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TRIENNIAL REPORT ON VACCINATION IN BENGAL FOR
          THE YEARS 1911-12, 1912-13 AND 1913-14.

1.     THIS report deals' with vaccination in the reconstituted Presidency of
Bengal for the triennial period 1911-12 to 1913-14.

2.    Officer in charge of the Department.—Major W. W. Clemesha, M.D.,
D.P.H., I.M.S., was in charge of the department throughout the period under
report.

During 1911-12 the area covered by the reconstituted Presidency was in
charge of two Deputy Sanitary Commissioners, while during 1912-13 practically
there was only one Deputy Sanitary Commissioner, but from 1st February
1913, the Presidency has been divided into four sanitary circles, viz., Presi-
dency, Burdwan, Rajshahi and Dacca. Captain H. M. Brown, I M.S., was
in charge of the present Presidency and Burdwan Circles from 23rd May
1911 to 12th July 1912 and Captain A. M. Jukes, I.M.S.. from 13th July 1912
to the end of the triennial period, but he was relieved of the charge of the
Burdwan Circle from 8th December 1913 by Captain K. K. Mukerji, I.M.S.
Drs. R. B. Khambata, M.R.C.S., D.P.H.. and M. E. Sufi, B A., D.P.H., held charge
of the Rajshahi and Dacca Circles from 18th January 1913 and 7th April
1913 respectively to 31st March 1914.

3.     Strength of Staff.—In Calcutta the average number of inspecting
officers and vaccinators was 7 and 44 against 7 and 31 during 1908-09 to
1910-11. In the Provincial rural areas and mufassal Municipalities and
dispensaries, etc., the inspecting staff and operators numbered 123 and 1,338
and 5 and 131 respectively against 118 and 1,309 and 5 and 134 during the
previous triennial period.

4.     General Operations.—The total number of operations performed in
the Presidency during the past year was 1,857,294, of which 1,575,510 were
primary and 281,784 re-vaccination cases against 1,984,399 with 1,787.143
primary cases and 197,256 re-vaccinations during 1912-13 and 1,946,584 with
1,803,652 primary cases and 142,932 re-vaccinations during 1911-12. The
average of the triennial period under review was 1,929,425 with 1,722,101
primary and 207,324 re-vaccination cases against 1,910,605 with 1,709,966
primary and 200,639 re-vaccination cases of the previous triennial period
1908-09 to 1910-11. There was an average increase of 18,820 cases, of which
12,135 were in primary vaccination and 6,685 in re-vaccination.

The ratio of success under the two different heads, primary and re-vac-
cination, was 97.99 and 60.78 against 97.87 and 63.51 during 1908-09 to
1910-11.

The average work of a vaccinator was 1,245 against 1,275 of the previous
triennial period. The average work of a licensed and paid vaccinator was
1,340 and 768 against 1,346 and 822 respectively during 1908-09 to 1910-11.

Compared with the previous year, there was an increase of operations in
11 and a decrease in 16 districts. The increase was marked in Rangpur,
16.119, Khulna 7,623 and Bankura 6,257, while the decrease calling for notice
occurred in 5 districts, viz., Bakarganj 70,240, Pabna 17,616, Dacca 13,309,
Midnapore 11,865 and Tippera 11,257. In Rangpur and Khulna the increase
is attributed to greater interest shown by the District Magistrate and his
subordinates and to activity on the part of the staff in suppressing out-
breaks of small-pox. No explanation of the increase has been furnished by
the Civil Surgeon of Bankura, but it is evident from the greater prevalence of
small-pox in this district as compared with the previous year that the same
cause is responsible for the increase here as in the other two districts named.
In Bakarganj there was a large decrease, but the explanation is quite clear.
The prolonged tour of the Deputy Sanitary Commissioner of the Dacca Circle
in this district during the last cold weather discloses that the figures of
previous years were totally unreliable and it is doubtful if the figures furnished
in this report are correct. The Civil Surgeon of Dacca ascribes the decrease to
prevalence of malarial fever in the Manickganj and Sadar Subdivisions which
retarded the progress of work in them and also to greater prevalence of small-
pox during the preceding year which swelled the number of operations in that