2

only 8 vaccinators for 23 thanas. It was at first thought that a partial
explanation of these figures might be due to the fact that the Lahore
district naturally contains a large number of purely urban thanas, but
enquiries have shown that the figure of 23 for the Lahore district refers to
rural thanas only, and it is therefore clear that the Lahore district board
will be well advised to increase its staff of vaccinators. It must not
of course be forgotten that the number of thanas in a district is fixed
not only with reference to its population but chiefly with reference to the
criminality of that population. Lahore therefore may be able to claim
that its crime index is so high that it has double the number of thanas
ordinarily required and that therefore one vaccinator can successfully cope
with two thanas. At the same time it is clear that the work in this
district is already showing signs of improvement as in paragraph 6 of
your report Lahore is shown as one of the districts in which there has
been a large increase over the figures of the previous triennium.

4.    As noted last year perhaps the least satisfactory feature of
the vaccination work in the Province is that portion of it which is done
in urban areas and particularly in the smaller towns. It is not easy to
suggest an immediate remedy for this somewhat unsatisfactory position,
but it is hoped that the continued efforts of your department will in
time bear fruit.

5.    The record of the activities of the special staff in 1928-29 is in
direct conformity with the conclusions reached by Government last year
that the natural tendency of the inhabitants of remote areas is to neglect
precautions until the danger becomes very obvious. The figures show
that the total number of operations in 1928-29 was more than double
that in the previous year. This rise is explained by you as due
to the efforts made by the Assistant Director of Public Health
assisted by a severe outbreak of smallpox in some of the hill
states. Which of the two is chiefly responsible for the increase is not
explained, but while appreciating the work of the Assistant Director of
Public Health, Government feel that the outbreak of smallpox was
probably the main cause of bringing home to the people the need of
vaccination. The members of the special staff and the Assistant Director
of Public Health are, however, greatly to be congratulated on the results
achieved, as it is only the presence of the staff and the confidence they
have inspired among the inhabitants of the hill states that rendered it
possible for the awakening caused by the epidemic to be translated into
actual figures of increased operations performed.

6. Government note with some regret that the attempts made
during the past three years to induce more town committees to adopt
the dispensary system of vaccination have not been attended with great
success, and they are inclined to agree with the view expressed by you
that primâ facie the dispensary system should be suited to the needs of
small urban areas. It seems necessary to persevere with the provision
of this form of facility for vaccination wherever it exists, and the education
of public opinion in the smaller towns of the Province should in time have
its due effect.

7.    It is satisfactory to note that the reference to the dangerous
practice of smallpox inoculation in the report of 1928-29 has proved to be
an isolated instance only and even so not definitely authenticated.

8.   In connection with the figures showing the cost of vaccination
operations, Government are inclined to agree with you that the expendi-
ture on the pay and travelling allowance of the Assistant Directors of
Public Health in charge of circles and their establishment should not be
regarded entirely as a charge on account of vaccination. The functions of
the Public Health Department have expanded in every direction, and it
is clear that the supervision of vaccination operations is now only a small
part of the duties of the Assistant Director of Public Health in charge of
a circle. The exclusion of these figures, however, will for some years
render it difficult to compare the cost of vaccination each year with the
figures of the past and it is for consideration whether for the purposes of