4

districts, because attempts to secure properly qualified men were not made by the
Taluk Boards. Special stress was laid on the subject by this department in previous
vaccination reports but with no tangible result. Presidents of local boards should
be required to appoint the full number with the least possible delay. There is no
dearth of qualified hands now, and if only the local boards would offer adequate
pay and allowances, any number of qualified men will be readily forthcoming. The
district of North Arcot gives a more adequate pay to its vaccinators and it would
be well for the other districts to follow its example.

Here it may be mentioned that only in a few districts in the Presidency the
posts of vaccinators are pensionable. As an important step towards improving the
efficiency of this branch of administration, the other District Boards would be well
advised to make the posts of vaccinators pensionable at as early a date as possible.

11.  The new scheme of vaccination was in force during the year throughout
the Presidency and the rules for working the scheme were revised and re-issued in
G.O. No. 832-P.H., dated 23rd May 1923. The quality of vaccination in general
showed a distinct improvement over the results recorded last year. The obstacles
to the progress of vaccination alluded to in paragraph 13 of the last year's report
remain much the same as before and any attempt at improvement is not possible
until the revenue authorities and magistracy evince a more genuine interest in the
progress of vaccination. The District Health Officer, Ganjām, brings to notice, in
this connexion, an instance, reported by a Health Inspector, where two villages were
badly infected with smallpox, and where all efforts made by the Inspector
to improve vaccination proved futile. He then applied to the Taluk Officer for
help. That officer wrote back to say that he visited the villages, spoke to the
people on the efficacy of vaccination, but they turned a deaf ear to him. He also
said that they thought that smallpox was due to the influence of a Goddess and
that vaccination would only incense her. The Assistant Director of Public Health
(Vaccination) brings to notice another instance in which the Village Munsif of
Madakasira, who is also the President of the Union Board, stoutly refused in
writing to render any help to the Health Inspector on inspection duty or to
produce the vaccination register for his inspection.

12.  The instructions regarding vaccination in rural areas are still being
honoured more in the breach than in their observance and unless the village
officers are made to realize their responsibilities in the matter of vaccination, all
the efforts of the Public Health Department will not be of much avail. Generally,
the Village Munsifs are also very indifferent in making prompt reports about
outbreaks of smallpox, so much so, the disease is often widespread before the
Health staff get any information. This is a serious obstacle to effective action.
In certain cases, the outbreaks are not reported at all, and the Health staff
come to hear about them during their usual visits to the affected villages. In all
these cases, all that is possible is to report the delinquent Village Munsifs to the
Revenue Divisional Officers or Collectors concerned for necessary action. This
matter has also been the subject of a separate correspondence with the Government.
The Revenue authorities should be requested to co-operate with the officers of the
Public Health Department by awarding exemplary punishments to defaulters
when these are brought to their notice by the Health staff.

13.  The practice of assembling children either for vaccination or for inspec-
tion at a central place although required under the rules is seldom observed
anywhere in the Presidency, even in the areas where vaccination is compulsory.
The Health staff in consequence are much handicapped in their vaccination and
verification work by their having to go from door to door. Instances of gross
neglect of duty on the part of the Village Munsifs when reported are lightly
disposed of.

14.  Another factor of great importance for the successful conduct of
vaccination is the introduction of compulsory vaccination throughout the
Presidency, except perhaps in such very backward parts as the Agency. Already
the introduction of this important measure is engaging the serious attention of a.
few District Boards and it is hoped that other District Boards will follow suit.