate in the district, being an increase of 58 over the previous year; and a large propor-
tion of these were new men, going to different parts of the district to those employed last
year; indeed it appears to be a general rule with these men to operate only once in two or
three years in the same batch of villages, and not to go to the same each year ; 153 of these
were supplied with vaccine materials, the remaining 14 having declined to wait until a supply
was forthcoming.

Causes of decrease
as compared with
last year.

" Of these 153, returns have been received from 98 only ; a few of the remainder are
known to have left the district without operating, four or five having brought back their
perwannahs, saying that they could get no practice this year. The returns received from these
98 men show 5,836 cases of vaccination, being a decrease of 2,200 as compared with last
year. This is due chiefly to a large reduction in the number of operations in the Banka and
sudder sub-divisions, in the former especially, the falling off there being nearly 3,000 cases,
and attributable to the absence of a Bengali vaccinator, who alone operated nearly 2,000 cases
last year under pressure of an existing epidemic of small-pox. The returns from Soopole and
Muddehpoora show 29 against 21 only in the preceding season. This is remarkable, as these
two sub-divisions include the most distressed portion of the district. It appears to indicate
increased confidence in the vaccination, and to a much larger extent even than is shown
by the figures, for from Soopole, returns have been received from only half the number of
men who received perwannahs (40), while the actual number of returns is the same as last
year, 20, the number of vaccinations, 164 last season, to 816 in the present. There is also a
falling off of more than one-third the number of cases in the sudder sub-division as compared
with the preceding season. The returns from this sub-division are, however, the most
imperfect of all.

" Vaccination was also carried on at the various dispensaries by the subordinates in
charge, though to a very limited extent only, as shown in the various returns.

" 6. The only paid vaccinators employed were Janky Ram, a man who had been attached
to the sudder dispensary in that capacity for some years, and Amjad Hossain, a former com-
pounder in the dispensary. These men were employed exclusively within the municipal
district, and their outturn of work was considerably less than in the previous year. The reason
they gave for this was that the people were unusually obstinate in urging objections by
reason of the absence of small-pox this season, and consequent want of stimulus to them
to prevent their children being attacked.

" 7. This was to some extent confirmed by a circumstance that came under my own
observation; for, when inspecting vaccination in some villages a short distance beyond
the municipal limits, the chief villagers came forward and told me that, in consequence of
two children having been brought to a neighbouring village suffering from small-pox, they
became alarmed and immediately sent for their vaccinator, and had caused all their children
to be vaccinated. There was another reason, however, which was probably still more effectual.
It was found when some work in the nature of relief works was opened in the municipality
that scarcely any men offered themselves for employment. In consequence of the extensive
relief works opened in the north of this and the neighbouring districts by Government, the
men had migrated there leaving the women in charge of their homes, and these the vaccin-
ators found far more difficult to deal with than the men. They repeatedly reported to me that
on their appearance in a village the women ran away with their children and hid themselves
or barricaded the entrances to their huts. The inoculators who were employed within the
municipality also reported their inability to prevail with the people to submit their children
for vaccination, though the reason they gave for it was that, in consequence of the high price
of food, the people were unable to pay them.

" 8. Another and very strong reason for the smaller outturn of vaccination is the imper-
fection of the returns; the plan suggested to obtain these was that the chowkidars of villages
should report the number of persons vaccinated to the thana police officer at the time of his
usual weekly report, while the vaccinators were to report to me direct; thus one set of returns
would check the other. Instead of doing this, the subordinate police officers called on the
vaccinators to report to them direct, thus obviating all the advantage to be gained by the
plan recommended, while time is lost by the men having to travel unnecessarily many miles
to the thanas; and having made their reports to the police, the men think it unnecessary to
send me a return at all.

Careless manner
of keeping returns
in the police
thanas.

" 9. At the thanas, again, the returns are very carelessly kept; at one a register was
shown me in which all cases of small-pox were entered indiscriminately with the vaccination ; at
another I found four or five cases of vaccination only in the register though it was being carried
on largely by several men in two large villages in the immediate neighbourhood. In one of these
I found several cases of inoculations also, and from this no report had been received at all,
though there are three chowkidars belonging to the village, and a police constable posted in
it permanently.